Children's Home run by London Borough of Hounslow in Hounslow

Unique reference number SC032600 Inspection date 19/07/2012 Inspector Karen Malcolm Type of inspection Full Provision subtype Children's home

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Date of last inspection 15/02/2012 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 short-break service provides care for up to five children and young people aged between 10 and 18 years of age who have either physical disabilities and/or special educational needs and who may also have a sensory impairment. The home is owned and operated by a local authority. The service operates every day, except Wednesdays.

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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 adequate .

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Overall effectiveness

The home provides all children and young people receiving short-break care an adequate service with the outcomes for children and young people being good. Children and young people are assisted by staff who are committed to helping them progress. The staffing ratios are high, enabling children and young people to be kept safe and receive individual attention. This supports their development and engagement in activities. The staff communicate effectively with all involved in the children and young people's lives. Parents and social workers are pleased with how the home positively affects the children and young people placed there. For those preparing to move into adult services the ‘My S.T.E.P.S.’ programme provide a good induction toward their independence, which parents and young people see as worthwhile. One parent said 'that the home always encourages the children and they find the reviews very informative. Prior to a review, the staff assist young people to

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Overall effectiveness

make 'display poster' of key words and photos. This display helps young people partake in the review and encourages discussion.'

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Overall effectiveness

The Registered Manager has a flexible arrangement with the local authority and now works part-time. The remaining hours are covered by the assistant manager who is in the process of submitting an application to also be registered. There are systems in place to that shows how the manager is tackling areas of weaknesses and improvement. However, with regards to the overall monitoring, shortfalls were identified relating to complaints outcomes, the Statement of Purpose and children and young people's guide, staff competence and the development plan.

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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 that the Statement of Purpose is available and understood by staff (NMS 13.1)  where a child requires it, the guide and Statement of Purpose are made available, when appropriate, through suitable alternative methods of communication, e.g. Makaton, pictures, tape recording, translation into another language (NMS 13.6)  have a written development plan, reviewed annually, for the future of the home, either identifying any planned changes in the operation or resources of the service (NMS 15.2)  ensure all staff are managed properly (NMS 19.2)  ensure that there is clear and effective procedures for monitoring and controlling the activities of the home. This includes the financial viability of the home, any serious incidents, allegations, complaints about the provision, and the quality of the provision. Children in the home are regularly involved in contributing to monitoring the operation of the home, and their views and any concerns are

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Recommendations

seriously taken into account. (NMS 21.2)

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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

Children and young people who attend the short-break service receive care and support which is responsive to their individual needs. Their overall outcome is managed positively by staff. Parents and carers are generally responsible for meeting the overall healthcare needs of their children. However, the home often supports children and young people with very complex medical conditions. Staff work very closely with children, young people and their families and, as a result, are able to meet their needs. Staff maintain good links with other professionals to ensure that the overall care of a child and young person is maintained, not only within the unit, but in their family home and school. This gives a holistic approach to the child’s overall care. Children and young people are relaxed in the home and become familiar with their surroundings. They are able to enjoy tea-time visits until they are ready for

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Outcomes for children and young people

Children and young people are able to extend their friendship groups and participate in activities that they may not otherwise have access to. They make good progress during their short break. For example, they experience improvements in their behaviour, nutrition, socialisation, and independence. These developments are significant in their lives. This demonstrates the positive impact this service has had on their lives and of those who live and work with them. Successful joint working with families and professionals provides a consistent approach to help achieve positive changes.

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Outcomes for children and young people

Children and young people’s health and lifestyles needs are promoting by the home. The home consults with parents and carers on every aspect of their child’s care prior to any placement being made; therefore, any particular complex needs is fully recognised and taken into account. Regular follow-up conversations are made after each over-night stay; therefore, all lines of communication are maintained for the well-being of the child. Children and young people enjoy a variety of activities. These stimulate all the senses, facilitate exercise and encourage engagement with the wider community. This does not preclude children and young people accessing places of interest further afield.

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Outcomes for children and young people

Handover of information from staff to parents or carers ensures continuity of care for children and young people. Parents are reassured through the knowledge they can contact the home at any time. Information about any restrictions on contact is clearly recorded. Consequently children and young people are kept safe.

