Children's home run by Lincolnshire County Council in Lincoln

Inspection report children's home: SC042994 1 SC042994 Registered provider: Lincolnshire County Council

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This local authority children’s home is registered to provide short breaks for up to six children and young people who have learning disabilities and physical disabilities.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

outstanding

How well children and young people are helped and protected good

p.1

outstanding

The effectiveness of leaders and managers outstanding

p.1

outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

p.1

outstanding

Date of last inspection: 17 February 2017

p.1

outstanding

Overall judgement at last inspection: sustained effectiveness

p.1

Key findings from this inspection

This children’s home is outstanding because: Inspection report children's home: SC042994 2  Children and young people, some of whom have the most complex needs, receive individualised care and support of an exceptionally high standard.

p.1

Key findings from this inspection

 Children and young people benefit significantly from taking part in a wide range of positive activities that they may otherwise not have the opportunity to do. This enables them to have the same opportunities and experiences as their peers.

p.2

Key findings from this inspection

 Children and young people become more independent, more confident and more able to express their wishes and feelings.

p.2

Key findings from this inspection

 The voice of the child is paramount. Staff encourage and enable children and young people to make choices and express their feelings about all aspects of their lives.

p.2

Key findings from this inspection

 Exceptionally well-planned short breaks ensure that children and young people derive the most benefit from their experiences in the home.

p.2

Key findings from this inspection

 High staffing levels and careful management of risk ensure that children and young people are safe, while not being deprived of enjoyable experiences.

p.2

Key findings from this inspection

 Staff are well trained, well supported, and demonstrate a real commitment to providing the children and young people with the highest standard of care. The manager enables staff to be creative and innovative, so that children and young people have the best experiences possible.

p.2

Key findings from this inspection

 The manager is aspirational, and a highly effective leader. She uses a range of monitoring systems to support her understanding of the strengths and shortfalls of the home, and to drive improvement.

p.2

Key findings from this inspection

 Partnership working with parents and other professionals is excellent. This ensures that care and support are provided consistently by all involved in the child’s or young person’s life. However, this does not prevent appropriate challenge, if it is in the child’s or young person’s best interests.

p.2

Key findings from this inspection

The children’s home’s areas for development:

p.2

Key findings from this inspection

 Formal staff supervision has not been taking place as frequently as it should. Consequently, there are missed opportunities for staff to benefit from protected, individual time to reflect on their practice.

p.2

Key findings from this inspection

 There are no formal systems to ensure that the temperatures of the medication room and medication refrigerator meet the requirements for the safe storage of medication. Inspection report children's home: SC042994 3

p.2

Inspection date Inspection type Inspection judgement

17/02/2017 Interim Sustained effectiveness 03/08/2016 Full Good 12/02/2016 Interim Improved effectiveness 19/10/2015 Full Outstanding Inspection report children's home: SC042994 4

p.3

Recommendations

 The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2)

p.4

Recommendations

 Ensure that the guidance ‘Managing medicine in care homes’ (March 2014) is applied. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.17) This relates to developing a system to monitor the temperature of the medication room and medication refrigerator.

p.4

Overall experiences and progress of children and young people: outstanding

Children and young people benefit enormously from their short breaks at this home. They have very positive experiences that they may otherwise not have at home. Staff are committed and passionate about children and young people not being disadvantaged because of their disability. Staff therefore make every effort to promote and support activities that children’s and young people’s non-disabled peers experience. These activities include going swimming on a regular basis, going to the cinema, going bowling, and going shopping. Where risks are identified, staff work hard to mitigate the risk rather than deny the child or young person the chance to take part in the activity. Children and young people access the community regularly. One parent encapsulated this by saying: ‘He does what his peers do. He goes out in the community, he goes swimming, and he spends his pocket money. It’s fantastic.’

p.4

Overall experiences and progress of children and young people: outstanding

The home provides excellent outdoor facilities that children and young people really enjoy. For example, there is a large outdoor play area equipped with an adapted swing, as well as a garden, where they grow vegetables. Children and young people engage in role play using the outdoor facilities. For example, they use the playhouse as a hospital, and the go-karts as ambulances. When they stay indoors, children and young people do a lot of art and craft activities, they play and listen to music, and they also enjoy more sensory experiences, such as foot and hand massages. The home also has a sensory room. These experiences are possible because of the high staffing levels, and the commitment and patience of staff to ensure that children and young people are happy and stimulated.

