Children's Home run by Action for Children in Hertfordshire

Unique reference number SC426172 Inspection date 25/01/2013 Inspector Deirdra Keating Type of inspection Full Provision subtype Children's home

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Date of last inspection 12/07/2012 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

The service is managed by a large charitable organisation. It provides short breaks for up to six children with learning difficulties and/or 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

Young people attend the service where their individual needs are planned for and met well. Parents state that young people using the service anticipate their stays eagerly and are happy to attend. Young people settle easily because they have strong relationships with key staff. Staff are welcoming and responsive to young people's needs. Although, at times staff shortages can affect the allocation of days offered and occasionally influence the quality of the care provided.

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Overall effectiveness

Young people are kept safe by staff who follow guidance in care plans and risk assessments to ensure each young person’s safety is prioritised. In contradiction to this there are two areas of the environment that do not adequately promote young people's health and safety. Other areas identified for improvement include staff training, external and internal monitoring and the recording of controlled medication. There has also been one occasion when Ofsted were not notified about a significant event. These areas are all related to management and effective monitoring procedures and do not impact currently on the good quality of care provided.

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Overall effectiveness

The manager is fully aware of the issues raised and action was taken to rectify some of these during the inspection with immediate effect. Overall, while there are a number of requirements raised young people benefit from the good outcomes the service provides and enjoy their short break stays.

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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) notify HMCI without delay any of the events listed in column 1 of the table in schedule 5 (Regulation 30 (1)) 08/02/2013

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Reg. Requirement Due date

(2001) establish a system for monitoring the matters set out in Schedule 6 and improving the quality of care provided in the children's home and ensure that the system provides for consultation with children, their parents and placing authorities (Regulation 34 (a) (b) ) 08/02/2013

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Reg. Requirement Due date

(2001) ensure that following visits to the home in accordance with regulation 33 a copy of the report is provided to HMCI and the registered manager or other persons responsible for the management of the organisation (Regulation 33 (1) (5) (a) (b) (c)) 08/03/2013

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Reg. Requirement Due date

(2001) ensure that all parts of the home used by children are kept clean and reasonably maintained (Regulation 31 (2) (e)) 08/02/2013

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Reg. Requirement Due date

(2001) ensure that there are suitable arrangements for the recording and safe administration of any medicines received into the home. (Regulation 21 (1)) 08/02/2013

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Reg. Requirement Due date

(2001) ensure all parts of the home to which children have access are so far as reasonably practicable free from hazards to their health or safety. (Regulation 23 (a)) 08/02/2013

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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 that all existing care staff attain a minimum level 3 qualification or be working towards the diploma within six months confirmation of employment (NMS 18.5)  ensure that the manager regularly monitors, in line with regulations all records kept by the home to ensure compliance with the home's policies (NMS 21.2)  ensure the overall number of staff on individual shifts can fulfil the home's Statement of Purpose and meet the needs of all children resident in the home. (NMS 17.1)

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Outcomes for children and young people

Outcomes for children and young people are good . Young people attend the home for short periods depending on days allocated by the service. Parents reported that young people look forward to attending the service and settle well. Young people observed on their arrival at the home appeared happy and animated to see staff. They confidently used the whole building, putting away their belongings into bedrooms and within the safety of the home they operated independently.

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Outcomes for children and young people

Parents and families gave good feedback about how young people are occupied during their stays, they felt reassured in the knowledge that staff listen to any concerns and positively address any issues raised. Staff work effectively in partnership with families, schools, and professionals. This helps address any concerns in a timely manner and promotes good continuity of care.

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Outcomes for children and young people

Young people benefit from an established staff team who they have been able to get to know over time. While staff shortages can cause some difficultly during busy periods, staff focus on ensuring that young people enjoy their stays. They provide activities, outings and experiences that support young people's interests and individual preferences. This challenges some of the barriers, which may affect children with disabilities. This provides young people with equality of opportunity and ensures that time spent at the service is stimulating and enjoyable.

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Quality of care

Staff have built a good rapport with young people using the service and are caring and responsive their changing needs. Staff know young people well and implement their individual routines. This helps young people feel secure. Staff work with young people to overcome the barriers that they face, they encourage young people using the service to spend time with one another. This encourages interaction between young people and develops their social skills.

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Quality of care

Parents' feedback about the quality of care is generally good. Parents report that young people settle quickly into practised routines at the service. Another parent said staff are well organised, listen carefully to handovers and keep parents informed throughout the stay. Some parents are unhappy about allocation of days offered reporting that these are sometimes too few and on days that do not best meet young people's needs.

