Children's Home run by N H Care Limited in Birmingham

Unique reference number SC365366 Inspection date 18/09/2013 Inspector David Morgan Type of inspection Full Provision subtype Children's home

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Date of last inspection 19/03/2013 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Brief description of the service

The home provides accommodation for up to three young people who have autism as a learning disability and is run by a private provider. Currently, one young person attends for school holidays only.

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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

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Overall effectiveness

The overall effectiveness is judged to be adequate .

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Overall effectiveness

New young people readily settle into the home and enjoy positive relationships with staff. They have easy and regular access to the community. Young people benefit from well-planned care, which is firmly focussed on their individual needs, and helps them make good progress. Safety measures are thorough in most regards with only a small number of issues requiring attention.

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Overall effectiveness

At the last inspection in March 2013 the home was judged to be making inadequate progress. Since then the progress of the service has been affected by the appointment of a manager who did not perform as well as necessary. A new manager from inside the organisation is now correcting the shortfalls arising from this short period. Most of these issues are either administrative or have only a potentially negative impact on young people who benefit from a good quality of care overall. A detailed development plan is in operation and the service now has the managerial capacity and leadership necessary to provide a strong service.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) provide suitable arrangements for the disposal of any medicines received in to the children’s home (Regulation 21(1)) 28/10/2013

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Reg. Requirement Due date

(2001) ensure all parts of the home to which children have access are so far as reasonably practicable free from hazards to their safety. This is with regard to radiator surface temperatures, garden fencing and the padlocked side entrance (Regulation 23(a)) 28/10/2013

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Reg. Requirement Due date

(2001) ensure that there is at all times a sufficient number of suitably qualified, competent and experienced persons working at the children’s home (Regulation 25(1)) 28/10/2013

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Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate training (Regulation 27(4)(a)) 31/12/2013

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Reg. Requirement Due date

(2001) keep a record of the actual rosters worked. This is with regard to it being clear who worked each shift, which version of the roster is accurate, and when senior personnel are on and off site (Regulation 29 (1), Schedule 4 (11)) 28/10/2013

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Reg. Requirement Due date

(2001) keep a record of all visitors to the home and to children accommodated in the home, including the names of visitors and the reason for the visit (Regulation 29 (1), Schedule 4 (13)) 28/10/2013

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Reg. Requirement Due date

(2001) ensure the children’s home is suitably furnished. This is with regard to there being curtains in each bedroom and the activity room. (Regulation 31(4)) 28/10/2013

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure children develop their emotional, intellectual, social, creative and physical skills through the accessible and stimulating environment created by the home. This is with regard to developing the back garden (NMS 7.1)  ensure that decisions about the use of locks are based on a careful risk assessment that allows children as much freedom as possible (Volume 5, statutory guidance, paragraph 2.108)  apply the emergency escape plan so that all staff and children are familiar with it and have practiced so they know what to do in an emergency. This is with regard to ensuring all staff undertake regular unannounced fire drills that use different scenarios (NMS 10.9)  ensure the children’s home has a clear Statement of Purpose, which is reflected in any policies, procedures and guidance. This is with particular regard to one child not being present in term time and the related matching procedures (NMS

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Recommendations

13.1)  ensure the system for recruiting staff and others includes an effective system for reaching decisions as to who is to be appointed. (NMS 16.5)

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Outcomes for children and young people

Young people have positive experiences in their home and new young people soon feel at ease. They benefit from careful attention to their communication needs, which means they are able to express opinions, make choices and participate as much as possible. Their learning disabilities are not an obstacle to progress in this area. This is also a critical contribution to the positive relationships they have with staff and their emotional good health. This is aided by the clear contact arrangements they have with friends and family members.

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Outcomes for children and young people

In the vast majority of cases, young people make effective and planned transitions to their next placements. They are able to develop the necessary skills both inside and outside the home. Their involvement in the community occurs routinely and means they develop social skills and benefit from the range of resources available in a large, multi-cultural city. Stimulating recreational activities are pursued in the home and a new room is now available for this purpose. Practical skills are practised so that young people are able to be as independent as possible. This applies to their personal health care as well as domestic routines such as planning and cooking meals. Healthy eating regimes are quickly understood by new young people and this improves their health and reduces behavioural difficulties.

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Outcomes for children and young people

Young people accept that formal education is an intrinsic part of their routine. If education placements are not available for short periods they undertake alternative programmes with staff to develop their learning. Such programmes are personalised and carefully monitored to ensure they are as beneficial as possible. Attendance at school is usually outstanding.

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Quality of care

Staff are of various cultural backgrounds and ages and are representative of the local community. This helps to expose young people to positive images of social diversity. Through personalised support of each young person, staff effectively ensure young people understand what is going to occur; complex issues, such as the anti-bullying policy and the children’s guide are addressed well. As a result of this close support and consultation young people are central to how the home operates.

