Children's Home run by Surrey County Council in Surrey

Unique reference number SC370703 Inspection date 10/09/2013 Inspector Jennie Christopher Type of inspection Full Provision subtype Children's home

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Date of last inspection 25/01/2013 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 service is owned and run by the local authority, providing care and accommodation for up to three young people and short breaks for up to 17 young people with learning disabilities.

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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

Young people who live in the home or use the service for short breaks have extremely positive relationships with staff. Staff work hard to make short breaks as enjoyable and rewarding as possible and as a result, outcomes for all young people are good. Staff have extremely effective relationships with parents, carers and external professionals, ensuring a cohesive approach to care planning based on individual needs. Staff support young people to have as smooth as possible transitions between settings to further ensure positive experiences. Young people appear to enjoy living in the home or using the service and parents talk enthusiastically about the care provided.

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Overall effectiveness

The service strives to involve young people and their families in service development via consultation through observations, direct discussion and questionnaires. This approach appears to work generally effectively. While parents are pleased with the care and the service for their child, there is concern regarding the future of the service, the loss of permanent staff and the use of agency staff.

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Overall effectiveness

The management team are aware of the strengths and weaknesses of the service, including the current staffing concerns and are actively seeking to improve wherever possible. Changes in the use of the service from short breaks exclusively to accommodating young people and providing shared care packages have resulted in changes in approach, which have been managed relatively smoothly. This has ensured continuity of care and positive experiences for young people. Recommendations from the previous inspection have been mostly acted on. New requirements and recommendations include providing a stable permanent staff team and ensuring recruitment checks are robust, among others.

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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 there is at all times, having regard to the statement of purpose, and the number and needs of the children accommodated or using the service; and the need to safeguard and promote the health and welfare of the children accommodated or using the service, a sufficient number of suitably qualified, competent and experienced persons working in the home (Regulation 25(1)(a)(b)) 29/11/2013

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Reg. Requirement Due date

(2001) ensure 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; with specific regard to experienced staff to sufficiently support both young people and staff in challenging situations (Regulation 25(2)) 29/11/2013

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Reg. Requirement Due date

(2001) ensure there is full and satisfactory information is available for all staff working in the home as detailed in Schedule 2; with specific regard to obtaining two written references, including one from the person's most recent employer, if any; and a full employment history, together with satisfactory written explanation of any gaps in employment. (Regulation 26(3)(d)) 29/11/2013

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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 home is well maintained and decorated, with specific regard to the kitchens and doors; including consideration of how to minimise damage to doors through alternative door closures (NMS 10.3)  ensure restrictions on movement, including those requested by young people, are not used unless necessary and are agreed with parents and the responsible authority (NMS 10.4)  provide all staff with regular supervision by appropriately qualified and experienced staff (NMS 19.4)  ensure individual children's risk assessments are reviewed and kept up to date (NMS 22)  implement a system to ensure significant events in relation to Regulation 30 are reported within 24 hours. (NMS 24.1)

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Outcomes for children and young people

Young people make good progress as a result of living in the home or accessing the service. Young people are supported to make positive steps towards independence in line with their individual plans and abilities. For example young people are supported to create their own menu, shop for food and then make meals. All young people who use the service in all its functions benefit from very clear plans, ensuring that not only their needs are met, but that they are able to progress towards achievable targets. Young people use a variety of communication methods, including Prox Talkers, PECS and social stories to ensure their views and ideas are communicated effectively. Staff are trained in the use of the techniques ensuring young people are continually involved in planning and decision making.

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Outcomes for children and young people

Young people are supported to understand healthy lifestyles and what this means for them individually. For example, using a juicer to make fresh drinks to increase fruit and vegetable intake; planned reductions in medication and increased engagement in physical activities. Young people who live in the home health needs are met through a variety of professionals including CAMHS when appropriate.

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Outcomes for children and young people

Attendance in education is excellent and proactive joint working ensures skills and development plans for individuals are maintained in all environments, ensuring further positive outcomes. Education is supplemented with meaningful leisure activities such as swimming, baking and visiting local parks. For young people using the service as short breaks, the visit itself is their desired activity and the thoughtful planning throughout their stay ensures they are able to engage in activities they enjoy and when appropriate improve their life skills.

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Quality of care

Young people thrive as a result of positive relationships with staff that are focussed on their individual needs. Parents say that staff ‘always give strong support and attentive care’. Placement plans are formulated in consultation with parents and other relevant professionals and are extremely detailed in all areas of care and day to day planning. The plans include individual’s physical and emotional care, communication styles and how the young person likes to be cared for from their arrival to the time they leave. Further shift planning details time limited activities for each young person to ensure they have routine and a balance of fun and life skills activities. This thorough approach to planning ensures young people benefit from consistent boundaries in their home or home from home environment. Regular reviews ensure care and care packages are still appropriate. Care plans are regularly updated in line with changing needs.

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Quality of care

Consultation with young people can be extremely effective through staff using individual communication techniques to ensure young people are able to share their views and concerns. The manager is actively seeking independent visitors for young people for whom the service is their home, but a lack of volunteers is hampering this. Further work is being completed to ensure young people with varying communication styles are easily able to access external advocacy services. When possible however, changes to the home and service are made as a result of young people views, such as placement of furniture and other items such as televisions in the home. Staff are in tune with young people’s needs and adapt when appropriate to accommodate young people’s wishes.

