Inspection Report: RNIB Pears Centre for Specialist Learning, 17/01/2014
RNIB Pears Centre for Specialist Learning:Inspection report for children's home
Unique reference numberSC030951
Inspection date17/01/2014
InspectorDawn Bennett
Type of inspectionFull
Provision subtypeResidential special school (> 295 days/year)
Setting address RNIB Pears Centre for Specialist Learning, Wheelwright Lane, Ash Green, Coventry, CV7 9RA
Telephone number 02476 369500
Registered person Royal National Institute of Blind People
Registered manager Linda Cope
Responsible individual Virginia Tyler
Date of last inspection 14/03/2013
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Service information
Brief description of the service
This is a large children’s home that provides care and accommodation for up to 30 children in five purpose built bungalows. The young people have a visual impairment, learning and physical disabilities, or sensory impairment. One of the bungalows is also registered by the Care Quality Commission (CQC) and provides a specialist service to young people with high health and medical needs who require long-term ventilation or who have life-threatening or life limiting conditions. This establishment is owned by a large national charity.
The inspection judgements and what they mean
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.
Overall effectiveness
The overall effectiveness is judged to be outstanding.
Young people have fun and achieve outstanding personal outcomes. Each young person is diligently cared for in line with their individual placement plans by their key worker and the wider staff team. Communication between staff, parents and other key agencies is excellent and effective. The provision has an extensive range of internal and external professionals that work directly with the young people and alongside the home's staff. As a result, the safety, education, social, physical and emotional well being of young people is truly promoted. The provision of care contributes to significant improvements in the development of social behaviours, independence and personal skills. The comprehensive analysis of data collated by staff relating to young people's improving behaviours is not routinely shared with placing authorities and parents in such detail. There is a clear and effective focus on the importance of young people’s rights, choice,privacy and fulfilment. Young people's views and opinions on their care are actively sought, valued and acted upon.
The management of the home is robust, transparent and professional. The Registered Manager has a clear vision for the service provision and is highly motivated and committed. The detailed knowledge of the service and the proactive actions taken to maintain and raise standards is not reflected in the analysis of the manager's quality assurance reports. Young people’s needs are effectively met because the operation of the provision clearly reflects the aims of the Statement of Purpose. The manager demonstrates ambition for the development of the service and the care provided for the young people.
Outcomes for children and young people
Outcomes for young people are outstanding.
Young people benefit from a service provision which recognises and values them as individuals with diverse needs. Placement planning is fully inclusive of their health, social care and education needs. Assessments, planning of placements, and any external or internal moves, include the views, wishes and feelings of parents, a wide range of professionals and the young person. For example, families can support young people to decorate their bedrooms when they first move into a house.
Young people grow in confidence because they and their parents are fully consulted in all aspects of care provision and service delivery. This leads to a transparency of provision which enables young people and their parents to express their views and if necessary seek support to make a complaint. Young people are involved in reviewing their care through a variety of forums and methods. This gives them experience in participation and reflects inclusivity in contributing to their own care plans. Young people are also consulted on the operation of the home through house meetings and school council. This supports them to experience expressing their views and see how this impacts positively on the service they receive.
Young people have excellent educational attendance and make outstanding personal educational progress. Their educational opportunities also increase through activities, projects and school
trips. They thrive and develop because there is effective partnership between care, health and education provision. For example, young people who have historically not accessed education due to life limiting or complex health needs are now attending and have timetables which take into consideration health and medical interventions.
Young people learn and grow. They choose and participate in varied social and educational activities. They also enjoy and try new experiences. One young person described going to the fair for the first time and returning to the home with his face painted. Young people are offered opportunities to learn about the wider community and current issues through play, trips out and projects. They are provided with regular opportunities to experience activities within the wider communities, including trips within the local community, trips in the wider community and holidays. This means that the home is actively developing young people’s social skills. They grow in confidence as they are consistently congratulated on their achievements.
