Children's Home run by London Borough of Hillingdon in Hillingdon

Unique reference number SC068789 Inspector Mark Broomhead Type of inspection Full Provision subtype Children's home

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Registered person London Borough of Hillingdon Registered person address Civic Centre High Street UXBRIDGE Middlesex UB8 1UW Responsible individual Merlin Joseph Registered manager Karen Barnaby Date of last inspection 28/03/2014 2 of 12 Inspection date 14/01/2015

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Previous inspection inadequate 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 that reside in the home or use the short breaks service are well looked after. Staff have very good links to other professionals and agencies and use this to ensure that children settle in to the service quickly and that they are provided with consistency in their routines and how they are cared for.

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Overall effectiveness

Staff and managers at the home are effective in providing personalised and well planned care. They take into account the individual needs of the children and young people and take into account advice from other professionals. Their health needs are well met. This means that children and young people are given the best opportunity to make progress in their lives.

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Overall effectiveness

The inspector was able to observe the interaction between staff, children and young people. This was good and staff were able to engage children and young people in activities that they enjoyed. Staff have the skills, competence and experience to have good communication with children and young people and are able to manage their behaviour well. The positive relationships that had been built by staff helped the children look forward to coming into the service and they enjoyed living at the home.

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Overall effectiveness

The home provides a safe environment for children and young people. The building 3 of 12 is controlled by electronic key fobs and alarms are fitted to external doors. The outside area offers a number of different activities. There is also a fence surrounding the property to ensure children and young people cannot leave and that members of the public cannot enter. Some areas of decoration within the home need attention. This is being addressed by the Registered Manager.

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Overall effectiveness

There is a Registered Manager and two deputy managers in the home. All are very familiar with the needs of the children. They understand the importance of reviewing placement plans and risk assessments to ensure they continue to meet the individual needs of children and young people and keep them safe. One key document was missing from the home in relation to child protection, although nearly all the staff were aware of its existence and knew what action to take.

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Overall effectiveness

As a result of this inspection five requirements have been made. These are in relation to: ensuring that the child protection policy is replaced and that all staff are aware of what to do in relation to any allegation; the visitors book records the reasons for the visit; the locations assessment is fully completed; visits by the independent person are evaluative and submitted on time and that Ofsted receive reports of the review of the quality of care at least once every three months.

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Overall effectiveness

Three recommendations have been made. These are in relation to: improving the decoration of the home; that there is a system in place that monitors quality of recording; and that risk assessments focus on individual risks, rather than being generic assessments, and that any steps taken to reduce the risks are recorded and evaluated. 4 of 12

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Information about this children’s home

This local authority service provides overnight short breaks, medium and long-term provision for up to eight young people aged between 10 and 17 years old who have physical and learning disabilities. In addition to this, the service also offers day services and tea visits.

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Inspection date Inspection type Inspection judgement

28/03/2014 Interim inadequate progress 07/05/2013 Full good 07/02/2013 Interim good progress 06/06/2012 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 that the a policy which is intended to safeguard children accommodated in the home and the procedure to follow in the event of any allegation or abuse is prepared and implemented. Regulation 16(1) 28/01/2015

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Reg. Requirement Due date

(2001) ensure that records specified in Schedule 4(13) are kept up to date. In particular that visitors record the reasons for the visit. Regulation 29(1) 28/01/2015

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Reg. Requirement Due date

(2001) ensure that a review of the appropriateness and suitability of the location of the premises to include local information and consultation with local bodies 11/02/2015 5 of 12 as appropriate. Regulation 31(1A)

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Reg. Requirement Due date

(2001) ensure that visits carried out by the independent visitor are evaluative of the care provided, as required by regulation, and are submitted to Ofsted in a timely manner. Regulation 33 28/01/2015

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Reg. Requirement Due date

(2001) ensure that HMCI is supplied with a report in respect of a review of the quality of care at least once every three months. Regulation 34(2) 28/01/2015

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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

