Children's Home run by Bayis Sheli Limited in Hackney

inspection

On 1 July 2016, the registered provider was issued with a compliance notice under section 22A of the Care Standards Act 2000. This was as a result of shortfalls identified at the full inspection of 22 June 2016. The compliance notice enforced the requirement for the registered persons to comply with Regulation 32 Schedule 2 of the Children’s Homes (England) Regulations 2015: Fitness of workers. The registered provider was given until 14 August 2016 to achieve compliance with this regulation. On 15 August 2016, at the monitoring visit, the registered persons demonstrated that they have improved the staff recruitment procedures and achieved compliance with Regulation 32 Schedule 2.

p.2

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.

p.2

because:

 The home does not demonstrate that children consistently receive well- planned care including health care.  Staff do not enable children to access the whole range of health services that they need.  The strategies required to minimise risks are not always fully implemented.  The hydrotherapy pool policy has not been updated when the practice changed.  The information on children’s files is inconsistent. It does not always accurately reflect the quality of care practice.  A weak evidence base means that the quality and impact of care on the children’s progress is not clearly planned and monitored.

p.3

The children’s home’s strengths

 The service is resilient. During a difficult time for the home, the staff’s commitment, morale and willingness to learn have remained strong.  The service has a capacity for improvement. The trustees have made additional resources available to effect positive change. This has included engaging the guidance of a consultancy organisation and providing a comprehensive training programme for staff.  Staff are particularly effective at meeting cultural and faith needs of Jewish children.  Staff promote children’s abilities to communicate and make choices effectively.  Children lead active lives. They access a wide range of activities in the home and in the community.  The home provides excellent facilities to enhance children’s sensory experiences and learning.  The home’s physical environment is maintained to a very high standard.  Staff work in close partnership with children’s families.

p.4

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.

p.5

Requirement Due date

(1) The health and well-being standard is that: (a) the health and well-being needs of children are met. (2) In particular, the standard in paragraph (1) requires the registered person to ensure: (a) that staff help each child to: (i) achieve the health and well-being outcomes that are recorded in the child’s relevant plans. In order to meet the health and well-being standard, the registered persons must ensure that children’s healthcare plans are comprehensive and regularly reviewed and updated. This includes any changes to medication. 01/12/2016

p.5

Requirement Due date

(1) The health and well-being standard is that: (b) children receive advice, services and support in relation to their health and well-being. (2) In particular, the standard in paragraph (1) requires the registered person to ensure: (b) that each child is registered as a patient with a general medical practitioner and a registered dental practitioner, and (c) that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. In order to meet the health and well-being standard, the registered persons must ensure, in particular, that children are registered with a dental practitioner and have access to the appropriate specialist services with regards to their vision and hearing. 01/12/2016

p.5

Requirement Due date

(1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In order to meet the protection of children standard, the 01/12/2016 registered persons must ensure, in particular, that all strategies identified in the home’s risk management plan regarding access to the home environment are implemented fully, and without delay. 12: The protection of children standard

p.5

Requirement Due date

(1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In order to meet the protection of children standard, the registered person must, in particular, review and update the policy and risk management plan regarding the home’s hydrotherapy pool so that the policy is consistent with the current practice and it is evidently safe. 01/12/2016

p.6

Requirement Due date

13: The leadership and management standard

p.6

Requirement Due date

(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: (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 (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. In order to meet the leadership and management standard, the registered persons must, in particular, improve the monitoring and review systems by ensuring that children have up-to-date care plans that identify specific targets and outcomes, and that their progress towards achieving those are clearly evidenced,

p.6

Requirement Due date

(1) The care planning standard is that children: (a) receive effectively planned care in or through the children’s home. In order to meet the care planning standard, the registered persons must, in particular, ensure that each child’s care plan is regularly reviewed and updated so that it provides a clear and accurate picture of the child’s needs. 01/12/2016

p.6

Information about this children’s home

A private limited company with charitable status provides this service. The home may accommodate up to eight children who may have a physical or learning disability. This includes up to four children under short-break arrangements and up to four children permanently. The home’s statement of purpose emphasises meeting the needs of Jewish children, in ways which are consistent with their culture and faith, as a particular focus of the service.

