Children's home run by The Chiltern Centre for Disabled Children Limited in South Oxfordshire

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:

 A small number of staff interactions have involved inappropriate language towards children and young people. The use of such language could adversely impact on children’s and young people’s self-worth and self- esteem.  Staff did not follow the service’s safeguarding policy and did not promptly report a concern to the service’s designated safeguarding lead.  Recruitment checks do not include verifying why an applicant left previous employment with children, young people or vulnerable adults. Thus, recruitment checks do not ensure that only safe adults work with children and young people.  Staff do not always ensure that children and young people have access to their communication aids.  Staff do not always follow the service’s medication policy.  The service’s missing procedures do not refer to the actions that staff must take to prevent an incident of missing occurring.  The safeguarding policy does not refer to self-harm or suicide.

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The children's home provision requires improvement because:

 Independent visitor reports do not contain the visitor’s opinion as to whether children and young people are adequately safeguarded or whether it is in their view that children’s welfare is promoted.

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The children's home strengths

 Children and young people benefit from short breaks that support them to have fun, develop skills and interact socially with others in a safe, well- maintained environment.  Staff celebrate children’s and young people’s experiences of the service and their achievements.  The service has good-quality individual plans in place, which support the delivery of personalised care.  Children, young people and their families are the focus of the service. Managers and staff work flexibly to accommodate and provide support to children, young people and their families.  Managers take their responsibilities to safeguard extremely seriously. When they have become aware of a safeguarding concern, they take the appropriate steps to protect children and young people.  The manager has a good oversight of the service and has comprehensive monitoring tools in place, which evaluate all key areas of the service.

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Statutory requirements

This section sets out the actions that must be taken so that the registered persons meet 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 persons must comply within the given timescales.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children's safety. The registered person may only employ an individual to work at the children's home if (a) the individual is of integrity and good character; (b) the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; (c) the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and (d) full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32(1)(2)(a)(3)(a)(b)(c)(d)) 28/08/2016

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Requirement Due date

6: The quality and purpose of care standard In order to meet the quality and purpose of care standard, the registered manager must (2)(b)ensure that staff (ii) protect and promote each child’s welfare; and (iii) treat each child with dignity and respect. 28/08/2016

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Requirement Due date

12: The protection of children standard In order to meet the protection of children standard, the registered person must (2)(a) ensure that staff (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; and 28/07/2016 (vii) are familiar with, and act in accordance with, the home’s child protection policies.

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Requirement Due date

The registered person must prepare and implement a policy (‘the missing child policy’) setting out the steps taken, and to be taken, to prevent children from being absent without permission. (Regulation 34(4)(a)) 28/07/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  The registered persons must ensure that medicines are administered in line with a medically approved protocol. (‘Guide to the children's homes regulations including the quality standards’, April 2015, page 35, paragraph 7.15)  The registered persons, when considering new placements, should fully consider the impact that the placement will have on children and young people. The registered manager should evidence their judgement of compatibility between children and young people. (‘Guide to the children's homes regulations including the quality standards’, April 2015, page 56, paragraph 11.4)  The registered persons must ensure that any individual appointed to carry out visits to the home as an independent person makes a rigorous and impartial assessment of the home's arrangements for safeguarding and promoting the

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Recommendations

welfare of the children in the home's care. In particular, they should provide a commentary in their report of their opinion to whether the home effectively safeguards and promotes children’s and young people's welfare. (‘Guide to the children's homes regulations including the quality standards’, April 2015, page 65, paragraph 15.5)  The registered person must ensure that each child is provided with support (appropriate to their age and understanding) to communicate their views, wishes and feelings and participate as fully as possible in all aspects of their care planning and daily care. This may include the use of and support to use communication aids, equipment and/or any necessary language support. (‘Guide to the children's homes regulations including the quality standards’, April 2015, page 22, paragraph 4.6)  The registered persons must make sure that the policy on protection of children from abuse and neglect includes the arrangements to counter risks of self-harm

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Recommendations

and suicide. (‘Guide to the children's homes regulations including the quality standards’, April 2015, page 44, paragraph 9.19)

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Information about this children's home

The service provides short breaks for up to five young people with learning difficulties, sensory impairment and/or physical disabilities. It is provided by a local registered charity.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

24/11/2015 Interim Sustained effectiveness

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Recent inspection history

13/02/2015 Interim Sustained effectiveness

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Requires improvement

This service has been judged as requires improvement. A small number of staff interactions, which have involved inappropriate language towards children, could adversely impact on children’s and young people’s self-worth and self-esteem. Some staff members were aware of these incidents but did not follow safeguarding procedures. Consequently, managers were not made aware of these concerns until a month after the event. This delay in reporting could have resulted in children and young people experiencing further poor interactions, which may have been detrimental to their well-being. Once aware of these concerns, manager were quick to address them and to follow safeguarding procedures. Further to these concerns, a requirement regarding safer recruitment has not been addressed since the previous inspection. As a result, the service has not carried out the required checks to adequately safeguard children.

