Children's Home run by Liverpool City Council in Liverpool

Unique reference number SC035969 Inspection date 20/06/2013 Inspector Denise Jolly Type of inspection Full Provision subtype Children's home

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Date of last inspection 29/10/2012 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 children's home is managed by a local authority, providing short-term breaks for up to seven children and young people at any one time. Children and young people with learning disabilities and physical disabilities are cared for.

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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

The short breaks service is making a positive difference to children and young people’s lives. They receive care from qualified staff who recognise and respond effectively to their complex range of needs. Although leadership has been inconsistent, the service has continued to develop the quality of care provided to vulnerable young people. The home additionally offers care to a minority of young people who live at the home.

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Overall effectiveness

Parents praise the dedication and commitment of staff, who help their child to experience activity and opportunity that may not otherwise be available to them. They say, ‘The staff inspire trust and communicate well.’ Managers support and review staff performance to ensure that the service improves care practice. All staff are committed to promote the welfare and progress of each individual. Staff encourage children and young people to communicate their views and make choices. They respond promptly to all efforts in communication.

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Overall effectiveness

A strong feature of the home is the warm and affectionate relationships between staff and young people. Vulnerable and complex young people appear happy, relaxed and confident during their time at the home. Staff encourage appropriate levels of independence, balanced against risk assessment and individual health and care needs. Parents and professionals say they can see that children and young people do well in safe and secure surroundings.

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Overall effectiveness

Despite changes to managers, the leadership team uses carefully considered development plans to underpin steady improvements to the systems and practices of the home. While staff, parents and professionals wish management personnel had been more consistent, they all acknowledge the distance the service has covered to secure improvement for young people. One requirement is made regarding consistency of staffing, and three recommendations address minor shortfalls in records of staff rotas worked, monitoring of records of disciplinary measures, and evaluation of progress young people make.

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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 employment of any persons on a temporary basis will not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 25 (2)) 09/08/2013

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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 staff encourage children to take appropriate risks, by recording in their risk assessment the progress they make in managing their behaviour and increasing their independence (NMS 4.4)  ensure the home regularly reviews incidents of challenging behaviour, examines trends or issues emerging from this, to enable staff to reflect and learn to inform future practice (NMS 3.21)  ensure that entries in records are legible and clearly expressed, particularly with regard to staff rotas. (NMS 22.4)

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Outcomes for children and young people

Young people are happy, comfortable and relaxed in the home. Parents and social workers are positive about the service the home provides, and confirm that young people enjoy improved outcomes. For example, some young people relax and sleep better at night, some adopt regular routines for independent personal care, and others learn to accept and value the company of other children. Parents say that staff understand the unique characteristics of their children, and encourage them to progress as individuals. One parent said, 'Staff understand his complex needs, and he has improved communication, listening and sociability.’

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Outcomes for children and young people

Children and young people with disabilities safely experience a wide range of new and developmental experiences. Consistent and dedicated staff support them to participate in activities they have chosen, such as bowling, or going to big swing parks. Within the home, they enjoy spacious rooms equipped for soft play, sensory exploration or simple relaxation. They choose from various domestic activities such as playing on the computer or using the paddling pool in the garden.

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Outcomes for children and young people

All children and young people come and go to school during their stay. They tell and show staff about what they have experienced, so that staff can support their learning and development. They demonstrate trust in the staff to help them to achieve success in their endeavours. This enables children and young people to broaden their understanding of the world, and have opportunities to be successful in everyday activities.

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Outcomes for children and young people

Children appear confident and secure in their time away from home and, if they choose, they bring their own belongings with them during their stay. Young people who live at the home personalise their bedrooms with family photographs and effects. They receive care that reflects their own and their family’s wishes. Young people influence decisions about daily life. For example, at breakfast time they choose what they want to eat from the kitchen and where they will go to eat it. However, at tea time, all children sit together when possible, to improve their social and interpersonal skills. Professionals say, ‘The staff know the needs of the young people and work very hard to meet them.’

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Outcomes for children and young people

Children and young people experience short breaks in small and compatible social groups. This enables them to learn about the needs and wishes of others, and to develop such skills as turn taking and playing with friends. Children and young people learn to share their interests with others, and begin to understand the give and take of personal relationships. Young people provide staff with ideas for activities and meals during their stay, by participating in meetings about planning. They communicate according to their individual skills and preferences; for some this involves looking at and responding to picture options and for others it means using signs and language to express their views. Because staff respond to their efforts, young people grow in confidence and self-esteem.

