Children's Home run by Isle of Wight Council in Isle of Wight

Unique reference number SC395944 Inspection date 29/08/2012 Inspector David Coulter Type of inspection Full Provision subtype Children's home

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Date of last inspection 12/01/2012 Website: www.ofsted.gov.uk

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Brief description of the service

This children's home is a purpose-built facility owned and operated by a local council. It is registered to take up to 10 young people with learning difficulties and/or physical disabilities between the ages of eight and 17 years.

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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

There have been a number of significant changes relating to the management of the home since the last inspection. The Registered Manager has moved on, the number of permanent residents has increased from two to four and a new outreach team is now operating from a base within the home. The home has also lost a number of permanent staff within a short period of time and as a consequence has had to increasingly rely on the deployment of bank and agency staff. This period of significant change has been managed by the deputy manager who has provided effective leadership and support to staff.

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Overall effectiveness

Although staff have had to adapt to changing circumstances within a short period of time, they have continued to provide good quality residential and respite care to a group of extremely vulnerable young people with complex care needs. Each young person receives individualised care that addresses their specific health, social and emotional needs. Outcomes for young people are good and young people respond positively to the attention they receive from staff and the stimulation they get from participating in a diverse range of social and recreational activities. The progress of each young person are carefully documented and appropriately shared with parents, teachers and social workers.

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Overall effectiveness

There were no actions or recommendations arising from the last inspection that needed addressing. Although a number of issues have been identified during this inspection that needs to be addressed to ensure compliance with national minimum standards, the quality of care within the provision is good. While it was recognised there are systems in place to monitor the progress of the home, a manager's report is not produced at regular intervals. Arrangements for the regular payment of young people’s allowances are not established to allow them develop their financial skills. Although permanent staff access specific behaviour management training, this has not been extended to bank staff to ensure a consistency in approach. A tour of the building and grounds indicated it would benefit from regular rather than sporadic maintenance.

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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 a monitoring report is written on the progress of the home at regular intervals and reports on areas identified in the regulations. (Regulation 34 Schedule 6) 01/12/2012

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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 young people in long term care are provided with access to their allowances so they can develop their financial capability, knowledge and skills (NMS 12.1f)  ensure all staff are trained in the use of physical restraint techniques and only use the homes agreed techniques. Training is regularly refreshed (NMS 3.15).  ensure the home and its outside environment is well maintained. (NMS 10.3).

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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 medical and care needs of each young person are appropriately met. The home's nursing staff ensure that all medical interventions are carried out by staff that have completed additional training and demonstrated their competence. As a number of the homes long term residents have complex health needs, additional support is sought from a range of allied health professionals. The privacy and dignity of each young person is valued and each is assigned a room, even if they are only undertaking a day visit. All personal care tasks are carried out sensitively. A range of specialist equipment allows staff to move and handle young people safely. Young people's medication is stored and dispensed appropriately. The home is wheelchair friendly and young people with mobility difficulties can access all areas. Young people are encouraged to remain physically active and can access a range of specialist play equipment both in the home and garden.

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Outcomes for children and young people

Young people are provided with nutritionally balanced meals. Introductory visits and effective liaison with families help staff establish each young person's culinary preferences and nutritional needs. Meals are currently produced on the premises by a number of designated staff while a permanent cook is sought. Although young people undertaking short stays are encouraged to try new foods, staff are realistic about what can be achieved and ensure each individual receives appropriate nutrition. Staff obtain the menu plans from each young person's school in order to avoid young people being served the same meal on the same day. Staff and young people eat together and this provides many opportunities for spontaneous social interaction.

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Outcomes for children and young people

By participating in stimulating individual and group activities in the home and the local community, the experience and social horizons of young people are extended. Although young people are provided with opportunities to develop a range of practical life skills related to such thing such as personal care and cooking, the development of their financial capabilities is inhibited by the fact they do not currently have direct access to their allowances. Staff help young people develop positive self-images and reinforce success with praise and encouragement. The home has its own specially adapted transport that ensures all young people, regardless of their mobility difficulties, can participate in trips out. Young people clearly benefit from the attention and stimulation they receive and those observed appeared at ease in the company of the staff working with them. Staff support young people's education and liaise with school staff to ensure consistency is achieved in relation to

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Outcomes for children and young people

such things as communication, medication and behaviour management.

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Outcomes for children and young people

Staff deploy a range of verbal and non-verbal communication techniques to ascertain the views of young people about all aspects of their care. Young people were observed exercising choice over the activities they wished to participate in and the food they wished to eat. Staff are clearly aware of the involuntary nature of many of the behaviours young people exhibit and the difficulties some experience in processing information. If appropriate young people are helped to make the link between actions and possible consequences. Young people displaying challenging behaviour are normally managed by the deployment of diversionary techniques that include accessing a specially designed safe room. Physical interventions are only ever used if is felt a young person is putting themselves or others at risk. Although staff have access to specific behaviour management training, not all bank staff have yet accessed it.

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Outcomes for children and young people

The majority of young people only spend a few nights a month and as a consequence have limited contact with their families during their stays. However, the home is now accommodating four long-term residents and arrangements are having to be made to ensure family contact is maintained. Staff are aware of the need to help the long-term residents feel settled and at ease with their new home and social circumstances.

