Children's Home run by Bristol City Council in Bristol

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:

 Children are cared for by trained and enthusiastic staff, who have the skills to meet their complex individual needs. Children enjoy their short break where they meet friends and have fun.  The manager and staff have strong partnership arrangements with parents and carers. Effective communication between the child’s home and school contributes to consistent care and shared goals.  Staff are vigilant in their supervision of children to ensure their safety. The team has a good understanding of safeguarding procedures.  Children’s health and medical needs are met by nursing staff at this short break service, in collaboration with community health professionals and medical practitioners.  There are areas for improvement. Records are poor and they do not reflect the good care practices that are delivered. Records fail to capture significant achievements to demonstrate progress that children are making.

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The children's home provision is good because:

Management monitoring of such records is insufficient in order to identify these shortfalls.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard the registered person must ensure that robust monitoring of case records occurs.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to;

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Requirement Due date

(2)(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 31/10/2015

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Requirement Due date

The registered person must maintain records (''case records'') for each child which include the information and documents listed in Schedule 3 in relation to each child. (Regulation 36(1)(a)) 31/10/2015

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4. (Regulation 37(2)(a)) 31/10/2015

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Requirement Due date

44: Independent person: visits and reports

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Requirement Due date

The registered person must ensure that an independent person visits the children's home at least once each month. (Regulation 44(1)) 31/10/2015

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Recommendations

 Ensure that action is taken to remove unpleasant odours from bedrooms. For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. (The Guide to the Quality Standards, page 15 paragraph 3.9)  Ensure that case records reflect purposeful activities undertaken by children and progress towards individual targets. Staff should keep and encourage children to keep appropriate memorabilia of the time spent at the home and help them record significant life events. (The Guide to the Quality Standards, page 62 paragraph 14.5)

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Information about this children's home

This children’s home is registered to provide short breaks for up to five children of either sex, with physical disabilities and/or learning difficulties. It is operated by the local authority.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

25/03/2015 Interim Sustained effectiveness

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Recent inspection history

22/01/2014 Interim Satisfactory progress

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good

Children experience good quality care during their short breaks. Staff are able to interpret and understand the children’s complex needs and this leads to the development of trusting relationships. Children benefit from the consistency and security that this established staff team provides.

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good

Staff are proud to report on children’s achievements, the skills they develop and how they gain in confidence. For example, staff excitedly report how a child enjoyed floating with buoyancy aids in a swimming pool for the first time. On hearing about this achievement, staff are thrilled and recall how this child didn’t like standing in shallow water at one time. Another child has become more sociable with other children and enjoyed joining in an outing to go bowling. This child has grown in confidence to take part and leave the property when his usual routine has been to elect staying in his bedroom for long periods of time.

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good

Children use a range of communication methods including pictures, symbols and objects of reference. Staff are aware of children’s individual abilities and have the necessary communication tools to support them. A parent reports how staff spend time with her to ensure that the most current symbols are available for her child to communicate with.

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good

Staff are very attentive, observant and skilled in reassuring children during difficult times. They know the children well and how to make their short break an enjoyable experience. Children are provided with opportunities for activities in the home, the garden and the wider community. Activities are adapted to meet the diverse range of needs and abilities. Outdoor play equipment offers a safe place for children to explore with music, toys and the sensory room available inside. Children enjoy visiting a local farm, shops and leisure facilities. This service has a minibus, with a lift, to enable children who use wheelchairs to achieve full participation in community activities.

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good

The skilled staff team promote new experiences for children regardless of their disabilities. For example, some children who receive nutrition through gastrostomy are able to cope with the sensation of food or drink in their mouth, so staff provide different tastes for a sensory experience and at the same time the stimulation of saliva glands to promote oral hygiene. The use of sound, lighting and touch enhances the activities for children who respond to show their enjoyment, or displeasure. The arrangements for the storage and administration of medication are safe and effective; qualified nurses have this responsibility. There are partnership arrangements with health professionals while ensuring that parents remain responsible for their child’s health and medical needs. Health professionals contribute to staff development through consultancy and training.

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good

Care plans are child-focused providing a good overview of identified needs. They provide clear guidance on how staff are to deliver personal care in a safe manner particular to each child. Overall, they are informative, effective documents and much improved since the last inspection.

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good

Children enjoy the space of the large communal area where they can watch television, play games and listen to music. The design of the large space provides smaller areas to go if children wish to be alone. Bedrooms and bathrooms are fitted with overhead tracking for use with a hoist, this provides safe transfer to and from a wheelchair. A collection of items stored in a named box helps to personalise the bedroom for each child before their arrival. Posters, toys and toiletry bags provide a familiar setting to welcome children who may visit less than once a week. One bedroom has an unpleasant odour. This was identified prior to the inspection by the manager, who is arranging a new floor covering as previous efforts to clean this room have not been successful.

