Children's Home run by East Sussex County Council in East Sussex

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.

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The children's home provision is outstanding because:

 Strong leaders and managers ensure that the well-being and safety of young people are prioritised, and that staff practise in ways that consistently meet the needs of the young people.  High-quality monitoring systems record the progress that young people make and identify appropriate targets for them to work towards. This is indicative of the high aspirations that managers and staff have for young people.  The views, wishes and feelings of young people are highly valued. Independent advocates adopt innovative approaches to communicating with young people and share their assessments with professionals responsible for their care.  There is a strong commitment to meeting young people’s healthcare needs. Excellent planning ensures that young people are well prepared for any medical procedures that need to be undertaken, causing them minimum anxiety.  Managers and staff develop effective links with schools and colleges.

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The children's home provision is outstanding because:

Partnership working supports young people to make good educational progress.  Care staff are focused on meeting the individual needs of young people. As a result, highly effective strategies for supporting young people to manage their behaviour and develop their social skills result in positive outcomes for young people.  Coordinated support for care staff ensures that they have the knowledge, skills and motivation to deliver high standards of care. Opportunities are provided for staff to reflect on their practice and continuously improve.  Leaders and managers respond to the changing needs of young people by providing additional training. This ensures that staff are equipped to meet the specific needs of each young person.  A proactive approach is taken to transition planning. Young people are well prepared for moving on from the home and consideration is given to the impact that this may have on the remaining young people.

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Recommendations

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

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Recommendations

 Ensure that the home's procedures take into account the views of appropriate local services, and have regard to police and local authority protocols for responding to missing person's incidents in the area where the home is located. ('Guide to the children's homes regulations including the quality standards', page 45, paragraph 9.29)

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Recommendations

 Ensure that staff support children to be aware of and manage their own safety, both inside and outside the home. Specifically, ensure that staff support children to understand the risks involved when accessing the internet and social media websites. ('Guide to the children's homes regulations including the quality standards', page 43, paragraph 9.9)

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Recommendations

 Review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home's location, and strategies for managing these. In particular, ensure that consultation takes place with relevant agencies when identifying potential risks in the locality of the home. ('Guide to the children's homes regulations including the quality standards', page 64, paragraph 15.1)

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Recommendations

 Ensure that staff can access appropriate facilities and resources to support their training needs. Specifically, ensure that staff are supported to update their training in relation to the management of epilepsy and ability to communicate using Makaton. ('Guide to the children's homes regulations including the quality standards', page 53, paragraph 10.11)

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Information about this children's home

This children's home is operated by the local authority. The service is registered to provide care and accommodation for up to seven young people with learning disabilities and physical disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement

p.5

Recent inspection history

22 March 2016 Interim Improved effectiveness

p.5

Recent inspection history

5 February 2015 Interim Sustained effectiveness

p.5

Outstanding

The home provides a stable, secure environment for vulnerable young people with highly complex needs. Committed staff have a thorough understanding of each young person’s support needs and their individual characteristics. They provide consistency and routine. This minimises young people’s anxieties and provides an environment where they can make good progress across many aspects of their lives.

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Outstanding

Staff develop affectionate, nurturing relationships with young people. They have high aspirations for the young people’s development and take pride in their achievements and progress. One member of staff, referring to a young person, said ‘she now feels safe and stable, and it is fantastic to see her progress. When she arrived, she had very little speech, but she has increased her vocabulary and can tell us what she wants.’ Staff prioritise the development of communication skills, and the progress they make in this area underpins their improvement in many areas. Staff know individual young people’s preferred method of communication and consistently encourage them to develop their skills, whether this is in the use of symbols, picture exchange, language or social stories.

