Children's Home run by Praxis Care in Leicestershire

Unique reference number SC032069 Inspection date 09/05/2013 Inspector Catherine Honey Type of inspection Full Provision subtype Children's home

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Date of last inspection 07/01/2013 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 provider organisation is a registered charity. This home provides respite care for young people with learning and physical difficulties, and often complex health care needs, accommodating a maximum of four at any one time.

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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

This short breaks service provides an adequate quality of care with individual plans for young people, based on their needs. The short breaks are planned with young people's friendships and compatibility in mind. Young people enjoy coming to the home and have good relationships with staff and with each other.

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Overall effectiveness

Young people are supported to share their views and make choices in their care and the running of the home. They make good progress in achieving positive outcomes and are enabled to increase their independence and take part in opportunities that would not usually be available for them. Staff work in partnership with parents to ensure outcomes are progressed in the family home as well as on their short break. Parents, carers and social workers extend praise to the service's flexible and individualised approach in supporting families and young people.

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Overall effectiveness

Young people indicate they feel safe at the home and parent and carers also confirm this. The manager evaluates the home's capacity to develop and is considering how the service can improve through the setting of realistic and challenging targets.

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Overall effectiveness

Three requirements and four recommendations have been made as a result of this inspection. These relate to supplying Ofsted with a copy of reviews of quality of care, shortfalls in the home’s Statement of Purpose, personal evacuation plans and staff access to reports on the conduct of the home. In addition, shortfalls were identified in signed permission being in place for physical restrictions on young people’s movement, appropriate deployment of staff and verification of references. These shortfalls have not impacted negatively on the welfare or safety of 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) supply to the HMCI a report in respect of any review conducted by him in relation to the review of quality of care (Regulation 34 (2)) 10/06/2013

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Reg. Requirement Due date

(2001) compile in relation to the children’s home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of a statement as to the matters listed in Schedule 1. This is in relation to point 14 (Regulation 4 (1)) 10/06/2013

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Reg. Requirement Due date

(2001) ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home. This is in relation to personal emergency evacuation plans. (Regulation 32 (1A) (b)) 10/06/2013

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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 the written report of a visit carried out under Regulation 33 visit is lodged in the home for the manager and staff to read and to respond (NMS 21.8)  ensure where physical restrictions on normal movement within the home are used to promote young people's welfare and development, such measures are only used where agreed with the responsible authority and, if appropriate, the parents (NMS 10.4)  ensure the overall number, competence and deployment of staff and number and deployment of staff, both as a staff group and on individual shifts, can fulfil the home’s Statement of Purpose and meet the individual needs of all children resident in the home (NMS 17.1)  ensure all people working in or for the children’s home have references checked to assess suitability before taking on responsibilities. Telephone enquiries are made as well as obtaining written references. (NMS 16.1)

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Outcomes for children and young people

Young people make good progress in achieving positive outcomes. The home has had a significant impact in supporting this progress. A parent said, ‘They understand my child really well, they know him, they know what he likes and dislikes and this helps bring him on.' Staff work closely with families, providing an outreach service to support young people and parents in the family home. Parents and carers receive support and guidance on all aspects of their child’s development including healthcare and the development of skills. This means the progress young people make on short breaks is continued in the family home.

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Outcomes for children and young people

Young people are encouraged to have a healthy lifestyle during their short breaks. Outdoor activities and being active is encouraged in order to promote healthy living. Young people enjoy healthy, home cooked meals when they stay at the home. Menus provide a balanced diet and take into account children's dietary needs and their personal preferences. Where young people have individual goals such as engaging in healthy eating, staff support them in making progress by offering healthy alternatives. Young people enjoy good health as a result of the strategies used by staff.