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Requires improvement

During this inspection, it was seen that children and young people enjoy good relationships with staff; they appear comfortable and relaxed with them. The majority of interactions are based on nurture and positive warm regard for the individual. Children and young people share lots of smiles. Staff are responsive and affectionate, making children and young people feel valued. Children and young people benefit from short breaks that support them to have fun, develop skills and interact socially with others in a safe, well-maintained environment. They have access to a variety of activities inside and outside of the centre, to ensure that they are positively occupied and stimulated. Trips out help to develop their social experiences and support integration into the wider community. Every other month, the centre has a different theme, which children and young people are encouraged to make arts and crafts for. These are displayed in the

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Requires improvement

main communal area. This encourages children to feel valued and part of the service. The centre promotes children’s and young people’s interests. Staff arranged a carnival for all children and young people who visit the service. This was particularly enjoyed by those who love music. A young person was recently supported to join a local gardening club, and children have been supported to plant flowers around the centre, which they enjoyed doing. Children and young people are able to develop new skills through the support of staff. For example, a young person who had previously refused to bath at the centre is now comfortable in doing so. The service continues to offer day care, and provides opportunities for young people to complete the Award Scheme Development and Accreditation Network’s programme. This enables young people to develop their skills in preparation for adult life and provides them with a sense

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Requires improvement

of achievement. Staff celebrate children’s and young people’s experiences of the service and their achievements. The home uses the ‘experiences board’ to display pictures of children’s and young people’s progress and participation in activities. This supports children to develop their confidence and ensures that they feel valued. The service has good-quality individual plans in place, which are signed off by parents. These plans support the delivery of personalised care for children and young people. Communication plans are detailed and advise staff what gestures mean and how to promote the best environment to promote children’s and young people’s communication. Staff are patient and use signs and ‘yes’ and ‘no’ indicators to enable children and young people to communicate their wants and needs and to make choices. However, a young person was not encouraged to use their communication book during their stay, and the book was put out of reach.

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Requires improvement

This does not promote consistency for the young person or their independence. Children’s and young people’s health needs are met to a good standard. The service employs trained nurses who ensure that all staff receive training appropriate to the needs of each child. As a result, staff are confident in caring for children and young people with a range of medical needs. However, there have been three medication errors since January 2016. Medication audits have also identified that staff have not been following the service’s medication policy when recording medication that has been administered. Managers continue to monitor this and take action to retrain staff when errors occur. Children, young people and their families are the focus of the service. Managers and staff work flexibly to accommodate and provide support to help families. Staff work closely with parents and social workers to tailor the child’s or young person’s

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Requires improvement

transition into the service to their particular needs. Staff have been working with a young person since 2015 to support them to eventually stay overnight. This has been successful, and the young person had their first stay overnight in July 2016. Staff also provide support to help young people to move on from the service. For example, staff shared their knowledge and practice with a young person’s new staff and allowed his new staff to work alongside them in the centre to enable them to get to know him. This sharing of knowledge and practice aided a successful transition. Children and young people staying together are matched well. This has supported them to develop friendships and their social skills. However, the manager does not currently evidence the decision-making in relation to matching. Judgement grade

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Requires improvement

Staff are alert to children’s and young people’s specific vulnerabilities and work closely with placing authorities to take appropriate action to care and protect them. However, there has been a safeguarding concern directly related to the quality of care provided to children and young people. In this case, staff did not follow the service’s safeguarding policy and did not report the concern to the service’s registered manager who is also the designated safeguarding lead. This meant that the registered manager was not aware of this concern for a month after the incident and was not able to take the appropriate action to safeguard children and young people. As a result, children’s and young people’s welfare was compromised. Managers take their responsibilities to safeguard extremely seriously. When they become aware of a safeguarding concern or an allegation against a member of staff, they alert the designated officer and take the appropriate steps to protect

