Children's Home run by Praxis Care in Leicestershire

Unique reference number SC032069 Inspector Catherine Honey Type of inspection Full Provision subtype Children's home

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Registered person Praxis Care Registered person address Praxis 25-31 Lisburn Road Belfast County Antrim BT9 7AA Responsible individual Irene Elizabeth Sloan Registered manager Ruth Nicola Harrison Date of last inspection 27/01/2014 2 of 10 Inspection date 09/07/2014

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Previous inspection satisfactory 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 adequate Leadership and management good

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Overall effectiveness

There has been a considerable amount of change at this home since the last inspection. The home has grown from a 4 bed to an 8 bed home. In addition, a new manager has been registered with Ofsted. The manager has a clear understanding of the home's strengths and weaknesses and has worked steadily and diligently to raise standards and the quality of care, and create an efficiently run home. Staff report feeling more empowered and a rise in morale. As a result of these changes, children and young people receive a highly individualised service. They have positive relationships with staff who know them well. Children and young people are relaxed, have the opportunity to experience new things and make progress during their short breaks.

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Overall effectiveness

Shortfalls identified during the inspection have not put young people at risk. Weaknesses were identified in the recording of suspicions of harm. The current system is not robust and does not reflect the strong management oversight or actions taken by staff. This is a recording issue rather than a practice issue, as local authorities confirm information is passed to them. The manager had already identified this shortfall and devised a new recording system during the inspection. Good practice recommendations are made in relation to fire doors being propped open on occasion, monitoring of the visitor's log and policy shortfalls in relation to 3 of 10 the use of electronic monitoring devices. There has been no negative impact on the welfare of safety of young people as a result of any of these shortfalls.

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Overall effectiveness

In the consultation Ofsted carried out with young people prior to the inspection, young people graded the home as either 'good' or 'great’. One young person commented, 'I feel happy here.' 4 of 10

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Information about this children’s home

The provider organisation is a registered charity. This home provides respite care for young people with learning and physical difficulties, and often complex health care needs, accommodating a maximum of eight at any one time.

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Inspection date Inspection type Inspection judgement

27/01/2014 Interim satisfactory progress 09/05/2013 Full adequate 07/01/2013 Interim inadequate progress 25/09/2012 Full adequate

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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) ensure written records are kept of any allegation of abuse or neglect, and of the action taken in response. (Regulation 16(2)(d)) 24/07/2014

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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 staff are provided with guidelines on their health and safety responsibilities. This is in relation to fire doors (NMS 10.7) 5 of 10  ensure where specific measures, including electronic devices, are used to monitor children, there is a written policy that sets out how they should be used, how they promote the welfare of children, how children will be informed of their use, how legitimate privacy of children will be protected and how children will be protected from potential abuse of such measures (NMS 10.5)  ensure there are clear and effective procedures for monitoring and controlling the activities of the home. This is in relation to the visitor's log. (NMS 21.1) 6 of 10

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Outcomes for children and young people good

Children and young people are confident during their stays and enjoy their time visiting the home. They learn how to improve their social skills and how to manage their feelings and emotions in an appropriate way. Young people enjoy a healthy lifestyle with plenty of opportunities for exercise and a good diet. They continue their education placements during their short breaks.

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Outcomes for children and young people good

Young people have opportunities to try new activities and experiences. For some young people these would not be possible without the input of the home. For example, young people access restaurants, local parks, and swimming pools. This helps young people to grow in confidence, cope with busy environments and access public places.

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Outcomes for children and young people good

Due to staff building up relationships and working with young people to develop appropriate behaviours, they are able to develop their skills and take part in community activities. Staff work hard to give consistent messages and work together to set clear expectations young people about appropriate behaviour. Frequent communication of information between all of those caring for the young people ensures young people receive consistent care

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Outcomes for children and young people good

Where possible children and young people's independence skills are promoted through activities such as developing skills in self-care, simple food preparation and domestic chores. There are opportunities for young people to participate in their own care and the running of the home, with staff ensuring that they are able to express their individual needs and likes and to make choices wherever possible.

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Outcomes for children and young people good

Children and young people work towards targets and achieve these. Targets have recently included helping young people use books appropriately instead of trying to tear pages. Young people develop new skills and make progress during fun, safe and secure short breaks.

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Quality of care good

Staff have a detailed knowledge and understanding of the children and young people in their care. They form strong, sound relationships with them. Staff are skilled at communicating with young people according to their preferred methods of communication; this ensures that young people's wishes are met and they feel understood and respected. Short break stays are arranged wherever possible to ensure that young people's friendships are facilitated. 7 of 10 Care plans are highly detailed and clearly set out specific, individualised needs. The plans include any relevant information about disability and medical requirements, and where appropriate any religious and cultural considerations. Plans are reviewed regularly in conjunction with families and care givers, and the placing authority. There are positive behaviour support plans which are used in conjunction with the risk assessments. Knowledge of young people’s needs and staff use of

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Quality of care good

communication methods with young people mean challenging behaviour is rarely displayed by young people. Some excellent detailed individual development target- setting work is in place, and key workers implement this in practice. Care plans are constantly updated to record the progress that young people are making. This information helps inform the next review and further plans.

