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Statement Of
Purpose
The Elms, Short Breaks for Children
and Young People with Learning
Disabilities
Service Details: Address: The Elms 17 Infirmary Road
Workington Cumbria CA14 2UG
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CONTENTS
Introduction:
Aims and Objectives 7
Short Breaks 7
Service Aims 7
Quality Standards
1 Quality and Purpose of Care
2 Children’s, Wishes and Feelings
3 Education
4 Enjoyment and Achievement
5 Health
6 Positive Relationships
7 Protection of Children
8 Leadership and Management
9 Care Planning
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Introduction
Aims and Objectives
The Elms provides short term care for children and young people with
learning disabilities including overnight breaks, and day care. The service
is operated by West House Children and Young People service. The aim of
this service is to ensure that children and young people with learning
disabilities and their families receive high quality, co-ordinated care which
is based on assessed needs, promotes social inclusion and helps children
to reach their full potential by developing life skills.
The service believes that, in line with article 14 of the Human Rights Act,
all children and young people with learning disabilities are children first.
They are individuals in their own right with the right to lead lives like any
others, with the same opportunities and responsibilities, and the right to
be treated with the same dignity and respect.
Short breaks
Short Breaks give Children and young people with disabilities the
opportunity to spend time away from their main carer/ families. A short break enables parents/ carers to have a break from caring, developing
positive family relationships and remain fit and healthy to enable them to
provide the best care possible for their child.
Caring for Children and Young People
The Service Aims to:
Promote therapeutic opportunities, increase independence and
quality time for children and young people with learning disabilities
and their families
Negotiate strategies with families which enables the child or young
person to achieve growth and development potential
Provide evidence based care, intervention and capacity building to
support children, young people and their families
Demonstrates effective partnerships in care within a multi-
disciplinary framework
Reflect the concept of ordinariness for children/ young people with
learning disabilities
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Listens effectively to parents and carers to enhance the living of life
for all family members
The Children Act also underpins the service delivery in order to achieve
the following objectives:
All children/ young people should have equal access to the best care
within a network of services that collaborate with each other
The service will be provided in a child/ young person centred
environment where they are made to feel welcome, safe and secure
at all times
Children/ young people should be informed and involved to an
extent appropriate to their development and understanding and
every effort will be made in order to ensure that all children/ young
people are provided with the support that they need to
communicate their wishes and feelings
Every child/ young person will have full opportunity for play,
recreation and education
Parents will be encouraged and supported to participate in the care
of their child and be empowered to participate in decisions
regarding care through a process of clear communication
Quality Standards
1 Quality and Purpose of Care
Outcomes for Children and Young people
The Children’s Homes Regulations 2015 including the Quality Standards
guides us in the delivery of the service to children, young people and their
families. Children and young people with learning disabilities are
encouraged to aspire to the same sort of outcomes as non-disabled
children, for example, having friends and interest, being part of the local
community, acquiring social and self-care skills and future independence,
feeling confident and respected by others and to experience success and
achievement. We recognise that what an outcome means for a child or
young person with a learning disability can sometimes be very different
for what it means for a non- disabled child. However we will strive to
ensure all children and young people will be encouraged and supported to
achieve and succeed in all areas of their lives.
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1) The Quality and Purpose of Care Standard
Overriding Principle
We ensure we deliver care which meets young people’s needs and
supports them to fulfil their potential. We provide personalised care that
meets individual needs and ensure staff are trained and have the
experience, knowledge and skills to provide high quality care.
2) The Children’s Views Wishes and Feelings Standard
Overriding Principle
We consider this as fundamental to meeting desired outcomes in other
areas of life for all children and young people who access the service.
The importance of other people who have regular contact with the child/
young person (including parents, carers, siblings, peers, teachers and
other professionals) who also have the knowledge and skills to
understand the individual child/ young person’s means of communication.
Apart from giving the child a “voice”, having the ability to communicate is
seen as opening doors to more opportunities, such as socialising, being
active and becoming more independent, which in turn will help to promote
feelings of security and self- esteem. We take young people’s views,
wishes and feelings in to account in relation to all aspects of their support.
We fully support young people to express their views, wishes and
feelings.
Sensitivity to the child/ young person’s identify and social integration is a
key objective and principle- “looking good”, wearing clothes similar to
their peers and being able to use attractive equipment whilst still offering
support. E.g. wheelchairs, all contribute to how young people feel about
themselves. We also stress the importance of the child/ young person
experiencing success and having their achievement recognised.
3) The Education Standard
Overriding Principle
We aspire to work with the child, young person, education staff and
significant others, to fulfil learning potential, which along with academic
achievements includes acquiring self-care and living skills and enjoying
stimulating environments. We work collaboratively within the education
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healthcare plans, supporting each young person to reach their goals and
outcomes.
4) The Enjoyment and Achievement Standard
Overriding Principle
This outcome encompasses various inter-related areas. For example;
socialising and having friends, having interests and being able to
participate and have great variety and opportunities, and making a
positive contribution. We want children and young people to feel they
matter, involving them in decisions about their lives, recognising their
individuality and uniqueness, respecting their dignity and privacy and
making them feel values.
5) The Health and Wellbeing Standard
Overriding Principle
We support young people to enjoy good physical and mental health as
well as promoting and advising the living of a healthy lifestyle. Regular
contact with relevant Health Professionals will be maintained to ensure
the children and young people receive the best care possible.
6) The Positive Relationships Standard
Overriding Principle
We ensure that young people are helped to develop and benefit from
relationships based on mutual respect and trust. This includes meeting
each young person’s behavioural and emotional needs and supporting
positive responses to other young people and adults.
7) The Protection of Children Standard
Overriding Principle
Keeping children and young people safe from exploitation, abusive
relationships or physical danger and awareness of the difficulties this can
pose when children receive care from a number of people, where they
cannot communicate well or lack an understanding of potential risks to
their wellbeing.
