Children's Home run by Bristol City Council in Bristol

Unique reference number SC031504 Inspector Janice Hawtin Type of inspection Full Provision subtype Children's home

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Registered person Bristol City Council Registered person address Bristol City Council, Director of Legal Services City Hall, College Green BRISTOL BS1 5TR Responsible individual Karen Mary Gazzard Registered manager Valerie Mower / Claire Marie Windeatt Date of last inspection 03/03/2014 2 of 12 Inspection date 21/11/2014

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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 adequate Quality of care adequate Keeping children and young people safe adequate Leadership and management inadequate

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Overall effectiveness

Children and young people receive a sound quality of care which is provided by experienced and qualified managers and staff. Particular vulnerabilities, relating to disability are identified and understood by staff, and this is reflected in detailed care plans. Feedback from parents about the staff team is very positive, one commented ‘we can’t fault the staff, communication is good, and they are loving, and caring.’

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Overall effectiveness

Managers and senior staff understand some of the weakness of the home and have a development plan in place. Consultation with young people, their parents and/or carers takes place and this has some impact on developing the home. New resources provided as a result include a ball pit and computer room.

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Overall effectiveness

Leadership and management arrangements are inadequate. The Statement of Purpose doesn’t accurately describe the home, and lacks detail of how it will provide for those children and young people who live in the home alongside providing short breaks for others.

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Overall effectiveness

Monitoring by the Registered Managers and monthly monitoring by a person independent of the home has failed to identify and therefore address several recording shortfalls. Amongst these issues, records of physical restraint are insufficient, the register of children and young people using the home is unclear, and 3 of 12 records of staff supervisions do not demonstrate suitable support for staff or evaluation of their work practice.

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Overall effectiveness

While lounges and communal areas of the home provide some home comforts other areas need attention, refurbishment or repair. With two exceptions, most bedrooms are sparse, clinical, and lack any personalisation. Attention to these things is particularly important for young people who live in the home on a full time basis.

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Overall effectiveness

Quite a lot of anxiety was expressed by parents and some staff about the plans to half the number of children and young people who are able to use this facility, by closing five of the beds available. They are keen to get some answers about future plans. Some are unclear whether they will get a service and/or whether it will include opportunities for their children to socialise with other children. 4 of 12

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Information about this children’s home

The home is managed by Bristol City Council. It provides care and accommodation for up to 10 children and young people, aged from five to 17 years at any one time, who have a learning disability and who may also have a physical disability. The home also provides an overnight short breaks service.

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Inspection date Inspection type Inspection judgement

03/03/2014 Interim satisfactory progress 25/11/2013 Full good 21/01/2013 Interim good progress 14/08/2012 Full adequate

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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

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children's home, a written record is made in a volume kept for that purpose of which shall include information listed as items 3 (a)-(i) and 4 (a) and (b) of this regulation (Regulation 17B (3)and (4)) 31/12/2014

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Reg. Requirement Due date

17A (2001) ensure that any measure of restraint used on a child accommodated in the home is only for the purpose of preventing injury to any person (including the child who is being restrained) or preventing serious damage to the property of any 31/12/2014 5 of 12 person (including the child who is being restrained) (Regulation 17A(1)(a)&(b)) 4 (2001) compile a statement of purpose which consists of a statement as to the matters listed in Schedule 1 and provide a copy to Ofsted (Regulation 4 (1)&(2)(a)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure the independent person carrying out visits routinely interviews or observes children, interviews their parents or relatives to form an opinion as to whether children are effectively safeguarded and the home promotes the well-being of children (Regulation 33(8)(a)(i)&(ii)) 31/12/2014

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Reg. Requirement Due date

(2001) establish and maintain a system for improving the quality of care in the home and include detail of this system in the report provided to HMCI at least every 3 months (Regulation 34(1)(a)&(b)&(2)) 28/02/2015

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Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate supervision (Regulation 27(4)(a)) 31/12/2014

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Reg. Requirement Due date

(2001) maintain in the children's home the records specified in schedule 4. In particular produce a clear register detailing the date of admission to the home of children and the statutory provision under which they are accommodated (Regulation 29 (1)) 31/12/2014

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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

 provide a comfortable and homely environment in which risk reduction does not lead to an institutionalised feel (NMS 10.3)  ensure that physical restrictions on normal movement within the home are not used unless this is necessary to safeguard children and promote their welfare and development. Such restrictions for one child do not impose similar restrictions on other children (NMS 10.4)  regularly review incidents of challenging behaviour, examine trends or issues emerging for this, to enable staff to reflect and learn to inform future practice. This particularly applies to the use of sanctions and update of behaviour management plans (NMS 3.21)  ensure that staff rotas have time scheduled to ensure handovers are held for members of staff coming on duty and that they include the planning of spending time with individual children (NMS 17.6)  ensure there is a system in place to demonstrate that all children and staff

