Children's Home run by Bedford Borough Council in Bedford

Unique reference number SC409502 Inspection date 23/05/2013 Inspector Rosemary Dancer Type of inspection Full Provision subtype Children's home

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Date of last inspection 03/01/2013 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 home is run by a local authority and provides care and accommodation for up to five children with physical disabilities, learning disabilities and sensory impairment. Three children or young people can be accommodated under short break arrangements, 1 young person can be accommodated as a permanent placement and 1 young person can be accommodated under a shared care arrangement.

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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

Children and young people living or coming to stay in the home benefit from personalised and well-planned care. Staff know and understand each young person's needs very well and are committed to ensuring that they achieve the best outcomes possible.

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Overall effectiveness

Children and young people's views about how they are cared for are obtained and acted upon; staff work very skilfully to obtain views from children and young people who have limited communication skills. Children and young people are happy during their time in the home because they have developed good relationships with the staff working there.

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Overall effectiveness

Children and young people are safe during their time in the home and their well- being is promoted well because staff understand their needs well and are trained and competent in safeguarding them.

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Overall effectiveness

There has been some recent uncertainty about the future of the home due to changes in the local authority's boundaries. This has led to an unsettling time for staff, parents and some young people. Staff and parents feel that changes have happened with little consultation. Some young people are not able to attend this home for breaks any longer or have had to move to this home from another home; this has meant that these children and young people have had to readjust to new surroundings. The manager and her staff have ensured the minimum possible impact on the young people who have been affected by these changes.

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Overall effectiveness

While overall the manager has a good awareness of the home's strengths and areas for development some shortfalls have been identified. These relate to: improving the monitoring arrangements of the home; repairing broken drains running across the car park; formalising the procedure for transferring medication and storing homely remedies; reviewing the use of a number keypad to exit the building and notifying Ofsted of significant events. None of these have a direct impact on the safety or well-being of children and 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) ensure that all parts of the children’s home used by the children are of sound construction and kept in good structural order; with specific reference to the broken drains crossing the car park area (Regulation 31 (d)) 26/07/2013

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Reg. Requirement Due date

(2001) ensure that the person carrying out the visit under regulation 33 interview, in private, parents and relatives of the children as appears necessary in order to form an opinion of the standard of care in the home (Regulation 33 (4) (a)) 28/06/2013

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Reg. Requirement Due date

(2001) ensure the review of the quality of care is focused on improving the quality of care and provides for consultation with children accommodated in the home, their parents and placing authorities. (Regulation 34 (1) (a) and (3)) 26/07/2013

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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 safe storage and transfer of medication; with specific reference to the storage and use of homely remedies and the procedure for the transfer of medicines, for example when a child is taken into school (NMS 6.13)  ensure that physical restrictions on normal movement within or from the home are not used unless this is necessary to safeguard children and promote their welfare and development; with specific reference to reviewing the need to use the exit key pad (NMS 10.4)  ensure that within 24 hours of the occurrence of a significant event the appropriate authorities are notified. (NMS 24.1)

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Outcomes for children and young people

Children and young people make good progress in this home as a direct result of the care provided to them. Staff are very skilled at communicating with the children and young people and use a range of means to communicate with them that are suited to their level of understanding; this means that they understand what is planned for them and they make choices during their stay in the home. One social worker said that the young person he works with is, 'more animated since going to the home and parents are very happy with how the staff interact with him.'

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Outcomes for children and young people

The children and young people who stay or live in this home settle well into life in the home. An independent reviewing officer said the young person he works with, ‘is far more settled and sleeping much better as a direct result of his stays at the home.’ Children and young people enjoy good opportunities and integrate into the local community successfully. Because their likes and dislikes are established, they take part in activities that stimulate them and that they enjoy. These can be in the home, such as crafts or baking, or in the community; for example, going swimming, shopping and bowling. Sometimes they do activities that they have not had the opportunity to do before; this provides them with new experiences and helps increase their confidence and means they develop an interest in their surroundings.

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Outcomes for children and young people

It is the responsibility of most of the young people's parents to ensure their child has good attendance and achieve at school. Staff do ensure that all children have good attendance at school when they are staying at the home and that they grow to reach their full potential.

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Outcomes for children and young people

Some children and young people staying in this home have very complex health needs and these are well met by a skilled, knowledgeable and committed staff team. Staff are trained and competent in complex procedures such as gastric tube feeding if a child or young person is unable to eat in the conventional way. Staff are also astute at noticing any changes in the health of a child or young person and this means that medical professionals are consulted promptly about any health concerns and that their health is promoted.

