Children's Home run by Lifeworks Charity Limited in Devon

Unique reference number SC003792 Inspector Norma Welsby Type of inspection Full Provision subtype Children's home

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Registered manager Urban Thomas Andrew Date of last inspection 06/11/2013 2 of 10 Inspection date 20/11/2014

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Previous inspection satisfactory progress Enforcement action since last inspection none

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Overall effectiveness adequate

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

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Overall effectiveness

The overall effectiveness of this service is judged adequate, with several good features, including outcomes for children and young people. Some areas raised at previous inspections, while acted upon, have either not been given enough attention or improvements have not been sustained. For example, quality monitoring processes and the formal supervision of staff are not of a consistently good standard. Furthermore, the leadership and management of the service does not effectively monitor the quality and adequacy of important records. Currently these shortfalls are not judged to overly impact on the day to day service delivery. They do, however, inhibit improvements that could be made to provide a more effective service overall.

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Overall effectiveness

During the past year the Board of Trustees have given careful consideration to how the service can be supported to improve. They have recently appointed a new Operations Director who is charged with devising and managing the improvement agenda. In addition, other key staff, such as a Training and Development Officer, have been appointed. Very recently, a new Independent Visitor has also been commissioned, as the trustees realised that the arrangements that had been put in place were not robust enough. While these measures are leading to improvements, many have yet to be implemented or are not yet fully embedded. However, they do demonstrate a firm commitment and capacity to improve. 3 of 10

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Information about this children’s home

This registered children's home is run by a charitable trust, providing care and accommodation for children and young people on both a long-term basis and for short stay breaks. The service provides eight short break and two long-stay residential places for children and young people who have learning disabilities and may also have physical disabilities.

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Inspection date Inspection type Inspection judgement

06/11/2013 Interim satisfactory progress 22/05/2013 Full adequate 06/02/2013 Interim satisfactory progress 16/10/2012 Full good

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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 that all persons employed receive appropriate supervision (Regulation 27 (4) (a)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure the independent person (a) interview children, their parents, relatives and persons working at the children's home as appears necessary to form an opinion as to whether (1) children are effectively safeguarded; and (ii) the conduct of the children's home promotes the wellbeing of the children; (b) inspects the premises and such of the children's home's records (2014, 31/12/2014 4 of 10 Regulation 33 (8))

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Reg. Requirement Due date

(2001) ensure the independent person produces a written report about a visit and provides a copy of the report to HMCI. The report may recommend actions that the registered person may take in relation to the children's home and timescales (2014, Regulation 33, (9) (10)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure the registered person establish and maintain a system for (a) monitoring the matters set out in Schedule 6 at least once in every 3 months; and (b) improving the quality of care provided, ensuring a copy is supplied to HMCI and shall provide for consultation with children, parents and placing authorities (Regulation 34 (1) (a) (b) (2) (3)) 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 all people working in the children's home have their written references checked to assess suitability before taking on responsibilities, and that the home has a record that these checks have been carried out (NMS 16.1 and 16.3)  ensure that all staff are provided with regular supervision, including bank staff (NMS 19.4)  ensure that visits carried out under Regulation 33 include relevant checks set out in regulations and guidance and checks of any disciplinary measures and use of restraint and records of missing persons reports (NMS 21.7)  ensure that the registered manager regularly monitors, in line with regulations, all records kept by the home to ensure compliance with the homes policies, to identify any concerns about specific incidents, and to identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring. In particular, this relates to the quality of

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Recommendations

records relating to physical restraints. (NMS 21.2)  ensure there is a system in place to monitor the quality and adequacy of record keeping and take action when needed, In particular, this relates to robust record of young people's monies managed by the home (NMS 22.1)  ensure that managers and staff are clear about their roles and responsibilities. The level of delegation and responsibility of the manager and staff, and the lines of accountability, are clearly defined. (NMS 21.4) 5 of 10 6 of 10

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Outcomes for children and young people good

This service provides a very child-centred and nurturing environment. Children and young people receive at least one-to-one support and have good relationships with staff. Appropriate emphasis is placed on matching skills and interests so that children and young people get the most from their stay. They are encouraged to have fun and enjoy themselves.

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Outcomes for children and young people good

Children and young people can participate in a wide range of activities based around their interests. These include activities in the home and local community, but also trips further afield to animals parks and theme parks. There is good attention given to supporting educational learning objectives as well as developing social and life skills. Young people enjoy visiting this service. Parents say that their children make good progress, developing confidence and social skills. One parent said; 'my son is so much more confident and his communication has improved. Visiting this service gives him opportunities that he might not otherwise have. They are very caring and supportive. I trust them to look after my son and they do an amazing job'.

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Outcomes for children and young people good

Children and young people have home cooked and nutritional meals while visiting the service. Good emphasis is placed on healthy eating and supporting greater awareness of healthy lifestyles. Mealtimes are also sociable opportunities. Staff sit and eat with young people, initiating conversation and promoting personal and social skills.

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Outcomes for children and young people good

The service is making plans to introduce an outcomes framework that is specifically designed for short stay services. While good attention is already given to enabling children and young people to participate in day to day decisions, the service intends to explore this further by embarking on an intensive period of consultation with young people and their parents. This is aimed at seeking views that will directly influence the future development of the service and how it can best meet individual needs, improve outcomes and evidence good practice.

