Children's Home run by Institute of Integrated Systemic Therapy in Norfolk

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’s provision is outstanding because:

 Children are able to communicate with staff who know them and with whom they have a good rapport. This has allowed many of the children to speak about negative experiences from their past and receive the support to manage the varied emotions that arise as a result.  Children with extremely challenging behaviour are able to live together in a warm, homely setting that provides them with the physical and emotional space to address issues that have had a negative impact on their lives.  The nurturing community meetings promote the children’s ability to reflect, negotiate and develop a sense of belonging.  Staff are extremely committed and dedicated to their work with the children.  Professionals praise the work of the team and its ability to engage positively with the children and other agencies.  Staff passionately advocate for the children, and over time enable the children to advocate for themselves.

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The children’s home’s provision is outstanding because:

 The children are attending education, maintain exceptionally high attendance levels and achieve qualifications.  The staff undertake a university-accredited therapeutic care course that enhances their ability to work positively with extreme levels of challenging behaviour.  The integrated systemic therapy (IST) model ensures that the children’s emotional, physical and social well-being, are core in all plans.

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Information about this children’s home

A registered charity owns and runs this children’s home. It is registered to provide care and accommodation for up to six young people who have emotional and behavioural difficulties. The home is a therapeutic community, based on an integrated systemic therapy model.

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Recent inspection history

Inspection date Inspection type Inspection judgement 01/03/2016 Interim Sustained effectiveness 17/11/2015 Full Outstanding 04/03/2015 Interim Improved effectiveness 09/07/2014 Full Good

p.4

Outstanding

The home is very well maintained and has a homely feel. A programme of building works and updates was ongoing during this visit. Children are able to personalise their rooms. One child was selecting some additional items for her bedroom as a reward for positive engagement.

p.5

Outstanding

The children have allocated link workers who meet with them to have individual time and link work sessions. Staff use the sessions to discuss progress and matters that assist with care planning. A link worker was busily preparing for a planned discussion about sexual health and returned speaking positively about how it went.

p.5

Outstanding

The children can choose a staff member on each shift to have individual time with and to assist them with settling for bed. Where children select the same staff member, arrangements are made for a later time or scheduled for the next day. This allows the children to have some choice in who provides their care and to develop relationships with a range of adults. It also teaches them that it is not always possible to have time with their preferred staff member and how to manage their disappointment positively.

p.5

Outstanding

Interactions between the children and adults during mealtimes resemble many family homes. There were lively discussions and disagreements about a range of topics. Children sad that they are encouraged to eat healthily, and they spoke about the menu and having a takeaway once a week.

p.5

Outstanding

Community meetings are held and involve children and adults meeting in the lounge to discuss plans for the evenings and weekends, how their days/weekends have gone and anything topical. The Wednesday meeting is a children’s meeting. This allows the children to discuss any matters they may wish to raise with the group as a whole. One young person said that he participates in these meetings but sometimes raises things with his link worker afterwards as ‘it makes it easier’ as ‘it can get heated’ between some of the young people as it had during dinner the night before. Staff are adept at managing the children when they are competing for attention. They are also able to work consistently and maintain clear boundaries, which allows the children to feel safe and nurtured.

p.5

Outstanding

Staff oversee the medical appointments for each of the children and ensure that they attend regular health check-ups. Each child has an individual book of prescribed and non-prescribed medications, which appropriately details medication administered and refused. This ensures that medication is tracked and ensures that staff are alert to the impact of any missed medication. The implementation of the IST model ensures that children live in a therapeutic setting. Direct therapy is accessed for those who are able to engage in these sessions. One child, for whom it is not appropriate at this stage, has commenced art therapy.

p.5

Outstanding

Each child is attending or receiving educational input. The team liaises with the schools and colleges to ensure that each child is working to their maximum potential. The children are making excellent progress. One child is now attending a large mainstream school. This is a great achievement given that it was not considered achievable when she moved in six months earlier, in March 2016.

p.6

Outstanding

Another young person sought and gained summer employment and has enjoyed working and earning. Her offer for a college placement was withdrawn when the college received additional information about her history. The child asked to meet the college’s safeguarding officer on her own and was successful in getting them to reinstate the offer and has now started college. Staff encouragement and support were instrumental in assisting her to believe that she could fight her case. This sense of achievement will assist her to address future setbacks in a positive way. It also allows her to share, with the other children, what is possible when able to make your argument in a self-regulated way.

p.6

Outstanding

Some of the children are aware that they will live at the home until they reach the age of 18. Two of the older children will soon commence transitional work that will assist them with increasing their levels of budgeting, cooking and general life skills. This increased level of independence will enhance the children’s ability to cope when living in more independent settings.

p.6

Outstanding

The children spoke happily about their recent holiday. They were looking forward to having a slideshow of the pictures at the end of the community meeting. The children spoke positively about the range of activities that they participated in during the holiday.

p.6

Outstanding

The children benefit from having a large garden with several large pieces of play equipment. They also access a wide range of activities within the community.

