Children's Home run by Halton Borough Council in Halton

Good

The children's home provides effective services that meet the requirements for good.

p.2

The children's home provision is good because:

 Young people are cared for by staff who know them well, and value their unique qualities and personalities. Relationships are warm and affectionate.  Young people make progress, because they enjoy a greater participation in family life, education and social play that enhances their quality of life.  Young people demonstrate their happiness in the home by their ready smiles, relaxed posture and confident interaction. Those who use language say that they are happy.  Social workers and parents praise staff for their child-focused approach and their commitment to cooperative multi professional work to help children‟s lives improve.  Parents say that their children are happy, well cared for and enjoy a range of activities that they may not otherwise have the opportunity to experience. They say that their family lives improve as a result of the service provided by the home.  Staff promote the views of young people by positive and proactive

p.3

The children's home provision is good because:

communication support that enables them to speak for themselves. They participate in day-to-day decisions about their lives. This improves their self- esteem and confidence in interacting with the world.  Staff provide warm and nurturing care for young people that ensures their safety and well-being. In order to maximise young people‟s individual potential, staff require additional training in understanding learning disability and how to break developmental goals into small steps.

p.3

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 „Guide to the children's homes regulations including the quality standards‟. The registered person(s) must comply within the given timescales.

p.4

The protection of children standard

12.—(1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) assess whether each child is at risk of harm, taking into account information in the child‟s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child;

p.4

The protection of children standard

In particular, to specify the procedures to be followed and the roles and responsibilities of staff when a child is missing from care or away from the home without permission, and how staff should support the child on return to the home. 15 July 2016

p.4

Policies for the protection of children

34.—(4) The registered person must prepare and implement a policy (“the missing child policy”) setting out— (a) the steps taken, and to be taken, to prevent children from being absent without permission; and (b) the procedures to be followed, and the roles and responsibilities of persons working at the home, in relation to a child who is, or has been, so absent. 15 July 2016

p.4

Independent person: visits and reports

44 (4a) The independent person must prepare a report about a visit (“the independent person‟s report”) which sets out, in particular, the independent person‟s opinion as to whether— (a) children are effectively safeguarded;

p.4

Independent person: visits and reports

In particular, a rigorous and impartial assessment of the home's 15 July 2016 arrangements for safeguarding and promoting the welfare of the children in the home.

p.4

Review of quality of care

45.—(3) After completing a quality of care review, the registered person must produce a written report;

p.5

Review of quality of care

In particular, that identifies areas of strength and possible weakness in the home‟s care, and clearly states how those actions to improve will be addressed. These includes staff training needs. 15 July 2016

p.5

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation(s):

p.6

Recommendations

 Ensure that staff have the knowledge and skills to understand each child's education and training targets and their next steps for learning, so that activity in the home can be suitably differentiated to maximise their potential for growth and development („Guide to the children's homes regulations including the quality standards‟, page 28, paragraph 5.11).  Ensure that each young person's healthcare plan is up to date and forms the basis of their care, including how they are supported to cooperate with administration of their medication („Guide to the children's homes regulations including the quality standards‟, pages 32, paragraph 7.1).  The registered person should ensure that all medication administration follows organisational and NICE guidance, particularly with regard to reducing the need for covert medication practice („Guide to the children's homes regulations including the quality standards‟, page 35, paragraph 7.17).

p.6

Information about this children's home

The home provides short-break care for up to four children with learning disabilities, physical disabilities and sensory impairment. It is managed by a local authority and provides a service to children from a number of local authorities.

p.7

Recent inspection history

Inspection date Inspection type Inspection judgement

p.7

Recent inspection history

16 March 2016 Interim Sustained effectiveness

p.7

Recent inspection history

4 March 2015 Interim Sustained effectiveness

p.7

Good

Staff provide children with good-quality, individualised care during their short breaks. The service remains sufficiently flexible to accommodate short-term emergencies such as family crises. Parents say that their children improve because of their experience in the home. One parent said, „(child) loves coming here, and he is increasing his independence and makes friends.‟

p.8

Good

Young people who live in the home demonstrate their trust and confidence in staff in the way that they approach them for help and attention. Seeking reassurance from staff, children were happy to play with the inspector, and were curious about her as a new person in the house. They were able to enjoy playing catch, ask questions, play finger rhymes and talk about their favourite activities with a new person, because they trust staff to support them. Social workers and parents say that staff have helped children to socialise more, make choices, and communicate their needs and interests more effectively to others. Staff take great pleasure in their achievements, and use praise and affection liberally to reinforce warm and positive relationships.

