Children's Home run by Rotherham Metropolitan Borough Council in Rotherham

Unique reference number SC037521 Inspection date 19/07/2012 Inspector Debbie Foster Type of inspection Full Provision subtype Children's home

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Date of last inspection 21/02/2012 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 is a short break service run by a local authority, providing care for young people with learning and physical 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 adequate .

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Overall effectiveness

This children's home is at the start of providing a wider-reaching service to children and young people. After recently refurbishing and enhancing the facilities, this service now provides a short break service for young people with moderate to severe learning disabilities. Some young people may have challenging behaviour and other young people will have physical disabilities and complex health needs.

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Overall effectiveness

A core group of staff have a wealth of experience and knowledge in caring for young people with physical disabilities and suitable skills to care for young people with learning disabilities. Staff are dedicated and caring, which assists them in providing sound and safe care to young people. This enables young people who have received the service for some time to make progress in their lives. As a result, these young people are achieving more positive outcomes in relation to their confidence, emotional resilience and independence skills. Young people new to the service are starting to settle after a transition from another service and beginning to build secure relationships with staff. Care planning and care practice are personalised and in the main meet the needs of young people.

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Overall effectiveness

In the main, staff work in a coordinated way with young people, their families and other professionals to ensure young people get the right care, assistance and support that they need. Young people's views are pursued to assist in the running of the home.

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Overall effectiveness

Young people are kept safe and this is a notable strength of the service. Thorough safety systems and effective care practice ensure the welfare and safety of young people are promoted at all times. Staff show a good knowledge and understanding of the risks young people face and always take positive action to ensure risks are minimised and safely managed. Young people have or are building trusting relationships with staff. This means they feel valued and cared for.

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Overall effectiveness

The leadership and management of the children's home are built on sound foundations. The manager places a strong emphasis on providing a safe standard of care and this improves outcomes for young people in social, emotional and independence skills, while ensuring young people have fun and enjoy their stay at the home.

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Overall effectiveness

This inspection identifies areas for improvement around the access to the home for children using wheelchairs, the processes for monitoring the quality of care and also with regard to the implementation of young people’s care plans. Other areas include aspects of some training and formal supervision of staff.

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Overall effectiveness

Sound monitoring systems are in place. However, the implementation of the findings from monitoring the service is not effective and robust enough. Some deficiencies identified by the manager have not been promptly addressed by the provider. Other deficiencies have not all been identified to ensure that improvements to the quality of care can be made.

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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) ensure the physical design and layout of the premises are suitable for the purpose of achieving the aims and objectives set out in the home's Statement of Purpose and meet the needs of the children accommodated. In particular, young people's access to all areas of the home and appropriate use of the hoist tracking systems ( Regulation 31 (4) (a)) 28/09/2012

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate training, supervision and appraisal. In particular, behaviour management and physical intervention training, formal supervision for all staff including agency staff, fire instruction for agency staff. (Regulation 27 (3)(a) 29/08/2012

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  ensure young people can pursue individual social interests and hobbies. This should include taking part in a range of activities. In particular, using the garden and routinely accessing the community through trips and other activities (NMS 7.2)  ensure young people's placement plans are monitored by a key worker within the home who ensures that the requirements of the plan are implemented in the day-to-day care of that young person. In particular, all plans are revised, followed specifically and demonstrate the progress young people are making (NMS 25.2)  ensure all staff are supported to manage their responses and feelings arising from working with children, particularly where children display challenging behaviour or have difficult emotional issues (NMS 3.10)  ensure the learning and development programme which staff and volunteers

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Recommendations

should be supported to undertake includes staff receiving training to enhance individual skills and to keep staff up to date with professional and legal developments. Staff must be equipped with the skills required to meet the needs of the young people and purpose of the setting; in particular, first aid, extending the training in caring, supporting and meeting the needs of young people with severe learning disabilities (NMS 18.1)  ensure young people's emotional and behavioural needs are met, as set out in their care plan. In particular, following specific behaviour strategies for all young people (NMS 3.7)  ensure that all staff practice is consistent with the Regulations, the national minimum standards, and the home’s policies and procedures, with particular reference to shift planning, and following care plans and supporting records of each young person’s care (NMS 21.3)  ensure effective procedures for monitoring and controlling the activities of the

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Recommendations

home. In particular, ensure monitoring systems identify all omissions and deficiencies and thereby take immediate action to assist in improving on the quality of care. Where deficiencies have been identified prompt action must be taken by the registered provider and the manager. (NMS 21.1)

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Outcomes for children and young people

Outcomes for children and young people are adequate .

