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

Unique reference number SC032600 Inspector Seka Graovac Type of inspection Full Provision subtype Children's home

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Registered person London Borough of Hounslow Registered person address Civic Centre Lampton Road HOUNSLOW TW3 4DN Responsible individual Jacqui McShannon Registered manager Philip Joseph Craig / Sally Caetano Date of last inspection 17/01/2014 2 of 11 Inspection date 20/01/2015

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness good

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

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Overall effectiveness

This is a genuinely child-centred service. Highly skilled staff members are able to form close, positive and lasting relationships with the children and young people in their care and their families. This includes children and young people who find relationships exceptionally difficult, such as those with an autistic or social spectrum disorder or attachment disorder. The care practice is highly personalised and underpinned by robust and comprehensive assessments and care plans. No matter how complex and challenging the needs of children and young people are, they are fully met by this service.

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Overall effectiveness

The staff work in effective partnership with the families, social workers, health professionals, teachers and any other professionals involved in the lives of children and young people. The consistent, joint holistic approach to care secures positive outcomes for children and young people.

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Overall effectiveness

Having developed a sense of security, safety and trust, the children and young people open up to new experiences. While having fun, they learn and develop in every aspect of their well-being. A mother told the inspector that the provision of short-breaks in this home has transformed the lives of her son and of the whole family. A social worker told the inspector that the young people she was responsible for made amazing progress while living in this home on an interim basis. 3 of 11 This inspection identified four breaches of The Children's Homes Regulations 2001. The main areas for improvement relate to the Statement of Purpose, staff supervision, the location assessment and the visits to the home by an independent person, on behalf of the local authority. Further improvement is recommended regarding consistency of the medication administration records and planning for the future of the home. Through monitoring activities, the leaders and managers have

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Overall effectiveness

already identified these weaknesses and have started addressing them. They have secured some improvement, but not full compliance.

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Overall effectiveness

None of the weaknesses impact negatively on the overall good, and in some aspects, outstanding quality of care that the children and young people receive. The outcomes for them and their families are very positive.

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Overall effectiveness

The home is managed by an interim Registered Manager and there is a lack of clarity re permanent management arrangements. 4 of 11

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Information about this children’s home

This local authority home provides short-breaks service and/ or full time care on an interim and emergency basis for up to five children and young people with emotional and/or behavioural difficulties, physical disabilities, learning disabilities and a sensory impairment.

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Inspection date Inspection type Inspection judgement

17/01/2014 Interim good progress 11/04/2013 Full good 14/12/2012 Interim satisfactory progress 19/07/2012 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

5 (2001) keep under review and revise the Statement of Purpose so that it accurately reflects the service and supply a copy of the revised document to Ofsted (Regulation 5 (a)(b)) 16/03/2015

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate supervision and appraisal (Regulation 27 (4)(a)) 16/03/2015

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Reg. Requirement Due date

(2001) review the appropriateness and suitability of the location of the home's premises at least once in each calendar year (Regulation 31 (1A)(b)) 16/03/2015

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Reg. Requirement Due date

(2001) ensure that the independent person's visits to the home take place at least once a month. (Regulation 16/03/2015 5 of 11 33 (7))

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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 there is a written record of all medication given to children during their placement. This in particular relates to ensuring that the staff members always sign when they give a medicine to a child (NMS 6.15)  ensure that there is a written development plan, reviewed annually, for the future of the home. (NMS 15.2) 6 of 11

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Outcomes for children and young people good

The children and young people have a very good school attendance and good educational attainment. This service enables them to continue to learn and develop in a different environment whilst having fun with their peers. Their learning, development and independence are maximised effectively.

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Outcomes for children and young people good

They are enabled to access a very wide range of stimulating opportunities and different experiences within the home and the community. This has had a very positive impact on their learning and social inclusion. They have made enormous progress in the development of their skills and confidence. Their communication and social skills have significantly improved. Children are more able to understand what is happening around them and the options that they have. They have got better at expressing themselves and knowing with confidence that their views count. Children are more able to participate in the decision-making process. They are listened to and their choices are promoted effectively and respected, whenever it is safe and in their best interest. Different aspects of their identity and their talents and abilities have been recognised, promoted and nurtured effectively.

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Outcomes for children and young people good

Children lead active lives and develop healthy lifestyles. For example, a social worker reported on a great progress that the young person has made at regulating her eating habits. Not continually grazing on unhealthy food has had a very positive impact on her weight. As a result, she has become more accepting of her femininity; her presentation, self-confidence, feelings of joy and participation in the activities has improved dramatically.

