Children's Home run by Northamptonshire Healthcare NHS Foundation Trust in North Northamptonshire

Unique reference number SC465287 Inspection date 04/02/2014 Inspector Natalie Burton Type of inspection Full Provision subtype Children's home

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Date of last inspection 22/07/2013 Website: www.ofsted.gov.uk

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Brief description of the service

This home is a six-bedded residential short break service managed by a healthcare foundation trust for children 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 a newly registered service and this is the first full inspection. Children and young people are cared for by staff who are dedicated to supporting them and their families through the provision of short breaks. They were seen to interact well with each other and all young people were engaged with various activities during the inspection such as playing with toys of their choice. Children and young people enjoy varied opportunities to engage in activities within the home and the community, and as a result, they improve their social skills and increase their self-confidence.

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Overall effectiveness

Children and young people live in a home they are safe in. they are kept safe by staff that follow guidance in plans and risk assessments to ensure each child’s safety is prioritised. Staff seek children and young people’s wishes and views, which significantly improves their sense of worth and control of their lives. The service positively impacts on children and young people’s lives. A strength of the home is the robust attention to the health needs of the children and young people.

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Overall effectiveness

Leaders and managers understand the strengths and weaknesses of the home and are actively taking action to address the shortfalls identified. For example, the service has prior to the inspection requested work to be completed to the shower room.

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Overall effectiveness

While there is minimal impact on children and young people, improvements need to be made to recordings of measures of control, medication, action taken following an allegation and all individual needs of the child and young person’s placement plans. In addition, internal monitoring records need to record consultation with parents and placing authorities, and improvement is needed to recruitment checks.

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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 (Regulation 17B (3)(a-i)) 31/03/2014

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Reg. Requirement Due date

(2001) ensure the system referred to in paragraph (1) shall provide for consultation with children accommodated in the home, their parents and placing authorities. (Regulation 34 (3) 31/03/2014

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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 a clear and comprehensive summary of any allegations made against a particular member of staff including details of how the allegation was followed up and resolved, a record of any action taken and the decisions reached, is kept on the person’s confidential file and a copy is provided to the person as soon as the investigation is concluded (NMS 20.7)  ensure there is a written record of all medication. In particular with regard to the recording of the homely remedies (NMS 6.15)  ensure the home provides a comfortable and homely environment and is well maintained and decorated. In particular with regard to the shower room (NMS 10.3)  ensure all people working in or for the children’s home have references checked to assesses suitability before taking on responsibilities. In particular with regard to telephone enquiries are made as well as obtaining written references (NMS 16.1)  ensure a clear and comprehensive summary of any allegations made against a

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Recommendations

particular member of staff including details of how the allegation was followed up and resolved, a record of any action taken and the decisions reached, is kept on the person’s confidential file and a copy is provided to the person as soon as the investigation is concluded (NMS 20.7)  ensure the short break plan is monitored by a key worker within the home who ensures that the requirements of the plan are implemented in the day-to-day care of the child. In particular with regard to identifying and implementing all individual needs of the child. (NMS 25.2)

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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

Children and young people achieve sound outcomes within a caring and supportive environment. For example some children and young people settle better at night, wash their hands independently before dinner and drink from a plastic beaker instead of a lidded cup.

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Outcomes for children and young people

Children and young people have a range of communication, complex health needs and learning disabilities. Staff are resourceful about interpreting meaning in speech, gesture, eye contact and photographs. Children and young people grow in confidence because they are treated with respect. For example, they are encouraged to express their view, wishes and feelings on a choice of activity and the food they like to eat. This support means that children and young people are confident that staff will know what they are communicating, and this helps them develop a positive and confident sense of self

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Outcomes for children and young people

Children and young people benefit from healthy lifestyles during their stays; they eat a balanced diet and make choices on their likes and dislikes. Where children have specific dietary needs staff follow this regime and contribute to planning where any individual progress could be promoted. Children and young people make good progress in their health because staff implement their health plans and administer their medication in line with their prescription and routine.

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Outcomes for children and young people

Children and young people enjoy activities in the community and the home. For example, going to the local park, sports centre taster days, library and playing with the toys, arts and crafts and computer. Children and young people receive positive recognition for their achievement, no matter how smalls. This promotes their confidence and positive behaviour. For example, learning to be more patient and eating with utensils.

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Outcomes for children and young people

Some young people make sufficient progress with self-care skills, so increasing independence. For example, they learn about money, shopping with supervision and cooking. This support gives young people a smooth transition to their next stage in supported accommodation as young adults.

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Quality of care

Children and young people enjoy positive relationships with staff that are stable, competent and enthusiastic. As such, children and young people benefit from long term relationships to key people. In addition, they enjoy good relationships with each other. This is because the staff use their knowledge of the children and young people to group them accordingly. For example similar interest in activities or a known friendship. Children and young people’s needs are well understood and interpreted enabling staff to respond to discomfort and anxiety promptly. Staff are vigilant to any changes and signs regarding children and young people to ensure that health, safety and welfare is promoted. For example, staff are aware of children and young people’s mannerisms which indicate that they may be unwell.

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Quality of care

Overall, children and young people are cared for in line with their short break plans. Close working with families and other agencies ensure that an integrated and consistent approach is taken to the care of the children and young people. Plans detail children and young people’s preferred ways of being cared for and this means that their stay in the home is consistent with the care they receive at home. Staff identify children and young people’s needs in relation to any disability and their level of functioning. Plans detail routine and more complex health needs such as those relating to epilepsy; health care plans written by the home’s nurses provide staff with detailed information about how to deal with these needs. However, not all plans cover the holistic needs of children. For example, some plans are lacking in fully identifying children’s cultural, emotional and social needs. This does not ensure that

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Quality of care

all children’s needs are wholly identified.

