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

Unique reference number SC031479 Inspection date 25/10/2012 Inspector David Putnam Type of inspection Full Provision subtype Children's home

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Date of last inspection 26/01/2012 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 local authority service. It provides short breaks for up to four children who have learning and/or physical disabilities.

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Brief description of the service

The children’s respite service shares the building with a similar service for adults. The services are kept separate by locked doors, but some facilities are shared. One manager is registered for both children's and adults' services. Staff also work across both provisions. The adult service is inspected separately by the Care Quality Commission.

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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

Children and young people show genuine eagerness to have short breaks in this unit. They say that they like the service and demonstrate through their demeanour that they feel comfortable and safe. Parents and placing social workers confirm their confidence in the care provided.

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Overall effectiveness

Children and young people are provided with a good quality of care when they stay. Effective planning ensures that committed staff get to know each child or young person extremely well. Individual needs are carefully identified and sensitively planned for. As a result, parents identify positive outcomes which they attribute to the service their children receive.

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Overall effectiveness

Children and young people’s experiences are limited because they do not currently have access to a variety of activities in the community away from the unit. Other shortfalls relate to a range of issues linked to the leadership and management of the service.

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Overall effectiveness

Requirements are made to improve information available to children and young people, supervision of staff, monitoring and review of the quality of care, and the notification of significant events and changes. Recommendations are made to increase opportunities for activities, produce a development plan and ensure all staff attain the expected minimum qualification for working with children and young people.

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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) produce a children's guide in a form appropriate to the age, understanding and communication needs of the children to be accommodated in the home (Regulation 4(4)) 21/12/2012

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Reg. Requirement Due date

(2001) ensure that all persons employed in the children's home receive appropriate supervision (Regulation 27(4)(a)) 21/12/2012

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Reg. Requirement Due date

(2001) ensure that if any of the events listed in column 1 of the table in Schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table (Regulation 30(1)) 21/12/2012

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at appropriate intervals and improving the quality of care; provide for consultation with children accommodated in the home, their parents and placing authorities; supply to the HMCI a report in respect of any review conducted (Regulation 34) 21/12/2012

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Reg. Requirement Due date

(2001) provide notice in writing to the HMCI that there is to be any change in the identity of the responsible individual. (Regulation 38(e)(iii)) 22/11/2012

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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 children take part in a range of activities, including leisure activities and trips (NMS 7.2)  produce 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, or confirming the continuation of the home's current operation and resource (NMS 15.2)  ensure all existing care staff have attained the minimum level 3 qualification and that all new staff hold the level 3 Children's and Young People's Workforce Diploma, which must include mandatory social care units; or be working towards the Diploma within 6 months of confirmation of employment. (NMS 18.5)

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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

Parents say that children and young people make noticeable progress and develop specific skills. For example, one young person now settles and sleeps in their own bed at home following their experience on short breaks. Another parent said that their son is now more willing to do things for himself, including aspects of self-care such as getting dressed. Managers and staff communicate with families prior to each stay to identify any significant changes in behaviour or needs regarding individual children and young people. Parents say that staff pick up information from them and practice new or developing skills during stays. This helps to provide continuity for children and young people.

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Outcomes for children and young people

Children and young people are supported to make individual choices. Free access within the unit allows them to move around communal areas or have privacy in their own room. Residents’ meetings are held at the beginning of each group’s stay. Staff encourage children and young people to express themselves by choosing activities they would like to undertake during their stay. Where children and young people are non-verbal they are given pictorial prompts to make choices. Alternatively, staff use their knowledge of children and young people to select activities they know will be enjoyed.

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Outcomes for children and young people

However, the majority of activities are undertaken within the confines of the unit, rather than in the wider community. Staff say that the individual needs of certain children or young people make it difficult to undertake certain activities. Records indicate that only 15 trips or activities outside the home were completed in the 39 weeks since the last inspection. Consequently, children and young people do not have stimulating or appropriate opportunities to expand their experience of the community in which they live.