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Outcomes for children and young people

The 'My S.T.E.P.S' project is going from strength to strength. All young people are encouraged and supported to develop new skills that will enable them to be as independent as possible in preparation for moving on to adult services. The project is a 12-week course which is designed around individual needs and ability, and remains successful. The project includes an independent travel and skills programme that supports young people to learn to use public transport safely and prepare meals with minimum support. One parent quoted in the surveys that ‘my child attended the home for semi-independence overnight visits and the youth club. We have both had a very positive relationship with the staff at the home.’ Others said it gave their children a good start in life.

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Quality of care

Children and young people benefit from a short-break service provision which meets their needs. Staff have the skills and abilities to effectively communicate with all children and young people, regardless of the method of communication in use. Short-break care plans are organised in advance of children and young people staying at the provision. The planning is inclusive of health, social care and education. The coordination of the placements takes into consideration the needs of the child or young person to support appropriate matching, with sensitivity given to considerations such as age, gender and behaviours.

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Quality of care

The views, wishes and feelings of children and young people are taken into account, but mainly through changes to individual's activity planning. There are plans to review the current complaint and survey systems, especially for those with complex communication difficulties, to enable them to have clearer informed choices and better opportunities to influence how the home is run.

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Quality of care

The home manages medication well. Clear written instructions are kept of medication needs and medicines are properly stored and administered. Parents and carers are happy with the systems in place. Staff are trained in skilled health tasks, including peg feeding, and this ensures children’s health needs are fully met. Parents complete and sign epilepsy management agreements forms where appropriate. As a short- break unit, health care is generally managed by parents on behalf of their children.

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Quality of care

Regardless of mobility, children and young people move around the home freely and participate in various activities, which may be within the home or in the community. The activities are successfully designed to keep their interest and provide opportunities to engage in new things. Children and young people using the service come from a wide range of cultural and religious backgrounds. The staff group reflects the diversity of the community in which the home is situated. Different religious or cultural festivals are acknowledged and celebrated.

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Quality of care

Children and young people are cared for in line with their individual short-break care plan. This information forms part of each individualised placement plan and addresses areas for children and young people to learn and develop. Personal care needs are understood and addressed with sensitivity. Staff help children and young people to understand what is socially acceptable behaviour. All care plans are reviewed by parents. Parents feel that staff show commitment and are supportive even when behaviour may be challenging. Key workers are committed and have good relationships with parents and the school. Any concern or outcomes are discussed with all parties.

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Quality of care

The home is designed for children and young people with disabilities split over two levels. Bedrooms are comfortable and well presented. Specialist equipment is in place for some rooms to ensure those children with a complex night-time routine are well cared for and supported appropriately. Communal areas are spacious and adequately furnished. There is a sensory area. The home has adequate bathing and toileting facilities to ensure all needs are met by the home.

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Safeguarding children and young people

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

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Safeguarding children and young people

There have been no concerns about the safeguarding of young people whilst in the care of the short-break service since the last inspection. Children and young people are safe in the home. They are cared for by staff who offer, at times, one-to-one support. Children and young people relate positively to the environment; their actions indicate how comfortable and secure they feel.

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Safeguarding children and young people

It is rare that children and young people go missing from the home. However, if they do go missing, there are clear procedures to support staff and children around being safe. The procedures now minimises the risk of any child or young person going missing and reduces the risk of harm should they go missing. The manager has built new links with the local police and the local authority designated officer (LADO). Staff have all been given a copy of the new procedures along with any updates and refresher training have been undertaken. These procedures, along with a number of policies, are currently being revised and updated.

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Safeguarding children and young people

Children and young people are looked after by staff who know and understand how to ensure children and young people are safe at all times. Staff know what to do should there be an allegation or suspicion of abuse or unexplained marks around the body, and implement the policies in practice. This safeguards the welfare of children and young people. The management team and staff are taught how to look out for signs of bullying and how to report and deal with any incidents. The home does not have any incidents of reported bullying. The nature of the children and young people’s behaviours means that conventional displays of bullying are not prevalent. The staff recognise that the impact of challenging behaviours upon others is a more likely occurrence. Staff and managers are aware of the behaviours, needs and risks of children and young people. Therefore, placements are assessed according to needs to ensure the group mix reduces the potential for harmful incidents.