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Outcomes for children and young people

Young people are at varying stages of developing emotional resilience and forming positive relationships with staff. Some young people have attended the short break service for a considerable length of time and have strong well-established relationships with the staff. Others have only just started to receive a short break service and are in the process of building relationships. Young people are well supported with their health needs. Although parents have full responsibility for their child's health, the staff ensure young people's health needs are effectively supported while on their short break. Staff demonstrate a good awareness of young people’s individual health needs. and ensure these needs are met. This ensures good health outcomes for young people.

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Outcomes for children and young people

Young people benefit from the provision of healthy and nutritious meals that also meet diverse needs. A young person said: 'I like my meals.' Young people make their own choices about the food they eat at meal times. The staff are aware of individual children's likes, dislikes and special diets to ensure that young people enjoy the food served.

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Outcomes for children and young people

All young people attend full-time education. They are well supported to maintain daily routines that benefit their education. For example, this includes having suitable morning and bedtimes routines to enable them to be refreshed and ready to go to school the following day. Staff assist young people with personal educational targets where appropriate during their stay. This positively supports young people’s learning.

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Outcomes for children and young people

Young people accessing this service still live at home with their parents or carers. Therefore, they have access to those people that are important to them the majority of the time. Good relationships exist between with parents and carers. This is achieved by regular contact by phone and records. A parent said: 'I have regular telephone contact with staff and they keep me up to date with my daughter’s care and what she has been doing. She loves visiting the home, she loves the staff and they do the little extras that mean a lot to her, like putting her favourite bedding on in her room.' Positive communication ensures that relevant care and support are provided to the young people during their stay.

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Outcomes for children and young people

Young people have broad-ranging differences and abilities to learn life skills. The staff have successfully assessed each young person taking into account individual needs. The staff proactively support each young person to take part in the daily living tasks appropriate to their ability and understanding. Therefore, young people receive care which supports them to prepare for adulthood.

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Quality of care

The home provides an encouraging environment for young people. A strength of the home is the quality of relationships that are formed or forming between staff and young people. The staff team demonstrate an understanding of young people's individual needs, personalities, preferences and interests. The management team is working actively to support staff within a new service, by acting as a role model and passing on their experience and promoting a positive ethos.

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Quality of care

Placement plans outline young people's individual and diverse needs; in most areas these are specific, with clear guidance for staff on how this should be achieved. However, not all plans have been revised since the re-opening of the service. Staff do not consistently implement the specific placement plan guidance for all young people, such as the daily and mealtime routines for young people with autism. The daily recordings do not always reflect what progress is being made against the placement plan and the targets set, for instance, assisting young people to clean their own teeth, This impacts on the quality of the service and young people's ability to attain new skills

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Quality of care

Staff promote positive behaviour within the home and recognise it as being essential to the quality of care that they provide. The staff team strive to manage negative behaviour through building positive relationships with young people. They set and maintain boundaries. Staff demonstrate an understanding of the individual behaviour strategies that are in place for each young person. However, these have been inconsistently implemented for some young people. Therefore, some young people do not sustain positive behaviour.

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Quality of care

Young people do influence decision making through a range of avenues. For example, they have been involved in devising new menus with their choices, and each visit they make choices about the activities they wish to undertake. Daily discussions, and residents’ meetings provide young people with an opportunity to express their opinions. Communication is enhanced by using the individual communication aids, such as, symbols and electronic aids, alongside speech. This ensures young people's views are gathered.

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Quality of care

There is clear information in the children’s guide about how to complain. This also includes information and contact details of external services for young people to contact if they are unhappy. Staff understand how to support young people in making a complaint and their role as advocate. The procedure on how to make a complaint has been discussed at a recent young people's meeting.

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Quality of care

Young people live in a well-equipped and maintained property, local shops are nearby, and the service has a minibus to access the local community. The newly refurbished home provides a modern comfortable environment for young people, with special adaptations for meet the needs of young people with physical and learning disabilities. There are tracking hoists in some bedrooms and rooms. There is a sensory room and soft play area, along with lounge and dining areas. A variety of bathing facilities including a Jacuzzi assist in meeting all the young people's personal needs. Young people have their own bedrooms, which they can personalise to reflect their individuality during their short break stay. This ensures young people benefit from a pleasant home with good facilities.

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Quality of care

However, several deficiencies have been noted during the inspection; the garden has not been accessible to young people to enjoy since the home opened. This is due to the garden perimeter being insecure and therefore affecting young people's safety. Although the manager has actively tried to resolve this issue, no positive outcome had been achieved. Young people who self-travel in wheelchairs are unable to access all parts of the home without the aid of a staff member. This is due to the doors being too heavy for them to push open. This impacts negatively on their independence to move around the home freely. Staff report that two tracking hoist systems are not working effectively Therefore, these matters affect the overall quality of the environment, and do not meet the needs of all the young people using the service. The practices in relation to the storage, handling, administration and disposal of

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Quality of care

medication are good and accurate and safeguard the welfare of young people. All staff have received training in basic first aid. The majority of staff have received training in epilepsy and gastro-tube feeding to enable them to respond to medical occurrences, where required. This effectively supports young people in this area.

