Children's Home run by The Rose Road Association in Southampton

Unique reference number SC042446 Inspection date 06/11/2012 Inspector David Coulter Type of inspection Full Provision subtype Children's home

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Date of last inspection 09/02/2012 Website: www.ofsted.gov.uk

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Brief description of the service

The service offers short breaks for up to 12 children and young people with severe learning difficulties that may include physical disabilities and additional health problems. It is run by a registered charity which provides support and information services to children, young people and their carers throughout the area. The service is available to children and young people, of both sexes, aged between two years and 17 years. The unit consists of two residential areas, one of which is registered with 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 good .

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Overall effectiveness

The service has experienced a number of significant changes since the last inspection. The service has now registered one unit with the Care Quality Commission as a provision for young adults. Although both units are managed by the current manager and staffed from members of the existing team, they operate separately. A reorganisation has also taken place within the staff team with the appointment of four new assistant managers, all of whom have undertaken specific training to prepare them for their new responsibilities. This period of change has been well managed by the manager who has provided effective support to staff.

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Overall effectiveness

The service continues to provide good quality respite care to a group of extremely vulnerable young people with complex care needs. The number of young people referred to the service with significant health difficulties has continued to increase. Consequently, staff have had to review a number of practices in relation to areas such as the administration of medication. Staff have now developed robust systems to ensure each individual's medical, social and emotional needs are met on a consistent basis

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Overall effectiveness

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 wide range of social and recreational activities. Staff successfully deploy a range of communication methods to seek out the views of young people about all aspects of their care. Although the progress of each young person is documented on an on- going basis, it is not currently possible to determine to track their development from their initial admission. Each young person’s progress is, however, appropriately shared with parents, teachers and social workers.

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Overall effectiveness

The service benefits from having an experienced and knowledgeable staff team who have established meaningful relationships with the young people in their care. Staff were able to speak with authority about the young people they were caring for and were clearly aware of their vulnerabilities on how to keep them safe. Observations indicated that young people were at ease in the company of staff and there was much playful social interaction.

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Overall effectiveness

The service has established effective monitoring systems that ensure that areas for improvement are appropriately addressed. The manager is clearly aware of the strengths and weaknesses in current provision and has a clear vision on how the service can develop to successfully address changing needs.

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Overall effectiveness

Although a number of issues have been identified during this inspection that need to be addressed to ensure compliance with national minimum standards, the quality of care within the provision is good.

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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

 introduce a system that demonstrates the progress and development each young person has made since admission (NMS 25)  ensure the service's learning and development programme is evaluated for effectiveness at least annually and if necessary is updated. (NMS18.2)

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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

Young people are cared for by a team of well-motivated staff who are conversant with their physical, social and emotional needs. A number of young people have complex health needs and staff undertake specific training to ensure they are appropriately met. The privacy and dignity of each young person is respected and all personal care tasks are carried out sensitively. Young people with mobility difficulties are assisted by staff who ensure their safety by accessing a range of specialist lifting equipment. During their visits young people are encouraged to be physically active and participate in a range of recreational and leisure activities. Young people eat well and have nutritionally balanced home cooked meals that reflect their individual preferences and special dietary and cultural needs. Although young people are encouraged to try new foods, staff are realistic about what can be achieved and ensure each individual receives appropriate nutrition.

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Outcomes for children and young people

During their visit young people participate in a range of stimulating individual activities in both the home and the local community. The home has its own specially adapted transport that ensures all young people, regardless of their mobility difficulties, can participate in trips out. For example, four young people went on a recent trip, by public transport, to London to undertake a flight on the London Eye. Such activities provide opportunities for young people to experience new things and extend their social horizon's. Young people develop their social and life-skills and get to access public transport, undertake shopping trips and take responsibility for keeping their rooms tidy.

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Outcomes for children and young people

Young people make significant progress in the attainment of personal development goals such as communication and personal care. The views of young people are obtained on all aspects of their care and ensure that each visit is planned around their specific needs and interests.

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Outcomes for children and young people

Young people clearly benefit from the attention and stimulation they receive from staff and the praise and encouragement they receive contributes significantly to the development of positive self-images. Young people develop meaningful and positive relationships with other young people and staff. School attendance by young people residing in the unit is excellent and transport is frequently provided to and from school. Staff liaise effectively with school staff to ensure consistency in the delivery of care. 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.

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Quality of care

Young people access the service via a well-established admissions process that includes discussions with key individuals such as parents and teachers. The process ensures the care needs and risks associated with each young person's health and behaviour are accurately identified. Prospective service users and their families are provided with key information on the nature of the service, the role of staff, contact arrangements and how to raise concerns or register a complaint. Information is written in plain accessible language and guides for young people are produced in different formats. Young people normally undertake a number of day visits and have to feel comfortable before embarking on any overnight stays. Staff are effective at establishing good lines of communication with parents

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Quality of care

The unit has developed an effective placement planning system that provides clear guidance for staff on how the specific care needs of each young person should be met. Staff seek out advice and guidance from a range of health professionals to address the health needs of individual young people. Placement plans are updated in response to changing circumstances and significant incidents. Information is effectively shared amongst staff via placement plans and handover meetings between shifts. Staff are extremely attentive to each young person and record key information relating to their progress on a daily basis. The stability of the staff team contributes significantly to continuity in the delivery of care. Staff deploy a range of communication techniques to ascertain the views of young people and are adept at reading the body language of young people who experience speech difficulties. Staff spoken with were clearly conversant with the care needs of young people in their

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Quality of care

The composition of each resident group is carefully planned to ensure that particularly vulnerable young people are put at risk by the challenging behaviours of others. Daily staffing levels are set 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. The service's effective internal communication systems help staff keep abreast of changing circumstances.