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Recommendations

are familiar with and have practice so that they know what to do in the 6 of 12 event of an emergency (MNS 10.9) 7 of 12

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Outcomes for children and young people adequate

Children and young people are encouraged to develop a positive self-view in this environment where staff are attentive to and understand their needs. Difference is valued and care is taken to provide an environment with resources to make staying in this home a positive and valuable experience. Good use is made of a relatively new ball pit and computer room. Work in partnership with parents informs staff of children and young people’s likes and dislikes contributing to their care being a positive experience.

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Outcomes for children and young people adequate

There are pictures of children and young people on the walls in the corridors of the home and a birthday board. This contributes to then feeling valued and encourages a sense of belonging.

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Outcomes for children and young people adequate

Children and young people benefit from attending full time education which supports their learning. Spending time in this home is the only opportunity some have to interact socially with peers outside a school environment. One parent commented ‘this is helping with their independence skills and allowing them to spend time away from us and feel safe’.

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Outcomes for children and young people adequate

Children and young people are involved in enjoyable activities in the home; they also make use of local facilities and are particularly fond of going swimming and of trips to the park. Parents report that children enjoy spending time in the home. One commented ‘ I show her an overnight bag and she can’t wait to go’. For the most part children and young people appear happy and content; they are helped to make choices regardless of their communication difficulties.

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Outcomes for children and young people adequate

All children and young people have some development targets included in their placement plan so that staff can focus on developing children to their full potential. Some progress for children and young people is evident, including developments in the use of communication skills and improvements in behaviour. Where possible they are involved in developing practical life skills and help with household task such as food preparation.

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Outcomes for children and young people adequate

Young people benefit from the attention given to preparing them to move on to adult services, and the opportunities to celebrate moving on.

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Quality of care adequate

8 of 12 Children and young people are able to make friends and interact with others in this home. For some their disability limits options to interact with other children and young people. Staff make sure they are involved as much as possible and informed about what is going on around them. A parent commented that their son ‘loves spending time in the home, he spends time with other young people and has some friends there, it’s safe and secure, we can’t fault it’.

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Quality of care adequate

There is a complaints policy in place and parents will advocate on behalf of children and young people if they are not able to make a complaint in their own right. Parents are offered consultation opportunities through annual feedback forms and through attendance at children and young people’s meetings. There is also a communications book which is used to pass information between the short breaks service, the child’s home and the school. Parents consulted as part of this inspection felt communication from staff, and their ability and willingness to deal with any concerns or issues is strength of the home.

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Quality of care adequate

Information kept on the child’s file including detail of theirs specific needs, likes and dislikes, this is recorded well and contributes to meeting their needs, and to the quality of care provided. Placing authority plans and information are available on the local authorities electronic recording system which can be accessed in the home.

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Quality of care adequate

Children and young people’s attendance at school is good. Staff organise and arrange transport to and from school for young people and make sure they are ready and have the necessary equipment needed.

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Quality of care adequate

Arrangements for dealing with medication are safe and effective, two staff are always involved in dealing with any medication administration, this avoids mistakes and makes sure children and young people get the medication they need. If there is any doubt about these things staff will always seek professional guidance and consult with parents.

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Quality of care adequate

There is always at least one member of staff on duty whom has a paediatric first aid qualification, so that any first aid or medical emergencies can be appropriately dealt with.

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Keeping children and young people safe adequate

Children and young people using this service have complex needs and many lack any understanding of risk. Registered managers and staff take seriously their responsibility to keep children and young people safe, and comprehensive risk assessments support this process. As a consequence children and young people are kept physically safe and in an appropriately secure environment.

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Keeping children and young people safe adequate

The staff team are attentive to identifying and addressing any signs of distress or discomfort, which is particularly important for children and young people who have 9 of 12 communication difficulties.

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Keeping children and young people safe adequate

There are clear practice arrangements in place which have been agreed with the local police and safeguarding board to support effective action should any children or young people go missing from this home. There have not been any incidents, and access to the community from the home is always supervised by the staff on duty.

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Keeping children and young people safe adequate

On occasion risk is avoided rather than managed and there is potential for this to limit access to some areas of the home without good reason. This includes access to the gardens and the kitchen area. Managing the presenting risks of one child can place unnecessary restrictions on others.

