Children's Home run by Liverpool City Council in Liverpool

Unique reference number SC035969 Inspector Denise Jolly Type of inspection Full Provision subtype Children's home

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Registered person Liverpool City Council Registered person address Liverpool City Council, Municipal Buildings Dale Street LIVERPOOL L2 2DH Responsible individual Bernadette Brown Registered manager Michael John Nagle Date of last inspection 23/01/2014 2 of 11 Inspection date 30/05/2014

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Previous inspection good progress Enforcement action since last inspection There has been no enforcement action since the last inspection.

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Overall effectiveness good

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

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Overall effectiveness

The short breaks service is making a measureable difference to young people's lives. Staff deliver highly valued care which enables young people to make good progress. Staff provide personalised and well-planned care that takes into account the individual needs and wishes of each young person, and the views of their families. Social workers and other professionals involved with the home, say staff use their knowledge, expertise and genuine interest in the welfare and development of vulnerable young people, to lay firm foundations for them to progress.

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Overall effectiveness

Parents praise the enthusiasm and interest of staff, who stimulate their children to experience activities and opportunities that may not otherwise be available to them. Managers conduct thorough and regular review of staff performance and placement outcomes, to ensure that the service delivers care practice that promotes the welfare and progress of each individual young person. Staff promote the views of children and young people, and respond promptly to all communication.

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Overall effectiveness

Staff create warm and affectionate relationships with young people and their families. Vulnerable and complex young people are happy, safe, relaxed and confident during their short break stays. Staff balance and encourage appropriate levels of independence against detailed risk assessment and individual health and 3 of 11 care needs. Children and young people flourish in appropriately safe and secure surroundings.

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Overall effectiveness

Dynamic and knowledgeable leaders and managers successfully communicate their vision for an ever-improving service. They oversee the impact of improvements by carefully monitoring and evaluating the service provided, and the skills of staff. They enthusiastically involve all stakeholders in development plans for the home. Staff are fully engaged in identifying and supporting ideas that further improve the impressive quality of service provided to children with learning disabilities. 4 of 11

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Information about this children’s home

The children's home is managed by a local authority, providing short-term breaks for up to seven children and young people at any one time. Children and young people with learning disabilities and physical disabilities are cared for.

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Inspection date Inspection type Inspection judgement

23/01/2014 Interim good progress 20/06/2013 Full adequate 29/10/2012 Interim satisfactory progress 22/05/2012 Full inadequate 5 of 11

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Outcomes for children and young people good

Children and young people with disabilities enjoy continually improving outcomes during their short break stays at the home. Children say, ‘I like you.’ This means they like staying in the home. They safely experience a wide range of new and developmental experiences very well supported by consistent and dedicated staff. Children appear confident and secure in their time away from home, follow familiar routines during their stay, and receive care that reflects their own and their family’s wishes. Parents say, ‘It is wonderful that my child can do so many exciting things that I am unable to offer her.’

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Outcomes for children and young people good

Young people participate in wide-ranging activities such as playing in the sensory room, participating in town centre experiences, trying out various modes of transport such as ferries, picnicking or visiting seaside resorts. They access each experience according to their ability. Young people who use wheelchairs enjoy the same opportunities for activities as other young people, because staff ensure transport options meet their access needs. This means young people can participate in activities that may not otherwise be available to them. This enables them to broaden their understanding of the world and have opportunities to be successful in aspirational and everyday activities.

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Outcomes for children and young people good

Children and young people experience their short breaks in small, compatible and settled social groups. This enables them to learn about the needs and wishes of others, and to develop such skills as turn taking and playing with friends. Parents see this as an essential part of their stay, and are pleased to meet the friends their children make, when they come to collect them. Staff enable young people to spend positive time with others, and in doing so they improve their skills in social interaction at a level appropriate to them.

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Outcomes for children and young people good

Children and young people learn greater flexibility in being able to tolerate different environments, and explore ways they can improve their independence. They acquire and use skills in managing their anxieties, or interacting appropriately with others, to help others understand their needs and wishes. They demonstrate affection towards and interest in other young people in their group. When they want time alone, they can choose to spend some time in their room, or in one of the cosy corners that staff have set up around the home.

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Outcomes for children and young people good

Staff help young people to access activities that offer everyday learning and enjoyment such as dancing, drawing or playing with interactive toys. This increases their range of fundamental developmental skills, such as object recognition and hand- to-eye coordination that underpins learning and progress. Some young people enjoy having books read to them, or engage in shared computer games, and this helps them to develop pre- communication skills like shared attention or pointing. 6 of 11 Children and young people, including those who do not communicate verbally, actively participate in everyday decisions such as what they eat, and what they want to achieve during their stay. Young people participate in children’s meetings, organised for the start of their short break, to express their choices about activities and food. Young people’s comments are recorded about how happy they feel about their stay in the home, or what activities they would like to do. Children and young

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Outcomes for children and young people good

people’s points of view are taken seriously as staff respond effectively to their suggestions, or explain promptly why it may not be possible to achieve their requests.

