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

Unique reference number SC365366 Inspector Carole Moore Type of inspection Full Provision subtype Children's home

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Registered person N H Care Limited Registered person address 3 Shetland Close BIRMINGHAM B16 0RF

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Responsible individual Rikesh Asthana Registered manager Carrie-Ann Selwood Date of last inspection 18/09/2013 2 of 10 Inspection date 02/05/2014

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Previous inspection adequate Enforcement action since last inspection none

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Overall effectiveness good

Outcomes for children and young people good Quality of care good Keeping children and young people safe good Leadership and management good

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Overall effectiveness

Young people receive good standards of personalised care in this home. Staff place the young person's well-being at the centre of their practice and are able to demonstrate a good understanding of the individual needs of the young people. A key strength of this home is the effective communication and consultation with the young people, who have limited verbal communication. Young people are very involved in using a variety of communication tools. Young people's individual needs are well met, and young people achieve good positive outcomes.

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Overall effectiveness

The home provides a comfortable environment for young people with appropriate space for communal living. Young people demonstrate by their trusting and relaxed behaviour in the home that they feel safe. Staff underpin this by good quality risk assessments and by their detailed understanding of each young person's moods.

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Overall effectiveness

There is a new manager in post and the registration process is almost completed. She has a clear vision for the development of the home. She is aware of the strengths and shortfalls of the service and has implemented a variety of new procedures to ensure best practice and further progress.

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Overall effectiveness

Five recommendations have been made as a result of this inspection. However, these shortfalls have had no impact on the overall good quality of care that young 3 of 10 people receive from the staff team and manager. 4 of 10

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Information about this children’s home

The home provides accommodation for up to three young people who have autism and is run by a private provider. One young person attends for school holidays only.

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Inspection date Inspection type Inspection judgement

18/09/2013 Full adequate 19/03/2013 Interim inadequate progress 25/09/2012 Full good 29/02/2012 Interim good progress

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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 the home provides a comfortable and homely environment and is well maintained and decorated (NMS 10.3)  ensure the learning and development programme is evaluated for effectivenes at least annually (NMS 18.2)  ensure that sanctions and rewards for behaviour are clear, reasonable and fai and that they are recorded as such (NMS 3.8)  ensure during the monitoring process that all records kept by the home are checked for compliance with the home's policies. Also specifically identify any patterns and trends and to evaluate these (NMS 21.2)  ensure the registered person has a written development plan, reviewed annua for the future of the home, in respect of it being a working document. (NMS 15.2) 5 of 10

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Outcomes for children and young people good

Young people make good progress throughout their time at the home. This is based on the attachments that they are able to make with a motivated and caring staff team that support them. As far as practically possible young people receive guidance to help them understand their circumstances and background. A social worker stated that staff have focussed on areas that are important to their young person such as lowering anxieties and this has really helped with their overall development and settling in to the placement.

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Outcomes for children and young people good

Young people's health improves through well organised and consistent approaches to some very complex health needs. Medication has been reduced for some young people and regular reviews are held with professionals to ensure that the most appropriate medication is administered. Also young people's diets have greatly improved with the support from staff.

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Outcomes for children and young people good

Young people respond positively to education provision and benefit from the good support that is offered. The close links between the tutor, school and the home allow for a consistency of expectations and high awareness of the young people’s needs. Achievements in meeting individual targets is well celebrated.

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Outcomes for children and young people good

Young people enjoy well supported contact with their families and carers where appropriate. Staff facilitate all the contact arrangements and families and carers are welcome to visit at any time.

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Outcomes for children and young people good

Staff encourage young people to enjoy their leisure time. Activities are highly individualised and good use is made of community resources to allow young people to have as many experiences as possible. Young people's activity plans are age appropriate and responsive to their likes and dislikes such as attending church, swimming, eating out and trips on public transport to their favourite shop. Within the home environment young people systematically develop their confidence by having access to stimulating resources and opportunities to share their leisure time with staff.

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Outcomes for children and young people good

Young people develop their independence skills at a pace that is manageable and realistic to them personally. A member of staff said, ‘Young people are encouraged to help with the cooking and clearing away after meals.' This means young people develop life skills despite the difficulties they face. As a result, young people develop a sense of achievement and pride.

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Quality of care good

6 of 10 The quality of care provided at the home is good. This is achieved through a committed staff team who have a thorough awareness of the differing needs of the young people and how to respond to their complex needs. Placement plans are informative and contain clear information for any new staff. A high level of detail is included within these plans and they clearly show a wide range of information about how the young person would like to be cared for. Placement plans link up to other plans, such as education and health plans, to ensure a continuity of care is achieved across the provision. Plans are updated on a regular basis to ensure that the correct information is in place. There are defined targets set and these are measured using a new progress monitoring tool to ensure outcomes for young people continue to improve. For example one social worker said, 'I am really pleased with the tremendous improvement made. He is a much happier young man.' As a result,

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Quality of care good

young people receive a comprehensive and integrated approach to meeting their assessed needs.

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Quality of care good

Staff use a variety of diversionary techniques for young people regarding their behaviours and innovative ways of affecting change in communication and in improving independent skills. Positive behaviour management is used and rewards given. However, there is no clear record of rewards as well as consequences.

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Quality of care good

A real strength of this service is the way the home captures the wishes and feelings of the young people and how they are included in all decisions made. Every effort is made to communicate with the young people in their preferred method of communication to ensure their daily living plans are really understood. Young people are also assisted in voicing any areas of unhappiness.

