Children's home run by Oldham Children’s Social Care in Oldham

children and young people since the most recent full inspection

This home was judged good at the last full inspection. At this interim inspection, Ofsted judges that it has declined in effectiveness . Since the last inspection, the home has undergone a variation in registration to increase the number of places available to seven children each night. It provides short breaks for children from two local authorities in a partnership arrangement that merged the two staff teams from across the two authorities. Although the teams have worked together since the beginning of 2016, managers and staff acknowledge that the transition to a joint service has created operational difficulties that have impeded progress in the development of the quality of care provided. Children are cared for by staff who support their physical health needs well, such as preparing liquid diets for gastrostomy feeds, and ensuring that their safety and dignity are protected during personal care routines. Staff offer companionship and

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children and young people since the most recent full inspection

comfort to children, and demonstrate interest in them as individuals. A lack of organisational and activity planning, reduced staffing levels and lengthy systems and processes for managing and administering medication, feeds and personal care limit the time that staff have to focus on play and socialisation. Children experience care in which their essential needs are met, without additional focus on improving their communication, self-advocacy, skills development and social integration. This limits their capacity to reach their full development potential. Despite a requirement at the last inspection to address shortfalls in care planning, records remain inconsistent. Approximately 35% of care plans remain out of date and have not been transferred to the home’s preferred format. The manager has not ensured adequate quality assurance of the revised care plans. Some records contain judgemental opinion, particularly in describing young people’s behaviour.

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children and young people since the most recent full inspection

Lack of detailed analysis and poor guidance mean that staff cannot consistently support young people to manage their own feelings and impulses. Other daily records, such as daily contact sheets, contain staff writing that requires further explanation and clarification, to enable the reader to assess the quality of care being provided to vulnerable children who have difficulties in communicating their views about their experiences. Transition planning remains weak. One young person is being introduced to the home without formal plans in place to support him, apart from an outdated care plan supplemented by current information about his complex health needs. Consequently, staff rely on word of mouth to understand and meet his care needs. Feedback to families is similarly informal. This inhibits effective planning and review to ensure that young people receive a positive and purposeful experience of care,

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children and young people since the most recent full inspection

while away from their families. The home does not routinely gather information about children’s well-being and experiences in their time away from home. This means that staff are impaired to make any judgement about the impact of those experiences, offer specific support to meet changing needs, or help children to integrate their short break into their understanding of the world. Despite efforts of the manager and senior managers to comply with a repeated requirement to improve transition planning for young people, they have been unable to demonstrate that the home has improved the information available to staff in this area. In part, this is due to vacancies in social work transition teams. This means that staff are unable to support any transition plans that are in place or help young people to think about their growth and development into adulthood. The independent visitor provides detailed reports that alert managers to shortfalls

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children and young people since the most recent full inspection

in systems and processes, such as out-of-date fire checks, however the reports are not readily made available to staff in the home. This inhibits the staff team’s ability to address the necessary action. In addition, the manager’s own monitoring report and outlined actions to improve the quality of care, published in April 2016, have not been implemented in many areas. This means that the quality of care has not improved, despite clear and measurable targets, such as supporting children’s communication and play, measuring their progress and providing evidence of consultation between the home and all stakeholders. In other areas, monitoring is weak. This includes the quality of written information and implementing fully any actions required by previous inspections. This has resulted in the lack of progress identified during this inspection. Many children who use the service have complex health needs that are supported

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children and young people since the most recent full inspection

by medical and intensive care routines. The administration and safekeeping of medication are areas that have caused difficulty in the operation of the home. Many improvements have been made, including an updated policy and procedure for handling medicines. The home has worked well with parents to reduce the number of cancelled visits due to incorrect medication being sent to the home. Some areas of practice do not reflect the revised policy. This includes the storage of controlled drugs, which are not separated from other medications despite a requirement made at the last inspection. Staff are still unclear about best practice related to crushing tablets when liquid is unavailable. Liquid feeds for gastrostomy meals are not returned to families at the end of each stay and some are out of date which increases the risk of unhealthy food being given to children. The door to the office in which medication is stored is left unlocked while children are in the

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children and young people since the most recent full inspection

home, which reduces the security of stored medication. An independent investigation into concerns about practice raised through whistleblowing procedures has resulted in a detailed report of findings that has been shared with the partner authority. A summary and action plan setting out key areas for improvement have been shared with all staff. Actions include; clarifying staff roles and responsibilities; staff and team development; improving patterns of working and improving communication and professional guidance for care practice. However, the plan is not broken down into small steps to assist the manager to frequently report, monitor progress and engage staff in participating in the plan. This means that staff are unclear about any progress being made. They do not readily identify the steps that are being taken, such as a group email system that ensures that all staff hear about all concerns and management responses, as part

