Children's Home run by Isle of Wight Council in Isle of Wight

Unique reference number SC395944 Inspection date 30/04/2013 Inspector David Coulter Type of inspection Full Provision subtype Children's home

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Date of last inspection 15/01/2013 Website: www.ofsted.gov.uk

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Brief description of the service

This children's home is a purpose-built facility owned and operated by a local council. It is registered to take up to 10 young people with learning difficulties and/or physical disabilities between the ages of eight and 17 years.

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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 home has continued to develop since the last inspection. The long term unit has been relocated to another part of the building and is now fully operational. The short break unit, though smaller, still continues to be fully utilised throughout the week. These changes are all reflected in the home’s revised Statement of Purpose. The home has continued to recruit permanent staff and its reliance on agency and bank staff has continued to decrease. This period of significant change has been effectively managed by the Registered Manager who has provided consistent leadership and support to staff.

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Overall effectiveness

Although staff have had to adapt to changing circumstances within a short period of time, they have managed to provide good quality residential and short break care to a group of extremely vulnerable young people with complex care needs. Each young person receives individualised care that addresses their specific health, social and emotional needs. Staff have aspirations for the young people in their care and there is an expectation they will lead full and active lives during their placements.

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Overall effectiveness

Outcomes for young people are good and all are fully engaging in their education and are regularly participating in a diverse range of social and recreational activities. Young people respond positively to the attention they receive from staff. The progress of each young person is carefully documented and appropriately shared with parents, teachers and social workers.

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Overall effectiveness

A number of young people regularly present with challenging behaviours that require physical interventions on the part of staff to keep them safe. There is an effective recording system that ensures the antecedents of all such interventions are identified and any significant learning identified and shared among staff. The manager recognises that on-going training for staff in the management of challenging behaviour remains a priority and there are plans to ensure permanent, bank and agency staff all complete the same behavioural management training.

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Overall effectiveness

There were no actions or recommendations from the last interim inspection. Two recommendations have been identified during this inspection that need to be addressed to ensure compliance with national minimum standards. Neither of the recommendations reflects negatively on the current quality of care which 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 more structured approach to promoting independent living skills (NMS 12.1)  ensure all staff undertake the same appropriate training in physical interventions (NMS 3.15).

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Outcomes for children and young people

The home now provides three short break and five permanent placements. The long term unit is now providing safety and stability to young people with extremely complex needs. All young people are treated as individuals. Staff deploy a range of verbal and non-verbal communication techniques to ascertain the views of young people about all aspects of their care. The recent introduction of computer tablets with communication software has further increased communication options. Young people are encouraged to assert their independence within the home by exercising choice over such things as the décor in their rooms, food and participation in leisure activities.

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Outcomes for children and young people

Staff are clearly aware of the involuntary nature of many of the behaviours young people exhibit and the difficulties some experience in processing information. Young people displaying challenging behaviour are normally managed by the deployment of diversionary techniques that include accessing a specially designed safe room. Physical interventions are only ever used if is felt a young person is putting themselves or others at risk. High staff ratios ensure they do not engage in bullying behaviour or unintentionally strike each other.

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Outcomes for children and young people

Many of the young people who access the home have complex health needs as a consequence of their disabilities. Key information on each individual's medical condition and its effect on behaviour is provided for staff. The effects of medication are also made clear. The home's nursing staff ensure that all medical interventions are carried out by staff who have completed additional training and demonstrated their competence. Specialist help is sought to address specific areas of concern such as mental health. Arrangements for the dispensing of medication are robust. All personal care tasks are carried out sensitively. The home is wheelchair friendly and young people with mobility difficulties can access all areas. A range of specialist equipment allows staff to move and handle young people safely. Young people are encouraged to remain physically active and can access a range of specialist play equipment both in the home and garden.

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Outcomes for children and young people

Each young person's culinary preferences and nutritional needs are established prior to their admission. Although young people undertaking short stays are encouraged to try new foods, staff are realistic about what can be achieved and ensure each individual receives appropriate nutrition. The home's cook obtains the menu plans from each young person's school in order to avoid young people being served the same meal on the same day. Staff and young people eat together and this provides many opportunities for spontaneous social interaction.

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Outcomes for children and young people

Staff are aspirational for the young people in their care; they are continually looking at different and imaginative ways of helping young people reach their potential. Young people are provided with a range of new social activities within the home and local community to extend their social horizons. The recent deployment of agency staff, many of whom come from overseas, has provided opportunities for young people to increase their understanding of different cultures. Staff reinforce success with praise and encouragement. Although young people have made significant progress in many aspects of their lives since their admission, the acquisition of independent life skills is currently ad-hoc. All young people are involved in education and attendance at school is good. Staff maintain good relationships with education placements and regularly exchange information regarding behaviour management and communication in order to establish a consistency in approach.

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Outcomes for children and young people

Young people are, when appropriate, helped to maintain contact with their families. Family members are encouraged to visit young people in the long term unit. Many young people undertaking short break visits are dropped off or picked up by their parents. Staff closely monitor young people both before and after contact and pass on any concerns.

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Quality of care

All new referrals to the home are carefully assessed by a placements panel. The religious, social and cultural needs of each young person are identified as part of the admissions process. Consideration is always given to the composition of the groups in both the short break and long term units. Placement plans indicate the needs of young people are clearly identified and staff produce guidance on how they can be met. Young people, their parents, teachers and social workers all contribute to the development of placement plans that are reviewed on a regular basis. Young people’s reviews have all taken place within agreed timescales. On admission all young people and their parents/guardians are made aware of how to raise concerns and make a complaint. All concerns and complaints are taken seriously and immediately investigated in line with the home’s policy.

