Children's Home run by Isle of Wight Council in Isle of Wight

Unique reference number SC395944 Inspector David Coulter Type of inspection Full Provision subtype Children's home

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Registered person Isle of Wight Council Registered person address County Hall High Street NEWPORT Isle of Wight PO30 1UD Responsible individual Robert Winfield Registered manager POST VACANT Date of last inspection 07/11/2013 2 of 11 Inspection date 14/05/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness good

Outcomes for children and young people good Quality of care outstanding Keeping children and young people safe good Leadership and management good

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Overall effectiveness

The home has continued to make significant progress since the last inspection. Although the new manager has only been in post since the start of the year, she has already made a significant impact by setting high standards and providing effective leadership. Both the long term and short term units are now well established and are functioning effectively with their own specific staff teams. Occupancy levels are high and both units are providing good quality individualised care for vulnerable children and young people with complex care needs.

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Overall effectiveness

The home's policy to operate with a permanent staff team has proved extremely successful and agency staff are now no longer required. All additional staffing requirements are now met by members of a staff bank, all of whom are conversant with the home’s policies procedures and working practices. Children and young people are responding positively to the greater stability and continuity being provided by familiar staff who are fully conversant with their needs. Children and young people, particularly in the long term unit, have clearly established trusting and meaningful relationships with staff.

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Overall effectiveness

Staff have aspirations for the young people in their care and there is an expectation their placements will provide them with opportunities to engage in a range of social and recreational activities that will contribute to their personal development. 3 of 11 Outcomes for young people are good and all are living full and active lives. The introduction of an independent living skills programme is providing an extremely useful vehicle for those in the older age group to acquire practical daily living skills that will prove useful when the move toward adulthood. Effective liaison with teachers, parents and social workers ensure that common development goals are identified and strategies agreed as to how they can be met. The progress of each young person is carefully documented and appropriately shared with parents, teachers and social workers.

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Overall effectiveness

Staff lay great emphasis on establishing appropriate methods of communication with each of the children and young people in their care and their views are regularly sought on all aspects of their care. Young people exercise choice about what they would like to eat and the activities they would like to participate in. The views of young people contribute to the homes on-going development.

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Overall effectiveness

The one action and one recommendation arising from the last interim inspection have been appropriately addressed. A new comprehensive system has been introduced to record all physical interventions and an independent living skills programme now helps young people prepare for adulthood. One recommendation has been identified during this inspection regarding an aspect of staff training, however, it does not reflect negatively on the current quality of care which is good. 4 of 11

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Information about this children’s home

This children's home is a purpose-built facility owned and operated by a local council. It is registered to take up to 10 young people with learning difficulties and/or physical disabilities between the ages of eight and 17 years.

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Inspection date Inspection type Inspection judgement

07/11/2013 Interim good progress 30/04/2013 Full good 15/01/2013 Interim good progress 29/08/2012 Full good

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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 all staff embark on NVQ level 3 training within 6 months of confirmatio of employment. (NMS 18.5) 5 of 11

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Outcomes for children and young people good

The home is now operating with two separate units, one providing full time residential placements and the other providing short term respite placements. While the aim of both units is to provide high quality care in a nurturing and stimulating environment, each unit has developed its own culture in response to the needs of the children and young people they accommodate. The privacy and dignity of each child and young person is respected and every individual is provided with their own room that is designated as their own 'personal space'. Children and young people can access their rooms at any time.

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Outcomes for children and young people good

The long term unit currently provides safety and stability to a group of vulnerable children and young people with extremely complex needs. Outcomes for this group are, according to placing social workers, extremely positive and all have made significant progress in many aspects of their lives during their placements. For the majority of children and young people accommodated, the unit represents their permanent residence. Although the strictures of the building make it difficult to create a 'homely' environment, staff have tailored the existing facilities to better meet the needs of the current residents. The unit's 'child centred' approach ensures each young person is treated as an individual with their own specific care needs. For example, a designated play area has been created and equipped to specifically meet the needs of one resident. Another young person enjoys walking, so on his return from school each day a member of staff is available to accompany him.

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Outcomes for children and young people good

Children and young people, many of whom have autism, respond positively to the behavioural boundaries and daily routines that staff have developed. A significant decrease in incidents within the long term unit indicates that children and young people are more settled and at ease in their surroundings and in the company of staff with whom they are familiar. Although young people are encouraged to live full and active lives by participating in regular activities, staff acknowledge that the unit is their home and represents a place to relax and unwind. Staff have, since the last inspection, developed a life-skills training programme that is now providing opportunities for those in the older age groups to acquire knowledge and skills that will better prepare them for moving on to adult services.

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Outcomes for children and young people good

Within the short break unit staff successfully ensure children and young people are provided with opportunities to participate in a wide range of social and recreational activities, interact with others and have fun.