 The home provides a comfortable and homely environment and is well maintained and decorated. In particular, removal of items used to stick papers and decorations to the walls, replacing box on the wall, replacing broken switches and cleaning windows. NMS 10.3  There is a system in place to monitor the quality and adequacy of record keeping and take action when needed. This relates to record keeping in a number of areas; risk assessments, restraint logs, policies and children’s files. NMS 22.1  The home implements a proportionate approach to any risk assessment. This relates to ensuring that risks are specific to each individual child and demonstrates steps taken to reduce the risk and validation of its effectiveness. NMS 4.5 6 of 12

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Outcomes for children and young people good

The outcomes for children and young people and the quality of the care being provided by the service are good. Children and young people benefit from having a caring staff team who are dedicated to their roles. The service provides a high standard of care to the children and young people. For example, when one young person allowed the inspector to look at their toys and posters in their bedroom, their enthusiasm to share their toys and talk about life experiences demonstrated the commitment of staff to cater to the individual needs and wishes of the children and young people

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Outcomes for children and young people good

Staff work exceptionally well in partnership with parents, the local authority, education and health professionals to achieve good outcomes for young people. A parent said ‘The staff are committed to working with my child as we work to the same programme. This has achieved so much as my child’s social development and behaviour has improved.’ This cohesive approach to providing consistent care enables children and young people to quickly settle into the home’s routines.

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Outcomes for children and young people good

Children and young people are asked about the activities they want to join in, and the activities are personalised to their own individual needs. A range of activities provide a stimulating environment for children and young people. They include, listening to music, relaxing in the well-equipped sensory room and watching the television and DVDs.

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Outcomes for children and young people good

Children and young people are making significant progress in developing their practical and life skills and are taking more responsibility for their own personal care. They regularly participate in activities such as baking, arts and crafts, independently dressing, swimming and recently enjoyed a holiday to the seaside. A child told the inspector, ‘I liked the sea.’

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Outcomes for children and young people good

Staff work closely with the young people and parents to encourage young people to play a positive part in looking after their own health needs. Overall, the service puts a high priority on promoting young people’s physical and mental health and emotional well-being. As a result, young people’s health needs are well met.

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Outcomes for children and young people good

Children and young people achieve very good school attendance. Staff communicate very well with the schools and have very good relationships with them. Staff have worked in schools to share good practice and ensure consistency for the children and young people. A social worker said, ‘The staff are keen to share important information with the school and me, this ensures we have a joint approach to children and young people’s care.’ This hands on approach improves children and young people’s educational opportunities and progress. 7 of 12

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Quality of care good

The service is making a positive difference to the lives of the children and young people with complex needs and learning disabilities. The effective quality of care is enabling them to achieve good outcomes. Children and young people are making significant improvements in their education, behaviour, independence and quality of contact with their family.

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Quality of care good

Children and young people spend their short breaks and longer term stays in a spacious and well equipped environment. The Registered Manager has access to good maintenance support for repairs and decoration. However, there were some areas in need of attention for example, windows needing cleaning and general maintenance.

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Quality of care good

Children and young people benefit from a healthy and varied diet. They are encouraged to live healthy lifestyles with plenty of activities which involve physical exercise in the outside play area. Children and young people also benefit from a staff team that works with medical teams, doctors and any relevant therapists. Staff are motivated and demonstrate a good level of understanding and knowledge in meeting children’s and young people’s complex needs on a daily basis. Children benefit from appropriate consistency, structure and routines. As a result, they feel settled and have a sense of emotional security.

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Quality of care good

Positive relationships are made between children and young people’s peers and link- workers. This ensures a positive and pleasant environment for children and young people to be able to enjoy their stay. Staff have high aspirations for the children and young people and they benefit from link-workers who care for them with affection and value their individual needs. This improves their outcomes and for some young people has improved their behaviour considerably. A parent said, ‘The staff are lovely, I feel okay to leave my children here as I was worried at first. I can always go and talk to my link-worker the kids love it here too.’

