Children's Home run by Progress Children’s Services Ltd in Walsall

Unique reference number SC038526 Inspection date 23/10/2013 Inspector Julian Parker Type of inspection Full Provision subtype Children's home

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Date of last inspection 14/02/2013 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 home provides care for up to five children and young people. This service is available to children and young people with a learning disability, a physical disability and/or sensory impairment. The service is operated by a private organisation.

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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

This home provides a good quality of care to children and young people who have complex disability and learning needs. Good assessments coupled with bespoke, personalised care planning shapes effective care provision around each individual young person’s needs.

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Overall effectiveness

Young people receive attentive one to one care and form trusting relationships with the staff team who look after them.

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Overall effectiveness

Young people live in a safe, healthy and homely environment that welcomes families and carers. Regular health and safety checks ensure the home is risk free and well maintained

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Overall effectiveness

Young people’s medical and educational needs receive the high levels of personal support necessary to maximise health and potential learning outcomes.

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Overall effectiveness

Stakeholders report a high level of satisfaction with the levels of communication with the home and care given to young people.

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Overall effectiveness

Management and staff continually evaluate the service being provided through enlisting stakeholder and service user feedback to ensure children receive the best quality of care possible to keep them comfortable and stimulated. Recommendations raised by the previous inspection have all been addressed satisfactorily. One requirement and two recommendations related to the homes administrative records are raised by this inspection, none of which have an adverse impact on the care of young people.

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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) Produce a guide to the children’s home in accordance with the regulations. Ensure the detail included is kept up to date. Regulation 4(3) 22/11/2013

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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 that a copy of the homes schedule 6 / regulation 34 monitoring document is forwarded to the regulator within the timescales outlined by Ofsted Guidance.( NMS 21)(Ofsted Conducting Inspections of CH Guidance: Para 21)  ensure that up to date information is retained on children’s case files. This relates to keeping care plans and details of persons providing consent accurate (NMS 22.1)

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Outcomes for children and young people

Young people are enabled make good steady progress in this home as a result of the nurturing and personal care they receive from their committed staff team. Within the parameters of their disability key social skills develop both within the home and wider community. Young people learn how to communicate effectively, using different media, with the people close to them. They learn how to get along with their peers and sustain attachments.

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Outcomes for children and young people

Despite not being able to communicate verbally most young people actively participate in day to day decisions about their lives such as identifying their preferred clothes, foods and activities. They are able to engage in meaningful routines such as enjoying regular contact by phone and Skype and by indicating through the use of signs and gestures when they are unhappy or uncomfortable. Using the range of communication tools available to them such as Makaton, time, listening and observation and regular key worker sessions, attentive and receptive staff understand the communication nuances of each young person and share their knowledge with other carers to widen the circle of social interaction. In this way young people receive help to participate as fully as possible to express their views.

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Outcomes for children and young people

The educational achievement of young people is very good taking into account both their attendance and progress from their starting point at the time of placement. Excellent levels of communication between each young person’s special school and home ensures that even minor milestones and achievements are celebrated, helping young people build self-esteem and confidence.

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Outcomes for children and young people

Young people enjoy recreational experiences in the community with the help provided so enabling them to visit parks, go shopping or take part in specialised activities such as riding for the disabled. The home acknowledges these special occasions with artwork pictures produced by the young people and photos of the events adorning the walls of the home and individual bedrooms.

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Outcomes for children and young people

Staff communicate effectively with children, helping them to understand about their backgrounds and keep in touch with families wherever this is agreed by the care plan as appropriate. This helps children feel secure in placement and develop greater levels of self-confidence while being looked after. Individual success, however small, is always praised consistently helping young people remain comfortable, confident and happy.

