Children's Home run by The Rose Road Association in Southampton

Unique reference number SC042446 Inspection date 03/12/2013 Inspector David Coulter Type of inspection Full Provision subtype Children's home

p.1

Date of last inspection 14/02/2013 Website: www.ofsted.gov.uk

p.1

This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

p.2

Brief description of the service

The service offers short breaks for up to 12 children and young people with severe learning difficulties that may include physical disabilities and additional health problems. It is run by a registered charity which provides support and information services to children, young people and their carers throughout the area. The service is available to children and young people, of both sexes, aged between two years and 17 years. The unit consists of two residential areas, one of which is registered with the Care Quality Commission.

p.3

The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

p.3

Overall effectiveness

The overall effectiveness is judged to be good .

p.3

Overall effectiveness

There have been a number of significant changes relating to the unit since the last inspection including the appointment of a new manager and a number of new staff. The inevitable period of disruption caused by such change has now passed and the unit is now settled and is providing good quality residential and short break care to a group of extremely vulnerable young people with complex care needs. The introduction of more permanent staff has led to a significant reduction in the use of agency and bank staff. The unit has responded to the closure of another short break service in the local area by providing placements to a group of children and young people identified as requiring nursing care. A team of specialist nursing staff now provide additional support for these young people when they are in residence. This development has proved extremely positive and the collaboration between nursing and care staff has led to the review of a number of existing policies, procedures and

p.3

Overall effectiveness

Outcomes for children and young people are good and evidence indicates individuals respond positively to the attention they receive from staff and the stimulation they get from participating in a diverse range of social and recreational activities. Each young person receives individualised care that addresses their specific health, social and emotional needs. Appropriate staffing levels and effective supervision keep children and young people safe. Staff are aspirational for the children and young people in their care and promote their independence by providing opportunities to develop a range of practical skills. The progress of each child and young person is carefully documented and appropriately shared with parents, teachers and social workers.

p.3

Overall effectiveness

There are no actions or recommendations arising from this inspection.

p.4

Outcomes for children and young people

Children and young people enjoy their visits and are able to participate in a range of fun activities both within the unit and local community. A mobile sensory unit and a large selection of toys help provide stimulation for children and young people even when they are in bed. The unit’s purpose built outside play area contains specially designed equipment that can facilitate individuals with mobility difficulties. A hydrotherapy pool is also accessible at certain times and provides individuals the opportunity to play in a water environment. Off-site activities are well planned, appropriately staffed and organised around the needs of young people. The home has its own wheelchair-friendly transport that is used to access community facilities and places of interest in the local area. Children and young people benefit from a range of experiences during their visits that extend their social horizons and provide

p.4

Outcomes for children and young people

them with opportunities to develop relationships with new people.

p.4

Outcomes for children and young people

During their visits, children and young people are encouraged to develop their independence by mastering a number of achievable practical skills. Unit staff liaise with parents and teachers to identify specific areas of development that individuals can work on during their visits. For example, some young people are provided with assistance to meet the challenge of being able to dress themselves, while others are being helped to acquire domestic skills such as becoming proficient at setting a meal table. During their visits each child and young person is also encouraged to assert their independence by making choices over such things as what they would like to eat and the type of activities they would like to engage in.

p.4

Outcomes for children and young people

Unit staff have established effective lines of communication with parents, teaching staff and social workers and information relating to transport, behaviour management and health is regularly exchanged. The regular sharing of information on each individual's progress and development leads to greater consistency in the delivery of care and better outcomes.

p.4

Quality of care

A comprehensive assessment process, good liaison with parents and pre-placement visits ensure that the needs of each child and young person are clearly identified before any overnight visits are undertaken. Each child and young person is subject to a 'support needs analysis' that determines an appropriate staffing level. Placement plans are accessible and provide staff with clear guidance on how each individual's care needs should be met. Risk assessments are used to identify any areas of potential concern. Placement plans are updated in line with changing circumstances and are subject to regular review.

p.4

Quality of care

Consideration is always given to the composition of each short break group and staff try to ensure that children and young people can be placed alongside their friends. Evidence indicates that children and young people who initially display anxiety about undertaking overnight stays quickly settle in. Each child is assigned a key-worker who assumes responsibility for monitoring their progress and acts as an advocate on their behalf. The care plans of all young people are updated at the end of each visit and significant information is effectively shared among staff. An effective internal communication system ensures staff keep abreast of changing circumstances and respond appropriately.

p.5

Quality of care

Due to their disabilities some children and young people can display involuntary behaviours that cause them to strike out. Staff are clearly aware of the potential for some children and young people to hurt themselves or others. Appropriate staffing levels and effective supervision ensure that young people do not engage in bullying behaviour or unintentionally strike each other. Physical interventions are only ever used if it is felt a child or young person is putting themselves or others at risk. In order to prevent the need for similar interventions reoccurring, all incidents and their antecedents are recorded and analysed for underlying causes. Young people displaying challenging behaviour are managed by the application of diversionary techniques. Praise and encouragement is successfully deployed by staff to reinforce positive behaviour.

