Children's Home run by Our Place (2008) Limited in Worcestershire

Unique reference number SC407929 Inspector Michelle Spruce Type of inspection Full Provision subtype Children's home

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Registered manager Lena Greatwich / Elaine Redding Date of last inspection 07/01/2014 2 of 9 Inspection date 02/10/2014

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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 adequate

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

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Overall effectiveness

This adequate service is effective in improving good outcomes for young people. The individual complex needs of young people are identified well planned. Young people make good use of their preferred style of communication to ensure their views and wishes are recognised and acted on.

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Overall effectiveness

Young people are safe in a home that recognises their vulnerabilities. Staff are proactive in promoting their safety. Privacy, trust and respect are high on the agenda for staff when supporting young people with complex care needs.

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Overall effectiveness

The bonds between young people and staff are formed over time. Young people show they have formed trusting relationships through their behaviour such as vocal tone and body language.

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Overall effectiveness

There is a sound leadership team driven by a competent and effective manager. Development plans underpin how the home will progress and continue to provide positive outcomes and good quality care.

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Overall effectiveness

There were some shortfalls identified and six requirements and one recommendation have been made. 3 of 9

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Information about this children’s home

This privately owned home is registered to accommodate eight children and young people with learning disabilities. The home has a school and offers planned short and long-term placements. The school is registered with the Department for Education.

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Inspection date Inspection type Inspection judgement

07/01/2014 Interim good progress 15/08/2013 Full good 17/12/2012 Interim good progress 01/08/2012 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

5 (2001) ensure the registered person shall keep under review and, where appropriate, revise the statement of purpose and notify HMCI of any such revision within 28 days (Regulation 5(a-b)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure the registered person shall make suitable arrangements for the recording, handling, safe keeping, safe administration and disposal of any medicines received into the children's home (Regulation 21(1)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure that all parts of the home to which children have access are so far as reasonably practicable 31/12/2014 4 of 9 free from hazards to their health or safety (Regulation 23(a))

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Reg. Requirement Due date

(2001) ensure that all persons employed by the registered person receive appropriate training, supervision and appraisal (Regulation 27(4)(a)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure that premises used for the purpose of a children's home are appropriately and suitably located, so that children cared for by the children's home are effectively safeguarded and are able to access services to meet needs identified in their care plans or placement plans (Regulation 31(1A)(a)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure the registered manager shall establish and maintain a system for monitoring the matters set out in Schedule 6 at least once in every 3 months and supply to HMCI a report in respect of any review conducted by him. (Regulation 34(1)(a)(2)) 31/12/2014

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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 visits of the home carried out under Regulation 33 include relevant checks set out in regulations and guidance (NMS 21.7) 5 of 9

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Outcomes for children and young people good

Young people with complex health needs make good progress in maintaining a healthy lifestyle. Some young people are now on reduced medication as a result of clear health planning and joint working with external health professionals. A social worker said, 'Fantastic improvement; no longer incontinent'. Health needs are met and routine appointments are attended. This promotes the health and wellbeing of young people.

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Outcomes for children and young people good

Most young people attend the on-site education provision. Young people make small steps in regards to their progress. A staff member said, ‘his education is better now; he is now taking part’. Further comments from a social worker confirmed this. A social worker said, ‘He is making progress in education; the teacher understands how to set out the curriculum to meet her needs'.

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Outcomes for children and young people good

Young people benefit from contact with those who are significant in their lives. Overnight stays and communication through tablets and iPads keep young people in touch with their families. For example, Skype is used which gives young people the opportunity to contact their family, while others prefer to communicate by using the telephone. This strengthens bonds and improves communication.

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Outcomes for children and young people good

Young people gain independence skills at a pace that is individual to their ability. For example, young people access the community and manage their own money while out shopping. Some young people now undertake more personal care for themselves. As a result, confidence and life skills improve.

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Quality of care adequate

Relationships are strong and trusting. Staff know and understand the complex needs of each individual young person. A staff member said, ‘We have a fantastic relationships; we work hard to gain trust and form friendships. You need to know the individual well; it takes time and is a gradual process’.

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Quality of care adequate

Activities encourage young people to participate and are stimulating. Staff work in partnership with young people and their families to ensure they are provided with experiences that meet their social and emotional needs. A staff member said, ‘We talk to families and previous placements to assess what young people like; some like horse riding and now go weekly’. As a result, co-ordination for some young people has improved.

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Quality of care adequate

Staff are sensitive and respectful in providing personal care to young people. Their 6 of 9 privacy is respected and independence is maximised and encouraged for those who are more able to undertake their own personal care with minimal assistance. A social worker said, ‘Staff are very good; they are pro-active and meet the needs of young people’.

