Children's Home run by Lodge Group Care UK Limited in Redbridge

Unique reference number SC064182 Inspection date 12/07/2012 Inspector Joanna Heller Type of inspection Full Provision subtype Children's home

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Date of last inspection 24/02/2012 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Brief description of the service

This privately run home provides accommodation and care for up to six young people with learning disabilities.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be good .

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Overall effectiveness

This is a suitably resourced and well managed home where little placement breakdown is experienced. Staff are competent, caring and well trained. Families and other stakeholders refer to high quality individualised care and support. Young people whether permanent residents, or receiving short break care, experience strong individual growth and progress during their time at the home. Staff focus on developing young people’s communication skills enabling them to have a wider understanding of their world around them. Families comment how staff have been able to reduce young people’s challenging behaviour making it easier for them to spend time with their families. Young people enjoy living and staying at the home and spending time with staff. Staff ensure all the young people have active lifestyles and opportunities to mix in the community which were not previously open to them.

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Overall effectiveness

The home’s development plan highlights how shortfalls in the building are planned to be addressed. Some requirements and recommendations have been made in regard to record keeping and undertaking a full review of the quality of care.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) take adequate precautions against the risk of fire, in particular; ensure the fire risk assessment is sufficiently detailed to reflect the issues identified and actions to be taken (Regulation 32(1)(a)) 20/08/2012

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control or restraint or discipline that a written record is made in a volume kept for the purpose (Regulation 17 b(3)) 20/08/2012

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring matters set out in schedule 6 at appropriate intervals and improving the quality of care provided in the children's home. (Regulation 34 (1) (a)(b)) 30/09/2012

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Reg. Requirement Due date

(2001) maintain accurate and up to date records, in particular; ensure all staff are recorded on the duty rota and that the admission register contains all required information. (Regulation 29(schedule 6)) 20/08/2012

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure an individual personal emergency evacuation plan (PEEP) is in place for each child (NMS 10.9)  undertake a risk assessment regarding providing accommodation to young adults over18 in line with Ofsted 'wholly or mainly' guidance.(NMS 4)

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Outcomes for children and young people

Outcomes for children and young people are good .

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Outcomes for children and young people

The home is welcoming and provides young people with a stable, secure and happy environment to live in. Young people’s experiences of the home are highly positive and they experience significant individual growth. Young people are healthy and enjoy healthy lifestyles.

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Outcomes for children and young people

Young people enjoy highly individualised care in accordance with their particular needs and equality and diversity is threaded through the care provided. Each young person has a detailed plan of care which includes all key areas of need and details of their routines. Any needs arising from cultural heritage or disability are identified and met. Varying methods, such as pictorial communication systems, symbols and photographs, are used to help staff and young people communicate effectively. Young people have experienced growth in relation to personal care skills, independence skills and managing their anger and behaviour, all of which has had a positive impact on their lives. Young people are able to make use of the wide variety of visual prompts to make choices. Young people access Picture Exchange Communication System (PECS), symbol key rings carried by staff so that they can communicate what they want. The strong emphasis on developing communication

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Outcomes for children and young people

skills enables young people to manage the world around them and help staff understand what young people want and need.

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Outcomes for children and young people

Young people are welcomed in a planned way which ensures staff are able to meet their individual needs. All of the young people have learning disabilities on the autistic spectrum. Families are able to have close contact with their child and are sensitively supported. Young people are supported in developing personal and self- care skills. Young people are well supported into moving into adult services and are now able to choose to move into the organisation’s adult home.

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Outcomes for children and young people

Young people have good school attendance. Young people are supported in making good educational progress and developing their communication skills. Staff attend key school events and meetings in the role of responsible parent. Young people enjoy active and varied lives and are able to participate in the community, for some young people this was not previously possible. Young people spend time on outside activities each day going out in the home's bus. Young people particularly enjoy local forests and parks where they are able to run freely in a safe environment. Young people also enjoy going on trips to the theatre, swimming and amusement parks as well as doing art and craft in the home. Families say that they feel their children are very well cared for by a committed team of staff.

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Quality of care

The building provides young people with welcoming homely accommodation that they are able to welcome their family and friends into. The accommodation is spacious, allowing each of the young people to relax independently of each other. Each young person has their own bedroom which they are supported to personalise according to their needs and wishes. The two front lounges allow young people space to relax in a welcoming, well-decorated and finished area. Overall, however, the home is adequately maintained and decorated. The manager advises that a programme of redecoration is planned for this financial year, as is development of the garden area to make it more accessible and enjoyable for the young people. Young people currently really enjoy and make full use of the large trampoline in the garden. Young people also enjoy the ability to use the art/ quiet room and the home’s sensory room. Young people move swiftly through the building and barriers

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Quality of care

to their freedom of movement distress them. The manager has identified the risks associated with propping open fire doors and is sourcing appropriate mechanisms to hold these doors open during the day whilst, allowing them to shut when the fire alarm is triggered.