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Outcomes for children and young people

Young people who live in the home enjoy good quality contact with people significant to them. Visitors are made to feel welcome in the home and contact is well- supported; this means that young people maintain relationships with those who are important to them. Staff work hard to ensure the compatibility of the group of children or young people staying in the home at any one time. This is at times difficult because of the arrangements for one young person to stay in the home on a full-time basis and another to stay under shared care arrangements. However, a lot of thought is given to ensuring that any impact relating to any incompatibilities is minimised. The children and young people who stay in this home have complex needs and will not live independently. However, the staff work with them and help them develop to reach their full potential in all areas of their lives. Children and young people develop

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Outcomes for children and young people

new skills that will be useful for them in their futures. For example, they help with mixing ingredients for a meal or are encouraged go shopping and choose what they want to spend their pocket money on. This provides children and young people with a good sense of achievement, helps them to gain a sense about the value of money and means their self-esteem and confidence develop well.

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Quality of care

Children and young people have developed very good relationships with the staff and enjoy their visits to the home. Parents' comments include, 'My child loves to come to the home and really looks forward to the next visit' and ‘I know she likes going she always has a big grin on her face. (Name of Home) is the tops!'

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Quality of care

Children and young people are not able to make a complaint in their own right in a formal way due to their complex needs; however, staff are attentive to them and recognise when they are unhappy about something and ensure it is addressed.

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Quality of care

The care planning for children and young people is of a good quality and ensures that their complex needs are identified and addressed. Parents are fully involved in planning for the care of their child and plans are reviewed periodically or when there is a change in needs. Children contribute to their plans and child-friendly care plans are developed for them. This means that they are cared for in line with their needs and preferences. For example, some young people have routines they like to follow at bedtime and these are kept; this is comforting for children and young people because it is familiar to them. One parent said, 'The staff are extremely caring towards my child and me I could not do without them, they are a huge part of our lives. Thank you (name of home)!' another said the best thing about the home is, 'the care and nurture my son receives. Staff genuinely care about him' and another

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Quality of care

said, 'The staff are enthusiastic, welcoming and sincerely interested in finding ways to support him during his stay. He looks forward to his respite stays.'

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Quality of care

Children and young people's preferences and dislikes are established through a range of means. Staff are very good at finding ways for children and young people with limited or no verbal communication skills to express their views. Young people are involved in making choices about various matters in the home, through monthly house meetings. During these the children and young people present are able to influence a range of things such as menus and the décor. Recently a meeting was held that looked at what music and musical instruments young people would like in the home; this was very skilfully managed and even young people with very limited communication skills where able to let their views be known.

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Quality of care

While for most children and young people it remains their parents' responsibility to ensure they attend and achieve at school, staff have good links with the local schools that some of the children attend. Staff work jointly with them to ensure that within both the home and the school environment a consistent approach is taken to meeting all their needs; for example, by taking a consistent approach to managing behaviour and to communicating with children and young people. Children and young people have the best opportunities provided to them to achieve well while living or staying in this home.

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Quality of care

The environment provided for children and young people is stimulating, comfortable and child-friendly. It has all the necessary adaptations and equipment to ensure that all children and young people who need a service can access the home. Children who live in the home on a permanent basis have individualised bedrooms which they and their families have had an input into. Those who come on short-break arrangements can choose which room they would like to stay in and these are prepared for them in line with their preferences.

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Quality of care

Overall the arrangements for the safe storage and administration of medication are sound. However, homely remedies are for use for any child or young person who needs them and the date of the opening of the bottle is not routinely recorded. Additionally, the procedure for the transfer of medicines, for example, when a child is taken into school is not robust enough. These issues mean that there is the potential for errors to be made or for cross contamination or stale medication to be given.

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Quality of care

Children and young people's diverse needs are well catered for in the home. Staff have a very good understanding about their needs in relation to their health, disability, culture, faith, gender, communication and personal identity and ensure that these are met to a high standard. For example, culturally appropriate music is played to one young person, dietary needs relating to religious beliefs are catered for and their needs relating to any disability are met to a high standard.

