Children's Home run by Progress Children’s Services Ltd in Sandwell

Unique reference number SC437486 Inspection date 18/10/2012 Inspector Elizabeth Barrett 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 service offers short breaks for up to five children and young people. The service is available to children and young people with a learning disability, a physical disability and/or sensory impairment. This service is delivered and managed by an independent provider that operates other social care services.

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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

Young people receive positive care and support while staying at this short break service. Young people with autism and specific learning disabilities make sound progress because they receive personalised care from a conscientious and developing staff team. There are care-planning frameworks to support young people’s health and well-being that focus on promoting their individual care, safety, learning development, and life skills.

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Overall effectiveness

This service has experienced a significant period of change since the registration of the home in February 2012. The provider has introduced a transitional action plan dedicated to developing a cohesive staff and management team, with every effort made to maintain a stable and secure service for young people. The commitment of the homes recently appointed manager, and the appropriate relationships in place with parents and other agencies, has meant young people continue to receive a positive level of care.

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Overall effectiveness

Safeguarding young people with disabilities and complex needs is secure and organised. The safety and welfare needs of young people are further improving, through the development of daily routines and robust monitoring structures. The homes manager and the provider recognise the strengths and weaknesses of this service, and plans are in place to address these shortfalls. This service places a clear focus on the need to improve all aspects of the homes practices and operations, to ensure young people achieve and sustain positive outcomes.

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Overall effectiveness

There are five statutory requirements and three recommendations set as a result of this inspection. Shortfalls are identified in the recording of some physical interventions, complaints and sanctions, staff recruitment, the availability of up to date care plans for some young people, and the external monitoring of the service.

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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

17B (2001) ensure within 24 hours of the use of any measure of restraint in a children's home, a written record is made in a volume which shall include details of the child's behaviour leading to the use of the measure, and the effectiveness and any consequences of the use of the measure (Regulation (17)(b)(f)) 30/11/2012

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Reg. Requirement Due date

(2001) ensure that a written record is made of any complaint, the action taken in response, and the outcome of the investigation (Regulation 24 (5)) 30/11/2012

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Reg. Requirement Due date

(2001) ensure that there is at all times, having regard to the size of the children's home, the statement of purpose, and the number and needs of the children accommodated there, a sufficient number of suitably qualified, competent and experienced persons working at the children's home (Regulation 25 (1)(a)) 21/12/2012

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Reg. Requirement Due date

(2001) maintain in respect of each child accommodated in a children's home a record in permanent form, as specified in Schedule 3 which includes a current copy of any plan for the care of the child prepared by his placing authority, and of the short break placement plan (Regulation 28 (1)) 30/11/2012

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Reg. Requirement Due date

(2001) ensure that the registered provider shall supply a copy of the report required to be made under paragraph (4)(c) to the HMCI. (Regulation 33 (5)(a)) 30/11/2012

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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 the home has a clear written policy on managing behaviour, which includes supporting positive behaviour, de-escalation of conflicts, discipline, control and restraint, that all staff understand and apply at all times (NMS 3.3)  ensure sanctions and rewards for behaviour are clear, reasonable and fair and are understood by all staff and children, and that all measures are suitable to working with children with learning disabilities (NMS 3.8)  ensure the home provides a comfortable and homely environment and is well maintained and decorated, and that children under short break arrangements can personalise their bedrooms during their stay. (NMS 10.3)

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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 with significant learning disabilities and complex needs are receiving individualised care and support during their stay at this short break service. The staff team help young people develop their physical and emotional health and well-being, because they promote positive relationships within the home, and through community based activities.

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Outcomes for children and young people

Young people with specific learning disabilities such as autism are making steady progress while staying at this service. Examples of positive outcomes include improvements in communication and sensory recognition, and a reduction in episodes of challenging behaviour. For some young people such episodes have reduced to minimum levels, through the establishment of clear and personalised care plans, and through positive relationships and communication strategies with parents.

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Outcomes for children and young people

Young people are encouraged and supported to develop their life skills and to achieve individual progress in areas of personal care and social interaction. Examples of improvements for some young people include, using a knife and fork to eat their meals, and sitting at the table with their peers during meal times. For some young people who were initially unable to feed themselves, sound progress is made in relation to eating regular meals during their stay.

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Outcomes for children and young people

Young people make acceptable levels of progress because the service has personalised and established routines and structures in place, which are tailored to individual behavioural needs. Staff work in partnership with parents and education, to ensure each young person receives care that is safe and secure. Staff use non- verbal communication methods to enable young people to express their views, wishes, and wants. Observations at this visit show staff interacting with young people using pictures and symbols, and basic sign language. Young people in turn, responded by laughing, smiling, pointing and leading staff to particular objects and pictures of reference. The recently introduced home to school communication records, ensure that all young people's daily welfare is efficiently communicated during transitional care arrangements.

