Children's Home run by The Together Trust in Stockport

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:

 The home provides a good quality short break service to children with autistic spectrum conditions.  Well-planned, person-centred placement plans guide staff to set realistic, individualised targets that help children develop new skills. Children benefit from a range of enjoyable experiences that widen their individual horizons and encourage flexibility of thought.  Strong partnership working with parents and other professionals ensures that children get the best possible service. The home goes above and beyond its remit in encouraging other agencies to fulfil their duty of care to children who use the serviced and young adults in transition.  Staff demonstrate warmth, kindness and humour in their interactions with children and show genuine commitment to providing a service that enhances their lives.  The home is well managed and promotes children‟s progress.  Children‟s safety and welfare is central to the home‟s practice. Restraint is

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The children's home provision is good because:

used only where necessary to keep children, staff and others safe from harm.  Alternative communication systems successfully support children who are pre-verbal to express their thoughts, wishes and feelings. The home is working on extending the range of communication methods to enable better communication with children.  Staff have completed basic training in understanding autism, but recognise that more in-depth training would increase their skills and confidence to meet the complex needs of the children using the service.  The Statement of Purpose does not fully reflect the service provided and the children‟s guide does not contain all the necessary information children need should they wish to complain about the service or seek help from an independent advocate.  The arrangements for the deployment of staff do not promote the best continuity of care for many children.

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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

Keep the statement of purpose under review and where appropriate, revise it; and notify Ofsted of any revisions and send a copy of the revised statement to Ofsted within 28 days of the revision. In particular, revise the statement of purpose to ensure it accurately reflects the service provision and includes the home‟s arrangements for keeping children safe. (Regulation 16 (3)(a)(b)) 02/01/2016

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  plan staffing levels to ensure they meet the needs of children. Ensure that staffing structures promote continuity of care from the child's perspective. In particular, review staffing arrangements to ensure, wherever possible, that each child is looked after mainly by a core team of staff he knows well (The Guide, page 54, para 10.15)

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Recommendations

 ensure that each child has access to the home's children's guide, which helps them to understand how they can access advocacy support or independent advocacy if eligible; and how to contact the Office of the Children's Commissioner (The Guide, page 24, para 4.22)

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Recommendations

 ensure that each child is provide with support (appropriate to their age and understanding) to communicate their views, wishes and feelings and participate as fully as possible in all aspects of their care planning and daily care. In particular, ensure children are supported to use any communication aids or equipment that helps them and have any necessary language support (The Guide, page 22, para 4.6)

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Recommendations

 ensure that each child can access all shared areas of the home unless there are specific reasons why this would not meet their needs. In particular, ensure that children for whom there are no restrictions on access to the kitchen and garden are freely able to use those areas of the home (The Guide page 15, para 3.10)

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Recommendations

 ensure that staff can access appropriate facilities and resources to support their training needs. In particular, provide access to more advanced training in understanding the needs of children with autism and how to protect them from self-harm and sexual exploitation. (The Guide, page 53, para 10.11)

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Information about this children's home

 The home is run by a charitable organisation. It is registered for up to five children with learning disabilities and/or physical disabilities. It provides short breaks for children with autistic spectrum conditions.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

17/10/2014 CH - Interim improved effectiveness

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good

The premises have been extended and refurbished since the last inspection and are once again fully operational to meet children‟s needs. Successful fundraising by parents and staff enables the centre to provide additional high quality facilities that further enhance the quality of the provision. A parent commented: „The house is sensitively designed to meet their needs. There are not too many things in rooms for children to obsess about and the children don‟t get attached to one room. The home is warm, friendly, inviting but the décor is not overly stimulating, so it meets their needs.‟ Parents and professionals speak highly of the service and the positive benefits it brings to children and their families. They recognise that children enjoy their short breaks, have new experiences and develop new skills through effective, person- centred care planning. Individual targets are set at the start of each quarter, in agreement with parents

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good

and social workers. These may be targets that children are working towards both at school and at home. Well-documented records demonstrate how small steps are promoted and measured during each short stay, giving clear evidence of children‟s progress and achievements. For example, over time, children learn self-care skills such as preparing a snack, learning to wash themselves or to brush their teeth regularly. Targets also include extending a child‟s flexibility and providing relaxation and enjoyment through the provision of new and interesting experiences. These range from baking to bubble baths, long walks and trips to Alton Towers or the seaside. A parent explained: „They don‟t take the safe option. They challenge my son to work on his independence skills. His key worker is fantastic and gets him to do things and go to places we couldn‟t manage. For example, they take him shopping for his own snacks and get him to use the scanner at the till and pay for things.‟