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Safeguarding children and young people

Physical intervention is seldom used, but when used, it is appropriate. All staff receive training from an accredited trainer within the home's staff group. Any intervention uses the minimum force for the minimum period necessary. Records of restraints are sound. Some improvement could be made by providing brief synopses on the types of restraint that can be used by staff, therefore, providing clearer guidance to all.

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Safeguarding children and young people

There are clear procedures with regards to recruitment and selection of new staff. Staff are carefully selected and undertake a series of checks to ensure they are suitable to work with vulnerable children and young people. All visitors are vetted appropriately. Children and young people enjoy a safe environment. Regular health and safety checks are carried out. In addition, testing of gas, electrical equipment and appliances are maintained. Repairs are reported and dealt with. The security of children and young people is not hindering their freedom or developmental needs.

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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

The management arrangement for the home has changed since the last inspection. The Registered Manager now has a flexible working arrangement. The temporary arrangement whereby some of the Registered Manager’s responsibilities were undertaken by one of the assistant manager remains. Due to this, the assistant manager is now in the process of submitting an application to register as the manager, during the times when the Registered Manager is unavailable to run the service appropriately.

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Leadership and management

The home’s Statement of Purpose accurately reflects the aims and objectives of the home. However, staff spoken to were unclear as to the purpose of the document and where it could be found. Also, there is no current system in place to produce a children and young people's guide, along with the Statement of Purpose, in other languages or other communication aid for those with complex communication needs.

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Leadership and management

At the last interim inspection two recommendations were made relating to producing a missing person and safeguarding policy and procedures. These are now in place and have been updated. The manager has demonstrated a capacity for continuing improvement, with regards to updating the other policies and procedures needed for the operation of the home. These are in the process of being reviewed and revised. Eventually, they will be stored on to a new internet site, for easier access and updates, such as any legislation changes. The manager said this has been time- consuming and a long process. However, a number of the policies and procedures viewed were in draft waiting approval from the senior management team to be signed off.

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Leadership and management

The overall monitoring of all complaints received by the home is not consistently investigated. Two complaints were received since the last inspection, of which one was thoroughly investigated in accordance with the home’s procedures, and one was not. The complaint that was not fully investigated had no clear evidence of whether or not any action was taken. Therefore, the registered persons had not effectively monitored or managed the complaint in accordance with the home’s procedures or the law.

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Leadership and management

Sufficient staff are employed to meet the needs of the children and young people. The staffing levels at the home are adequate. The staff team also reflect the cultural diversity of the children and young people who use the service. The staffing levels are always risk assessed to ensure the needs of the children and young people are appropriately supported. Staff all said that they appropriately supervised regularly and that there are team meetings.

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Leadership and management

Children and young people are cared for by a team who are trained, experienced and skilled. All staff training have been recently updated. Staff spoken to were very positive about what had been improved since the last inspection. They all said there have been ample opportunities to undertake further refresher training courses and they have also had input into the review of some of the home's policies and procedures that have been recently updated. Generally, they feel that it has been good coming into work. Staff also said that the management team is very supportive. But, all agreed that working with the children and young people is the best reward, especially seeing them improve and move on. However, there have been some staff competency issues; these have not been effectively managed by the registered person.

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Leadership and management

The relationships with some key outside agencies remains positive, in particular the local authority children's services and health professionals. The majority of children and young people who use the service are children in need; very few are looked after children. Therefore, all reviews and short-break plans are devised by the home. Social workers do contribute to and attend reviews when appropriate. Comments received from social workers were, 'although, the home offers short breaks and their parents are mainly responsible for healthcare issues, the home are very good in identifying any concerns around a child or young person health needs.'

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Leadership and management

The home has procedures for monitoring the quality of the service provided. The Registered Manager has ensures that regulatory quality assurance checks are undertaken. However, some shortfalls were identified with regards to the overall monitoring relating to the complaints, the Statement of Purpose and children's guide, supervision and appraisals and the development plan. Records are stored securely and information sharing is in accordance with data protection. All significant events relating to the protection of young people in the home are notified as appropriate and actions taken as required. As a result, the quality of care and the welfare and protection of children and young people is monitored.

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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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