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Outstanding

As young people develop their communication skills, they become better equipped to make their views known. These are acted upon whenever possible. Consequently, increasing numbers of young people have their rooms decorated in the style of their choice. The home’s commitment to young people’s participation has resulted in young people making a major contribution to the new garden design and the purchase of outdoor recreational equipment.

p.6

Outstanding

A strength of the home is the use of independent advocates to help young people express their views. Through observation and a variety of communication techniques, advocates assess and report on how young people may perceive the quality of care that they are receiving. These reports are taken into consideration at every review meeting of children looked after. Advocates are also using a new and creative approach known as ‘intensive interaction’ to communicate with non- verbal young people. This demonstrates leaders’ and managers’ willingness to embrace new, research-based approaches to enhancing the life experience of young people at the home.

p.6

Outstanding

All young people have a place in local schools or colleges and have high levels of attendance. Careful consideration is given to young people’s travel arrangements to and from school to minimise any anxiety that the young person may feel on the journey. Staff communication and liaison with education providers is excellent. Staff often spend time in the classroom with young people to familiarise themselves with young people’s learning. Teaching staff are invited to visit the home in order to promote greater understanding of how young people’s holistic needs are met. As a result of effective partnership working, young people make good progress with their education. Since coming to the home, one young person has made significant progress in mathematics, and the school reports that since he moved into the home he is far more settled.

p.6

Outstanding

The health needs of young people are clearly recorded and known by members of staff. They are observant, and quickly identify any deterioration in young people’s health. Consequently, referrals to medical professionals are prompt. Staff maintain regular dialogue with parents and carers regarding young people’s health needs, and in some cases accompany them to consultants’ appointments. This ensures that all those involved in caring for the young person are familiar with the healthcare plan. Specific training is undertaken by staff when required so that some medical procedures, such as correcting feeding tubes, can be undertaken at the home. Procedures for the recording and administration of medication are thorough.

p.7

Outstanding

Comprehensive plans are made for young people in preparation for admissions to hospital. Consultation recently took place with a number of professionals, including behaviour management specialists, prior to a young person being admitted for a number of procedures under anaesthetic. A social worker reported that after the young person’s discharge from hospital, a medical practitioner contacted her to ‘compliment the care staff in planning for the admission, which resulted in minimal distress for the young person’.

p.7

Outstanding

Young people are treated with dignity and respect, and their individual needs are well catered for. Managers and staff closely monitor whether young people remain suitable for the home and, when there is any doubt, take steps to mitigate against any negative impacts. For example, staff are currently encouraging one young person, with abilities significantly higher than many of the other young people, to build a friendship with a young person from another of the provider’s homes which is close by. As a result, he is learning the social skills needed to build beneficial peer relationships.

p.7

Outstanding

The registered manager promotes timely and detailed transition planning to ensure that young people are well prepared for moving on from the home. She recognises that the complexity of need means that this will be a long process for some young people and therefore engages other professionals early in the process. Some young people become anxious when another young person moves on and, to resolve this, current young people undertake visits to their peers’ new placement. Young people are therefore reassured that moving on is a safe thing to do.

p.7

Outstanding

Staff are skilled listeners and respond effectively to parents’ and carers’ anxieties about the progress and well-being of their young people. They take a proactive approach to planning contact between young people and their families, making these positive occasions for all concerned. The staff team’s focus on promoting the welfare of young people means that they often pick up on any anxieties that young people have regarding contact arrangements, particularly when they cannot verbalise these. Managers and staff advocate strongly on young people’s behalf when contact arrangements have become unreliable.

p.7

Outstanding

The overall quality of care that young people receive is exceptional. The culture of the home is wholly child focused and young people make excellent progress as a result. This was confirmed during the inspection by an independent reviewing officer who commented ‘the home provides the most child-focused care that I have seen in a residential setting’.

p.8

Good

Managers and staff prioritise the need to keep young people safe and protect them from harm. This is reflected in their day-to-day practice. Young people at the home have complex care and support needs which can result in them demonstrating challenging behaviours which have the potential to harm other young people. Staff are acutely aware of this risk and consistently remain vigilant and provide high levels of supervision. As a result, young people are able to communicate that they feel safe in the home.