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Outcomes for children and young people

Because the health needs of young people receive careful consideration prior to their admission they can be effectively addressed. The manager and trained care staff work very closely with families, specialists and medical professionals to address the routine and complex medical concerns presented. Young people’s mobility benefits immensely from the provision of appropriate equipment such as hoists, specialist beds and wheelchairs that assists their particular freedom of movement needs. Alongside the promotion of everyday healthy eating young people’s specific dietary needs including likes and dislikes are well catered for. Staff understanding, training and health monitoring meet the specific needs of young people having specialist nutritional and feeding requirements. A social worker commented that this elevated level of care is ‘second to none.’

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Quality of care

A social worker new to the children’s home records in their compliments book that; ‘Following my placement visit to see my child I was extremely pleased to see how well he was doing. It is clear he is settled and secure in his placement and this is testimony to the quality of care he receives. The staff present as very caring and it is evident they have the wellbeing of all the children in their care at heart. All in all an excellent placement for ‘my child’.

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Quality of care

Young people receive observable sensitive and nurturing care. They demonstrate strong caring attachments, particularly evident when children, through their disability or medical conditions become distressed or urgently need holding to reassure and keep them safe.

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Quality of care

A detailed knowledge and understanding of young people enables staff to recognise the particular indicators of mood, behaviour and body language that non-verbal individuals rely upon to communicate. In this way the care provided is adapted to meet individual needs and young people learn to develop constructive relationships with their carer’s. Detailed, live care plans inform the provision of individualised care and include regular updates confirming that service delivery is flexible and able to adapt to changing need. However, some of these key documents require further clarity in identifying when they were initially produced and most recently reviewed by the key worker and manager.

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Quality of care

This home is very effective because the complex and disability needs of children receive thorough and careful assessment prior to admission. For example, one member of staff met with and stayed with a child in hospital for several days prior to the admission to confirm that the home could confidently meet the young person’s needs. From this level of pre admission assessment the individual care plans drawn up for young people provide informed guidance about how to best deliver care and how specific needs are expected to be met. Plans identify the additional services and support needed, principally related to disability but also include ethnicity, race, sexuality, faith or religion in so far as these are requested from both the young person and their family. This ensures that all staff are consistent in their approach so that young people benefit from a service that is tailored to meet their individual

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Quality of care

Effective working arrangements between the home and other support services exist, for example the close working relationship between management and staff from the home and the young people’s individual special schools ensure the promotion and achievement of best educational outcomes. The home receives daily updates from schools either by phone call or via communication book facilitating the sharing of key information about each young person. Staff will attend school and work alongside teaching staff to support individuals to settle in or during difficult periods. The families of young people receive help from the home to attend school events and celebrate their child’s educational achievement. Arrangements for transporting young people to and from school using vetted and recognised escorts ensures that young people are safe during the transition between daily routines.

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Quality of care

Young people are well cared for by staff that are appropriately trained to promote their, often complex, health needs. The manager and staff advocate effectively by their liaison and positive working relationships with other professionals. Wherever practicable, parents and families are fully involved in these discussions. Staff access the full range of health related services including child and adolescent mental health service’s (CAMHS), specialist consultants, occupational health advisers and specialist equipment providers in order to progress each young person’s medical needs and promote general health. Robust systems employed within the home ensure the safe storage, handling, monitoring and disposal of all medication. Staff receive specialised training to administer medication safely and lift and handle young people safely. The homes manager complimented her organisation’s commitment to developing staff

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Quality of care

knowledge and skills in all aspects of caring for disabled children. She believes this valuable input keeps children safe and staff motivated.

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Quality of care

Although behaviour management is not an observable concern within the home young people always receive support and consistent encouragement through the use of praise to behave in an acceptable manner. Informative behaviour management plans using information and risk assessment sourced from school staff, social workers and parents are collated to form the key behaviour management strategies promoted by the plan. The effectiveness of these plans is measured by reductions in the incidence of difficult behaviour and young people gradually learning how to self- regulate their behaviour. For some young people, because of their complex needs, these changes are subtle and take place over prolonged periods.