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8) The Leadership and Management Standard
Overriding Principle
We ensure that an inspirational approach to leadership and management
leads to a culture that helps children aspire to fulfil their potential and
promotes their welfare. Monitoring and review systems are in place to
make continuous improvements to the quality of care provided. Regular
supervision of staff and ensuring training opportunities are available to
develop a competent and knowledgeable team will be provided.
9) The Care Planning Standard
Overriding Principle
While for non-disabled children, independence is often seen as the child
being able to do something without help, for many children and young
people with a learning disability, this is not achievable in certain areas of
their lives.
Managing self- care tasks as independently as possible, or without
support is a key priority in order for every child/young person to reach
their full potential. This also includes the areas for example, making
snacks, handling money and managing unforeseen circumstances when
out and about.
A coordinated care package with all people involved with the child or
young person will be in place and regularly reviewed.
Making a Positive Contribution
Overriding Principle
We encourage being part of the local community, having the same access
to opportunities and activities as non- disabled peers, along with feeling
involved and having the opportunity to exercise choice is paramount.
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Economic Wellbeing
Overriding Principle
We support children and young people when exploring employment
opportunities and meaningful occupations. Specifically, outcomes for
children and young people with learning disabilities involve wider
definitions of key concepts. For example, whilst a child or young person
may not be able to achieve full independence, this does not indicate a
poor outcome.
Achievements need to be seen and celebrated within the context of the
child’s abilities and potential. In addition we recognise that an outcomes
framework sometimes involves the goal is not progress, but maintaining a
particular level of physical functioning or ensuring that a child can
continue enjoying treasured aspects of their everyday lives.
We advocate the strong interdependence between outcomes and that
particular attention should be paid to the fundamental outcomes. For
instance, communication is important for all ages, maximising a child or
young person’s communication ability and others ability to understand the
child/ young person’s communication opens doors to opportunities to
socialise and be active.
We also highlight the need for multi-agency partnership in services. Areas
such as friendships, skills acquisition and opportunities to make choices
do not take place in one particular context.
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Our approach to achieving outcomes
We place significant emphasis on assessment, planning and review for
children and young people. The overall plan will demonstrate a child,
young person centred approach. This will include:
Person Centred Approach How it can be useful
Relationship circles
Identifying gifts
Skills and interests
For finding out who can contribute
For identifying relationships
that could be developed or strengthened
For showing the balance of family, friends and others in
the young person’s life
For showing what the child,
young person enjoy, are good at and can contribute to
For identifying things the child, young person may want
to do more often For starting to think about the
kind of people the child,
young person gets on well with
For showing what the child/
young person enjoys or has a passion for
For showing what talents they have and the things they are
good at For showing what they can
contribute For identifying things they
may want to do more often For identifying the places,
people and activities that
make them happy
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Learning about hopes and
dreams
Recording how to provide
good support
For finding the direction the
person wants their life to go For inspiring action
For bringing people together
around a common purpose For getting a sense of what
makes the child/ young person tick and what
motivates them
For identifying what exactly
good support means for the child/ young person
For describing what people must do to support the child/
young person for discovering what motivates
Who is the service for?
The service is for children and young people who have global learning
disabilities, which are distinguished from specific learning difficulties such
as literacy and numeracy problems. A learning disability is defined as a
“significant reduced ability to understand new or complex information, to
learn new skills (impaired intelligence), with a reduced ability to cope
independently (impaired social functioning), which started before
adulthood” (Department of Health, 2001). 'Global Developmental Delay'
(GDD) is used to describe a learning disability. GDD describes a condition
that occurs between birth and the age of 18 which prevents a child from
reaching key milestones of development like learning to communicate,
processing information, remembering things and organising their
thoughts. The following are considered to be the main areas of adaptive
skills which would be included in the definition for a learning disability.
There would have to be a limitation in at least two of the following areas:
Communication
Self-care
Self-direction
Home living
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Health and safety
Functional academics
Leisure or work
The range of needs of young people
The range of needs of the young people may be in one, some or all of the
categories highlighted by Maslow’s hierarchy of need, as below:
The age range for using the service is 8 to 18 years of age. Allocation of
service is via the Short Break Panel where all referrals are discussed and
places allocated if criteria for admission are met.
The Location of the home
The bungalow is situated within a residential area of Workington, and is
within walking distance of the town centre. The front of the property faces
a minor road, which is used for access to residential properties. The rear
of the property backs on to a disused railway line, which is now a public
footpath. There are transport links via bus stops on the main road, bus
station (within walking distance) and the railway station. The crime rate
in the area is relatively low and the property has well defined boundaries
with a secure garden area.
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The premises
The Elms can accommodate children/ young people with learning
disabilities who also have a physical disability. The bungalow has four
bedrooms, three are single and one is a double. The double room can be
used for example for twin brothers/sisters or indeed as a larger single
room. Two bedrooms have access to overhead hoists and the bathroom
also has a hoist. There is a separate shower room which has equipment to
assist individuals with physical needs. There are no stairs and the
environment is spacious to ensure ease of access for physically disabled
individuals and those who need to use a wheelchair.
The building can accommodate four young people for overnight stays. The
Elms offers a service to both male and female children/young people but
provides single sex accommodation in identified areas, specifically
bedrooms and toilets. This supports the respect, dignity and privacy of
the children and young people. Where possible children/ young people
choose their bedroom, who they would like to be their keyworker for their
stay and what activities they would like to do. Young people are grouped
according to their needs and compatibility for example age and if they
know each other.
All children and young people who use the service will be encouraged to
bring their own clothing and belongings; this will be explained prior to
visits. Staff will follow guidelines regarding clothing, requisites, as this
forms an important part of the care plans.
Support to individual children and young people- meeting need
All children and young people will have individual support needs and these
may vary at any given time. We feel it is important to take the view of the
whole life of the child/ young person, which includes their emotional,
physical, educational, cultural, linguistic, religious, social and recreational
needs and the particular needs they may have in these key areas. All staff
will be clear, understand and adhere to the principles as outlined in policy
guidance for supporting individual children and young people.
