Children's Home run by Nottinghamshire County Council in Nottinghamshire

Unique reference number SC036726 Inspector Amanda Ellis Type of inspection Full Provision subtype Children's home

p.1

Registered person Nottinghamshire County Council Registered person address Nottinghamshire County Council, County Hall Loughborough Road, West Bridgford NOTTINGHAM NG2 7QP Responsible individual Vonny Senogles Registered manager Robin Taylor Date of last inspection 24/03/2014 2 of 10 Inspection date 10/12/2014

p.1

Previous inspection good progress Enforcement action since last inspection none

p.2

Overall effectiveness adequate

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

p.2

Overall effectiveness

This home is adequate because not all children and young people get their care needs sufficiently met, also some children and young people are poorly matched to the home. This has resulted in some children and young people not benefiting from care that meets their individual needs. The management team recognise the issues, however, at the time of the inspection, managers had not effectively addressed these. This has meant that there are insufficient measures in place to adequately support all children and young people, promote their welfare and meet their individual needs.

p.2

Overall effectiveness

The home does provide a nurturing environment for children and young people who receive long-term care and access the short breaks service. The majority of children and young people continue to receive high standards of care and support from a dedicated staff and management team.

p.2

Overall effectiveness

There are five statutory requirements and two recommendations set as a result of this inspection. These include improved management monitoring; statement of purpose review and submission to Ofsted; missing from care arrangements; provision of support for children with sensory disabilities and meeting the welfare needs of all children and young people. Two recommendations have been set in relation to ensuring effective management monitoring and the home environment. 3 of 10

p.2

Information about this children’s home

This home is operated by the local authority. It provides a residential service for six children and young people, and a short-break service for six children and young people. All the children and young people have severe learning disabilities and challenging behaviours.

p.3

Inspection date Inspection type Inspection judgement

24/03/2014 Interim good progress 27/11/2013 Full outstanding 06/03/2013 Interim good progress 22/11/2012 Full outstanding

p.3

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.

p.3

Reg. Requirement Due date

4 (2001) ensure a copy of the Statement of Purpose is provided to Ofsted which shall consist of a statement as to the matters listed in Schedule 1 (Regulation 4 (1) (2)) 27/12/2014

p.3

Reg. Requirement Due date

(2001) ensure that the children’s home is conducted so as to promote and make proper provision for the welfare of children accommodated there, with specific reference to ensuring compatibility of children and young people, with due regard to their disabilities (Regulation 11(1)(a)(b) & (2)(b)) 27/12/2014

p.3

Reg. Requirement Due date

16 ensure in regard to the missing child policy, the 27/12/2014 4 of 10 (2001) registered person shall (i) consult, and take into account the views of, such local persons or bodies as the registered person considers appropriate; and (ii) have regard to any relevant local authority or police protocols on missing children (Regulation 16 (5) (i) (ii))

p.3

Reg. Requirement Due date

(2001) ensure the registered person provides each child with individual support as he may require as a result of any particular disability he may have. With specific regards to sufficiency of British Sign Language interpreters for the communication needs of deaf/hearing impaired children (Regulation 20 (2) (c)) 27/12/2014

p.4

Reg. Requirement Due date

(2001) establish and maintain a system for monitoring all matters set out in Schedule 6 at appropriate intervals and ensuring a copy of the report is submitted to HMCI at least once every three months. (Regulation 34 (1) (2) 27/12/2014

p.4

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.4

Recommendations

 ensure 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 institutionalised feel (NMS 10.3)  ensure the 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. (NMS 21.2) 5 of 10

p.4

Outcomes for children and young people adequate

The majority of children and young people are reported to be happy in the home and make good progress concerning their health, education and contact with their families. However, recent changes in dynamics, as a result of placement changes, have led to some children and young people feeling less emotionally resilient which has had a negative impact on their emotional and physical well-being. This has led to increased levels of self-injurious behaviours and high anxiety levels with some children and young people. The admission of young people at short notice, combined with a lack of dynamic risk assessments, fails to ensure welfare needs are met and does not promote positive outcomes for some children and young people.

p.5

Outcomes for children and young people adequate

Some children and young people cannot consistently participate in day to day decisions about their life, as not enough staff are able to communicate appropriately with them.