p.6

Outstanding

Staff facilitate contact visits, some at great distance from the home. This ensures that children maintain links with their families and other significant people in their lives. Judgement grade

p.6

Outstanding

The home offers a high staffing ratio and this results in a minimal amount of missing from care. Although it is rare, staff know the procedures to follow and are able to demonstrate the actions that they would take, including regular calls and texts to the child’s phone, should it occur.

p.7

Outstanding

The team has a good working relationship with the local authority designated officer for safeguarding. They have made a number of referrals and consultations relating to allegations and safeguarding issues. These have generally related to events in the children’s history or external to the home, and have been reported and overseen appropriately.

p.7

Outstanding

Children say that they feel safe and that they know who they would approach if this changed. The children spoken with were able to name a number of staff they felt they could approach. One child spoke in a link session about having children in the future and there only being two people they would trust to look after them, their link worker and a former carer. This positive view of the link worker reflects the level of trust that the children have in the staff.

p.7

Outstanding

Each child’s risks assessments are under constant review. At the weekly review meetings, staff discuss any changes that result in updates being required. This has included 1-to-1 staffing for a young person and liaison with colleges about potential risks. This ensures that the safety of the children and others is assessed fully and appropriate safeguards are put in place. An example of this is the employing of a teaching assistant to be onsite at college when a young person commences lessons. The dedication in ensuring that children receive this level of support, in an external setting, demonstrates that everything is being done to ensure that children are not being limited in their choices.

p.7

Outstanding

The children benefit from clear consistent boundaries. This can initially prove quite challenging for the children and is evident in the number of incidents that occur at times where children arrive or leave the group. The level of the physically challenging behaviour can result in the use of physical intervention. Staff monitor and track these events to establish antecedents and precedents. The insight gained is used to help the children learn to self-regulate their emotions.

p.7

Outstanding

One child had described feeling as though their room was too big and how this made them feel unsafe. Staff discussed how they could add additional furnishings to use some of the space. This demonstrates that children are happy to discuss their feelings, and that staff actively listen and how they jointly develop solutions. Judgement grade

p.7

Outstanding

The manager has a level 4 national vocational qualification for care management and an advanced diploma in psychological care, and has been with the organisation for several years prior to becoming the registered manager in August 2015.

p.8

Outstanding

The management team oversees the placement plans and risk assessments and incorporates matters raised at the weekly review meetings to ensure that the plans are constantly updated and reflect the children’s ever-changing needs. This results in a climate of high aspiration and increases the children’s life chances.

p.8

Outstanding

There are also review meetings to discuss any physical interventions that have occurred that week. The managers and staff discuss the events and explore the events with the aim of assisting the children with identified strategies.

p.8

Outstanding

One staff member described the induction process and the workbooks to be completed as part of their induction. The staff member felt that the team ‘has children’s best interest at heart and are working towards them having a good life’. This reflects the aspirational goals that staff set for the children.

p.8

Outstanding

Staff undergo a university-accredited therapeutic diploma specifically devised by the organisation to ensure that staff are able to work positively with and see beyond the extreme levels of challenging behaviour that the children present. All staff complete clinical logs and are required to undertake set hours of reflective practice. The skills and insight developed were apparent when a staff member was able to engage positively with a child who had punched her in the face a short time earlier.

p.8

Outstanding

Staff receive regular supervision and have annual appraisals. These are of a good standard and demonstrate that staff are able to raise issues and discuss improving practice. The staff report that they find their supervisors and the managers supportive. A staff member spoke of raising a matter in supervision, the supervisor sharing this with the manager, who had sought her out to have a discussion. The staff member said this made her ‘feel cared for’. This level of support allows the children to be looked after by staff who feel valued and develops a strong competent team.

p.8

Outstanding

The previous inspection report recommended that children be able to see the results of their views being listened to and acted upon. This has been fully addressed. In addition to the diligent review of documentation and files, the manager compiles a six-monthly report that summarises events within the home and identifies any areas that require development. The manager is aware of the home’s strengths and aims to build on these by increasing the number of staff on each shift. Recruitment of additional staff is in progress and the manager is clear about the type of staff the home needs.

p.8

Outstanding

The managers ensure that in accepting new placements they conduct a rigorous matching process that includes the child visiting the house. A child described feeling ‘welcome’ and ‘part of the home’ after her visit. The manager, included the child who had moved in the day before on the homes holiday to prevent the child having to be placed in respite care. This demonstrates the manager’s commitment to the child’s well-being prior to them moving in.

p.9

Outstanding

The organisation is part of a children and mental health service outcomes research consortium. This involves children’s progress being scored and charted using a children’s global assessment tool. The managers incorporate this information into the children’s care and placement plans. The detailed analysis is worthy of wider dissemination.

p.9

Outstanding

Professionals praise the work of the team and their ability to engage with the children and other agencies positively. A team leader said that they get ‘detailed reports and have good communication’ with the home and that their child was ‘settled and happy in the placement’.

p.9

Outstanding

A social worker said that communication with staff is good and said ‘Given the level of challenging behaviour each of the children present, it is striking how calm and like a family home it feels.’

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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 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, 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,

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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

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

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Information about this inspection

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

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