Children's Home run by Anna House Limited in Havering

Unique reference number SC058603 Inspector Sharon Lewis Type of inspection Full Provision subtype Children's home

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Registered manager Margaret Akullo-Odiya Date of last inspection 15/01/2014 2 of 11 Inspection date 31/07/2014

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Previous inspection satisfactory progress Enforcement action since last inspection none

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Overall effectiveness adequate

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

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Overall effectiveness

Children continue to benefit from good outcomes and a quality service. There are, however, some shortfalls in safeguarding and in the leadership and management arrangements. These shortfalls do not have a direct detrimental impact on children, but it is the expectation that the home complies with regulations. The home provides children with a life enriching service, which focuses on their strengths and ability. Children are able to maximise their potential and they are progressing in all areas of their lives. Children benefit from focused care planning within a warm, homely, nurturing environment. They enjoy a wide range of activities, exploring their local areas and further afield. Children have the opportunity to practice their independent skills and make a valuable contribution to the home.

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Overall effectiveness

Children are comfortable within their surroundings; displaying a sense of peace, familiarity and happiness. They have strong attachments to staff and benefit from effective key work relationships. Their relatives and involved professionals are also very appreciative of the service. Leaders and managers model a commitment to meeting children's needs. Children also benefit from the positive partnership arrangements with external agencies. The home is currently being refurbished and it is recommended that this is promptly addressed; to provide a pleasant environment for children. Some relatives also highlight that staff would benefit from training in non-verbal communication, to further enhance the quality of interactions with 3 of 11 children.

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Overall effectiveness

There are satisfactory safeguarding arrangements, however, there are shortfalls in the recording, reporting and management of incidents. Staff promptly refer safeguarding matters to local authorities, however, they tentatively manage bullying behaviour. They do not always use or record sanctions to help children understand the consequence of their actions. Quality assurance practices do not meet regulatory requirements. The home has not appointed an independent person to undertake the Regulation 33 monthly monitoring visits. Regulation 34 reports do not include consultation with children, parents and placing authorities. Notifiable events are also not consistently reported to Ofsted. 4 of 11

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Information about this children’s home

This privately-operated children's home provides respite and longer term care for up to six children and young people with physical and learning disabilities.

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Inspection date Inspection type Inspection judgement

15/01/2014 Interim satisfactory progress 28/08/2013 Full good 11/03/2013 Interim good progress 23/08/2012 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) appoint an independent person to visit and report on children's home in accordance with Regulation 33( Regulation 33 (1)) 01/10/2014

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Reg. Requirement Due date

(2001) notify Ofsted of all events listed in Schedule 5, column 2 (Regulation 30) 01/09/2014

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control , restraint or discipline, that a written record is made in a book kept for this purpose. (Regulation 17B (3)) 01/09/2014

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Recommendations

5 of 11 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 environment and is well maintained (NMS 10.3)  provide training in non-verbal communication training to enhance staff members individual skills. (NMS 18.1) 6 of 11

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Outcomes for children and young people good

Children continue to benefit from good outcomes. Families describe children as being 'happy'; stating that they have 'completely changed' and 'smiles a lot more'. Children maximise their potential and are making encouraging progress. Professionals comment on their improved behaviour, social, negotiation and communication skills. Children have greater awareness of themselves, an example of this is controlling their moods. Children's moods are stable, which positively influences their emotional well- being Children have greater confidence and self self-esteem linked to their increased ability.

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Outcomes for children and young people good

Children engage in a wide range of fulfilling activities, which take account of their needs and interests. They have the opportunity to try new experiences and they benefit from individual and group activity programmes. Activities provide an opportunity for children's learning and personal growth. Children explore the local recreational facilities, visiting parks, adventure play centres, the cinema, bowling and going swimming. They enjoy browsing in shopping centres and eating out. They learn to appreciate animals through visiting farms and zoos. They also enjoy trips further afield to the seaside and other places of tourist attractions. Children also enjoy internal activities, they express their creativity in arts and crafts. They enjoy listening to music and playing with a variety of games and with general and sensory toys.