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Quality of care

The service operates within a purpose built environment that provides ease of access for young people with mobility difficulties. Specialist equipment, including overhead hoists and assisted baths, are widely available and contribute to safe care practices. Young people are provided with their own rooms but can, if they wish, share with a friend. Young people can personalise their rooms with picture and posters for the duration of their stays. Both units were clean, tidy and in good decorative order. Décor in each unit is age appropriate. The numerous murals and photograph displays of young people enjoying fun activities create a pleasant and stimulating environment. Young people can access a number of safe outside play areas that contain a collection of exciting play equipment suitable for a range of age groups.

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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 not risk averse and aim to provide opportunities for young people to experience new social and recreational activities during their stays. All staff are made aware of the individual needs and potential risks associated with the behaviours of the young people with whom they work. Risk assessments are extensively used and allow staff to identify areas of potential concern relating to each young person. There are well established procedures for responding to serious incidents such as a young person going missing. Specially adapted vehicles and safe care practices allow young people with mobility difficulties to undertake activities outside of the home including visits to the beach, country parks and local restaurants.

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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. In such instances, staff deploy individual behaviour management strategies. Physical interventions are only ever used if it is felt a young person is putting themselves or others at risk. Staff are trained in restraint and de-escalation techniques. Staff promote positive behaviour and help young people understand in appropriate terms the consequences of their actions and their impact on others. All staff undertake safeguarding training and are aware of their individual responsibilities to report any 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 by staff who have been deemed suitable to work with vulnerable young people. Staff are recruited via a rigorous recruitment process and can only assume their full responsibilities when they have demonstrated their competence in key areas. All staff are issued with a job description that details their responsibilities. Staff access regular training opportunities to ensure they have the necessary knowledge and skills to meet changing demands. Although the unit has, at times, got to increase its staffing compliment by calling upon bank and agency staff, there are suitable arrangements to ensure temporary staff are appropriately supervised by senior staff.

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Safeguarding children and young people

Delegated health tasks are only carried out by staff who have received training from an appropriate health professional. Although systems have been developed to ensure medication is stored and administered appropriately, the volume of medication being handled has increased significantly in recent times. A number of recent incidents identified shortcomings in procedures and has resulted in the introduction of some new working practices.

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Safeguarding children and young people

Young people are cared for within a purpose built environment that has been designed to provide easy access for young people with disabilities. As all the accommodation is on ground level, young people have access to all areas. Young people are protected from external intrusion and access to the site is extremely limited. All visitors have to report to staff, identify themselves and sign in before being provided entry. There is clear guidance for staff to follow in the event of a fire and full evacuations are carried out at regular intervals. Specialist equipment is subject to regular maintenance.

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Leadership and management

The leadership and management of the children's home are good .

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Leadership and management

The service benefits from having an experienced and well-motivated staff team who are committed to providing good quality care to disabled young people. Most of the staff have worked in the service for many years and have contributed to its development. Staff spoke in extremely positive terms about their work. All staff are receiving regular supervision that provides the opportunity to reflect on their practice. There was a recognition that many of the young people now accessing the service have complex health needs that require specialist interventions. While staff have undertaken training on a variety of delegated health tasks there was an acknowledgement that they would benefit from having regular access to medical advice. This has been recognised by the service's senior management who have already sought approval for the appointment of a specialist nurse. The manager promotes training and there is an expectation that all staff will

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Leadership and management

continually update their professional knowledge and skills. Although a record is kept of all courses attended, the current system does not provide an overview of the whole staff team and as such makes it difficult to identify future needs.

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Leadership and management

A comprehensive range of policies and procedures, which are subject to regular review, provide the basis for efficient working practices. The home has well established recording systems and records and documents examined were stored appropriately and found to contain recent and relevant information. Although each young person's achievements are regularly recorded in different areas, it is not currently easy to track the significant progress they have made since their admission.

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Leadership and management

The service is effectively monitored and is subject to regular internal auditing by the manager and external scrutiny by an experienced consultant and trustee. Any areas requiring attention are highlighted in reports and are addressed appropriately. The service is pro-active in seeking out the views of young people, their families and placing authorities about all aspects of the service. All concerns and complaints are taken seriously and initiate an investigative process. Recommendations arising out of complaints are responded to positively and have led to improvements in policies, procedures and working practices. Comments from parents indicate a high degree of satisfaction with the service and special mentions were made about the facilities, the activities and the helpfulness of staff.

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Leadership and management

The recommendation arising from the last inspection has been appropriately addressed and all staff are now receiving regular supervision.

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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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