NumberFour

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 Transitions are effectively managed. Admissions are based on rigorous multi- agency assessment and staff are provided with good information and training prior to young people being admitted to the home. This ensures staff are well prepared and able to meet young people’s known needs from their point of arrival.  The home commissions the services of the child and adolescent mental health team and maintains excellent working partnerships with them. These links are effectively utilised to inform young people’s care plans, risk management plans and staff practice. This ensures young people’s diverse and sometimes complex needs and behaviours can be consistently met, even at the most challenging times.  Young people generally make good progress, relative to the time they have been in the home and their individual starting points. They benefit from good support from competent and able staff. Parents and professionals speak very

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The children's home provision is good because:

positively about young people’s overall experiences and attribute their good progress to staffs efforts.  Young people’s risks and behaviours are effectively managed by competent and well trained staff who have a good knowledge and understanding of the young people in their care. Well thought-out and positively informed strategies and interventions are used to help and protect young people and ensure that their safety is consistently promoted. A number of safeguarding areas require improvement. These relate to self-harm records, missing from home return interviews and records of restraint.  The home is effectively run by an experienced and competent manager. Staff are well supported in the day-to-day care of young people and have good opportunities to enhance their skills and knowledge through formal supervision and training.  All requirements and recommendations from the previous inspection have been

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The children's home provision is good because:

suitably addressed, improving the quality of care and welfare of young people. However, further shortfalls have been identified relating to outstanding repairs and redecoration and the formal supervision of the Registered Manager.

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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 a homely environment is maintained, specifically that that the ceiling in the downstairs hall is repaired and the outstanding redecoration of the hallway and dining room is completed. (The Guide to Quality Standards, page 15, paragraph 3.9)

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Recommendations

 Ensure staff maintain an accurate record of the steps they have taken to manage any assessed risks, in particular those relating to self-harm. This is with specific reference to making sure that staff can fully evidence the rationale for why any identified action within these documents has not been taken. (The Guide to Quality Standards, page 42, paragraph 9.5)

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Recommendations

 The registered person must ensure that when a child returns to the home after being missing from care or away from the home, the responsible local authority must provide an opportunity for the child to have an independent return home interview. The home should take account of information provided by such interviews when assessing risks and putting arrangements in place to protect each child. (The Guide to Quality Standards, page 45, paragraph 9.30)

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Recommendations

 Ensure the record of restraint enables the registered manager to be clear about what if any injuries have been sustained as part of a physical restraint. This is with specific reference to ensuring that body maps of young people are completed in a timely manner. (The Quality Care Standards, page 49, paragraph 9.59)

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Recommendations

 The registered person must ensure that the Registered Manager receives supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (The Quality Standards, page 61, paragraph 13.2)

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Information about this children's home

This service provides residential accommodation for up to five young people with a mental health disorder and learning disability. The home is owned by a private company who enlist the support of a child and adolescent mental health team who support them with their care practice.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

07/01/2015 CH - Interim Sustained effectiveness

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good

Young people, social workers and specialist child and adolescent mental health services are fully involved in the formulation of detailed care plans and risk assessments. Staff effectively translate these plans into practice and ensure young people’s known and emerging needs are fully considered and met on a day to day basis. As a result, young people make good progress in many aspects of their lives.

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good

Young people are protected by high levels of staff support and supervision. Their individual care plans and risk assessments, which are regularly reviewed, clearly identify their strengths, needs and vulnerabilities. Staff regularly talk to young people about their care and provide them with the opportunity to express their views and wishes and raise concerns in a safe space. This means they are encouraged to be involved in making decisions about their lives, as well as reflecting on their own behaviour and making positive changes for the future.

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good

Admissions to the home are based on rigorous assessment and are carefully planned. The home has a strong working partnership with the child and adolescent mental health team and managers work in conjunction with this service from the point of admission. They are fully involved in preparing staff for the admission of young people including providing them with needs specific advice and training. This ensures that staff are well-equipped to meet the needs of young people, prior to them being admitted to the home.