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children and young people since the most recent full inspection

of the actions to support the overall objective of improvement. This means that staff morale continues to be low. It is early days since the publication of the action plan, and so progress is not yet measureable. Staff and the manager said that they feel that limitations are placed upon opportunities for children to experience high-quality activities and support because of erratic staffing levels, and groups of mixed-ability children visiting at the same time. The environment is not suitably adapted to support children’s communication, freedom of movement or sensory needs, particularly related to autistic spectrum disorder. Ideas, such as improved picture communication resources, have been identified without accompanying action. This means that some children are unable to use their individual voices effectively during their short breaks. The home has reviewed the use of equipment that may contribute to a mechanical

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children and young people since the most recent full inspection

restraint. Managers have acted upon a recommendation made at the last inspection, to seek appropriate professional oversight for individual children’s plans. Now, only children who have been assessed as needing this level of support use such equipment as a safe space bed, or bed sides. However, due to lack of occupational therapy services support from one local authority, some children have been unable to access the short breaks service because their parents feel that they are not safe in a bed without the use of sides. The local authority has identified a commissioning agreement that will rectify this shortfall, but, at present, some young people are unable to receive a short breaks service, contrary to their assessed need. Senior managers have identified that team-building is essential to future development, but there is no specific plan yet available. This continues to limit the progress that the home can make in improving the quality of the service provided.

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children and young people since the most recent full inspection

Senior managers have reviewed the monitoring and support arrangements for the home and have arranged additional on-site support, although it is not yet implemented. The impact of this will be reviewed through senior management oversight.

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Information about this children's home

This is a local authority children’s home that works in partnership with a neighbouring local authority. It provides short breaks for up to seven children and young people who have complex needs, at any one time.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

1/02/2016 Interim Sustained effectiveness

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Recent inspection history

27/02/2015 Interim Sustained effectiveness

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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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14: The care planning standard

(1) The care planning standard is that children (a) receive effectively planned care in or through the children’s home; and (b) have a positive experience of arriving at or moving on from the home. This is with particular regard to ensuring that information related to transition from the home to adult services and to the routine transition in and out of each short break is published and understood by all stakeholders and staff. 07/10/2016

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18: Placement plan for a child who is not looked after

(1) This regulation applies to a child who is not looked after by a local authority. (4) The registered person must prepare a placement plan for the child before the child is admitted to the home or, if that is not reasonably practicable, as soon as possible after the child is admitted to the home. (5) The placement plan must set out, in particular (a) how, on a day-to-day basis, the child will be cared for, and the child’s welfare safeguarded and promoted by the home; and (b) the arrangements made for the child’s care, education and health. This is with particular regard to ensuring that all care plans share a common format, and that the plans are regularly reviewed. 07/10/2016

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9: The enjoyment and achievement standard

(1) The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their 07/10/2016 needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. (2) In particular, the standard in paragraph (1) requires the registered person to ensure (a) that staff help each child to (i) develop the child’s interests and hobbies; and (ii) participate in activities that the child enjoys and which meet and expand the child’s interests and preferences.

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13: The leadership and management standard

(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that (a) helps children aspire to fulfil their potential. (2) In particular, the standard in paragraph (1) requires the registered person to (b) ensure that staff work as a team where appropriate; (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. This is with particular regard to ensuring that any action plan to improve the home reflects the findings of both external and internal monitoring and is broken down into measureable steps that are regularly reviewed for progress. 07/10/2016

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6: The quality and purpose of care standard

(1) The quality and purpose of care standard is that children receive care from staff who (2)(iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; (vii) provide to children living in the home the physical necessities they need in order to live there comfortably. This is with particular regard to ensuring that all children who have communication and sensory needs stay in a suitably adapted and accessible environment. 07/10/2016

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23: Medicines

(1) The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. This is with particular regard to ensuring that controlled drugs are managed according to the home’s policy and that suitable security and quality checks are made for all medication and liquid feeds. 07/10/2016

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What the inspection judgements mean

At the interim inspection, we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the ‘Inspection of children's homes: framework for inspection’.

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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 focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the Children's Homes (England) Regulations 2015 and 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

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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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