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Outcomes for children and young people good

Children maintain contact with their families, in accordance with their best interests. They receive protection as outlined by their placing authority, staff assist with supervised contract arrangements. Family, friends and other significant persons can pop into the home unannounced. They take advantage of the 'open door policy', whilst respecting the request not to visit early in the morning or late at night. Guests are offered refreshments and made to feel welcome. Children enjoy spending time with their relatives in the home or they can go out together, if they choose. Children also keep in contact by phone or email. Children enjoy socialising with their relatives and staff at the home's annual barbecue. They also have the opportunity to meet children and young people who previously used the service. Children benefit from the home's close working relationship with parents.

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Outcomes for children and young people good

Children learn a wide range of independent living skills which build on their self- worth. This includes attending to their personal care, shopping, money management, baking, making snacks, drinks bed making, laying and clearing the table, tidying their room, doing their laundry, watering the garden and other household skills. Children's participation in these tasks is dependent on their ability. Children influence decision making, through exercising their daily choices and participating in key work meetings. 7 of 11

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Quality of care good

Children continue to benefit from a personalised life- enriching service. Staff work significantly well with relatives, placing authorities, schools and a wide range of involved professionals. Relatives describe the home as 'brilliant', stating it 'has been a saviour for us'. They highlight that staff are 'very friendly and always keep me informed'. Social workers comment that they are 'very happy with the care' and the children placed are 'well cared for'.

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Quality of care good

Leaders and managers tenaciously endeavour to meet children's needs. This includes advocating for specific medication, purchasing specialist furniture and equipment. Leaders and managers pride themselves on their desire to 'go the extra mile' for children. Children have positive attachments with staff and the local community. The home has good links with local charities and churches. They give practical donations to the home and send cards to celebrate religious festivals.

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Quality of care good

Staff effectively manage a range of health needs, this includes including enteral feeding, diabetes and oxygen masks. They receive specialist training enabling them to be responsive to children's health conditions. Health professionals highlight that they are 'very impressed' with the care. They describe staff as being 'very attentive'. Staff escort children on health appointments and they have a good working relationship with health related staff. Staff respond to health concerns in a timely manner. The formulation of an emergency plan is a good example of the home proactively responding to possible hospital admissions. This plan contains pertinent information for medical staff, to enable them to swiftly address issues.

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Quality of care good

Children benefit from the comprehensive care planning system, which clearly highlights their needs. Plans include their personal care, feeding, socialisation, interests, behaviour, communication, health, disability, culture, religion and sexuality. Children have a pictorial care plan written in person- centredered language . This document concisely details their preferences in relation to their care, diet, communication and interests. Staff also benefit from the efficient guidance regarding children's health needs, an example being repositioning and manual handling. Plans are subject to regular reviews and records positively highlight each child's progress.

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Quality of care good

Children lead a healthy lifestyle, which includes a nutritious balanced diet and regular exercise. Relatives highlight their child 'prefers the food, here', as it is 'more spicy and international'. Staff cater effectively cater for individual preferences, allergies and religious traditions; this includes gluten free and halal diets. The home has a culturally diverse staff team who share their culinary skills with children; enabling them to appreciate dishes from around the world.

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Quality of care good

The home provides children with a clean, comfortable environment. The ground floor is suitably adapted for physical disabilities. The two rooms downstairs have specialist 8 of 11 beds, chairs and a portable hoist. The adapted bathroom has a shower chair and handrails. Children who have mobility needs are aided by the built-in ramps at the entrance and the rear garden pathway. Children have a sense of belonging as their photographs and art work are on display. The entrance area also has photographs of staff, which helps children identify staff members.

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Quality of care good

Children have their own rooms which are individually furnished and decorated to reflect their needs and interests. This includes providing an airy atmosphere and sensory equipment to stimulate their senses. Children spend the majority of the time relaxing in the lounge, which includes a dining area. Children enjoy watching television, listening to music or playing with the games or toys. In the warmer weather they enjoy being out in the garden, strolling around or jumping on the large outdoor trampoline.

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Quality of care good

The home is currently being refurbished, and children will benefit from new carpets and the redecoration. Areas within the home require further attention which the home is aware of. This includes scuffed skirting boards, sofas and flooring, nail varnish on bedroom furniture and curtains requiring rehanging. The latter two issues are located in a room which is currently unoccupied. Leaders and managers give their assurance that these matters are being addressed. This does not have a detrimental effect on the otherwise homely environment.

