Children's home in Watford

Outstanding

The children's home provides highly effective services that consistently exceed the standards of good. The actions of the home contribute to significantly improved outcomes for children and young people who need help, protection and care.

p.2

The children's home provision is outstanding because:

  Young people are the centre of the home. Staff strive to provide the highest quality of care to young people to meet their complex needs. Exceptional relationships are maintained with families, education and specialist agencies, and as a result, there are bespoke packages of support around the young people. The staff team is remarkable at keeping young people safe and living with their families for longer. This is a commendable ethos relevant to all short-break services nationwide.

p.3

The children's home provision is outstanding because:

 Research-informed practice has enabled staff to build quality relationships that, in turn, improve outcomes for young people. This philosophy is evident in the celebration of achievements when a young person takes steps to meet their targets and goals. A parent said ‘they have helped my child to move on and progress with life skills, they are a lovely bunch of people’.

p.3

The children's home provision is outstanding because:

 Staff enable young people to make choices. A multitude of communication tools and methods are used to assist young people to communicate their needs, preferences and feelings. Staff have very good skills in sign as well as using communication aids to overcome barriers to communication. Young people are safer because of this.

p.3

The children's home provision is outstanding because:

 Staff take ownership of records and make them clear, succinct and meaningful. Care plans are explicit about the care that young people require during their short breaks. Staff are well informed of strategies to manage behaviour, emergency protocols and healthcare plans. The monthly auditing system ensures that records kept about the young people are ‘live’ documents.

p.3

The children's home provision is outstanding because:

 The format of staff supervision is exemplary. Staff embrace regular supervision that focuses on young people and their needs. Staff self-critique the care that they provide to young people, and this facilitates learning and impacts positively on young people’s experiences during their short breaks.   Staff feel supported by an effective and qualified registered manager. Staff prioritise the needs of young people over any business needs. Team morale is high despite the forthcoming closure of the home. The registered manager leads the service with strength and tenacity that expresses concern to professionals about future support on behalf of young people.

p.3

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation:  ensure that staff have access to specialist training that improves their skills and expertise in caring for children and young people with Autism Spectrum Disorder (‘Guide to the Children's Homes Regulations, including the quality standards’, paragraph 10.11, page 53).

p.5

Information about this children's home

The home is registered to provide residential short breaks for up to four young people, with learning and/or physical disabilities, between the ages of five and 17 years. The project is run by a large national children's charity through a service-level agreement with the local authority. The service is currently providing 2,200 six-hour 'sessions' per annum for 14 young people. The service is due to close on 31 March 2016.

p.6

Recent inspection history

Inspection date Inspection type Inspection judgement

p.6

Recent inspection history

21 January 2016 CH – Interim Sustained effectiveness

p.6

Recent inspection history

26 February 2015 CH – Interim Sustained effectiveness

p.6

Recent inspection history

21 January 2014 CH – Interim Good progress

p.6

Outstanding

Staff display a genuine warmth towards young people. There is an obvious positive atmosphere in the home as young people arrive from school, smiles and affectionate greetings from everyone. The needs and feelings of young people are valued with high regard. Staff help visitors to acknowledge some young people’s anxieties around new people and give them tips to overcome this. Confident attachments are visible between young people and staff. These attachments contribute to young people having positive experiences during their stays.

p.7

Outstanding

Young people enjoy making day-to-day choices about their lives, such as food and activity choices. Staff enable this to happen through using various communication aids. Photographs play a large part in helping the young people to make choices. Staff listen to young people and develop their care around them. Activities young people have chosen and enjoyed include trips to the seaside, bowling, music and country walks. Furthermore, the staff recognise the importance of family activities. Every so often, the home organises an event at a local tourist attraction for all young people to attend with their families. The most recent one at a zoo was a goodbye party, due to the impending closure of the home.

p.7

Outstanding

Staff instil a confidence in young people that they can achieve and that increases their independence. Young people have targets they are working towards that are completely personal to them. Young people have many achievements here, such as learning to brush their teeth, increasing their mobility, making a drink and improving their communication. Progress is celebrated as part of daily life. Staff recognise when young people do well and readily praise their success.

p.7

Outstanding

The care planning process is robust and young people identify their own needs with assistance from their families and the professionals who support them. Records come to life as they are read. The excellent quality records are in place that successfully capture the individuality of the young people.

p.7

Outstanding

Comprehensive healthcare plans detail explicitly the needs of young people. Staff work closely with families and a specialist healthcare practitioner to provide a high level of healthcare. Regular and effective liaison with consultants and health professionals is commonplace, particularly in supporting medication changes or new complex procedures.

p.7

Outstanding

Staff carefully consider any changes to young people’s daily routines. The use of ‘social stories’ and schedule timetables is routine in communicating plans for the day or how many nights a young person is sleeping at the home. Staff plan more complex transitions, such as a change to a new service, with rigour. A detailed transition plan supports young people to move successfully and to build new relationships.

