Children's Home run by Barnardo’s in Oxfordshire

Unique reference number SC013144 Inspector Stella Henderson 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 Ruth Madeleine Clacy Date of last inspection 06/02/2014 2 of 9 Inspection date 01/10/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness outstanding

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

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Overall effectiveness

The quality of care given to children and young people in this short-break service is excellent. There is strong partnership working with parents who confirm that their children are safe here. Staff work closely with young people's families and professionals to promote a consistent approach to meeting young people's complex needs. As a result, young people are assisted to overcome the challenges they face in their lives and the impact of their complex needs is minimised.

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Overall effectiveness

Highly effective leadership is at the heart of the service's success. The registered manager places a strong emphasis on adding value to children and young people's lives by providing high quality care, delivered by very competent staff. This is achieved through continuous and sustained improvement and development.

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Overall effectiveness

One minor shortfall is identified in relation to capturing the views of children and young people, their parents and stakeholders in monitoring reports. A recommendation is also raised to improve the timeliness in undertaking staff supervision. These have no direct impact on the safety or welfare of children and young people. 3 of 9

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Information about this children’s home

This residential short-break service caters for up to six children or young people at any one time. 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. The home is also registered with the Care Quality Commission.

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Inspection date Inspection type Inspection judgement

06/02/2014 Interim good progress 19/09/2013 Full outstanding 12/02/2013 Interim good progress 15/10/2012 Full good

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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 that the wishes, feelings and views of children and those significant to them are taken into account in monitoring staff and in developing the home (NMS 1.7)  ensure staff have access to support and advice, and are provided with regular supervision by appropriately qualified and experienced staff. This is with specific reference to complying with the home's supervision policy. (NMS 19.4) 4 of 9

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Outcomes for children and young people outstanding

Outcomes for children and young people are excellent. This is because they are seen as 'children first', defined by their unique personalities and character rather than by their complex needs. One young person expressed this by indicating 'I like to be dressed like a teenager'.

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Outcomes for children and young people outstanding

Children and young people really enjoy coming to the resource centre and give it the 'thumbs up'. It is a fun place for them to be and their lives are enriched in many ways. There is a strong emphasis on taking children and young people's preferences into account in all aspects of their care.

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Outcomes for children and young people outstanding

For example, they have a choice about how they spend their time at the centre. There are plenty of things to do for those who like to get out and about. There are visits to local and national attractions, museums, wild life sanctuaries and shopping expeditions.

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Outcomes for children and young people outstanding

Quieter activities are on offer such as pottering in the garden, sitting in the hot tub, having foot massages and spending time in the sensory room. Play still features large for a number of children and young people, some of whom like throwing and catching games. Others enjoy pillow fighting and general 'larking around'. Older teenagers sometimes prefer just to sit and look at books or do nothing much at all if they so wish.

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Outcomes for children and young people outstanding

Parents retain primary responsibility for their children's health and education. The home supports good outcomes in these areas by helping children and young people continue with the daily routine of their lives. Regular school attendance and high standards of personal care are therefore maintained.

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Outcomes for children and young people outstanding

Objectives are set however to further improve individual experiences and well-being. Children and young people make excellent progress in reaching these personal milestones. This is often measured in small changes, such as sampling new foods, trying new activities or managing personal care tasks. For children and young people with highly complex needs this represents significant achievement.

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Outcomes for children and young people outstanding

The emotional health of children and young people is extremely well promoted. Staff recognise that children and young people can feel sad, become depressed and suffer anxiety, just like anyone else. In this staff are highly attuned to individual behaviours. They are skilled at identifying the minute differences which may indicate a change of mood in a child, or the conveying of an emotion, through facial expressions, body language or tone in vocal expressions. Prompt referrals are made if required to services such as the Child and Adolescent Mental Health Services (CAMHS) which helps young people get the specialist help they need. 5 of 9 Young people are supported to be as independent as possible, particularly where personal care is concerned. As a result some are able to accomplish simple practical tasks which will help cope with adult life. When young people are moving on to the care of adult services, this special occasion is marked with a celebration. A parent

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Outcomes for children and young people outstanding

commented on the 'excellent work' in preparing their child for transition to adult services.

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Quality of care outstanding

Children and young people enjoy rewarding and fulfilling experiences during their short breaks. This is because their needs are accurately assessed and there is very careful matching. Peer relationships are taken into account as well as the ability of staff to meet the mixture of very high and complex levels of need.

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Quality of care outstanding

Introducing children and young people to the resource is sensitively managed. A professional commented on the quality of the planning which is 'undertaken at the child's pace' and the 'excellent skills in engaging parents.' Parents confirm they are fully involved as partners in the provision of care for their children.

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Quality of care outstanding

Strong partnership working with parents also enables staff to gain an in-depth understanding of each child. This helps to provide a 'bespoke' package of care for each individual which recognises and celebrates their diversity. A parent commented that going for short breaks was for their child, 'a very positive experience because staff know my child's needs very well.'

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Quality of care outstanding

One of the key strengths of the home is the seamless service provided for children and young people, who often do not cope well with even small changes to their routine. Transitions between home and the resource centre, and the resource centre and school, are managed exceptionally well. This ensures young people experience continuity of care.

