Children's Home run by Kent County Council in Kent

Unique reference number SC037282 Inspection date 04/11/2013 Inspector Sophie Wood Type of inspection Full Provision subtype Children's home

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Date of last inspection 20/02/2013 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

This children’s home is operated by a local authority and provides short break care for children and young people aged between 5 and 17 years, who have learning difficulties, physical disabilities and other associated complex needs.

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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

Children and young people thoroughly enjoy using this service. They frequently stay alongside their friends and this enhances their social opportunities. A safe and welcoming physical environment is further complemented by the care and expertise of a suitably qualified, trained and experienced staff team. Children and young people with complex care needs are competently cared for and make good progress in all aspects of their growth and development.

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Overall effectiveness

Positive and appropriate relationships are quickly fostered between the staff and the children. Genuine affection is demonstrated and enjoyed by all parties. A good balance is struck between the establishment of appropriate behavioural expectations and creating a warm and loving environment. Parents capture the culture of the service by saying, 'it's like leaving my child with a trusted friend.'

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Overall effectiveness

Staff know the children and young people very well. Care needs and wishes are regularly reviewed and updated, incorporating the views of parents, carers and children. Health and medical needs are comprehensively looked after and recorded. Staff's actual understanding of additional care needs, such as a child's personal identity and independence skills is strong. However, these areas are let down through poor recording. The overall quality of short break care plans is compromised because of this and a requirement is made to address this shortfall.

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Overall effectiveness

Staff conscientiously implement the service's health and safety policies and procedures. They further demonstrate a clear awareness of the potential risks that children's individual disabilities and behaviours may present. Incidents affecting the safety and welfare of the children are rare. In the event of accidents, safeguarding concerns and welfare issues, the service responds swiftly and implements improved practice from the lessons learned.

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Overall effectiveness

The Registered Manager has a good and accurate understanding of the service's strengths and weaknesses. Recent improvements, resulting from robust monitoring include better communication systems and consultation processes being established for all stakeholders. Work is currently underway to further improve the content and quality of the Statement of Purpose to ensure parents, carers and social workers fully understand the aims and objectives of the service. A small number of areas, particularly some records, still need tighter monitoring and the Registered Manager is already aware of this. Regulation 33 monitoring is recognised by the local authority as being inconsistent. A recommendation is made to ensure the very new process is robustly monitored to ensure its continued effectiveness.

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Overall effectiveness

A total of two requirements and three recommendations are made from this particular visit. These are largely concerned with making improvements to records. These shortfalls do not currently compromise the safety and welfare of the children and young people using the service.

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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

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children's home, a written record is made in a volume kept for the purpose of which shall include- (a) - (i). This requirement is made within the context of ensuring that all of the areas listed are included (Regulation 17B (3)(a)-(i) 17/12/2013

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Reg. Requirement Due date

(2001) prepare a placement plan for the child setting out, in particular - (a) how, on a day to day basis, he will be cared for, and his welfare safeguarded and promoted by the home. This requirement is made within the context of ensuring that short break care plans comprehensively cover all areas of a child's needs and how these will be met. (Regulation 12 (1B)(a) 17/12/2013

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  ensure that there are clear and effective procedures for monitoring and controlling the activities of the home. This recommendation is made with regards to ensuring that all areas monitored under Regulation 33 and Regulation 34 are robustly checked (NMS 21)  ensure that the revised aims and objectives of the Statement of Purpose are child focused and show how the service will meet outcomes for children (NMS 13.2)  ensure that there is an emergency escape plan that all staff and children are familiar with and have practised so they know what to do in an emergency. This recommendation is specific to ensuring that all written fire evacuation instructions are consistent with each other. (NMS 10.9)

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Outcomes for children and young people

Children and young people enjoy their short breaks at the service. They establish safe and appropriate relationships with staff members. This enables them to become confident in their surroundings. They learn to explore their environment and take full advantage of the opportunities and activities available to them.

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Outcomes for children and young people

Secure and happy children develop confidence in their own skills and abilities. Staff provide a stimulating environment which encourages growth and development. Children receive targeted support on specific areas derived from regularly updated care planning. Steady progress is made with regards to their emotional, social and behavioural development. Parents capture this by saying, 'welcoming helpful staff help my child to gain independence and make friends.'

