Children's home run by The Qalb Short Break Services Ltd in Tower Hamlets

Outstanding

The children's home provides highly effective services that consistently exceed the standards of good. The actions of the home contribute to significantly improved outcomes for children and young people who need help, protection and care.

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The children's home provision is outstanding because:

 This home offers outstanding short-breaks services to young people and their families in this community. High levels of staff ensure excellent supervision, safety and time to nurture relationships with young people.  Young people and their families benefit from excellent assessments and transitions into short breaks. Careful introductions ensure that young people do not become overwhelmed but understand the process.  Effective consultation takes place with all relevant professionals and family members to ensure that clear information is in place prior to any stays taking place. Families have choice in the planning of their children’s short breaks during holiday periods.  The company is working jointly with neighbouring and host boroughs on a government-led initiative, ‘Transforming Care,’ which is looking at how to maintain young adults who have complex needs in their own homes with support.  Young people have individualised care plans and regular reviews. The

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The children's home provision is outstanding because:

manager has just introduced an excellent photographic review booklet for young people, which shows a pictorial journey of their time and progress in the home.  Young people can make a wish on the wishing tree and staff will do what they can to make their wish come true. One young person recently attended a premier league football match and met one of his football idols.  Managers and staff regularly engage with the wider community through an autism awareness day, children’s forums and a weekly parents’ group. There are excellent opportunities for young people to enjoy activities outside the home and to take part in outings, which they would be unlikely to experience at home.  A superb team of motivated and experienced staff works in this home. An excellent registered manager and responsible individual support them.  There are no breaches of regulation at this service. Leaders and managers have acted on a previous requirement and recommendation and see

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The children's home provision is outstanding because:

inspection as an opportunity to improve.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

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Recommendations

 Ensure that staff are familiar with the home's policies on record-keeping and understand the importance of careful, objective and clear recording. This is in relation to the updating of medical consents and attendance record sheets. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)  The home's policy and procedures on the protection of children should reflect any requirements of other relevant legislation. This is in relation to self-harm and preventing radicalisation. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.22)

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Information about this children's home

This service is owned and managed by a limited company. The home provides short breaks for up to eight children at any time.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

3/03/2016 Interim Declined in effectiveness

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Recent inspection history

19/03/2015 Interim Improved effectiveness

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Outstanding

The staff provide an exceptionally high quality of individualised care for young people coming for short breaks. They know the young people well and anticipate their needs, ensuring that they are met promptly and with care. Excellent assessment work is completed prior to short breaks commencing. The manager has appointed an assessment officer who completes and coordinates the assessment work, involving the allocated key worker in home and school visits. This process ensures that the assessments are completed quickly with the involvement of the key staff member who will be responsible for that young person’s care once the short break begins. High-quality case records give a clear understanding of young people’s needs, wishes and feelings. Photographs with speech bubbles, introducing each section of the file, give a real sense of individuality and respect for the young person. Some attendance records sheets require updating. However, this has no impact on the

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Outstanding

quality of service being offered. The staff team shares positive relationships with young people, which show respect, patience and endearment. Excellent nurturing relationships are developed, which include a real sense of fun and ambition for young people. Staff obviously enjoy their work and this shows in their interactions with young people. Young people make excellent progress within their own limitations and from their starting points. Small steps can represent quite significant changes, for example being able to manage to use the lavatory unassisted or becoming aware of their own daily care needs. Professional practice consistently exceeds the standard of good and results in sustained improvements in the lives of young people and their families. One parent said, ‘They help in so many different ways. His speech has improved so much. He is a different character. His confidence grew with speech. He is learning life skills. Little things that don’t mean much to other people are