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good

Parents value this service and provide very positive feedback. ‘An extremely caring environment, staff are exceptional.’ Parents comment on working together with staff, ‘they help you with any problems you may have at home (behaviour etc) and come to school meetings so we are all doing the best for the child’. ‘We suggested a change to booking arrangements. They not only listened, they fully implemented the suggested changes.’

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good

Children enjoy their short break in a safe environment. The spacious ground floor property enables children to move around freely. Safeguards such as a secure garden and automatic closures on fire doors enable children to wander outside to play without restrictions on their movement.

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good

Staff know and understand any complex care needs children have and how these impact on their safety. Risks are managed well and ensure that children are safe while staying in the home. As needs change, risk assessments are adjusted to ensure that strategies for managing risks remain effective. The manager and staff are not risk adverse, promoting opportunities for children with disabilities such as swimming and outings in the community. Children benefit from these experiences and enjoy the participation alongside other children.

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good

The planning for children new to the service to have a short break, as well as the planning for those more established, incorporates good consideration of risks including looking at the compatibility of children who stay at the same time. Children benefit from the stability of the staff team, being supported by staff they know and can trust with their personal and medical care.

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good

Parents report high levels of satisfaction and confidence in the care their children receive. ‘We feel comfortable placing our child with them, we can phone and check-up how he is doing and talk to someone if we have concerns.’ Another parent reports that their child has complex health needs and can be difficult to care for properly, ‘but we had the greatest confidence that he was well cared for’.

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good

Staff supervision has ensured that there have not been any recorded incidents of children going missing. Procedures are ready to follow in the event that this should occur. Staff are trained in safe care practices and supported by policies and procedures. Staff know how to recognise and respond to any suspicions or concerns should they arise. Vigilance leads to the identification of any changes in children’s behaviour or their physical appearance. Regular communication with parents and school staff ensure that changes, no matter how subtle, are shared and recorded.

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good

Children receive consistent responses from the staff through clear routines and boundaries. Staff give praise and encouragement to promote positive behaviour. Forward planning to prepare the environment to meet individual needs and choices reduces the potential for distress and conflict. For example, for a child that enjoys a particular style of music, the CD is ready to play on his arrival. As a result of effective behaviour management, staff do not need to use physical intervention to safely manage children’s behaviour.

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requires improvement

The manager of this short break service has been in post for 18 years. He is a qualified learning disabilities nurse, receiving support with his professional development from the local health authority and the city council. The manager is currently working towards a management qualification at level 5. He keeps abreast of current research and practice in the field of children with disabilities through news alerts and publications via the internet. The staff team are enthusiastic about their work and they work well together with a clear aim of supporting children, their families and carers. Children benefit from good staffing ratios, ensuring they are sufficient to supervise and engage them in purposeful activities and leisure interests.

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requires improvement

The commitment from staff to support children in reaching targets and extending their individual progress occurs during each short break. These positive experiences are not always captured in daily records and therefore fail to demonstrate the progress that children are making. For example, records fail to document when children develop skills and confidence in a swimming pool, or experience new food or tastes. Records of a child’s stay at this short break service lack impact and fail to evidence progress; there is a lack of photography to record and celebrate significant events.

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requires improvement

The manager has a development plan and recognises the need to improve records. He is developing a more formal approach to target setting for individual children, linked to their care plans. This system has yet to be implemented. Without it, the manager struggles to evidence progress that children make as a result of their short break experience.

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requires improvement

Monitoring of day-to-day care practices is thorough with shift leaders having supervisory responsibilities. The manager works alongside staff during some evenings and weekends, this enables him to have direct observations of practice and time with the children. Routine checks occur with regards to health and safety, staff training and supervision. The monitoring undertaken lacks depth when reviewing records and care plans. The manager has details of each child’s short break arrangements and the dates they occur however, these details are not captured in one document such as a register, as required by regulations.

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requires improvement

An independent person does not undertake visits to the home each month. The Responsible Individual reports that it has been difficult to recruit to this role but an independent person is now in post to complete monthly visits. The impact of not having this level of scrutiny has meant the shortfalls in recording have not been identified or challenged by an independent person.

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requires improvement

The experienced team is comprised of registered nurses and support workers. Staff report that they are supported and trained to do their job, receiving supervision as individuals and collectively through team meetings.

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requires improvement

There are effective working relationships between staff, parents and carers. A parent reports that this service, ‘is run efficiently, professionally and always taking into account the needs of the child and their family’. The manager and staff collaborate well with other agencies such as, health professionals, teachers and social workers. A social worker reported that she finds the staff, ‘flexible and willing to adapt to meet the needs of the children and their families’.

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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

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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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