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Requires improvement

children and young people. This includes removing members of staff from rotas and offering them support until the investigation is completed. Managers have taken action to reiterate to staff their duty to protect children and young people and to challenge and report concerns to managers as soon as possible. The safeguarding policy does not refer to self-harm or suicide, as required by guidance, which may result in staff not being advised of what actions to take to protect children and young people in these instances. There have been no incidents of children or young people going missing from the service in the past year. This is because of the service’s high staff ratios, comprehensive risk assessments and highly individualised care planning. However, the service’s current missing procedures do not refer to the preventative actions that staff must take to prevent an incident of missing occurring. This may result in

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Requires improvement

staff not taking proactive steps to reduce the likelihood of a child going missing in the future. A requirement regarding recruitment checks was made at the previous inspection. An evaluation of recruitment records found that reasons why staff left previous employment with children, young people or vulnerable adults are not consistently verified. As a result, recruitment checks do not ensure that only safe adults work with children and young people. Children have individual and comprehensive risk assessments, from which strategies are developed so that staff can care for them in the best way. These risk assessments are regularly updated to ensure that staff have a good understanding of how to care for the children and protect them. Staff understand challenging behaviour as communication and respond to it as such. They have a good understanding of the triggers and environmental factors that can affect children’s and young people’s behaviours. As a result, staff

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Requires improvement

successfully interpret behaviour. They are adept at distracting and diverting children and young people to de-escalate potentially challenging situations. In response to new behaviours, staff quickly review their strategies to ensure their continuing effectiveness. This has been effective in supporting children and young people to reduce incidents of challenging behaviour. Consequently, there have been no physical interventions or sanctions in the service for over a year. All required health and safety checks are completed on a regular basis to ensure that the service and environment remain safe.

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Good

The registered manager has a level 4 qualification in childcare and, in 2015, he obtained a level 5 award in leadership and management. He has a number of years’ experience in this sector and was registered as manager of this service in 2014. The registered manager is acutely aware of his role and responsibility in relation to safeguarding. He has taken appropriate action to address concerns and has completed thorough investigations, liaising with the necessary professionals when needed. Concerns regarding staff practice are addressed quickly and are monitored to ensure that improvements are made. Complaints are well managed to the complainants' satisfaction, and actions are implemented to improve service delivery. The registered manager is committed to ensuring that children, young people and their families are central to the service and that it continues to develop and improve to meet their changing needs. An application to the care quality

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Good

commission to extend the service’s registration to provide care for adults aged over 25 and to include nursing care is currently underway. The registered manager is clear that any provision provided to ‘older’ adults will take place on separate days from that of children. To ensure that staff are able to care for the varying and complex needs of the children and young people who attend the service, he has employed nurses to ensure that staff have the skills and knowledge necessary to care for a variety of medical needs. The registered manager has a good oversight of the service and has comprehensive monitoring tools in place, which evaluate all the key areas of the service. He has a good understanding of the strengths of the service as well as areas for development. The manager audits all incident reports to identify patterns and trends. This enables a prompt review of the strategies used to support children

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Good

and young people to make sure that they remain effective. Parents and professionals actively have the opportunity to provide feedback on the care that their child receives and on the development of the service. This means that children, young people and their families contribute to the future planning of the service, which enables the service to evolve with the needs of the community. The service’s development plan is detailed, and actions for improvement are clearly based on the manager’s analysis of the quality of care provided and feedback from others. Areas for improvement are centred on the needs of the children and young people and on how their experiences can be improved. An independent visitor visits the service on a regular basis. However, their reports do not make recommendations to improve practice. These reports also do not contain the visitor’s opinion as to whether children and young people are

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Good

adequately safeguarded and whether it is their view that children’s welfare is promoted according to regulation. This lack of challenge does not assist the registered manager in striving to improve and develop the service. The centre’s statement of purpose outlines the aims and objectives of the service. This ensures that placing authorities, parents and other stakeholders are provided with information on what this home intends to provide. Placing authorities can be clear whether this service is the right one for a child’s or young person’s assessed needs. Staff receive regular supervision and team meetings. These provide staff with chances to review and reflect on children’s and young people’s progress and needs. It also provides them with an opportunity to review their own performance and development needs, the running of the home and how best to develop and improve the standard of care and support provided. When appropriate, managers

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Good

provide supervision more often to support, monitor and improve staff’s practice. Staff are equipped with mandatory training in safeguarding, first aid, fire awareness, food hygiene and behaviour management. Some staff have completed specialist training in caring for particular health needs. This ensures that staff have the skills needed to care for a variety of complex needs. All staff who are required to, have completed or are in the process of completing their qualifications and credit framework (QCF) level 3. Obtaining this qualification will ensure that staff have the skills required to care for children and 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 that 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

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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