Children's Home run by Barnardo’s in Oxfordshire

Unique reference number SC069128 Inspector Emeline Evans Type of inspection Full Provision subtype Children's home

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Registered person Barnardo's Registered person address Barnardos, Head Office Tanners Lane, Barkingside ILFORD Essex IG6 1QG Responsible individual Julie Carole Gibbard Registered manager Susan Winifred Morris Date of last inspection 12/12/2013 2 of 10 Inspection date 19/08/2014

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Previous inspection good progress Enforcement action since last inspection None

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Overall effectiveness good

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

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Information about this children’s home

The service caters for a maximum of seven children and young people at any one time, including one emergency bed. It provides a residential short break service and a domiciliary care service that is inspected by the Care Quality Commission (CQC).

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Information about this children’s home

The service is provided by a national charity in partnership with a local authority and a primary care trust. Children and young people can therefore be provided with care and health packages. Most of the children and young people using the service have complex health needs, or are on the autistic spectrum and have associated challenging behaviour.

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Inspection date Inspection type Inspection judgement

12/12/2013 Interim good progress 17/04/2013 Full good 09/01/2013 Interim satisfactory progress 23/04/2012 Full good

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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) ensure if any of the events listed in column one of the table in Schedule five takes place, the registered person shall without delay notify the persons indicated in respect of the event in column two of the table. (Regulation 30 (1)) 22/09/2014 4 of 10

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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

 produce a written policy that sets out how electronic listening devices should be used, how they promote the welfare of children, how children will be informed of their use, how the legitimate privacy of children will be protected and how children will be protected from the potential abuse of such measures (NMS 10.5)  ensure that the children's home has a clear statement of purpose which is available to and understood by staff and children and reflected in any policies, procedures and guidance. In particular ensure that staffing details are up to date and accurate (NMS 13.1)  ensure visits to the home carried out under Regulation 33 include checks of the use of restraint and reports following the visit are sent directly to Ofsted (NMS 21.7)  update the organisation's safeguarding policy and procedure to include information about child sexual exploitation, and also forward a copy of the updated policy to the local authority designated officer (LADO) for

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Recommendations

approval. (Statutory guidance, vol 5, para 2.67) 5 of 10

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Outcomes for children and young people good

Young people progress well in many aspects of their lives as a result of accessing the service. Individualised support enables them to have improved confidence to spend time away from their families. Staff are skilled at understanding and interpreting the very individual and complex needs of the young people. This enables them to develop and progress in many areas.

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Outcomes for children and young people good

Young people have individualised admission arrangements. They have a tailor-made transition, which includes visiting the service to meet staff and joining in with activities before building up to an overnight stay; this helps to develop their confidence and trust in the staff. This thorough transition means that they are prepared emotionally and practically to embark on their planned short break care package. The service demonstrates a needs-led approach to accommodating young people and it strives to match them to appropriate peer groups, to promote friendships and appropriate shared activities. The home have recently had some emergency admissions. The management team are in discussion with the commissioners about the admissions process and procedures to ensure that emergency admissions do not have a negative impact on the service being provided to other families.

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Outcomes for children and young people good

The home communicates well with educational settings. This ensures young people’s educational needs are fully supported. This is further enhanced by staff meeting regularly with local schools and attending educational reviews as appropriate. This proactive approach to educational achievement ensures young people are provided with support and guidance to reach their individual goals.

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Outcomes for children and young people good

Young people receive good support to lead a healthy and active lifestyle. They are able to access the services which they need through the close relationships which the staff team has with local health services and health advisors. Trained nurses work alongside care staff to ensure health needs are monitored. Young people’s health care needs are clearly and accurately detailed in care plans which provide staff with guidance to follow to ensure individual health needs are met. The service closely monitors young people’s health during their stays and responds promptly to any emerging health concerns.

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Outcomes for children and young people good

Young people’s individual preferences and dietary requirements are catered for in addition to the daily menu which offers balanced options at meal times. Mealtimes are relaxed and social occasions where young people are offered support in a discrete and sensitive manner whilst ensuring that independence, choice and experimentation with new food is promoted.