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Quality of care adequate

Medication arrangements are not always followed in line with the home’s policy and procedures. For example, medication that has previously been dispensed from blister packs but not used is kept in the medication cupboard instead of being returned to the pharmacy. Topical creams are not routinely labelled with the date they are opened. This makes it difficult to know when to dispose of them.

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Quality of care adequate

Health and safety monitoring is completed on a regular basis to ensure the home is free from hazards that present a risk of accident or injury. Some hazards were identified during the inspection that required attention. For example, there were broken bathroom tiles and missing shower hoses. Furthermore, the record of electrical safety testing was unsatisfactory. This does not guarantee that the home environment is safe.

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Quality of care adequate

The manager does not have a home location risk assessment that identifies any risks with the location of the home. This means any placements that are taken or considered are not effectively matched in conjunction with the needs of the young people to the location of the home. The communal space for young people within the home is limited. However, the school site provides additional space for young people to enjoy.

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Quality of care adequate

Staff use young people's preferred method of communication to gain their view, wishes and feelings. For example, a young person did not like his shoes. He used his book to show a picture of his Pedro boots to tell staff he did not like them. Staff acted on his wishes and changed his shoes.

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Keeping children and young people safe good

Young people demonstrate how safe they feel by expressing their feelings through vocal sounds, body language, signs and symbols. Staff said, ‘We know they feel safe by how they react; we recognise changes in behaviour that reflect how they are feeling; they use communication aids to tell us how they feel’. Survey responses also confirm that the young people are safe because risk assessment and staffing levels keep them safe.

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Keeping children and young people safe good

Young people have individual behaviour plans that identify targeted behaviours. Staff monitor patterns and trends and evaluate how to support young people. For example, one young person had gone from 209 to 35 behaviour episodes over a period of five months. Staff took into consideration the effects of medication. This prompted a review of medication. As a result, medication was gradually reduced and finally removed. 7 of 9 Some young people require the use of physical intervention to protect them or others from harm. Staff are trained well and manage behaviour appropriately and safely. As a result, the need for physical intervention is reducing. A staff member said, ‘Physical intervention has massively reduced; there is more re-directing now; he responds well’. Staff help young people to communicate their response to how they feel following physical intervention by using pictures signs and symbols.

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Keeping children and young people safe good

Young people are extremely vulnerable and depend on staff to keep them safe from harm. Young people do not go missing from home because staff supervise them closely. This keeps them safe.

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Keeping children and young people safe good

The recruitment process is thorough. Staff do not begin employment until full and satisfactory checks are completed. Visitors are vetted on arrival to the home and have to sign in and verify their identification. This protects young people from the risk of harm.

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Keeping children and young people safe good

There have been no allegations since the last full inspection. Young people have advocates to act on their behalf. This helps them to raise concerns or complaints.

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Keeping children and young people safe good

Fire drills and equipment tests are completed in line with the home’s policy and procedures. This keeps everyone, living, working or visiting the home safe in the event of a fire.

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Leadership and management adequate

The service benefits from a Registered Manager who has been in position since April 2014. The manager is qualified to level 4 in management and health and social care. Additionally, there is a committed and strong staff team that support the operation of the home.

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Leadership and management adequate

Staff feel valued and supported by their manager. Staff confirm they receive regular supervision but are not annually appraised. Staffing shortfalls are supported by the use of agency staff. However, they are not equally provided with the opportunity to receive supervision to monitor and support their practice. Mandatory training is up- to-date, but staff that undertake invasive care procedures have not had refresher training. Furthermore, there are no certificates to demonstrate who has received training and who is competent in practising invasive care procedures. This means staff are not suitably trained, supervised or appraised. As a result, the quality of care young people receive is compromised.

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Leadership and management adequate

The manager has not reviewed the quality of care since November 2013 or sent a report to Ofsted in line with the timescales required under Regulation 34. Monitoring is completed monthly by an independent visitor and a report is provided to the manager and Ofsted. However, the report does not include reference to relevant 8 of 9 checks set out in regulations and guidance. This means the monitoring is incomplete in informing the manager about the service.

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Leadership and management adequate

The revised Statement of Purpose has not been sent to Ofsted or completed in line with the revised regulations from April 2014. This means anyone wishing to know about the service is not provided with up-to-date information.

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Leadership and management adequate

Regulation 30 notifications are recorded in line with legislation and are sent to the appropriate authorities.

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Leadership and management adequate

Records of confidential data are kept in locked cabinets. This protects confidential information and restricts unauthorised personnel having access to it.

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Leadership and management adequate

The manager has formed a development plan for the home with staff. The plan is a working document that covers three phases. Unfortunately planned work to extend the building to create more recreational space has not yet got underway. This has not impacted negatively on the young people placed.

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Leadership and management adequate

There were no requirements or recommendations made at the last inspection. Complaints are addressed by the manager in a fair, equal and timely manner. Website: www.ofsted.gov.uk

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Leadership and management adequate

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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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