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Policies and procedures
The home has organisational policies and procedures which are available
electronically to all staff working in the home. The home also has service
specific policies and procedures which support staff with a comprehensive
range of aspects including, safeguarding, behaviour management.
There are clear policies and procedures regarding behaviour management
and the use of physical restraint. Restraint is only every used in
exceptional circumstances. A behavioural management policy is in place
which all staff understand and adhere to. The child/ young person and
their family are informed of behavioural management in practice and
principles and guidelines are followed.
Quality Monitoring
The registered manager employs an expansive quality monitoring system
across the service to ensure a high quality of care. This includes daily,
weekly and monthly checks and audit tools covering areas such as
incidents, comments, complaints and compliments, health and safety.
Regulation 44 Visits
The Elms is visited each month by an independent Regulation 44 visitor
from NYAS (National Youth Advocacy Service). The visit includes areas of
quality assurance with the registered manager and discussions with staff,
young people and families to ensure standards are met and quality is
maintained/ improved.
Regulation 45 Reports
The registered manager completes a 6 monthly report, which covers all
aspects of quality monitoring. The report includes any actions that are
required as a result of the quality of care review. It includes a full review
of the quality of care provided to young people, feedback and opinions
about the service, the facilities and the quality of care young people
receive.
Young People’s File Audits
To ensure the quality of care is maintained throughout the care planning
process, there is a comprehensive file audit tool which enables each
young person’s file to be checked against a set of standards. This includes
the following areas:
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Is care delivered that meets the young person’s needs and supports
them to fulfil their potential?
Is there evidence that the young person’s views, wishes and
feelings have been expressed
Is the young person at risk of harm?
Are all records/ care plans/ risk assessments up to date?
Educational health care plan/ school review papers in place?
2 Views wishes and feelings
Consultation, participation and involvement
In order not to take for granted those children and young people’s needs
and views which are known already, consultation, participation and
involvement in systems and processes within the home are reviewed at
planned intervals in line with the care planning process.
If and when any changes and developments are being planned, children
and young people will be consulted appropriately and their views recorded
where possible.
The ways in which children and young people are helped to participate in
their care will take in to account their background and attention will be
afforded to gender, ethnicity, religion, language and culture.
We also strive to ascertain the views of parents and families in the
following areas
The overall care within the home
Relationships and communication with the staff team
Furnishings and environment
Future ideas and suggestions
Consultation and decision making will be recorded in individual care plans
and communicated and if necessary actioned by staff.
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Equality and diversity
Following the equality and diversity policy and approach to care,
arrangements are made for children/ young people to attend any religious
instruction whilst they are staying at the Elms, this includes any other
ceremonies or celebrations. These areas are discussed prior to using the
service and as part of the care plan and reviewing process.
There are also specific policies and regular training for all staff around the
areas of anti- discriminatory practice. These include equality and
diversity, promoting privacy, dignity and respect, being open, deprivation
of liberties, mental health legislation.
This forms regular agenda items on staff team meetings along with review
and reflective practice relating to the principles of Person Centred
Planning.
In our vision for children and young people with learning disabilities we
are committed to ensuring that the Elms is a place where all children and
young people and the staff team work in a clean, safe and healthy
environment.
Diversity- working with children and young people from different
backgrounds
We work with children and young people with learning disabilities from a
wide range of different backgrounds and our aim is to respond flexibly to
meet the diversity of need. The following points should be considered
when formulating support plans:
Children and young people have the right not to be ill-treated but
the responsibility not to ill-treat others
The right to be heard, the responsibility to listen to others
The right not to be put at risk and the responsibility not to put
others at risk
The right to live free from verbal and physical intimidation or
bullying and the responsibility not to intimidate or bully others
The right not to be discriminated against and the responsibility not
to make discriminatory remarks or take discriminatory action
Children and young people with learning disabilities may not understand
these responsibilities, but never the less need to be helped with their
behaviour to achieve greater responsibility.
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Anti- Bullying
We endeavour to promote and safeguard the welfare of each child, young
person and staff to feel safe in the environment. All staff are clear and
understand that it is everyone’s responsibility to ensure that all staying
at, or working in the home are treated with respect and protected from
oppression, humiliation and all forms of abuse, which includes bullying.
The home has an anti-bullying policy which all staff have read and
understood.
Staff will aim to identify children/ young people who are at risk of being
bullied and will endeavour to protect all children/ young people from all
verbal, physical abuse, maltreatment or exploitation, including sexual and
racial abuse.
At all times staff will promote anti oppressive practice both with children/
young people, and each other and any other person visiting the home in
either a professional or personal capacity.
Children and young people are encouraged to recognise their own rights
and to understand that rights carry a responsibility to respect the rights of
others.
Friends of the elms/ question of the month
The Elms holds monthly friends of the elms meetings where children and
young people are invited to discuss current issues. This includes seeking
thoughts and opinions around specific matters and consulting children and
young people around any changes and developments, for example the
purchase of equipment, planned activities and outings.
Advocacy
NYAS provides a range of rights based services for children and young
people. There are numerous ways of contacting NYAS:
Telephone: 0808 808 1001 Email: [email protected] Post: freepost
NYAS
Staff can help young people to contact NYAS if they need to speak to
somebody and details can be passed on to the families. Details of other
services providing advice or advocacy can also be provided.
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3 Education
Education
We recognise that education in all its forms is the cornerstone of personal
growth and development. All children and young people will be actively
encouraged to attend their usual education facility.
Each child/ young person will have all the relevant details regarding their
education recorded in their personal file and staff will be familiar with
these.
The individual placement plan will also demonstrate interagency working
and how the child/ young person is progressing.
All children/ young people will receive encouragement and assistance
from staff to attend school and educational achievements will be
celebrated.
