Children's Home, Residential special school run by The Children’s Trust in Surrey

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 management team clearly prioritise the young people’s needs, and respond promptly to any concerns. They challenge other professionals and strongly advocate for young people.  Young people are safe and happy in the homes. Staff understand the unique needs of each young person they care for. This means that young people with severe communication difficulties have a voice .  Staff demonstrate a professional approach to meeting the complex health needs of the young people in their care, which is also very nurturing and caring.  Having complex health needs does not prevent young people here from enjoying an extensive range of activities, and staff are proactive in seeking out new opportunities for young people to do things that they enjoy.  From their starting points, progress has been made by young people with varied and highly complex health needs.  Adopting safe working practices is integral to how the home operates and

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The children's home provision is good because:

includes staff being trained specifically in procedures relating to the individual health needs of young people.  Strengths and weaknesses are fully recognised and any areas for further development are taken on board and reflected upon.

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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

Ensure a written record is made of the use of any measure of control, restraint or discipline, in a volume kept for the purpose of which shall include the matters listed within Regulation. (Regulation 35((3)(a)(b)(c)) 24/02/2016

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Requirement Due date

Ensure where a person works in the children's home in a care role, that person attains or holds the required care role qualification within the necessary timescales . (Regulation 32(4(a)(b)5(a)(b)) 24/03/2016

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Ensure the individual appointed to carry out visits to the home as an independent person makes a rigorous and impartial assessments of the homes arrangements for safeguarding and promoting the welfare of the children in the home's care. In addition, internal monitoring evaluates arrangements for safeguarding and the quality of care (The Guide to the Quality Standards, page 65 paragraph 15.2 and 15.5)  Ensure records kept electronically in relation to training can be easily accessed. (The Guide to the Quality Standards, page 61 paragraph 14.2)  Ensure records of safeguarding incidents clearly define responsibility in progressing and closing cases in line with the homes safeguarding policy. (The Guide to the Quality Standards, page 44 paragraph 9.21)  Ensure the home’s space is able to provide room for independence skills are far

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Recommendations

as is feasible. This specifically relates to ensuring that storage of equipment is out of communal areas. (The Guide to the Quality Standards, page 17 paragraph 3.25) 

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Information about this children's home

This home is linked to the on site non maintained school and is therefore also a residential special school. It provides holistic services for children with multiple disabilities and complex health needs. The school provides 52-week placements for learners and is therefore registered as a children’s home. This is in addition to being registered with the Department for Education as a non-maintained school for children with profound and multiple learning difficulties with an age range between five to 25 years. The school has 44 educational placements. The registered children's home accommodates 33 young people, in single or twin bedrooms. The residential accommodation comprises three separate houses. At the time of this inspection, there were 32 residential children. The three houses are also registered with the Care Quality Commission.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

22/06/2015 CH - Interim sustained effectiveness

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good

‘Its first class and I can’t think of a way to improve it,’ ‘she has maintained her skills which is great as generally children with this disorder loose them.’ Just some of the positive comments received from professionals and parents alike. Young people enjoy care from staff dedicated to providing them with positive, life- enhancing experiences. Young people show warmth and affection for the care staff and there is a very relaxed atmosphere across the homes. Staff demonstrate a professional approach to meeting the complex health needs of the young people in their care, which is also very nurturing and caring. Staff members were heard to be constantly talking, praising and complimenting young people. Everyone was seen to have fun and staff were aware when young people required addition support. The views, wishes and feelings of young people living here are of great importance. Staff understand the individual communication styles of each child

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good

with severe communication difficulties. Young people’s views are sought regularly in areas of their care. This gives young people a sense of identity and belonging. Further work is being completed in levels of participation to enable young people to have a full choice in all areas of how the homes are run. Due to the relationships young people have formed staff are able to advocate on their behalf if the need arises.

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good

From their starting points, progress has been seen for young people with varied and highly complex health needs. Young people have progressed with their communication and medication reviews have taken place, this has enhanced their quality of life with young people being more alert and being able to interact with others. They are happy and feel safe and secure within the environment. Individual health needs are being exceptionally well managed in very close collaboration with health professionals, and in some instances, significant progress has been achieved. The home has a large amount of medical and health input on site. In addition, there have been strong links developed with specialist medical professionals in the local community. Robust procedures are in place in case of emergency, which all staff understand.

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good

The focus by the management team on the initiation of the medication project has continued. This has focussed specifically on training in medication arrangements and the reporting of incidents involving medication errors. There are approx. 850 doses of medication each day across the three residential homes and they have an error rate of less than 0.1%. They continue to seek to reduce any medication errors. One house has been involved in the medication project pilot and this has involved assessing competency in administering medication and training in the use of information technology systems. Clear flowcharts are now in operation and staff understand the processes to follow. The management team reports this is having an impact in increasing staff confidence. There has been liaison with external agencies to consider their medication protocols. Having complex health needs does not prevent young people from enjoying an

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good

extensive range of activities, and staff are proactive in seeking out new opportunities for young people to do things that they enjoy doing. Individual interests are extremely well catered for and trips out as a group are regular features of the activities provided. Activities include ice skating, horse riding, theatres and scout groups. There is good community involvement to give young people a sense of belonging and positive community presence. All the young people attend the school on site, there is good communication with the teaching staff to ensure consistency in approach and enable important information to be shared. Teaching assistants work in the residential accommodation to ensure 24 hour learning programmes are in place with clear goals and targets. Staff work in partnership with parents and professionals to ensure that a collaborative approach is achieved. Effective communication ensures that key

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good

messages about young people’s care and well-being are properly addressed. When young people transition into the service a team around each young person is put in place to ensure all health and welfare needs are met and understood by a core team before other staff are involved in the care for that young person. One parent stated ‘they do not just see the child as a list of medical needs; they understand their likes and dislikes and their personality.’