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Quality of care

By regularly working a one-to-one basis with young people staff become conversant with their needs and can act as effective advocates on their behalf. Staff confront discrimination if it arises and are effective advocates of young people with disabilities. Young people were observed to be treated by staff with respect and dignity. It is clear the young people enjoy and respond positively to the care and attention they receive from staff and social interaction was observed to be spontaneous and warm. Staff spoken with were conversant with the care needs of all the young people in their care and could illustrate areas of significant progress.

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Quality of care

Due to their disabilities, many young people do not spontaneously engage with others; however, they are generally tolerant of each other and peacefully co-exist. Staff closely supervise young people in group situations to prevent any form of bullying. Staff use praise and encouragement to reinforce positive behaviour and de- escalate challenging situations. Staff closely monitor the behaviours and moods of each young person and identify antecedents and possible triggers surrounding significant incidents. All significant incidents are appropriately recorded and reported.

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Quality of care

The home is structurally sound and in generally good decorative order. It is subject to regular maintenance and refurbishment. Young people are provided with their own well-appointed bedrooms that are designated as their own 'personal space’. Communal areas are bright and welcoming. Being centrally located young people are within close proximity to shops, leisure facilities and parks. Staff encourage young people to develop their own interests and hobbies. Activities in the local community are well planned, appropriately staffed and organised around the needs of each young person.

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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

Although safety underpins all working practices, staff are not risk averse and young people are encouraged to learn and develop skills through participation in activities both within the home and local community. Staff are clearly aware of their vulnerabilities and their limited ability to assess risk. An effective assessment process identifies the particular vulnerabilities and risks associated with each young person’s behaviour and level of understanding. Due to their complex needs, young people are always supervised. Staffing levels ensure young people are not at risk when out and about in the community. No young people have ever been reported missing, however, staff are all made aware of the procedures to follow if such an eventuality should occur.

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Safeguarding children and young people

Young people are cared for by a group of dedicated staff who have completed a rigorous recruitment and selection process to determine their fitness to work with vulnerable young people. The home’s reliance on agency staff has continued to decrease as new permanent staff have been appointed. Most of the agency staff currently deployed have been working in the home for some time and are familiar with its policies, procedures and working practices. Many have established good relationships with the young people accessing the home and are conversant with their care needs. All new staff have to complete a detailed induction programme and demonstrate their competence before assuming their full responsibilities. Staff are aware of their individual responsibilities in regard to the reporting of any safeguarding worries or concerns.

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Safeguarding children and young people

Detailed behaviour management plans have been developed in respect of each young person. Physical interventions are only ever used if it is felt a young person is putting themselves or others at risk. A number of young people present with extremely challenging behaviour and staff have had to develop strategies, such as escorting them to the soft play area, to ensure they do not sustain serious injuries. All physical interventions are recorded. Although agency and bank staff have received training in the use of physical interventions, it has not always been the same. Behaviour management training has not been the same for all staff. Such a situation could lead to misunderstanding and possible inconsistency in approach.

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Safeguarding children and young people

The home is a safe environment that is free of any unnecessary hazards. Experienced staff carry out regular health and safety checks within the home and garden. Access to the home is limited and all visitors have to report to staff and sign in. The fire alarm system is tested weekly and regular fire evacuations ensure staff and young people remain conversant with procedures.

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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 Registered Manager has successfully managed the home through a particularly challenging period during which a new full-time unit has been created. Throughout this period of transition she has ensured that staff have remained 'child focused' and concentrated on meeting the complex needs of the extremely vulnerable young people in their care. She has been well supported by a dedicated staff team who are aware of their personal roles and responsibilities. The manager regularly reviews the progress of the residents and the performance of staff. The operation of the home is monitored on a monthly basis by an independent reviewing officer and regular visits by the service manager.

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Leadership and management

Staff spoken with talked in positive terms about recent developments and felt they were able to contribute to future planning. The management team are clearly aware of the home’s strengths and areas in need of development. Good lines of communication have been established between staff operating on different shifts and regular staff meetings aid consistency in the delivery of care. Regular supervision provides opportunities for staff to examine their practice and aid their professional development. Staff keep abreast of developments within the child care field and regularly access training opportunities. There is a culture of training and professional development within the staff team. Recent training has included: food hygiene, health and safety, makaton, autism awareness and safeguarding. There is a member of staff responsible for training and professional development. A record is kept on staff files of all courses attended.

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Leadership and management

The home operates an extremely effective placement planning process that ensures each young person's specific physical, social and emotional needs are clearly identified and clear guidance produced for staff on how they should be met. Individual plans are regularly reviewed. Staff have created a safe and nurturing environment that is greatly assisting young people grow and develop. Young people respond positively to the home’s approach and this is reflected in a reduction in incidents of challenging behaviours. Each young person’s progress is reflected in their looked after children reviews.

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Leadership and management

The home has embarked on a development programme that demonstrates a clear commitment to continuing improvement. The home is appropriately resourced and evidence indicates it operates in the best interests of young people with complex needs. Records and documents contain recent and relevant information and are stored in appropriately locked facilities.

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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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