p.5

Quality of care

Many of the children and young people accessing the service experience communication difficulties and staff use a variety of communication techniques to illicit their views about various aspects of their care. By observing the non-verbal behaviours of individuals over time, staff become extremely adept at identifying the meanings behind significant gestures and expressions. Children and young people were observed to be treated by staff with dignity and respect and were responding positively to the attention they were receiving.

p.5

Quality of care

Fresh, nutritionally balanced food is produced on the premises by an experienced cook. Each child or young person's food preferences and nutritional needs are identified as part of the admission process and although all are encouraged to try new dishes, staff are realistic about what can be achieved and ensure each individual receives appropriate nutrition. The cook always provides a choice of main courses and special dietary needs are incorporated into each day’s menu plan. Care plans make explicit the assistance staff need to provide for each individual when eating.

p.5

Quality of care

The health and well-being of each individual are appropriately monitored and medical interventions are only carried out by staff who have completed additional training and demonstrated their competence. The privacy and dignity of individuals are respected and everyone is assigned a room of their own that they can access at any time. All personal care tasks are carried out sensitively. A range of specialist equipment allows staff to move and handle young people safely. Although arrangements for the storage and dispensing of medication are appropriate, a review of the home’s policy is currently being undertaken to incorporate new guidance from nurses and pharmacists.

p.5

Quality of care

The unit is purpose built and has wide corridors and large communal areas that provide good access for those in wheelchairs to move about freely and participate in social interactions. A range of specialist equipment, including overhead hoists and power assisted beds allow staff to move and handle children and young people safely. Children and young people are encouraged to remain physically active and can access a range of specialist play equipment.

p.6

Safeguarding children and young people

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

p.6

Safeguarding children and young people

The association has a rigorous recruitment process that ensures unsuitable individuals do not gain access to the vulnerable children and young people in their care. All prospective employees are subject to a range of checks and assessments before being offered a position. The composition of the staff team has changed since the last inspection. The creation of more permanent posts has led to greater stability and less reliance on agency and bank staff. New staff only assume their full responsibilities once they have completed their induction and demonstrated their competence in key areas. All have settled in well and are making a significant contribution to greater consistency in the delivery of care.

p.6

Safeguarding children and young people

All shifts are managed by experienced assistant managers. Due to the complex health needs of the children and young people accommodated, staffing levels are high and ensure each individual is appropriately supported. For safety reasons, night staff carry out regular checks on young people with a history of having seizures. Each young person has an individual protocol. All staff are aware of how the policies and procedures of the unit are translated into effective working practices that keep young people safe. Staff are aware of their individual responsibilities in regard to the reporting of any safeguarding worries or concerns.

p.6

Safeguarding children and young people

Staff carry out regular health and safety checks within the home and garden. The unit, being part of a larger complex, has access to maintenance staff. All safety issues are prioritised and dealt with swiftly. The unit has a range of specialist lifting equipment, including overhead hoists. All such equipment is subject to annual servicing by specialist engineers. Fire alarms are tested weekly and full evacuations carried out at regular intervals. Access to the service is limited and all visitors have to report to staff and sign in. Keypad entry is required to access the unit. There are suitable arrangements to report any young person who goes missing. There have been no reported incidents of any young person going missing in recent times.

p.6

Safeguarding children and young people

On admission all young people and their parents/guardians are made aware of how to raise concerns and make a complaint. No complaints have been made since the last inspection. All significant incidents are investigated and if any concerns are identified the relevant policy, procedure or working practice is reviewed.

p.6

Leadership and management

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

p.7

Leadership and management

A new manager has been appointed since the last inspection and is currently in the process of completing the registration process. Although she has only been in post for a short period of time, she is deploying her extensive knowledge and organisational skills to raise standards and make the service more efficient and responsive to the changing needs of children and young people and their families. A number of new monitoring tools have been introduced to ensure that the performance of staff and progress of each child and young person are subject to regular review. The manager is clearly aware of the strengths and areas in need of further development. Staff spoken with, talked in positive terms about recent developments and feel they are able to contribute to the home’s future planning.

p.7

Leadership and management

Good lines of communication have been established between members of staff on different shifts. Key information relating to each child and young person in residence is shared between all members of the staff team. The professional development of staff is enhanced by participation in the numerous training opportunities available and regular supervision. The deputy manager undertakes regular observations of staff while they engage in practice such as personal care. Nursing staff provide specialist training on medical tasks such as gastric feeding. A record is kept of all supervision sessions and training courses attended.

p.7

Leadership and management

The operation of the home is effectively monitored on a monthly basis by the Trustees and a written report completed. The home has well-established recording systems and records and documents were found to contain recent and relevant information. Confidential information relating to each young person is kept safe within appropriately locked facilities.

p.7

Leadership and management

There were no actions or recommendations arising from the last inspection to be addressed.

p.7

About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

p.8

About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection and the evaluation schedule for the inspection of children's homes.

p.8