Children's home run by Bristol City Council

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 receive good-quality care in a warm, welcoming environment by staff who have a good understanding of young people’s needs and vulnerabilities.  A particular strength of the home is the stability of the staff team. This enables young people, and their parents and carers, to develop warm and trusting relationships with staff.  Effective planning for short-break stays ensures the compatibility of the group. This ensures that young people get the most out of their stay away from their home.  Young people understand the routines and boundaries in the home. This results in socially acceptable behaviour and incidents of physical intervention are rare.  The large rooms provide an environment that offers a safe space to play and have fun.  Young people’s often complex health needs are catered for very well by staff who are trained and competent in a range of medical procedures.  There is a range of activities on offer to young people. These activities have

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The children's home provision is good because:

improved social interaction for some young people and developed their confidence.

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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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Requirement Due date

6: The quality and purpose of care standard In order to meet the quality and purpose of care standard, the registered person must— (2)(c)(i) ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. 31/10/2016

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Requirement Due date

13: The leadership and management standard In order to meet the leadership and management standard the registered person must— (2)(f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; and (2)(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 31/10/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Ensure that children's targets are promoted to encourage them to achieve to their potential and beyond. In particular, ensure that these targets are incorporated in the written care pans. The registered person is responsible for leading a team which provides high-quality care for all children in the home. They must lead and manage the home in a way that delivers the ethos, outcomes and approach set out in the home's statement of purpose. They should also play a key role in shaping the ethos of the home through developing a culture of high aspiration for children, which is demonstrated through the care, resources and opportunities offered to the children. (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.4)  Ensure that those with a leadership and/or management role are visible and

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Recommendations

accessible to staff and able to deliver their leadership and/or management responsibilities. Any registered manager employed in the home should have sufficient capacity to ensure that the Quality Standards are met for each child in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.7)

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Information about this children's home

This children’s home is registered to provide short breaks for up to five children, irrespective of gender, with physical disabilities and/or learning difficulties. It is operated by the local authority.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

02/02/2016 Interim Sustained effectiveness

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Recent inspection history

25/03/2015 Interim Sustained effectiveness

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Good

Young people benefit from an introduction to this short-break service that is offered at a pace to suit their needs. Initial visits extend in duration, to involve staying for a meal before finally having an overnight stay. Parents report that they welcome this phased transition to enable them to feel confident that their child is being cared for according to their wishes. Young people receive good-quality care from a staff team that places the safety and well-being of young people at the centre of its practice. Staff form warm and nurturing relationships with young people, understanding their individual emotional and physical needs. As a result, young people make progress as they gain in confidence and improve their self-esteem. A parent reports how well their child has settled at this short-break service as the staff have got to know him really well in a short space of time. Young people show warmth and affection for the staff, their demeanour indicates

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Good

that they feel safe and are able to approach the staff with any concerns or anxieties. There is a relaxed atmosphere within the home, with plenty of singing and laughter. Young people have fun during their short-break experience. Personalised care planning promotes young people’s dignity and privacy, particularly in relation to intimate care practices. Care plans are detailed and reflect the integrated approach from the other professionals involved. There is an effective use of photographs to inform all staff on the correct positions required for maximum benefit to young people. For example, when receiving exercises provided by a physiotherapist, sleeping positions and when using equipment such as hoists and wheelchairs. These documents provide clear guidance to staff and ensure that the care provided is individual and safe for each young person. Care plans specify the religious and cultural needs of young people and how they

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Good

will be met. This addresses a shortfall identified at the previous inspection. Targets are set to encourage young people to achieve in areas such as self-care, social development or use of communication. Staff assist young people to work towards these targets and enable them to reach for higher goals. The records for young people do not always reflect the achievement of meeting targets nor do they routinely show how young people are being encouraged to progress in several areas of personal development. The accommodation is spacious and enables young people to play in a safe environment. Lots of colour and pictures decorate the communal areas. One of the bathrooms has an old shower with foam protection visible over the pipes. The manager reports that a new shower is to be installed, resulting in the removal all the exposed plumbing. To avoid the look of a public building, some unnecessary signage needs to be removed, such as a wheelchair logo on the toilet and

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Good

bathroom doors. Young people enjoy cooking and making snacks and they are encouraged with these simple life skills. When a risk assessment concludes that young people are not safe to be in a kitchen environment, the hatch through to the kitchen can only be closed off by a shutter that acts as a fire shield. The use of the shutter to restrict some young people’s access to the kitchen is commercial and unsightly. The manager has secured funding to refurbish the kitchen. There are plans to provide a more domestic looking door to the hatch during the refurbishment. This will promote a more homely environment.