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Quality of care outstanding

Operating in partnership with a local authority and a primary health care trust, integrated working with other professionals is securely established. Highly individualised care plans are regularly reviewed with social care, education and health colleagues. One professional described the service as being 'extremely responsive' to children with complex needs. Qualified nurses work within the home which means children and young people can get the specialist medical attention if they need as part of their care package.

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Quality of care outstanding

The home is appropriately designed and suitable for children and young people who need a lot of space to move around in. There is ample room for group activities and privacy and solitude if young people want this, and a huge garden full of play equipment. Parents describe the resource centre as providing 'a relaxed atmosphere' and a 'home from home' environment. 6 of 9

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Keeping children and young people safe outstanding

Safeguarding practice is excellent. Parents say they are confident their children are safe at the home and professionals concur with this view. Staff are alert to the increased levels of vulnerability associated with children and young people who have complex needs. In response to this heightened risk a number of highly effective safeguarding measures are in place.

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Keeping children and young people safe outstanding

For instance, there is keen vigilance of the behaviour and demeanour of children and young people. This same vigilance is applied to staff practice; where people are in the building and what they are doing with children and young people. Staff encourage children and young people to manage as much of their personal care as they can. When this is not possible, staff provide personal care in a way that affords children and young people privacy and dignity.

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Keeping children and young people safe outstanding

Staff are suitably trained and take a proactive approach to any safeguarding concerns, working closely with relevant agencies. Children and young people's behaviour sometimes poses problems for others as they learn about acceptable behaviour. This is managed well and in a way that sets clear boundaries for young people that they can understand.

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Keeping children and young people safe outstanding

Children and young people are protected because all specialist equipment is regularly serviced to ensure it remains in excellent working order. A host of personal and environmental risk assessments are in place and regularly reviewed. Each child and young person has a personal fire evacuation plan. There is robust practice too in relation to the administration and audit of medication.

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Keeping children and young people safe outstanding

Safe recruitment guidelines are implemented which means that children and young people are protected from those who are unsuitable to work with vulnerable individuals. The independent visitor makes it her business to see and speak to children and young people and there is constant and visible management presence. These measures provide a valuable additional element of safeguarding for children and young people.

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Leadership and management outstanding

The resource centre is managed by a highly skilled and experienced manager who was registered with Ofsted in 2010. She has a degree in social work and a recognised management qualification and actively maintains her professional development.

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Leadership and management outstanding

The manager provides exceptional leadership to the staff team, and is a recognised source of expertise within the wider organisation. She maintains a visible and active presence within the resource centre and is a strong advocate for children and young 7 of 9 people.

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Leadership and management outstanding

The manager ensures that the centre is very well resourced, in terms of staffing levels, property and equipment. The manager's development plan includes further investment in these areas all of which is to the advantage of children and young people. The centre has a high profile within the local community and benefits from donations both from individuals and national organisations.

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Leadership and management outstanding

The deputy manager and staff team play a significant role in creating a positive atmosphere within the centre. Their hard work ensures children and young people have a great time at the home every time they visit. Behind the scenes is a team of highly skilled administrative staff. In consultation with care staff, they deal efficiently with the often dynamic and complicated task of booking in the short breaks, responding to cancellations and making sure there are no unfilled beds.

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Leadership and management outstanding

This ensures the service works to full capacity at all times which benefits children and young people and their families. Together with highly effective partnership working with family and other professionals, all of this amounts to a very strong 'team around the child'.

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Leadership and management outstanding

The service is highly regarded by parents and professionals. A professional commented on the willingness of staff 'to go the extra mile in sometimes very difficult circumstances'. One parent described staff at the home as 'absolutely amazing; I can't praise them enough. Communication is excellent, staff are very approachable and any issues easily dealt with'. Another parent commented that staff, 'had gone out of their way to help me'.

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Leadership and management outstanding

Independent scrutiny of the home's performance is robust. It holds the manager to account and helps to improve the quality of care that children and young people receive. The independent visitor spends a lot of time observing children and young people and their interactions with staff. This report could be enhanced by including the views of parents more often.

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Leadership and management outstanding

Similarly the manager's own rigorous monitoring procedures ensure that high standards in the quality of care are maintained and the service runs efficiently and effectively. However these reports too would benefit by reflecting more of the ample consultation that is undertaken with children and young people, their parents and social workers. These changes would help to demonstrate better how the views of those using the service were being taken into account.

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Leadership and management outstanding

Staff turnover is very low which is beneficial for children and young people who respond well to stability and predictability. The staff team are dedicated and demonstrate energy, enthusiasm and creativity in improving children's lives. Staff confirm they are afforded effective training, support and supervision which enables young people's needs to be successfully met. 8 of 9 Supervision does not always take place within the timescales recommended within the organisation's own policy. This has no impact on children and young people as there is frequent informal discussion between management and staff. However it may mean that practice issues are not addressed in a timely way.

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Leadership and management outstanding

The home's Statement of Purpose has recently been updated in line with changes to regulation. This information is supplemented by the children's 'welcome guide' which is available in pictorial format. This helps to inform those who use the resource about the standards of care and service they can expect. Website: www.ofsted.gov.uk

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Leadership and management outstanding

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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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