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Keeping children and young people safe adequate

There are satisfactory safeguarding arrangements, however, there are shortfalls in the recording, reporting and management of incidents. Staff refer safeguarding matters promptly to local authorities, however, they do not routinely report them to Ofsted. Staff tentatively manage bullying behaviour. This includes inconsistently using disciplinary measures and not recording a sanction when it was imposed. Children, however, do learn that the home will not tolerate unacceptable behaviour and that appropriate action will be taken. Professionals thank staff for their 'hard work' commenting that 'it has not been easy and I must say Anna House and its staff have been professional throughout'.

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Keeping children and young people safe adequate

The home provides a place of refuge for children who are placed there for short periods as part of child protection plans. Staff understand their duty of care and most decision-making promotes the welfare and best interests of children. This includes providing additional staffing during difficult periods. The home has good links with the Local Safeguarding Children Board. Staff are able to access relevant training; refresher safeguarding training is imminent. Training includes child protection and highlights the specific vulnerability of disabled children. The complaints procedure is widely available and children have a pictorial policy to guide them through the process. 9 of 11 The home provides an appropriately safe environment for children. There is sound risk management system covering all aspects of children's care, the environment and working practices. There is a sharp consideration of potential hazards and the action

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Keeping children and young people safe adequate

needed to promote a safe and secure establishment. Certificates confirm the regular checks of electrical, gas and fire safety equipment. Children participate in fire drills and benefit from personalised fire evacuation plans. There are sound staff recruitment procedures, which includes an interview, completing a written exercise and verifying references. New staff are suitable to work with children and they have relevant experience within the social care field. Children receive assistance to develop socially acceptable behaviour. The home produces balanced behaviour profiles, enabling staff to take a consistent approach to issues. Children respond well to the reward scheme which focuses on building on positive behaviours. Children enjoy receiving praise, encouragement and stickers. Professionals, staff and relatives report that children are making satisfactory progress with managing their moods, although, occasionally staff have to physically intervene

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Keeping children and young people safe adequate

and restrain children for their own or others safety. Children enjoy being at the home and they are no issues with them being missing from care.

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Leadership and management adequate

Children, relatives and professionals appreciate the service and comment that the staff are 'fantastic'. The home has not fully implemented all the changes in the new regulations. Regulation 33 reports are not being completed by an independent person. Notifiable incidents have not been reported to Ofsted, however, the home informed placing authorities. At the last inspection the home had one requirement. This related to Regulation 34 reports including consultation with the children, parents and placing authorities. A Regulation 34 report has been completed, however, it did not include the necessary consultation. These shortfalls do not have a direct detrimental impact on children, however, it is the expectation that the home complies with regulations. At the last inspection two recommendations were made to further improve practice. The home was asked to consider improving their risk assessment system and

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Leadership and management adequate

produce a service development plan. Both of these actions have been completed and as a result children are better protected and they all have sound risk assessments. Service development is appropriately addressed in the organisation's quality assurance report. Leaders and managers model a commitment to meeting children's needs. Children also benefit from the positive partnership arrangements with external agencies. The registered manager is also the owner of the home. They have an appropriate vocational management qualification and personal experience of caring for their own disabled child Their prior experience also includes being a member of several management committees for charities dedicated to the care of disabled children. They also hold a diploma in business studies which assists their strategic oversight. They have been the registered manager since June 2009. Staff state that the manager is 'really good' and really supportive'. Management have a sound

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Leadership and management adequate

10 of 11 understanding of the home's strengths and the areas requiring further development. Management arrangements are strengthened by the deputy position. The deputy manager has a suitable qualification in leadership and management. They have eight years experience of working with disabled children in residential settings. Children benefit from a caring, committed staff team. Staff have all worked within social care and their prior experiences include midwifery, nursery nursing and teaching. The staff team is gender balanced and culturally reflective of the children. The high staffing ratio enables children to have one to one attention, as needed. Staff have the necessary vocational training or are working towards achieving this qualification. Staff receive complementary training to meet children's holistic needs. Some relatives, however, would like staff to receive further training in non-verbal communication.

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Leadership and management adequate

The updated statement of purpose adequately highlights the changes in the regulations. Children have their own pictorial guide which provides a summary of the service. The home's ethos and practices positively promotes equality and diversity and children's rights. The individuality of each child is celebrated and valued. Staff securely store children's files and understand the importance of confidentiality. They also maintain satisfactory records which highlight children's experiences and progress. Website: www.ofsted.gov.uk

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Leadership and management adequate

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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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