Children's Home run by Reamcare Limited in Kingston upon Thames

Unique reference number SC423606 Inspector Barbara (Polly) Polain Type of inspection Full Provision subtype Children's home

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Registered person Reamcare Limited Registered person address 361 Ewell Road SURBITON Surrey KT6 7BZ

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Responsible individual Younoos Jeetoo Registered manager Jennifer Michelle Frogley Date of last inspection 18/02/2014 2 of 10 Inspection date 04/09/2014

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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 good Keeping children and young people safe good Leadership and management good

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Overall effectiveness

This home provides both residential and short break care to young people with learning disabilities. The home specialises in the care of young people with autistic spectrum disorders. Most young people using the service are residents and only one room is left available for short breaks. The young people using this service do so on a rotating basis and only one will be admitted at any time. These young people are from a regular group of six and are well known to the residential group. Although this means that some young people do come and go, managers ensure that all are familiar with the routines that support the changeovers. This mix of short breaks and residential seems to work well and this is achieved through careful matching of personalities and levels of ability.

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Overall effectiveness

The home benefits from strong and stable leadership and management. The current manager and deputy have been in post from the start. They have a good rapport with the young people and set an example to staff of positive interaction and engagement in a nurturing environment.

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Overall effectiveness

Social workers report that the home is good at safeguarding vulnerable young people and any incidents that do occur are dealt with promptly and effectively. Young people say they feel safe in the home. 3 of 10 Staffing levels are high and this allows sufficient time for staff to spend nearly all of their time on shift with the young people. Staff members demonstrate dedication and commitment to their roles and this ensures that the environment is an emotionally warm, nurturing one, making this a good place to be for both staff and young people. Expectations are high both for the home and for the residents. Staff are expected to provide good quality care and young people are strongly encouraged to make progress in terms of independence. The ethos of the home supports a belief that to achieve the best possible outcomes for young people it is necessary to provide a level of challenge which will ultimately result in the

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Overall effectiveness

development of improved confidence and skills. This has led to improvements in young people's speech and language skills and capacity for independence.

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Overall effectiveness

Social workers and parents are pleased with the progress of the young residents and speak highly of a nurturing environment in which young people are encouraged to challenge themselves.

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Overall effectiveness

Two recommendations were made as a result of this inspection and both are in regard to furnishings and fittings. Some areas of the home currently reflect the need to ensure fixtures and fittings are suitable to withstand heavy wear and tear but are not conducive to the creation of a homely environment. This is especially the case in the main sitting room which has a slightly institutional feel. A further recommendation is that the furnishings in the young people's bedrooms should be regularly reviewed to ensure they remain suitable and appropriate with respect to age and development. 4 of 10

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Information about this children’s home

This home provides care and accommodation for up to six young people who have a learning disability. It is operated by a private organisation and provides short breaks in addition to longer periods of care.

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Inspection date Inspection type Inspection judgement

18/02/2014 Interim good progress 05/06/2013 Full good 21/01/2013 Interim good progress 29/08/2012 Full adequate

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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

 NMS 10.3. The home provides a comfortable and homely environment and is well maintained and decorated. Avoidable hazards are removed as is consistent with a domestic setting. Risk reduction does not lead to an institutional feel.  NMS 6.1. Children’s physical and emotional and social development needs are promoted. 5 of 10

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Outcomes for children and young people good

Young people are encouraged to develop independence skills and to gain confidence with day to day tasks. Staff encourage young people to dress themselves, learn to cook, assist with laundry and cleaning and to generally take part in the running of the home. Each young person has tasks to complete which are suited to their individual capabilities. These may include cooking a meal once a week or going to the shops to buy something and successfully returning with a receipt.

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Outcomes for children and young people good

Each young person is assessed in terms of their unique sets of skills and abilities and encouraged to make progress through a series of small steps and with the aid of constant encouragement. The home supports young people to stretch themselves and to try new things. In this way they believe increased confidence and self esteem will follow.

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Outcomes for children and young people good

Education is strongly promoted and all young people are in school. Staff are in regular contact with schools in order to provide a consistent level of care and support. The management team also advocate for their resident young people to ensure that they are not disadvantaged. A recent example occurred when the home disagreed with a school that planned to leave a young person out of a school trip because of the high level of supervision and support required. The managers negotiated to provide extra support and advice to the school to ensure this did not happen.