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Outcomes for children and young people

Young people benefit from access to a range of activities that provide new and challenging experiences. These activities are individualised in relation to a young person’s likes and dislikes. For example, they take part in train rides, swimming, art and craft activities, cinema and bowling trips. There are plans in place to replicate a summer holiday from last year where young people were able to experience camping for the first time. In addition, staff work consistently with young people to continuously promote their independence. Young people are offered choice, are encouraged to attempt tasks for themselves and are enabled to be as independent as they can be during their stays. Consequently, young people develop new skills and grow in confidence. This aids older young people’s transition to adult services.

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Outcomes for children and young people

Young people are achieving good outcomes in their education and this is complemented by the provision of learning activities while on their short break. For example, when a young person learnt how to make scrambled eggs, other learning activities such as counting and learning about animals were incorporated in to the task. As a result, young people achieve their potential and learn skills appropriate to their age and understanding.

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Quality of care

Staff know young people very well and value them as individuals. A social worker commented, 'Staff see young people as children first. They acknowledge who they are, who they are as individuals. They are not seen as disabled young people above all else. They help them to achieve and see the potential in all of them.' Young people enjoy warm and positive relationships with staff and receive care and individual support in line with their needs. Young people receive a warm welcome on arriving at the home from school, quickly make themselves at home and are clearly relaxed and enjoy being in each other's company. Personal care needs are met in a discreet way. Young people's bedrooms are prepared in line with their likes and dislikes and young people are able to personalise their rooms during their stay with personal mementoes and photos.

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Quality of care

Young people receive planned care that meets their individual needs as well as their likes and dislikes. They are able to participate in making choices about routines, activities and life in the home using various formats and communication methods. A social worker stated, 'They try and get the child’s view with everything. They know the needs of the children very well.' As a result, young people benefit from access to a range of activities and events they would not otherwise have the opportunity to experience. Staff have a sound knowledge of a variety of communication methods and are able to respond to the individual communication needs of young people. A children's nurse stated, 'Communication with the young people is really good. Age appropriate language is used. They don’t baby the children. They treat them fairly and age appropriately. Always integrating them in to a discussion. They are never spoken about or over.' As a result, young people benefit from positive interaction and

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Quality of care

engagement with staff. Young people are supported to make and sustain friendships.

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Quality of care

The views of parents are sought through regular review of care meetings with staff. There is a complaints policy available for staff, parents and carers and young people. This has been used on a number of occasions since the last inspection. The manager and staff follow the appropriate protocol in relation to complaints received and involve external parties such as social workers as soon as concerns are raised. Following concerns regarding poor practice in relation to a missed overnight feed, changes have been made to handover documents to ensure incidents are less likely to happen, consequently practice has been improved.

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Quality of care

Staff have good relationships with a range of healthcare professionals such as the young people's nursing service and work closely with parents who primarily retain responsibility for their child's healthcare. This promotes the physical, emotional and psychological health of the young people. Individual health and dietary needs are effectively communicated and met. The majority of young people have complex health needs and require regular administration of medication to support their well- being. Staff are trained in first aid and the safe handling and administration of medication. Staff employ an additional safeguard by cross-referencing prescription information with parents to make sure medication is safely administered. This means the arrangements for dealing with medication are safe and effective. There is good partnership working with the majority of other professionals such as schools, although some identify that partnership working towards joint goals for young people

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Quality of care

and communication could be better. The Registered Manager has already identified this as an area for improvement.

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Safeguarding children and young people

The service is adequate at keeping children and young people safe and feeling safe. Positive behaviour is encouraged by giving lots of praise and frequent expressions of approval. These strategies are supported by strong, positive relationships between young people and staff. A parent said, 'One of the biggest benefits of his stays are the opportunities for socialisation.' Staff are trained in managing challenging behaviour and methods of intervention. Young people display very positive behaviour during their stays at the home. As a result, physical intervention has not been used for a significant length of time.

