Children's Home run by Lifeworks Charity Limited in Devon

Unique reference number SC003792 Inspection date 22/05/2013 Inspector Norma Welsby Type of inspection Full Provision subtype Children's home

p.1

Date of last inspection 06/02/2013 Website: www.ofsted.gov.uk

p.1

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.

p.2

Brief description of the service

This registered children's home is run by a charitable trust and provides care and accommodation for children and young people on both a long-term basis and for short stay breaks. The service provides eight short break and two long-stay residential places for children and young people who have learning disabilities and may also have physical disabilities.

p.3

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

p.3

Overall effectiveness

The overall effectiveness is judged to be adequate .

p.3

Overall effectiveness

This service provides good care and children and young people achieve good outcomes. Most of the children and young people visit this service for overnight stays and short breaks, while a minority are resident. The service is very flexible in responding to individual needs and family circumstances, including responding positively to emergency, crisis situations. For example young people may visit only once or twice a month or may enjoy extended short breaks or several overnight stays every week. The flexibility of the service is extremely well thought of by both professionals and parents alike.

p.3

Overall effectiveness

The service has been operating since 2000 and since that time has developed its expertise in caring for children and young people with complex and diverse needs. Over this time, it is felt the needs of young people being supported have changed and increased considerably. The core staff team provides stability, while good arrangements are in place when additional staff support is needed during weekends, school holidays and other periods of high take up of places. Staffing levels are good and young people benefit from at least one-to-one staffing support. This means that they are safe and well supervised, but also have opportunities to pursue individual interests and enjoy a good range of social opportunities and activities.

p.3

Overall effectiveness

The leadership and management of the service, while good in many respects, has shortfalls which have had a bearing on the overall judgement of this inspection. For example quality monitoring processes, including external monitoring visits and internal reviews of quality of care, take place but are not robust or challenging enough. They do not demonstrate that thorough consultation has taken place with young people, parents, staff and placing authorities or the impact of such consultation on the development of the service and the quality of care provided. Communication with other agencies is not always effective and notifications are not always submitted to Ofsted.

p.3

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.

p.4

Reg. Requirement Due date

(2001) ensure if, in relation to a children's home, any of the events listed in column 1 of the table in Schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table. This includes any significant events in relation to the safeguarding of young people. (Regulation 30 (1)) 15/07/2013

p.4

Reg. Requirement Due date

(2001) ensure the person carrying out registered provider visits shall interview, with their consent and in private, such of the young people accommodated there, their parents, relatives and persons working at the home as appears necessary in order to form an opinion of the standard of care provided in the home (Regulation 33, (4) (a)) 15/07/2013

p.4

Reg. Requirement Due date

(2001) ensure the review of quality of care and the report supplied, shall provide for consultation with young people accommodated in the home, their parents and placing authorities (Regulation 34 (3)) 15/07/2013

p.4

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.4

Recommendations

 ensure the home provides a comfortable and homely environment, in particular attention given to removing audit stickers from pictures and furnishings and that personal care items are discretely stored, to prevent presenting an institutional impression (NMS 10.3)  ensure staff are provided with regular supervision and have their performance individually and formally appraised at least annually, including bank staff (NMS 19.4 and 19.6)  ensure all people working in the children's home have their written references checked to assess suitability before taking on responsibilities, and that the home has a record that these checks have been carried out (NMS 16.1 and 16.3)  ensure effective leadership that delivers sound, good quality care that meets the individual needs of each child, including working effectively in partnership with other agencies and professionals to ensure shared decision making that protects

p.4

Recommendations

young people and promotes their welfare and personal development (NMS 14.5 and 4.7)  ensure care practices in the home do not restrict the liberty of any child as a matter of routine, in particular that the unacceptable behaviour management strategy of bedroom door holding is not used again (NMS 3.19)

p.5

Outcomes for children and young people

Children and young people using this service achieve good outcomes. Without exception all comments received from young people, staff, parents and professionals confirmed that young people enjoy their visits and have made good progress. For example they have opportunities to socialise with peers and develop their confidence in a range of scenarios. They also receive individual support to pursue specific interests, which they may not have otherwise enjoyed and which contributes to young people achieving good outcomes and making personal progress in their overall lives. For example young people attend youth centres, play for football clubs, attend surfing weekends and visit climbing centres. This is important in helping young people develop a positive self-view and confidence in their ability.

