Inspection report for children's home
Unique reference number
SC396884
Inspector
Jacqueline Malcolm
Type of inspection
Full
Provision subtype
Children's home
Registered person
Registered person address
Cygnet Health Care Limited
Cygnet Hospital Godden Green Sevenoaks Kent
TN15 0JR
Responsible individual
Peter David Lawson
Registered manager
Zoe-Ann Jackson
Date of last inspection
14/01/2014
Inspection date
02/06/2014
Previous inspection
satisfactory progress
Enforcement action since last inspection
None.
This inspection
Overall effectiveness
good
Outcomes for children and young people
good
Quality of care
good
Keeping children and young people safe
good
Leadership and management
adequate
Overall effectiveness
Judgement outcome
good
Young people are happy to visit the home and they enjoy their short breaks.
Personalised care planning ensure that young people’s needs are effectively met. As
a result, young people make good, measurable progress. Young people have good
opportunities to participate in a range of activities in a safe and nurturing home
environment. Parents and stakeholders are satisfied with the quality of service that
young people receive and they raise no safety and welfare concerns. One social
worker said, ‘it is clear that young people are able to settle well and thrive’. Good
communication between the home, parents and other professionals provide young
people with continuity of care. This keeps everyone involved in the young people’s
development and enables opportunities for parents and professionals to resolve any
emerging issues.
Overall, the home is well managed by a qualified and experienced Registered
Manager. A well-established staff team has the experience, skills and relevant
training to effectively care for young people with disabilities. Requirements and
recommendations raised do not impact on young people's safety and welfare, but
they are intended to improve their outcomes. These relate to the Statement of
Purpose, aspects of management monitoring, staff recruitment and records. The
provider has given a firm assurance to address the shortfalls raised. This shows their
commitment to driving improvement and provide the best possible outcomes for
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young people.
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Full report
Information about this children’s home
This is a privately run home. At any one time it provides short breaks for six young
people who have autistic spectrum conditions and associated disorders.
Recent inspection history
Inspection date
Inspection type
Inspection judgement
14/01/2014
Interim
satisfactory progress
21/05/2013
Full
good
19/02/2013
Interim
good progress
24/04/2012
Full
adequate
What does the children’s home need to do to improve
further?
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.
Reg.
34
(2001)
Requirement
establish and maintain a system for monitoring the
matters set out in Schedule 6 at appropriate
intervals at least once in every 3 months; and
improve the quality of care provided in the
children’s home; and supply to HMCI a report in
respect to any review conducted by him for the
purposes of paragraph (1) (Regulation 34) (1) (a b) and (2))
5 (2001) keep under review and, where appropriate, revise
the statement of purpose and the children’s guide;
and notify HMCI of any such revision within 28 days
(Regulation 5) (a) (b)
Due date
31/07/2014
31/07/2014
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Recommendations
To improve the quality and standards of care further the service should take
account of the following recommendation(s):
ensure that there is an effective system in place for reaching decisions as to who
is to be appointed and the circumstances in which an application should be
refused in the light of any criminal convictions or other concerns about suitability
that are declared or discovered through the recruitment process (NMS 16.5)
ensure that a written or electronic record is kept by the home detailing the time,
date and length of supervision held for each member of staff and this is signed
by the supervisor and the member of staff at the end of the supervision. (NMS
19.5)
ensure visits of the home carried out under Regulation 33 include relevant checks
set out in regulations and guidance. Specifically ensure that the reports provides
a coherent evaluation of the homes strengths and areas for development (NMS
21.7)
ensure that young people’s records are legible, clearly expressed, non
stigmatising and distinguish as far as possible between fact, opinion and third
party information. This specifically relates to ensuring professional use of
language when recording information about young people’s daily activities (NMS
22.4)
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Inspection judgements
Outcomes for children and young people
good
Young people make good measurable progress in relation to their starting points.
Their positive attachments supported by caring staff help them to thrive. Young
people experience a flexible, safe, needs led service that enables them to have fun
during their short breaks stay. This is supported by the comments made by a young
person and a parent. One young person said 'you get to do what you want within
reason. It’s chilled'. A parent said, ‘my daughter attends for three nights a month.
(the home) always tailor activities around her needs and likes. They will always adapt
situations if they are not working for her'.