Staff will support children/ young people in terms of any issues and/ or
difficulties with school, transport to and from school, uniform and
equipment needed. Staff will also attend/ contribute to school reviews and
co-ordinate and communicate any actions. They will also attend other
school functions and provide the conduit for information shared between
the home and school.
Children and young people will be provided with facilities within the home
that are conductive to homework. E.g. Quiet and private areas,
computers, books etc., and they will receive help, support and
encouragement from staff to undertake this.
Education healthcare Plans
An Education, Health and Care (EHC) plan is for children and young people aged up to 25 who need more support than is available through
special educational needs support.
EHC plans identify educational, health and social needs and set out the
additional support to meet those needs. The Elms work alongside the young person, their family and specialist education school in the
development of education healthcare plans. The outcomes identified within the plans are transferred to the short breaks setting where goals
and outcomes work in collaboration.
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4 Enjoyment and achievement
Leisure activities
We acknowledge and recognise that leisure and activities contribute to the
overall development of children and young people and we therefore strive
to create a positive culture within the home in respect of leisure and
activities.
All children and young people referred to the service have access to, and
are encouraged to participate in a range of positive leisure activities.
Information regarding their hobbies and interests, likes and dislikes and
area areas of support needed to enable participation will be identified in
the care planning process and reviewed regularly. A range of activities
both in the home and within the community are provided. Community
activities include, for example, visits to local parks, the countryside,
bowling and the cinema.
The home also has the use of a mini bus which is well maintained and all
children and young people with physical disabilities can access.
Children and young people are encouraged to bring pocket money in
order to access community activities and the home has a clear system of
recording and managing this.
Informing young people of planned activities
Notice information boards display up and coming events and days out/
activities in a form that children/ young people with communication needs
can access. Children/ young people can add their suggestions and ideas
via the notice board, the suggestions box, friends of the elms meeting/
question of the month or through discussion.
Consulting children and young people
Children and young people are actively encouraged to participate and
contribute to the running of the home. We have a suggestion box,
discussions following activities, feedback from stays and visits and staff
also observe, assess and review behaviour in relation to those children/
young people with complex needs. For those children with communication
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needs there are a variety of resources available in order to achieve
feedback. We also liaise with parents, carers and other professionals
involved for their feedback and views. There are resources available for
children/ young people and their families to inform and advice on healthy
living, staff adapt information on health according to individual needs.
5 Health
Health needs assessments
We recognise the need to provide children and young people with healthy
living environments that promote good health. Each child/ young person
will have a health needs assessment that identifies their physical and
mental health needs and the ways these can be met. These will be clearly
documented in the care plans and will cover the following areas:
Medical history
Any necessary preventative measures
Allergies and adverse effects
Dental health needs
Health monitoring of specific issues
Involvement of parents/ carers in addressing health needs
Hearing needs
Optical needs
Developmental checks
Specific therapies or treatments
A personal profile of each child/ young person is completed prior to
commencing the service. This provides an informative and collaborative
approach to person centred care. The health information and needs of
each child/ young person are collated and assessed prior to using the
service and support and training for staff is in place prior to admission.
Care planning
The staff team work towards a co-ordinated care plan that includes the
identification and collating of all up to date information for example-
health and wellbeing and possible stressors to health. There are regular
multi-disciplinary reviews which include the child, young person and their
carers which aim to negotiate strategies and enable the child/ young
person to maximise access to and receive appropriate support from
relevant services.
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Individual care plans and on-going assessments include physical health
monitoring such as height, weight, bowels, bladder, dental, skin,
nutritional intake and also details regarding specific equipment will be
included in care plans.
Staff contact the child/ young person’s family/carer prior to every stay in
order to update and ensure care is current or if any changes are needed.
Children and young people are offered choices in relation to food and
nutrition and staff encourage the importance of healthy lifestyles. There
are also close links with home and school regarding nutritional planning
and health issues.
Care plans for children and young people with dysphasia are evidence
based and monitored with the involvement of appropriate professionals
for example speech and language and consultants.
Emotional health and well-being are monitored via observations, active
interaction and discussion where possible and staff understand when to
contact other services if needed.
Behavioural observations and assessments can also be informative in
relation to the child/ young person’s health as often changes may be
displayed through behaviour.
A written record will be kept for each child/young person of all significant
illnesses, accidents or injuries that occur during their stay.
The health needs of children/ young people from minority, ethnic and
cultural groups will be given specific attention in order to address and
support any specialist needs.
Children/ young people will be supported and provided with appropriate
advice and intervention regarding sexual issues and sexual health. Issues
regarding personal hygiene will be addressed in sensitive and proactive
ways with an overall atmosphere that helps the child/young person
develop a positive self-image.
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Responsibility for health care
Each child/ young person remains registered with their GP and dentist and
staff have access to contact details and understand when and who to call
for medical emergencies and enquiries
Children/young people will be supported by staff with regard to
appropriate support in relation to their health needs and staff will also
work closely with parents and other professionals in order to seek
guidance and direction where necessary. The overall responsibility for the
young persons health remains with their parents/ families with staff
offering advice and support where necessary.
Medication
There are protocols regarding medication for each child/ young person
both prior to admission and on a planned review basis. These are
monitored and verified via the GP/ prescribing consultant and the child/
young person and their family is made aware of the need for these
protocols prior to using the service and when required. Staff understand
and adhere to the medication policy and also receive regular training
regarding this.
6 Positive Relationships
Contact with parents and families
We aim to develop effective partnerships between the child/ young perons
home. Parents and carers need to know that the care their child is going
to receive matches that which they would deliver themselves. Parents,
carers and other significant family members are encouraged to call in or
stay for a while if this helps the child/ young person to settle. Contact
arrangements will be discussed prior to the child/ young person using the
service and also reviewed in line with the care planning process.
Children and young people are encouraged to have regular contact with
their parents and family when they are staying- they have access to
phones and if necessary staff will assist and support this.
