Children's Home run by Action for Children Services Ltd in Buckinghamshire

Unique reference number SC424089 Inspection date 02/07/2013 Inspector Thomas Webber Type of inspection Full Provision subtype Children's home

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Date of last inspection 19/12/2012 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

This is a short break service for young people with learning disabilities, sensory impairment and physical disabilities. It is run by a national children's charity and can accommodate up to a total of 14 young people. Young people may have challenging behaviours associated with their disability and complex health needs that require nursing input.

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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 provides young people with a very good standard of care where good outcomes are achieved for them in all areas apart from leadership and management. Not all of the recommendations from the last inspection have been complied with, there are difficulties in ensuring that all staff are appropriately qualified.

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Overall effectiveness

Young people attend the home for short term respite care and as a result they make good progress within the confines of the service. Young people thrive and benefit from the high level of care and support they receive during their stay by an experienced and dedicated staff team. The physical and emotional well-being of young people is central to all aspects of the care provided.

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Overall effectiveness

Care planning and practice are personalised to meet the individual needs of young people. The placement plans focus on the diverse and complex needs of the young people accessing the service with staff engaging well with young people. Staff use the preferred method of communication for each young person and are aware of and observe all non-verbal communication.

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Overall effectiveness

Staff actively support young people to attend their respective educational placements. Clear routines are well established which contribute to them achieving excellent attendance. Young people engage in a range of stimulating and enjoyable activities both within the home and the wider community. They are also encouraged to learn and try new experiences during their stays. Staff maintain good communication with the parents of young people and other professionals. This ensures that all parties are kept informed and up to date about all relevant matters relating to the care of young people.

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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

 review the development plan to identify the future of the home and how the home will achieve outcomes for children (NMS 15.2)  ensure that all existing care staff have attained a minimum level 3 qualification. All new staff are to hold the level 3 Children and Young People's Workforce Diploma or be working towards the Diploma within six months of confirmation of employment (NMS 18.5)  ensure the review of matters set out in Schedule 6 of the Children's Homes Regulations 2001 enables the provider to identify any trends or issues of concern, in order to improve the quality of care provided. Reports of these reviews under regulation 34 should be completed at six monthly intervals and a copy of every report should be sent to Ofsted within 28 days of completion. (Volume 5, statutory guidance, paragraph 3.14)

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Outcomes for children and young people

This home provides young people and their parents with a valuable and essential short break service. Young people thrive and benefit from the high level of care and support they receive during their stay by an experienced and dedicated staff team. The physical and emotional well-being of young people is central to all aspects of the care provided. Staff are particularly skilled at understanding and interpreting the needs and wishes of young people who are fully supported to make choices about aspects of their care.

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Outcomes for children and young people

Young people benefit from their brief periods away from the family home. They engage in a range of purposeful and enjoyable activities both within the home and the wider community. They are also encouraged to learn and try new experiences during their stays.

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Outcomes for children and young people

Staff maintain good communication with the parents of young people and other professionals. This ensures that all parties are kept informed and up to date about all relevant matters relating to the care of young people.

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Outcomes for children and young people

Staff actively support young people to attend their respective educational placements. Clear routines are well established which contribute to them achieving excellent attendance. Staff maintain good communication and contact with the schools to ensure that a holistic approach is maintained. Staff also participate in the educational reviews of young people.

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Quality of care

Young people benefit from living in an environment where warm, caring and supportive relationships are established between themselves and staff. Young people receive a high level of care from a very committed and experienced staff team who undertake their duties in a warm, supportive and respectful manner. Young people are relaxed and at ease in the company of staff and within their environment.

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Quality of care

Comprehensive placements plans are well established for young people. These ensure that their individual needs are fully understood and met by staff. The placement plans focus on the diverse and complex needs of the young people accessing the service. Staff engage well with young people and use their preferred method of communication. Staff are aware of and observe all non-verbal communication and are very proactive in reassuring young people at all times. They achieve this by using a sensitive approach while maintaining a very good understanding of their needs. Staff support young people to express their views about the care provided. Young people are also supported to make daily choices during their stays for example in relation to snacks, drinks, what they wear and activities.

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Quality of care

Clear policies and procedures are well established for dealing with complaints. These are produced in user-friendly formats understandable to young people. Young people's parents are also encouraged to raise any concerns or make positive comments about the care provided. These are used to inform and improve the home's practice. There have been three complaints received from parents since the last inspection. The manager has taken action to fully investigate these. Complaints are responded to and addressed without delay, depending on their complexity. A number of compliments have also been received. These reflect the positive care and support provided to young people and in some cases to their parents.

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Quality of care

The parents of young people retain responsibility for the health care needs of their children. However, staff are fully aware of the specific health conditions and needs of young people. Young people who are mildly unwell will be catered for during their stay. However if they are significantly ill, contact would be made with their parents with a view to them returning home. Robust arrangements are well established for the safe storage, receipt and administration of medication for the protection of young people. Staff work closely with the parents of young people and the community nurses to monitor young people’s health during their stays and respond appropriately to any concerns. This ensures continuity of care is achieved.