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Outcomes for children and young people

Children with additional health issues receive the support they need. Specific interventions and medical regimes are safely delivered but this does not interfere with having fun. Looking after children's health needs is an integral part of their stay but it is not the only focus. Children say, 'I like coming here to play and to see my friends.'

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Outcomes for children and young people

As a short break service, there is no requirement for it to promote the educational achievement of children. However, for the benefit of those using the provision, children do maintain their usual routines by attending school when they stay during term-time. Staff liaise regularly with school colleagues. The impact of this is particularly positive for children when both services share information and work collaboratively on specific goals and targets. Examples include behaviour management strategies and providing a consistent approach in teaching self-help skills. Children enjoy a better chance of success from such consistency.

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Outcomes for children and young people

Parents routinely say that they can readily contact the staff and their child during a stay. One comment received to the contrary is being further explored by the Registered Manager. Parents often report that they feel the need to maintain frequent contact when they first start using the service. Over time and with increasing confidence, this need lessens. Comments from parents include, 'they were very patient with me and I could 'phone whenever I wanted. I don't feel the need to do it as much now' and 'once we were all confident the service has become a lifeline, my child has a wonderful time and we re-charge our batteries. The benefits are for the entire family.'

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Outcomes for children and young people

Children and young people become increasingly independent. Individual examples demonstrate young people, and their families, being appropriately supported in preparing to move onto adult services. Other examples show younger children acquiring new skills, such as using communication aids, dressing themselves and learning to use their own cutlery utensils. There are rare occasions where potential growth and development may be hindered or restricted. For example, through compromised independence in attending to their own personal care needs due to the supervision and safety procedures of the service.

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Quality of care

Children and young people positively respond to the consistent, well informed practice of the staff team. Individual personality traits are very well known. This factor enables staff to anticipate and therefore reduce potential triggers which may otherwise lead to difficult or challenging behaviours. Children experience feelings of safety and security because their needs are well known and effectively looked after.

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Quality of care

Behaviour management plans and individual risk assessments clarify potential triggers and unsafe behaviours. Appropriate guidance is subsequently implemented by staff and this is regularly reviewed and updated in response to any incidents or changes. Team meetings are particularly effective in monitoring these areas.

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Quality of care

Good planning enables children and young people to frequently access the service alongside their friends. The allocation of dates is subject to a range of factors; maintaining peer friendships and meeting parental requests heavily influences this process. Examples of responding to emergency requests reflect the service's aims of supporting whole families in times of need. Parents say that this flexibility adds to the quality of the provision.

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Quality of care

In recent months, much work has been completed on consultation and communication processes with children and their families. A spirited and energetic drive in improving these areas is already realising positive results. The increased use of communication aids and adaptations ensures that children have ready access to making their needs and wishes more immediately known. This further complements consultation processes. Recent children's meetings have focused upon topics including how they can raise concerns and complaints and how children wish to spend their time when staying at the service.

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Quality of care

Children and young people's health needs are fully recognised and carefully looked after. A high number of children have complicated conditions, requiring expert care and attention. Medical procedures and therapeutic techniques are overseen by professional nursing expertise; care staff receive bespoke training and on-going monitoring of their practice. The complex care needs of children are confidently absorbed into the daily operation of the service. Their health needs are significantly important but meeting these does not impinge upon their additional wider needs of being a child. Social, emotional and intellectual growth is equally nurtured through play, activities and much one to one support.

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Quality of care

Short break care plans are used to capture the holistic and wide ranging needs of each child and young person. Sections are dedicated to all potential areas of need and care but some are better completed than others. Areas with regards to health are clear and succinct; this written guidance is being competently implemented. Those areas covering topics such as personal identity and independence sometimes lacks such precision. Staff are generally able to describe the presenting needs of the children in these areas but with less clarity. A requirement is made to address this shortfall to ensure that children receive a very individual approach to care planning across every area of need.