p.7

Outstanding

Young people who stay here are diagnosed with physical and/or learning disabilities. As such they rely on staff to meet their needs and to keep them safe. The environment is sensitively adapted to ensure the safety of young people. The enclosed garden enables them to have independent access to the outdoors.

p.8

Outstanding

Specialist moving and handling equipment is available throughout the home and is kept well maintained and serviced. This equipment enables young people to feel safe and secure while taking a bath or shower, getting into bed or relaxing in the sensory room hammock. Staff are suitably trained and use this equipment proficiently.

p.8

Outstanding

For those young people with serious and life-threatening health concerns, clear emergency healthcare plans detail the response required by staff. Staff have training in specific health procedures, such as epilepsy management, oxygen saturation management and gastrostomies. Effective partnership working with health professionals means relationships are strong and support is readily available.

p.8

Outstanding

Each young person has an individualised risk assessment that effectively informs staff how to keep them safe. Strategies to reduce risks are unique to each child and focus on de-escalation. It is acceptable for young people to vent their frustrations in their bedrooms. This often sees them reach a calm equilibrium quickly, with minimal intrusion from staff.

p.8

Outstanding

Medication is stored safely and administered by staff with care and competence. A robust medication procedure is in place and staff carefully check and audit medication to reduce the risk of error. This level of rigour works, as one near-miss was spotted and swiftly rectified with no impact on the young person.

p.8

Outstanding

Behaviour management plans effectively identify young people’s anxieties and the impact this may have on their behaviour. Staff are attuned to young people, to their needs and they recognise when distraction techniques may benefit young people. Effective communication with families and education staff prior to a young person’s stay informs staff of any anxieties young people may be experiencing. These techniques and levels of communication work exceptionally well, and the use of physical intervention is a rarity.

p.8

Outstanding

One young person’s behaviour management strategy includes the use of a prescribed pro ne rata (PRN) medication. Specialist consultants share the plan for its use with staff, which they follow with rigour. Records are explicit and staff recognise it as a form of chemical restraint. The registered manager’s oversight of such medication safeguards this young person.

p.9

Outstanding

Staff have regular training about safeguarding young people that is specific to young people with disabilities. Staff understand the child protection policy and their responsibility to keep young people safe and to report concerns. The staff’s knowledge and skill in communication with young people makes young people safer.

p.9

Outstanding

The registered manager reviews accident logs, injuries and concerns effectively. He has built strong links with the local authority and professionals who safeguard young people. A professional said ‘communication is good and I am informed of any concerns that may arise’.

p.9

Outstanding

The registered manager is a skilled individual, with qualifications that include management and care. He has over 15 years’ experience of caring for vulnerable young people. His innovative ideas are often disseminated throughout the company (a large national charity), an example being his creation of a tool to set targets and measure young people’s progress. Staff deliver care to the young people with the most recent research and new legislative frameworks in mind. The registered manager delivers in-house workshops to staff on current topics and new developments that relate to their service. All staff complete the core training package and have regular refreshers. Autism training does not currently form part of the training programme and this is a weakness. The supervision policy is effective, as all staff receive monthly reflective supervision. These meetings focus on the experiences of young people, reflect on

p.9

Outstanding

the care staff provide to them and highlight staffs’ learning and development needs. Staff feel supported in their role. One member of staff said ‘we sit and reflect on how we could have supported a young person better.’ All staff have their development targets reviewed annually: goals are set and supervision records evidence staffs’ progress in achieving them. The registered manager’s oversight in the home is exceptional. The development plan identifies progress that the team has made in the last year. Families’ anxieties are recognised and supported during a turbulent time in changes to services. Staff are sensitive to this and offer the flexibility of short breaks wherever possible. The registered manager is a strong advocate for all young people and prioritises their needs with passion. He is not afraid to critique and challenge the local authorities when he feels decisions do not meet the needs of young people. He did

p.9

Outstanding

not accept new referrals received two months before the home is due to close despite pressure from the local authority. The registered manager has been vocal in his concerns about future provision and the lack of transitional arrangements for young people in the local area. Staff conduct monthly audits of the information held about young people. This audit keeps records up to date with young people’s current needs. The registered manager’s daily monitoring of incidents, significant events and concerns is robust. His feedback and constructive criticism is well accepted and the staff embrace an ethos of learning and improving care. The statement of purpose has been reviewed since the previous inspection. As a result, the document clearly sets out the ethos of the home and the aims of the service. Children’s guides are in symbol format, which meets the communication needs of young people. The registered manager is managing the forthcoming closure of the home as a

p.10

Outstanding

positive role model and states that ‘the focus remains on young people.’ Staff are equally as determined in celebrating the home and making every remaining short break experience for young people a positive one.

p.10

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’.

p.11

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

p.11

What the inspection judgements mean

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

p.11

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

p.12

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 .

p.12

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, work- based 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,

p.13

Information about this inspection

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

p.13

Information about this inspection

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

p.13

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

p.13