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Outcomes for children and young people good

Care planning recognises the individual and diverse needs of the young people who 6 of 10 access the service. Staff are innovative in developing and creating opportunities in which young people with more complex needs can be involved. This practice enhances their self-esteem and enables them to develop new skills. Young people benefit from these periods away from home; they develop new social skills and are supported to make decisions in order to maximise their independence.

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Quality of care outstanding

The quality of care received by young people at the home is outstanding. This is mainly due to the excellent relationships that exist between young people and the staff team. Staff demonstrate exceptional understanding of the needs of all the young people, which was echoed by parents and social workers alike. Social workers spoken to were extremely complimentary about the relationships staff have developed with families and how proactive staff are in working together in the interests of the child. Young people receive excellent support to enable them to maximise their potential and make progress in many areas of their lives. Observations were indicative of the trusting and fulfilling relationships between the young people and staff. A parent described the staff as, 'lovely and caring.'

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Quality of care outstanding

Ascertaining the views of the young people is central to the way in which the staff team work. Young people's views are gained on all areas of their care during their stay at the unit. Staff are particularly aware of the need to ensure that young people have a say about who supports them with their intimate care needs. This ensures that they are confident and relaxed when at the unit and their dignity is given high regard. Staff are extremely tuned in to young people's emotional well-being. Although a young person may not make a formal complaint, if they appeared unhappy staff immediately advocate on their behalf. Parents were complimentary about the staff team and the regular open communication that exists to ensure that young people's welfare is given the highest priority.

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Quality of care outstanding

Young people engage in all sorts of activities in the community and are encouraged to learn and try new experiences when visiting the home. Staff ensure young people make use of age-appropriate local amenities such as parks, swimming pools, walks and the cinema. This helps children to develop an understanding of the community environment and become confident in social situations. There is a real emphasis within the service on ensuring that young people have fun during their stay at the home.

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Quality of care outstanding

Individualised and person-centred planning is key to the high quality care young people receive. Excellent care plans detail all areas of care and the support staff will provide. Care plans are completed in a very comprehensive format that is easily read and fully informs staff practice. Staff are extremely proactive in gaining the views of all the professionals who are working with each young person. This effective working partnership enables staff to incorporate key information and strategies when planning young people's care. Staff handover meetings are comprehensive and are 7 of 10 used to communicate all relevant information. These have been adapted to ensure care plans are used fluidly across shifts; this has created consistency of care.

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Quality of care outstanding

Young people's life skills and opportunities are increased through attending this short break service. The physical environment is well maintained, bright, colourful and child friendly. Specialist adaptations are in place for young people requiring extra support. Permanent murals are present in the unit and a range of sensory experiences that encourage both visual and tactile sensory stimulation.

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Keeping children and young people safe good

Parents and social workers say that their children’s safety is given a high priority within the home. Staff receive regular training on safeguarding and they recognise the particular vulnerabilities relating to the needs of children and young people with disabilities. One parent commented ‘My son feels safe at the home and is always happy to go.’

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Keeping children and young people safe good

Young people are closely supported by the staff team, who recognise their diverse needs and take steps to address them. Staff are sensitive to young people’s need for privacy and dignity. Care planning documentation identifies risks and preventative measures. These are consistently implemented and keep young people safe.

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Keeping children and young people safe good

Staff receive regular training in safeguarding and recognise the particular vulnerabilities relating to the needs of children with disabilities. Young people feel safe and well cared for. They have very good relationships with staff who understand and recognise changes in behaviours. This knowledge enables staff to identify and act upon instances when a young person is worried or upset. The current safeguarding policy does not make reference to child sexual exploitation or the procedures to be followed in this instance. This does not enable staff to have clear guidelines on the correct procedures to follow if they had concerns. There is no evidence that the policy has been submitted to the local authority designated officer for approval and advice.

