Children's home in Birmingham

Good

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

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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 greater participation in family living, education and social play, which enhances their quality of life.  Young people demonstrate their happiness in the home by their ready smiles, relaxed postures and confident interactions.  Social workers, teachers and parents praise staff for their child-focused approach, and their commitment to cooperative, multi-professional work to help young people’s lives to improve.  Parents say that their children are safe and happy because staff care about their well-being and help them to enjoy new experiences.  Staff understand the importance of reducing young people’s anxiety. They expertly anticipate and respond to their support needs, and help them to find safe ways to communicate their feelings.

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The children’s home provision is good because:

 Staff promote the views of young people by positive and proactive communication support that enables them to speak for themselves. Young people participate in day-to-day decisions about their lives. This improves their self-esteem and confidence in interacting with the world.  Managers have planned and driven improvement through consistent monitoring of detailed actions that are set out in the home’s development plan. Further work is planned, to ensure that all staff accurately follow incident reporting procedures, so that all relevant professionals are informed within regulatory timescales.

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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 within the given timescales.

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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.

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The protection of children standard

(2) In particular, the standard in paragraph (1) requires the registered person to ensure:

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The protection of children standard

(vii) are familiar with, and act in accordance with, the home’s child protection policies.

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The protection of children standard

This includes ensuring that complete records are kept of any reports of and outcomes to investigations related to unexplained minor injuries to young people. 31 August

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Notification of a serious event

40 (4e) The registered person must notify HMCI without delay of any incident relating to a child which they consider to be serious, including any minor injury that is unexplained. 31 August

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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 comprehensive written guidance for the use of a mechanical restraint, such as a limiting car seatbelt, is available and regularly reviewed, to ensure its appropriate and effective use. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.55)  The registered person should ensure that case records, including risk assessments and behaviour support guidelines, are consistently kept up to date, particularly during transition of key worker responsibilities. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.3)

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Information about this children’s home

This children’s home is registered to provide care and accommodation for up to six young people with learning disabilities, including complex health needs and autistic spectrum disorders. Three young people were living there at the time of the inspection. The home is privately owned.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

29 March 2016 Interim Improved effectiveness

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Recent inspection history

20 February 2015 Interim Sustained effectiveness

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Good

Young people enjoy affectionate and positive relationships with staff. Young people trust them and have confidence in them. Staff demonstrate kindness, respect and value for their individuality by responding to each young person in ways that best meets their needs. Parents and social workers talk enthusiastically about the impact the home has had on improving young people’s self-regulation, communication, social relationships and independence. One parent described her joy at the improvements in her relationship with her child, and the importance of staff support in enabling him to rebuild other family contacts.

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Good

Young people are making discernible progress in many areas of their lives. Staff have improved their understanding of how to support young people to communicate more effectively. As a result, one young person has an increasing repertoire of signs and sounds, with an emerging use of words. This has given him confidence to increase his social interaction with more adults, as he becomes confident that he can make his needs known. He has a higher level skill than just using behaviour to express his views, and this has reduced his anxiety and frustration. He demonstrates this new happiness by relaxed posture, smiling and making jokes with staff and others, and has begun to spend brief amounts of time with other young people, both in the home and at school.

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Good

All young people attend school. Key workers are working hard to improve liaison with teachers, so that important targets like independence skills practice and communication approaches are mirrored in all environments. This has benefited young people. For example, they are discussing the range of pictures and prompts one young person needs in order to maximise the way he uses his iPad to help his communication of choice and understanding of his day.

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Good

Young people are increasing the amount and range of activity they take part in. For some, this involves short trips out to the community, enabling them to choose their own clothes and toiletries, improve their mobility and increase their understanding of the world. For others, they identify places they would like to go, such as the park or a local wildlife park. All young people took part in a camping trip during a recent school holiday. This was a new experience for them, and they thoroughly enjoyed exploring and using the local leisure facilities, such as bowling and restaurants. Due to careful risk assessment and planning, young people were able to use shared facilities like camp bathrooms, and this gave them valuable opportunities to improve their hygiene routines because they could see others taking their washbags and towels into the facilities. Staff understand the importance of modelling good routines and social relationships. This has helped

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Good

young people to explore their own tolerance to change and the needs of others, and they are making good progress in this area. Staff support this progress by approaching each young person’s sexuality, self-help and emotional control needs with patience, good humour and a proportionate understanding of the pains of being a teenager. This skill is recognised by parents and professionals alike, who say that staff are crucial partners in young people’s lives.