p.8

Good

Risk management procedures are highly effective. Individual risk assessments are reviewed and updated to reflect the changing circumstances of young people. Recording of significant events, such as physical restraints of young people, are incorporated into risk assessment documents. This allows for quick and easy analysis of whether risk levels are increasing or decreasing. Care is taken to ensure that risk assessment processes do not impinge on young people’s access to a range of recreational activities purely as a result of their disability.

p.8

Good

There is a locality assessment for the home which identifies some of the risks that young people could be exposed to in their local community. However, managers have not consulted widely with other agencies or considered all available information pertaining to the locality as part of the assessment process.

p.8

Good

Young people are relaxed and at ease in the company of staff. They have varied ways of communicating their needs and staff are familiar with these. Some young people who communicate verbally with staff have sought advice and guidance on sensitive matters. This indicates that they have the confidence and trust in staff to share any worries or concerns that they may have. The close monitoring and supervision of young people ensure that they do not go missing from the home or from their carers when they are out in the community. A missing person risk assessment has been undertaken in the case of one young person who is more independent than other young people, which highlights the potential for him to leave the home. This provides staff with guidance on how to prevent such an occurrence and what actions to take should there be a ‘missing’ episode.

p.8

Good

At the interim inspection in March 2016, a recommendation was made to update the home’s missing person procedures to take into account the local authority and police protocols. The home’s practice of reviewing policies annually means this has not yet been actioned. While this has not had a negative impact upon the young people, the procedure still contains gaps. Consequently, this recommendation is repeated.

p.9

Good

Care plans include detailed strategies for promoting positive behaviour and guidance for staff responding to challenging behaviour. Young people are praised for behaving well and some can earn rewards for reducing negative behaviours. Managers and staff take a proactive approach to identifying the underlying causes for emerging challenging behaviours and adopt creative approaches to supporting young people to deal with these. One young person recently demonstrated an obsessional need to know the whereabouts of staff and young people at particular times of the day. The young person became increasingly anxious and challenging as a result. Staff responded effectively by taking the young person on a short camping holiday to break the cycle. On return to the home, the young person had learned, and was reassured, that staff and peers remained safe even when she had not been able to verify their location.

p.9

Good

Physical restraint of young people is only used as a last resort and in accordance with the legislative framework. In the last seven months, there have been just five occasions when staff have used physical restraint, despite the fact that some young people can demonstrate behaviours that would put themselves and others at risk. Staff are trained in appropriate restraint techniques and are offered bespoke training when necessary. Recently, staff were trained in the use of appropriate restraint techniques when in a car. This resulted from a growing awareness among the team that a young person’s current level of anxiety increased the potential for restraint techniques to become necessary when travelling. This proactive approach to behaviour management ensures that young people are kept safe in all environments.

p.9

Good

Detailed records are kept of incidents culminating in the restraint of a young person, and these indicate that staff always consider whether young people should be medically examined following an incident. The registered manager monitors these records and ensures that high standards of practice are maintained. Staff meetings provide an opportunity to reflect on any restraint incidents and identify triggers and situations that may lead to a young person becoming aggressive. Young people’s behaviour management plans are amended, if necessary, as a result of these discussions.

p.9

Good

Some young people have the capacity to make use of the internet and clearly enjoy the experience. Software installed on the home’s computers prevents access to any inappropriate websites and staff supervise young people who are using the computers. Most young people would have limited understanding of both the risks associated with online grooming and the ability to access the internet without staff support. However, one young person at the home has significantly higher abilities than the other young people and is therefore more likely to access the internet when away from the home. Staff are aware that this young person has been given advice and guidance at school about keeping safe on the internet, but this message has not been reinforced at the home.

p.10

Good

The registered manager works closely with relevant professionals when any child protection concerns come to light. This includes attending strategy meetings and communicating effectively with parents. A high standard of record keeping clearly defines what action has been taken and whether any specific steps need to be taken to keep the young person safe.

p.10

Good

Robust recruitment procedures minimise the prospect of inappropriate adults being employed at the home. Thorough background checks are undertaken before any new appointments are made. The interview process is particularly effective in establishing whether candidates have the emotional resilience to meet the needs of highly vulnerable young people. This ensures that young people are looked after by staff who can maintain the high standards of care that are delivered in the home.