If there any safeguarding concerns regarding contact, these will be clearly
recorded and communicated to all staff. All staff have a responsibility for
encouraging, facilitating and providing practical support in order to ensure
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that individual needs regarding contact are implemented and reviewed
where necessary.
Contact with friends
We encourage young people to identify peers they wish to visit alongside.
Observations are made around the compatibility of young people including
positive interactions. Staff support young people where possible to attend
classes and clubs outside of the Elms. All arrangements are comunicated
with the family as appropriate.
7 Protection of Children
Room Searches
Each child/ young person has the right to privacy, but interventions may
on occasion be needed in order to help them and others remain safe: this
may include the area of room searches.
Security
At the Elms we encourage and actively support children and young people
to explore, we also consider and assess any potential risks regarding
supervision and observation needs. We discuss these with the child/
young person where possible and also with their carers and families. Any
restriction placed upon the freedom to move around is a serious matter
and reasons why this measure needs to be implemented will be discussed
with all involved in the care of the child/young person and recorded .
As the Elms is a spacious building, the doors to the outside are kept
locked for safety reasons. E.g. prevent intruders entering the building,
preventing possible crime (particularly at night) and to ensure the privacy
and protection of children, young people and staff. Children and young
people however have free access to the outside via the patio door and
also information and guidance on how to use the other exits.
Staff resources are planned around the support needs of children resident
to ensure they receive the best care possible and are kept safe from
harm. All children/ young people are assessed initially on referral and on
an ongoing basis where any alterations or changes to rota’s will be
implemented as needed. The guidelines on security and locked doors are
clearly stated in the pre admission information and also form part of the
care planning review process.
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Children and young people’s behaviour
The Children Act 1989 places a legal duty to safeguard and promote the
welfare of children and young people and this sets the expectations in
relation to behaviour management.
In addition, The Human Rights Act 1998, requires that children and young
people are treated fairly, have their rights respected and are free from
harm and discrimination. The British Institute of Learning Disability (BILD)
provides recognised good practice guidelines for those working with
children and young people who have a learning disability.
It is important that staff and carers recognise that difficult and sometimes
challenging behaviour is part of the natural process of growing up. It is a
key task to help children and young people gain insight and control in to
their behaviours, however the individual needs of the child/ young person
should be discussed, assessed, reviewed and evaluated using a person
centred approach to care planning.
Understanding Children and Young People
Difficult or challenging behaviour can occur for a number of reasons:
As means of expressing emotions
Through attachment issues with parents, carers
Through learned behaviours in which challenging responses have
become habitual
Anxiety or frustration
Used as a method of communication
It is beneficial and helpful if staff and carers can understand the cause of
a child/ young person’s behaviours and provide the help and support they
need to manage these.
When working with children and young people with learning disabilities we
consider the following to be starting points:
The age of the child/ young person and consideration of their
understanding and development
That the objective of positive behaviour management is not to
punish or to have control over the child/ young person but to assist
and support their learning development and skills in relation to
behaviour
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Challenging and undesirable behaviour should not lead to an
emotional distance between the child, young person, staff and
carers
The more staff/carers can understand a child/ young person’s
behaviour they will be better able to meet their needs in a fair,
balanced and consistent way
Some children and young people with a learning disability may need extra
support and help regarding their behaviour. Their life may be full of
stresses that are hard to manage or they may have needs around social
skills and understanding that in turn affect their behaviour. It is important
that whilst staff and carers are realistic regarding expectations, this
should not lead to underestimating a child/ young person’s ability to learn
about behaviour. The service ensures that:
Children and young people with learning disabilities who have
difficulties with their behaviour are cared for in ways that are
sensitive to their needs
Provide safeguards for staff and carers in this rewarding, though
sometimes difficult responsibility
Ensure that the safety of both children, young people and staff is
treated as equally important
Encouraging positive behaviour
Developing positive relationships between children, young people
and staff/carers
Children and young people learn how the world works and their role in it
mostly from adults who care for them. They do this on the basis of
trusting and caring relationships.
How staff and carers respond to behaviour is vital to helping the child/
young person develop successfully. It is important that staff and carers
recognise the behaviour for what it is and understand it even through it is
often directed at them, it is not personal. Rather, it is the product of the
child, young person’s needs and both past and present experiences.
Staff should always seek to maintain relationships with children and
young people that are positive and based on mutual respect. It is
important staff appreciate the need to take the initiative to sustain
relationships with children and young people with learning disabilities who
at first may not want to have such a relationship.
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Privacy and confidentiality
We place particular emphasis on the need for children and young people
to have their privacy and confidentiality respected. There may be times
when it is in the child/ young person’s best interests to share confidential
information between staff and colleagues and there may be occasions that
in order to keep the young people on safe, their privacy may have to be
compromised. Both these areas will be approached in sensitive, respectful
and transparent ways.
Staff will understand and adhere to protocols in relation to privacy and
confidentially, having training and also access to specific policies.
Personal space
We recognise that all children and young people should be able to secure
their own possessions and also have privacy in their rooms and that staff
adhere to guidelines and protocols regarding respectful observation.
No child or young person is ever locked in their rooms. Many children and
young people as part of their needs may walk around the building. Staff
acknowledge that it is important to recognise where the child/ young
person is trying to go and also that walking to particular areas of interests
will be of benefit to them and indeed that this walking is not necessarily
negative. Behaviours of this nature will form part of the initial and on-
going assessment and form part of the care plan which will also include
the child/ young persons need for movement and activity in a positive
way.
Positive Reinforcement
It is an expectation that staff will develop positive and supportive
relationships with children and young people with learning disabilities and
they will be managed through the positive reinforcement of appropriate
and desirable behaviours.
Prior to admission to the service and also following regular planned and/
or when needed care reviews, staff will discuss and negotiate
expectations or areas of need concerning behaviour. It should not be
assumed that all children and young people using the service understand
general expectations of behaviour, be that from their own specific
individual needs/ and or own home/ living situation. It is a key task of
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staff to discuss and explain these issues with the child, young person and
their carers.
