Children's home in Birmingham

This monitoring visit

This home was judged inadequate at the full inspection on 11 November 2015. Following this monitoring visit we have made a new full inspection judgement in line with our Inspection of children's homes: framework for inspection. The home's new full inspection judgement is that the home requires improvement .

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This monitoring visit

One young person has moved from the home, and one has moved into the home since the last inspection. The home is making every effort to rectify all shortfalls identified at the full inspection. Senior managers have conducted an investigation into the significant safeguarding incident that occurred prior to the full inspection. They have conducted an inquiry into the matters raised during that inspection. A report and action plan is published, that sets out comprehensive steps to improve every aspect of care in the home. On a weekly basis, senior managers monitor how well the Registered Manager is implementing those actions. This ensures that there is minimal drift, and improvements persist.

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This monitoring visit

Leaders and managers have identified personnel and system errors that contributed to the shortfalls found. They have demonstrated a commitment to address all matters at their source. Managers have resisted a ‘quick fix’ approach to improving the service and this means that while all areas are being addressed, not all shortfalls have been completely rectified. Quality assurance processes do not yet analyse the impact of changes on the quality of care provided. Managers accept that the action plan is very much a work in progress, and remains subject to change dependent upon outcomes for young people.

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This monitoring visit

Improvements in the quality of care planning is dependent upon a number of other factors. For example, the recruitment of experienced and qualified staff; improved induction and developmental training opportunities; improved supervision and a move to reflective practice; coaching and mentoring opportunities; review of care planning documentation; key worker training and support; dedicated time for care planning and records. Care plans still require improvement, both in layout and content, to ensure all staff work consistently and proactively to deliver quality care that supports young people to make progress in every area of their lives.

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This monitoring visit

Development work has begun. There is a full, permanent staff team to support young people. The training department is working collaboratively with the home, to devise and deliver a workforce development plan and bespoke training package that meets the needs of young people placed. There are exemplar documents completed for improved risk assessments, revised care planning tools and clearer identification and support of young people’s needs. Key workers are newly appointed and enthusiastic, and staff are beginning to familiarise themselves with new styles of recording and planning.

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This monitoring visit

Risks to young people’s health have been minimised due to improved staff knowledge and understanding. Health practitioners and pharmacist support have refreshed staff skills in caring for young people who have gastrostomy procedures and epilepsy. A medical professional has clarified emergency action following severe seizure activity. There is an improved response to emerging risk, such as a crash mat being provided for a young person following a fall out of bed. Parents and social workers discuss any concerns with the home, and changes have been made, for example, to how one young person’s clothes and toiletries are stored following inappropriate use of those items. A visiting social worker said that they have found the home to be responsive to suggestions she has made to improve the safety and welfare of young people, and the young person she supports is making progress.

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This monitoring visit

Collaborative work with medical professionals and parents continues to support improvement in young people’s health and independence. One young person has improved mobility and increased diet. Another young person has successfully undergone surgery and recovery. Another is gaining new strategies to manage his anxiety and overcome his fear of new situations. Consultation with appropriate pharmaceutical agencies ensure there is ongoing improvement in the administration and safekeeping of drugs. Audit systems require improvement, to identify any loss of, or use of, out of date controlled drugs, and to further improve safe disposal of bottles that had contained liquid medicines.

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This monitoring visit

All areas regarding the protection of young people have improved. Staff demonstrated increased understanding and confidence in whistleblowing procedures. They relate this change to their experience of the internal investigation process, and recent training in internal procedures and in child protection. Further training is planned, to ensure staff are able to act appropriately at all times to protect children with disabilities. Learning from recent experience, the organisation has implemented a critical incident analysis, debrief and action planning procedure. This encourages reflection and transparency in identifying and managing serious incidents that may occur in the future.

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This monitoring visit

The home is undergoing a fabric and building review. External doors have been strengthened while new ones are on order, and a fob system has reduced the risk of young people leaving the home unnoticed. There are plans to fit a window with a tamper-proof curtain in the bedroom of a young person who removes all coverings, to protect his privacy. Internal doors have new handles fitted that improve movement around the building. Protective padding around one bed is being replaced, to provide a more hygienic and appropriate cushion.

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This monitoring visit

Young people continue to live in accommodation that reflects their needs and interests. Parents are encouraged to contribute their thoughts and wishes about how to arrange the accommodation to best meet their child’s needs, and this has enabled young people to settle into the home. Improved communication between staff ensures that handover times include a count of all young people present. Signs are used to alert staff to risky procedures taking place, such as the administration of medication. This enhances the privacy and dignity of young people as well as minimising the risk of others taking medicine that is not theirs. Managers have introduced a new system for identifying and measuring risk. This provides a clear account of the level of risk faced by and posed by individuals. The risk support strategies cover how to prevent, minimise and react to each area of need. Still in the very early stages of development, records demonstrate that this

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This monitoring visit

approach provides greater evaluation of the effectiveness of the approaches used, to enable meaningful review and development. Not all young people have this revised assessment plan in place, but the manager has published effective interim strategies to ensure young people’s safety is a priority.

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This monitoring visit

The home has addressed all of the critically unsafe issues and events that could impact on the immediate welfare and safety needs of young people. Managers are taking an in-depth, rather than a sticking plaster approach, to improvement. This means that the changes are more likely to be sustained. However, this can only be seen over time. The home has a good track record in operating in compliance with the regulatory framework for children’s homes. Senior managers, the Registered Manager and staff all demonstrated a commitment to improvement.

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Information about this children's home

 the home is registered to accommodate up to six young people with learning disabilities and mental health needs  The home is privately owned

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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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The quality and purpose of care standard

6.—(1) The quality and purpose of care standard is that children receive care from staff who— (a) understand the children's home's overall aims and the outcomes it seeks to achieve for children; (2) In particular, the standard in paragraph (1) requires the registered person to— (iv) provide personalised care that meets each child's needs, as recorded in the child's relevant plans, taking account of the child's background; 21/03/2016

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Medicines

23.—(1) The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children's home. 21/03/2016

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Children's case records

36.—(1) The registered person must maintain records ("case records") for each child which— (a) include the information and documents listed in Schedule 3 in relation to each child; in particular parts 20 and 26) (b) are kept up to date; 21/03/2016

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Implement practice related supervision, to ensure staff reflect on their practice and the needs of young people in their care. (The Guide to the Quality Standards, page 61, paragraph 13.2)

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Recommendations

 Ensure that all reviews of the quality of care provided identifies the impact that care is having on outcomes and improvements for young people. (The Guide to the Quality Standards, page 65, paragraph 15.2)

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the home since their last Ofsted inspection. This inspection was carried out under the Care Standards Act 2000. 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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