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Quality of care

The home has continued to develop the service that it offers to families caring for young people with complex disabilities. As well as offering respite care the home now offers four long-term residential placements and outreach support. The implications of these changes on staffing levels and existing facilities are still being realised. For example, the four permanent residents all have complex care needs and require consistently high levels of staff support. The increasing demands and staff shortages have resulted in an increasing reliance on bank and agency staff. In a number of instances respite visits have had to be cancelled in order to ensure appropriate staffing levels could be maintained. This difficulty is clearly recognised and additional permanent staff are being recruited. Although the homes long-term residents are accommodated in their own dedicated area of the building they can access all

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Quality of care

communal facilities. Young people undertaking respite stays cannot enter the long- term unit unless invited.

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Quality of care

Although the home provides one emergency bed, the majority of young people arrive via a well-established admissions process that includes short day visits. An effective assessment process, that includes discussions with key individuals' such as parents and teachers, ensures the care needs and risks associated with each young person's health and behaviour are accurately identified. Detailed guides provide young people and their families with key information on the nature of the service, the role of staff, contact arrangements and how to raise concerns or register a complaint. On admission all young people are allocated a link worker who liaises with key individuals who contribute to their care. Young people only embark on overnight stays when they and their parents feel comfortable. Staff are extremely attentive to the young people in their care and closely monitor their progress. Young people's placement plans are updated in response to changing circumstances and significant

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Quality of care

The composition of each daily respite group is planned in advance to ensure staffing levels are appropriate to meet the needs of the young people being accommodated. Although the majority of young people are cared for on a one-to-one basis, a number require additional assistance at specific times. The care plans of all young people are updated at the end of each visit and significant information is effectively shared amongst staff. The effectiveness of the homes internal communication systems help staff keep abreast of changing circumstances and respond appropriately.

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Quality of care

The home is subject to heavy usage and as a consequence suffers from wear and tear. The behaviours of some young people can also result in significant damage to the fabric and fittings of the building. Although the home was observed to be clean and tidy a number of areas appeared tired and in need of refurbishment. The outside play area was somewhat overgrown inhibiting the movement of young people with mobility difficulties. While the home is subject to maintenance it is sporadic and determined on a needs basis.

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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

Staff are recruited via the local authority's rigorous recruitment process and can only assume their full responsibilities when they have demonstrated their competence in key areas. Although recent staffing difficulties have resulted in an increase in the deployment of bank staff, they are always appropriately supported and supervised by senior staff. All staff are made aware of the individual needs and potential risks associated with the behaviours of the young people with whom they work. Appropriate staffing levels ensure the movements of young people around the home are carefully monitored.

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Safeguarding children and young people

Due to their disabilities a number of young people can present with behaviours that can result in them causing harm to themselves and others. While staff are normally successful in diffusing challenging situations by the deployment of diversionary techniques, in certain instances they have to use physical interventions to keep young people safe. Although permanent staff undertake regular training on the use of physical interventions, such training is currently not being accessed by all staff. Staff are aware of their individual responsibilities to report any safeguarding concerns and note any unexplained marks or bruises they observe on a young person’s body. Staff liaise effectively with parents, teachers and social workers and ensure they are informed if any young person has received an injury while in their care.

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Safeguarding children and young people

Young people are cared for within an environment that has been specifically designed to provide ease of access for those with mobility difficulties. Young people can move freely around the building and have direct access to a number of safe play areas around the site. Play equipment has been selected to meet the needs of young people with restricted movement. Access to the site is limited and all visitors have to report to staff and sign in. There is clear guidance for staff to follow in the event of a fire. The fire alarm system is tested weekly and full evacuations carried out at regular intervals. These measures further safeguard the young people accommodated.

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Safeguarding children and young people

Young people are encouraged to engage in a range of leisure and recreational activities in the home and community, staff are aware of each individual's vulnerabilities and incorporate risk assessments in the planning process. There are well established procedures for responding to serious incidents such as a young person going missing. Staff aim to ensure no young person is disadvantaged from participating in trips due to their disabilities or health needs and have developed a range of effective working practices for administering medication and carrying out personal care tasks while out of the home.

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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

Recent changes have had a significant impact on how the home operates. As a respite service staff have primarily focused on planning and managing short stays that provide young people with stimulating and enjoyable visits. The implication of providing long-term care to a group of young people for whom the home is their permanent residence is still being realised. Staff are clearly aware of the need to further develop existing facilities, create a more homely environment and provide opportunities for individuals to develop a range of social and life skills.

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Leadership and management

The team of well-motivated staff are committed to further improve the individualised care they provide for each young person. Through regular supervision staff are provided with opportunities to reflect on their practice and identify areas to further develop their professional knowledge and skills. Staff keep abreast of developments within the childcare field and are provided with additional specialist training to help address issues relating to areas such as mental health. A record is kept of all courses individual staff attend. A comprehensive range of policies and procedures that are subject to regular review, provide the basis for efficient working practices. Job descriptions and a detailed induction programme ensure all new staff are made aware of their individual roles and responsibilities.

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Leadership and management

The home has well established recording systems and records and documents examined were stored appropriately and found to contain recent and relevant information. Each young person’s progress is reflected in their looked after children review reports. Although the operation of the home is subject to a monthly monitoring visit by a local authority officer, comprehensive progress reports are not currently being produced at regular intervals as required.

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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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