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Outcomes for children and young people

Children and young people receive prompt attention to their immediate health and comfort needs. They use well-equipped and spacious bathrooms that protect their dignity and maximise opportunities for them to be independent. Additionally, they have their emerging needs identified and met by staff that work very well with them, their parents and specialist professionals, such as psychiatrists and epilepsy nurses. This enables them to attend medical appointments with their parents and receive regularly updated health care.

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Quality of care

Staff provide good care to ensure children and young people enjoy their time at the home. Relationships appear to be well established; young people express confidence and contentment by their settled behaviour and the progress they make. Parents, social workers and independent visitors are complimentary about the positive impact the service has on the lives of children and young people. Staff use observation of young people, and reflective practice, to ensure that the short breaks service adapts to support the unique needs of individual children.

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Quality of care

Staff see children and young people in a realistic light, and recognise their strengths and development needs. This means young people progress, supported by encouraging staff who are proud of their achievements. Staff help children to find activities they can enjoy safely. For example, they gradually introduce children to practise skills in choosing and preparing snacks safely. This improves their awareness of a range of constructive activities while becoming more independent.

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Quality of care

Staff place young people’s well-being at the centre of their practice. Key workers prepare and regularly review improved care plans to ensure that children receive appropriate support to meet their needs. Parents and social workers agree the plan at the beginning of each stay, so that all changes important to the young person are incorporated. For example, staff refresh their knowledge of medication administration for each young person, or adapt a personal routine due to progress young people have made. If necessary, managers identify additional training for staff in specialist areas like oxygen support protocols, to ensure they provide competent care. Staff discuss the plans in staff meetings and daily handovers. This ensures staff continually update their knowledge and understanding of the impact of the plans on the welfare of young people.

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Quality of care

Staff have worked hard to improve systems for recording the storage and administration of medicines. Consequently, arrangements for dealing with medication are safe and effective, and staff are suitably trained. Managers monitor staff practice, to ensure children get the medication and health support they need. Children are familiar with the routines associated with how they receive their medication and are happy to cooperate with staff.

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Quality of care

Staff set clear and appropriate boundaries for children and young people, while recognising their individual starting points. Careful grouping of children to maximise shared interests or need areas helps them to access activity that is appropriate to their ability, and this helps children to remain calm and enjoy their stay. Parents of young people who live at the home recognise that relationships between staff and their child are strong because staff know them very well. Parents say that this fosters a sense of security in their child, which leads to a reduction in outburst type behaviour, so they cause less harm to themselves or others.

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Quality of care

Managers and keyworkers promote communication between the local authority, health professionals, school, families and the home to provide an effective team approach to support the child or young person. Young people who live at the home benefit from detailed and regularly reviewed plans of care that identify all actions necessary to promote their welfare and development. This includes, for example, how and when contact with families will take place, and how much support staff will give to enable the contact to be successful. Parents value the efforts of staff to create safe and happy contact arrangements.

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Quality of care

Young people contribute their views and opinions in a variety of ways, specific to their unique communication style and ability. Some young people write down their needs and wishes, while others have their views interpreted and recorded for them by staff. Parents also provide feedback to staff about the quality of care provided. When they raise concerns, staff do their best to rectify the situation. Parents say, ‘Communication from the home is excellent.’ While it is unusual for young people to complain, staff are alert to any sign of unhappiness and work hard to improve matters. Parents and social workers say staff are good at listening and responding to suggestions for improvement to the service, to provide consistently improving care practice.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people appear safe and happy in the home. The environment is spacious, and affords safe access to bedrooms and leisure spaces. Waking night staff ensure the oversight of young people’s health while they sleep. Staff provide sensitive and personalised care for young people with complex needs. Parents and social workers say the staff are very good at providing for the needs of young people, and work hard to keep them safe. Staff communicate very well with parents, and keep them informed of any injuries sustained by young people.