p.5

Outcomes for children and young people

The service is very child-centred and staff are very positive and nurturing in their care of young people. Individual and personal care needs are responded to sensitively with staff being very mindful of personal dignity and privacy. Staff are also aspirational for young people and are very motivated to ensure that young people benefit from their visit and that their experiences while staying with them contribute to their personal progress. For example, staff provide opportunities through activities and day to day activities that support educational targets such as developing numeracy and communication skills that will help them in their daily lives. Young people benefit from the excellent relationships that they have with staff and the individual support they receive. While many of the children and young people do not communicate verbally, staff are very knowledgeable about each one of them and are skilled in ensuring their inclusion in day to day matters and personal decision

p.5

Outcomes for children and young people

making. Young people have equal access to local facilities and attractions, regularly visiting the nearby community centre, swimming pool, parks and local beaches. This provides them with diverse opportunities to develop their social skills and confidence in a range of settings.

p.5

Outcomes for children and young people

Home cooked and nutritional meals are provided daily. Catering staff have an excellent insight into the differing dietary needs of all individuals. Good emphasis is placed on healthy eating and encouraging young people to make informed healthy choices, for example in choosing snacks and drinks after they arrive from school. Those children and young people that are able to be involved with food preparation and cooking are given good opportunities to develop such independent living skills, which supports their learning at school. There is a very well equipped and designed domestic kitchen adjacent to the main kitchen which young people regularly access with staff support.

p.6

Outcomes for children and young people

Young people benefit from staff supporting their transitions in education and their living arrangements. Staff work incredibly positively and individually with young people and their nurturing approach enables young people to develop their confidence and skills in a very safe and secure way. Children and young people attend a variety of schools according to their assessed needs. They benefit from staff supporting their learning and liaising well with their school.

p.6

Quality of care

Children and young people enjoy really positive and constructive relationships. Staff work hard to overcome barriers where limited communication exists and are effective in including all young people in decision making. A variety of communication techniques are used, many being highly personalised to individual young people.

p.6

Quality of care

The staff team provides a good balance of age, gender and experience, which enhances the care children and young people receive. Staff are very motivated and committed to providing good quality care that meets diverse needs as well as providing young people with opportunities to enjoy their visit. Staff ensure that young people have detailed individualised care plans. There is a very child-centred, holistic and comprehensive approach to care planning that ensures when young people visit their diverse needs are addressed. Plans are regularly reviewed and updated and include contributions from young people, parents and professionals. Staff are mindful of the importance of continuity of care and care plans include details such as night time routines, personal hygiene needs, food preferences and what young people enjoy doing. Liaison with parents is very good and one parent said that her son has done extremely well, has made very good progress and that

p.6

Quality of care

the service keeps her very well informed.

p.6

Quality of care

There is an established complaints procedure in place and young people know how to complain. For those who have more complex needs, any areas of concern are raised through their parents or social workers. Recent complaints made by young people have been handled positively and swiftly, with the young person being kept fully informed of the process and outcome. For example, recently a young person expressed concern about the overall quality of the particular bathroom they use and this is now being refurbished to include a modern shower which the young person prefers.

p.6

Quality of care

All children and young people are registered with local healthcare services. Through school, specialist intervention services are provided to address specific needs, such as speech and language and physiotherapy. These services also provide a range of aids and adaptations to meet the physical needs of young people and promote good wheelchair access. Good systems are in place for the safe storage, receipt and administration of medication. Recently, following an incident, procedures have been further tightened to ensure medication is correctly administered to young people during their stay.

p.7

Quality of care

The home is appropriately designed, equipped and located. It provides children and young people with a safe, light and spacious environment. Externally young people have access to a good range of facilities, such as sand and water play, play equipment and use of a school pool. Considering the size of the building, staff have achieved a really comfortable and domestic like environment in which young people can enjoy a variety of activities: watching television, listening to music, cooking, and making crafts. However, following an audit, catalogue stickers have mistakenly been applied to pictures and furniture and these along with items of personal hygiene, such as gloves and wipes that are on display in the dining room, detract from what otherwise is an attractive and homely environment.

p.7

Safeguarding children and young people

The service is adequate at keeping children and young people safe and feeling safe.