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Quality of care good

Young people's health care is central to the home. Young people receive effective support to access the health services they need in line with their differing range of needs and the complexities of their conditions. Suitable arrangements are made for their basic healthcare. For example, medicals, dental treatment and routine health visits, as well as more specialised services such as dietary advice and medication. All staff have had medication training to ensure safe practice in this area.

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Quality of care good

Staff fully support young people through providing a continuity of care that covers education. Care staff are involved in supporting young people's education and this is both within the home and in mainstream school. All necessary education meetings are completed to make the most of the educational provision and allow young people to develop as much as possible.

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Quality of care good

The home is reasonably well maintained and decorated. There are some areas which look slightly tired and this is to be addressed. Young people are able to personalise their bedrooms with the support from staff if this is appropriate for them. The home is suitably located and benefits from easy access to community resources and facilities. This further supports young people’s social and emotional development. 7 of 10

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Keeping children and young people safe good

Young people are protected by robust and effectively implemented safeguarding arrangements. Their well-being is promoted at all times because safeguarding is at the heart of the service. Through surveys, social workers have expressed they are confident that the service keeps their young people safe.

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Keeping children and young people safe good

All staff are aware of their own roles and responsibilities, and those of other agencies involved in keeping young people safe. The manager and staff are proactive in establishing effective links and working partnerships with the police and the local safeguarding children's team. This liaison results in safeguarding concerns being robustly investigated and addressed. All staff are up to date with their safeguarding training.

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Keeping children and young people safe good

No young people have gone missing from the home but should this ever occur the home has excellent systems in place to protect young people. The home follows the local authority’s policy on young people missing from care and implements this in accordance with a young person’s risk assessment and placement plan.

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Keeping children and young people safe good

The staff team are calm, skilled and confident in defusing any potentially difficult and challenging situations swiftly and without issue. They are aware of the known triggers and the primary intervention to follow. Staff receive regular training and updates regarding behaviour management. All staff have a good understanding of individual plans relating specifically to differing behaviours and the strategies in place for responding to these. Young people experience high quality nurturing, warm and positive relationships with staff. This in turn creates effective routines and boundaries and these are well established. Restraint is used as a last resort. However, in the event of a restraint taking place appropriate records are maintained.

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Keeping children and young people safe good

The environment is physically safe. Daily checks of systems and equipment as well as risk assessments contribute to the safety of the premises. A high profile is given to fire safety and each young person has a personal evacuation plan to make sure all young people know how to respond in the event of an emergency in order to keep them safe. Fire training for all staff including night staff is all up to date. The Fire Service have also visited to check the premises and no recommendations were made.

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Keeping children and young people safe good

Young people are protected by robust recruitment processes. Visitors are checked, vetted and monitored. Good staffing levels further help to keep young people safe and reduce any risk of harm. The organisation’s effective recruitment procedures ensure the careful selection, recruitment and retention of staff. New staff are comprehensively vetted prior to their deployment in the home and before having unsupervised access to any young person. This ensures young people are safe and have a staff team who know them well. 8 of 10

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Leadership and management good

The manager is currently undergoing registration and is also undertaking the Level 5 Diploma. She provides effective leadership and has a clear vision and plan for improving the home. The manager has satisfactorily addressed the recommendation from the previous inspection, which has resulted in better safeguarding practice in relation to fire safety. She has also put in place a suitable location assessment.

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Leadership and management good

Appropriate monitoring arrangements are in place. There is a new independent Regulation 33 visitor who is experienced and well prepared to challenge. The home have ensured the Local Authority have given their consent for their case files to be inspected during these visits. The manager also undertakes her own regular monitoring and there is clear evidence that she challenges staff practice when required. The Regulation 34 reports are sent into Ofsted at the required intervals. However there is insufficient reflection on identifying patterns and trends and evaluating these within the reports.

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Leadership and management good

The staff team is well-balanced in terms of age, gender and life experience which provides young people with a richness of experiences and relationships. New staff are familiarised with their role and develop the required skills and competencies through a good induction training programme Staff confirmed they felt well equipped to do the job. Most staff are well experienced and suitably qualified. This ensures the delivery of good, safe care.

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Leadership and management good

The registered person has systems in place to notify the appropriate authorities of all significant events relating to the protection of looked after young people and confirming that appropriate action follows any incident.

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Leadership and management good

Competent and knowledgeable staff are committed to promoting good outcomes for young people in their care. The staff are managed in a way that encourages regular reflection of their work, which in turn helps identify ways of improving the service. The staff attend regular staff meetings and receive one-to-one supervision and appraisals. There is a positive commitment to professional development, with staff regularly updating their core training to refresh their knowledge and understanding. This ensures they possess the competences and skills to meet young people’s diverse needs. However the learning and development programme is not currently evaluated for its effectiveness on an annual basis.

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Leadership and management good

The statement of purpose is clear, concise and detailed and the home meets the aims and objectives set out in it. Young people, placing social workers and the staff team have an accurate knowledge of the stated aims and objectives. The manager consistently and actively monitors the quality of care provided by the home and has a strong and accurate knowledge of the home’s strengths and weaknesses. The manager has plans for the development of the home so that it continues to provide high quality care for young people. However the development plan is not a working document as such and would benefit from clearer aims and objectives and indicate 9 of 10 when these have been achieved. Website: www.ofsted.gov.uk

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Leadership and management good

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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