p.5

Outcomes for children and young people adequate

Children and young people learn about healthy lifestyles, with skilled staff supporting with health promotion. Health issues such as diet, active lifestyles and personal hygiene are some of the issues that are routinely promoted. Parents commented on improvements in toilet and self-care skills, weight management and skincare. Because children and young people learn to make positive choices about their health, they become healthier over the course of their placement at the home. This leads to improved health outcomes.

p.5

Outcomes for children and young people adequate

The home effectively promotes family contact arrangements for children and young people who are resident in the home. Staff work flexibly to promote positive contact. This partnership work ensures children and young people benefit from good quality contact designed to meet the needs of children and their families. Parents of children and young people who receive short break provision also report excellent levels of communication with the staff. Effective communication ensures that parents and carers are reassured that their child is being well cared for and that their complex needs are being met. One parent said ‘Communication between us and the staff is excellent.’

p.5

Outcomes for children and young people adequate

Children and young people develop independence skills in line with their age and ability levels. They learn skills such as preparing food, household chores and learning to manage money. A parent commented, ‘My son has improved in everything. They have worked really hard to help him improve his independence skills.’ Staff work closely with young people, families and professionals to devise transition plans for those young people approaching eighteen years of age, who will be leaving the provision. Consequently, young people receive care to help them prepare for transition to adult care. 6 of 10

p.5

Quality of care adequate

Not all staff have the skills and abilities to communicate with all children and young people living in the home. Some young people with sensory disabilities require staff to communicate using British Sign Language. While the relevant keyworker is BSL trained, the home does not have sufficient staff with these skills to consistently communicate and meet the needs of such children. Consequently, some children cannot always have their wishes and feelings interpreted. This has meant they have displayed challenging behaviours because of their frustration. This approach fails to support children with a sensory disability and does not meet their support needs.

p.6

Quality of care adequate

Staff are experienced and dedicated in their work. They demonstrate consistent concern with the welfare and progress of young people. They provide a nurturing environment in which young people can thrive and develop. Consequently, most young people make positive progress because of relationships with staff.

p.6

Quality of care adequate

Cohesive relationships with parents and external agencies ensure that the needs of young people are the staff’s priority. The staff team maintain highly effective dialogue with parents, carers and a range of professionals. One parent commented ‘The home is well run; the staff are always accessible and willing talk and help. The management team is also very visible and involved with the children and try to meet any needs you may have.’ Consequently, good communication means concerns are easily resolved and agreed plans followed.

p.6

Quality of care adequate

Many of the children and young people are non-verbal, some with limited understanding. This means participation in the home is promoted through a range of means, including ensuring all children and young people have a ‘Wishes and Feelings’ journal. This document provides a colourful photo journal of children and young people exercising their wishes, feelings and choices in a variety of ways. This means most young people are enabled to make choices about their care and the running of the home.

p.6

Quality of care adequate

The home ensures that health promotion is of paramount importance. They engage with health services to meet general health and medical needs. Such support enables young people to benefit from good physical and emotional health. The arrangements in place for the management of medication are robust, safe and effective. As a result, most young people’s physical, emotional and psychological health needs are promoted in a positive way.

p.6

Quality of care adequate

Staff are proactive in supporting educational attendance and achievement. Communication between education providers and staff is consistent. The home supports some children and young people with alternative educational plans and a range of educational activities. Children and young people learn and develop because the service is committed to multi-disciplinary partnerships and work effectively 7 of 10 alongside education providers.

p.6

Quality of care adequate

Staff support all children and young people to engage in a wide range of meaningful activities. This exposure to structured and meaningful activities means children and young people experience social and recreational activities, which expand their horizons and promote their development.

p.7

Quality of care adequate

The home is of a suitable design for its purpose, generally well decorated and well maintained. At the time of the inspection, the corridor of the residential unit had all ornamentation and wall displays removed due to damage caused by children to the interior of the home. This led to a clinical and institutionalised appearance. This does not provide a homely environment. The home is situated in a rural area and has extensive grounds with a range of outdoor activities for children and young people. The home environment offers space for both privacy and communal activity.

p.7

Keeping children and young people safe adequate

Parents and social care professionals confirm that staff effectively safeguard children and young people. There are no reported incidents of bullying; however, some children and young people do not feel safe or secure due to the behaviours of other residents. Staff monitor interactions and provide consistent levels of supervision.

