Children's Home run by Grace Care Limited in Nottingham

Unique reference number SC436818 Inspection date 23/08/2013 Inspector Katarina Djordjevic Type of inspection Full Provision subtype Children's home

p.1

Date of last inspection 18/02/2013 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

The children's home is run by a private company. It can accommodate up to three children with learning 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 is the first full inspection since the home was registered in February 2012. Young people have been admitted to the home since March 2013. They are making good but steady progress given their starting points. Young people receive a good level of individualised care and support from a committed and enthusiastic staff team. Young people’s attendance at school is very good which improves their chances of achieving positive outcomes.

p.3

Overall effectiveness

There is a clear desire and commitment from the Registered Manager and the staff to develop the service in order to continually improve young people’s lifestyles. Working with parents, schools and other relevant professionals and the quality of young people’s care records including risk assessments are particular strengths of the home. Empowerment of young people is also at the forefront of practice and every effort is being made to enable young people to give them choices about their lives.

p.3

Overall effectiveness

Young people present challenging behaviours and staff are working hard and consistently to manage these needs. As a result, young people are making steady progress in changing their behaviours. Young people are safe. However, the home has not followed procedures in dealing with an allegation made against a staff member; this was investigated by the local authority and was not substantiated. There is no evidence of this impacting negatively on young people. However, failure to follow appropriate procedures potentially affects the ability of staff to protect young people from the risk of harm and abuse.

p.3

Overall effectiveness

Feedback from parents and placing authorities is positive about the care provided and about the progress made by young people so far. One parent commented about staff ‘They are welcoming and offer good care’.

p.3

Overall effectiveness

Four requirements have been made regarding child protection procedures; notifying appropriate authorities of all significant events; producing the children’s guide in an appropriate format and keeping records of complaints and concerns raised. Two recommendations have been made regarding staff training and the home’s development plan for the home.

p.4

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) produce the children’s guide in a form appropriate to the age, understanding and communication needs of children accommodated in the home (Regulation 4 (4)) 30/09/2013

p.4

Reg. Requirement Due date

(2001) implement the written policy which sets out the procedure to be followed in the event of any allegation of abuse or neglect. This is with specific reference to referring all allegations made against staff to the local authority designated officer (Regulation 16 (2) (b)) 30/09/2013

p.4

Reg. Requirement Due date

(2001) ensure that a written record is made of any complaint, the action taken in response, and the outcome of the investigation (Regulation 24 (5)) 30/09/2013

p.4

Reg. Requirement Due date

(2001) shall without delay notify the persons indicated in respect of the event in column 2 of Schedule 5. This is with specific reference to notifying Ofsted of any serious complaint about persons working at the home and the instigation and outcome of any child protection enquiry. (Regulation 30 (1)) 30/09/2013

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

 consult with staff and young people on the home’s development plan and include measurable targets (NMS 15.2)  ensure all staff are working towards the level 3 Children and Young People’s Workforce Diploma within six months of confirmation of employment. (NMS 18.5)

p.4

Outcomes for children and young people

Young people are making good progress considering the short time they have been living at the home. Feedback from placing authorities is very positive about the progress made so far by young people given their starting points; taking into account their complex needs and the short time they have been at the home. One professional commented that the young person’s ‘quality of life has improved considerably’ since being at the home.

p.5

Outcomes for children and young people

Young people’s behaviour is very complex and they are making steady progress in changing their behaviour which also improves their safety and the safety of others. These improvements in young people’s behaviour enable them to access a wider range of leisure activities. This is helping them to develop social skills in preparation for adulthood.

p.5

Outcomes for children and young people

Young people’s health improves greatly during their time at the home. This is because they receive a range of health services based on their individual physical, emotional and psychological health and dietary needs. They attend their routine health appointments regularly and that they are receiving the treatment and support they need. Some young people’s diets have really improved which has helped them to lose some weight. These improvements have been recognised and confirmed by placing authorities.

p.5

Outcomes for children and young people

Young people enjoy school and their attendance at school is very good. Some young people’s attendance at school has improved significantly. This helps to promote their educational achievements and develop social and independence skills.