Staff should always be aware of their own behaviour and modelling
appropriate responses to a range of situations. They should also
consistently provide feedback to children, young people and their carers
around behaviour (including positive behaviour) and its impact.
As children and young people attempt to manage their behaviours they
need encouragement and support to reward their efforts and to promote
further change. Staff need to be optimistic that things can change, but
also realistic around how long this may take and that the child, young
person and carers may need to expect, from time to time, setbacks,
shortfalls and mistakes.
Staff should always bear in mind that the objective of positive
reinforcement is to promote change and help children/ young people and
their family manage behaviour more effectively, it is not simply about
maintaining control.
Positive preventative strategies
The best way of dealing with a difficult situation is to prevent it from
happening in the first place. A clear process using assessment,
implementation, and evaluation of behaviours and the associated needs of
the child/ young person and the support needed by staff is important in
planning and managing the care of the child/young person.
Risk Assessment
All children and young people will be risk assessed prior to commencing
the service and at regular planned times following the care planning
process.
Missing Child/ young person
We aim to minimise the possibility of children/ young people being
missing from the home though:
Precautions and planning involving assessments, observation levels
and allocation of staffing both on initial referral and on-going as
part of the care planning processes and changing needs of the child/
young person.
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Staff will understand and adhere to individual care plan
recommendations regarding observation and supervision and they
will also understand and implement protocols in the event of a
missing child/ young person in line with the policy.
Children, young people and their carers will be informed of the
missing child/ young person policy and the policy will also be
reviewed and updated on a planned basis and following any incident
in line with governance process.
Behaviour management plans
Following the risk assessment this leads to a clear and agreed behaviour
management care plan. The plan will be drawn up with the child, young
person and their carers, involving others who know them well. The plans
will also identify strengths and interests.
Behavioural guidelines
A component of the behavioural plan will be confronting the consequences
of actions and providing an incentive to reflect where possible on
behaviour and modify it. Staff will communicate with children and young
people about the reasonable expectations in terms of their behaviour and
the possible consequences of not meeting these expectations.
Staff will discuss with the child, young person when they are in a position
to understand the consequences of their behaviour and how they can
learn from it. Discussion and communication will have to be proportionate
and appropriate to the behaviour and relevant to the child/ young
person’s age, understanding and overall care plan. This will need to be
timely and not disruptive to the other children and young people in the
setting, whilst being applied consistently and fairly.
The following is not permissible:
Corporal punishment- any act intend to cause pain
Use of disrespectful language which includes swearing, is
demeaning or humiliating toward the child/ young person
Deprivation of food and drink
Restrictions on communication with family/ carers
Withholding medication
Enforced isolation
Restricting of liberty
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The use of physical intervention and the law
Restraint or physical intervention refers to the use of appropriate physical
means whereby staff need to manage a child/ young person’s behaviour
to prevent injury to themselves or to others. It is expected that this is an
exceptional method of management and is employed to make the
situation safe as opposed to overpower the child/ young person.
The intent of physical intervention is to calm a situation, prevent
escalation and keep the child, young person and staff safe. All staff will be
trained in Team Teach Intervention in relation to practice principles and
physical intervention or restraint. All incidences will be reported to
relevant people involved with the child, reviewed, discussed and any
further actions, lessons learned agreed and documented.
Restraint (physical intervention)
Staff will be trained in Team Teach physical skills interventions and the
management of violence and aggression on a planned, regular basis; this
includes safe touch and holding.
Staff Debrief
Staff will be supported in dealing with challenging behaviours as this may
be an area that they feel anxious and vulnerable with. The manager will ensure debrief, reflective sessions and supervision are
planned regularly and when needed.
Independent advocacy following restraint
Following an incidence of restraint a young person is offered access to an independent advocate. This service is offered to every young person in
this situation, with parents/ carer’s/ families being informed of and
involved in the referral to act in the young person’s best interests. There are numerous ways of contacting the organisation which offer this service,
these are displayed within the Elms.
Complaints
It is an important safeguarding and welfare issue that children/ young people and professionals are given every opportunity to comment on their
experiences and make complaints if they so wish. All children/ young people and their families/carers will be given
information about and who to access if they have concerns and complaints and these will be taken seriously and investigated.
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Recording and Monitoring
In order to establish a clear outcome from care plans and behavioural management plans it is important to ensure that incidents concerning
behaviours are clearly recorded, reported and analysed. This is to ensure that the effectiveness of any interventions are evaluated and adapted if
necessary. It will also ensure progress regarding any child/ young person.
It is also important to ensure that any pattern of risk both to children,
young people or staff is not emerging and where there are, action is taken.
Clear and accurate recording helps all involved in working and caring for a child/ young person to analyse and act upon all the factors which may be
influencing behaviours. The service has a clear and agreed format and process for recording and
reporting incidents.
Training All staff will be trained in the prevention and management of aggression
and will have regular planned updates. The training programme includes an assessment of skills and physical ability to utilise techniques. Regular
in house reflection following incidents support with highlighting any
issues, which may arise around competency of staff with restraint. This training includes:
Understanding behavioural policies Positive strategies to manage behaviour
Preventative strategies to manage behaviour Assessment of incidents and issues
Risk assessments and care planning Understanding the cycle of aggression
Observation, safe touch Breakaway techniques and de-escalation
Recording and reporting incidents and concerns
Safeguarding
The overriding principle regarding safeguarding is that the welfare of the
child/ young person is paramount.
There are specific policies, protocols and procedures regarding safeguarding. All staff receive regular training and understand the
definition of abuse, what they should do and who they should contact if they have any concerns at all about the welfare and treatment of the
child/ young person.
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Contact names and details are available for all staff regarding
safeguarding.