p.7

Keeping children and young people safe adequate

Staff effectively manage children and young people’s behaviour. The use of physical intervention is to support young people from harming themselves or others. Staff are suitably trained to undertake any physical intervention and recording of such incidents is in line with the legislative framework. Although this protects young people from injury or harm, the manager does not effectively monitor episodes of physical intervention and associated injury from self-harm. This means the manager is unable to monitor patterns or trends linked with self-injurious behaviours. As a result, preventative action may not be identified and young people’s welfare may be compromised.

p.7

Keeping children and young people safe adequate

Historically incidents of children or young people going missing from care has not been an issue for this home. However, recent behaviours indicate a risk of some young people going missing from the home. The local authority has its own missing from care policy in place. However, the home does not have a policy that is in accordance with regulatory requirements. They do not have a current protocol with police in relation to missing from care. This means the staff do not have agreed arrangements in place, which will ensure effective action if a child or young person were to go missing.

p.7

Keeping children and young people safe adequate

Staff recruitment practices are robust and visitors to the home are requested to sign in and produce identification. This ensures that young people’s safety is promoted and potentially unsafe and unauthorised persons do not have access to the home or young people. 8 of 10 The home environment is safe and includes physical adaptations to meet the differing and complex needs of children and young people. Maintenance within the home is of a high standard, with managers undertaking consistent monitoring of health and safety issues. All required checks on fire safety equipment, electrical and gas appliances are up to date. Fire drills are regularly conducted and ensure all children, young people and staff have participated in recent drills. This means that all children, young people and staff are fully practised in emergency escape procedures that would ensure safe evacuation in the event of a fire.

p.7

Leadership and management adequate

The manager became registered in this post in 2007. He has a Diploma in Social Work; Advanced Certificate in Management, Postgraduate Certificate and Diploma in Public Services Management and Post Graduate Certificate in Learning Disabilities. This means the manager has suitable qualifications and experience for the post of Registered Manager within this service.

p.8

Leadership and management adequate

Development planning enables the management team to track progress towards identified goals. Effective development planning has driven improvements in promoting outcomes for most children and young people.

p.8

Leadership and management adequate

External quality assurance processes identify some weaknesses, promote improvement and guide development. However, these visits are not wholly effective as they have failed to identify shortfalls noted within this inspection. Children, young people and stakeholders routinely feedback their views on the care provided and outcomes. Consequently, care delivery is informed through consultation from key individuals.

p.8

Leadership and management adequate

Internal quality assurance processes do not contain the required information, such as complaints in relation to the home and actions taken to resolve issues and missing from care arrangements. Thus, these monitoring reports are not in accordance with regulatory requirements. These reports are not submitted to Ofsted as required, therefore impeding the regulator in reviewing the home’s performance.

p.8

Leadership and management adequate

Staff confirm they receive regular support, supervision and appraisal. However, the Registered Manager does not maintain records to monitor the consistency of supervision arrangements. This makes it difficult to establish if all staff receive up to date and regular supervision.

p.8

Leadership and management adequate

Staff have access to a training programme delivered to meet the needs of the children and young people. However, the Registered Manager does not monitor the training of the staff group as a whole. Consequently, he is unable to demonstrate that all staff has up to date mandatory training in areas including safeguarding, first aid and health and safety. This means the manager cannot be certain that the staff 9 of 10 have the relevant skills and knowledge to meet the needs of young people. This means the safety and welfare of young people is potentially compromised.

p.8

Leadership and management adequate

The Statement of Purpose provides a detailed guide to parents and placing authorities about the aims and objectives of the home and care provided. The document does not however include detailed information about staff qualifications and experience, nor does it detail the safeguarding and missing from care policy. Additionally, this document has not been submitted to Ofsted, as required under regulation.

p.9

Leadership and management adequate

The Registered Manager has systems in place to notify relevant agencies, including Ofsted, of significant events to ensure the protection of young people by multi- agency decision-making. Notifications are carried out as required and appropriate action is taken to follow procedures and protect children and young people. Website: www.ofsted.gov.uk

p.9

Leadership and management adequate

This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

p.10

Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

p.10

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.10

Judgement Description

Adequate A service that only meets minimum requirements.

p.10

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.10

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.

p.10

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.

p.10