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Outcomes for children and young people good

Children and young people have access to purpose built outside play areas that contain specially designed equipment that can facilitate individuals who experience mobility difficulties. The home is well resourced and has its own wheelchair-friendly transport that is used to access places of interest around the locality. Off-site 6 of 11 activities are well planned, appropriately staffed and organised around the specific needs of each young person. The experiences gained from undertaking activities in a range of different settings, helps boost individuals self-confidence, extend their social horizons and provide them with opportunities to develop relationships with new people. Respite unit staff are in the process of liaising with parents and teachers to identify existing areas of personal development that children and young people can work on during their visits. The regular sharing of information on each individual's

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Outcomes for children and young people good

progress and development leads to greater consistency in the delivery of care and better outcomes.

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Outcomes for children and young people good

Within both units staff deploy a range of verbal and non-verbal communication techniques to ascertain the views of young people about all aspects of their care. Children and young people can 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. The views of young people are now contributing to the further development of the home.

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Outcomes for children and young people good

The health and well-being of each individual are appropriately monitored. Many of the young people who access the home have complex health needs as a consequence of their disabilities. Key information on each individual's medical condition and its effect on behaviour is provided for staff. The effects of medication are also made clear. The home's nursing staff ensure that all medical interventions are carried out by staff who have completed additional training and demonstrated their competence. Specialist help is sought to address specific areas of concern such as mental health. Arrangements for the dispensing of medication are robust. All personal care tasks are carried out sensitively. The home is wheelchair friendly and young people with mobility difficulties can access all areas. A range of specialist equipment allows staff to move and handle young people safely.

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Outcomes for children and young people good

Children and young people are provided with well-balanced nutritious meals. Each young person's culinary preferences and nutritional needs are established prior to their admission. Although young people undertaking short stays are encouraged to try new foods, 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. Staff and young people eat together and this provides many opportunities for spontaneous social interaction.

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Outcomes for children and young people good

Education is clearly recognised as playing an important role in each young person’s personal development. Staff maintain good relationships with education placements and regularly exchange information regarding behaviour management and communication in order to establish a consistency in approach. School attendance levels for young people in the full-time unit are excellent. Staff have been pro-active in advocating on behalf of one young person to ensure that he has access to educational support in a form that is appropriate to his needs and abilities. 7 of 11 Young people are, when appropriate, helped to maintain contact with their families. Family members are encouraged to visit young people in the long term unit. Staff closely monitor young people both before and after contact and pass on any concerns.

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Quality of care outstanding

All new referrals are made through an assessment panel who consider if the home is the most appropriate setting for meeting a child or young person’s care needs. The home’s comprehensive assessment process ensures the physical, social and emotional needs of each child and young person are identified prior to admission. The views of young people, their parents, teachers and social workers are appropriately sought and contribute to the assessment process. Well-developed care plans provide staff with clear guidance on how the specific care needs of each individual should be met. Risk assessments are used to identify any areas of potential concern. The care plans of children and young people undertaking respite stays are updated at the end of each visit and significant information shared among staff. Within the long-term unit care plans are subject to regular review and updated in line with changing circumstances and significant incidents. Staff work closely with placing

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Quality of care outstanding

social workers to ensure reviews take place within appropriate timescales.

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Quality of care outstanding

Consideration is always given to the composition of each short break group and staffing levels adjusted to ensure appropriate support is available. Staff closely supervise young people in group situations to prevent any form of bullying or discriminatory behaviour. Staff reported that children and young people who initially display anxiety about undertaking overnight stays settle in within a short time. Internal communication systems within the home are good and there is a free flow of information between staff operating on different shifts. Staff spoken with were all conversant with the care needs of the young people with whom they were assigned to work. Due to the complex needs of the young people in the long term unit staffing levels are always maintained at a high level.

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Quality of care outstanding

Many of the children and young people who access the home experience communication difficulties and staff utilise a number of communication techniques to gather their views about various aspects of their care. The development of two permanent staff teams has enabled staff to work consistently, often on a one-to-one basis, with the same young people. Staff have become increasingly adept at identifying the non-verbal cues and the meanings behind significant gestures and expressions of the young people in their care. This has made them extremely effective advocates on their behalf. Children and young people were observed to respond positively to the care and attention they were receiving from staff.

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Quality of care outstanding

On admission all young people and their parents/guardians are made aware of how to raise concerns and make a complaint. All concerns and complaints are taken 8 of 11 seriously and immediately investigated in line with the home’s policy. No complaints have been made since the last inspection.

