Children's Home run by Barnardo’s in Oxfordshire

Unique reference number SC069128 Inspection date 17/04/2013 Inspector Clare Davies Type of inspection Full Provision subtype Children's home

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Date of last inspection 09/01/2013 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 caters for a maximum of seven children and young people at any one time, including one emergency bed. It provides a residential short break service and a domiciliary care service that is inspected by the Care Quality Commission (CQC).

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Brief description of the service

The service is provided by a national charity in partnership with a local authority and a primary care trust. Children and young people can therefore be provided with care and health packages. Most of the children and young people using the service have complex health needs, or are on the autistic spectrum and have associated challenging behaviour.

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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

This short break service is well resourced for children and young people with disabilities where nursing care is available. The care delivered by all staff is exceptionally child-centred, involving parents and professionals with an agreed care plan. Children and young people have access to sensory and stimulating play in a homely environment. They benefit from good levels of support from a dedicated staff team who enjoy their work. Children and young people are happy at this short break provision and their well-being is safeguarded as the staff team carefully match those children who use the service.

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Overall effectiveness

Good knowledge and understanding of individual needs by the staff team enhance the children and young people's stay by delivering consistent care. This helps reduce any anxiety and promotes a safe environment to have some fun. Personalised communication systems ensure that children and young people are consulted and that they can contribute to the planning of their short break.

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Overall effectiveness

Staff receive good support from the management team and the organisation provides a comprehensive training programme. Parents report high levels of satisfaction with this service, along with senior managers in health and social care. Some aspects of recording on incidents involving physical intervention require improvement and the Statement of Purpose is out of date. These issues do not directly impact on the quality of care provided to children and young people. Monitoring of the service by the manager has failed to identify and address these minor shortfalls.

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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 that the registered person keeps under review and, where appropriate, revise the statement of purpose and the children's guide (Regulation 5(a)) 31/05/2013

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children's home, a written record is made in a volume kept for the purpose of which shall include (a) to (i). (Regulation 17B(3)) 31/05/2013

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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 there are clear and effective procedures for monitoring and controlling the activities in the home. In particular, a system to ensure all care plans are regularly updated. (NMS 21.1)

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Outcomes for children and young people

Children and young people have a planned transition into this service that assists them in becoming familiar with the staff and the environment before their first overnight stay. Parents and carers are fully involved with the introduction and provide key information about their child's needs and routines. This ensures that children and young people are cared for according to their parents' wishes and that they receive continuity of care.

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Outcomes for children and young people

Children and young people receive support to lead a healthy and active lifestyle. Individual preferences and dietary requirements are catered for and incorporated, where possible, into the daily menu. Mealtimes are planned as a family occasion at the table with staff, where social skills and independence are promoted. Choice and experimentation of new food is encouraged to extend the limited diet of some children and young people. There are opportunities to be independent in making drinks and snacks and, with staff assistance, baking as an activity.

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Outcomes for children and young people

Children and young people are cared for by competent staff, trained to administer medication and medical procedures. Parents and medical professionals provide agreed protocols ensuring that children and young people receive the appropriate medical care. Personal care is delivered by trained staff who respect the privacy and dignity of children and young people and support them in understanding, and coping with, the changes to their body associated with puberty.

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Outcomes for children and young people

Children and young people participate in a wide range of activities at this service and in the community. Available transport ensures easy access for trips and outings to local facilities. The children and young people enjoy the secure outdoor space at this service. There is a range of play equipment and raised vegetables plots to further promote the use of the garden.

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Outcomes for children and young people

Staff are skilled at using different communication methods to connect with the children and young people. This enables children and young people to feel safe and confident during their stay away from home. Educational needs are fully supported and promoted through play and activity. Children and young people enjoy access to a computer, music, DVDs, toys, games and a jacuzzi. There is soft play room available and sensory stimulation throughout the home with lighting, music and play materials. Children and young people enjoy these purposeful activities and many develop skills in becoming more sociable with others.

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Quality of care

The staff team clearly know the children and young people well and consequently consider individual needs when planning short-break allocation, staffing levels and preferences for activities and meals. Consultation occurs daily with children and young people and more formally through review meetings. Parents are advised of the formal complaints procedure and the child-friendly version is currently being reviewed and improved. This service has not received any complaints since the last inspection.

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Quality of care

Positive relationships are formed between the staff and the children and young people. Observations of interactions highlight the warmth and humour involved, enabling children and young people to feel relaxed and secure. Parents say, 'I am really pleased with the service, nothing is ever too much trouble.' 'The staff are very enthusiastic and the children pick up on this.' 'My child is pleased to go, therefore I know she is happy there.'

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Quality of care

There are sound systems for the management of medication. Qualified nurses within the team have completed a recognised additional teaching and assessment qualification. With these skills the nurses deliver the training regarding administration of medication and invasive care procedures to the staff team. The nurses assess the competence of each staff member, this ensures that medication is administered safely and according to the instructions from medical practitioners. There is a clear audit trail of medication coming into and out of the service. Some children and young people have complex health care needs that are managed very well by the staff. This supports parents and carers in the knowledge that their child is being cared for by competent, medically trained staff.