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Quality of care good

Social workers and parents speak very highly of the home and the care that the staff provide. A professional commented: 'There are competent, knowledgeable and caring staff. Children and young people are at the heart of what they do. The home offers the children and young people lots of opportunity and choices. They support them as individuals and allow them to express and have their needs met. It has a warm atmosphere, with lots of planned activities to enable them to have fun and experience play and stimulation.'

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Quality of care good

Staff work closely with health professionals, and seek their expert advice appropriately. Staff receive specialist training for administering some medication. Arrangements for the administration of medication are safe and robust. There is a robust audit system in place to ensure these arrangements remain high quality and safe. Young people enjoy freshly cooked food and any dietary restrictions and allergies are taken into consideration when planning menus. Consequently, children and young people's health needs are well met.

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Quality of care good

The home is purpose built and designed to meet the complex needs of the children who access the short break service. A new extension to the existing building has provided further beds. The layout of the home is spacious, allowing for two distinct areas to meet the differing needs of the young people. Photographs of young people add a welcoming touch to the environment. Outside areas are accessible for young people and contain toys and play equipment. The home is well cared for to ensure it remains welcoming and safe for young people.

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Keeping children and young people safe adequate

Children and young people are kept safe during their stays due to high levels of supervision and the in-depth knowledge staff have of their needs. Young people do not go missing; this reflects the very high staffing ratios in the home at all times and the support provided to them. Staff are vigilant to ensure that children and young people do not harm themselves or others. Consequently, young people are protected and kept safe. 8 of 10 Staff are very clear about how they would deal with any issues of concern and are clear on their responsibilities in relation to safeguarding the young people in their care. They are aware of children’s and young people's specific vulnerabilities and take action to protect them. Where there are suspicions of harm, this information is quickly shared with the placing authority and parents where appropriate. Social workers confirm that good quality information is shared. However, currently the

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Keeping children and young people safe adequate

recording system used in the home does not fully reflect each event and the action taken by the home. The manager had already identified this shortfall and put a new recording system in place during the inspection. This is a recording issue rather than a practice issue but lack of robust recordkeeping could put young people at risk.

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Keeping children and young people safe adequate

Sanctions and physical restraints are very rare as most behaviour is managed by gentle guidance, or talking to the young person. By staff working consistently with others, young people's behaviour gradually improves over time, and young people make progress given their starting points. Where children or young people have specific night-time health needs listening monitors enable night staff to monitor the young person concerned without unnecessary intrusion. Parents and the placing authority are aware of the use of these devices. However, a policy on their use is needed to ensure that they are used appropriately. The manager is already aware of this shortfall and is taking action to rectify it

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Keeping children and young people safe adequate

Staff recruitment and selection processes ensure comprehensive checks are made to ensure that young people are cared for by appropriately experienced staff. Security both within and outside of the home is also appropriate. Visitors are escorted into the home and checks undertaken of their identification and reason for visiting. Visitors remain supervised during their visits ensuring both the visitor and young people are kept safe.

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Keeping children and young people safe adequate

The home is well maintained. Services such as electricity, electrical appliances and firefighting equipment are regularly checked by the appropriate professional companies. Fire evacuations are practised and there are individual risk assessments for each young person with regard to evacuation in an emergency. During the inspection several fire doors were observed to be propped open to provide better ventilation in the hot weather. Although this does not happen when young people are resident, this occasional practice could put staff and the building at risk in the event of a fire.

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Leadership and management good

The manager is a qualified nurse and holds a National Vocational Qualification in management and leadership at level 4. She is considering a level 5 qualification to further enhance her skills. The manager has worked for many years in residential care for children meaning she is well-experienced and appropriately qualified for the role. 9 of 10 At the last inspection, a shortfall was found in Ofsted not being notified of a significant event. This requirement has been met as the manager and management team have familiarised themselves with the events requiring notification to the regulator.

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Leadership and management good

The manager has a clear understanding of the strengths and weaknesses of the home. Since the last inspection she has focussed on raising standards and stabilising the staff team, ensuring they have the support and training they need to provide high quality care to young people. The home has a development plan in place. The Registered Manager regularly reviews this document, to ensure that all actions set are completed.

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Leadership and management good

Staff receive regular formal supervision and the mandatory training and specialist health care training pertinent to the care of the young people attending the home. All staff are suitably qualified or working towards professional qualifications. They feel well supported by high levels of training and high quality supervision. A member of staff commented: 'Managers are always keen to hear ideas for improvement and are accepting that they need to listen to the staff who are actually working with the young people.'

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Leadership and management good

An independent visitor carries out monthly quality assurance monitoring visits on behalf of the Responsible Individual. The quality of these reports has improved greatly since the last inspection. The manager conducts monthly monitoring of the service to ensure high levels of care. While the monitoring is of good quality, a minor shortfall was observed in the visitor's book where not all visitors have signed out. A recommendation is made to ensure this additional monitoring takes place. The home’s Statement of Purpose gives a good overview of the home. It contains all the required information to give parents and the local authority a clear picture of the aims and objectives of the home and the facilities and services that are provided.

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Leadership and management good

Staff and the manager ensure that when new referrals are received, detailed planning takes place. This includes regular meetings with parents/care givers and social workers to gather detailed information about the needs of the child or young person. It also includes visits to the home for children and their parents. This enables a smooth transition to the short break service and allays any concerns or anxieties parents may have. 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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