Young people's health needs are expertly met and their health promotion is of paramount importance. The quality of care and outcomes achieved are maximised with the inclusion of medical professionals, nursing and social care teams who understand their specific medical and physical needs.
The health needs of each young person are detailed within individualised planning, with the full inclusion of family, significant others and medical practitioners. Young people benefit from a proactive approach to including them as far as possible in having their health care needs met. Young people’s physical and emotional health is excellently promoted and monitored under the supervision of medically trained practitioners and with an appropriately trained and skilled social care team. For example, a young person was consulted on the medical equipment they wanted to use and were listened to when they expressed a preference due to the reassuring sound it made. Young people benefit from an environment which provides space and a diverse range of activities. The buildings designs are bespoke and provide ideal spaces to meet the needs of the young people within five separate bungalows. The young people are able to engage in a range of indoor and outdoor activities. This includes active play and more passive play. The resources are diverse and meet the needs of young people who have complex needs and are partially sighted or blind. As a result young people are able to experience and develop from a wide range of leisure and learning activities.
Quality of care
The quality of the care is outstanding.
Young people's placement plans are exceptionally detailed and comprehensively address how support for individual needs will be provided. Staff are proactive in ensuring that pertinent information is sought and used to inform plans, thereby ensuring the best outcomes for the young people. Key workers and 'the team around the child' work closely with young people to identify targets and plans. Key workers then ensure these are implemented. The plans take account of young people's needs in relation to culture, religion, gender, personal history and disability. By focusing on the unique character of each young person staff are able to respond to young people's changing needs. This supports young people to achieve outstanding personal outcomes.
There is a child-centred approach to care and education. Education is an intrinsic part of life. Young people are well supported to achieve according to their ability. Most young people attend the provision's school, although the service does also support young people to access alternative educational provisions. The support which enables young people to attend these schools is excellent. Care, health and teaching staff work in partnership to enable the young person to fulfil their potential.
Health provision is outstanding. All staff have excellent awareness of the health requirements of young people with complex needs who are blind and partially sighted. The service employs qualified nurses who ensure young peoples' health care needs are met at all times. Health is a consideration from assessment, through to transition on into adulthood. For example, initial assessment is undertaken by a multi-disciplinary team which includes speech and language therapists, nurses, mobility specialists and physiotherapists. They all feed into personalised placement plans which include support for young people who have specific and sometimes complex health needs.
Young people with high health and medical needs who require long-term ventilation or who have life-threatening or life limiting conditions receive outstanding individually tailored care and education. They are effectively supported in their bungalow by an experienced and professional team of social care and health staff who are specifically trained to met each young person's needs. The management of health and medication right across the site is overseen by a medicines management group.
Young people live within an environment where they can express themselves because of the multi-disciplinary commitment to provide and facilitate communication strategies for all young people. For example, all young people have communication passports developed by the speech and language therapist. These are then shared across the service, and with parents, to ensure consistency of approach. As a result of strategies such as this young people inform and influence the service they receive. This ensures their diverse needs are effectively met.
Young people live in exceptionally well maintained bungalows, within the grounds of a school. The provision is well resourced, secure and safe and maintained to a high standard. Each bungalow provides a comfortable living environment which is safe and homely. The standard of décor and furnishings throughout is exceptionally high. The bungalows are spacious and offer space for communal and private time. There are excellent levels of privacy for young people. Young people are proud of their bedrooms which are individual to them. One young person showed how staff had taken the time, in line with her requests, to ensure all medical equipment was discretely hidden in her room. This resulted in a stylish, trendy room which was welcoming and homely.
Safeguarding children and young people
The service is outstanding at keeping children and young people safe and feeling safe.
The home has a superb track record with regards to safeguarding young people. The emphasis on safeguarding practices and strategies is embedded within the functioning of the service. For example, a safeguarding group meet regularly to review issues, agree policy and raise concerns. This group includes a corporate safeguarding officer, the Registered Manager and parent governor members.
