Children's home run by Birmingham City Council in Birmingham

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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The children's home provision requires improvement because:

 The registered manager and her staff team have met a number of requirements to ensure that this service is no longer inadequate. However, there are still some ongoing areas for improvement.  Ongoing improvements in child-focused recording need further work to ensure that children, young people and their families understand records about their care and their experiences.  Use of symbol, pictures and sign language is still not an integral part of the service or of staff practice.  Advocacy is not extensive enough to meet the needs of children and young people.  Some of the improvements to the physical environment are only still at planning stage.

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The children's home strengths

 All children and young people continue to have good support to ensure that their school attendance remains good.  Robust fire, health and safety procedures keep children and young people safe.  Working in partnership with health counterparts provides wraparound healthcare for children and young people with complex medical needs.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person 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 must comply with the given timescales.

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Requirement Due date

6: The quality and purpose of care standard:

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Requirement Due date

In order to meet the quality and purpose of care standard, the registered person must ensure that children receive care from staff who —

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Requirement Due date

(2)(c) ensure that the premises used for the purposes of the home are designed and furnished so as to—

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Requirement Due date

(ii) enable each child to participate in the daily life of the home; 30 May 2016

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Requirement Due date

7: The children's views, wishes and feelings standard:

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Requirement Due date

In order to meet the children‟s views, wishes and feelings standard, the registered person must ensure that children receive care from staff who—

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Requirement Due date

(ii) help each child to express views, wishes and feelings;

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Requirement Due date

(iii) help each child to understand how the child‟s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child.

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Requirement Due date

(i) is enabled to provide feedback to, and raise issues with, a relevant person about the support and services that the child receives;

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Requirement Due date

(iii) is given appropriate advocacy support. 30 May 2016

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Requirement Due date

The registered person must ensure that a disabled child accommodated in the home is provided with access to such aids 30 May 2016 and equipment as the child may require as a result of the child‟s disability in order to facilitate the child‟s communication with other persons (Regulation 22(4)).

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Requirement Due date

The registered person must maintain records (“case records”) for each child, which are kept up to date and are signed and dated by the author of each entry (Regulation 36(1)(b)(c)). 30 May 2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Record information about the child in a way that will be helpful to the child („Guide to the Children‟s Homes Regulations, including the quality standards‟, page 62, paragraph 14).

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Recommendations

 Support children and their parents to understand the nature of records kept in the home and how to access them. Staff should understand their role in encouraging the child to reflect on and understand their history, according to their age and understanding. Staff should keep and encourage children to keep appropriate memorabilia and help them to record significant life events („Guide to the Children‟s Homes Regulations, including the quality standards‟, page 62, paragraph 14.5).

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Information about this children's home

The home provides care and accommodation for up to 16 children and young people with physical and/or learning disabilities. The home provides ten long-term placements and six short-break placements. The home is operated by a local authority. The home is also registered with the Commission for Quality Care.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

27 March 2015 CH - Interim Declined in effectiveness

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Recent inspection history

19 February 2014 CH - Interim Good progress

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Requires improvement

Children and young people receive individualised care due to improvements in care planning. Their support is needs led with good working in partnership with health authority counterparts and a range of agencies. All children and young people now have up-to-date local authority placement plans. Improvements in care planning provide bespoke and safe care for all children and young people. Children and young people now live in a safe environment due to extensive work carried out by the registered manager and staff. Extensive repair of the building, upgraded fire safety checks and a review of all health and safety throughout the service have been carried out. For example, the roof in the main reception is now repaired and all fire exits and doors are now fully functional. The updated fire risk assessment has addressed outstanding recommendations and made further improvements to fire safety in the home. Children and young people have far greater opportunity to reach their potential as

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Requires improvement

they now enjoy a range of activities. The home is well resourced with play equipment, arts and crafts, in order to encourage sensory play. Refurbishment of the sensory room, improvements in computer access and a chill-out room are all ongoing, in order to improve the experiences and development of children and young people. Progress in meeting the requirement to improve the physical environment is ongoing and acceptable within the timescale since the last inspection. Young people‟s bedrooms were due to be decorated the week after this inspection. Plans for decoration and visual referencing in the corridors are drawn up but are not yet complete. The requirement is therefore repeated, in order to monitor the momentum in improving the physical environment for children and young people. The registered manager and staff are committed to developing an all-inclusive communicative community where all children and young people can be understood

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Requires improvement

and express their views. Improvements in communication processes and partnership working with schools to work collaboratively on communication programmes are ongoing. The registered manager and staff make steady and measured progress. Sign language and symbol use are much improved, and these developments are further reinforced as a staff member embarks on sign language training to enable training for all staff in the home. New notice boards have information about how to complain, the independent visitor and activity plans displayed in symbol form. Improvements in communication have a positive impact on children‟s and young people‟s abilities to contribute their views and wishes about their care and the running of the home. For example, they have good information about activities in the home. They are consulted in young people‟s meetings and a list of activities is displayed so that everyone can keep in touch with what is happening in the home.