p.7

Recent inspection history

Inspection date Inspection type Inspection judgement 22 June 2016 Full Inadequate 22 March 2016 Interim Not judged

p.7

Requires improvement

Managers and staff do not fully demonstrate that children consistently receive well- planned, good quality care. The files do not always provide an accurate and coherent picture of the children’s lives and the support that they receive. The impact of the care on the children’s outcomes and experiences is not always clear.

p.8

Requires improvement

The care plans are not formally reviewed frequently enough. When things change, they are not updated; this means staff are not guided by accurate written information. This shortfall is particularly significant for children who are non-verbal and unable to say what they need. The inconsistencies within the information on the children’s files create confusion and risk inconsistency of practice. The weaknesses in the evidence-based practice undermine the manager’s and staff’s ability to track, measure and evidence children’s progress and achievements.

p.8

Requires improvement

When children come for a short break, staff do not always record the conversations that they have with the parents about any significant events or any changes to the child’s needs. Regardless of the time passed, short breaks do not trigger any recorded review/update of the care plan or the assessment of risks that were initially agreed with the parent/carer. This means opportunities to capture progress and development are lost.

p.8

Requires improvement

One child currently lives in the home. They were placed on a long-term basis, approximately five months ago. Prior to that, they were staying in this children’s home for short breaks. The child’s care plan is out of date. The placing authority has conducted two formal reviews of the arrangements for their care. The home’s staff took part in these reviews. However, they did not update the child’s care plan in light of these meetings and discussions. This document still contains some information which relates to the time when the child still lived with their family.

p.8

Requires improvement

The outcomes that are identified in the child’s care plan are not specific enough. For example, staff are asked to promote the child’s independence as much as possible. The descriptions of the staff support that he needs in order to achieve this particular outcome are vague. Not having specific outcomes makes staff support less focused. It also makes it much more difficult to measure the child’s progress and monitor the impact of care provided.

p.8

Requires improvement

In recent months, there have been significant changes to the child’s medication regime. The medication records have been updated. However, the relevant part of their health plan, in particular epilepsy management plan, has not been updated. This means that the information on his file is inconsistent and does not provide staff with accurate guidance.

p.8

Requires improvement

Staff are unable to evidence clearly what efforts are being made to make sure that the current child has regular health checks across all aspect of his health care needs. Their file lacks important health information, such as the details of his dentist, optician and hearing specialist. This is despite the concerns about his vision and hearing. Staff explained the barriers to registering this young person with the local health services and what they were planning to do about it. However, there was nothing on his file in relation to this and no robust plan to ensure these shortfalls are addressed.

p.9

Requires improvement

Staff are able to describe children’s needs. They know and understand children in their care very well. They show caring attitudes towards children and are sensitive and attentive to them. There is positive, protective and enabling interaction between the child and the staff. This aides communication and helps children feel looked after.

p.9

Requires improvement

The currently placed child has formed a bond with a particular staff member. This staff member has been working with them for many years. Initially, this was within his family environment. After the child became looked after, the home employed this staff member to help to promote continuity and stability in his life. Close partnerships with the child’s family and the local Jewish community also have a positive impact on his sense of continuity and belonging.

p.9

Requires improvement

The promotion of children’s cultural identity is a strong aspect of the service. Staff are particularly sensitive towards the child’s faith needs. They make sure that their needs in this respect are met. They regularly take part in Jewish customs and celebrations. He continues to experience a Jewish way of life.

p.9

Requires improvement

Staff promote children’s communication and the ability to make choices effectively. Staff are committed to enabling non-verbal children to express their wishes and feelings, and to make choices. They have recently focused on developing more individualised visual tools for promoting the child’s communication. For example, they have made pictorial symbols bigger to make it easier for the child to see. They have used specially created photo-albums and visual story-telling to explain things and to promote their individuality.

p.9

Requires improvement

The currently placed child leads a very active life. They access a wide range of activities in the home and in the community. They have recently enjoyed a camping holiday with friends, in an area of outstanding natural beauty.