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Safeguarding children and young people

Young people indicate that they feel safe in the home and parents and carers are confident with the home’s ability to keep young people safe during their stays. Staff demonstrate good safeguarding knowledge and awareness of whistleblowing procedures. There have been no incidents of young people going missing from the home. A specialist sleeping system is used for some young people, which means they are contained in a space for their own safety during the night time. Staff are very clear on the reasons why the sleep system is used and on the safeguarding measures in place to keep young people safe. As a result, vulnerable young people are kept safe during the night-time, however permission for use from the placing authority and parents are not in place.

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Safeguarding children and young people

Young people are protected, from unsuitable people gaining employment, by a robust recruitment process. However, references are not verbally verified before new staff start work. The Registered Manager took immediate action regarding this during the inspection. Visitors to the home are asked to sign in and identification is checked. This further ensures young people are protected from harm.

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Safeguarding children and young people

The environment is physically safe, appropriately secure, checked regularly and is well maintained. Risk assessments are carried out in relation to the premises, grounds and activities. Regular fire, maintenance and equipment checks further promote young people's safety. Arrangements for fire safety are good. A fire officer regularly visits the premises and during the inspection conducted a tour with the Registered Manger to identify any updates needed in relation to the fire risk assessment as a result of building work taking place. Fire drills are regular with each young person have the opportunity to be part of an evacuation process. This means young people's individual evacuation needs have been considered. Staff state fire safety arrangements are confirmed at every shift handover although this is not always written down. In addition, specific details regarding young people's individual evacuation procedures are not written down.

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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 Registered Manager is eager for the home to progress. He has considered areas for the service’s development and improvement, has lot of ideas and is putting them in to practice using a development plan. The plan sets out realistic goals for the service to achieve in the next 6 months and 12 months to improve the quality of care the home provides. Recently there have been significant changes to the paperwork used within the home in relation to young people's care plans, residential plans and risk assessments. These changes have been implemented to try and provide even more individualised care and to aid staff by having important information in one place. This demonstrates how the home continues to progress and move forward. The Registered Manager recognises the new system needs further consolidation to provide thorough and useful care planning information. A shortfall was found in the home's Statement of Purpose in the description of recreational, sporting and cultural

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Leadership and management

The requirement and recommendation made at the interim inspection have been met. The majority of staff have undertaken physical intervention training with the two outstanding members of staff due to have their training in June 2013. Requirements made at a monitoring visit in March 2013 have also been met. Notifications of serious events are now being received by Ofsted within appropriate timescales and the staff rota is now kept up to date with details of actual hours worked. The manager has improved the monitoring form used for monitoring the quality of care in the home and has identified monitoring of quality of care as an area for further development. For example, it is difficult to gain a good overview of the progress young people are making as information in relation to young people's aims, achievements, progress and development is not regularly recorded. Although monitoring reports have been more regularly completed, they have not been sent in

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Leadership and management

to Ofsted in the required timescale. In addition, reports conducted on a monthly basis by a senior manager on the conduct of the home are not available for staff members to read or comment on.

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Leadership and management

The home is undergoing significant remodelling with a new extension being built. There has been no negative effect on the care the home provides as a result of the building work apart from the loss of an activity room. Staff are compensating for this by using the dining room area for activities instead. Arrangements for safe working are rigorously implemented and are backed up by appropriate risk assessments. Site activity is kept to a minimum during times when young people are using the home. Young people enjoy watching the changes that are taking place and were particularly excited to see a big digger on site.

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Leadership and management

Staff and placing social workers are clear about the provision's aims, services and facilities it provides. Newly employed staff speak positively of the induction they are receiving. Shifts are prepared and planned for by team leaders who lead a handover every day. New staff members take part in a shift in a shadowing role and are gradually integrated on to the rota as a member of staff as their confidence grows. Young people are cared for by competent and resourceful staff who are committed to meeting young people's individual needs and enabling them to progress. Staff are sufficient in number, appropriately trained and effectively supervised and supported. However, on one occasion, a new member of staff was used in place of an experienced member of staff. This did not affect the safety of the young people being cared for but lead to a less individualised approach to care.

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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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