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Requires improvement

Staff demonstrate a clear commitment to advocating on behalf of children and young people. For example, challenging agencies results in some children and young people being assessed with regards to being able to eat their own food. Staff have also made sure that children‟s and young people‟s needs and rights are promoted on visits to hospital. Their insight enabled an understanding that refusal to eat was more to do with trust, and staffing was arranged accordingly. This advocacy and intervention meant that this young person was not tube fed and retained their dignity during a recent stay in hospital. The registered manager has also used an agency‟s complaints‟ procedure to ensure that children‟s and young people‟s needs and rights are respected. Managers and staff have made good progress in consulting with children and young people. Attempts to improve children‟s and young people‟s access to independent advocacy are thwarted by a poor response from the local authority‟s

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Requires improvement

rights and participation team. It cannot respond to the complex needs and turnover of the short break service, because of its time commitments. The staff team continues to look for advocacy support that meets and promotes the needs of the children and young people. Good partnership working with medical and health professionals results in ongoing assessment and exploration into children‟s and young people‟s complex medical challenges. Staff are alert to changes in children‟s and young people‟s dispositions and behaviours. They explore reasons for such changes, in order to provide sensitive and insightful responses to support children‟s and young people‟s health and personal welfare. For example, children and young people are safer due to staff responses and monitoring of sleep systems and the regularity of seizures. Staff also have good insight into the childhood experiences that can have an impact on children‟s and young people's development and emotional welfare. For

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Requires improvement

example, staff are mindful about how a series of placement breakdowns can have an impact on children‟s and young people‟s emotional welfare. They understand the importance of emotional health, monitor children‟s and young people‟s responses and work closely with parents to ease possible transitions to home. All children and young people attend full-time education. Staff work with families, transport and a range of schools to ensure good connections when children and young people come for short breaks and have to attend school. Children and young people have continued to progress since the last inspection. Staff are keen to enable independence. Children and young people develop skills to feed themselves and take part in a wider range of activities. Where this is not the case or there are concerns, managers and staff are quick to reach out to medical, health and education professionals to research and resolve concerns.

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Requires improvement

Children and young people enjoy positive relationships with staff. They are relaxed and comfortable in the setting because staff take time to support sensitive transitions between home and school. Children and young people are given good boundaries and are enabled to understand the qualities that help them to live with and respect others. Some children and young people understand their peers‟ needs and seek out friendships. Transitions to the short break service are handled sensitively and taken at a gentle pace, according to the individual needs of the child or young person and their family. Parent‟s value visiting the service. They feel reassured because staff effectively include the whole family in the transition process.

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Requires improvement

Concerns about the restriction of liberty of children and young people are addressed. The manager is measured in her approach and says, „Everyone is working together. Taking time. Measured, steady progress.‟ For example, the registered manager is working closely with the occupational therapist to explore and improve the prescribed use of bed restraints. Developments are well planned, with each child and young person receiving an individual assessment. Risk and behaviour management plans now promote staff supervision and enablement of children and young people, to keep the children and young people safe. All high door handles are removed and no longer restrict children‟s and young people‟s liberty. The registered manager is strategic in her approach and says, „It not just about looking at equipment as restraint. The occupational therapist had a meeting with the staff to get staff to think about it in a different way. Gradually changing ideas.

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Requires improvement

Getting it changed bit by bit.‟ As a result, staff are becoming aware of the need for balance between children‟s and young people‟s safety and the need for clear assessment of equipment that may restrict their liberty. For example, staff are aware that all children‟s and young people‟s beds are being individually assessed. Staff are exploring their own practice and they found input from the occupational therapist at team meetings useful. The requirement to ensure the safe administration of medication is addressed. Care staff present as knowledgeable about children‟s and young people‟s medical needs and implement robust medication procedures. The registered manager continues to have a good understanding of child protection procedures. Children and young people do not go missing, due to the secure environment and staff vigilance. There are no concerns about sexual exploitation of the children and young people.

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Requires improvement

Improved care planning, strategic leadership and more child-centred care mean that this service now meets the home‟s reviewed and up-to-date statement of purpose. The registered manager uses feedback from independent monitoring visits to drive improvement, for example, by ensuring that personal education plans are up to date and making medication audits more regular. Her own monitoring is more robust and results in robust health and safety, and bespoke individual care planning. Renewed and more effective monitoring of the service give the registered manager a consistent benchmark by which to monitor and evaluate the service‟s quality of care. Care planning is streamlined, and children‟s and young people‟s files are much more organised. Streamlining now means that the day-to-day care of children and young people is effectively drawn together. Attention to detail is very good, and the individuality of each child and young person shines through.

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Requires improvement

A combination of risk management and focused healthcare ensure that care and safety are at the forefront when children and young people come for their short breaks. Recording, on the whole, is much improved, but there are still some shortfalls, for example in charting children‟s and young people‟s food and toileting programmes. These omissions hamper review and monitoring of their healthcare needs. The registered manager and staff work in partnership with a range of agencies, such as physiotherapy, school nurses, teachers, paediatric consultants, community paediatricians and speech and language therapists, to meet the complex medical and development needs of children and young people. This collaborative approach provides good care for children and young people. Communication between staff members is good. There is a good emphasis on the health needs of children and young people. Staff take time to work in partnership

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Requires improvement

with schools. They ensure that essential and new information is routinely handed over, in order to promote the safety and welfare of the children and young people. The manager and staff are keen to explore research and keep up with developments. This renewed commitment can be clearly seen in the developments in communication and participation for children and young people with complex learning and/or physical disabilities. All staff are qualified in caring for children and young people and now receive regular supervision. The registered manager has managed this home since March 2007. She has extensive experience and is suitably qualified to carry out her role with a level 4 national vocational qualification in management. Staffing arrangements meet and facilitate both evening and morning routines for children and young people with complex needs. Higher staffing levels in the morning ensure that children and young people get ready and are prepared for

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Requires improvement

school in good time. Evening staffing levels enable children and young people to have a relaxing transition from school and to take part in a range of activities. The registered manager liaises with her health counterparts and strategically leads her staff team to drive improvements at the service. Much has been achieved in addressing the inadequate areas of the service. The registered manager is measured and very resourceful in driving and, most importantly, sustaining improvement.

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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 children looked after 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 in which 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 that 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 whom 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

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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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