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good

Staff devise social stories to help children learn appropriate behaviour. For example, staff help children to learn that it is not appropriate to stimulate themselves sexually in public and they direct children to do this in the privacy of their own bedrooms. Staff are patient and kind in their interactions with children, treating them with respect and warmth. They ensure children‟s dignity is not compromised by following effective strategies to deliver and supervise personal care safely. The home promotes children‟s good health by ensuring they receive any treatment prescribed, supporting their personal health and hygiene, and assisting with toileting as required. They assist with psychological and psychiatric assessments by providing impartial evidence for professionals from the child and adolescent mental health service and provide emotional support to children by talking to them about their anxieties. Many children have self-limiting diets and staff work with parents to

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good

provide each individual with meals they enjoy, recognising the importance of ensuring children have positive experiences during their short break. Key workers visit schools and observe practice. They share knowledge and behaviour management techniques with parents and teachers so that each child‟s professional team is working collaboratively to support the child consistently and in the best possible way. They follow through on social stories used in school to help embed learning and they communicate with parents and teachers by routinely providing a regular short written report at the end of each short break. A parent observed, „They work well with school and school respects them‟. The home supports children preparing for transition to adult placements well. Staff accompany parents on visits to potential placements as required, and provide advice and guidance to parents at planning meetings that helps inform decisions.

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good

The manager and staff expressed frustration about poor placement planning by some local authorities that places additional pressure on families and does not ensure young adults are matched to adult provision that can meet their needs. At times, this causes undue distress and anxiety for children and families. Most staff have good observational skills and this helps them to understand children‟s needs and wishes. Additionally, they are trained to use picture exchange communication symbols to assist children with limited or no speech to express their views, wishes and feelings. Staff consult with children about how they wish to spend their time and seek to empower them by giving them choices. The manager and staff recognise their communication skills are limited and this undermines their ability to communicate as effectively as possible with all children who use the service. They are keen to develop their skills in alternative languages further.

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good

The children‟s guide does not provide contact details of independent advocates or Her Majesty‟s Chief Inspector, for children who may wish to raise concerns about the service. It is available in one format only and this does not ensure it is suitable for use by the majority of children. Judgement grade

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good

Routine health and safety measures and regular premises checks ensure that children are cared for in a safe and secure setting. Staff are familiar with risk assessments and individual risk management plans which they follow to ensure each child‟s safety. No children have been missing from the home. Staff ensure children‟s safety by careful supervision of all children and in particular, by managing the space within the home effectively. They keep children whose behaviour can be challenging apart from those who are more vulnerable , wherever possible. This is aided by the layout of the home and the different activity rooms available, including a light and sound room, computer and games rooms, and wet play areas. Staff engage children in relaxing and interesting activities that help them to stay calm. They know children well and this helps them to recognise and predict children‟s mood changes and respond accordingly. This is particularly useful when

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good

staff are working with children who are pre-verbal. The home is ever alert to signs of distress or unexplained injuries. Allegations, suspicions or disclosures of abuse are taken seriously and staff know how to respond to such incidents, reassuring children and working effectively with partner agencies. This ensures children‟s on-going safety. Individual risk assessments are detailed, person-centred and continually reviewed. They inform staffing levels for each child, which are increased from one-to-one to two-to-one, for children who present volatile and challenging behaviour. This enables staff to keep children and others safe, both in the home and on outings. Incidents are effectively reviewed and where action is required to improve a child‟s safety or well-being, this is addressed quickly. A parent explained: „There was an incident in the car with her taking her safety belt off and getting out of her seat.

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good

They immediately put a plan in place. They came up with the name of a suitable harness that she is much more comfortable with. They didn‟t say, “She can‟t go in the car”. They said, “How can we support her better so she can travel safely.‟ Behaviour management plans outline how children, including those with complex care needs should be restrained where their safety requires it. For example, staff use a handling belt to limit a child with severe allergies from accessing the kitchen. This promotes his safety as well as that of the staff and deters the escalation of his anxieties. Restraint is used effectively to prevent children from hurting themselves or others. Each incident is carefully evaluated and records demonstrate good reflection that helps staff to consider whether alternative interventions could have avoided the need for the restraint. In all but one of 21 incidents since the last inspection, the

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good

records demonstrate that restraint was, the most appropriate intervention to protect the child and others. No children have been hurt in a restraint. Children do not always have full access to all shared areas of the home. At times, the kitchen is locked for the safety of particular children, but this impacts on others having a short break at the same time, so that they have to ask staff to unlock the door if they wish to use the kitchen. This does not support their independence and undermines the homeliness of the home. One child was prevented from going in the garden one evening before bedtime and this resulted in an incident in which the child was restrained for the safety of staff. The manager challenges poor practice and supports staff to reflect on incidents. This ensures that lessons are learned and practice is continually improving. Staff provide good support to children who self-harm through talking openly about

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good

why they hurt themselves, recognising triggers and taking action to avoid situations in which children self-harm. The manager recognises there is more they can do to educate and provide emotional support to these children. The home has a designated room for the storage and safe administration of medicines. Despite this, there have been three errors since the home reopened in April 2015. None of the errors has had a detrimental effect on children‟s health. In each instance, the home has recognised the error swiftly through its good and regular monitoring systems. The home has taken robust action to address each incident, including suspending staff from administering medicines during an internal investigation undertaken by a senior manager, independent of the home. Each staff member has received refresher training before being allowed to administer medicines again. Safe medicine administration is continually promoted

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good

as a regular agenda item in team meetings to promote good practice.