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Quality of care good

Children and young people are asked about their wishes and feelings and, where appropriate, they are responded to. Staff listen to them and have regular children’s meetings and staff advocate very well for the children. Good use of communication symbols has helped to support the communication with young people. This promotes young people’s participation and ability to express their thoughts.

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Keeping children and young people safe adequate

8 of 12 Children and young people who live at the home or use the service are kept safe. The environment is controlled so that no one can enter the home without appropriate authorisation from staff by use of an electronic fob. In addition, the outside space has secure boundaries. Staff identify those children and young people with the abilities and tendencies to leave the home and, in accordance with their risk assessments, provide appropriate ratio of children and young people to adults to monitor the children and young people and ensure they are kept safe. This reduces the risk of harm to children and young people by maintaining security of the premises. At the time of the inspection, the inspectors were asked to sign a visitors’ book. A requirement in regulation is that the book should record the purpose of the visit. This does not feature in the current visitors’ book and a requirement has been made at this inspection.

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Keeping children and young people safe adequate

The home does have a policy for child protection however the document had been misplaced at the time of the inspection. Discussions with staff confirmed that most of them were aware of the policy and would know what to do in the event of an incident. Staff were also aware of what to do should children and young people present themselves with signs of abuse on their admission to the service.. The home must ensure that the policy is physically replaced within the home and that the policy is implemented so that all of the staff are aware of what to do in the event of an incident or allegation, particularly when there is no manager on duty. This has been raised as a requirement at this inspection. The home has in place an appropriate policy that states what must happen should a child go missing from the home.

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Keeping children and young people safe adequate

Staff actively encourage good behaviour from all children and young people in the home. Different methods of managing behaviour have been identified which are individual to each child. This means that the management of behaviour is more effective. Staff employ these methods to distract from negative behaviour. The home utilises the services of a clinical psychologist to develop behaviour management techniques with some of the children and young people who display increasingly challenging behaviours. The home uses rewards to encourage good behaviour. For example, one child was able to explain how tokens are given for positive behaviour; these are then used for rewards such as new compact discs, trips out to the cinema or new games for their console when their targets have been reached. Targets are reviewed so that children and young people have to demonstrate increases in their positive behaviour to achieve rewards. Because the staff utilise this way of managing

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Keeping children and young people safe adequate

behaviour, children and young people are less likely to be subject to restraint. As a result, the use of restraint in the home is minimal. Where restraint has been used there is a clear record of the effectiveness and any consequence as a result of using it. Children and young people have developed friendships within their peer group at the home. This is significant progress for some of the children and young people who have limited social skills due to their complex needs.

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Keeping children and young people safe adequate

Care plans include risks to individual children and young people. At the time of the inspection the assessment of risk included generic risks which made some of the plans cumbersome. In addition, the calculation of the risk was shown without a key. 9 of 12 This meant the reader may not understand the level of the risk. The assessments identified the likelihood and severity of the risk and the action taken to reduce that risk. The assessment did not effectively validate that the steps taken showed that the risk was being reduced. The Registered Manager will review the risk assessments so that they demonstrate an actual risk posed to individual children and young people. This will allow staff to be able to identify risks more quickly and easily to promote better care. It will also ensure that children and young people are less likely to come to harm if measures to reduce risk are effective. This has been raised as a

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Keeping children and young people safe adequate

Staff are recruited in accordance with the local authority’s policies and procedures. The steps taken help prevent unsuitable people having the opportunity to harm children and young people. Appropriate checks are made with the disclosure and barring service which are reviewed and a new check requested regularly. This ensures that children and young people are looked after by staff who are safe to do so.

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Leadership and management adequate

There is a new manager in place since the previous inspection who registered with Ofsted in November 2014. The Registered Manager has the appropriate skills, experience and qualifications to manage a children’s home.

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Leadership and management adequate

There were five requirements and four recommendations made at the last inspection. Evidence gathered at this inspection confirmed that all had been met. This demonstrates the home has the capacity to make improvements which has an impact on the care provided.

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Leadership and management adequate

Only one complaint has been received since the last inspection. This was appropriately investigated and a response sent to the complainant. This illustrates that the Registered Manager is able to investigate concerns in a way which is unbiased and gives integrity to the outcome.