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Outcomes for children and young people good

Social workers report good progress at school this year for all resident young people. They also report good liaison with professionals to ensure that young people are making progress and learning new skills. Maketon and PECS training at the home is provided individually by schools, to ensure that the approach is consistent and that staff understand the particular and individual communication strengths and preferences of each young person.

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Outcomes for children and young people good

Young people's health needs are also well met at the home. Medicines are kept in a locked cabinet and arranged in separate sections for each young person. There is good liaison with treating doctors and GP's. Healthy eating is encouraged and a range of outdoor activities are on hand to encourage young people to take sufficient exercise. These include horse riding, swimming, football and walking. One recent group activity was a weekend at Centre Parcs.

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Outcomes for children and young people good

Social workers and other professionals report that young people show a decrease in erratic and problematic behaviour at the home as well as a corresponding decrease in the level of drug therapy required. 6 of 10

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Quality of care good

Staff have a good understanding of the needs of the young people and key working arrangements are strong with the result that young people benefit from positive relationships with staff and with each other. This provides opportunities to develop social skills and to learn how to engage with others in an appropriate way.

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Quality of care good

As far as possible young people take part in the day to day running of the home. They are encouraged to have their say in regard to menus and activities as well as being prompted to get involved in shopping, cooking, laundry and cleaning tasks. All staff are expected to share cooking and cleaning duties and young people are encouraged to work alongside and learn as they would in a family home.

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Quality of care good

Young people understand how to make their wishes and feelings felt and to express their views. This is encouraged through key working sessions and other interactive meetings. Overall the level of engagement with young people by the staff and management at this home is very high.

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Quality of care good

Social workers praise the quality of care at the home and comment upon the flexibility of the managers in terms of providing extra staffing when needed and addressing behavioural concerns as they arise. Good communication with professionals was also noted.

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Quality of care good

Contact with parents and others who are significant to the young person is often supervised by workers from the home. Staff encourage young people to maintain relationships with those who are important to them and will facilitate contact either at the home or in the community.

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Quality of care good

The home provides a healthy, active environment which promotes the young person's individual identity and cultural background. Young people can also access a range of services and support to ensure that complex needs can be comprehensively met.

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Quality of care good

Social workers were particularly impressed with the individuality of the care. Care plans and behaviour management plans are detailed and thorough. Staff encourage young people to progress and achieve relative to their individual starting points:

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Quality of care good

' I am very pleased with the quality of care received, and parents have also said that they are also happy. The young people access activities suitable for their needs and age and programmes are tailored accordingly.'

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Quality of care good

Young people say they are happy there and want to stay as long as possible. Some young people who have had difficulty settling at other homes have settled in well here and are thriving.

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Quality of care good

Young people are encouraged through their key worker sessions to explore their interests and talents. Staff are proactive in seeking out activities which will promote 7 of 10 these, thereby also ensuring that young people have opportunities to engage with the wider community. Each young person resident at the home is pursuing separate activities in line with their preferences, these include drama classes, theatre productions, football and cadets. The home also has a visiting 'patting dog' which all young people are encouraged to engage with.

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Keeping children and young people safe good

Safeguarding standards are high and staff have a good understanding of the particular safeguarding challenges of the group of young people currently using the service. There are sufficient staff on duty at any one time to provide protection and care to vulnerable young people and to prevent bullying.

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Keeping children and young people safe good

Young people say they feel safe in the home. The physical environment is safe and secure, appropriate to the level of need. For instance, the home uses only 'tough furniture' specifically designed for young people with behaviour problems to ensure it does not shatter or splinter on impact. Damage levels are kept to a minimum and young people are less likely to be hurt in the process.

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Keeping children and young people safe good

Young people rarely go missing and there have been no serious incidents in which the police have been called to the home. Two safeguarding incidents have been recorded since the last inspection and both were dealt with appropriately and in a timely manner by managers and staff. Social workers report that in each case communication with themselves was extremely good and the manager assessed the situation and acted decisively. Overall social workers reported no concerns in regard to safeguarding; 'Where there have been any safeguarding concerns body maps have been received and attendance at LAC and safeguarding meetings by staff have been prioritised'. Social workers also reported that if extra staff are required in order to safeguard, then these are always quickly provided.