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Quality of care

All staff are invested in the progress of young people in their care and support educational placements with robust communication between schools and the service. Thorough daily handovers between home and on site school staff ensures there is a consistency of approach to care which aims to lessen the stresses that transitions can cause for young people with complex needs. For young people who do not attend the onsite school, staff remain in close contact with and visit schools regularly to maintain continuity of care and sound information sharing.

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Quality of care

Regular contact with health professionals including CAMHS ensures staff have the most up to date knowledge in how to manage individual’s health and emotional needs. Medication is stored appropriately and there is a robust monitoring system to ensure safety when receiving, administering and returning medication. In case of emergency, there are several qualified first aiders on site at all times.

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Quality of care

The building is spacious and well resourced, although tired in some areas, particularly kitchens. There is also damage to fire door closures as a result of a young person’s frustration. There are separate areas for privacy, play or group interaction. Young people who live in the home have their own individual lounge alongside a larger communal area. Young people using the service as short breaks are able to personalise their rooms during their stay.

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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 to feel safe living in the home and while using the service. Staff do all that they can to keep young people safe through close observation and responding to any changes in their behaviour. There have been no intentional incidents of bullying, and staff respond to any incidents of negativity between young people promptly and effectively. Staff are acutely aware of young people’s individual needs and vulnerabilities and do all they can to protect them from abuse and harm. Any concerns regarding young people’s welfare are reported swiftly and records are clear and include body maps detailing any marks or injuries. Staff are confident in the processes to follow should they be concerned for a young person’s safety or welfare. Young people do not go missing from care, but there have recently been incidents of young people being away from staff in public. Thorough investigations regarding these incidents have resulted in increased staffing for trips out in some

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Safeguarding children and young people

instances and updates to risk assessments. There are several physical protective measures in place to keep young people safe, including key pad entry doors and secure fences.

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Safeguarding children and young people

Individualised behaviour planning promotes and rewards positive and appropriate behaviour. Unwanted and negative behaviour is mostly challenged effectively and diverted. However staff are concerned that they are unable to respond in certain circumstances due to lack of confidence in staff who are not regularly on shift. However responses and tactics in place are mostly a very effective diversion and restraint is rarely required. A recent request from a young person to lock staff the other side of the door from him is not ideal and requires further consideration.

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Safeguarding children and young people

Young people are protected as far as possible from fire, accidents and other hazards as a result of thorough checks and procedures. Each young person has their own fire practice risk assessment to ensure they are able to participate without too much distress. Individual risk assessments are thoughtful and allow young people as much freedom as possible in line with the need to keep them safe. This includes consideration as to whether young people can have access to door keypads to allow freedom of movement around the building and grounds. Some risk assessments have not been reviewed since the young person started using the service.

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Safeguarding children and young people

The organisation’s recruitment is not robust and is not ensuring young people are protected from harm through personnel checks for staff. For example, the practice of only requiring one reference instead of two from internal applicants as raised in the last full inspection, still remains and applicants do not consistently have full employment histories on file with reasonable written explanations for gaps in employment.

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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 registered manager has a very good understanding of the strengths and weaknesses of the home and service and is effectively guiding the staff and service during uncertain times. While there are instances of non-compliance with the requirements of regulation, such as lack of recruitment of permanent full time staff and recruitment checks not being thoroughly robust, the registered manager has raised these issues with senior managers within the organisation. As a result of the shortfall in staffing, the provider is unable to fully meet the aims and objectives as set out in the Statement of Purpose. Parents have raised concerns regarding staffing and the uncertainty over the future of the service, stating that the service ‘is not being utilised to its full potential currently and so many more families could benefit from the provision’ and ‘it would be nice to see permanent staff being employed with secure futures, rather than agency staff being used’.

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Leadership and management

The committed staff team who are in place, fully understand the functions, purpose and ethos of the home and services it provides. They feel well supported by the management team, commenting that managers and senior managers have supported them on shift when required. Recently implemented consultation meetings with managers allow staff to raise any concerns regarding young people. They feel this has helped bring the staff and management team closer together and made them even more accessible. Staff consider they have all the training they require to complete their roles effectively and further training can be accessed if they choose to. Further training needs are identified in yearly appraisals and monitored through supervision. However due to a reduction in the number of senior staff, not all staff have benefitted from regular supervisions. Newly appointed bank staff complete an induction programme specific to the service alongside the Children’s Workforce

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Leadership and management

Development Council’s induction standards.

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Leadership and management

Monthly evaluations of the services’ building and records ensure short falls are quickly identified. Regulation 33 reports are sound. The management team seek the views of young people and their families through varying methods including general discussions, questionnaires and observations. Information and ideas gained help ensure young people continue to benefit from an evolving service. The development plan is stifled by uncertainty regarding the future of the service, but the registered manager has strived to identify achievable key areas for improvement.

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Leadership and management

The home and service demonstrates excellent multi-agency working to improve outcomes for young people. Specialist mental health and behavioural services, among others are actively involved to ensure the best possible care and outcomes for young people. Services that are not performing are challenged appropriately. Further ways to support young people to complain when necessary are being implemented. Complaints from parents are handled appropriately and usually have a positive resolution. The young people’s guide is in two adaptable formats, dependent on communication styles and contains all information young people require on living in the home or staying for short breaks.

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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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