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Safeguarding children and young people

Managers conduct rigorous recruitment procedures that protect young people from unsuitable individuals having access to them in the home. Staffing levels are sufficient to maintain the safety and welfare of young people. Staff know and understand procedures to safeguard and protect young people, and have attended refresher training from child protection professionals to enhance their knowledge and understanding. When necessary, managers support staff to whistle-blow about any inappropriate practice of colleagues. This ensures independent oversight of any concerns or allegations made and further enhances the safety and security of children. In such cases, managers work with protection professionals to identify and implement risk assessments that protect young people from harm during any investigation.

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Safeguarding children and young people

Staff are mostly successful in redirecting children and young people when their behaviour challenges the safety or welfare of themselves or others. Trained in an accredited behaviour support approach, staff encourage young people to adopt less harmful ways to express themselves. Improved recording systems, for additional measures of control that are used in the home, guide staff to provide a clearer picture of any physical interventions they perform. Staff use restraint and other measures of control, such as directing children to their bedroom, when they endanger their welfare or the safety of others. Parents say, ‘We are always kept fully informed if there are any incidents requiring our son to be restrained.’ Senior practitioners assess each incident report, but managers do not identify trends or issues emerging from the records. This prevents staff from being able to reflect and learn to inform future practice.

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Safeguarding children and young people

Children and young people stay in a home that is physically safe and appropriately secure. Staff complete risk assessments for all aspects of life at the home to provide young people with safe opportunities for development and independence. However, staff do not always record the progress young people make in their behaviour and safety within individual risk assessments, and this reduces the opportunity for staff to celebrate their success with them, or to understand fully the progress they have made. Children are very well supervised during activities, and as a result do not go missing from the home. Managers ensure the regular maintenance of specialist equipment such as hoists and electric beds.

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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

A qualified and experienced manager has applied to be registered, following the recent departure of the Registered Manager. He leads an experienced and qualified team that provides a service that is valued by parents and social workers. Due to staff absence and vacant posts, there has been recent inconsistency of staff for a number of shifts, particularly at weekends. Managers use a combination of relief staff and agency workers to cover the shortfalls. This limits the opportunity for children to experience consistent care from adults who fully understand their needs. However, due to the efforts of permanent staff, the impact on the care given to young people is minimised. Parents and professionals recognise that although this has not adversely affected their child, they have experienced minor inconsistency in the way the home is managed, due to differing priorities and changes in personality.

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Leadership and management

Staff access a comprehensive training programme to enable them to support young people with complex medical, behavioural and communication needs. Managers enable staff to attend training, to improve deficits in skill and knowledge, identified during the last full inspection and from their own analysis of staff performance. Staff have attended courses with education professionals about communicating with children, and have been tutored by nurse specialists in many health-related practices and systems of care. Senior practitioners offer regular and developmental supervision, to assess the impact of training on staff practice. Staff enjoy the opportunity for professional development because it enhances their ability to care more effectively for vulnerable young people.

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Leadership and management

Children and young people benefit from joint planning and review to ensure staff consistently meet their needs. Managers and key workers attend meetings for parents and all professionals who support the child. When meetings are overdue, staff remind others of the importance of planning meetings and persist in seeking an arranged appointment. This enables discussion to take place to identify emerging need or change in circumstance. One social worker said, ‘The home has improved in efficiency dramatically over the last year, and is clearer about the roles of other professionals supporting the child.’

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Leadership and management

Staff have worked hard to provide clearer and more accessible care plan records, including improved rationales for risk assessments, and more consistent plans to support the behavioural needs of young people. However, some records do not provide sufficient information; for example, staff rotas do not consistently identify relief staff as temporary team members. While this has not affected the welfare of young people, it prevents an accurate record of the conduct of the home.

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Leadership and management

Staff respond quickly and enthusiastically to any realistic suggestions for improvements. This maximises opportunities and increases horizons for the development of children and young people. This includes successful transition to adult services, and support for some children to spend time with their families.

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Leadership and management

Managers have successfully addressed serious shortfalls in the quality of care offered to young people, through a development plan that all staff are enthusiastic about achieving. Managers have improved records of disciplinary measures kept in the home, to meet the requirement made at the last inspection. Additionally, both recommendations, to improve the quality of care planning, have been achieved. This means records relating to children are clear, regularly updated and communicated to all parties. This ensures children receive safe care that helps them to progress. Parents recognise the benefit of the placement for their child and say, 'The best thing is that my son is happy and safe.’

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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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