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Quality of care

Good, individualised support is reflected in each young person’s records and in the detailed care they receive. This applies from before they are admitted, when methodical steps are undertaken to assess young people and to make admissions as successful as possible. Strategies are carefully implemented to ensure consistency and effectiveness of practice; strategies implemented in previous placements are continued, where appropriate. This is particularly valuable for those young people who live elsewhere during term-time. Former carers confirmed that there is good continuity in this regard. Any obstacles to progress are addressed promptly and proactively with the agencies concerned. Young people’s progress is clear and additional processes are being introduced to demonstrate this more accurately.

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Quality of care

Health care and medicine administration occur appropriately in most regards. Health professionals are used who are known to have special skills in meeting the needs of young people who have learning disabilities. This is an important contribution to young people’s on-going good health because they are made to feel safe during appointments. Medicine disposal is safe but does not always occur in the required way. Improved management means this shortfall is unlikely to recur. A social worker confirmed there is good contact with external professionals about welfare issues.

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Quality of care

The property is in a suburban location and has easy access to public transport and amenities. It is presented to a good standard overall and decorated in a calming way that reflects the needs of the young people. Curtaining is necessary in two rooms to ensure the privacy of young people and staff. The rear garden is a potentially valuable source of stimulation and activity but is under-resourced.

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Safeguarding children and young people

The service is adequate at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Appropriate systems are in place to ensure that young people and staff are as safe as possible in most ways. The recruitment of new staff and engagement of agency workers, for example, is undertaken in a way that safeguards young people. There have been no incidents of young people going missing and they are protected well in this regard. In terms of physical safety, young people have had very few accidents. However, the temperature of the radiator in the shower room is not sufficiently well controlled and poses a risk of burning if someone falls against it. Also, both the main exits from the property are locked at all times, which is unnecessary for the safety of the young person who lives here permanently. In addition, the gate from the rear garden to the front is padlocked with a key that is not on staff’s key rings. This poses a potential safety risk if an evacuation occurs into the rear garden. Also, the garden

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Safeguarding children and young people

fences are not sufficiently secure to prevent young people scaling them. Fire drills occur regularly but are not unannounced and do not serve to train staff in a variety of possible scenarios, for example in the use of the nearest exit as required by the policy. This reduces the ability of staff to deal with an actual emergency.

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Safeguarding children and young people

Behaviour management is addressed adequately. The previous manager allowed sanctions that were poorly conceived and ineffectual. The approach is now much more constructive. Staff do have to hold young people from time to time. Such holds are relatively non-invasive and usually serve to simply guide young people. Behaviour management strategies are compiled for each individual and adjusted as necessary. Staff proactively teach young people about bullying. Some behaviour management strategies require staff to be suitably trained but such training does not always occur promptly. This increases the likelihood of miscalculation and accidents.

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Leadership and management

The leadership and management of the children's home are adequate .

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Leadership and management

The staffing and management arrangements in the home are satisfactory. After a manager was dismissed in December 2012 another was appointed in February 2013. She led the service for approximately two months after it was reopened following closure for refurbishment. This manager was dismissed in August 2013 due to performance issues, some of which are identified in this report. A competent person has now been appointed and will undertake registration with Ofsted as soon as possible.

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Leadership and management

These changes occurred in order to ensure that the high expectations of the directors were maintained. However, they led to a period of significant change, uncertainty and a number of shortfalls. For example, there have recently been occasions when inexperienced staff have not been supported on site by experienced staff. This has reduced the quality of care provided to young people and left staff vulnerable to allegations of misconduct. Also, although records are now appropriate in the majority of cases, some recent staff rosters are not sufficiently detailed to confirm who was on duty at any one time and whether senior personnel were present or not. This creates difficulties when enquiries are made about staff performance. Visitors are required to sign and out. This is an important safety measure but the log does not show where visitors are from or which organisation they represent. This undermines the monitoring function of the record. In other

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Leadership and management

regards, there are satisfactory monitoring systems in place.

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Leadership and management

The staff training policy is adequate but it has not been applied consistently in recent months, especially with new staff. This was also raised at the last inspection. This shortfall means that new staff in particular gain skills at a later stage than is desirable, for example, regarding behaviour management. However, high staffing levels, and the improved managerial support that is now in place, reduce the impact of this shortfall.

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Leadership and management

The Statement of Purpose is up to date, is reviewed regularly, and an appropriate children’s guide is used with new residents. However, the name of the home on the Statement of Purpose is different to that on the registration certificate, which indicates that reviews are not as thorough as necessary. The Statement of Purpose is also insufficiently clear about the fact that the home provides holiday accommodation for one child. This is important information for placing authorities for whom the arrangements to match young people are crucial.

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Leadership and management

The previous inspection raised three requirements and two recommendations. Staff training remains a shortfall especially regarding mandatory courses, although workforce induction standards are being undertaken. This increases the potential risk to young people if they display challenging behaviour. Other matters have been addressed. The supervision and appraisal of staff is on target with minimal slippage. Young people are aware of the fire evacuation procedure and records show what additional support they need. However, this report makes additional recommendations to ensure that fire drills are as effective as possible. The service now has a written development plan in which the planned improvements to the service are described.

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection and the evaluation schedule for the inspection of children's homes.

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