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good

The registered manager has extensive experience of working with children in social care and has been in post for four years. She is suitably qualified and manages the home competently. She is well trained and knowledgeable about autistic spectrum conditions. She is ably assisted by a knowledgeable and experienced deputy manager who is further engaged in management training, thus enhancing his leadership and management skills. The manager receives appropriate professional support and supervision and has access to a range of therapists and professionals employed by the charity. This supports her in the delivery of an effective service that meets children‟s individual needs. The manager inspires the staff team to have high aspirations for children and to take pride in their work. Parents and social workers recognise this and one parent explained: „They treat our children like their own extended family.‟

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good

The quality of professional relationships with parents and partner agencies is good and this promotes good quality care and all-round support to children. Staff work effectively with schools and parents, so that children are responded to consistently. This helps them to feel secure and to develop new skills through the provision of consistent support and parenting. Commissioners report they are, „impressed with the service‟ and highly satisfied with the arrangements for care in the home. Funding cut backs are impacting on the quality of the service children receive. Managers actively challenge other agencies to improve their services to children when responses from those services are ineffective. For some children, this has resulted in a return to previously agreed care package that enables them to spend more hours at the home so that they can enjoy outings with staff and benefit from experiences that their families cannot provide. However, some children, who need

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good

a ratio of two to one staffing to ensure their safety in the community, do not get the level of support they need and this reduces their access to the community and limits activities available to them during their short breaks. The home continues to advocate for increased funding and facilitates alternative community activities where staffing ratios permit this. Parents value the way the home advocates for children. For example, a parent explained: „They attend all his reviews and TAC (Team around the Child) meetings and advocate for him with the local authority,‟ and another parent said, „She was excluded from transport and they really fought her corner. They know her really well. It‟s good to have another voice speaking up for her – they don‟t back down easily. They stepped in and transported her to school when things got bad.‟ Good leadership, monitoring and regular review of children‟s progress and

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good

outcomes ensures that children receive high quality care that provides them with varied and enjoyable experiences and promotes their development. A parent said: „They really know the children well. They give them opportunities to do things they couldn‟t do otherwise – like going to a theme park or swimming at Water-world‟. The manager knows the strengths and weaknesses of the home and continually drives improvements to the service. For example, she has introduced better person-centred placement plans that are shared with children, families and social workers. They are clearly focused on outcomes and on providing children with positive experiences during their short breaks. They demonstrate how the home is supporting children to have fun and to learn new skills and text is supported by photographs, which children and parents appreciate. Commissioners and parents value these documents. A parent said: „The person-centred placement plans are

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good

brilliant. I was given a draft EHC (Education, Health and Care) plan for my daughter and there was no comparison. The PCPP really reflects her.‟ The home‟s development plan stems from continuous review of the operation of the home and children‟s outcomes by both the manager and the independent person. Both the manager and the independent person consult with parents, children, staff and social workers and continuous monitoring, reflection and feedback further drives improvement. Staff receive regular and effective supervision that supports them in their work. The home promotes their continuous development through a rolling programme of training and refresher training as well as through the allocation of specialist roles that enable them to develop skills in particular areas such as transition work, developing social stories or supporting children at risk of sexual exploitation. The manager and staff recognise they could provide an even better and more

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good

individualised service if the staff team had more than a basic understanding of how to support children with varied complex autistic spectrum conditions. For example, staff provide only limited support for those approaching adulthood to understand their sexuality and appropriate social, emotional and sexual relationships.

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good

Children attend for varying numbers of days per year to meet their individual needs and their families‟ needs for respite. Few children have a set pattern of regular days. This makes matching children to friendship groups difficult and is not the best way of promoting social interaction with peers. There are 25 residential care workers and three night staff, whose shift patterns are not fixed. In a minority of cases, a team of staff is allocated to support children who present particular challenges. However, mostly, staff are not matched to children. This means that children who do not attend frequently, may be cared for by a range of different carers. This does not ensure that children are cared for by regular staff with whom they have developed a strong and trusting bond.

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good

The home‟s statement of purpose is written generically and does not provide an accurate reflection of the home. For example, it says: „All children are encouraged to become members of the local library…‟ The manager confirmed that this and other aspects of the report are not an accurate reflection of the service. This means information provided to parents and commissioners is not wholly reliable.

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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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