p.9

Requires improvement

The child clearly enjoys the spaciousness of the home. They appear to love walking around the environment and riding a tricycle in the safe place outside the building. This enables the child to experience a sense of exploration and freedom that may otherwise be missing from their life. The home’s physical environment is maintained to a very high standard. The excellent facilities provide children with rich sensory experiences and learning opportunities. The sensory and soft-play rooms are well equipped. There is a large fish tank and an in-house enclosure for a rabbit.

p.9

Requires improvement

A mother of a child who uses the short-breaks service is highly satisfied with the service. She said that she was very happy with how staff treated her son.

p.10

Requires improvement

Professionals provide positive feedback about the quality of the service and the child’s progress. The school staff work closely with the home to promote learning and educational engagement.

p.10

Requires improvement

Despite the weaknesses in the recorded information on the children’s files, verbal and photographic evidence suggest that children often have positive experiences and continue to make progress in many aspects of their well-being. Reportedly, the current child’s personal care skills have continued to improve. Their mobility and fine motor skills have improved. The child had become more able to feed themselves. The child’s teacher said that one of this their most recent attainments was that they had started pointing at things that they wanted.

p.10

Requires improvement

The safeguarding practice in the home has improved significantly since it was judged inadequate in June 2016. However, further work is required to demonstrate a good standard.

p.10

Requires improvement

Although the risk management has significantly improved, the work on reducing the risks as much as possible is still in progress. A risk assessment regarding the young person’s use of the hydrotherapy pool has been completed. However the home’s policy has still not been updated to show that qualified lifeguards are no longer used. This shortfall has not had a negative impact on children; the pool is currently not in use. The health and safety water checks are regularly undertaken. Any actions needed are followed up.

p.10

Requires improvement

A detailed risk-management plan, to minimise any risks created by the use of the same premises by another organisation and the local community, is now in place. However, the implementation of the strategies that have been identified to ensure children’s safety is still in progress. This means that the registered persons do not yet demonstrate that they have done everything they can to provide a safe and secure environment to children. For example, a door that separates the visitors’ waiting area and the children’s home is not closing properly. Engineers have looked into it, but the issue has remained unresolved. The verbal agreement regarding information-sharing between the home and the other organisation to assure safeguarding of children has not been formalised in writing. The manager has a list of initials of this organisation’s staff and the confirmation of their disclosure and barring service’s checks.

p.10

Requires improvement

Some risk assessments on the young person’s file have not been reviewed since last year. This indicates that the staff do not use the risk management process as effectively as they could.

p.11

Requires improvement

Safeguarding children has a higher profile within the service. Staff have received training on a number of safeguarding topics, including child protection and safeguarding, behaviour management, safe management of medication, first aid, manual handing, understanding disability and care of children who have special educational needs and/or disabilities. At the team meetings, the manager and staff regularly discuss the home’s safeguarding policy, best practice, working together with other professionals and the procedures for effective sharing of information and reporting of concerns.

p.11

Requires improvement

Staff’s safeguarding awareness, and in particular the awareness of the risks to children’s welfare, has improved. Staff now know what good safeguarding practice looks like. Their understanding of what constitutes a restraint and deprivation of liberty has improved. For example, they realised that using a wheelchair for an ambulant child is a form of restraint. They have stopped this restrictive practice. Staff are committed to implementing good practice in their work with children. They want to do everything they can to keep children safe and to maximise their independence.

p.11

Requires improvement

There has been a notable improvement in the effectiveness of safeguarding practice. There have been no reported incidents of any child being left unsupervised and no incidents of any child’s liberty of movement being restricted. There have been no reported incidents that resulted in behaviour control measures, such as restraints or sanctions. Neither has there been any medication errors. No complaints, concerns or allegations have been made since the last inspection.

p.11

Requires improvement

Regular health and safety checks ensure that the physical environment is kept safe. Fire safety checks also take place regularly to enhance fire safety. Regular fire-drills ensure that everybody knows what to do in case of fire.

p.11

Requires improvement

Comprehensive vetting checks ensure that the staff recruitment is robust. The staff are suitable to work with children.