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Quality of care

Parents, carers and children do play an active role in day-to-day care planning. Parents are required to check short break care plans at every third stay. Annual review meetings also capture the input of parents and children. These processes are used to identify goals and targets for children during their stays. Good quality examples show children making great progress, such as improved social interaction and becoming more communicative. These plans are clear and staff know what is required. However, there are also examples where the guidance for staff is not as clear. Addressing personal identity needs is often ambiguous. This omission risks less progress being made or good progress being missed.

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Quality of care

During term time, children and young people are well prepared to attend their usual school. Transport arrangements run smoothly and the vast majority of education reviews are attended by the service. This process allows staff from both settings to share information and to work collaboratively. When children are not in school, they take full advantage of the wide range of activities provided by the service.

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Quality of care

The premises are fully utilised in this regard. The spacious accommodation includes a soft play area, a sensory room, spa, quiet areas and extensive outdoor space which is fully equipped with toys and large play apparatus. Parents usually commend this provision but some say that their child would benefit from more off-site activities. Consultation meetings are currently exploring children and young people's views with regards to activity provision.

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Quality of care

A robust maintenance programme ensures the provision is appropriately equipped, well-decorated and comfortably furnished. Children and young people have particular favourite bedrooms because each is uniquely decorated to reflect the wide ranging preferences of those who use the service. A dedicated team of ancillary staff take great pride in the presentation of the premises. All areas are cleaned and maintained to a high standard. Children and young people with associated physical disabilities enjoy freedom of movement around the premises and are not restricted in terms of accessing the provision.

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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

Children and young people enjoy their time at the service within safe and secure boundaries. Staff competently implement the guidance they receive from comprehensive, regularly updated safeguarding training. This is tailored specifically to include the challenges presented in looking after extremely vulnerable children, whose needs are complex.

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Safeguarding children and young people

The service strives to achieve an appropriate balance in providing children with freedom, the opportunity to learn through appropriate risk taking and keeping them physically safe and secure. Good use is made of premises, group and individual risk assessments in this regard. For the vast majority of children and young people this works well. However, there has been an example of a child leaving the premises and another feeling their privacy was compromised due to excessive supervision. In both instances, the service has conducted thorough investigations which have driven improvements in these areas.

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Safeguarding children and young people

Staff are good at recognising and reading the unique and sometimes idiosyncratic behaviours of children and young people. Individual behaviour management plans describe many of these as vital tools of communication. This results in children's individual needs being well understood and subsequently, many challenging behaviours are avoided. Staff do receive accredited training in the use of physical intervention techniques. However, staff skills in the use of de-escalation techniques result in the relatively infrequent use of such interventions.

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Safeguarding children and young people

Children and young people are suitably protected by the minimal use of sanctions and physical interventions. Transparent practice also ensures that parents and carers are informed of any such use. Staff record any form of physical guidance as a restraint measure. This ensures the team maintains a heightened awareness of the frequency of its use and whether it is appropriate. Although the Registered Manager follows up each incident, the recording log does not hold all of the required information in the same place. There are also a few examples whereby the effectiveness of the measure has not been robustly described. There is a potential risk that robust monitoring could be compromised by such shortfalls. A requirement is made to ensure all of the required elements are held in the dedicated log.

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Safeguarding children and young people

The Registered Manager maintains regular, professional links with placing social workers. Sensitive and appropriate information, including any safeguarding concerns are effectively communicated. Staff, including the ancillary team, understand their own roles and responsibilities to report any such concerns. Explicitly clear lines of accountability and the action to take in dealing with allegations is well understood. This guidance places the welfare of the child at the centre of staff practice.

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Safeguarding children and young people

Children and young people are suitably protected by the service's robust recruitment procedures. New staff do not commence until all required checks and references are in place. Volunteers, including work placement students are sometimes used. They too, are subject to appropriate vetting and their roles and responsibilities are made explicitly clear. They and visitors to the service are appropriately supervised when on the premises.

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Safeguarding children and young people

Children and young people stay in a safe and secure environment. Routine maintenance systems are expertly implemented by the service's handy person. Health and safety checks are routinely conducted and the servicing of specialist equipment is up to date. Fire safety records are diligently completed and fire practice drills occur very regularly. Staff are acutely aware of fire safety; this is referred to at every night-time handover. Staff practice far exceeds the quality of one aspect of the written guidance. For absolute clarity, this needs to be updated.