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Quality of care good

Staff provide good quality of care at this service. Care planning is highly personalised and child-centred. There is excellent recognition of diverse needs and how these are met. Staff liaise really well with parents to ensure that they provide consistent care and routines that reflect usual daily expectations.

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Quality of care good

Written care plans are detailed and regularly updated. They contain all the key information that staff need to provide safe and nurturing care. They detail personal hygiene needs, night time routines, food preferences and information that provides 7 of 10 insight into how the young person may behave and how staff should best respond. There is considerable evidence of parents' involvement in these plans, which parents confirmed. This means that parents feel confident that they can trust that staff know and can meet the diverse needs of their child while they are visiting. Parents say that they always know they can contact the service to speak with someone and that the manager and staff communicate well with them.

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Quality of care good

Staff are experienced at working with children and young people with diverse communication. They are effective at overcoming communication barriers, ensuring young people are engaged in making choices.

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Quality of care good

There is an established complaints procedure in place. Complaints made are handled positively and quickly.

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Quality of care good

All children and young people are registered with local healthcare services. Where specific health care needs exist, individual protocols are in place and specialist training is provided to staff. Good liaison exists with specialist children's nurses to maintain their professional input. Good systems are in place for the safe receipt, storage, recording and administration of prescribed medication.

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Quality of care good

The environment is appropriately designed and equipped. Internal standards are very good, with on-going redecoration and refurbishment to maintain high standards. All bedrooms are for single use. Communal areas are light and spacious. Children and young people have access to a lounge, a separate games room and a small kitchen that adjoins the main kitchen. These diverse facilities provide choice and opportunities for a range of social activities. Favourite activities include playing on the computer, art, playing musical instruments and cooking.

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Keeping children and young people safe good

Children and young people's safety and welfare are of paramount importance to the manager and staff. At least one-to-one support is provided and, if necessary, to ensure individual safety and also that of others, additional staffing is provided. Careful attention is given to assessing risk and taking appropriate action to ensure that all children and young people have an enjoyable and safe stay.

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Keeping children and young people safe good

All staff have recently had refresher training in safeguarding. In addition a safeguarding audit has been commissioned.

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Keeping children and young people safe good

Behaviour is positively managed. Staff use distraction and de-escalation techniques effectively. A very nurturing approach is taken. Sanctions are not used as it is not felt they would be meaningful, although staff do intervene appropriately in a way that the young person can understand. For example, if a young person is hitting out at the television, it may be switched off for a couple of minutes while the member of staff explains why this should not happen. This gives the young person a moment to 8 of 10 calm and reflect and then the television is put back on. If this technique does not work staff may then opt to distract the young person by offering alternative activities, such as a trip to the park.

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Keeping children and young people safe good

The service has a policy and procedure in place for the use of physical restraint. Restraints are used minimally and are low level. Techniques are drawn specifically from accredited training that all staff receive.

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Keeping children and young people safe good

The physical environment is well maintained. There are regular health and safety checks in place. Equipment is serviced regularly and staff receive instructions on safe and appropriate usage of specialist equipment. A fire risk assessment is in place and staff and young people have opportunities to practice fire evacuation. The service is aware of the need to complete a review of the appropriateness and suitability of the location of the premises before the end of the calendar year.

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Keeping children and young people safe good

A safer recruitment policy and procedure is in place. It has been reviewed and updated recently. The service continues to struggle with staff retention. Leaders and managers are investigating ways to improve this as they recognise the importance of retaining an experienced and qualified staff team. Staff recruitment procedures are thorough and most records are well organised. However, of the sample examined, not all contained written evidence that verbal verification of references had taken place, although it was advised that this is done in practice. Visitors to the setting are vetted and a visitor's book is maintained.

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Leadership and management adequate

The leadership and management of this service are currently judged as adequate. This is based on the response to previously identified shortfalls and the specific findings of this inspection.

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Leadership and management adequate

Staff do not consistently receive regular formal supervision that meets the expectation of the service. This includes core staff and bank staff. Current staffing arrangements do not make it feasible for senior staff to effectively fulfil their supervision responsibilities. Quality monitoring processes, while taking place, do not occur as regularly as required under The Children's Homes Regulations. The Independent Visitor reports and the Manager's Review of Quality of Care are often not completed in a timely way or sent to Ofsted. They lack rigour and detail and there is little evidence of how they are contributing to improving the service.

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Leadership and management adequate

The quality of records, while improving, is not of a consistently good quality. There is a lack of robust oversight that should identify and remedy shortfalls. For example, records relating to the management of young people's money only accounts for part of their funds. Records of serious incidents and physical restraints are unnecessarily duplicated, with individual records not always being properly completed. 9 of 10 There are, however, early indications of improvements that are being put in place. For example this includes the appointment of new senior staff to compliment the leadership and management team. The newly appointed Training and Development Officer has introduced a new induction programme which provides a more cohesive induction process. She intends that this initial training will be embedded in practice through individual supervisions and care plan meetings. Other training needs are currently being identified. The appointment of an Operations Director is a significant

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Leadership and management adequate

development that has occurred in recent months. She is charged with devising and managing the improvement agenda and supporting the Registered Manager. The commissioning of an Independent Visitor, initially for an intensive period, in excess of the requirements of The Children's Homes Regulations, is also intended to accelerate improvements. There is a real sense that the trustees, leaders and managers understand the strengths and weaknesses of the service and are committed to making improvements that will further benefit children and young people. 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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