Children's Home run by Resicare Alliance Limited in Birmingham

Unique reference number SC463639 Inspection date 13/11/2013 Inspector Julian Mason Type of inspection Full Provision subtype Children's home

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Date of last inspection 19/07/2013 Website: www.ofsted.gov.uk

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Brief description of the service

The service is operated by a private company and is registered to provide care and accommodation for up to four 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

This is the home’s first inspection since registration in August this year and has been providing services to an increasing number of young people since this date.

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Overall effectiveness

Young people benefit from a home environment that provides a nurturing and safe foundation for them to settle and make progress in their lives. This helps each young person build on their social skills and develop their relationships. The staff team work well together and with external services which helps ensure young people experience coordinated care and support.

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Overall effectiveness

High staffing ratios ensure young people receive the attention they require so they can be fully involved in their care and support arrangements. Young people’s daily arrangements are planned and organised to match their growing independence and social skills. Staff continually assess risks; balancing the need for young people to learn from their experiences against the need for everyone to be safe. Staff want all young people to make progress and achieve their full potential irrespective of their learning disability.

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Overall effectiveness

Five requirements and one recommendation have been made as a result of this inspection. Overall, staff are appropriately vetted and checked before they start work in the home but records do not always fully evidence an applicant’s work history or gaps in employment. The home’s Statement of Purpose does not clearly reflect how emergency admissions will be managed. The home’s complaint record does not always outline actions or outcomes of complaints and not all significant events have been notified to Ofsted as required. Staff do not receive formal supervision with the frequency outlined in the home’s staffing policy. Systems for gathering feedback from stakeholders as part of the manager’s quality assurance processes are not yet in place. Overall, these shortfalls are minor and do not significantly impact on young people living at the home presently.

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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) keep under review and where appropriate revise the Statement of Purpose to ensure it reflects all matters listed in Schedule 1 (Regulation 4(5)(a)) 31/12/2013

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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)) 31/12/2013

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Reg. Requirement Due date

(2001) ensure all persons who work at the home are fit to do so and that information is available in respect of each of the matters specified in schedule 2 of this regulation (Regulation 26(1)(a) and (3)(d)) 31/12/2013

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Reg. Requirement Due date

(2001) ensure any of the events listed in schedule 5 of this regulation takes place, the registered person shall without delay notify the persons indicated in respect of the event (Regulation 30(1)) 31/12/2013

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Reg. Requirement Due date

(2001) ensure the system referred to in this regulation shall provide for the consultation with young people's parents and placing authorities. (Regulation 34(3)) 31/12/2013

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure that staff are provided with regular supervision in accordance with the home's policy (NMS 19.4)

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Outcomes for children and young people

Outcomes for young people are adequate .

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Outcomes for children and young people

Young people are welcomed into the home and are encouraged to make a positive start towards achieving the agreed aims and goals of their placement. Staff work in a coordinated and planned way to build familiar care and support routines that match each young person’s needs and circumstances. This has been slightly undermined recently because plans to admit a new young person had to be brought forward at short notice. Although risks are assessed in these circumstances, this in reality did not help prepare the team to manage some very difficult and challenging behaviour. For a period of time, this had a negative effect on other young people’s comfort and welfare. However, staff have worked hard to overcome these difficulties, which has resulted in all young people making some progress in comparison to their circumstances on arrival.

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Outcomes for children and young people

Young people's needs in relation to their health and well-being are consistently met. Staff aim to maintain and improve young people’s health and fitness through the promotion of good diets and regular exercise. Medication is safely administered and closely monitored to ensure young people benefit from the prescribed medicines they take. This is especially the case for medicines that are taken for life long health conditions and diagnoses. Young people’s health also benefits from effective partnerships the home has with health professionals such as mental health and learning disability specialists as well as local General Practitioner services. This ensures key professionals can quickly access information from carers to help with the treatment and review of long term conditions that can impact on an individual’s quality of life.