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Keeping children and young people safe adequate

Some young people are not able to express themselves well and their behaviour can quickly deteriorate without warning. Staff were observed dealing with some very difficult behaviour, their actions demonstrate quick thinking, assessment of the surroundings and reduction of risk to others. Staff are quick to respond and assist one another if there are difficulties and this protects both children and young people and staff. The numbers of physical interventions and restraints used in the home remains high. There is no evidence to suggest that these interventions are inappropriate or that any child or young person has been hurt during these incidents. However records do not currently provide clear and accurate information.

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Keeping children and young people safe adequate

The home has a small darkened room with padded walls, a padded bench and beanbags. Children and young people can use this room to get away from noise and other sensory stimulation. A record is kept of its use and demonstrates that children and young people choose when and for how long to stay in this room.

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Keeping children and young people safe adequate

Staff understand how to avoid any incidents of bullying and staffing number are such that incidents are few and far between. A child friendly guide has been produced and offers easy to understand explanations of bullying and what can be done about it.

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Keeping children and young people safe adequate

Arrangements for the recruitment of staff follow child protection guidelines and avoid unsuitable adults working with what are some of the most vulnerable children and young people.

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Leadership and management inadequate

The home is managed by two Registered Managers who work on a job share basis. Both have more than fifteen years of experience in children’s and residential services, they also hold professional qualifications in 'Social Work’ and ‘Leadership and Management.’

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Leadership and management inadequate

The Statement of Purpose has not been updated to include how the home will meet the needs of both children and young people who live in the home alongside those attending for short breaks. The additional facilities, equipment and emotional support 10 of 12 needs of children and young people living in the home have not been fully considered or described in this document.

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Leadership and management inadequate

A concern raised at the last inspection has not been fully addressed by the Registered Managers. Records of the use of physical restraint remain inadequate. While there is no evidence of any harm to children or young people, records do not demonstrate any attempt to de-escalate the situation or sufficient details to evidence that these interventions were necessary to prevent serious harm. In addition there is no detail of reflective practice to inform future interventions and try to reduce the numbers of physical restraints. Recording of sanctions has been improved, unfortunately the effectiveness of their use has not been transferred to behaviour management plans and this has led to the repeat of some ineffective sanctions.

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Leadership and management inadequate

Monitoring by the Registered Managers has failed to identify several shortfalls in records, or provide an effective system which contributes to developing and assuring the quality of care provided to children and young people. Staff rotas are unclear and some staff are coming on duty without an opportunity to discuss and/or plan the work they will be doing. This limits chances to consider the needs of young people and how their targets for development will be met. The register of children and young people using the home is ambiguous and difficult to interpret.

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Leadership and management inadequate

Independent monitoring of the home under Regulation 33 of the Children's Homes Regulations 2001 contributes to developing the home and identifying some action points. There is a failure in identifying shortfalls in some records. This visitor does not routinely consult with children and young people, or their parents, as expected to determine the quality of care provided is suitable, or to ask if they have any concerns.

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Leadership and management inadequate

Regular health and safety checks take place to avoid any unnecessary risk to children and young people. Fire drills and evacuations take place on a regular basis. Records of evacuations do not capture the information needed to make sure all staff and children and young people have had the opportunity to practice these drills. The deputy manager took immediate action to amend the records this during the inspection.

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Leadership and management inadequate

Training opportunities for staff are suitable and more than ninety percent of the care staff team have a professional child care qualification. There is also some succession planning, and the organisation invest in higher level qualification for senior staff. This allows them to take on some management tasks and to deputise in the absence of the Registered Managers. The frequency of supervision to care staff, and supervision records do not meet the expectations of the provider, or the support needs of staff. There is no evidenced of reflective practice or ensuring the individual roles and responsibilities of staff are confirmed.

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Leadership and management inadequate

Regular team meetings and senior meetings supports staff understanding and provide opportunities to discuss concerns, and consider how to develop the home. A 11 of 12 development plan has been produced from this consultation and some staff feel that they contribute to the development process. Staff are allocated individual responsibilities within the team which promotes their skills and aids personal development.

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Leadership and management inadequate

Managers and staff have particularly good relationships with other agencies. They communicate on a daily basis with education providers to share information about children and young people and to avoid any difficulties. This is a local authority home and as such senior representatives from the authority play a role in supporting the staff team and supervising managers. Website: www.ofsted.gov.uk

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Leadership and management inadequate

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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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