All staff understand they have a duty of care to be aware of their role in supporting the systems of safeguarding and welfare of children and
families in Cumbria. This includes the need to work closely with other agencies which comprise the Local Safeguarding Board. Safeguarding
issues are covered in team training days and this encourages awareness
and openness. It is also included in monthly staff supervision.
There is a raising concerns policy, which all staff are aware of and are clear around. The manager also attends local steering groups in relation
to safeguarding.
Children/ young people are given information regarding what they should do if they are worried or unhappy. This includes how to raise a concern
both formally and informally via “I want you to know” aids. The resources reflect, where possible, the varying needs of children/ young people and
assist them to explain how they are feeling. Staff also observe and respond to any changes in children/ young people’s behaviour that may
indicate or suggest they are unhappy or worried.
8 Leadership and Management
Registered Provider: West House, 26 Standley Street Workington
Staffing
Registered Manager:
The manager is responsible for the day to day operational management of
the team and the service. .
Responsible Individual: Catherine Parker
Qualifications of staff
Registered Manager
Deputy Manager
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Community Support Worker
NVQ 3 in Children and Young People
Community Support Worker NVQ 3 in Children and Young People
Community Support Worker
NVQ 3 in Children and Young People
Community Support Worker
NVQ 3 in Children and Young People
Delegated Authority and Notification to Senior Staff
The manager is responsible for the day to day operational management of
the team and the service. Key objectives for the manager are to improve the standards of the service delivery and to develop the service to reach
the maximum numbers of service users in the most efficient way. This includes dealing with governance and regulation such as using service
user feedback to improve the quality of the service, ensuring audits take place, and all regulations are adhered to. A further key area for the
manager is to ensure all staff are managed appropriately and receive
regular supervision, appraisal and support.
The deputy manager supports the manager in their role and deputises in
their absence, taking a senior practitioner lead role within the home. Each member of staff is clear and understands their role which includes the
delegation of tasks. Monitoring of accountability is maintained by the cycle of supervision and appraisal and also includes in house monitoring
processes that evaluate effectiveness, communication lines, documentation and reassessment if required.
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All staff are clear and understand the requirements and procedures
regarding notifiable incidents to senior staff and the regulatory body and there are on call systems in place to undertake this and also seek advice.
Telephone numbers and contact details are always accessible to the staff team.
Governance systems are in place to monitor, review and evaluate
“lessons learned”.
Continuity plans are also in place covering areas such as loss of facilities,
staffing and severe weather.
Staffing
The service has up to 20 members of staff. These staff will work both full time and part time. The staff team are able to meet the emotional and
physical health needs of the children and young people who use the service. They are able to do this as a result of the training they have
received and from the wealth of personal life experiences.
Staffing levels are planned according to each child/ young persons assessed needs, the number and compatibility of the young people using
the service, initially on referral and on an ongoing basis, these are
adjusted is required.
Arrangements to cover staff sickness include the use of bank staff and there are procedures in place regarding this.
Staff rota allow for the following: Individual time with children and young people
Written recording and care planning Planning and carrying out care plans
Attending reviews and other meetings Handover
Rostering shift handover
Maintaining continuity of information between shifts in an important and crucial part of providing safe, quality care within the home.
The handover within the home is:
planned and occurs at shift cross over has adequate dedicated time
demonstrates clear leadership contains sufficient and relevant information exchange that includes
child/young person’s needs, tasks not yet completed, plans for further care, prioritising of tasks.
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Promoting Role models of both sexes
The staff team is presently all female but they are aware of the
need to try and encourage positive role models for all young people and be able to provide a range of activities for both
genders.
Support Staff role
There are ???? Community Support Workers whose responsibilities are:
To support and undertake a range of activities linked to children/young people who are having difficulty with their
behaviours, or who have associated health requirements whose need cannot be met by other existing services
Enable children/young people and their families to achieve their goals, improve the quality of their life and promote the development
of social inclusion
This is done under the direct supervision of the Registered Manager and Deputy Manager supervision.
Shift patterns
Shift patterns are flexible and varied in order to meet the needs of the child/ young person and their families.
Staff work early shifts, late shifts, night shifts and day shifts. We have waking night staff to accommodate the needs and safety of children/
young people and night time routines and sleeping patterns are assessed, recorded and communicated via the individual care plan, along with
regular reviews.
Supervision
The manager arranges monthly (or when required) supervision for all
staff to ensure the team receives regular support. Supervision is recorded
and forms part of the process of monitoring and progressing staff’s
personal development.
Each member of staff has an annual appraisal. Within this process their
training needs and continuous professional development needs will be
highlighted and matched against the person specification for their role. It
includes mandatory training requirements and identifies other
development needs and areas where further support is required or further
training. Compliance with mandatory training is very important and
current up to date records are kept regarding this. Through the Appraisal
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and supervision process staff can also identify and access other training
which may benefit their development and improve service delivery.
Staff training
All staff caring for children/ young people in the service are specifically
trained to understand and respond to health, emotional, developmental,
communication and cultural needs..
All new staff receive induction training in order to ensure that they have
the information they need to carry out their role efficiently and
appropriately. The manager is responsible for ensuring that this takes
place. Regular Team meetings for the staff are planned these support the
development of staff competencies and the promotion of high quality
care.
9 Care Planning
Referral and Admission Criteria
In order to ensure that children and young people receive the service
appropriate for their needs, referrals are submitted to the Cumbria multi-
agency short breaks panel which responds to all requests for short breaks
across the county. The terms of reference for this group are:
To develop and encourage a more integrated approach to
supporting families and carers for children and young people with
learning disabilities
To ensure the needs of children and young people and their families
are met in the most appropriate setting
To ensure consistency of approach across the county
To ensure equality in the allocation of resources
To ensure a child centred approach to resource allocation
To provide information to support on-going commissioning of
resources
To encourage a creative response to needs and to meet outcomes
that might cross traditional boundaries
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Admission process and reception of children/ young people
The service considers that outcomes for children and young people with
learning disabilities often improve when they are actively involved in
decision making. Referral to the service is planned with the child/ young
person’s involvement and at their pace. Introductions are flexible and
staff also discuss communication, preparation and planning with the child/
young person and their family. Staff discuss and identify contingency
plans and arrangements should the child/ young person not settle in to
the service.