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good

Staff interpret young people’s behaviours well and are therefore able to act upon instances when young people are worried or upset. Staff understand young people's individual needs and vulnerabilities and do all they can to protect them from abuse and harm. The service works closely and effectively with the local child protection agency. Staff are confident with processes, such as whistleblowing, to follow should they be concerned for a young person's safety or welfare. They are diligent in keeping comprehensive logs, such as body maps, where appropriate. Bruising is now being well monitored with a clear procedure in place with medical oversight. Records of any safeguarding concerns are kept online and reported to the necessary people both in the organisation and externally. However, it is not apparent from the records where the responsibility lies in following up concerns or who can close an open case. Staff receive training in safeguarding young people

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good

and they are knowledgeable about how to apply this if they have a concern. Staff understand that young people’s disabilities make them highly vulnerable and attend relevant professionals meetings to share appropriate information about young people's well-being. This demonstrates effective partnership working. One professional stated, ‘They are open to change and to progressive working.’ Some young people who live in the home have risks associated with osteopenia (low bone density); there have been occasions where young people’s bones have fractured due to fragility. These cases have all been investigated by senior medical staff and referred to the necessary safeguarding professionals with no evidence of maltreatment identified. Risk assessments and recommendations have been made to ensure staff can fully support young people. The service is aware that they cannot meet some young people’s support needs. This demonstrates an awareness

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good

of their capabilities as a staff team in keeping everyone safe.

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good

Staff are acutely aware of the specific vulnerabilities of each young person and adequate staffing ensures young people are suitably protected from harm at all times. Adopting safe working practices is integral to how the home operates and includes staff being trained specifically in procedures relating to the individual health needs of young people. This includes procedures for gastro feeding, the administration of oxygen, and emergency medication for those at risk of having seizures. There is a very clear understanding amongst staff of the importance of contacting the doctor’s onsite, the local hospital or emergency services when necessary. Bullying and going missing are not identified issues in this home. Young people who live here are not currently assessed as displaying high risk in the areas of self harm or Child Sexual Exploitation. Staff are aware of the policies and have received information to enable them to act on concerns. Likewise, there is no need for the

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good

use of any physical intervention in the behaviour management. Staff know each young person well and are able to identify behaviour that is associated with their health needs or perhaps arising if a young person in pain or upset. At times young people’s liberty is restricted so they can be independent in a safe and contained environment. This is documented in care plans and now on a specific record, however this record does not detail the reason for it being used on each occasion or reviewed for effectiveness. This does not enable effective review to determine if this is an appropriate measure. Due to the cognitive ability of the young people, sanctions are not a common strategy and have not been used. The home has a sound recruitment process in place, which ensures all the necessary checks are completed before a member of staff starts work. This protects young people from having contact with unsuitable people. The premises

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good

provide an environment where young people feel safe and where they are being safely cared for. Privacy is now maintained with the bedroom doors with viewing panels now having blinds on them. Young people are protected by sound health and safety routines and the home is appropriately secure, taking into account the needs of the young people. During the inspection, it was observed that equipment is being stored in communal areas due to lack of storage. This restricts some movement in areas and therefore opportunities for independence. Routine testing of the equipment and detailed risk assessments are regularly undertaken to ensure a safe environment is maintained.

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good

The Registered Manager has been in post in the children’s home since December 2014. She holds the necessary qualification’s to manage this children’s home. Staff describe the management team as approachable and knowledgeable. The Registered Manager and staff team are focused on improving the quality of care in the home. A deputy has been appointed since the last full inspection; this has had a positive impact with staff having more opportunity to gain advice and management responsibility being shared. As a team they are forward thinking and passionate about providing a child-centred provision. There is an open culture which ensures the home is receptive to new ideas and any concerns or complaints are thoroughly addressed. The home has a good track record of addressing requirements and recommendations from previous inspections and there is a strong and clear commitment to the continuing improvement of the

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good

service. The organisation recognises that staffing levels are not at the level the management identify as ‘ideal’. There is a recruitment and retention drive in operation, which has begun to reduce the number of vacancies across the homes. The organisation has recruited from overseas to ensure there are sufficient and suitably qualified staff on site. The staff are very enthusiastic and passionate about their work and demonstrate that they know the young people well. One parent commented, ‘children have strong relationships with staff members.’ Staff undertake training which enhances their individual skills. Staff are complimentary about the quality and types of training they receive because it is relevant to their work with individual young people. However, staff who have been in post a number of years do not all hold a level 3 qualification. In addition, some training documentation was not clearly evidenced due to a change in computer systems

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good

making relevant data unavailable. The Statement of Purpose clearly states the aims and objectives of the service and the facilities it provides. There is a clear focus on working in partnership with young people, parents and professionals to achieve a consistent approach to meeting the needs of young people. This was seen as being achieved both in practice and through conversations. Strengths and weaknesses are fully recognised and any areas for further development are taken on board and reflected upon. The service is monitored and subject to regular internal auditing by the management team and external scrutiny by other professionals. However, the monitoring reports have limited evaluation of the quality of care provided or if young people are effectively safeguarded. This hinders the ability of the manager to identify patterns and trends. The management team clearly prioritise the young people’s needs, and respond

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good

promptly to any concerns. They will challenge and strongly advocate for young people if they feel they require additional services and support in respect of their care planning. They work very closely with the young people, staff and professionals to make sure the young people are the priority and they develop and achieve as a result of this placement.

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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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