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Outcomes for children and young people

As a short breaks unit, responsibility for children and young people’s on-going education and health remains with parents. However, staff consistently maintain contact with relevant professionals in these disciplines. Information is exchanged effectively and contributes to the continuity of care for each individual child or young person. Placing social workers confirm this, saying that managers and staff ensure education is supported and health needs are met.

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Outcomes for children and young people

All children and young people staying at the unit attend school. There are sound relationships with all schools. Staff are invited to attend school reviews, and communication books are exchanged with both schools and parents. In this way positive contact is maintained and any issues relating to children and young people are shared effectively.

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Outcomes for children and young people

Transition to adult short breaks services is made easier for young people who are able to transfer seamlessly to the linked adult service based within the same building. Young people benefit further as staff work in both settings. This means that the individual needs of young people are already known and understood by staff who are familiar to the young people.

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Quality of care

Children and young people have a positive experience when they stay at this short breaks unit. One young person repeatedly signed and spoke the name of the unit and said, ‘good’. When asked directly if he liked it he said, ‘yes’. Others who are non- verbal demonstrate through their demeanour that they are relaxed and comfortable in the unit.

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Quality of care

Parents express confidence about the care provided to their children. One parent said, ‘I can rest assured that staff have the skills and expertise to deal with my son.’ Another described the unit as, ‘a home from home', adding that their child, ‘loves it’. Staff are sensitive to the needs of all children and young people, who are relaxed in each other’s company. One parent said, ‘I feel he sees others there as his mates… he feels comfortable in their presence.’ As a result, children and young people are helped to build positive relationships with staff and others using the service. Where particular friendships, or clashes, are noted, managers and staff do all they can to adjust visit plans accordingly.

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Quality of care

Dedicated staff take time to get to know the children and young people they care for, allowing them to identify and meet their individual needs. Placing social workers describe staff as, ‘approachable and flexible’, and commend them for identifying and meeting the emotional and psychological needs of children and young people. Staff use their knowledge of individual children and young people to communicate effectively. Parents say that at times staff get to know their children over many years and build up a good rapport with them over time.

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Quality of care

Managers and key workers prepare for new placements by producing detailed care plans prior to initial visits to the unit. These plans link directly to individual risk assessments and behaviour management plans and demonstrate detailed liaison with parents. Visits to the home are encouraged so that parents know what to expect from the service, and children and young people are comfortable with the setting. Staff stage introductions at a suitable pace for each individual, attempting to ensure there is as much consistency and continuity as possible. Care plans are formally reviewed annually, but are amended as necessary to enhance the knowledge of children and young people. This contributes to ensuring children and young people enjoy their short breaks while having their diverse needs met.

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Quality of care

As part of the assessment process, the cultural, personal and religious identity of children and young people is sought, acknowledged and respected. Relevant information is transferred to individual care plans. Details relating to dietary needs are provided to staff who prepare meals. Prompt cards are also displayed inside kitchen cupboards to remind all staff of this important information. This augments information recorded on quick reference sheets kept on individual files. These ensure staff are provided with all the information needed to care for each child or young person.

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Quality of care

Most children and young people using the service would struggle to conceptualise what a complaint is. However, they are able to communicate when they feel content, happy or distressed. Staff are sensitive to any changes in demeanour and respond quickly and appropriately. Parents say they know how to make a complaint and would feel comfortable doing so. When complaints are received, they are addressed promptly in a manner that promotes resolution.

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Quality of care

Since the last inspection the home has been redecorated and refurbished. Children and young people now enjoy a pleasant, fresh and bright environment during their short breaks.

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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

Children and young people are safe and feel safe. Anxious or distressed reactions from children and young people are minimal and are responded to quickly and appropriately by staff. One parent said they were confident their child was safe in the care of staff adding, ‘it gives me peace of mind when he is there’.

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Safeguarding children and young people

Children and young people are safeguarded through comprehensive risk assessment and management arrangements. All necessary checks of the building are up to date. Issues relating to individual children and young people are considered and risk assessed as part of their short-break care plans.