Robust written guidance is in place for the staff regarding privacy, confidentiality and personal care practice. Staff are sensitive to the individual circumstances of young people and maintain appropriate levels of confidentiality. For example, non-verbal communication techniques take place in a manner that respects the young people's privacy and confidentiality.
Safeguarding strategies and practice are supported by incident report procedures, individual behaviour management, intimate care procedures, physical intervention and restraint, handling allegations, recruitment and young people's risk assessments. These are regularly monitored by the Registered Manager and specialist staff across the site. Any issues arising are quickly addressed and pattern and trends are monitored by subcommittees, working groups and the Registered Manager.
Safeguarding policies include strategies to ensure safeguarding is responsive to the needs of young people with complex needs and who are blind or partially sighted. Staff receive appropriate child protection training on induction which is then refreshed annually for all staff. This helps staff protect young people from abuse and ensure they respond appropriately to any allegation or suspicion of abuse.
The home has a clear no tolerance approach to bullying irrespective of who the victim or perpetrator may be and any bullying is dealt with immediately. Bullying is not evident within this provision. It is more likely that behavioural incidents with young people may cause unintentional harm. For these occurrences there are policies and practices which ensure that the communication of relevant information is exchanged; preventative practices reviewed and pertinent records updated. Every young person would be supported to exercise the right to raise concerns.
Staff have positive relationships with young people. All young people have individual profiles that focus on their behaviour, development and disability needs. Interaction between staff and young people is observed to be caring and supportive. Training in behaviour management, including de-escalation techniques and the use of physical intervention, is provided to staff, together with written guidance. Positive behaviour strategies are developed formally in a comprehensive behaviour support plan, which inform school, social care and allied professionals on the strategies used for individual young people. Positive regard and expressions of praise and encouragement are used universally, both verbally and in non-verbal communication. Positive behaviour is also encouraged and rewarded according to the individual needs of the young person.
Young people’s behaviour improves significantly through the observation by staff, the identification of triggers to behaviours and then solutions to modify and minimise unwanted and challenging behaviour. The use of physical restraint is variable and dependent on behaviours and risk. It is used as a last resort when a young person is placing themselves or others at risk. As a result of the behaviour management practices young people are observed to learn to improve in their interaction with staff and each other. Records kept by staff provide excellent data and analyses of young people's progress. This information is not always used to its full potential and is not systematically presented to external professionals and parents to demonstrate the achievements of young people.
The home has a good missing from care procedure and protocol developed with the police and local authority. The home has been proactive in securing the protocol and meeting with the police. Excellent levels of supervision ensure young people are kept safe and do not go missing.
The systems in place to keep young people and adults safe from the risk of fire and other potential hazards are robust. Staff carry out regular fire drills and checks on the fire equipment. Appropriate service contracts are in place for fire and electrical
equipment. Staff also carry out a range of recorded risk assessments covering, for example, general health and safety matters.
Recruitment records show that young people are cared for by adults who have been selected through a robust recruitment procedure. A record of visitors is maintained and proof of identification is requested where appropriate. These measures contribute to young people's safety.
Leadership and management
The leadership and management of the children's home are outstanding.
The Registered Manager and staff are very clear about their roles, aims and ethos. The Statement of Purpose and other literature provided by the home clearly communicates this to young people, their families and social workers. As a result, they are able to make well-informed decisions about whether the home can meet their specific needs.
Staff ensure young people have access to a range of information, that is personalised in each case, to ensure it is informative and easy to understand when they are preparing to move into the home. This, along with excellent support from staff, ensures they feel welcome and quickly settle into the home.
Young people are supported by a stable and committed team of staff who deliver consistent care and support. The commitment from staff is a strength of the provision. Most staff absences are covered from the existing team who are already known by the young people. When there is a need to use agency staff, the provision tries to use the same staff. If a young person moves between bungalows staff will move with the young person. This practice ensures continuity of care for young people. The number of appropriately qualified staff on duty is high and always enough to meet the needs of young people and ensure their welfare and protection.