p.10

Good

Regular health and safety checks are undertaken and all equipment is serviced and maintained to a high standard. This includes fire safety equipment. All young people have emergency evacuation plans and drills ensure that staff are familiar with these. As a result, young people live in a safe environment where the risk of them coming to physical harm is minimised.

p.10

Outstanding

The home is exceptionally well managed. The registered manager has been in post for nine years and holds both the national vocational qualification level 4 in childcare and level 4 in residential childcare management. She is supported by an experienced deputy manager and a stable and committed staff team. The majority of the team holds suitable qualifications and the two staff who do not are working towards these. The registered manager is an excellent role model for the staff and promotes a culture of respect and high aspiration for the young people. Highly effective monitoring systems ensure that excellent levels of care are maintained. A recent development has been the introduction of monthly profile reports for each of the young people. These identify the changing needs of young people and analyse why they may be making good progress in some aspects of their lives yet need additional support in others. These reports are an excellent tool

p.10

Outstanding

for monitoring young people’s progress over time and for adapting care plans to ensure that they reflect young people’s priority needs.

p.11

Outstanding

An independent visitor ensures regular external scrutiny and monitoring of the quality of care. Recommendations made by the independent visitor are promptly actioned. Six-monthly quality of care monitoring reports, written by the registered manager, provide significant data and factual information. They do not yet contain the same level of analysis and evaluation as seen in the young people’s profile reports and the registered manager is focused on improving these.

p.11

Outstanding

Efficient monitoring of the home’s performance ensures that any weaknesses are quickly identified. An evaluation of the quality of staff supervision, in consultation with team members, identified areas for improvement. The registered manager subsequently created a new supervision template which prompts discussion on those issues identified during the consultation. Staff report that supervision has improved as a result.

p.11

Outstanding

Staff feel valued and listened to by managers. They are given the support that they need to deliver high standards of care in demanding and challenging circumstances. This includes consultation with specialist advisors in behaviour management and young people’s psychological well-being. Team meetings provide excellent opportunities for staff to reflect on young people’s needs and how effective their practice has been in meeting these. Through this medium, staff share their knowledge and observations of young people and develop new strategies for caring for them. Examples include reducing young people’s anxiety when one of their peers is distressed and identifying possible medical issues which may be impeding young people’s social development.

p.11

Outstanding

A good range of training opportunities enhances the ability of staff to provide excellent care and ensures that they are competent in keeping young people safe and protecting them from harm. Managers are responsive to the development needs of staff and quickly identify additional training to further improve the quality of care. As a result of one young person recently displaying increased levels of anxiety, training on understanding stress and anxiety in autism is to be delivered by a specialist voluntary sector provider. Staff also report that they are able to access individual training to increase their professional development. This has included additional training for some on parental mental health and against child sexual exploitation.

p.11

Outstanding

Despite this positive approach to ensuring a skilled and knowledgeable workforce, a minor shortfall was identified in the delivery of some training. Not all staff have completed Makaton training, which is the favoured communication method for one young person and some staff have not recently updated their training on epilepsy. This has not had a negative impact on the young people.

p.11

Outstanding

The registered manager has a thorough understanding of the needs and vulnerabilities of each young person. She maintains oversight of their care plans to ensure that these are focused on improving the life chances and experiences of young people in the home. Creative approaches are taken to identify the changing needs of young people where these are not immediately obvious. In one case, the care plan now includes mood charts as a way of establishing whether the young person is experiencing deteriorating mental health.

p.12

Outstanding

Leaders and managers maintain excellent working relationships with external professionals and staff mirror this practice. This approach contributes towards improved outcomes for young people. For example, the registered manager regularly consults the clinical psychiatrist assigned to young people at the home for advice on aspects of their care. Positive communication is also maintained with parents and carers and is effective in allaying their anxieties around the care and progress 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’. 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

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What the inspection judgements mean

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 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 ‘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 .

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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 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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