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Quality of care

The environment is equipped well to ensure young people are offered choices about how to spend their time. There are soft play areas available where young people can benefit from physical indoor play and sensory and craft activities are provided. Resources are stored and labelled well to promote young people's independence and choice.

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Quality of care

The building is purpose built and designed with the facilities that meet young people's needs. These include a sensory light room and a lounge area where young people can relax and watch television. All bedrooms are single and personalised with belongings as young people arrive. Bedrooms overlook the rear garden and outdoor play equipment, however, the maintenance of the garden is poor. The building is kept clean and maintained with the exception of the kitchen and garden. Cleaning checks for the kitchen are inconsistent resulting in areas that are not clean. Perishable food is not systematically labelled when opened and the storage arrangements for dry foods are poor.

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Quality of care

Staff try to gain young people's views as best they can using a range of alternative communication methods. These include pictorial time lines, photographs and symbols that enable young people to make their feelings known. Staff involve young people fully in the interviews for potential new staff. Following each visit to the service, staff review young people's views of the visit.

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Quality of care

The service has developed care plans, guiding the care of young people and providing a history of previous breaks. The plans provide insight into young people's cultural and religious backgrounds. Young people's individual health needs are complex and met by staff trained by health professionals in a range of procedures. Staff provide young people with the level of medical care required and administer medication daily. However, the record of administration for controlled medication does not meet guidelines issues by the Royal Pharmaceutical Society.

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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 who use this service have limited means of communication. However, feedback from parents is that all young people are happy to visit the service and this demonstrates they feel safe. Staff have good knowledge of individual safeguards for each young person and their routines which ensures they feel familiar and comfortable.

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Safeguarding children and young people

Placement plans detail all risks associated with individuals and these are regularly assessed. Assessments are clear and instructive and detail specific risks particular to individual young people. Staff support and ratios are adequate in keeping young people safe. The building is secure and visitors are carefully checked and chaperoned.

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Safeguarding children and young people

Staff are proactive in ensuring that missing from home procedures are robust. Details recorded at the start of each visit describe young people's appearance. This ensures that in the event of any young person going missing appropriate action is planned in accordance with the vulnerabilities of the young person.

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Safeguarding children and young people

Staff understand the safeguarding procedures and are trained in providing personal care and protecting children. There have been no child protection investigations, although there has been investigations conducted by the manager with the involvement of the local authority designated officer (LADO). This shows transparency and clarity of procedures in accordance with the home's policies. Young people are protected from fire by regular drills. This ensures a quick and timely response is taken in the event of an emergency. The interior of the home is generally safe, although, there are some procedures that are not effective such as the correct labelling and storage of food. The interior of the house is safely maintained, however, the garden is unkempt and there are some broken toys and equipment. Overall, risk assessments and daily monitoring of the environment are weak and this could potentially compromise young people's health and safety.

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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 service has a permanent Registered Manager who has a clear knowledge of the service. Supervision and support of staff throughout the service is adequate. Developmental plans define areas for improvement that relate directly to outcomes for young people. Requirements raised previously have been addressed demonstrating the home has the capacity to maintain the quality of care.

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Leadership and management

The Statement of Purpose reflects recent management and staffing changes. However, there are staff shortages and while a recruitment drive is underway there is an impact on the young people using the service. For example, as young people arrive the staff on duty are stretched to meet their needs for the first half hour. Feedback from parents and scrutiny of the records indicate the service has closed on occasions due to staff shortages. This does not meet the needs of young people using the service or reflect the aims in the Statement of Purpose.

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Leadership and management

Monitoring is weak, while external visits are regular and raise improvement points, reports following these visits are not seen by the manager nor are they submitted to Ofsted within appropriate timescales. In addition the manager's monthly monitoring does not provide a review of the quality of care and is not rigorous. This means an opportunity to provide an extra safeguard for young people and ensure standards are maintained is lost.

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Leadership and management

Training is key at this service, as staff care for young people with varying and complex needs. A range of training is provided and good links with the community nurse mean that staff are supported to learn procedures with health professionals. This means that staff can meet a wide range of health needs. However, while there are some qualified staff, there are also staff who have no Level 3 training as required. This could influence the quality of care provided to young people.

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Leadership and management

Records are reviewed regularly and stored securely. These provide a valuable overview of how to care for young people using the service and are crucial to ensuring individualised care. Records also provide an overview of events at the home, of which there are few. The manager has on one occasion failed to notify Ofsted about a significant event in the home. However, the following investigation of the event was managed well. The investigation demonstrated good communication with other professionals and full transparency. Therefore, in this instance young people's safety was not compromised.

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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 and the evaluation schedule for children's homes.

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