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Good

The home works well with parents and health professionals to ensure that young people’s complex medical needs are understood and supported. Due to improvements in young people’s communication and understanding of self- regulation, it has been possible for some to reduce and then avoid the need for medication that provides support for their mental health. This has improved their underlying health and well-being. Although they remain under the care of health professionals, they have reduced stress because they have fewer medical examinations and blood tests. Additionally, staff complete work with young people to increase their understanding of health-related scenarios, such as visiting the dentist. Over time, this increases their willingness to participate in preventative visits and treatment.

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Good

The home engages well with professionals who are responsible for helping young people to prepare for moving to adult services. One parent explained how helpful the staff were in ensuring that she understood the range of options available to her child, so that she could promote the best possible outcome for her. The specialist nurse responsible for the transition of her complex health plan was complimentary about the care and attention staff pay to her, to ensure that they deliver healthcare that reflects her age and vulnerabilities.

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Good

Staff understand how to support young people to make choices, and are mindful of their fluctuating capabilities in communication and self-regulation. This means that behaviour support plans are written to ensure that staff consider these fluctuations, and give young people every opportunity to resolve their own difficulties, while maintaining their safety. Records and observations of interactions in the home provide evidence that this approach has enabled young people to take great steps towards managing their own lives, safe in the knowledge that staff will support them when necessary. Judgement grade

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Good

Young people live in a comfortable and safe environment that is continually improving, and is made bespoke to their needs. Layout and decor of their individual lounges and bedrooms are completed through consultation with them, their families and the placing authority. This ensures that their home reflects important elements, such as protective cabinets for televisions, or blinds that are integral parts of windows, to maintain young people’s safety and privacy during periods of upset or sensory overload.

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Good

Staff use reflection and discussion with parents and professionals to identify potential solutions that promote improved safety and welfare for young people. Most importantly, they include young people in problem-solving too, by careful observation of their behaviour and encouraging improved communication. As a result, young people are enjoying greater stability in their emotions. Periods of upset have diminished in frequency and intensity, and any physical intervention is minimal and rare.

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Good

The high quality of relationships and interpersonal support that staff provide is underpinning improvement. Growing levels of trust and confidence mean that young people are more relaxed, and look to staff for solutions to their frustrations. Staff care about their comfort, and are alert to small changes in their demeanour or routine that may indicate increased arousal. Their early intervention enables young people to be supported to learn and adopt skills to manage their own feelings. For example, one young person was initially unsettled by having an inspector in his home. He was able to exit to a ‘safe’ distance in the garden, and talk to the inspector from there. This demonstrates a marked improvement in his ability to tolerate new people, which in turn has reduced the number of anxious outbursts he experiences.

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Good

Managers and staff ensure that young people are prepared well for their move to the home. Parents and professionals confirm that staff spend time getting to know individuals and gathering information that helps them to understand the range of their risks and needs. As a result, young people settle in very well and make progress in overcoming unsafe patterns of behaviour, such as throwing furniture or trying to assault others.

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Good

Improved formats for the assessment of risk and need are in place, to ensure that staff understand how to avoid, deflect and respond to potentially unsafe situations. This paperwork does not consistently reflect staff’s level of knowledge about young people when rapid change is encountered. For example, one young person no longer needs to be physically linked at all times in the community, because he now prefers to spend time with staff rather than to run across roads or to approach strangers. This important progress is not reflected in his risk assessment, although all staff describe how they make judgements about when to use this approach based on individual situations.

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Good

Although no young person has been missing, staff know what to do in the event of such an emergency. Improved protocols are differentiated according to young people’s individual needs and vulnerabilities. Appropriate supervision and a proportionately safe environment further limit opportunities for young people to leave the home unsupervised.

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Good

Staff are skilled in using positive approaches to behaviour that support young people’s identities, preferences and vulnerabilities. This means that as young people improve, external support for their behaviour reduces. Overseen by a medical consultant, one young person has been able to cease taking medication to reduce anxiety, because he has improved his communication and self-regulation. Additionally, staff have not used a restrictive harness available for him to limit unsafe behaviour in a vehicle. Nevertheless, this harness remains available for use, and there is insufficient written information available to ensure that staff fully understand when and how to use it. This has not impacted upon his safety and welfare, because staff have helped him to avoid the need for it.