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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

Children and young people who live or come to stay in the home are safe. Good attention is paid to ensuring that children and young people are protected from harm and that their well-being is promoted during their stays or while living in the home. For example, children and young people's plans clearly identify any risks and protective factors; these are consistently applied. Staff have a good level of knowledge about additional risks relating to children and young people as a result of their disabilities and have had specific training in relation to safeguarding disabled children.

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Safeguarding children and young people

Children and young people do not go missing from the home. There is a door number pad to exit the building that children and young people are unable to use; no child or young person staying in the home currently are likely to be at risk of leaving the building so a review of its use has been recommended.

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Safeguarding children and young people

Positive behaviour is encouraged and staff are good at diffusing situations before they become an issue. Staff work with young people in a calm and reassuring way and this helps them to modify any disruptive behaviours. Physical restraints are not used and sanctions are rarely used because the complex needs of the children and young people who live or stay in the home mean sanctions are meaningless to them.

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Safeguarding children and young people

The home is appropriately located within a quiet residential street and is close to shops and other amenities. Overall the environment within the home is safe and secure and all routine checks to health and safety matters are undertaken; in the event of a fire all young people have an individual escape plan to ensure their safety. Outside the premises there is a hazard relating to broken drains in the car park; the manager has requested that this be addressed but has not yet received a positive response; a requirement has been made in respect to this under leadership and management.

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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 work of the home is underpinned by a comprehensive Statement of Purpose that clearly sets out, to interested parties, the aims and objectives of the home. The Registered Manager manages the home effectively and efficiently and in line with the statement, despite recent unsettling changes within the local authority. Changes made by senior managers within the local authority who have now left the authority, have had a negative impact on the morale of staff and the confidence of parents in the home's continuing viability. Numbers of children using the facility have significantly fallen and this means that staff and parents continue to be anxious about the home's future. One parent commented, 'I have concern about the home's future! I'm unclear about its viability as recently numbers of children receiving respite were withdrawn to more local provision.' However, the manager and deputy manager, in partnership with the local headteacher of a school some of the young

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Leadership and management

people attend, are promoting the home to parents it is felt may need a service; this is a positive development.

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Leadership and management

There have been no complaints since the last inspection but there have been many compliments from parents about the work the home does for their children. The home has a good capacity for improvement; this is shown by the responsiveness to inspection findings and monitoring visits. There is a development plan and an action plan to address issues arising.

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Leadership and management

In respect to statutory monitoring the monitoring arrangements are overall adequate and in respect to the independent monitoring there is a comprehensive report produced monthly. However, the person carrying out these visits does not periodically seek the views of parents about the quality of care their child receives. The manager carries out the required monitoring of records and other matters on a monthly basis. However, her six-monthly report of this monitoring is not evaluative, is not focused on improving the quality of care and does not show how it provides for consultation with children accommodated in the home, their parents and placing authorities. A professional working with one of the children felt that there were too few opportunities to discuss, plan and agree actions to be made.

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Leadership and management

While overall the physical environment at the home is well-maintained and furnished to a high standard, there are drains across the car park that have become unstable and unsafe. The manager has requested that these are fixed and this needs to happen as a matter of urgency. Staff are aware of this and ensure that children are not at risk from, for example, their wheelchair tipping over however, they remain an unnecessary hazard to anyone crossing the car park.

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Leadership and management

The arrangements for staffing are good. This is in terms of numbers of staff, the competence of staff and the stability of the team. The staff of the home are committed, enthusiastic individuals who provide a high quality of care to the children and young people they care for. One parent said, 'Staff are brilliant' and another said, 'The staff are caring, attentive and sympathetic.' Staff are well trained and supported through supervision, appraisals and team meetings and more informally by the manager and her deputy. One member of staff said, 'My managers always listen and try their best to make changes or get equipment to improve our standard of work. They are very good at supporting me to get the best out of my work. I love my job!!' another stated, 'to be able to discuss the child’s needs amongst ourselves in team meetings has really helped us to be consistent and really help the child to learn themselves how to express themselves in a better way.'

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Leadership and management

The records made and maintained in the home are of a good quality and detail all the required information. They provide a good record of a child's time in the home and detail any work carried out in relation to transitions. They are kept up to date and show that staff are fully involved in the reviews for each young person.

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Leadership and management

The numbers of notifications are low because significant events requiring notification are low; however, a very recent incident should have been reported to Ofsted with 24-hours and was not; this had no impact on the young person involved because the action taken on this occasion to ensure his safety and well-being was wholly appropriate.

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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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