p.8

Good

Staff are knowledgeable about each young person, and provide care for them that takes account of their health, social and communication needs. They participate in multidisciplinary planning meetings, and share the progress that children make with other professionals who support them. Parents value the consultative and inclusive approach used by the home. It means that children experience care that reflects important family routines, such as bedtime rituals, so that they feel safe and happy during their stay. Staff help them to practise emerging skills such as toilet routines, independent dressing and use of cutlery, so that they can more easily participate in family life and social activity. This enriches their experiences, and offers them opportunities to make choices about the way in which they express themselves.

p.8

Good

Careful and structured introductions to the service means that care plans are clear about how staff meet needs in a way that promotes well-being and protects children and young people. Due to the complex nature of many, the manager ensures that staff understand the correct channels for decision making, so that consultation is fostered and delegated authority is understood. This protects young people‟s rights to have appropriate decisions made about their education, health and self-determination. When necessary, advocacy services are used to ensure that their views are gathered and verified independently. When possible, children and young people choose how they spend their time in the home, and staff offer guidance and encouragement to help them to make positive choices. This approach has helped some young people to cooperate with their medication regimes and, consequently, eradicated the need for covert medication

p.8

Good

administration. However, healthcare plans do not set out clear reviews of the need for covert medication, thus do not consistently reflect the changes that staff make as children progress in this area.

p.9

Good

Young people improve their social communication. For some, this involves a „yes or no‟ choice of two options, and for others this means that staff support them to think about the needs and interests of others, as well as their own. Staff patiently persuade them to wait, share or take turns at a favourite activity such as spending time in the sensory or cinema rooms. This helps them to learn about how their choices impact upon others, and experience the „give and take‟ of successful social relationships.

p.9

Good

Records show that staff are unclear about how to break down developmental and communication goals into small steps. Staff records of how children participate in activities and their impact are not sufficiently detailed or evaluative to underpin a measured approach to enhancing progress in play, communication and self- regulation. Equally, the inspector noted that not all staff have the skill to extend and diversify activity for some children, and there was a variable quality of interaction with them. This means that opportunities for learning are limited. Managers are keen to address this area of staff development, particularly as it has recently been identified through external monitoring of the home.

p.9

Good

Managers have agreed a plan to refurbish parts of the home and garden that are beginning to look tired and unwelcoming. This includes some bedrooms, the bathroom and the grassed area that children use for barbeques and tub gardening. Additional outdoor equipment, such as a trampoline, play tent and scooters, have been purchased to enhance play activities on the safe-surface play area. Following parent fundraising, key workers are consulting with children to find out what additional equipment and activities they would like. Some children are able to communicate directly about their wishes while, for others, staff observe and interpret their views from their reactions and free exploration. Because staff help them to achieve some of those desires, children experience reinforcement of their own importance and ability to influence their world. This increases their resilience and willingness to explore new adventures, from food to friendship.

p.9

Good

Staff work with multi professional teams to complete and implement person- centred plans for young people who are moving to adult services. The manager prompts and chases the allocation of social workers at this important stage of young people‟s lives. An independent professional from a local self-advocacy group was very complimentary about the way that staff offer support and care to young people and their families during this process. He said, „They advocate well for young people because they know them extremely well, and turn up to planning meetings to share that knowledge and make sure it is taken into consideration.‟ Staff are often the consistent professional voice for young people who are experiencing much change and disruption, and this improves their outcomes.

p.9

Good

Children and young people who have disabilities and complex health needs enjoy their time in the home, because caring and knowledgeable staff help and protect them. Key workers liaise with parents and professionals to identify risks carefully and minimise them.

p.10

Good

Young people respond well to the simple verbal communication and physical prompting by staff, because they trust them to help them to feel better. Staff are trained in a positive approach to managing behaviour. They use planned ignoring or attention, and simple redirection such as a change of activity to prevent young people from becoming upset. For example, one child became overstimulated while playing in the foot spa. Staff immediately recognised that he had become anxious and was creating an unsafe situation, because he splashed water everywhere and tried to drink it. They talked to him about finishing that activity, and made suggestions for alternatives until he chose to go out into the garden. This helped him to self-regulate and, consequently, reduced the risk of unsafe behaviour.

p.10

Good

Staff are routinely trained in protecting children, but have not been updated in protecting children who have disabilities. However, staff are alert to signs of discomfort or distress that may require further assessment, and communicate any concerns to appropriate professionals. Any injury, however slight, is recorded. It is reported to social workers and parents, if appropriate. Parents say that they believe their children are safe and happy because of the pleasure that they demonstrate when anticipating their short break. Parents have honest communication with staff, and they have no concerns that they could not share with them. Children are better protected, as a result. Staff training has included how to protect children from the risks of sexual exploitation, so that they are equipped to recognise warning signs and take effective action when necessary.