Although parents maintain overall responsibility for young people's education and
health care, these aspects continue to be met to a good standard during their short
breaks stay. Good collaborative practices between the home, parents and other
stakeholders drive the implementation of young people’s individual health and
education plans. This consistent practice meets young people’s holistic needs,
enhances their development and supports a seamless service that causes minimal
disruption to their lives.
Young people benefit from the small steps taken by them to learn independence
skills. Examples include dressing, shopping, assisting with food preparation and eating
without help from staff. This equips young people with useful skills that in some cases
exceed expectations. This enables them to feel confident in their abilities.
Quality of care
good
Young people have positive relationships with experienced and committed staff who
know them well and they are consistently concerned with their welfare. A young
person responded in a completed questionnaire that the care and support is very
good ‘all of the time’. Parents comment that one of the strengths of the home is their
confidence in the staff team. Typical comments include, ‘very pleased with the
provision. A knowledgeable staff team in terms of ASD (autistic spectrum disorder)
and epilepsy and they genuinely care about our child. It is the only time that we can
relax knowing that out son will be cared for and the staff can meet his needs’ and
‘we fully support the service and staff and are totally happy with the service’.
Young people benefit from individualised person centred care plans. These are
tailored to meet young people's individual needs. Good consultation with parents and
other professionals ensure that their contributions to the plans promote all young
people’s needs. This includes young people’s needs arising from their personal
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identity, which are well met. This promotes equality and diversity, which enables
young people to be treated as individuals in their own right.
Arrangements for promoting young people’s health, including appropriate medication
management keeps them safe. Young people’s good education attendance engages
them into the school community. Good communication between the home and school
keeps everyone informed about any pertinent issues that may impact on young
people’s care and welfare.
The home effectively nurtures good communication with parents and stakeholders
through formal and informal means. Parents and social workers indicate that
communication is good in the majority of cases. A parent said, ‘on the whole
communication is good and the home diary always has a detailed account of how x
has been doing during her stay’. A social worker said, ‘I am frequently in contact with
(name of home) both via email and telephone contact. Both management and
support staff have been very accommodating when I have arranged visits. Staff are
very quick to respond to any enquiries I have or information that they need to share
with me’. Young people benefit from individual consultation using their preferred
method of communication, such as signing and using pictorial aids to make known
their wishes and feelings. These are acknowledged by staff who respond accordingly,
which ensures that young people feel listened to.
Young people participate in a range of activities during their short breaks stay, which
builds on their self-esteem, confidence and learning opportunities. For instance,
young people enjoy playing with toys and play equipment both inside the home and
the garden. Young people who enjoy creative arts and singing are encouraged to
freely express themselves. Young people enjoy trips out. This includes visits to the
local parks, restaurants and other places of interest further afield. This enables young
people to develop new interests and to simply enjoy themselves. Parents comment
positively about the range of activities on offer to their children. One parent said that
their child enjoys, ‘a range of activities provided for him to gain a better
understanding of the world but also for him to enjoy his short breaks’. Photos of
young people’s activities serve as a positive memory of their short breaks experience.
Staff have gone the extra mile to develop individualised memory books for young
people who have moved on. This shows how much they are cared for and valued.
Young people benefit from having short breaks in a well located home within a
residential area. It is appropriately designed to respond to the needs of young people
with complex and diverse needs. Communal areas of the home are child friendly and
provide personal and communal space that provides young people with safe areas to
play and relax. Parent comment that they like the home and one described the home
environment as ‘homely’. These positive elements ensure that young people feel
settled and happy during their short breaks stay.
Keeping children and young people safe
good
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Young people are protected by safe care practices from trained staff who place a
high priority on their safety and welfare. This is designed to ensure that staff can
recognise and respond to any safeguarding concerns. Staff ratios ensure close
supervision and monitoring of young people. This protects young people from harm,
arising from neglect, abuse and incidents that some young people may find
unsettling. Parents express confidence that their children are safe during their short
breaks. A social worker said, ‘x is staffed 1:1 support at (name of home) throughout
the day to ensure he is kept safe and well. X has no road safety awareness and
therefore requires supervision at all times. (name of home) have carried out risk
assessments around this to ensure risk can be minimised. They have also carried out
work in the form of social stories around stranger danger. When travelling in the car
he has a booster seat and uses a standard seat belt’. These practices are good
because they keep young people safe.