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Outcomes for children and young people

Some young people arrive at the home having experienced significant difficulties with behaviour and attendance at their educational placements. Staff promote the value of education and learning; they work with education professionals and advocates to improve engagement and attendance. Staff fully involve young people in these processes to ensure programmes meet their learning needs and circumstances. Those young people who have established patterns of good attendance and engagement are well supported to make continued progress.

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Outcomes for children and young people

Young people are supported and encouraged to maintain and develop family contact and friendships. The staff have a good focus on working with families to ensure young people maintain positive contact. Appropriate arrangements for contact are promoted and facilitated for each young person including visits to their family as well as welcoming social visits to the home. Young people are encouraged and supported to learn about independence and develop their skills according to their own abilities and potential. Staff expect young people to expand and develop their social and personal skills irrespective of their learning disabilities. Staff do not make assumptions about young people's capabilities. They assume that all young people have the potential to develop their practical and social skills in pursuit of greater independence and autonomy.

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Quality of care

Staff are attentive and flexible as they get to know young people and learn about their histories and backgrounds. Currently, young people who are still new to the home sometimes continue to display difficult and challenging behaviours. They are sometimes resistant to the guidance given by staff and this has an impact on what they can help young people achieve in the short term. However, young people are forming attachments with the team; which has helped reduce the incidents of poor and risky behaviours. Staff are positive about their work and recognise that each young person has the potential to make progress despite some of their difficulties. This demonstrates the potential of the team to have a greater and lasting impact on young people’s behaviour in the future.

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Quality of care

Young people's views, wishes and feelings are acted upon in the day-to-day running of the home and each young person is involved in decisions or changes in their lives. All young people are encouraged and supported to communicate their views about their care and support because attention is paid to the ways in which they communicate. This includes the use of visual aids as well as observing non-verbal communication that reflect choices and preferences being expressed through behaviours and gestures. The staff team’s growing knowledge, awareness and skills in communication is supporting the development and implementation of personalised care.

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Quality of care

Young people, placing social workers and families are able to raise any concerns they have about the service quickly and easily. Several complaints have been made by young people since the home opened but these have been resolved satisfactorily, although actions and outcomes are not always recorded in the home’s records as required.

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Quality of care

Staff are knowledgeable and aware of each young person's background, family circumstances and learning disabilities. They can draw from a detailed range of information that helps them learn about individual identities and specific needs. Young people’s individual placement plans are monitored and kept under review to ensure that day-to-day care reflects agreed plans. For instance, staff spend lots of one-to-one time with young people to ensure that weekly planners are implemented in full. Placing social workers and families are also involved in care planning and reviews, and regularly receive updates regarding progress and developments. Placing social workers are positive about the care and support provided and the progress young people have made so far.

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Quality of care

Young people develop their social and physical skills through the accessible and encouraging environment created by the home. Young people are supported to pursue their favoured activities. Staff regularly help young people to make choices about the use of their leisure time that includes accessing lots of community and recreational venues and activities. Staff ensure that young people enjoy their free time and are not disadvantaged because of their learning disabilities.

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Quality of care

Young people live in a clean, tidy and safe home. The house has lots of space and is in a suitable location where access to local facilities and services is good. The home’s environment is well maintained and decorated and includes a sensory room and an indoor soft play area. Staff receive health and safety training which helps them assess and manage environmental risks. Health, safety and fire equipment checks and routines are carried out regularly to ensure the home is safe. This means that young people benefit from living in a comfortable, safe domestic setting that is monitored regularly.

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Safeguarding children and young people

The service is good at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Young people are safe and their welfare is effectively promoted. They do not leave the home without permission or go missing from care. Staff are establishing positive relationships with young people which supports improving peer and staff interactions. Staff are aware and alert to any signs and symptoms that might indicate that a young person is at risk. Staff implement risk assessments in practice which means that they consider how young people are supported in a safe and proportionate way. This means balancing risks between the need to experience appropriate levels of independence and to maintain everyone’s safety.