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Outcomes for children and young people good

Children and young people receive sensitive support and redirection to help them understand and improve their emotional and physical health and well-being. They stay in a home that is well equipped to meet their needs, such as space for wheelchairs and adapted bathrooms and beds. Their health needs are clearly identified in detailed plans. Children and young people receive prompt attention to their immediate health and comfort needs from suitably trained staff. This enables young people to feel safe and happy, and receive continuity of care for important support routines such as personal care. Parents say their children continually benefit from continuity of care; for example, ‘Staff have taken care to find out from us the best way to support our child.’

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Quality of care good

Qualified, experienced and dedicated staff provide a wealth of developmental opportunity and sensitive support to complex and vulnerable young people. Through warm and trusting relationships with staff, young people with a learning disability grow in confidence, maturity and positive self-view. Young people express confidence and contentment by their settled behaviour and the progress they make. Without exception, parents are very complementary about the positive impact the service has on the lives of children and young people. One parent said, ‘The staff are fantastic, my child loves coming here, staff are great at talking to me about my child.’

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Quality of care good

Staff create and implement individualised care plans for each child and young person. Key workers demonstrate a willingness to work in partnership with all relevant adults. They visit young people’s schools, to gather information about educational goals and strategies used to support progress. They meet with social workers, to ensure that short break plans are updated to reflect changing need. Managers ensure that young people experience effective transition into the service, because key workers arrange home visits prior to placements beginning, in order that positive relationships can be established. This creates excellent opportunities for collecting information from families, and meeting children in familiar environments. Once children begin to stay at the home, they contribute to their care plans because staff analyse and evaluate their responses and behaviour, to modify initial plans for their short break. This

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Quality of care good

enables young people to develop new and improving routines at their own pace. 7 of 11 Parents appreciate the open and honest communication staff provide, and say that they feel equal partners in planning their child’s programme of care. They particularly like the arrival and collection visits they make to the home, because this has vastly improved direct communication with staff who are caring for their child. Children progress because staff deliver short break care that is fully integrated into the goals identified for every aspect of their lives, including from their family, education and health.

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Quality of care good

Young people have prompt access to a range of health care services. Staff diligently work with any specialist professional advice or programmes of care, such as mental health services or epilepsy care. As a result, young people experience continuity of care that leads to improvements in their general health and well-being, as they receive appropriate intervention that reflects the way in which their parents support them at home. Parents say that staff are very careful about gathering information about their child’s health, and that this enables them to respond consistently and effectively to any emerging health need. Because of the high level of health care some young people need, staff attend appropriate specialised training at regular intervals, to ensure they are up to date with best practice. Staff also research specific medical conditions affecting young people, and provide briefings to the staff team.

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Quality of care good

This enhances staff knowledge and understanding of the breadth of issues young people face, and increases their confidence to assess and respond to emerging need.

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Quality of care good

Arrangements for the administration of medication are extremely well organised. Staff work with parents to ensure they provide detailed and updated information and medication for each stay. Staff administer all medication safely, effectively and respectfully to young people, by including them as much as possible in the routines, and by allowing them to take the time they need to understand what is happening. This approach encourages young people to be as independent as possible in taking their medication.

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Quality of care good

Key workers have good knowledge and understanding about each young person’s communication and care needs. They create a placement plan that is clear and accessible to all. Managers are reviewing the quality of plans, to ensure that they contain important information such as how to better measure progress young people make in their short-term goals.

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Quality of care good

Staff are developing ways to support children and young people to contribute their views and opinions in a variety of ways, specific to their unique communication style and ability. Key workers are researching individual communication styles and preferences, and creating communication support tools that are unique to each young person. This helps staff to be thoughtful about ensuring that all children have the same access to choice and self-determination as those who are able to communicate verbally. Staff use symbols, simple language, and warm and affectionate relationships to assist young people to understand and participate in daily routines. This approach encourages young people to be as independent as possible and make effective choices about their everyday lives, such as when they 8 of 11 wish to go out into the garden, or when they want drinks or snacks.

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Quality of care good

Staff regularly reflect on the importance of understanding equality and diversity concerns, and engage in thoughtful discussion on these matters. Recent staff development days and staff meetings have focussed on staff mindfulness regarding the impact of disability on young people, and the importance of effective communication. Managers have worked with adult services, to identify young people’s needs and rights as they transition into their adult lives. This enables staff to promote improving outcomes for children, and increase their expectations of other professionals who support them.

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Quality of care good

The home remains a warm, spacious and comfortable space for children to enjoy their time away from home. Recent improvements include an accessible playground for all young people to enjoy, and refurbished bedrooms that provide space for young people’s needs to be met with dignity, such as the discreet use of hoists and multi-level beds.