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Outstanding

really significant. They are helping him to be independent.’ The highest attention is given to healthcare. Staff are all first aid trained and recently completed theory training for gastrostomy feeding. A qualified nurse observes practical gastrostomy feed training, and this enables staff to manage these specialist-feeding procedures. The manager has negotiated with the host placing authority a qualified nurse to support this important training. This will ensure that young people receive the highest quality of care from familiar staff. Young people experience excellent opportunities to try new activities while having short breaks, for example going with other young people in the minibus to visit the science museum, cable cars or the London Eye. One parent said, ‘Some activities I can’t do because of the younger children, but I don’t have to as he does these things at short breaks.’ Exceptional care planning and review ensure that young people’s progress is

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Outstanding

monitored and actions taken to address any concerns. Simple targets are set with young people, their families and other involved professionals, for example brushing their own teeth or clearing their own plates away after meals. One parent said, ‘The review is for both of us. They help me with any issues I have as well, for example getting him to use the shower instead of bathing.’ In addition to care and placement planning, young people benefit from equality and diversity plans. This ensures that when there is not an exact identity or cultural match in the setting, action plans ensure that cultural, religious, language and dietary needs are met. The manager and staff team plan to ensure appropriate menu choices and activities across the diversity of the group. The manager recently introduced picture progress books for reviews, which are beautiful pictorial diaries of young people’s activities and progress while on short

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Outstanding

breaks. These books present an accessible and easy format for sharing and discussion with young people who have verbal communication difficulties. Highly motivated and experienced staff are committed to offering the best-quality care for young people, for example ensuring that regular feedback is sought from young people, by completing questionnaires regularly with them. This informs and directs future practice. A selection of young people’s feedback includes:  ’Staff take me to Arabic classes’,  ‘I enjoy eating yoghurt’,  ‘I can choose from the menu’, and  ‘I like choosing activities’. There is an excellent cook employed at the home who cooks a selection of fresh and healthy food for young people. Young people eat together and are encouraged to clear their own plates and wash up if they are able. Parents’ feedback includes:  ‘There are really healthy options’,  ‘There is always fresh fruit and vegetables’,

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Outstanding

 ‘They cater really well for my child’, and  ‘He can make his needs known’. Judgement grade

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Good

The home continues with its exemplary record of keeping young people safe while they are on short breaks. Excellent risk assessment begins during the assessment stage, prior to short breaks starting. Regular revisions take place throughout young people’s time at the home. Risk assessments are clear and cover all key areas, identify triggers to behaviours and offer staff strategies to manage. A highly committed staff team offers clear boundaries for young people. Staff receive training in managing challenging behaviour and work together as a team to ensure that clear and consistent boundaries are given. Restraint is never used in this home and staff think that it would be inappropriate. Staff understand the vulnerabilities of the young people they work with and are extra vigilant to ensure their safety. For example, body maps are completed when young people arrive for short breaks, at every shift change and when young people

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Good

go home. This ensures that any injury, however minor, is recorded with its cause. Contact is made immediately with parents/carers if there is any accident or illness while young people are on short breaks. There is closed-circuit television (CCTV) and camera surveillance in use in the home. There are also some restrictions of liberty for young people via digital locking pads and high-handle fixings on some doors, for example to the stairs and the kitchen and outside car park. Shortfalls identified at the interim inspection received thorough re-inspection and now meet regulation. All young people have risk assessments and parental consents signed in respect of CCTV and restrictions in place within the home. The host authority, which holds a service level agreement and is the main placing authority, requested an overall impact assessment be undertaken with reference to the legal frameworks,for example, The Human Rights Act 1998, The Data

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Good

Protection Act 1998, Protection of Freedom Act 2010 and the Surveillance Code of Conduct 2013. This assessment is now in place and has been agreed by the placing authority.

