John Greenwood Shipman Centre

Unique reference number SC465257 Inspection date 20/02/2014 Inspector Mary Timms Type of inspection Full Provision subtype Children's home

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Date of last inspection 29/07/2013 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 home is a twelve-bedded residential short break service managed by a healthcare foundation trust for children with learning disabilities and children with physical disabilities and associated health care needs. The service is also registered with the Care Quality Commission as care arrangements include regulated activities within the health care provision.

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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 inadequate .

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Overall effectiveness

This is the first inspection of this home, known to service users as 'JGS', since the service was re-registered with Ofsted following a change in provider organisation. The service has incorporated two separate staff teams from different services, resulting in some initial differences in areas of practice and recording systems. The Registered Manager is prioritising assimilation of the teams and the planning and recording processes.

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Overall effectiveness

The home provides personalised care which prioritises the complex health needs of children receiving short breaks. The environment is purpose built and is well- maintained. Facilities take into account children's individual needs, allowing them to enjoy a range of activities that also promotes opportunities to develop new skills.

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Overall effectiveness

Children are cared for by appropriate numbers of committed staff who are knowledgeable and very focused on the promotion of good outcomes for children. Parents feel welcome in the home and have a positive view of the service provided.

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Overall effectiveness

The Registered Manager and external managers from the provider organisation operate monitoring systems to continually review outcomes for children and the quality of care provided. However, management oversight is not fully effective in all areas as there has been a failure to ensure an appropriate record was kept, and response made, to a safeguarding concern, as well as a failure to identify areas of shortfall within recruitment checks. Further shortfalls identified on this inspection also include a lack of detail in staff supervision records, some risk management plans and a failure to submit a required notification to Ofsted.

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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) prepare and implement a written policy which sets out the procedure to be followed in the event of any allegation of abuse or neglect and provides for the prompt referral to the local authority in whose area the children's home is situated (Regulation 16 (1b) and (2b)) 11/03/2014

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Reg. Requirement Due date

(2001) prepare and implement a written policy which provides for written records to be kept of any allegation of abuse or neglect, and of the action taken in response (Regulation 16 (2d)) 11/03/2014

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Reg. Requirement Due date

(2001) ensure that the registered person shall establish and maintain a system for monitoring the matters set out in Schedule 6 points 7 and 8 (Regulation 34 (1a and b)) 11/03/2014

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Reg. Requirement Due date

(2001) promote and make proper provision for the safeguarding and welfare of the children accommodated. In particular this relates to the need to ensure risk management planning and placement planning is fully detailed in line with identified individual needs (Regulation 11(1)(a)) 11/03/2014

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Reg. Requirement Due date

(2001) ensure that without delay Ofsted are notified of any of the events listed in column 1 of the table in Schedule 5 taking place (Regulation 30 (1)) 11/03/2014

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Reg. Requirement Due date

(2001) ensure that full and satisfactory information is available when making decisions about the fitness of staff to work at the children's home. (Regulation 26 (3)) 11/03/2014

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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 there is a good quality learning and development programme. In particular this relates to the need to ensure that all staff are suitably knowledgeable about inter agency safeguarding policies and procedures and their personal duty to report in line with Local Safeguarding Child Board procedures (NNMS 18.1)  ensure that written references are verified by telephone enquiries. (NMS 16.1)  staff have access to support and advise and are provided with regular supervision. This specifically relates to the need to record an appropriate level of detail about the topics discussed during supervision in order to demonstrate that safeguarding issues are discussed broadly and necessary actions are agreed. (NMS 19.4)

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Outcomes for children and young people

Children enjoy their short break visits to this home. This is because they receive personalised care provided by staff who understand their needs and who are passionate about their role. Observations and feedback from both parents and social workers evidences that children have good relationships with staff and are confident in the staff caring for them. Staff say 'it is important to us that children have fun when they are here'. Parent’s comments include 'I am confident in the service and happy because x always gets excited as soon as he knows he is going to JGS'. The good quality of care provided ensures that children have a positive experience during stays at this home.

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Outcomes for children and young people

Children receive good support to maintain their health. Children's care requirements present as diverse and complex health needs which are monitored and well supported by care and nursing staff.

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Outcomes for children and young people

Complex health needs and disabilities do not preclude children from taking part in a range of leisure and social activities. Recent activities include, lunch out in a restaurant, country park walks and feeding the ducks locally. Comments from parents include 'I am really pleased because my child has now been to the cinema and viewed a film right the way through, which is something they have never managed previously'. Opportunities at JGS support children to grow in confidence and to learn new skills.

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Outcomes for children and young people

Children enjoy the benefits of the light and airy purpose built facilities which were fully refurbished prior to the change in service provider in July 2013. A range of communal and activity areas are available to children who choose whether to spend time alone or share group time. Facilities and high staffing ratios support children to benefit from access to the sensory and soft play areas, a computer room and access to a kitchen where baking takes place.