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Good

Young people are cared for by staff who are carefully recruited, and are selected for their skills in working with their complex needs. Sufficient checks are in place to help prevent unsuitable adults from working in the home. The manager is working with one placing authority to enable staff to access their multi-disciplinary child protection training, to enhance staff knowledge and understanding of local authority procedures further.

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Good

Staff record incidents and accidents appropriately, and report any injuries sustained by young people. However, there was a delay of one day in reporting to the local authority one minor unexplained injury of a scratch, and there was no clear outcome recorded of the social worker’s investigation. The home has not followed their own procedures for reporting and recording such events, and it delayed independent professional oversight, although it has not affected the welfare of the young person.

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Good

Improved induction and staff development reviews mean that the manager is able to assess the performance and quality of care provided by new staff. This means that young people receive safe care that meets their needs. Judgement grade

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Good

Leaders and the manager have taken on board lessons learned from previous shortfalls in practice and have continued to drive improvement over time by developing systems and staff. Their commitment to provide safe and high quality care is evident in the progress made since the last inspection. Staff, parents, teachers and social work professionals confirm that young people are making very good progress from their starting points. They say that this is because the home supports their needs, and engages effectively with all stakeholders, to asses and review good quality programmes of care. Without exception, all expressed high degrees of satisfaction with the home and valued the warmth and dedication that staff demonstrate towards young people.

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Good

The staff team has now stabilised following a period of change. It demonstrates enthusiasm and commitment to the improving outcomes for young people. New staff have been carefully supported, to ensure that they are competent to work with young people with very complex needs. Staff are complimentary about their induction experience, because they say it helps young people to familiarise themselves with them, and helps them to better understand young people’s needs.

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Good

Staff value the improved development and training programme that includes access to accredited courses on autism and learning disability. An autism specialist now visits the home, and has worked with staff to create autism profiles for young people. This improves staff knowledge and understanding of how best to support progress in key areas of young people’s development and emotional well-being.

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Good

The manager is continuing to refine the staff training and development programme. He has identified all areas that relate to professional competences, and is prioritising the delivery of the programme according to his staff skills analysis. This ensures that he targets the most important areas first, and is addressing those through dedicated key worker meetings and reflective supervision. Improved job descriptions help staff to understand their roles and responsibilities, and how to work in effective partnership with others, to benefit young people.

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Good

Together with senior staff, he monitors staff practice, and encourages thoughtful and open discussion about how to help young people to improve. This creates a firm foundation for continuing positive development of the quality of care provided. Staff say that they feel well supported, and enjoy seeing how they help to make a difference to young people’s enjoyment and development. Staff meetings are used effectively, to ensure that staff are kept up to date with any developments related to young people, or the conduct and stated purpose of the home. The independent visitor supports effective monitoring of the conduct of the home, and the safety and welfare of young people. She has built positive relationships with young people, and this has enhanced her understanding of the progress they are making. The manager responds to any actions she identifies for improving the quality of recording, although due to changes in key workers, some care plans

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Good

have not been updated consistently. This includes how young people’s progress is captured in relation to the targets arising from the new autism profile.

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Good

Young people are involved at an appropriate level in their plans. Staff relate their day-to-day behaviour and communication to their engagement with their plans, and are flexible to make changes when necessary. For example, one young person demonstrated a high degree of anxiety about a visit that had been planned. Staff took the initiative to cancel the visit, and then worked with the young person to better prepare them for another time. This gave him confidence that staff would support his ups and downs, and he has since re-engaged with important family contacts. Equally, professionals confirm that staff represent young people’s views well during any formal review of their care plans. They provide evidence-based examples of progress, and engage in finding solutions to difficulties as they arise. As a consequence, all young people are making very good progress in social interaction, communication and skills development, as well as leading increasingly

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Good

Managers communicate well with placing authorities, to ensure that they know about all significant events that happen to young people. However, they failed to notify Ofsted on one occasion when an unexplained minor injury to a young person was investigated. The matter was explored and resolved through appropriate protection procedures, and this regulatory omission did not affect the welfare and safety of young people.

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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 where 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 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

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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, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after 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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