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Good

The statement of purpose and children’s guide make parents, young people and professionals aware that the home has CCTV systems in communal areas and restrictions on some doors. These ensure that young people cannot leave the home without the support of accompanying staff members. Most young people using this service would be vulnerable alone in the community. Some young people have plans, enabling them to request to leave the unit, accompanied by staff, if they want to go out. This is reflected in risk assessments or health and education plans. Staff receive excellent training, which helps them to meet the complex needs of the young people they care for. Staff receive regular safeguarding training and have recently completed training on the risk of radicalisation. This regular and updated training ensures that staff are aware of all risks present for young people, and makes them confident about what they would need to do to protect the young

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Good

people in their care. One staff member said, ‘Preventing radicalisation was very interesting. It makes you realise how easily people can be influenced.’ In addition, the manager organised a police officer to come to the home and talk to the staff about the risks of sexual exploitation. The manager and staff hold safeguarding as central to practice. Young people benefit from a clearly written safeguarding policy, which helps staff to feel confident to report or whistle blow if they see or suspect poor practice. The manager is currently updating the safeguarding policy further, to include the risk of self-harm and prevention of radicalisation. One shortfall in communication and recording legal changes for one young person was found. This did not impact directly on the young person, however it could have been an issue should emergency medical treatment have been required. The health and safety records remain exemplary. Further improvements include all

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Good

young people having emergency evacuation assessments and personal evacuation plans. This ensures that staff are prepared for and knowledgeable about all young people’s needs in the event of a fire or other emergency that would require evacuation. Robust staff recruitment processes are in place. These protect young people from exposure to unsafe people working in their home. There is a comprehensive risk assessment of the building, including a review of the local area to assess for further risks.

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Outstanding

This remains an exceptional service where there are no breaches of regulation. Leadership and management give the highest priority to planning and meeting the complex needs of young people using this service. Managers have successfully addressed the requirement and recommendations made at the interim inspection. The manager feels that he is better equipped and has a much more thorough understanding of the issues surrounding monitoring and restrictions of liberty for young people. Leaders and managers welcome inspection and constructive criticism, which helps them to learn. The manager has shown a strong desire to improve services and to remain a leading provider for short-breaks provision. Leaders and managers involve themselves in the local care partnership programme, which meets quarterly with all providers, schools, children and adult services. This forum looks at transitions for young people when they reach 18 and

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Outstanding

takes into account parents’ and carers’ views in planning services. In addition, the leaders and managers are involved in ‘Transforming Care’. This is a government initiative looking at supporting young people who have complex needs to receive care in their communities instead of placements outside of the borough. Leaders and managers are a hub in the community. They understand family struggles and represent and advocate for parents’ and carers’ views. A social work manager said, ‘They support parents to advocate. Staff see them more regularly and know them better. We see this as a strength.’ The home runs a weekly parents’ group, uses communication books and provides a quarterly newsletter. All these forums allow parents and carers to have their say and to influence how services are delivered. Commissioners speak very highly of this service. They state that the service is very flexible and has managers who are able to juggle things in order to support them

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Outstanding

in emergencies, for example, when short breaks will provide consistency if a young person needs to come into care at short notice for any reason. Leaders and managers are working exceptionally hard to provide an equitable service in partnership with placing authorities. The manager introduced an allocation meeting prior to each school holiday, in response to parents’ and carers’ requests to have more control over when short breaks are allocated. This has resulted in a better-organised system that gives parents and carers choices of dates. There is effective monitoring of the service by an independent person who visits the home monthly and prepares a report. A new independent visitor has recently taken up this role and always includes parents’ and young people’s feedback. These monitoring reports are of good quality and help to support improvements in practice. The manager completes his own internal monitoring reports, which feed

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Outstanding

into an overall development plan for the service. The home has excellent levels of staffing, ensuring a high ratio of staff to young people. Staff feel well supported to undertake their roles. They describe group supervisions and team meetings in which they look at different regulations and how they are meeting these effectively. The staff enjoy their work and describe managers as ‘excellent’ and ‘really helpful’. Regular staff forums now take place in response to a suggestion from the independent visitor. These are development sessions held monthly and provide a forum in which to share knowledge, to feedback on recent training and to focus on learning. This ensures that all staff benefit from training undertaken by any staff member and give time to communicate useful knowledge. The home continues its excellent participation in regular autism awareness days at the sister home in the borough. It also attends a yearly autism conference where

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Outstanding

latest research in practice is shared, keeping staff and managers up to date with best practice.

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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 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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