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Safeguarding children and young people

Overall, the home has systems and processes in place to help determine the suitability of newly employed staff to work with young people. Newly recruited staff do not start work in the home until all necessary checks have been completed. These systems also include gaining key vetting information from employment agencies when temporary staff are used. However, staff profiles do not fully reflect necessary information about work histories or subsequent gaps in employment. Important information is available about criminal record checks and work references but there is a slight increase in the risks to young people when the suitability of staff is being determined.

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Safeguarding children and young people

Positive behaviour is promoted and restraint is only used in accordance with the staff team’s training and the home’s behaviour management policy. Young people are encouraged to take responsibility for their behaviour in a way that is appropriate to their age, abilities and understanding. Staff are well supported to manage their responses and feelings arising from working with young people when they display challenging behaviour or have emotional difficulties. Staff understand their role in helping to prevent poor behaviour between young people, close supervision of interactions helps staff respond quickly in reducing the impact of these incidents when they occur.

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Safeguarding children and young people

Methods to de-escalate potentially difficult behaviour are used whenever appropriate to avoid the use of physical restraint. Where young people are not able to safely control their behaviour staff use a range of methods to physically intervene. Many of these interventions are to guide and divert young people away from difficult situations and to help them regain control of their behaviour. Staff maintain a range of records in relation to the use of physical interventions and sanctions. Written records are completed and maintained along with detailed incident reports that supplement information recorded in a central log.

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Leadership and management

The leadership and management of the children's home are adequate . The home is newly registered; it has been operational for just over four months and has only just started to increase the numbers of young people being admitted. Since registration, the Registered Manager has left the service and a new manager has been appointed and is preparing to make an application to register with Ofsted.

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Leadership and management

Overall, the home meets the aims and objectives of the Statement of Purpose. The document places a strong emphasis on matching and planning for new arrivals, so full consideration can be given to the existing group of young people. However, the Statement of Purpose does not clearly describe how any emergency admissions will be managed in this context. Young people have access to a range of information about how the home operates which is being improved further to help them better understand what to expect from the service.

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Leadership and management

The new manager and staff team work well together to ensure the appropriate management of the service and to consider how the home will develop as young people become more familiar with the team and their placements stabilise. The new manager and responsible individual have plans in place that detail recent and proposed actions that reflect necessary areas for development. Monthly monitoring visits are carried out and written feedback is provided about key areas of the home’s operation, which includes what is being achieved for young people and areas for improvement. The manager also evaluates how well the home is meeting young people’s needs and keeping them safe by using a newly developed quality assurance format. However, the process does not yet include regular consultation or feedback from placing social workers or parents.

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Leadership and management

The new team of staff have completed a range of basic training as well as more specific training around young people’s needs. Those who do not hold an appropriate qualification in working with children and young people are enrolled with a local training provider to complete this. The permanent team are growing in confidence and experience and feel well supported by colleagues and managers in their day-to- day work. However, they do not receive formal supervision with the frequency as outlined in the home’s policy. Managers have yet to achieve a consistent pattern of supervision where practice and performance matters are discussed more formally.

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Leadership and management

The manager closely monitors staffing levels and adjusts these where necessary to ensure that young people receive the support consistent with their assessed needs. However, a combination of circumstances has necessitated the use of an increasing number of staff from other homes and from an employment agency. Although individual shifts are still led by permanent members of the team, the opportunities young people have had to develop relationships with all their carers over the last few months has been limited. Although the manager has worked to try and reduce the impact of these circumstances, young people have not known some of their carers very well. A number of agency staff have now been recruited on a full time basis and this has helped stabilise and reduce the numbers of staff working in the home.

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Leadership and management

Overall, there are established procedures in place to share information about significant events with appropriate agencies including Ofsted when they occur. However, one recent event that required a notification to Ofsted has not been made although the home’s records show that appropriate actions have been taken to promote the health and safety of the individual concerned.

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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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