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Quality of care outstanding

The unit is purpose built and has wide corridors and large communal areas that provide good access for those with mobility difficulties 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 both in the home and gardens. The recent appointment of permanent maintenance staff now ensures repairs are addressed quickly and improvement projects initiated. The building was observed to be clean, tidy and in good decorative order. Communal areas are bright and welcoming. The grounds were well maintained with colourful planting. Grass play areas had been recently cut to provide even access to the many pieces of adventure play equipment. Being centrally located children and young people have access to

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Quality of care outstanding

shops, a leisure facilities and a large park.

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Keeping children and young people safe good

Although safety underpins all policies, procedures and working practices within the home, staff are not risk averse and children and young people are encouraged to engage in an extensive wide range of social and recreational activities. The particular vulnerabilities, risks and level of understanding associated with each child and young person are clearly identified and strategies developed to ensure they can be managed within different environments and social situations. High staffing levels ensure young people are appropriately supervised and not at risk during off-site activities. All staff are conversant with procedures to follow in the event of a child or young person going missing.

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Keeping children and young people safe good

Staff are clearly aware that due to their impaired levels of understanding some individuals can, through their actions, put themselves or others at risk. By gathering information from a range of informants, including parents and teachers, and analysing the circumstances and antecedents of significant incidents staff identify the risks and vulnerabilities associated with each individual. Individual behaviour management plans are developed in respect of each child and young person The plans identify the possible triggers that can lead to challenging behaviours and the types of diversionary techniques that can be used to defuse potentially volatile situations. Staff indicated that praise and encouragement is frequently used to reinforce positive behaviour and de-escalate stress and anxieties. Although staff have all completed training in the use of physical intervention, such interventions are only ever used if is felt a child or young person is putting themselves or others at

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Keeping children and young people safe good

significant risk. Effective supervision ensures that individual's do not engage in bullying behaviour or unintentionally strike each other. A new recording system now ensures that all information relating to physical interventions is appropriately recorded. 9 of 11 The home operates with a group of extremely motivated and dedicated group of staff all of whom have completed a rigorous recruitment and selection process that has determined their fitness to work with vulnerable young people. All staff have to complete a detailed induction programme and demonstrate their competence before assuming their full responsibilities. Staff undertake regular safeguarding training and are aware of their individual responsibilities in regard to the reporting of any safeguarding worries or concerns.

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Keeping children and young people safe good

The home's policy of appointing permanent staff has provided much greater stability. Agency staff are no longer deployed and any staffing short-falls are now met by members of the homes staff bank. The stability in staffing has resulted in much greater consistency in the quality of care delivered. As one member of staff remarked, 'the home is much calmer, staff are organised and everyone knows what they should be doing. It is a great place to work'.

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Keeping children and young people safe good

The home is a safe environment that is free of any unnecessary hazards. Experienced staff carry out regular health and safety checks within the home and garden. Access to the home is limited and all visitors have to report to staff and sign in. The fire alarm system is tested weekly and regular fire evacuations ensure staff and young people remain conversant with procedures.

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Leadership and management good

The home is now operating with a new manager who has only been in post for a few months. She is in the process of seeking registration. Having many years’ experience in both the health and social care field her knowledge and skills are particularly well suited to the management of the home. She is providing good support and clear guidance for staff. The home's management and staff are continually looking at ways to improve the quality of the care they provide. This is clearly reflected in the home’s new statement of purpose and the aims and objectives identified in the home's 2014 service/development plan. The management team are, along with key staff, currently reviewing the home’s policies and procedures to ensure that best practice is being followed in key areas such as health and wellbeing, safety and supporting young people with their education.

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Leadership and management good

Staff spoken were extremely positive about how the home has developed in the last year and there was a general consensus that the creation of two staff teams has created much greater stability and consistency in the quality of care delivered. Good planning and effective communication between members of each team ensure that resources, such as transport, are shared appropriately. Both units provide safe and stimulating environments in which young people can grow and develop.

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Leadership and management good

Staff have proved extremely adept at responding to the changing needs of children and young people. As one senior manager with the local authority pointed out, 'staff 10 of 11 at the home are always willing to go the extra mile to meet the needs of the children and young people in their care'. Evidence indicates that children and young people, particularly in the long term unit, have respond positively to recent changes and this is reflected in a significant reduction in incidents of challenging behaviour. The progress of each young person is reflected in regular progress reports that are shared between all interested parties. The operation of the home is monitored on a monthly basis by an independent reviewing officer and regular visits by the service manager.

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Leadership and management good

There is a culture of training and professional development within the home. Regular supervision sessions provide opportunities for staff to reflect on their practice and identify any particular training needs. Staff keep abreast of developments within the child care field and regularly access training opportunities. The service has an expectation that all staff obtain an NVQ level 3 qualification, however a number of staff have yet to either embark on or complete their training. The member of staff responsible for co-ordinating training and professional development keeps a record on staff files of all courses attended. All confidential records and documents relating to young people and staff are kept in appropriately secure facilities. Website: www.ofsted.gov.uk

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Leadership and management good

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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