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Quality of care

Children and young people’s educational needs remain their parents responsibility. However, there is a developing integrated approach taken to children and young people’s education. For example, staff have visited their schools to identify how they can support children and young people to reach their identified goals.

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Quality of care

Children and young people’s personal care is sensitively managed to preserve dignity and afford privacy. Arrangements for storage of medication are sound, and qualified nurse safely administer medication. This is a positive aspect of the home given the complexity of some children’s and young people’s medication regimes. In addition, all children and young people have agreement in writing from their general practitioners of the homely remedies they can have with their prescribed medication. However, on one occasion, staff did not update the homes stock record on purchasing a homely remedy. Whilst there was minimal impact on children and young people; because there was a clear record of the medication administered within the children and young people’s records. This is not in line with the homes medication policy.

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Quality of care

The home is fit for purpose and provides children and young people with appropriate individual and communal accommodation. Children and young people have their own rooms for their stays. The home provides them with good resources including a sensory room, outdoor activities and play equipment. The home is clean and tidy and generally well maintained. However, whilst there is a plan for improvements to the shower area, due to damage to water damage, this does not provide for a welcoming environment in line with the rest of the home.

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Safeguarding children and young people

The service is adequate at keeping children and young people safe and feeling safe. Staff take their responsibility seriously for keeping children safe. Good levels of supervision both inside and outside the home recognise their significant vulnerability. There are effective arrangements to safeguard children and children are safe. This is because the staff promote a culture that ensures children are listened to. Children and young people who use this service have limited means of communication. However, feedback from parents and carers is that children and young people are happy and safe.

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Safeguarding children and young people

The home has policies and procedures in place to safeguard children and young people and staff demonstrate a good understanding of the action to take should they have any concerns about the young person’s safety or well-being. In addition, staff receive safeguarding training; as a result children and young people are protected. On occasion staff have been made subject to allegations. The organisation has taken sufficient action, for example, by informing the placing authority’s social worker, implementing risk assessments and conducting an internal investigation. While there is minimal impact on young people, as appropriate action has been taken, there is a lack of a clear written record.

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Safeguarding children and young people

The design and layout of the home provides for high levels of security for vulnerable children and young people. For example, some doors have key pads on them to occasionally restrict access when there is a risk, such as entering the kitchen with hot pans. Practice is informed by clearly assessed risks which balance minimising risks without impeding children and young people’s independence. As a result, children and young people are not unnecessarily restricted when accessing the community and activities.

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Safeguarding children and young people

Staff know children and young people well, and can often pre-empt a difficulty or divert them when they appear anxious. The organisations behaviour management policy effectively promotes positive behaviour. In addition, staff present as positive role models promoting appropriate behaviour. However, some measures of controls used have not been sufficiently recorded. For example, records lack detail of how long children and young people are in time out in their rooms, or lack recording of the effectiveness of the measure used. As a result, records are not consistently clear to fully inform whether the strategies used are successful for that young person.

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Safeguarding children and young people

Children and young people are protected by a sufficient recruitment process. However, not all references are verified by telephone. Such as, referees have been contacted through e mail. While there is minimal impact, this does not demonstrate good recruitment practice.

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Safeguarding children and young people

The building is kept safe from hazards and is well maintained to provide a homely environment. Health and safety checks of fire equipment are routinely undertaken to maintain a homely environment. Children and young people take part in fire drills when appropriate. This means that they know, within their level of understanding, what will happen should they need to evacuate the building. In addition, all staff have received fire safety training.

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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

This is the home’s first inspection since registration. This service does well in providing children and young people with a stable and child-centred environment with positive levels of care and support. There are clear policies and procedures, effective organisation of staff and appropriate implementation of care practice.

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Leadership and management

The home is effectively and efficiently managed. The Registered Manager has recently been promoted in the organisation and a new manager recently appointed, who is currently in the process of registering with Ofsted. Managers monitor practice and records monthly. However, internal monitoring reports do not provide for consultation with placing authorities and parents. This does not impact on children and young people because their views are sought during visits to the home. Independent monitoring visits support overall improvement and provide children and young people with the opportunity to contribute their views. In addition, an effective senior management team has a robust risk management system that informs the manager of any significant trends and patterns. For example, the system may identify an increase in incidents at a certain time of the day. This may result in additional staffing or further investigation to establish the reason for the increase. As

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Leadership and management

a result, children and young people benefit from a robust monitoring system that provides additional safeguarding to their welfare.

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Leadership and management

Children and young people stay in a home which has clear accountability and leadership. Staffing levels are high and staff enjoy their work and opportunities to develop areas of expertise and interest. They are well trained and undertake the required qualifications. Member of staff spoken to gave positive comments about the managers strong and supportive leadership of the service. Staff work efficiently as a team and report feeling well supported in their role. Regular meetings and supervisions ensure practice improves further and the focus remains on children needs. There is always a high level of staff on duty at all times to provide safe care and this gives staff plenty of opportunities to spend quality time with young people. Children and young people benefit because staff are supported, knowledgeable and suitably trained to meet their needs.

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Leadership and management

The home offers care and accommodation for children in line with its Statement of Purpose and objectives which are understood by interested parties. There is a child- friendly version, in a format accessible to children and young people, which explains what they can expect. Developmental plans define areas for improvements that relate to the quality of care for children. For example, all children and young people will have goals and outcomes set and measured.

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Leadership and management

The home has not had to notify of any significant events. However, managers and staff are aware of the process and the need to be transparent and accountable for its actions to promote children and young people’s welfare. Children and young people’s records are held securely and kept confidential. These records inform staff practice and help to underpin the care provided.

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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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