Children's home in Birmingham

The effectiveness of the home and the progress and experiences of

children and young people since the most recent full inspection. This home was judged inadequate at the full inspection. At this interim inspection, Ofsted judges that it has improved effectiveness . Young people are making progress in their understanding of the world. They are growing in confidence because they have trusting and nurturing relationships with staff. This helps them to try new experiences such as going on public transport, eating a wider range of food or visiting a new park. Staff are enthusiastic and are working hard to promote independent communication, and offer play and leisure opportunities that stretch and develop young people’s skills and interests. However, staff lack specialist knowledge to ensure that communication tools and prompts are fully effective. For example, one young person’s choice board was a mixture of words, pictures and photographs and it was unclear as to her preferred

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The effectiveness of the home and the progress and experiences of

prompt or level of understanding. Another young person was developing his own sign and sound vocabulary with staff. The improvement in his communication intent is remarkable, but understanding is limited to a minority of staff and this does not help him to communicate without their interpretation. Staff are keen to understand and expand young people’s communication skills, but their capacity to support development in this area is limited due to a lack of training and experience in autism, communication and sensory needs. An autism specialist provides support on an occasional basis, to review goals and strategies for their development. While young people are making progress, their potential is not yet fully realised. Following requirements made at the last inspection, managers have continued to revise and improve care planning and staff support. This includes improved supervision and a move to reflective practice, coaching and mentoring

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The effectiveness of the home and the progress and experiences of

opportunities, a review of care planning documentation, key worker training and support and dedicated time for care planning and records. Managers have re- structured records to ensure that all staff work consistently and proactively to deliver quality care that supports young people to make progress in every area of their lives. Key workers are being coached and supported in their role by the managers. They have a clearer understanding of their particular responsibilities in ensuring that young people’s plans are up to date and circulated among staff. Improvement is evident in the quality of communication and developmental targets for young people, although it is early days. Staff continue to be enthusiastic about their ideas for helping young people to develop. For example, one key worker showed the inspector her plans for introducing sensory play and exploration for one young person, and how this would help her to occupy herself independently and

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The effectiveness of the home and the progress and experiences of

constructively. Young people live in an improving environment that is designed to support their needs and reflect their personalities. For one young person, this means that his bedroom windows have blinds set within a tamper-proof unit, to ensure privacy. For another young person, protective padding around her bed has been updated to provide a more hygienic and suitable covering. This ensures that young people are cared for and protected appropriately according to their individual needs. New front doors are still being waited for, to ensure that there is minimal opportunity for young people to exit the building unnoticed. There is a permanent staff team to support young people, although there are some vacancies that the manager is recruiting to fill. Most shortfalls in rota cover, occur during school holidays, and generally staff work additional hours so that young people have familiar faces to care for them. Staff confirmed that these extra hours

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The effectiveness of the home and the progress and experiences of

are not excessive. The manager is waiting for final feedback from the training department to confirm how they intend to deliver a bespoke training package that meets the needs of young people placed at the home. New staff are being enrolled onto an improved induction and probation plan that has clear milestones for their professional development. It is taking longer to transfer other staff due to delays in the completion of a staff skills checklist. Young people are supported to enjoy good health. One young person has been able to receive treatment from a chiropodist and visit a dentist, both of which have previously been difficult to achieve. His key worker is committed to ensure that he adopts routines that will help him to access this important healthcare in the future. Staff accompany young people to hospital appointments so that they can learn first-hand what health specialists have to say. Parents appreciate this, and say that

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The effectiveness of the home and the progress and experiences of

staff enable clear discussion about their child’s needs. For example, due to improvements in seizure activity, a specialist has agreed that one young person can discontinue her medication that had been prescribed for emergency use. This has increased her leisure and social opportunities because she is no longer dependent on adults trained in its administration to accompany her into the community. Staff have redeveloped the medication room, to ensure that the organisation and layout provide a clean and tidy environment that minimises any risk of error in administration or stock control. Audit systems have been improved, to identify any loss of or use of out-of-date controlled drugs, and to further improve safe disposal of liquid medicines. While there is much improvement in medication administration, not all procedures for the administration of medication consistently include clear instructions for how medication is to be dispensed according to risk assessments.

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The effectiveness of the home and the progress and experiences of

For example, it has been identified that one young person may swallow the contents of a bottle of medicine if he gets hold of it. Procedures do not specify how medication travels from the medicine cabinet to the young person. This means that errors or inconsistencies could result from staff who, for example, leave the medicine bottle out while they dispense medication. Staff demonstrate an understanding of how to protect and safeguard young people. Staff are recruited in accordance with procedures that help protect young people from unsuitable adults caring for them. Further training is planned to ensure that staff are able to act appropriately at all times to protect children with disabilities. Behaviour management is a strength of the home, with staff competently predicting young people’s needs, and diverting unwanted behaviour by positive strategies, such as offering favourite activities including computer time

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The effectiveness of the home and the progress and experiences of

or a walk, when young people demonstrate agitation or anxiety. This helps young people to learn skills in self-regulation. Through good use of routines and simple instructions, staff help young people to predict what is happening next. This gives them confidence to overcome their fear of change, and helps them to go to school for example, or tolerate new people in their home. In turn, this exposes young people to new and developmental opportunities that they may previously have avoided, and enhances the quality of their lives. Managers and staff are working together to continue to rectify all shortfalls identified at the full inspection and subsequent monitoring visit, when progress was evident. All actions are identified and tracked through the home’s improvement plan. Senior managers regularly monitor how well the registered manager is implementing those actions. The independent visitor scrutinises the

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The effectiveness of the home and the progress and experiences of

plans, and spends a lot of time with young people, so that she can assess the improving quality of care and protection provided. Staff confirm that they are fully informed about changes to recording and communication systems. They have allocated time on shift to engage in learning and coaching about their role, to improve the way that they support young people. This ensures that there is minimal drift, and improvements persist.

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Information about this children's home

The home is owned by an independent provider. It provides care and accommodation for up to six young people with learning disabilities, some of whom have autism.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

20/02/2015 CH – Interim Sustained effectiveness

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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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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. (Regulation 23 (1) 16/05/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  The registered person should ensure that sensory assessment is undertaken for young people, to enable staff to maximise and tailor opportunities for young people to develop themselves in accordance with their needs and interests, and have fun (Guide to the Children’s Homes Regulations, page 31, paragraph 6.4).  The registered person should ensure that staff can access appropriate resources to support their training needs regarding understanding autism, communication and sensory needs (Guide to the Children’s Homes Regulations, page 53, paragraph 10.11).

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What the inspection judgements mean

At the interim inspection we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the Inspection of children's homes: framework for inspection.

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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 focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

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 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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