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Good

Young people benefit from there always being a qualified learning disability nurse on duty. The provision for management and administration of medication is robust as the nurses take responsibility for this element of care. The skills and expertise of nursing staff enable young people with complex health needs to experience a safe short break away from their home. All staff are trained in the management of epilepsy, gastrostomy and other medical conditions to promote the safety of young people while away from their parents and carers. Staff maintain a safe environment by being vigilant at all times. There are no concerns regarding young people going missing from care. The risk of going missing is minimised by the level of staff supervision. Risk assessments detail known risks for individual young people, the accommodation, activities and trips. Details from care plans specific to young people are incorporated into risk

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Good

assessments for staff to follow. For example, a care plan that states, ‘When in the mini bus I need an adult to sit next to me as I may try to undo my seatbelt.’ This risk is transferred into a risk assessment document to ensure that staff always sit next to this young person and know what behaviour to look out for. Young people are encouraged to take measured risks as part of their growth and development, regardless of their disabilities. For example, using the climbing frame, going swimming and going out in the community. Behaviour management is effective. Staff have a good understanding of the triggers for young people to become distressed and they are very observant to notice any changes in young people’s demeanour. Staff promote positive behaviours by giving consistent messages to young people alongside a focus on encouragement, rewards and de-escalation. As a result, behaviour is managed well, with very few incidents and the use of physical intervention is rare. The

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Good

settled behaviour of young people reflects their confidence and contentment during their short break. Staff are trained in safe care practices and supported by policies and procedures. Staff training covers safeguarding and how to recognise and respond to any suspicions or concerns about a young person. Parents report that they feel confident that their child is safe during their stay. The environment is physically safe where matters of health and safety are routinely checked by staff and visiting engineers. An improvement since the previous inspection is the increased frequency of fire evacuation drills. The records of these regular events list the names of staff and young people involved along with the duration of the evacuation. To further improve this fire safety practice the time of the evacuation should be recorded.

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Requires improvement

The registered manager is a qualified learning disabilities nurse and has been in post for 19 years. He is currently working towards a management qualification at level 5. The manager receives support and clinical supervision from the local health authority and the city council. The manager works alongside staff on shift patterns and consequently does not have sufficient time to undertake management tasks. He lacks the physical capacity to fully deliver his leadership and management responsibilities. This is evident as the monitoring of records and care practices lacks depth. For example, the targets for some young people recorded in their care plans lack challenge and creativity. Staff improvise well and create targets for young people without recording them. Records of a young person’s stay lack impact and outcomes. There is a lack of photography to record and celebrate significant events and achievements. Without

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Requires improvement

comprehensive records, the manager is unable to effectively evaluate the progress of young people as a result of their short-break experience. The manager introduced a system for handing over information between morning and afternoon staff on duty. Records provide a brief summary of each young person’s stay and there is a form for the staff team to complete to consider what went well and what could have been done differently. This opportunity for reflection is not occurring, as most days the form is left blank. The manager has failed to ensure the implementation of this process and there has not been any review of its effectiveness. Staff are supported through team meetings, training and supervision. The records of team meetings fail to provide clarity on any action points, who is responsible and what the timescale is. Similarly, records of supervision do not always provide action points for staff to achieve before their next meeting with their supervisor.

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Requires improvement

These shortfalls are a consequence of the manager not taking sufficient time for management tasks. The manager, and his line manager, report that from September 2016, his working hours will reflect office hours with occasional evening and weekend shifts. Since the previous inspection, the manager has improved some areas such as monitoring the frequency of training and supervision to ensure that staff receive these regularly. The style of recording staff supervision has improved and the manager has developed the welcome pack for parents and young people new to the service. This includes a colourful new guide to the service with photographs of all the staff. The manager has ensured that the requirement from the previous inspection to have regular fire evacuation drills is met and that care plans have improved by detailing cultural and religious needs. As some areas of monitoring need further improvement, this requirement is being repeated at this inspection.

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Requires improvement

Consultation has developed with surveys for parents and young people. Parent views were sought as to the most convenient times to collect and drop off their children, to ensure that the short-break service meets their needs. Young people have indicated through picture communications and symbols the type of activities that they enjoy. Parents are very positive about this short-break service with comments such as, ‘This service is a godsend. I don’t know what I would do without it. All staff are great and I have confidence in leaving my son here.’ Another parent said, ‘The quality of care is great.’ The interactions between staff and family members are consistently warm and relaxed. Strong working relationships are evident. The staff team is enthusiastic about its work, many members of staff having been employed for 16 to 20 years. They are very proud of the young people’s achievements and have young people’s safety and well-being at the forefront of

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Requires improvement

their practice. Staff are passionate about promoting good experiences for young people and work well as a team to ensure that this is achieved.

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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 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. 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 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, 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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