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Quality of care

The manager ensures that the provision of short break care does not impact on the long term placements. The home provides short break care to a small group of three young people ensuring that all young people’s needs continue to be met. Equality and diversity is threaded through the service provision. Staff ensure that young people’s needs relating to their cultural heritage, religion and disability are recognised and met. Families comment that they feel that the diversity of the staff team means that young people benefit from a staff group of men and women from a wide variety of backgrounds.

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Quality of care

Young people enjoy healthy lifestyles and are supported to access medical professionals such as doctors, dentists and opticians as appropriate. A variety of specialist health professionals such as psychiatrists and children and family consultation teams are involved in their care. Staff are proactive in seeking diagnostic tests and medication reviews when they are concerned about young people’s health and welfare. When young people have required hospitalisation, staff have stayed with them to ensure their care needs are met. Staff encourage young people to eat a healthy diet and encourage them to try new things. For some young people the introduction of healthy options is a protracted process and staff continue to balance developing a healthier diet with individual choice. Staff are well trained and competent having received training in key areas such as first aid, food handling and caring for young people with autism.

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Quality of care

Staff and management display a solid commitment to ensuring young people have the best life outcomes possible. Young people enjoy living in or staying at the home. One parent commented how their child stood at the gate, laughing and obviously happy, waiting for the staff to collect him. Management are very clear and specific as to the type of young person whom they are able to care for and the importance of matching young people well, therefore, no inappropriate placements are made. the admissions process is very much geared towards the young people and their families’ needs and overnight stays are only attempted when the young people are happy to stay. Young people using the service have learning disabilities on the autistic spectrum, with associated challenging behaviours and are very vulnerable. Family members say they are made very welcome and have developed positive relationships with all staff. Parents refer to staff working closely in partnership with them, sharing

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Quality of care

the behaviour strategies used in the home.

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Quality of care

Staff deliver highly individualised care in accordance with each young person's particular needs. Due to their care characteristics young people are most settled when routines are clear and familiar. Staff closely adhere to these routines with any variations fully explained, using pictorial communication aids to reinforce this. Similarly, when young people present challenging behaviour, staff adhere to the guidelines in the detailed behaviour plan ensuring a consistency of approach throughout the staff team. When a young person is challenging boundaries staff try to establish what may be being communicated by this and seek to understand the young person’s feeling and views. Young people are again encouraged to use the PECS symbols to communicate what it is they want. Staff have an in-depth awareness of each of the young people and how they communicate. Staff use PECS and pictorial prompts to support speech and push young people to further develop

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Quality of care

their communication and understanding as part of daily life. Young people are therefore assisted in expressing their thoughts wishes and feelings at every level.

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Quality of care

Staff find that young people enjoy being kept active in the morning then having scheduled break time to have some personal space before having lunch. Staff are aware that challenging behaviour may be the result of being easily bored or conversely over stimulated. Staff therefore are constantly monitoring the interaction of young people with staff and their environment. Staff have been trained in restraint and clear records are held of any restraint applied. This means that staff are competent to safely restrain a young person and do so only when young people are placing themselves or others at risk. Staff are not, however, recording low level restraints such as the holding down of hands to prevent further hitting out in the central record of restraint applied. The failure to include all incidents of physical intervention in this record means that emerging patterns and trends may not be identified.

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Quality of care

Education is positively promoted and geared at levels appropriate to the needs of the young people. Young people are helped to gain an understanding of the world around them through daily activities in the home. Staff ensure that young people maintain excellent regular school attendance. Staff are sensitive to any issues at school which may impact on attendance. Staff are aware of the educational abilities and goals of each of the young people and attend all school events and meetings in partnership with parents.

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Quality of care

There is a good life skills programme which young people are working though. This is very much aimed at each young person’s level, for example, managing the toilet independently or cooking simple snacks. Young people experience small but personally significant personal growth. This is individually demonstrated through development of their skill base and well-being, such as, improvements in self-care skills, continence, and behaviour and communication skills. The organisation has recently established a care home for adults with disabilities in order to provide a more seamless transition to adult services for young people. People supporting the young people in their day-to-day lives, whether in school or at the home, are aware of key information and changes.