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Safeguarding children and young people

Staff promote the safety and welfare of children and young people. Considerable thought goes into providing a safe experience for everyone using the service. Staff take precautions to ensure that children and young people do not go missing from the home. Procedures exist which outline action staff would take if a child or young person did go missing. A relationship with the local police exists through the local community support officer. This provides a positive role model for children and young people. It also supports police officers to understand the vulnerabilities of children and young people and respond promptly should any go missing in the future.

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Safeguarding children and young people

Staff are trained in an appropriate technique to assist in avoiding crises and responding accordingly. However, staff say they would only use restraint in exceptional circumstances. Even then, techniques used would be to guide a child or young person away from a dangerous or potentially dangerous situation. Records demonstrate that sanctions are used sparingly and that no restraints have occurred since the last inspection.

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Safeguarding children and young people

Robust practice regarding the storage and administration of medicines is rigorously followed and helps to keep children and young people safe. The local authority supports formal processes for the recruitment and selection of staff. These are sound, ensuring that unsuitable applicants are prevented from progressing to work with children and 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

The short breaks unit is managed by an extremely experienced and committed Registered Manager who advocates strongly for the children and young people using this service. Following a period when opening times were reduced, the Registered Manager was able to persuade senior managers to open the service full time again. This brought direct benefit to children, young people and their families who had expressed concern about the reduction in service.

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Leadership and management

The service is respected in the local area and there are positive relationships with other agencies, such as schools, health and social services. The Registered Manager is supported by a dedicated group of staff which reflects the diversity of the community in which the home is situated.

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Leadership and management

The one requirement and one recommendation made at the last inspection have been fully addressed. Regular monitoring visits now take place every month. The same person visits consistently and they know the home well. Reports provide advice and challenge in an encouraging style to promote improvement in the service for children and young people. Copies of these reports are submitted to Ofsted. The staff group have now received training in managing challenging behaviours and the use of recognised restraint techniques. This ensures that children and young people are dealt with safely if their behaviour puts themselves or others at risk. The Registered Manager is looking into the possibility of staff being trained to deliver this course in the future to ensure that skills are kept up to date.

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Leadership and management

A clear Statement of Purpose remains in place, meaning that parents and professionals are clear about the services and facilities provided in the short breaks unit. This has been reviewed and information contained in annexes has been updated.

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Leadership and management

A children’s guide exists and is made available on a notice board in the unit. However, the document is long, wordy and contains no pictures or symbols. The majority of children and young people using the service do not have the ability to access this document. Staff estimate that no more than 15% of service users could read this document but confirmed that they were unlikely to do so. Children and young people who communicate in different ways are not currently catered for.

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Leadership and management

Reviews of the quality of care are not completed at appropriate intervals, meaning that there is limited understanding of the strengths and weaknesses of the service. Similarly, there is no development plan in place setting out any planned improvements in the way the service will run over the next year. The performance of individual staff is appraised annually. Targets are set to focus development over the following year. Short training courses are made available to all staff. These enhance learning in areas specific to the individual needs of children and young people. Staff are experienced and skilled. This is demonstrated by the qualifications they hold in regards to adult social care. However, several do not hold the relevant minimum qualification relating to children and young people.

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Leadership and management

The Statement of Purpose says that all staff have a supervisor and receive supervision every four to six weeks. Records demonstrate that in reality supervision takes place infrequently. Consequently, staff are not supported, challenged and developed consistently throughout the year. Individual staff files contain records of only three or four supervisions over a 12 month period.

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Leadership and management

The inspector identified one example where a referral of child protection concern was made to the local authority, but was not notified to Ofsted. The impact upon the child concerned was minimal as a result of staff taking immediate and appropriate action to protect them. However, without formal notifications being made it is not possible for the regulatory body to properly monitor the short breaks service.

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Leadership and management

Eleven months ago Ofsted received notice of a change in identity of the responsible individual for this home. Direction was immediately provided in writing regarding the appropriate process to be followed for this change to be completed. At the time of this inspection no further information had been forwarded to Ofsted.

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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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