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good

Young people’s known and emerging health needs are met on a day to day basis. They are supported to access routine health services and benefit from the continued involvement of the child and adolescent mental health team throughout their placement. Their expertise is used to inform care planning, including the formulation of risk and behaviour management strategies. Staff are well supported in their delivery of well thought out interventions, which are regularly discussed through daily handovers and team meetings. As a result, young people receive a good level of care from a knowledgeable staff team.

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good

Staff value education for all young people and maintain positive and effective partnerships with education colleagues. The manager and staff are proactive in their efforts in overcoming barriers to participation. When problems arise, they work closely with education providers and placing authorities to ensure difficulties are overcome or alternative arrangements are made. As a result, young people have good academic opportunities and make good progress relative to their age and life circumstances. Staff encourage and sensitively support young people to maintain contact with significant family members. They value the importance of contact in helping young people understand and maintain their identity. Individual contact plans are used to ensure contact is organised, safe and as positive an experience as possible for all involved. The manager and staff are acutely aware of the emotional impact that contact can have on some young people. When concerns arise, they are quick to

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good

share these with young people’s social workers and use this information to inform future plans. This supportive approach ensures young people sustain regular, good quality contact with family members and enables them to develop and maintain positive relationships with those who are significant to them.

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good

Staff provide young people with a range of opportunities to develop basic life-skills and increase their levels of independence. Young people are routinely encouraged to participate in everyday tasks such as shopping, cooking and cleaning. For the majority of young people this has enabled them to develop a range of new skills which will be useful to the when they make the transition to adult life.

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good

Young people are protected by a range of health and safety risk assessments and environmental checks, which staff regularly complete. The house is a large, detached property and provides young people with ample space for privacy or spending time with their family members when they visit the home. Some refurbishment is required. This includes outstanding redecoration of the hallway and dining room, and necessary repairs to the ceiling in the downstairs hall, which is cracked and appears to have dropped. The responsible individual is in the process of commissioning a suitable person to undertake this and other work that has been identified.

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requires improvement

Young people say they feel safe. They are kept safe by staff that are aware of their safeguarding responsibilities. This is because they receive safeguarding training, which is frequently updated. Staff know about the homes whistle blowing policies and are confident in their implementation of safeguarding procedures. As a result, staff take the right action to keep young people safe.

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requires improvement

Young people are encouraged to behave in a manner that is acceptable and safe for them and others. Behaviour management plans clearly identify, and inform staff in their responses to challenging behaviour and how they should reward young people when they behave appropriately. Staff are constantly looking for individual ways to help young people manage their anxieties and reduce emotional outbursts, some of which arise due to their disabilities. For example, providing a young person with the visual reference of an egg timer to identify how long they have to wait until their activity, has recently been introduced for one challenging young person. The full impact of this strategy cannot be fully measured as this is a relatively new approach, although initial signs are that it is beginning to reduce the number of emotional outbursts.

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requires improvement

Some young people display risk taking behaviour, including self-harm. Staff work collaboratively with young people, social workers, parents and the child and adolescent mental health service to develop suitable risk and behaviour management strategies, which are fully recorded. These plans are regularly reviewed to ensure practice is current and relevant to addressing young people’s known and emerging needs. This includes the actions staff should take to help and support young people to manage their risk taking behaviour, including ligature related self-harming. Incident records are completed following all such events. However, a number of these records lack sufficient detail and do not provide an accurate reflection of staff actions, in particular when staff have deemed it not necessary to apply certain elements of the agreed strategies.