p.4

Overall experiences and progress of children and young people: outstanding

Although children and young people spend the majority of their time at home with their parents, the short breaks contribute to the progress they make. Some group activities are used to promote the development of a skill, such as teeth cleaning or hair brushing, Inspection report children's home: SC042994 5 so that it becomes fun. One parent commented: ‘He is now able to wash himself, choose his clothes, and put them on with minimal support. We struggled with that at home.’ Children and young people develop their independence skills, they improve their social interaction, and they learn to share. Each child and young person has a small number of targets that they work towards each time they come for their short break. These targets are agreed with parents, schools and social workers, and the targets are monitored regularly and discussed at reviews. This process demonstrates the progress that children

p.4

Overall experiences and progress of children and young people: outstanding

and young people are making, both because of the short break but also because of the cooperative, consistent care practice of everyone involved in the child’s or young person’s life.

p.5

Overall experiences and progress of children and young people: outstanding

The home provides short breaks for children and young people who have the most complex needs. These needs are well met because staff provide individualised care and support of the highest quality. Staff are well trained and competent to meet the varied healthcare needs, and a specialist nurse is available to provide training and advice when this is required. Medication arrangements are well managed. However, a minor shortfall has been identified as a result of this inspection. Although the medication room and medication refrigerator are equipped with thermometers, staff do not monitor the temperatures on a consistent basis. Therefore, they cannot be assured that medication is being stored at the correct temperature.

p.5

Overall experiences and progress of children and young people: outstanding

Relationships between children, young people and staff are very positive. Staff know the children and young people very well, and they provide nurturing and consistent care. It is evident that they are very committed to the children and young people and want the best for them. The staff are exceptionally committed to listening to and acting on the expressed wishes and feelings of children and young people. The system of recording ‘my voice’ underpins and supports this commitment. It is evident that children and young people, despite different communication styles, are empowered to make choices about every aspect of their care. The use of an independent advocate enhances this commitment to hearing the child’s voice. The advocate visits monthly, she spends a lot of time with the children and young people to observe their experiences, and she provides the manager with a written report of her findings, to support any improvements

p.5

Overall experiences and progress of children and young people: outstanding

Communication and engagement with parents are exemplary. Parents can ring the home at any time, to check that their child is settling in. At the end of the short break, staff provide a detailed report to inform parents of the activities that their child has taken part in, examples of how they have made choices, and the food they have eaten. The report also includes photographs of things they have been involved in. This is excellent practice. Parents are very happy with the service. One parent said: ‘Staff do an amazing job.’ The home also provides social events during the year so that children, young people and their parents can meet together and have a good time in an environment that is supportive.

p.5

Overall experiences and progress of children and young people: outstanding

Exceptionally careful planning underpins the allocation of a short break. Prior to receiving a service, the parents or carers are encouraged to look around the home to see if they feel it would be suitable. The key worker then holds a care planning meeting with the Inspection report children's home: SC042994 6 parents to discuss the care and support needs of their child in detail. This then informs the care plan used by the staff in delivering care and support. A child or young person has as many introductory visits as they need. A social worker commented very positively about this process, in relation to a young man who was reluctant to access the service initially. She said: ‘It is fantastic what they have done for him. They took it at his pace. It was the little touches, like the cartoon characters that he liked in his bedroom to help him settle.’ However, if it is apparent that a child or young person does not want to stay

p.5

Overall experiences and progress of children and young people: outstanding

for a short break, and their anxiety is increasing, the staff take this seriously and promote the child’s or young person’s best interests. The organisation of each short break is extremely well done. The assistant manager takes into account a number of factors, to ensure that children and young people have the best possible experience. Factors include friendship groups, the individual characteristics and needs of the children and young people and the type of accommodation required, as well as any special requests for dates.

p.6

Overall experiences and progress of children and young people: outstanding

When young people become 18 years old, and therefore transfer their short breaks to adult service providers, staff provide the young people with a lovely book of pictorial memories of their time at this home. Young people and their parents really value this, as demonstrated by thank-you cards and small gifts given in appreciation. Young people also have a leaving party or meal out with their key worker to mark the event.

p.6

How well children and young people are helped and protected: good

Children and young people are safe in this home. High staffing levels, detailed risk management plans, and a robust understanding of children’s and young people’s vulnerabilities protect them from harm. Children and young people do not go missing during their short breaks, and they do not engage in risk-taking behaviour. However, their varying disabilities and complexities contribute to their increased vulnerability. Staff understand and manage this well. For example, staff always tell the other staff where they are going when a child or young person requires personal care. Staff demonstrate respect for the dignity and privacy of children and young people by providing the least intrusive care necessary.