p.11

Requires improvement

A parent said that she felt that her son was 100% safe when on a short break in this home.

p.11

Requires improvement

Observations during the inspection indicated that the current child was comfortable and safe. A staff member provided them with effective guidance and clear behavioural boundaries, to which they responded very well.

p.11

Requires improvement

The registered manager is a social worker with many years of experience of managing residential children’s homes. He has been managing this home since its registration in 2015.

p.12

Requires improvement

At the full inspection, in June 2016, the service was judged inadequate across all its aspects, and 16 requirements and three recommendations were made.

p.12

Requires improvement

The service has improved significantly since it was judged inadequate, less than three months before. However, the quality of practice and, particularly of the required records, is variable. Good practice has not been embedded. At this point in time, more work is required for the home to be able to demonstrate fully that it consistently meets a good professional standard for children’s residential care.

p.12

Requires improvement

Significant improvement has been achieved in respect of the safeguarding practice. Out of 16 original requirements, the registered persons have achieved compliance with twelve of them. They have done significant work around addressing the other shortfalls. Shortfalls in meeting some aspects of the quality standards relating to leadership and management, care planning and child protection have improved considerably. Although requirements have been raised in relation to these standards there are no failures that directly place children at risk of harm. The service is safer.

p.12

Requires improvement

The registered persons and the board of trustees’ took the inspection findings seriously. They showed a genuine commitment towards children who have disabilities and their families. They acted with integrity and determination to improve the service. They made extra funds available to raise the quality of the service and to make sure that it fulfils its statement of purpose effectively. Together with the registered persons, they created and implemented a comprehensive action plan to secure a better service.

p.12

Requires improvement

The trustees recognised that, despite their good intentions, they might lack in- depth knowledge about regulations and quality standards for professional care. As a result they commissioned expert consultants with knowledge in the children’s care field to help them to move the quality of the service forward. They appointed a consultancy organisation to carry out a comprehensive review of the service. The consultants have advised on the improvement actions needed and supported the registered manager in effecting positive change. In order to strengthen the external monitoring further, the registered persons have also appointed a new independent visitor. This professional has provided them with more robust and detailed monitoring reports than was previously in place.

p.12

Requires improvement

The placing authority’s increased involvement has also contributed to the enhanced scrutiny of the quality of care provided. While, in the past, the home was operating to some extent in isolation, the quality of working together with the statutory organisations and independent professionals has improved. A placement manager commented that the local authority received frequent and good quality reports from the home.

p.13

Requires improvement

The registered manager has taken the service and all staff on an effective improvement journey. No staff left following the inadequate inspection judgement. During a difficult time for the home, the staff morale and commitment to provide an improved service remained high. Extensive induction and comprehensive training programmes have helped staff to develop their knowledge and skills further. The staff members without the relevant qualification have been enrolled on an appropriate course. All staff have received supervision more frequently. Their practice has remained subject to formal periodical performance reviews. Regular team meetings have provided them with the additional opportunities for reflecting on practice. Those meetings have also promoted the team’s cohesion and consistency of approach to care.

p.13

Requires improvement

A newly recruited assistant manager and two senior care workers have strengthened the management team’s capacity to influence improvement. Their appointments have enhanced the support available to staff and provided a more practice-based leadership and on-the-job coaching. However, these appointments were very recent. There is still significant improvement work to be done, in particular to bring the care planning, healthcare, risk management and record- keeping to the high professional standard that is expected from a good service.

p.13

Requires improvement

The registered manager is aware that the evidence-based practice in the home is weak. The home’s records do not always accurately reflect the practice. This has undermined the registered person’s ability to demonstrate consistently good care planning and good healthcare. Although the registered manager and staff have a good understanding of the children’s needs, progress and outcomes, the records do not fully demonstrate how they monitor the impact of the service. Improving the case management documentation and records is high on the registered manager’s and staff’s agenda. They were planning to focus on this in the week of the inspection.

p.13

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’.

p.14

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

p.14

What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

p.14

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

p.15

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 .

p.15

Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

p.16

Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.16

Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.16

Information about this inspection

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

p.16