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Keeping children and young people safe good

There are no concerns regarding young people going missing from care. The risk of young people going missing is minimised by the high level of staff supervision. Staff spoken to are aware of the procedures to follow in the event of young people going missing. Young people enjoy positive and warm relationships and interact well with staff. The service promotes strong behaviour management strategies with a positive culture of managing behaviour. De-escalation and diversionary tactics are employed, sanctions are rarely used and praise and encouragement is evident. The service closely monitors the use of measures of control and discipline, and this scrutiny ensures that trends and patterns are monitored and behaviour plans are adjusted accordingly. Instances of physical intervention are recorded in a bound volume in line with regulatory requirements. 8 of 10 The service has a robust recruitment process in place, which ensures all the

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Keeping children and young people safe good

necessary checks are carried out before a member of staff starts work. This protects young people from having contact with unsuitable people.

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Keeping children and young people safe good

The home uses listening monitors in the bedrooms; the use of the listening monitors is for the purpose of safeguarding certain young people. However, there is not an up to date policy in place to guide staff on the appropriate use and management of such devises and how they promote the welfare of young people. There is also no clear policy or procedures to ensure young people are protected from the abuse of such measures. However, staff spoken to were clear on how to ensure young people’s privacy is protected in practice.

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Keeping children and young people safe good

The home is appropriately secure and takes into consideration the needs of the young people. Detailed fire risk assessments, equipment safety checks and regular health and safety audits are undertaken to promote safety and well-being.

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Leadership and management good

There is a strong management team effectively led by the Registered Manager. The Registered Manager has been in post in the children’s home since May 2011 and has completed a level 5 qualification in Leadership for Health and Social Care and Children and Young People’s Services. She is also a registered learning disability nurse. She has the necessary experience to provide strong and effective leadership. The manager has an active role within the home both working with the young people and working in partnership with other agencies. The whole team communicate a sense of striving for improvement. There is a development plan in place; this is comprehensive, with a clear focus on providing a high quality service to young people and their families.

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Leadership and management good

Staff are well motivated to improve outcomes for young people who use the service. They feel supported by the Registered Manager and senior staff and benefit from daily handovers and the opportunity to attend regular team meetings and team days. Annual appraisals are carried out in order to review staff’s performance and formal supervisions and informal support are frequent. The service provides a detailed induction programme about the service and how to support the young people. Mandatory training is delivered and is regularly updated. Staff report that health intervention training is good and equips them well with the skills to support children with complex health needs.

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Leadership and management good

The home is sufficiently staffed and resourced to enable it to meet the needs of the young people currently accessing the service. Planning of shifts is carefully considered to ensure young people’s individual needs are met. Agency staff have not been used; this ensures continuity of care for young people.

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Leadership and management good

The Statement of Purpose is comprehensive, setting out the home's objectives. There 9 of 10 is a clear focus on working in partnership with young people, parents and outside professionals to achieve a consistent approach to meeting the needs of young people. However, there is limited information in relation to the numbers of staff and their experience. This does not enable parents and placing authorities to be fully informed about the service being offered. Ofsted, in its role as regulator, was not informed of a recent notifiable incident by the home. Although the home did take appropriate action in this instance, the lack of notification prevents the transparency necessary to ensure that young people are not only safe but seen to be safe.

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Leadership and management good

The service is monitored and is subject to regular internal auditing by the manager and external scrutiny by other professionals. Any areas requiring attention are highlighted in reports and are addressed appropriately. However, within Regulation 33 reports physical intervention records have not been accurately reported on in every instance. There is no evidence in the last report that the physical intervention that had been used was fully scrutinised. In addition, the Regulation 33 reports are not being sent directly to Ofsted by the independent visitor. This does not ensure independence. The service is pro-active in seeking out the views of young people and their families about all aspects of the service. All concerns and complaints are taken seriously. There have not been any since the last inspection.

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Leadership and management good

Young people’s files are stored securely and contain documents which are relevant and contribute to an understanding of the young people’s life. At the last interim inspection in December 2013 no requirements or recommendations were made. 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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