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Outcomes for children and young people

Parents maintain the primary responsibility for ensuring their child receives appropriate health care and support during their overnight stays in this home. The individual health care needs of all young people are continuously assessed with parents to ensure all young people receive appropriate and consistent responses to individual needs. Observations made during this inspection show staff encouraging and supporting young people with specific physical health related tasks, including assisted bathing, toileting, and other aspects of personal care. Staff and parents comment positively on the progress some young people are making in relation to establishing and maintaining balanced routines in these areas.

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Outcomes for children and young people

Young people are safely enabled to participate in a range of activities and leisure pursuits suitable to their individual skills and abilities. Staff support young people to engage in community-based activities such as attending the local parks, walks in the community and day trips, in addition to activities in the home including arts and crafts and the use of the Wii. Young people are actively encouraged to access new activities that they otherwise would not have an opportunity to experience. Comments from one parent at this visit includes, 'My son is now mixing with other children and developing his social skills. I was impressed to see him with other children and how the staff interacted with them.

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Quality of care

Young people receive a stable and developing quality of care during their stay at this home. The appointment of a permanent manager has meant that the service is making extensive improvements to the quality of care provided.

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Quality of care

Young people receive a positive quality of care in this home from an evolving staff team, who are genuinely interested in, and concerned for their welfare. This service has experienced significant staffing changes, with staff and young people continuing to build constructive and meaningful relationships. Staff spoken to at this visit say that it has been a difficult time, with a core group of staff working tirelessly alongside agency workers to maintain a safe and secure environment for young people. The appointment of a manager to the home during recent months has seen improvements made across all areas of the services care practices. Staff speak highly of the manager and of the on-going developments to the service.

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Quality of care

Improvements made to the care planning and risk assessment framework ensures all young people receive personalised care, based on a detailed assessment and a partnership approach. Staff are developing a more thorough understanding of the complex and specific learning and disability needs of all young people. This means that they are more focused and confident, about meeting the day-to-day care arrangements for young people. The service's care plans are current and reflect the assessed needs of the diverse group of young people, inclusive of short break care planning requirements. Parents and staff are working together to ensure that individuality is promoted, and continuity of care maintained within both the home and family environment. However, not all young people have up to date local authority short break care plans in place.

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Quality of care

Young people are supported and encouraged to participate in their stay, and work towards achieving individual targets. Observations made during this visit include staff actively demonstrating suitable levels of patience and understanding, in relation to the individual behavioural and communication needs of all young people. One to one staffing arrangements ensure young people receive organised personal care and support, and staff use non-verbal skills and visual aids to enable young people to manage their daily tasks and personal care needs.

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Quality of care

Staff work positively with parents and schools to ensure young people's educational, social and leisure needs are met. Whilst the parents of young people cared for under short break arrangements retain the primary responsibility for their child's education, there are appropriate records and communication systems in place. Processes are developing to enable this service to be regularly involved in looked after children and educational reviews, and planning. Comments from a parent includes, 'The care provided by the home is good. The staff communicate well and discuss any issues and concerns in relation to my child's transition from home to school.'

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Quality of care

Young people live in a healthy environment that is adapted to their specific needs, including the availability of aids and adaptations such as hoists and personal care equipment. Young people receive health planning and care tailored to meet their identified and diagnosed needs, including cerebral palsy and autism. Staff receive specialised training such as personal and intimate care, medication and sign language. The arrangements for dealing with medication are safe and effective. The home keeps medicines in a locked cupboard and two staff administer medicines and check stock. Recent improvements to the auditing of the medication processes and systems, and the recording of medication in and out of the premises, ensure well- organised and safe practices.

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Quality of care

The home is well maintained, clean, and tidy. Décor and furnishings are appropriate and homely. Individual bedrooms are available to those young people receiving short breaks care, including rooms adapted for wheel chair users. Activities are risk assessed ensuring young people are supervised and supported in the home, while allowing them the freedom to move around all areas as they would in a family environment. Young people have access to a sensory room in the home however, this room is currently undergoing refurbishment, additionally, the young people's bedrooms would benefit from more age appropriate personalisation.