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Quality of care

Individual care needs are identified within placement plans and this includes needs relating to cultural background and personal identity. Parents are involved, consenting to the placement plan and to the care outcomes that are identified. Examples of outcomes may be as follows; to improve communication skills therefore staff are to provide the young person with regular opportunities to express choices or, an outcome to socialise with others to be achieved through taking part in a group activity. The care provided is child-centred and personalised. The majority of care plans/profiles have been reviewed and updated, a small number require updating to ensure they reflect the care delivered.

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Quality of care

This service is located in a bungalow and therefore enabling easy access to children and young people with limited mobility and wheelchair users. Some rooms have overhead tracking installed to assist in delivering personal care. Waking night staff are available throughout the night with the support of staff sleeping on the premises if required to assist.

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Quality of care

Parents report very high levels of satisfaction with this service and have no suggestions as to what could improve the service. A senior manager within the local authority reports, 'Their care is exceptionally child centred. They make every effort to understand the different children's needs, engaging other professionals and parents in planning how to respond.' A manager form the health service states, 'this service ensures that there are good outcomes for children and young people in addition to providing relief care for parents.'

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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

Safeguarding policies and procedures are comprehensive and up to date with reference to current guidance. There has been consultation with the Local Safeguarding Children Board to ensure that the training and policies incorporate local guidance. The commitment given to the importance of staff training is evident through a recent two day event the majority of the staff attended. Consequently, staff are trained and alert to the vulnerabilities of children and young people.

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Safeguarding children and young people

Parents report that they feel their children are safe throughout their short-break stay. This is underpinned, not only by the staff knowledge in child protection but through the physically safe environment. The building is secure without restricting children and young people's liberty and good levels of staff supervision contribute to their safety. There are clear procedures to follow should a child or young person go missing.

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Safeguarding children and young people

Behaviour support plans assist staff in providing a consistent response to behaviour with the emphasis on distraction. Staff are trained in the safe handling of challenging behaviour and any physical intervention is recorded. The two current recording systems for physical intervention are confusing as they do not capture the same information. This shortfall does not directly impact on the care given to children and young people but makes it difficult to monitor incidents to identify trends and patterns of behaviour.

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Safeguarding children and young people

Staff are creative and persistent in finding a way to support children and young people who may be distressed. Risk assessments are devised for individual children and young people; this supports the staff in their consistent approach. Senior managers in the health service and the local authority praise this service for their robust risk assessments and the achievement of safe outcomes for children.

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Safeguarding children and young people

There are sound generic risk assessments to cover aspects of the building, the garden, transport, activities and outings. Fire safety procedures are known by staff and reinforced through training sessions. There are regular checks of the fire detection system, door closures and appliances. These are further checked by a contractor to ensure safety is paramount.

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Safeguarding children and young people

This organisation adopts a robust procedure to employ new staff following safer recruitment practices. Stringent checks are equally applied to volunteers. Visitors are required to show some identification and sign the visitors' book. These systems help to protect children and young people as they ensure that unauthorised individuals are not able to gain access to 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

Since the last inspection the manager has addressed the one requirement and one of the two recommendations that were made, the second recommendation has been partially met. Monitoring reports and reviews of the service are supplied to Ofsted and all new staff undertake an induction programme incorporating relevant standards. In addition to the monitoring completed by the manager, external managers within the organisation complete visits and report in line with Regulation 33 of the Children's Homes Regulations. The majority of care plans have been reviewed and updated, a small minority require amendment to reflect the care practices delivered.

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Leadership and management

Consultation with children, young people and their parents contribute to the development of the service. This service is committed to a multi-agency approach for the benefit of the children and young people. A strength of this service is working in partnership with health professionals, school staff, social workers and families. The success of this approach ensures that the focus remains on the child or young person and ensures their needs are met in the most suitable way.

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Leadership and management

Sound policies and procedures provide clarity and guidance to the staff team. Staff receive regular supervision and good training opportunities. Some staff take responsibility for areas, such as coordinating and leading the shift, equality and diversity, and health and safety. Regular staff meetings provide a forum for sharing best practice and keeping abreast of new policy and guidance at a local level, within the organisation and nationally from government departments. Professional development is encouraged for all staff. Nursing staff receive clinical supervision and have access to training to maintain their professional registration.

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Leadership and management

The staff team are enthusiastic about their work and in supporting children and young people to have an enjoyable stay with purposeful activities, to enable them to reach their potential. The service is sufficiently resourced with good staffing ratios, access to varied activities and outings, and a pleasant homely environment.

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Leadership and management

The Statement of Purpose clearly outlines the aims and objectives of the short-break service. However, it requires updating to reflect the current service.

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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 the inspection of children's homes.

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