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Outcomes for children and young people good

A mother told the inspector that her children loved coming to this home and were always happy while there. In the home's own consultation exercise, a young person described that living in this home made her feel happy because it was, 'such a fun place to be and staff were nice.' Young people told the inspector that they loved the home and were happy to be there. The inspector observed the young people having a good time, relating well to the staff members and being relaxed and contented, after a busy day at school or with their families.

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Quality of care good

This home plays an important part in the lives of children and young people and their families. It makes a strong contribution towards positive outcomes. This includes the promotion of stability in their lives. It is quite common that children with disabilities are introduced to this service while young, and continue to benefit from it until they become adults. The service supports them effectively throughout childhood and 7 of 11 teenage years and prepares them well for the transition to adult services or semi- independence.

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Quality of care good

Staff members work closely with families to provide them with the information and advice on how to support the development of their children. They are effective at promoting skilled parenting and a good family life. At times, this has included challenging stereotypical ways of thinking relating to disabilities or gender or helping to reconnect divorced parents for the sake of their children. A mother told the inspector that she felt that by providing good short-breaks, this service gave her back the joy of her family-life.

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Quality of care good

The service is flexibly shaped around the needs of children and young people and their families. Although the home mainly provides short-breaks, the management responds positively to the needs of some young people to stay full time on an emergency basis. Recently, this included looking after a young person while her mother was in a hospital. This young person made excellent progress during that time. Another example of providing and promoting the stability in the lives of children and young people, is of a young person who had nine disrupted fostering placements. In between her moves, this person returned to this home, where she is always happy to stay. The staff have always been there for her when she needed it and provided her with stability in her life.

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Quality of care good

In discussions with the inspector, a young person described the staff members as 'very considerate, funny, helpful and always smiling'. A number of professionals who contributed to the inspection, commented positively about the home's welcoming and homely atmosphere, inclusiveness and good communication. They also highlighted the genuine passion the staff members had for providing children and young people with the best possible care.

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Quality of care good

Staff members know children and young people exceptionally well and are deeply sensitive towards their needs and anxieties. They are highly skilled at communicating with children and young people and forming positive and trusting relationships with them. They creatively use arts, play and other fun activities to make children and young people calm, interested and open to learning. Their work focuses on empowering children and young people to embrace their talents and to be proud of who they are.

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Quality of care good

Staff work in effective partnership with the young people, their families and other professionals who are involved in supporting them. They follow a joint, holistic, social pedagogy approach to addressing any challenges to the progress and further development of children and young people. They advocate tirelessly for what is in the best interest of children and young people. They ensure that children and young people have a voice and are heard. An example of this is insisting on having a review of the young person's medication in which this 15 years old young person was fully consulted about the need for the treatment and the treatment-options. Staff ensures the participation of children and young people in their care planning as much as 8 of 11 possible. The care plans are highly individualised, comprehensive and detailed.

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Quality of care good

Many aspects of the care provided have outstanding features and a special quality that genuinely caring, compassionate and exceptionally skilled staff bring to their relationships with children and young people.

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Quality of care good

However, the records of medication need to be maintained consistently. Despite stringent quality assurance mechanisms that include daily audits of medication, the inspector found that in the last four weeks, on two occasions the staff members did not sign when they gave anti-convulsing medicine to the young person. Not updating the records has had no impact on the young person. However, it increased the margin for a more serious error to occur.

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Quality of care good

The home considers seriously any complaints raised by or on behalf of children and young people. The management and staff approach the complaints with honesty and openness. The complaints procedure is effective at identifying any areas for improvement and driving the quality of the service forward.

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Quality of care good

The home's environment includes a large garden and a smaller sensory garden which are kept clean and well maintained. It is well equipped to promote positive outcomes for children and young people. The sensory room and the soft-play room are particularly popular with children and young people. Those rooms are used to provide them with relaxation and quiet stimulation. A mini-bus is available to take them to visit experience and learn about various places in the local community and further afield.

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Keeping children and young people safe good

Highly personalised, comprehensive care plans and robust written risk assessments clearly and incisively describe protective strategies for keeping children and young people safe. Staff understand risk management as a dynamic proactive process. They implement individually tailored strategies consistently, but also adapt them while continuing to sensitively, flexibly and fluidly reassess the situation at each particular moment. Having the expertise of a staff member who is a behaviour management trainer adds a significant strength to the team's skills, knowledge and expertise.