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Quality of care

Young people enjoy very positive relationships with staff. Parents refer to staff who are very kind and patient and for whom nothing is too much trouble. Parents state that they have noticed a big difference in their children who have developed more skills, are better behaved and are happy to come to Cameron House. Parents rate the support given to them and their children as outstanding.

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Safeguarding children and young people

The service is good at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Young people feel safe, secure and well cared for. Parents refer to having full confidence in staff to keep their child safe at all times. Young people using the service have autism and challenging behaviour and will target their anger or frustrations at staff and anyone in the vicinity. Staff actively work to prevent this through vigilance and helping young people develop their communication skills in more socially appropriate ways. High staffing levels when going out in the community mean that the public is effectively safeguarded from assault. Staff reinforce appropriate behaviours supported by visual prompts and individual communication tools such as PEC’S. Staff seek to understand and respond to young people's needs based upon their knowledge of them.

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Safeguarding children and young people

Individual behaviour management plans focus on possible triggers for distress and emphasise clear routines. Sanctions, as such, are not used due to young people’s very limited understanding of consequences. Staff are trained in restraint and use only to safeguard young people or others. Records of individual restraints are detailed and staff reflect on each incident seeking to understand the cause and whether the situation could be better managed in order to improve future practice. Records of low level restraint, such as, holding arms to prevent young people hitting others, are not always recorded in the central restraint record. This means that a true and accurate record of all physical intervention in the home cannot easily be ascertained and therefore patterns and trends may go unidentified.

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Safeguarding children and young people

Young people’s care characteristics mean that they would be at risk if leaving the home unsupervised and would be immediately reported missing. Young people are safeguarded from going missing by appropriate security measures including a door alarm and safety chain. High staffing levels mean that young people are under constant supervision to keep them safe. Health and safety systems in the home are sound. However, fire doors were observed to be propped open presenting a fire risk. Young people move swiftly around the building and need freedom of movement to prevent them becoming anxious. The provider has identified this safety conflict and is in the process of sourcing the most appropriate magnetic closure devices. The fire risk assessment, however, fails to fully detail this, nor is there a personal emergency evacuation in place for each young person. Comprehensive risk assessments identify children and young people's vulnerability and any risks regarding activities.

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Safeguarding children and young people

Staff are trained in safeguarding children and are aware what to do should an allegation of a child protection nature be made. Feedback from families and stakeholders is that young people feel safe and well cared for.

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Safeguarding children and young people

No staff have been recruited to the home within the past twelve months. The manager states that they ensure no member of staff is employed at the home until statutory checks including those with the Criminal Records Bureau are carried out.

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Leadership and management

The leadership and management of the children's home are adequate .

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Leadership and management

Management arrangements are clear and the home is adequately resourced to ensure that young people receive good levels of support. However, there is no record of how much time the manager spends in the home. Some shortfalls in record keeping were highlighted to the manager during the inspection such as the recording of all physical holding as a form of restraint. Similarly risk assessments regarding fire risks and health and safety issues were not sufficiently robust, failing to reflect the particular issues for people with disabilities. No formal appraisal of the quality of care has taken place, in line with Regulation 34, in order to fully review and develop the quality of care provided. Requirements set at the last inspection relating to the development and distribution of the children’s guide have been met.

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Leadership and management

Staff demonstrate a solid commitment to working with young people. All care and support is individualised and child focused responding to each of the young people’s complex and diverse needs. Parents, placing authorities and education give highly complimentary feedback on how staff support the young people in their care.

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Leadership and management

No complaints have been received by the home and families have confidence in the home’s ability to respond to any issues of concern which they may raise. Many of the young people, due to their care characteristics require the support of a family member or advocate to assist them should they wish to complain. A pictorial complaints procedure is in place. The manager intends to make this available in a more simplified version and in alternative formats.

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Leadership and management

The home is well staffed ensuring that young people's needs are met. Staffing is arranged according to the needs of the young people. All of the young people are supported on a minimum ratio of one staff to each young person during the day. When going out in the community each young person is supported by two. Two waking staff are on duty each night. This ensures that young people have staff support available at all times and that staff are available to respond flexibly to young people's needs and desires. Staff are competent in the roles they perform and establish positive relationships with young people, parents and other agencies.

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Leadership and management

Staff feel that one of their strengths is the fact that they work solidly together as a team to ensure good outcomes for young people. Regular staff meetings and supervision ensure that staff are aware of key issues within the home. The organisation demonstrates a commitment to staff training and staff benefit from training relevant to the roles they perform. Core training such as child protection, first aid, food hygiene, restraint, and working with young people with autism, is provided to all staff. Most staff have completed the National Vocational Qualification at level 3 in Caring for Children and young people, or are undertaking equivalent training.

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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