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requires improvement

Physical restraint has been used on a number of occasions. All staff are trained in the use of restraint and only use it to keep young people and others safe, when all other interventions have failed. Staff and young people are given the opportunity to be de-briefed following any physical intervention. These debriefs enable young people to consider their actions and develop alternative ways of managing their own behaviour. All incidents of restraint are recorded, including the completion of body maps, which are used to record any injuries or marks sustained during the restraint. However, on at least one occasion, a body map was not recorded in a timely manner. As a result, the manager could not be clear about what, if any injuries had been sustained as part of a physical restraint. This has the potential to compromise young people’s safety and leave staff open to unnecessary allegation or challenge.

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requires improvement

Staff know what action to take when young people go missing from home. They make satisfactory attempts to locate young people and inform the police within the timeframes identified in their care plans. They keep parents and social workers fully informed and welcome young people back to the home when they return. However, not all young people have been given the opportunity to be interviewed by an independent person when they return. This is a missed opportunity to explore the reasons young people go missing, information which could be used to inform future risk management and care practce.

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leaders and managers

The manager, who has been registered with Ofsted since May 2015, continues to manage the home effectively. She has the necessary skills and qualifications to lead and manage a large team of care staff. She keeps her knowledge and skills up to date through regular attendance at training and self-directed learning from internet resources. Consequently, she is familiar with recent changes to legislation, The Quality Standards and the inspection framework.

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leaders and managers

The manager frequently monitors young people’s progress. Good relationships with social workers, health professionals and the police mean that she is able to discuss young people’s needs and share concerns appropriately. Feedback from professionals confirm that there is effective communication with the home, through regular updates and well-written monthly reports. The manager regularly consults with placing social workers and seeks their feedback about the services and support provided by the home. Family members are extremely complimentary about the home. They speak positively about the progress their children make and attribute this to the good levels of care and support they receive from staff. One parent reported, ‘I am over the moon that (Name) has come to a place where we as a family have noticed a dramatic change in all that she does. I am very pleased with how staff have supported (Name) since arriving at the home. I know through

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leaders and managers

conversations with (Name) that she really likes it where she is and gets on with all of the staff.’

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leaders and managers

Young people are cared for by a sufficient number of staff. During the inspection young people were seen to be happy in their home and have lots of conversations and interactions with staff. Staff talk positively about working at the home and say they feel well-supported by managers who help them to deliver a good standard of care. Effective use is made of training, team meetings and clinical and professional supervision, to ensure staff are up-to-date with their knowledge and have the ability to meet young people’s needs. However, the responsible individual does not ensure that the Registered Manager has regular formal supervision. This means they do not have the opportunity to reflect on their performance and develop their practice.

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leaders and managers

Suitable action has been taken to address the requirements and recommendations from the previous inspection. Unqualified staff have been enrolled on a relevant childcare qualification to ensure they have the right credentials for their roles. Arrangements are now in place for an independent person to undertake monthly monitoring visits and provide an action plan which identifies what the home needs to do to improve. Internal monitoring, which is undertaken by the manager, has also been improved. Increased scrutiny, of the quality of care promotes the home to develop and improve the quality of services provided for young people.

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leaders and managers

The manager effectively monitors serious incidents to ensure appropriate action is taken and any points of learning can be integrated into future practice. All significant events relating to the welfare and protection of young people living in the home are notified to the appropriate agencies in a timely manner. This ensures relevant parties can discharge their duties swiftly in order to promote young people’s welfare.

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leaders and managers

The manager and responsible individual are proactive in ensuring young people receive the services and support they are entitled to. They appropriately challenge underperformance by external agencies and will escalate concerns when required. For example, when placing authorities are not timely in identifying adult placements for young people who are due to move on. This ensures placing authorities are aware of their duties and young people receive the input from all agencies to ensure they can move from the home in a well thought-out and planned manner.

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leaders and managers

Young people’s case records accurately reflect their everyday experiences and the work that is undertaken by the staff team. They highlight young peoples’ needs, strengths and vulnerabilities, as well as their achievements and future plans. All information is stored securely and only shared with authorised persons. This ensures young people's right to privacy is maintained.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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