p.6

How well children and young people are helped and protected: good

Behaviour is managed well. Children and young people have detailed behaviour management plans that outline the triggers, and the strategies to use to avoid escalation of any behaviour that challenges. If these do not work, staff are trained in an approved physical intervention method. Any incidents are recorded, monitored, and evaluated, to see if there is any learning to be gained to inform and improve future practice. Both physical intervention and sanctions are used appropriately.

p.6

How well children and young people are helped and protected: good

The manager has a good relationship with the designated officer for the local authority, although there has been no need to contact them recently. There are clear procedures for managing potential safeguarding concerns, and staff are fully aware of their roles and responsibilities in relation to these procedures. Staff have benefited from safeguarding training that specifically relates to children and young people who have learning disabilities. This has increased their awareness and understanding of the additional issues involved. Inspection report children's home: SC042994 7

p.6

The effectiveness of leaders and managers: outstanding

The manager is a highly effective leader, who is ably assisted by an assistant manager. Together they form an excellent management team. The manager is very experienced, knowledgeable and appropriately qualified. She has high aspirations for the service, and she inspires staff to have the same aspirations. She encourages innovation and creativity, using the strengths and interests of the staff team to the best effect. It is a very child-focused service, and everyone working here has a ‘can-do’ attitude, wanting the best for the children and young people. Although there has been an unprecedented level of staff long-term sickness in the last few months, children and young people have not experienced any reduction in the quality of the service. This is due to the commitment of staff and their hard work. Because of the staff sickness, the home has not developed at the pace the manager would have liked. Despite this, there have been

p.7

The effectiveness of leaders and managers: outstanding

developments, such as improved information for parents, and there is a detailed plan to continue this process.

p.7

The effectiveness of leaders and managers: outstanding

Monitoring is well developed, thorough, and leads to improvements in practice. The manager provides a detailed, analytical, and evaluative report every six months, and she uses this to inform the development plan for the home. In addition, there are file audits, review meetings, supervision, and feedback from the parents’ survey. The manager has an excellent understanding of the strengths and areas for development.

p.7

The effectiveness of leaders and managers: outstanding

Staff are also involved in analysis. Team meetings provide an opportunity for staff to evaluate and reflect on incidents and accidents, which form part of a PowerPoint presentation for ease of access. Reflective practice is an area which the manager is developing, using a shift reflection tool. This offers staff the opportunity to consider what went well, what could have been better, and how they will improve this in the future. This is partly in preparation for the social pedagogy model of social care, about which the staff are receiving training in the very near future. Team days, held twice a year, further support reflection and development.

p.7

The effectiveness of leaders and managers: outstanding

Staff feel well supported. Although the frequency of formal supervision has decreased due to the impact of staff sickness, staff describe managers as approachable and accessible. A new member of staff commented that her induction was the best she had ever had. Staff training needs are well addressed, and any additional training is sourced, if the needs of the children and young people require it. This enables staff to provide a service of the highest quality.

p.7

The effectiveness of leaders and managers: outstanding

Partnership working is excellent. Children’s and young people’s social workers speak highly of the communication and the flexibility. One social worker said of the staff: ‘They are professional, child-focused and supportive. They know the child inside out, and work with the family. It is individual and tailor-made.’ This was reinforced by another social worker, who commented: ‘Working relationships are really good. Staff have been really helpful in supporting contact and have gone above and beyond.’

p.7

The effectiveness of leaders and managers: outstanding

Managers and staff place the needs of the children and young people at the centre of Inspection report children's home: SC042994 8 the service, and they challenge partners if there are deficits in service provision. For example, there has been robust challenge in relation to a child’s care plan and contact arrangements. In addition, despite it not being the responsibility of the home, the assistant manager was instrumental in successfully challenging the refusal of a blue badge. This demonstrates the commitment of the home to the family as a whole, as well as to the children and young people who use the service.

p.7

Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people whom it is trying to help, protect and look after.

p.8

Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children's home: SC042994 9

p.8

Children’s home details

Registered provider: Lincolnshire County Council

p.9

Children’s home details

Registered provider address: County Offices, Newland, Lincoln LN1 1YL

p.9

Inspector(s)

Ros Chapman, social care inspector Inspection report children's home: SC042994 10 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

p.9

Inspector(s)

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.10

Inspector(s)

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.10

Inspector(s)

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

p.10