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Quality of care

The staff team have high aspirations for the children and young people in their care and work closely with schools and parents to promote achievement within education. They know children well, understanding their needs and behaviours in the context of their disabilities. Positive comments from parents refer to the consistent manner in which staff work with both themselves and teaching staff to implement agreed behaviour management guidelines. This commitment to consistency supports children to progress and achieve within their individual education arrangements.

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Quality of care

Parents have a positive view of the service their children receive. Comments confirm that they feel their child is well-cared for and that children are safe during their short break placements at this home. They confirm that they are comfortable raising issues with the manager and also that they feel listened to. Comments include 'staff are very quick at understanding xx's needs' and 'the staff and the manager are fantastic!'.

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Quality of care

The diverse and complex health needs of children using this service are reflected within detailed health care plans. Health needs are prioritised within care arrangements and are supported by nursing staff who work in the home 24 hours a day. Medication administration is well managed. Medication is stored securely and is administered appropriately within a system led and monitored by nursing staff. While health plans are well-detailed broader areas of individual placement planning documents, such as risk management plans, are found to be more inconsistently developed. As a result staff guidance in some areas lacks an adequate level of detail to ensure that needs will always be fully met.

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Quality of care

The service consults with children and their families. Parents confirm that they have been involved in parent forums and are frequently asked for feedback about the service. Children are consulted about service development. A recent example is consultation about the option of staff wearing a uniform. The consultation was supported imaginatively by the use of an appropriate presentation of information and choices. Staff have an excellent understanding of the best way to manage individual communication needs. Choice and engagement is promoted by the use of sign language, photographs, symbols, object reference and schedules which support children to make choices and make their views known.

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Quality of care

Children's care is supported by a wide range of environmental adaptations and facilities identified to ensure that group and individual needs are met. The environment is readily accessible for wheelchair users and personal care needs are supported by a range of specialist beds, adaptations and hoists. As a result children care is individualised and enables them to make the best use of the facilities and service provided.

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Safeguarding children and young people

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

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Safeguarding children and young people

Children are looked after in a safe environment and parents feel confident about the manner in which children are safeguarded. The home and facilities are maintained to a high standard and fire safety arrangements take a high profile within service delivery. The high levels of support and monitoring afforded to children promotes their protection and well-being. Young people’s whereabouts are always known to staff. As a result there are no occasions where children go missing from the home. Staff know the children well and understand that changes in demeanour, or behaviours, may indicate a response is required in relation to health or welfare. However, while parents are informed promptly if safeguarding concerns are identified the required reporting procedures, in-line with the home's and the Local Safeguarding Children Board procedures, are not always adhered to. As a result there has been delay in appropriate decision makers being able to take immediate action to investigate

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Safeguarding children and young people

Care arrangements are supported by safeguarding policies and procedures. However, when these were reviewed the documents in use were found to be out-of-date, as they reflected interagency guidance from Working Together 2010 which was updated in 2013. The policies and procedures also made reference to initial referral teams, which are no longer operational. As a result staff practice is not guided by current and appropriate information to ensure that children will be fully safeguarded.

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Safeguarding children and young people

New staff are subject to vetting, including checks with the Disclosure and Barring Service. However, full recruitment checks have not been undertaken in all cases. For example, when providing student nursing placements the service has not followed up on the checks undertaken by the lead university. There is also a lack of evidence to show that references are always verbally verified and that evidence of qualifications are obtained.

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Leadership and management

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

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Leadership and management

The service is managed by an experienced Registered Manager and a dedicated staff team who are available in appropriate numbers to support individual and group needs. Daily routines and effective handover meetings between staff teams provide for good levels of communication. As a result staff understand children's changing, or evolving, needs for their current short break placement.

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Leadership and management

Staff receive training and supervision to support them to undertake their roles. The majority of staff have completed a relevant level three qualification and newer staff members are working through an induction programme over the first six months of their employment. After the merging of two staff teams in August 2013 the Registered Manager is acting to ensure that all staff have completed the latest core training programme and has plans to broaden training to include dedicated disability training for care staff. Nursing staff attend on-going personal development training and are provided with specific updated training in relation to the complex and individual health needs of children using the service. As a result children are cared for by a broadly knowledgeable staff team. However, the shortfall identified during this inspection, in relation to the reporting of potential safeguarding concerns, highlights a need for refresher training in this area. While staff receive regular

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Leadership and management

supervision the records of these meetings do not always clarify how safeguarding concerns were followed up to demonstrate robust management oversight.

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Leadership and management

The quality of care provided is monitored by external managers who visit the home on a monthly basis and report on their findings. The Registered Manager also undertakes internal quality assurance monitoring checks as required by regulation. However, management oversight has failed to identify the shortfalls and breaches of regulation established during this inspection. As a result necessary actions to improve the quality of service provided has neither been identified as necessary, nor acted upon. Required notifications are also not always made to Ofsted in line with regulations. As a result Ofsted have been unable to monitor the manner in which children are safeguarded within this home.

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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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