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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

Young people are cared for in a safe environment. Observations at this visit demonstrate that young people are safe from harm because of the supervision arrangements in place, and the individualised care of those young people with more complex needs. Young people with limited verbal communication can identify issues through visual aids and gestures, and through the staff team's awareness of their personal triggers and behavioural thresholds. Social workers and parents comment at this visit that they have no current safeguarding concerns in relation to this service. The environment is sufficiently risk assessed to ensure young people are safe from potential hazards and harm. Close working relationships with parents and education providers ensure young people develop strategies to manage their own behaviours in a safe and socially acceptable manner. Safeguarding policies and procedures compliant with those of the local authority are in place in the home. Staff spoken to

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Safeguarding children and young people

are aware of the policies and procedures, and say that they receive regular training on safeguarding and child protection matters. Staff can identify the key indicators of abuse, and how to identify these in young people with learning disabilities and more complex needs.

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Safeguarding children and young people

There are no episodes of missing from home since the registration of this service. The home has current procedures in place with the local authority and the police, which address the particular safeguarding needs of young people using this service. There is minimum use of physical restraint and sanctions; however, there are shortfalls in the recording of some incidents. Some records are not made in sufficient detail to demonstrate the reasons why interventions where necessary, the effectiveness of such interventions, and the cross-referencing with incident reports. The home's manager said that the service now has individual behaviour management strategies and risk assessments for all young people. This means that episodes of challenging behaviour are managed individually, and without recourse to restraint or sanction.

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Safeguarding children and young people

The home environment has established systems and structures in place to ensure safe practices, and fulfil health and safety requirements. All fire, gas, and electrical appliances have recently been checked, and there is a comprehensive fire risk assessment and evacuation procedure. Individual and premises risk assessments, alongside supervised visitor arrangements, ensure young people are safe and suitably protected. Young people are further protected by effective staff recruitment procedures.

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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 effectiveness of the leadership and management of this home has been compromised since the registration of the service in February 2012. The home has experienced significant staffing changes in recent months, with the Registered Manager and some established staff moving on from the service, and other staff undertaking promoted roles and responsibilities. The current manager of the home was appointed to the role from within the organisation, and is in the process of registering as the manager for this service with Ofsted. Additionally, the manager is in the process of enrolling on the Level 5 Diploma in management to ensure he meets suitable management requirements.

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Leadership and management

While the provider has made every effort to ensure continuity of staffing during this transitional period, there has been a high use of agency staff. The deployment of suitably qualified and experienced staff, both as a group and on an individual basis, has affected the home’s ability to meet all day-to-day operational responsibilities. The provider is currently recruiting new staff to this service; however, this process has not been completed in a timely manner. Additionally, there have been shortfalls in maintaining accurate, consistent, and accountable records in the home. This has affected the effective monitoring of care practice, with patterns and trends not always identified and responded to efficiently, including behavioural management issues and concerns.

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Leadership and management

Young people’s needs are being met by sufficient staffing levels. Staff receive formal support and supervision to guide them with the work they do with young people. Day-to-day support from managers and seniors is also available to help staff through the routines of each day, and to ensure any incidents of concern receive appropriate support and response. Mandatory training requirements are up to date with most staff qualified or studying towards such qualifications. The home's manager has made good improvements to the operation of this service in the last two months. For instance, changes to the care planning and safeguarding frameworks, and to stabilising and building a new staff team.

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Leadership and management

The home has a current Statement of Purpose that reflects the ethos and practice of the home, and what the home sets out to do for young people who receive a short break service. Copies of a children's guide is available in widget form for those young people with specific learning disabilities. An external manager to the home currently monitors young people’s care on a monthly basis. Visitor reports identified some administrative and practice shortfalls, however not all reports include areas for action and improvement, whereby managers can effectively address any on-going issues. In addition, reports have not been forwarded to Ofsted as a regulatory requirement.

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Leadership and management

Managers have an understanding of the strengths and weaknesses of the home, and there is a transitional action plan in place for this service. The plan addresses such shortfalls as effective quality assurance processes, the recording practices of the home, and the meaningful engagement of parents and stakeholders in the development of the service. The homes manager and the provider are now making progress in addressing these areas. For example, the appointment of a senior operational manager who will undertake the direct supervision of the homes manager, and monthly monitoring visits to the service.

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Leadership and management

The home ensures that notifications of incidents in relation to Schedule 5 are made to the appropriate agencies, and stored securely within the home. However, some shortfalls in the monitoring of some complaints, the processes followed, and the outcome of such complaints, require further attention. Particular attention is required, to ensure that all records in the home are current, accurately recorded, and provide a clear and detailed account of individual young people's stays in the home.

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Leadership and management

Discussions with the homes management team demonstrate a clear awareness of the improvements required to this service. While considering these shortfalls, young people continue to be cared for in a safe and secure environment, and managers express their determination and commitment to initiating and implementing the required changes.

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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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