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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's safety and welfare are a priority and central to the quality of care provided. Young people are safe, and a parent said: 'My child is very safe, the care is excellent and I'm highly satisfied and my child loves visiting.' Detailed risk assessments are in place for each young person, the building and the activities undertaken. The staff demonstrate a very good awareness of the risks identified for each young person, and how they implement the actions to reduce or eliminate these risks. Suitable staffing levels are in place to support young people and keep them safe.

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Safeguarding children and young people

Strong safeguarding arrangements protect young people, and clear protocols with local authorities ensure decision making is open and transparent. Staff are knowledgeable on safeguarding procedures and have undertaken training. They are aware that any concern must be promptly reported, investigated and concluded.

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Safeguarding children and young people

Permanent staff are trained in physical interventions and few are undertaken. This demonstrates young people's care plans balance individual risks. Staff use de- escalation and diversion techniques to manage challenging behaviour in most instances. Managers monitor any incidents, with the aim of reducing the incidents of challenging behaviour in which young people may harm themselves and others. However, some shortfalls in the training of agency staff have been identified, as some are not trained in the home’s approved method of restraint. They therefore do not have the same knowledge and skills as the permanent staff team. Not all behaviour strategies are being implemented consistently by staff, particularly in relation to managing the behaviour of young people with autism and learning disabilities. As a result, this is impacting on the progress that some young people make in behaving in a more socially acceptable way and could potentially affect the

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Safeguarding children and young people

Young people are protected and kept safe by the staff implementing a wide range of health and safety procedures and risk assessments. Staff carry out regular health and safety checks, including fire drills, to ensure the premises are safe and young people know what to do in case of an emergency. There are appropriate systems in place to ensure that visitors to the home are suitably checked and supervised to protect young people.

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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

An experienced manager and management team support staff to provide a short break service. The service has recently undergone a significant change, although still providing a short break service. The service now offers care to young people with learning disabilities, including some with autism, as well as those with physical disabilities. The home is also providing an emergency bed for families in crisis. This has brought about a period of managing change within the service and a period of transition, as a result of significantly broadening the remit of care provided. This has destabilised aspects of the care delivered and reduced the overall quality of care.

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Leadership and management

The two recommendations made at the last inspection have been met in that the children's individual needs relating to cultural and religion are set out in each young person's placement plan. All staff have received training to enhance individual skills in the complaints procedures.

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Leadership and management

A Statement of Purpose outlines the aims and objectives of the home and is available to inform professionals and members of the public about how care is provided at the home. Young people and parents receive information in the form of a children's guide to inform them about the home and what to expect, prior to receiving a short break service.

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Leadership and management

There is a core number of staff who have a range of skills and experience among its members. A staff member said: 'We have been adjusting to the changes, and the young people new to the service are now starting to settle.' The management team are make changes to adjust the mix of young people receiving a service on each night and weekends to enable the staff to better meet the needs of all young people accessing the service at all time. However, during the period of transition in the service, staff have not been routinely receiving regular formal supervision and this includes agency staff, and shifts have not always been consistently run by shift leaders. As a result, this has affected the quality of care for some young people by not providing consistent care in line with their care plans at all times.

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Leadership and management

Although there are sufficient staff employed at the home, this has been affected in part by not providing all the staff with the experience of caring for the new young people to the service. There has been a delay in recruiting to permanent vacant posts to assist in providing a full permanent staff complement. As a result, this has affected the consistency of care provided to all young people.

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Leadership and management

Staff are trained in a wide variety of safety and childcare subjects. The majority of staff have the National Vocational Qualification at level 3 in Caring for Children and Young People. However, refresher training in first aid is overdue for some staff. Some agency staff are not recorded as receiving fire instruction. The training in the conditions and needs of young people with severe learning disability is not extensive. As some staff may lack understanding, knowledge and skills to enable them respond appropriately to all the care needs of the young people, this could impact negatively on the standard of care delivered to young people. Monitoring of the home is adequate. The manager has suitable systems to monitor, report and evaluate the administration systems of the home to help ensure that any areas of weakness identified are acted upon. This is supported by regular unannounced visits from the provider to monitor and improve the quality of care at

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Leadership and management

the home. However, these quality assurance systems have not addressed a number of the care and welfare matters raised in this report, and prompt action is not taken to secure improvements to the quality of care for young people.

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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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