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Keeping children and young people safe good

The home has a stable core of experienced workers but is currently recruiting additional staff to prepare for the opening of a new home. The home aims to maintain continuity and stability of staff whist the preparations are unfolding in order to avoid unnecessarily exposing vulnerable young people to excessive change.

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Keeping children and young people safe good

Behavioural management techniques are based on a thorough analysis of each young person and individually tailored to ensure that trigger factors are noted and acted upon quickly to prevent problems escalating. Although physical intervention techniques are used all staff are trained in non restrictive 'breakaway ' techniques by a reputable and BILD accredited provider and each incident is recorded clearly and concisely, including the reason for the restraint, the length of time it was used for and any follow up actions required.

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Keeping children and young people safe good

Staffing levels are calculated based on information to hand in respect of each young 8 of 10 person's behaviour and overall need. Risk assessments are updated in line with any changes to behaviour and requirements for a higher ratio of staff to young people are responded to rapidly.

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Keeping children and young people safe good

Rewards and sanctions are reviewed regularly for effectiveness and are appropriate to each young person's particular level of understanding and capacity to take responsibility for actions. These are sometimes loss of television time or an appropriately compensating task such as helping to clean and tidy a room if the young person was responsible for the disarray.

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Keeping children and young people safe good

Staff training is a mix of online and face to face training, provided by either independent services or by the local authority, who currently provide safeguarding training to all staff.

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Keeping children and young people safe good

Staff recruitment is done by the responsible individual and the registered manager. Work records are carefully checked to ensure there are no unexplained gaps in employment. References and police clearances are obtained and held at the head office of the organisation.

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Leadership and management good

The home is effectively and efficiently run by a manager and deputy manager who are suitably qualified and experienced. The home has had the same management team from the start and they fully understand the strengths and weaknesses of the home. When weaknesses are identified, they are quick to make changes. For instance, the previous provider of NVQ training was found to be unreliable and the management team quickly arranged to transfer to a different provider. All staff receive regular supervision and have an annual appraisal. There is a programme of training which all staff are expected to engage with and staff members either have the NVQ3 award or are working towards it.

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Leadership and management good

The manager and deputy manager were responsible for the setting up of the policies and procedures which the home uses and ensure that these remain relevant to the prevailing ethos and vision of the home. The home has also clearly benefitted from this continuity and stability. Good systems for recording are in place and young people's files provide clear and useful information which accurately documents their individual journey through the placement. File notes also evidence that overdue reviews and statutory visits are followed up by the home. Overall the home works closely with local authorities to ensure the best possible outcomes.

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Leadership and management good

The management team has the support of the responsible individual and a generous budget for staffing, maintenance and improvements is available. There have been no complaints since the previous inspection.

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Leadership and management good

The statement of purpose is clear and the aims and objectives accurately reflect the 9 of 10 day to day operation and practice of the home.

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Leadership and management good

Young people respond well to the nurturing approach of staff and managers and seem comfortable and happy. Managers adopt a very 'hands on' approach in the home and are able to monitor and evaluate the quality of care. Social workers particularly praise the quality of care and identify this as a key strength of the home.

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Leadership and management good

There is a good range of activities both inside and outside the home and young people are encouraged to participate even when the activity takes them outside their 'comfort zone'. This reflects a key aspect of the ethos of the home which is to encourage young people to challenge themselves.

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Leadership and management good

Staff receive training in both PECS and Maketon through the young people's schools. This allows them to receive training and guidance on the individual communication styles of each young person resident at the home.

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Leadership and management good

The home also benefits from the input of a consultant who provides regular supervision and support to the manager as well as training and advice to all staff.

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Leadership and management good

The home appears suitably resourced and there is evidence that the budget provided is adequate to manage and run the home effectively.

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Leadership and management good

Monthly independent visitor reports are received by Ofsted in a timely manner as are the registered manager's three monthly monitoring reports. Any issues identified in the independent visitor reports are shown to be dealt with in a timely manner by the managers of the home. 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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