No young people have gone missing from the home. However, staff know what to do
if this occurred, which promotes young people’s safety and welfare.
Young people’s complex and challenging behaviours are well supported through
individual care planning. This is galvanised by the positive relationships developed
between staff and young people. This enhances their understanding of young
people's likely triggers, although for some young people, these can be unpredictable.
Appropriately trained staff are responsive to young people’s changing moods and
behaviours. They work in partnership with parents and other professionals to review
behaviours and agree behaviour management strategies. Few incidents of physical
interventions occur as a result of de-escalation techniques used by staff when young
people present with challenging behaviours.
Recruitment checks, including written and verbal references have been obtained for
staff working with young people. However, not all personnel files contain all of the
required information. For example, the provider has not demonstrated effective
assessment of issues raised when references are verified. This does not make clear
how the provider has reached the decision to confirm an applicant’s suitability to care
for children and young people. A recording discrepancy has not been checked to
confirm an applicant’s length of time in their previous employment. Management
monitoring systems have not identified and remedied these issues. The provider is
looking into this matter to ensure the records reflect a consistently robust
recruitment process. Visitors to the home are appropriately checked and monitored
around young people. This protects young people from individuals who may pose a
threat to their safety and welfare.
The home provides children and young people with a safe environment where they
enjoy their short breaks. For example, checks on electric and gas appliances as well
as fire prevention equipment ensures up to date equipment that safeguards young
people from potential hazards to their health and safety.
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Leadership and management
adequate
Overall, the home is well managed by a Registered Manager who has been registered
with Ofsted since 2010. She is suitably qualified and experienced in managing and
delivering short breaks services to young people with disabilities.
Leaders and managers are acutely aware of most of the homes strengths and
weakness and a development plan is in place. Action taken to address most areas for
development is achieved through the existing internal and external monitoring
systems. This influences improvement. However, aspects of monitoring lack rigour.
This means that some shortfalls have not been quickly identified, which does not
enable the manager to drive improvement in a timely manner. For example, external
monitoring conducted on behalf of the provider does not demonstrate consistently
good evaluation of the all of the areas checked. It is therefore not explicitly clear
what improvements need to be made. Similarly, internal management monitoring
does not evaluate all of the required areas as prescribed in the children’s homes
regulations. Therefore shortfalls in recruitment records, for example, have not been
recognised and addressed to ensure consistently good recruitment practices. A copy
of the manager’s review of the quality of care has not been forwarded to Ofsted. This
remains an outstanding requirement from the previous inspection. This impedes
Ofsted from having an oversight of care practice in the home outside of the
inspection timeframes. Other good practice recommendations made at the last
inspection have been suitably addressed. This demonstrates capacity for
improvement. The shortfalls in management monitoring have had no negative impact
on young people's safety and welfare.
The Statement of Purpose is currently under review. This ensures that it meets the
children’s homes regulations and informs young people, parents and stakeholders
who may access the short breaks service in the future. Although the young people's
records are generally well ordered and confidentially maintained, a small number of
entries in some individual records are not written in a professional manner. This does
not promote young people’s dignity.
The Registered Manager is ably supported by senior care staff and a well retained
staff team who know how to meet young people’s diverse and complex needs. This
drives them to provide good quality care and promote good outcomes for young
people. Staff enjoy their role and demonstrate a firm commitment and responsibility
to improve young people's life chances. One member of staff said, 'I am really proud
of what we do' and another member of staff said that the team 'feels like a family'.
Young people are supported by a mostly qualified staff team who have the
experience and motivation to care for them. Staffing levels are in accordance with
young people’s individual needs. This ensures that young people receive personalised
care, support and guidance. Staff feel well managed, supervised and supported.
However, not all supervision records are consistently signed to confirm ownership of
the process. Professional training and development opportunities afforded to the staff
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team ensure that their skills and knowledge continue to inform their practice.
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What inspection judgements mean
Judgement Description
Outstanding
A service of exceptional quality that significantly
exceeds minimum requirements.
Good
A service of high quality that exceeds minimum
requirements.
Adequate
A service that only meets minimum requirements.
Inadequate
A service that does not meet minimum requirements.
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.
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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Website: www.ofsted.gov.uk
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