Emergency admission
The Elms does not have specific procedures for emergency admission or
facilities to deal with this but encourages parents/ carers who access the
Elms to contact the service and strives to advise and help where possible.
Care Planning and Assessment
We place significant emphasis on assessment, planning and review for children/young people. The overall placement plan will demonstrate
assessed needs, the objective of using the service and how these will be met on a daily basis.
A care plan will be developed for the Elms and key areas identified will
include; Independence and personal care skills
Health needs and health promotion Education needs and attainment targets
Cultural, religious, language and ethnic needs and how these will be met Leisure needs
Contact arrangement for family, friends and significant others. How these will be met on a daily basis
How staff will contribute and promote these
How the effectiveness of the placement will be measured and reviewed Each child/young person and their carers will understand the aims and
contact of the placement and care plan and they will be involved in compiling, reviewing and assessing these plans
Staff will monitor plans and ensure they are implemented, monitored and reviewed.
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Risk taking and risk assessments
As visits should be enjoyable and safe, care is planned around individual needs including compatibility and age. Care plans and risk assessments
are completed before the child/young person commences with the service and are reviewed as part of the care planning process. All children and
young people, have an assessment of their needs including risk
assessment, this includes areas of physical health and any moving and handling needs. All children and young people are assessed with regards
to safety and the support ad observations they may need. The risk assessments will be regularly reviewed and updated in line with the care
planning process and this in turn will provide a framework for the individual child/ young person’s safety and the safety of others.
Behavioural management plans are risk assessed, details including de-
escalation and distracting techniques and instances and situations where they may be used. Following all episodes and incidents which require
behavioural intervention and management, staff complete and incident form and also document in the child/ young person’s care plan and
records. The family is also informed and offered the opportunity for discussion and make comments. Staff discuss the incident with the
manager in order to check if there are any changes required to the child/
young person’s care ad allow the opportunity for reflective practice and lessons learned. Parents and carers will be informed immediately of any
unforeseen incidents, the action taken and subsequent outcome.
Reviews
The staff and Registered Manager will also regularly seek the views of child, young person and their carers on the content of the plans and make
changes where necessary.
Staff contact children/ young people and their carers before every visit in order to ensure that any changes, requirements or preferences are
discussed and communicated.
Care plans are reviewed formally three monthly and a collective bi-annual
review of the care planning process, therapeutic interventions, goal planning and opportunities and experiences are carried out, with the
children/ young people and their families.
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Case recording and access to records
Each child/ young person will have a permanent, private and secure
record of their history and progress and all children/ young people and their carers will be made aware of this.
Each child/young person will have a Elms/home diary in which staff will
record information during each stay
The home has a written policy that clarifies the purpose, format and
content of information to be kept in each individuals files. Staff understand the nature of records maintained and follow the homes policy
for record keeping and retention of files, managing confidential information and access to files.
There is an audit system in the home to monitor the quality and adequacy
of record keeping, action is taken if required.
Children, young people and their families understand the nature of the records maintained and how to access them. Information is kept
confidential and only shared with those who have a legitimate need to know the information.
The overall aim of case recording is being, to contribute to an understanding of the child/ young person’s life.
Multi agency working
Communication methods with other agencies include the use of diaries,
newsletters and regular “exchange” invitations to open days and events.
There are proactive and positive working relationships with schools and education establishments. Staff are invited to, and attend, regular
educational reviews and also by arrangement, visit the school on an informal basis to ensure consistency of care delivery.
There are robust working relationship with other professionals for
example the staff team have regular meetings with education, Children’s
Services and private care providers. The staff team are well known to the teachers of the local specialist school. The staff team also work closely
with the local Children’s Community Learning Disability Nursing Team.
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Working with parents and carers
We recognise the centrality of the family in and child/ young person’s life
and adhere to the key principles: Communication is important in all stages of care
Family strengths and individual styles of coping should be respected Care should be flexible and respond to child, young person and
family needs
We acknowledge and respect diversity in family structure and cultural identities
We also follow three main indicators for good practice relating to family centred care which are:
To gain understanding of the impact of those factors that influence a child/ young person’s families adaptation to needs- from the child/
young person and the families perspective To utilise this knowledge
To negotiate strategies with families to enable the child/ young person to achieve growth and development potential
Log book and Diary recordings
In order to compliment and support hand over, the home has a daily log
book to record events that reflect daily life e.g. phone calls, reminders to
read files, any work or maintenance issues and any issues relating to the staff team.
This will be kept confidential, safe and secure and is open to inspection. An annual diary will also be kept in order to record appointments, tasks
and important dates. The log book and diary will form an important part of the handover
process.
Complaints
The Elms is committed to maintain the highest standards of professional
practice. We do however accept that difficulties may arise in the course of our work and we hope that any difficulties can be resolved by talking with
members of staff or the Manager of the home.
In situations where it has not been possible to resolve the problem
informally by talking with a member of staff, or the manager of the home, a formal complaint can be made via the West House Complaints
procedure, to Ofsted, by telephone or in writing. Families, Children and young people are provided with details of how to make a complaint and
leaflets are always on display in the Elms. Any complaints will be investigated via the complaints procedure and a record of all complaints,
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whether formal or informal, will be kept by the home and if the complaint
is made by a child/ young person a record will also be kept in their individual file.
A complaint can be made directly to Ofsted:
Complaints department Piccadilly Gate
Store Street
Manchester M1 2WD
Telephone number: 0300123 1231
NYAS can also help to support with complaints through their issues based
advocacy service and can provide investigating officers for dealing with complaints:
Telephone number: 0808 808 1001
Online: [email protected]
Write: freepost NYAS
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