p.10

Good

There has been one incident of a young person going missing from the home. He was found relatively quickly. At the last inspection, recommendations were made to improve recording and evaluation of that incident to ensure that managers can identify learning that would prevent further episodes. This has been done, but managers have not fully explored and rectified every error. Staff revisited the policies and procedures to be followed in the event of this happening, and are confident about what to do. The breach of security at the garden gate has been rectified. There is an improved perimeter security check that takes place at each shift handover, and clearer instructions for staff to maintain line of sight when children play outside. However, risk assessments and individual procedures for reporting children missing still do not highlight the need to call the police immediately, and indicators of vulnerability for young people are not fully

p.10

Good

described. Although the child concerned no longer lives in the home, the arrangements put in place to track his movements were not fully explained in his care plan. This limits the effectiveness of the home to protect children from harm, and reduces the support that children may receive when found by those who search for them. There have been no further incidents of children going missing.

p.11

Good

Behaviour management is a strength of the home. Staff support young people who have complex needs to find ways in which they can manage their anxiety, improve their social skills and communication, and reduce unwanted and harmful behaviour that limits their interaction with the world. Staff work with medical, mental health and education professionals to understand and identify the range of strategies that are most helpful to them. Staff are creative in thinking about ways to redirect or divert young people, and this means that children are not restrained. Parents, social workers and other professionals praise staff for their cooperative, enabling and sensitive approach to young people.

p.11

Good

The registered manager and deputy work well together. The deputy manager spends a large proportion of his time on shift with children, which limits his managerial oversight. They review and oversee improvements in the quality of care provided to children to enable them to live full and enriched lives with their families and community. All staff, including the cook and ancillary staff, offer consistently positive care and attention to children that celebrate their unique personalities and reflect their wishes. Children demonstrate their happiness in the home by ready smiles, confident interaction and exploration of the home.

p.11

Good

Staff report very high levels of satisfaction at the management support that they receive. Parents and professionals also voiced high praise for the way that staff support and develop transparent and effective communication between all parties, to the benefit of children. Surveys, both independent and those commissioned by the home, demonstrate appreciation for, and satisfaction with, the quality of care provided. Staff are trained effectively in specific procedures such as peg-feeding, administration of oral rescue medications for epilepsy and the use of hoists. This means that children receive competent care that protects their dignity and supports good health.

p.11

Good

The needs of children are a high priority. Staff recognise, enjoy and celebrate the efforts of young people to improve their knowledge and understanding of the world, and their interaction with it. Staff are proud to describe the individual achievements of children, and know their development needs. This underpins the progress and enjoyment that children experience in many aspects of their lives.

p.11

Good

Children make progress in the quality of their sleep, independence, communication and behaviour. However, the activity programme fails to provide differentiated, targeted, developmental and social opportunities that enhance their learning. Managers do not routinely assess the quality of activities and outcomes for children against their starting points. Access to community-based activity is inconsistent, sometimes because staffing ratios are not flexible enough to respond to changing needs, such as when a child is unwell. Not all staff training needs are identified, such as understanding autism and learning disability, child development and supporting communication. This limits the effectiveness of the care plans that key workers devise. Opportunities are missed, such as when staff do not use agreed communication prompts, to maximise children‟s potential to enhance their understanding.

p.12

Good

The manager‟s oversight of the home includes regular monitoring of how well the children are looked after, but it lacks in-depth evaluation and leads to the minor shortfalls found in this inspection. Many practical improvements are identified, such as changes to the layout of the home and making bedrooms more child-friendly, and there are clear plans in place to make steady progress, as budgets allow. Despite a recommendation at the last two inspections to improve the quality of independent monitoring of the home, slow progress has been made. Visitors observe and interact with children and speak to staff about their plans, but they do not evaluate the quality of records about their lives. There is a plan in place that includes training for corporate visitors in their role and responsibilities. Senior managers are ndertaking some visits to ensure that children continue to be safe and well looked after. The format of the report to collect visitors‟ evaluations and

p.12

Good

opinions about the home has been improved. The date for the impact of these improvements to be felt is expected to be late summer.

p.12

Good

Managers attend reviews of children who are not looked after, as well as those who are, to ensure that their plans remain relevant to meeting their needs. Key workers present monthly reports to social workers that describe the progress and setbacks that children make. Parents receive feedback from staff after each stay so that they can talk to their child about their experiences, and work with staff to overcome any difficulties. There are consistent messages from professionals and parents that say that the home provides holistic and all-round support, and it is clear from daily records that this is a strength of the home. This proactive approach means that managers succeed in working cooperatively with the range of adults who support each child, and this improves their life experiences and potential.

p.12

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.13

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.

p.13

What the inspection judgements mean

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.

p.13

What the inspection judgements mean

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.

p.13

What the inspection judgements mean

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

p.13

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.

p.14

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 „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 0300 123 4234, or email enquiries@ofsted.gov.uk .

p.14

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.15

Information about this inspection

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

p.15

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.15

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.15