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Keeping children and young people safe good

An example of the effectiveness of the behaviour and risk management is that the staff effectively manage some young people with very challenging and unpredictable behaviours. This includes a young person who was recently expelled from a school, after he had injured five staff members in one week. This is a special school that openly acknowledged that they could not safely meet this young person's needs. The staff in the home know how to manage this young person well. They are able to effectively promote his safety and the safety of everybody around him, without having to intervene physically. 9 of 11 The log of physical interventions is well maintained. The records show that the interventions are proportionate to the risks and used appropriately to protect children and young people. The log also evidences that over a period of time, the staff have enabled young people to regulate their behaviour better. An example of this is that a

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Keeping children and young people safe good

young person whose behaviour required staff's physical interventions once in August 2014 and twice in September 2014 has become much better at being able to contain her frustration and anger. She was proud that the staff members trusted her with various responsibilities within the home. She felt that really helped her to gain a better control of her feelings and behaviour. Her social worker was very pleased with her progress and how the staff supported the development of this young person's resilience through authentic relationships and effective key-working.

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Keeping children and young people safe good

Those young people who were able to speak to the inspector, confirmed that at all times, they felt safe at the home. A mother told the inspector that there were not many places that she would trust with her children. She added that she knew that in this home, they were, 'in completely safe hands'.

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Keeping children and young people safe good

Staff have been effective at keeping children and young people secure and safe. For example, although some young people have a history of absconding from their family homes and from other services, they have never absconded from this home.

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Keeping children and young people safe good

The management has developed good relationships with other agencies and public bodies in the borough, including the Local Safeguarding Children Board.

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Leadership and management adequate

During the absence of the permanent Registered Manager, the home has been managed efficiently and effectively by an experienced and qualified interim manager. The interim manager registered with Ofsted in January 2014. He had been registered for many years previously, as the manager of different children's homes. He is currently employed on a short-term contract. The permanent Registered Manager remains on extended leave following maternity leave. It is unclear when the permanent Registered Manager will return to work. The current management arrangements are appropriate, but remain on an interim basis. This is unsettling for the home.

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Leadership and management adequate

There is some evidence of discussions and planning at senior levels for the future and possible development of the service. However, the last written development plan for the home was for the year 2013/2014. The leaders and senior managers have not set a clear direction for the service development.

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Leadership and management adequate

The Statement of Purpose (SOP) was last formally reviewed in July 2013. The inspector saw some amendments to this document that the interim Registered Manager has proposed to the senior team. They have not responded, as yet. The proposed amendments do not go far enough in taking into account the differing 10 of 11 needs of children and young people who live in the home and those who use it as a short-term service. In addition, the current SOP does not accurately represent the actual service, which is very good. For example, the SOP wrongly states that the home does not have a role in promoting education of children and young people. The staff demonstrated at the inspection that they promoted children's learning and education effectively. This view was also supported by a teacher from a local special school who spoke to the inspector.

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Leadership and management adequate

The shortfalls in the SOP have already been identified by the independent professionals who visited the home, on behalf of the local authority. The purpose of these visits is to check on the conduct and the effectiveness of the home. The local authority has failed to ensure that these visits happen at least once a month, as required. No visit was made in the month of September 2014.

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Leadership and management adequate

The Registered Persons have also failed to complete a review of the appropriateness and suitability of the location of the home. The interim Registered Manager has started working on this document. He has written to the local police seeking information and their views, but has not received a response as yet.

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Leadership and management adequate

Another weakness in the management relates to the staff supervision and the annual appraisals of the quality of their work. Although the majority of staff receive regular formal supervision and appraisal, this is not the case for all of them. For example, one night care staff member had only two supervision meetings in the last 12 months. These meetings happened in September 2014 and in December 2014. The negative impact of this is compounded by the fact that night staff work alone. In addition, they do not regularly attend the weekly team meetings. The Registered Manager has reviewed and improved the arrangements for supervision. He has adjusted the staff duty roster to make it easier for the night staff to attend the team meetings more regularly. In addition, two staff members did not have a review of their performance formally completed, last year. The appraisals that look at the staff performance in 2014 are currently in progress.

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Leadership and management adequate

The delivery of the actual service has been managed efficiently and effectively. The changes in the management and the regulatory breaches have not had a negative impact on the quality of the service, the outcomes for children and young people and safeguarding culture in the home. The staff team is highly experienced, skilled and passionate about their work. This is how a social worker described the main strength of the service, in the Ofsted on-line survey: ''Passionate staff who clearly care about the children they look after. They put their interests first and support them to grow''. The management and staff embraced the inspection in a positive manner and demonstrate a commitment to learning and improvement. 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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