p.7

Safeguarding children and young people

Children and young people are supported by good staff ratios. Overall, complex and challenging behaviour is managed well using positive and supportive strategies. Staff receive appropriate training including accredited training in the use of physical restraint. The home has an appropriate policy and procedure for the use of physical restraint, which is used minimally.

p.7

Safeguarding children and young people

Since the last inspection in February, the increasing challenges presented by an individual led to the use of restrictive behaviour management practices for a short period of time. This matter was subject to a strategy meeting and the service quickly responded to improve its practices. Following consultation with other professionals, including the placing authority and school, plus additional input from family, the matter has been resolved and new strategies deployed have improved the young person's behaviour during recent visits. However, this incident highlighted that although effective communication with other agencies and professionals also involved in the care and protection of the young people is improving, it does not always occur or is not always timely. For example notifications required to be made to Ofsted are not always submitted. When significant events are not shared thoroughly, joined up working and shared decision making, in the best interests of

p.7

Safeguarding children and young people

young people, is compromised. As young people attending this service are highly vulnerable and have complex needs, shared decision making is particularly important to consider all aspects of their welfare and safety. Young people are protected by vetting of visitors and a visitor’s book is maintained. The recruitment of staff is very comprehensive. The manager is involved in the recruitment and selection of staff and there is an on-going recruitment drive in place to ensure appropriate staffing arrangements. Original recruitment records are maintained in the organisation's nearby central office. These are extremely well organised and thorough. While all checks are carried out thoroughly prior to a new member of staff starting to work with young people, records omit to clearly evidence that verbal verification of references has taken place, although this is done in practice.

p.7

Safeguarding children and young people

The environment is physically safe and secure. There are regular health and safety checks along with servicing of equipment to protect young people. A fire risk assessment is also in place and a fire detection system. Young people and staff regularly practise evacuations so that they know what to do in an emergency. A member of staff is designated as 'fire marshal' on each shift, which is good practice, ensuring good levels of vigilance and safety.

p.8

Leadership and management

The leadership and management of the children's home are adequate .

p.8

Leadership and management

The leadership and management of the service, while good in many respects, has shortfalls which compromise the overall quality of this service, specifically the safeguarding of highly vulnerable young people and the robustness of its own quality assurance processes.

p.8

Leadership and management

While external monitoring visits are regularly undertaken and reports produced, these visits are not particularly robust or challenging. While the reports give a good flavour of the visit, they do not contribute effectively towards the direction of the service and its capacity to make further improvements. While consultation does take place with staff and young people, consultation with parents is not evidenced. Furthermore, the impact of consultation, on the opinion formed of the standard of care provided, is not clear. Similarly with the manager's review of quality of care, the process of consultation with young people, parents and placing authorities is not evidenced, nor is its impact. These shortfalls make it difficult for the service to demonstrate that its leaders and managers take action to tackle weaknesses and make improvements.

p.8

Leadership and management

A positive feature of the service is the staffing arrangements, including the staffing structure and staffing levels. All young people have at least one-to-one support and where necessary have two-to-one support. These arrangements provide the supervision necessary to keep young people safe but also provide excellent opportunities for young people to pursue individual routines and interests. A core team of staff are employed. In addition an equal number of bank staff are appointed, who work regular shifts. Given the nature of the service, with its changing demands for staffing, these arrangements provide good flexibility and continuity. The service has a good staffing structure with clear lines of responsibility. There are good arrangements in place for staff to progress through internal opportunities to shadow and act in more senior positions. These arrangements demonstrate a commitment to staff development and to ensuring that young people are cared for by suitably

p.8

Leadership and management

The Registered Manager and staff team as a whole are suitably qualified and experienced. Training opportunities are thorough and well organised. While bank staff benefit from training they do not have the same opportunities for regular supervision or annual appraisal. It is important that this shortfall is addressed to ensure that all staff caring for young people are equally supported and competent to fulfil their care responsibilities.

p.9

Leadership and management

At the last inspection in February 2013, one requirement was made. This related to the formal notification of serious incidents to the required authorities, including Ofsted. While there is evidence that such communication has improved, shortfalls continue to exist. For example in omissions and in the thoroughness of an audit trail of action taken. During this inspection further clarification was provided about the nature of incidents needing to be notified. Furthermore, clarification was also provided about the importance of sharing information with other agencies so that in keeping with good practice and in the best interests of young people, shared professional decision making can take place.

p.9

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.

p.10

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.

p.10