Viking House

Updated 22 April 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions on 18 February 2020. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service under the Care Act 2014.

This inspection was not aligned with Ofsted’s inspection. A separate Ofsted report is available at http://reports.ofsted.gov.uk

Inspection team

The inspection team consisted of one children’s services inspector, and one specialist advisor who has expertise in nursing children who require complex care.

Service and service type

Viking House is a children’s residential ‘care home’ which provides short breaks for children and young people with a range of complex needs and disabilities. Children and young people in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since their registration with CQC. We also looked at information and findings from the last Ofsted inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with one young person who used the service. We also spoke with spoke with eight members of staff including the registered manager, team manager, senior care workers, care workers and clinical staff.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at four documents relating to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed

After the inspection

We continued to seek clarification from the provider to validate evidence found. We also spoke with two parents and carers of children and young people who used the service.

Updated 22 April 2020

The published date on this report is the date that the report was republished due to changes that needed to be made. There are no changes to the narrative of the report which still reflects CQCs findings at the time of inspection.

About the service

Viking House is provided by Barnardo’s and serves as a residential short break centre for children and young people with severe, profound and complex physical and learning disabilities. The resource centre consists of seven bedrooms which provide overnight accommodation for children and young people aged between 5 and 18 years of age.

The centre is a large home which is significantly bigger than most domestic properties. At the time of our inspection it was registered to provide accommodation for a maximum of seven children and young people at any one time. However, the seventh bed is often reserved as an emergency bed to provide emergency care for children referred by the local authority. This may be when there are safeguarding concerns, family break down or for post-operative care, where it is not possible to care for the child in their own home.

During our visit, four children and young people were scheduled to receive respite. The home is situated in a residential area, close to shops and other local amenities.

The home comprises of five activity rooms that include jacuzzi, ball pool room, multi-sensory room, T.V and computer room, art and craft materials, books, musical instruments and a wide range of toys and games that are suitable for all age groups. We noted that in the records of children and young people we reviewed, that many children and young people enjoyed use of the jacuzzi during their stay. However, at the time of our inspection visit, the jacuzzi was out of use and had been for a significant period of time. We were not made of any plans to address this issue at the time of our visit.

The spacious nature of the home and multiple quiet spaces was benefitting children and young people who have sensory processing issues and who become overwhelmed in busy, noisy environments. All quiet spaces were accessible and had overhead hoisting systems.

Managers and staff made conscious efforts to ensure that the home was homely and made attempts where possible to avoid any signs both inside and outside of the home which may indicate the nature and purpose of the building. Staff did not wear uniform, but their own clothing which was appropriate for the nature of their work.

Viking House consistently applied the principles and values that underpin Registering the Right Support and other best practice guidance. Staff strived to ensure that the children and young people who used the service were supported to lead active, meaningful and fulfilling lives whilst also providing support for their families, parents and carers.

There was a positive, embedded ethos of promoting independence and choice. We found that staff took time to get to know the interests, preferences and aspirations of the children and young people who attended the home for respite and aimed to involve them in a range of activities which further cultivated their interests and personal development. Children and young people who used the centre benefitted from planned and co-ordinated person-centred support that was appropriate for their individual needs.

The centre had been fully adapted to enable children and young people who rely on the use of wheelchairs and other mobility aids, to move around the home autonomously and with ease. The centre had a sensory space and a large garden and patio to the rear. These areas could be accessed by children and young people who had mobility issues independently. The outdoor play equipment in the garden area had been specially adapted so it could be used by residents with a range of physical disabilities. The garden had been thoughtfully planted with a range of fragrant, vividly coloured plants and flowers to meet the sensory needs of children and young people with visual impairments.

Staff were knowledgeable and well trained to provide complex care. They knew the children and young people they were working with well and knew how to keep them safe from abuse and harm. However, clear guidelines were not in place to set out the steps staff should take if a child absconded or went missing from the home

The centre was clean and had been specially adapted to ensure that children and young people could move freely and independently without causing injury to themselves.

There were robust and effective medicines management procedures in place which avoided medicines errors. Medicines were stored safely.

There were a range of comprehensive procedures and policies in place which staff adhered to. However, some of these policies were in need of review.

Staff had not received sepsis training to help them to identify the signs and symptoms of sepsis and identify the risk associated with children and young people’s health.

Children and young people with additional vulnerabilities and identified safeguarding risks were well safeguarded. However, leaders did not ensure that staff were trained in accordance with current inter-collegiate guidance.

There was a blind cord in one of the communal areas which could have been used as a ligature point. The keys to a lockable bathroom cabinet were accessible to older, more able-bodied children who may be curious about the contents of the cabinet.

Care was effective and met the multiple and complex needs of children and young people.

We found evidence of effective partnership working with outside partners and agencies which contributed to effective care.

Leaders and staff were committed, kind and demonstrated caring attitudes to children and young people.

There was an embedded “think family” approach at the centre. Staff provided on going care and support to parents and carers which was valued by the parents we spoke with.

Care was child centred. The needs, feelings and aspirations of children and young people were paramount.

The centre provided an extensive range of activities and excursions that enriched the lives of children and young people.

Leaders and staff were proactive in collating feedback and using such feedback to continually develop and drive improvements.

Staff were innovative and creative in the way that they interacted and communicated with non-verbal children and young people.

Leaders were visible, accessible and staff we spoke with told us that they felt well supported and understood.

Despite ongoing recruitment and retention issues, leaders were flexible and innovatively seeking solutions. Staffing issues were not adversely impacting on safe and effective care being provided.

Processes to monitor quality and performance were effective.

Leaders did not have formalised arrangements and processes in place to ensure that all staff understood how to contact the registered manager or team leads out of hours.

Leaders had successfully embedded a clear culture of transparency and candour. They were open and honest about when things went wrong.

People’s experience of using this service and what we found

One young person we spoke with told us “I like it here. It’s nice. I like to chill out and I like to eat dinner here.”

One parent we spoke with told us “The staff at the home are amazing. They feel like an extension of our family really.”

We have identified one breach in relation to safe care and treatment. We have also made seven recommendations in relation to safeguarding training, infection control, governance and policy and guidance.

This service was registered with us on 12/04/2019 and this is the first inspection that we have carried out at this location.

Why we inspected

This was a planned inspection which we are requested to carry out during the 12 months post registration of the service.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.