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Quality of care

The service has received no complaints since the last inspection. A complaints procedure is in place that has been adapted into a format that is understandable to children with learning difficulties by using signs and symbols. The high level of familial and social worker involvement within the home effectively provides advocacy in addition to the formal organisations available to children. Because staff understand the children they work with very well any unexplained change in presentation or behaviour is quickly recognised and explored. The one-to-one time staff spend time with young people helps ascertain their feelings and provide the opportunity to communicate through their preferred mode of communication any concerns they may have.

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Quality of care

Staff fully acknowledge the need to protect vulnerable children from any form of oppressive, hurtful or bullying behaviour by taking assertive action if such concerns arise. Careful placement matching, including assessing the compatibility of young people, and enabling high levels of staff vigilance significantly reduces the potential for this behaviour.

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Quality of care

Staff support young people to access to a range of appropriate leisure opportunities, both on site and in the community. This encourages young people to enjoy familiar activity and places and explore new activities and develop new skills. Group activities do take place, such as organised holidays and day trips out but most activities are individually focused upon known interests and needs. The homes staffing levels ensure that adequate numbers of staff are on duty to meet recreational needs. As with all aspects of this service, organised activity plans confirm a sensible balance between children’s levels of activity and relaxation.

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Quality of care

A social worker commented that her child is always well groomed because she enjoyed pedicures and manicures as a favoured activity.

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Quality of care

The home is very supportive to children’s parents, family and carers. Where permitted by care plans staff work closely and cooperatively with families and by doing so develop excellent relationships that support improved outcomes for young people. Placement plans specify permitted contact arrangements. Social worker feedback confirms that the home is ‘fantastic’ at supporting contact arrangements.

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Quality of care

Young people enjoy living in a clean, comfortable, well-maintained home. The dormer bungalow style dwelling is purpose built providing adequate space and facilities for young people, most of whom may have mobility difficulties and are wheelchair dependent. Young people receive help to personalise their bedrooms by expressing their preferred colours and pictures and displaying favoured toys. Most rooms have televisions and DVD players enabling children the option of watching their own preferred programs rather than communal viewing. For most young people specialist equipment is necessary, for example hoists, beds and chairs. Walls display pictures of events and activities involving young people’s artwork or involvement in activities.

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Quality of care

The small, fully enclosed, safe back garden, complete with play equipment, offers young people valuable access to fresh air and sunshine. The front garden includes a chalet which is used for relaxing and key work sessions, various surfaces and plants chosen for their sensory properties.

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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

Recognising the vulnerability of young people living in this home, the operational systems for safeguarding children and the managing risk of all types attract high priority. The manager and staff team have an excellent understanding of how to practically protect, safeguard and keep vulnerable young people with complex needs safe. Clear direction, visible instructions and regular training ensure that all staff know their responsibility for reporting any concerns about shortfall in practice or colleagues conduct.

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Safeguarding children and young people

Staff dedicate time for being with young people in key worker sessions where they convey information relating to risky behaviours, subject to levels of understanding, such as running away, stranger danger and road safety. These sessions also enable young people to communicate any concerns or anxieties they may have about their own wellbeing and safety.

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Safeguarding children and young people

Recognising young people’s susceptibility to harm staff are aware of the procedure to follow in the event of a young person going missing, even though it is unlikely because of low levels of mobility. Permanently high levels of supervision reduces this risk significantly and all staff know what immediate action is required to search for and report a young person missing to the police, using the existing protocols. Local police visit the home socially and have a good first hand understanding of the vulnerability of residents.

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Safeguarding children and young people

The home provides a safe and relaxed environment for young people to live where intentional behavioural challenge is uncommon. Staff receive appropriate behaviour management training and understand the individual plans and the strategies in place for managing potential emerging behaviour. This enables staff to confidently and skilfully discuss how to manage emerging situations individually and as a team.