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Leadership and management adequate

The home has made improvements since the last inspection. The Registered Manager demonstrated a good understanding of the needs of the children and young people that were either resident in the home or used the service. The Registered Manager was able to acknowledge the areas of concern raised during this inspection and provide explanations and ideas about how the service can be improved to meet those shortfalls. The Registered Manager demonstrated commitment to delivering improvements in the care provided to children and young people.

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Leadership and management adequate

The Statement of Purpose had been reviewed and was undergoing a further review due to recent changes in the structure of the organisation.

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Leadership and management adequate

The home has a staff team with a range of experience and competencies. This is 10 of 12 supplemented by a confident and competent management team. Supervisions and appraisals are carried out regularly. These are utilised to support staff in identifying areas for their personal development. This information enables the Registered Manager to formulate a training plan so that all staff have either received training or have it planned. This means that staff receive sufficient training to enable them to provide good quality and safe care for children and young people. Staff also have the opportunity to attend conferences. For example, a safeguarding conference takes place in February which allows staff to update their knowledge and share best practice with those from other homes. Some staff are given the opportunity to manage others and to provide coaching and support to them. This enables staff to promote their individual skills and improve their professional development. This

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Leadership and management adequate

creates a supportive staff team which benefits from a consistent approach when providing care to children and young people. Staff felt supported by the managers of the service and felt confident to raise concerns about the home without fear of criticism or judgement.

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Leadership and management adequate

Staff are deployed so that the number of staff required to meet the individual needs of the children and young people are met. The use of agency staff has significantly reduced since the last inspection. Agency staff are used to cover night duties due to substantive staff being away from work for a long period of time. The Registered Manager ensures that the same agency staff are routinely employed. This ensures that children and young people are looked after by staff that understand their needs.

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Leadership and management adequate

The physical environment of the home does not promote a homely environment. In many areas, general tidying to remove sellotape and tacking putty from the walls is required. In addition, some of the windows in the communal areas require cleaning to make the environment more pleasant. Light switches in some of the bedrooms have been damaged and damage has been caused to a sensor on a wall. Some improvements had been made to the home, such as the installation of external door alarms, but the remedial work of the plaster surrounding the alarms has not been completed. The home uses an external provider for maintenance and the Registered Manager is taking steps to address these concerns. This has been raised as a recommendation at this inspection.

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Leadership and management adequate

Recording within the home is not consistent. Some elements of recording were missing or required review. For example, when reviewing the restraint log, the inspector could see that the duration of the restraint had not been completed on two occasions. This is required by regulation. In addition, risk assessments were not always detailed enough to be able to appropriately demonstrate the risk. For example, one risk assessment showed a risk of ‘crying’. The Registered Manager must implement a system that monitors the quality and adequacy of record keeping and take action when needed. This has been raised as a recommendation at this inspection.

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Leadership and management adequate

Visits by an independent person, and the subsequent submission of a report, were not consistent. A visit and report should be completed at least once a month. The 11 of 12 inspector found that some monitoring visits required by regulation had not taken place and also that some reports of visits that had taken place had not been submitted to Ofsted as required. In addition, a review of the quality of care, which must be undertaken by the Registered Manager at least once every three months, had not been submitted to Ofsted. This was for the period of September 2014 to November 2014. Failure to send these reports to Ofsted means the regulator has a reduced opportunity to monitor the care provided by the home on a regular basis. This has been raised as a requirement at this inspection.

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Leadership and management adequate

The home has prepared a locality risk assessment which reviews whether the premises are appropriately and suitably located. The current assessment does not contain enough detail to make a judgment about the suitability of the location. For example, the current assessment does not include the analysis of local data or consultation with appropriate local services, such as the police. The assessment should include specific risks affecting the home and develop strategies for managing these. This has been raised as a requirement at this inspection.

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Leadership and management adequate

The Registered Manager ensures that events that require notification to Ofsted are detailed and demonstrate that appropriate action is taken following an incident. 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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