p.5

Outcomes for children and young people

Young people really benefit from the range of social and leisure activities that they are provided with. Some young people are being provided with opportunities and experiences they have never had before. For example, young people recently went on holiday for the weekend which they thoroughly enjoyed.

p.5

Quality of care

Young people receive a good standard of individualised care which takes into account their starting points, previous histories, experiences and identified risks. Young people’s age, gender, levels of abilities and disabilities, sexual orientation, race, religion, culture and communication and language needs are also taken into account. Staff demonstrate detailed knowledge of young people’s individual needs, wishes and preferences even though they have only known young people for a short period of time. This has been possible due to staff’s excellent liaison with young peoples’ parents, placing authorities, schools, previous placements and other relevant professionals. This communication has enabled staff to produce very detailed placement plans (known as residential action plans), risk assessments and associated records which helps to meet young people’s needs in a safe and nurturing manner. One young person’s social worker said that the communication from staff at

p.5

Quality of care

Empowering young people to enable them to contribute to the planning and provision of their care is at the forefront of practice. Staff are working closely with other professionals to ensure they are able to communicate with young people and enable them to make choices based on their levels of understanding and abilities. Staff have received some training on different communication systems. The Registered Manager is researching the best communication aids to purchase to improve young people’s opportunities to make choices. She has consulted with the young people’s schools and other professionals who have specialist knowledge on this matter. Young people make day-to-day choices wherever possible. Young people also have access to an advocate who visits the home monthly. This ensures all young people have equality of opportunity to exercise their rights; and helps them to feel valued and increases their self-esteem.

p.6

Quality of care

Staff are committed to ensuring young people’s health needs, some of which are complex, are met and that young people live healthy lives. Staff have worked collaboratively with a range of health professionals to ensure young people’s health needs are met in a safe and nurturing manner. This has included staff receiving training from health professionals in order to meet specific individual needs. For example, staff have received training in epilepsy and the administration of medications which are usually administered by health professionals. This close consultation and effective communication has ensured that relevant health information is included in young people’s placement plans. Staff have also received training in first aid, the administration of medication and manual handling.

p.6

Quality of care

Young people’s health is further promoted by the safe implementation of medication procedures. The medication systems are monitored by the Registered Manager which helps to further protect young people and promote their health and welfare.

p.6

Quality of care

Staff are committed to meeting young people’s individual dietary needs and promoting healthy diets. Young people have a say in what they want to eat and menus reflect their individual dietary needs and likes and staff actively encourage young people to try different foods.

p.6

Quality of care

Education is seen as important at the home and is based on individual needs. Staff worked closely with schools and other professionals as part of the admission process to obtain important information about individual’s needs, routines, likes and dislikes and what strategies to use to manage their behaviours. This also helped to provide a smooth transition for young people moving into the home. This continued commitment to working with young people’s schools is improving young people’s opportunities to achieve their full educational potential. Reports from school recognise the improvements in attendance and behaviour made by some young people since living at the home.

p.6

Quality of care

Young people live in a home which is comfortable, and furnished and decorated to a good standard. The décor, furnishings and physical restrictions take into account the behavioural needs and safety needs of young people. Young people are actively supported where appropriate to personalise their bedrooms which ensures their individual identities and interests are reflected.

p.6

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

Staff are fully committed to protecting young people from the risk of harm and abuse. Placing authorities and parents report that young people are safe living at the home. Staff receive a range of training including child protection; behaviour management and health and safety. The home has a clear safeguarding policy which has been considered by, and agreed with the person in the local authority responsible for safeguarding.

p.7

Safeguarding children and young people

Individual placement plans, risk assessments and behaviour management plans are very detailed and contribute to keeping young people safe. These are effectively implemented and regularly reviewed by staff. Furthermore, staffing levels are flexible and take into account young people’s changing risks and identified needs.

p.7

Safeguarding children and young people

Staff are clear about their responsibilities in reporting any child protection concerns. However, the home’s safeguarding procedures are not always followed which may place young people at the risk of harm and abuse. For example, a young person made an allegation against a member of staff and although the placing authority were notified, this was not referred to the person in the local authority responsible for safeguarding. The allegation was unfounded. Additionally, Ofsted were not notified of this complaint as required. This prevents Ofsted from monitoring the quality of care and that care practices are safe.