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Safeguarding children and young people

The use of physical restraint, applied using a permitted methodology, is available as a last resort in an extreme circumstance to young people hurting themselves or others. In the event of a restraint taking place or a sanction being applied appropriate records are maintained. Sanctions are rarely used as young people receive consistent constant praise for their good behaviour and reminded if this slips below what is expected. Clear guidelines and practice helps young people enjoy the praise they receive from behaving appropriately and safely.

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Safeguarding children and young people

The homes manager and senior staff recognise that changes to staffing may be disruptive to the young people’s routines. Importance is given to ensuring wherever possible staff from the home cover weaknesses or shortfalls in the daily roster. In this way young people benefit from knowing which staff will be looking after them. Only suitably experienced adults are employed at the home having been authorised by the provider’s robust recruitment policy and practices. Visitors to the home must provide evidence of their identity and to sign a visitors’ book. These safeguarding systems ensure that children receive protection from any unauthorised individuals.

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Safeguarding children and young people

The health and safety of young people, staff and visitors by the home is prioritised. Effective management of the overall physical safety of the home is through on-going review of any potential dangers identified through generic and specific risk assessments that cover all aspects of daily living. A rolling maintenance programme addresses environmental shortfalls and necessary repairs quickly. These potential risks include those from fire hazards, from the behaviour of children and from recreation or outdoor activities. Risk assessments take into account changes to daily routines, shortfall with the fabric of the home, egress from the home in an emergency and the effective maintenance of staffing levels. Suitable levels of public and employee liability insurance are in place.

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Leadership and management

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

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Leadership and management

Since the last inspection the home has benefited from a change of registered manager and appointment of a deputy manager. The employment of a full time manager with additional responsibility for the provider’s immediately neighbouring service effectively covers the leadership and management needs of both homes. A committed staff team competently supports the qualified and experienced manager. Together they provide the home with the stability required to offer young people support and security in their placement. Staff aim to deliver a consistently dependable high quality of care that enables positive outcomes to be achieved.

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Leadership and management

Having direct access to the provider’s comprehensive policies, procedures and guidance enable care staff practice to be both informed and developed. On-going training opportunities exist for staff to further enhance individual personal development. This factor contributes to the overall competence and drive of the home for understanding and successfully managing complex disability related behaviour. Management records and staff feedback confirm that regular supervision and annual appraisal of individual performance supports staff practice.

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Leadership and management

The home continues meeting the aims and objectives as outlined by its Statement of Purpose and continues to provide a high quality of care to children. A visual guide is available describing key information for children in different communication formats however this key document is now out of date and misleading. The manager and staff team fully understand the purpose and ethos of the home and share this with stakeholders including social workers children and their families.

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Leadership and management

There have been no complaints or concerns about the service provided to young people by the home since the last inspection. Social workers responding to an inspection survey said that they would recommend this home to their peers. One said it is a ‘brilliant placement’ its ‘very good at ensuring needs are met’ and that young people are ‘treated as individuals’

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Leadership and management

Leaders and managers understand the strengths and weaknesses of the service. Quality assurance systems include regular consultation with external stakeholders, such as placing authorities, along with more regular input from young people, their parents and staff informs the manager’s day-to-day practice and the homes evolving development plan. All placing authority social workers contacted comment very positively about working as partners with the home to progress their children’s placement plans.

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Leadership and management

The provider has fully met the requirements from all previous regulatory inspections.

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Leadership and management

The home benefits from monthly monitoring visits by an independent person. The manager and a member of senior house staff undertake in-house quality control monitoring. The frequency and focus of the latter while meeting the expectation of the regulatory schedule falls short because copies of these are not forwarded to the regulator for scrutiny as prescribed by Ofsted guidance. This means that record monitoring and audit trails confirming how the manager has addressed potential concerns are not apparent.

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Leadership and management

The hard copy and electronic personal records of young people are stored securely and kept confidential. They cover all matters required by the regulations, inform staff practice and confirm how children can receive help and support to achieve.

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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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