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Keeping children and young people safe good

Children and young people are safe and well looked after in the home. Staff carefully integrate their knowledge and understanding of the needs of young people with learning disabilities, with their knowledge and understanding about how to help young people to stay safe. This highly effective combination enables staff to identify key triggers to changes in mood and resilience, and work with children, young people and other professionals to reduce any risk arising from such changes. By being proactive, staff improve young people’s feelings of security and well-being, and this leads to improvements in their overall welfare and progress.

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Keeping children and young people safe good

Staff demonstrate open and transparent communication with young people, their families and professionals who support them. Parents say staff keep them very well informed about the welfare of their child during their stay, and that they have every confidence that staff do their best to ensure their safety. Professionals are unanimous in their confidence that staff know and understand the policies and procedures necessary to provide safe care.

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Keeping children and young people safe good

All staff, including ancillary staff attend regular and up-to-date training in child protection that includes the particular vulnerabilities of disabled children. Effective systems are in place to record and manage any concerns regarding the welfare of children. Staff demonstrate knowledge and understanding of the need to highlight any physical or emotional changes in young people that may indicate they have suffered harm. They readily record and communicate any concerns about children’s welfare to parents and appropriate professionals to ensure that children’s safety and comfort is prioritised and addressed.

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Keeping children and young people safe good

Staff use a recognised behaviour support approach, to help young people to develop 9 of 11 strategies to manage their own feelings and behaviour. By reviewing behaviour support skills, staff have better understood the importance of accurate data collection to analyse behaviour. Key workers produce careful and detailed risk management plans in consultation with parents and relevant professionals. This means they retain a relevance to the changing needs of young people. Staff are competent in redirecting young people before their behaviour challenges the safety or welfare of themselves or others. This enhances their emotional well-being and improves their safety.

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Keeping children and young people safe good

Staff use restraint rarely, and careful examination of such incidents includes opportunities for staff to reflect on their own performance, to identify ways to improve. Managers oversee the records of physical intervention, and identify any shortfalls in staff practise or response to young people's needs. Managers demonstrate the importance of transparency in records of behaviour management by ensuring all lessons learned are shared with the staff team. This approach enhances the safety and welfare of all who use the service.

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Keeping children and young people safe good

Managers operate careful selection and vetting of staff working in the home to prevent unsuitable people having access to vulnerable children. Rigorous multi- agency induction programmes ensure staff are equipped to care safely for each child in a manner that protects their rights and dignity. New staff are carefully supported into their practical roles by experienced staff. This ensures safe caring practice is maintained, and children remain comfortable with staff that support their personal care.

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Keeping children and young people safe good

Children and young people enjoy short breaks in a home that is physically safe and appropriately secure. Managers ensure regular fire evacuation practise takes place, to remind staff of what to do in an emergency. Staff regularly update children’s risk assessments to reflect identified safety concerns. When necessary, the environment is adapted to provide young people with safety without restricting their movement, such as removing unnecessary items from bedrooms to prevent falls by children who like to climb the furniture, or providing crash mats or bed-sides for those who may require additional protection from falling out of bed.

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Leadership and management good

The Registered Manager has been in post since July 2013 and provides energetic and enabling leadership to a stable, committed and competent staff team. He is suitably qualified to undertake his responsibilities with a Level Three award in childcare, and a Level Four award in the management of children’s homes. Staff respond enthusiastically to the manager’s expectation that they will deliver ever improving care to complex and vulnerable young people. Young people benefit from placements that support their emotional and learning needs, and help them to progress. Staff recognise, enjoy and celebrate the efforts of young people to improve their knowledge and understanding of the world, and their interaction with it. Staff say, 10 of 11 ‘The greatest pleasure I have in coming to work, is seeing the young people really enjoy the new activities we offer.’

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Leadership and management good

The Registered Manager incorporates any findings from feedback gained from consultation exercises with stakeholders, including professionals and families, into reports on the conduct of the home. The report plans and records progress made against actions to support the development of the home. Each revised plan identifies adjustments to the performance criteria for the home, in order that progress is maximised. This includes promoting staff interest in professional development through independent study. Young people’s views and wishes remain central to planned development for the home, and staff share their aspirations for young people and the service during team development days. As a result, the service provided to children and young people remains fresh and relevant to meet their needs.

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Leadership and management good

The home meets the aims and objectives of the Statement of Purpose. Families, social workers and other professionals are clear about the services and support the home provides. The Registered Manager works with independent visitors who visit on behalf of the provider, to assess the quality of care provided and to identify any development need required for the home to continue progressing. Staff benefit from regular and developmental supervision. They say that this helps them to reflect on their performance, and ensures they continually improve the quality of care they provide.

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Leadership and management good

Professionals and parents offer high praise for the service, and recognise that staff offer young people opportunities for development and growth that they may not otherwise have. Results clearly demonstrate the positive impact and value that living at the home has on the lives of children and young people, who grow in confidence and maturity, and develop skills in independence and self-determination. 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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