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Quality of care

Young people are supported to eat a healthy and balanced diet. The specific likes and dislikes of young people are well catered for as well as any special dietary needs. Young people are able to participate in some food preparation where appropriate.

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Quality of care

The home is well resourced to stimulate young people and promote sensory development through the use of the sensory room, garden and activity rooms. Young people also enjoy the wide variety of toys, games and activities within the home. These include activity areas for art and craft and soft play as well as a large range of outdoor play equipment.

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Quality of care

The home is divided into two units. Young people live in a caring, safe and pleasant environment which is generally well maintained. The premises provide young people with a good level of communal space to cater for group and individual activities. The home also provides sufficient specialist equipment to assist in delivering personal care needs and to ensure the individual needs of the young people accessing the service are met. These include specialist items such as ceiling hoists and adapted baths.

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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

Young people who access this service are kept safe. Staff are trained and competent in their knowledge of safeguarding young people by ensuring they are fully protected from harm. Young people live in a safe environment where their welfare is promoted. Staff have an excellent understanding and awareness of the needs and vulnerabilities young people with disabilities have and how to safeguard them. Staff maintain an open and supportive dialogue with young people, their parents and other professionals.

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Safeguarding children and young people

The manager intends to review the existing recording system and cascade this to staff to ensure that a comprehensive record is maintained in the event should a young person go missing. However, this does not impact on the welfare of young people as there have been no incidents where they have gone missing for a considerable period of time. The high staffing levels, based on the individual needs of young people, and vigilant monitoring positively contribute to this area of practice. Staff are well aware of the written procedure for responding to any such incidents.

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Safeguarding children and young people

Young people live in an environment where they are supported to develop positive behaviour. Comprehensive individual behaviour plans: 'my plans' are well established for young people who display specific behavioural needs. These together with thorough placement plans and risk assessments provide staff with clear guidance and strategies for effectively supporting and managing the behaviours of young people. These also ensure that young people receive a consistent approach from all staff. Restraints and sanctions have been used where necessarily but are kept to a minimum wherever possible. Suitable records are maintained of all incidents. Staff have recently received a range of training in effective behaviour management.

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Safeguarding children and young people

Robust staff recruitment practices are established to ensure the protection of young people. These practices ensure that new staff are suitably vetted and do not commence employment in the home until all the relevant checks have been carried out.

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Safeguarding children and young people

Young people are protected by sound health and safety routines. The various fire and health and safety tests and servicing arrangements are also carried out at the required intervals to safeguard young people. Staff work with young people to prepare and involve them in the action to take in the event of a fire or an emergency.

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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 home is managed by a management team who are very committed to improving the quality of care provided and who strive to maintain high aspirations for the care and support young people receive. The Registered Manager has fully addressed two of the four recommendations identified at the last interim inspection. These relate to ensuring that the overall number of staff fulfil the Statement of Purpose of the home and are equipped with the skills to also meet the individual needs of young people using the service. The manager is still in the process of producing the home's new development plan. Although the manager has been compiling Regulation 34 reports on a monthly basis, she has not collated these into the six monthly reports which reviews the quality of care provided. Copies of these are also not being sent to Ofsted.

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Leadership and management

The manager ensures that suitable staffing levels are maintained throughout the day and night to meet the individual and collective needs of the young people who access the service. This is achieved in part by the need to use regular agency staff who supplement the permanent staff. A review of the staffing structure of the home has recently taken place which is due to be implemented in the near future. However, difficulties still exist in recruiting suitable staff to the home despite the organisation's continuing recruitment drive to fill the vacant positions. The staff to young people ratio is also currently being helped through a lack of referrals hence the reduction of young people using the service at any one time. This does, however, assist young people to receive continuity and consistency of care within the current staffing constraints.

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Leadership and management

The Statement of Purpose clearly states the aims and objectives of the service and the facilities it provides to young people. The staff, under the leadership of the home, maintain a clear focus on working in close partnership with young people's parents and other professionals. This is to achieve a consistent approach to meeting the diverse and complex needs of the young people. Separate guides have been produced for young people and their parents. These documents provide them with useful information they need to know about the service and the level of care delivered. The young person's guide is also produced in a suitable format aimed at the level of understanding for young people. There are still plans to transfer this document onto a DVD to aid and support young people with more complex needs to understand the aims of the home.

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Leadership and management

The Registered Manager, who is supported by a senior management team, provides suitable leadership. Staff are very appreciative of the level of support available. Staff benefit from receiving annual appraisals and regular formal individual supervision of a good quality. These forums provide staff with the opportunity to raise and discuss strategies for supporting young people and to share good practice. This ensures that the performance of staff is also continually monitored so that young people are continually well cared for.

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Leadership and management

Staff are now being provided with a range of training opportunities to equip them with the skills and knowledge to meet the specific needs of young people using the service. Staff spoke very positively about the range of training available, particularly during this year. There is a significant shortfall in the number of qualified staff employed at the home. Currently 60% of the staff team hold the required qualification with a further four staff working towards this.

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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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