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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 staff team is effectively led and well supported by an experienced, appropriately qualified Registered Manager. The senior team is comprised of long serving permanent staff who also possess the qualifications and experience relevant to their positions. More junior and part-time staff benefit from good oversight and management. Duty rosters ensure the presence of senior leadership, as well as clear on-call arrangements across every shift. The individual and group needs of children are meticulously scrutinised to further ensure that good and safe staffing levels remain consistently in place.

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Leadership and management

Staff across all disciplines receive supervision and appraisal in a frequency and depth which is commensurate with their roles and responsibilities. Mandatory training for all staff is closely monitored to ensure this remains up-to-date for the benefit of the children and young people. Additional training and development needs and opportunities are tracked through supervision and performance systems. Staff receive much encouragement to further develop their skills and knowledge. The combination of a team made up from health and social care expertise is providing children and young people with the expertise their carers need.

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Leadership and management

The service actively encourages parents, carers and children to make full use of complaint's procedures. Areas described by parents as being 'of moderate concern' receive the same level of scrutiny which is applied to formal concerns and complaints. These are recorded in the same way; hence, the service's complaint's log shows a relatively high number; six since the last inspection. The Registered Manager maintains this approach is vital to ensure the robust monitoring of all types of concerns, leading to reflective practice and continued improvements to the quality of the provision. Two of these complaints have additionally been made to Ofsted. The service has instigated thorough investigations and instigated improved practice as a direct consequence.

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Leadership and management

No requirements or recommendations were made from the previous inspection. Historically, the Registered Manager demonstrates a timely response when this has occurred. She also demonstrates a transparent approach in sharing information with external agencies. Notifications of significant events and incidents are made to Ofsted in a timely manner. Such information is candid, accurate and relevant.

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Leadership and management

Children and young people benefit from using a well-equipped and safely maintained service. Appropriate staffing levels provide much one to one care. Specialist equipment is regularly serviced. Specific medical and therapeutic techniques are only delivered to children by staff who have received the required training and on-going supervision. Parents routinely commend these aspects because they are reassured that their child's individual and unique needs are being effectively met.

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Leadership and management

Relevant care records are generally informative and well maintained. Incident and accident records for example, are diligently completed. Staff handover information provides clarity and medical records are robustly scrutinised. Some parents express frustration at the time taken to admit their child's medication. However, the diligence in place around children and young people's medical and health needs is largely responsible for keeping errors and concerns to an absolute minimum. The majority of parents commend the written reports they receive following their child's stay. This is particularly relevant to children and young people with communication difficulties who cannot always describe their own experiences. Partnership working and communicating with parents and carers is a strength. Individual short break care plans contain a lot of relevant information. In some cases, children's targets and achievements are explicitly clear and records effectively demonstrate how they have

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Leadership and management

made good progress over time. However, there are other examples where this information is less evident.

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Leadership and management

The service links its monitoring findings into an evolving development plan. This remains focused upon securing short and longer-term improvements. One example includes the decision to review and update the Statement of Purpose. The service recognises the need to be more explicit in describing its safety and security arrangements and care planning processes to ensure parents and carers' full understanding and expectations of the provision.

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Leadership and management

The Registered Manager comprehensively monitors many areas of practice and service delivery. This is conducted under Regulation 34 and has instigated a number of improvements. Previous shortfalls relating to communication and consultation processes have been successfully addressed. Complaint's information is shared openly across the whole team and its findings positively influence necessary changes. Some areas still need greater scrutiny, such as behaviour management records and the detailed quality of individual care plans. However, the overall outcomes of such monitoring are positive and lead to improving the quality of care received by the children.

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Leadership and management

Monthly Regulation 33 visits are also used to report on the quality of care to the Registered Provider, Kent County Council. This process is currently subject to on- going changes. Although some areas are keenly explored, others receive less scrutiny and evaluation. Visits are sometimes conducted by different individuals and the reports have not always been returned to Ofsted within the required timescales. Current decisive action is tackling this shortfall but the benefits of this revised approach are yet to be established.

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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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