Behind the Inspection Rating: Nursery helpschildren communicate
Tristan Donovan
Monday, September 28, 2015
The Cleveland Unit, Middlesbrough - Specialist nursery inspection - July 2015.
"We're a little unusual," says Jennie Kitchen, manager of the Cleveland Unit assessment nursery.
The "outstanding"-rated nursery is part of the child development centre at James Cook University Hospital in Middlesbrough and it works with threeto four-year-olds who have complex needs and/or disabilities.
"Child development centres are a joint provision between health and education, but most are predominately health and then bring in some education staff," says Kitchen. "The Cleveland Unit has switched that on its head because, although we are based in the hospital, it is predominately an education provision and a council service."
While this means most staff are teachers or teaching assistants, strong links with health workers remain paramount. "We take children who professionals and parents feel are not going to be able to go straight into a mainstream setting and have success," says Kitchen. "So they stay with us for a period of assessment and then move onto a special school or, for about a third of them, to mainstream settings with varying levels of support."
Making such assessments is a multidisciplinary process. "We do a double whammy job," says Kitchen. "A lot of our work is like that of any nursery. But we also complete detailed assessments and work with a multidisciplinary team, including health professionals, to find out as much as possible about each child's special needs, so that we can advise the local authority and the parents as to what kind of support they might need before they go into school."
The nursery's children have conditions ranging from spina bifida to being on the autistic spectrum or having learning disabilities for which a cause might never be found. As such, finding ways to communicate with them is vital.
"Just about every child who comes here has communication difficulties in some form and we have a lot of different systems and strategies," says Kitchen.
These methods include using Picture Communication Symbols, Makaton, objects of reference and photographs. "For example, if we need to tell the children it's time to go home, the staff will have an object, a symbol and a photograph that always represents home time," she says.
Building strong relationships with the children is also vital, so when children are about to join the nursery, staff do home visits and work with parents to fill in highly detailed registration documents.
The home visits help children see the teacher as a person their parents trust, while the documents help staff find how best to care for the child.
"We get as much information as we can, the tiny bits of information that parents don't even think about but are crucial to making their child feel comfortable," says Kitchen.
But that information cannot be treated as set in stone, she adds. "Over time it changes, so we communicate well with the parents all the time to keep up to date."
This applies to key workers too. If the child gravitates to someone other than the worker assigned before they started, that person becomes their key worker. "The key worker is responsible for all of that child's intimate care, so it is important that it is someone the child warms to and is comfortable with."
Fact File
- Name: The Cleveland Unit
- Location: Middlesbrough
- Description: The Cleveland Unit is an assessment nursery based in the grounds of James Cook University Hospital that works with threeand four-year-olds with complex health needs and/or disabilities. The nursery serves children from the Middlesbrough, Redcar and Cleveland areas who have been referred to it by a children's professionals. None of its children are inpatients at the hospital. The Cleveland Unit registered with Ofsted in 2004.
- Number of children: 52 on roll, 60 places
- Ofsted reference number: EY277385
Helpful Hints
Co-location brings benefits. Having the Cleveland Unit nursery based within the grounds of James Cook University Hospital helps the children, says manager Jennie Kitchen. First, it means that when going to hospital for medical appointments, the children don't feel they are going to a strange place. Second, it means health professionals are readily available. "If we need a community nurse, epilepsy nurse or a therapist for the children, they are usually in the buildings and can see the children without an appointment," says Kitchen.
Keep parents informed. "A lot of our children are not brought in by their parents because we cover quite a large area geographically, so we don't have that chance to chat to them," says Kitchen. Alongside its diaries and Facebook page for parents, the unit is about to start using the smartphone app MarvellousMe to securely share videos and photos of what children have been doing with parents. "We're hoping parents will get lovely messages that say things like, 'I've just taken my first steps today'."