p.7

Safeguarding children and young people

Staff are working very hard with young people to manage and enable young people to make changes to their extreme challenging behaviours. Staff have worked hard with schools and families to understand what works for individual young people and to provide a consistent approach in managing young people’s behaviours. This close working has informed the very detailed risk assessments and behaviour management plans which are effectively and consistently implemented. Additionally, staff are proactive in making changes to the environment to ensure the safety of young people and have consulted with young people’s schools and occupational therapists. As a result, young people are making steady progress in this area. Restraint is only ever used as a last resort and records are kept as required.

p.7

Safeguarding children and young people

The management of health and safety is good and helps to protect young people and staff from the risk of harm and injury. This is because: all staff take responsibility for the day-to-day management of health and safety; regular testing and servicing of fire safety equipment takes place. Additionally, fire practices take into account young people’s levels of understanding. For example, each young person has a personal emergency evacuation plan. A range of risk assessments are in place which further promotes safety. Safe and rigorous recruitment practices help to ensure young people are protected from the risk of harm and abuse. Appropriate checks are carried out and visitors’ identity is checked.

p.7

Leadership and management

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

p.8

Leadership and management

There is a clear Statement of Purpose which informs parents, carers and placing authorities about what to expect. Practice in the home is in line with the Statement of Purpose. The children’s guide is not in a form which is accessible to children and young people with learning disabilities. This prevents young people from having the opportunity to understand what they can expect from the home.

p.8

Leadership and management

The Registered Manager is clearly committed to improving the lives of young people and presents as a positive role model to young people and staff. She has ably led a new staff team in establishing a good level of individualised care. Young people receive care and support from a staff team who really enjoy working at the home. Staff feel that the team works well together; the team is quickly developing to challenge each other’s practices where necessary which helps to ensure the provision of consistent care. Daily handovers and weekly staff meetings (in school term time) take place which ensures good communication between staff.

p.8

Leadership and management

Staff feel very well supported by the Registered Manager and appreciate her approachability and availability. The Registered Manager is working alongside staff to support them and to set standards and a positive culture within the home. Staff receive regular supervision although they said the Registered Manager is always available if they need to discuss any issues. Staff have a range of experiences and backgrounds in social care although very few have a minimum level 3 qualification in working with children and young people. Staff will enrol on the level 3 course once they have successfully completed their probationary period. However, they have received a range of training including safeguarding; first aid; food hygiene; fire safety; behaviour management and medication training. The commitment to staff training and development is evident in that specialist training has been sourced to ensure staff have a good understanding and awareness of different needs and

p.8

Leadership and management

disabilities. For example, staff have received training from an independent specialist provision on autism; they have received training from the specialist epilepsy nurse.

p.8

Leadership and management

There is a complaints procedure and a file to record details of any complaints or concerns received. Although some concerns have been raised by parents and these have been dealt with the Registered Manager has not kept records of these. This prevents the monitoring of practices and the quality of care in the home.

p.8

Leadership and management

The home has a development plan. However, objectives are broad and do not include measurable targets. Staff and young people have not contributed to the plan.

p.8

Leadership and management

The commitment to continual improvement is evident in the range of internal quality assurance systems. Monitoring of records and practices is undertaken by the Registered Manager who regularly checks and signs a range of records. The whole staff team also take responsibility for monitoring systems and practices within the home. This helps to ensure: practice is safe; care is provided in line with young people’s placement plans and individual protocols. This also informs future developments and practices. The range of internal quality assurance systems are further complemented by the monthly visits carried out by an independent person.

p.8

Leadership and management

There is a system in place to notify appropriate authorities of all significant events relating to the protection of young people living at the home. However, on one occasion Ofsted were not notified as required of a complaint made against a member of staff; and on another occasion was not notified about the admission of a young person to hospital although this was only for a brief period of time. This prevents Ofsted from monitoring the quality of care and that care practices are safe.

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