Children's Home run by London Borough of Brent in Brent

Outstanding

The children's home provides highly effective services that consistently exceeds 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:

 Since the last full inspection, which judged the service to be outstanding, managers and leaders have continued to implement new systems to further improve the high quality of care provided  Managers have improved upon the centre’s existing monitoring systems and safeguarding mechanisms, which act to protect further children from abuse and harm.  Children immensely enjoy and benefit from their experiences while staying at the centre; feedback from children and their parents and carers is overwhelmingly positive.  Staff are expertly skilled in working sensitively and effectively with children living with learning disability, profound and multiple physical disabilities and complex medical needs.  Staff know each child, their preferences and needs, exceptionally well.  Staff continue to devise and track children’s individual short break targets. Good effort is made to support children achieve established goals.

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The children's home provision is outstanding because:

 The manager is working with staff to implement a person centred support approach to care, which will further increase children’s opportunity to make choices and decisions for themselves.  Staff are highly passionate and committed to the work they do and share trusting relationships with children.  Since the last inspection, managers have been successful in appointing key permanent care and support staff to ensure there is effective continuity of care.  Staff’s partnership working with internal and external professionals continues to be highly effective, ensuring that care is well co-ordinated and meets children’s needs well.  The centre continues to attract and secure placements from neighbouring boroughs who seek high quality placements for children living with complex medical conditions and profound disabilities.

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 Ensure children's case records, in particular written risk assessments and short break plans are kept up to date. (The Guide to the Quality Standards, page 62, paragraph 14.3)

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Recent inspection history

Inspection date Inspection type Inspection judgement 16/02/2016 Interim Sustained effectiveness 28/09/2015 Full Outstanding 02/03/2015 Interim Sustained effectiveness 12/08/2014 Full Good

p.4

Outstanding

Children immensely enjoy their short break experience and have good opportunity to make stable friendships in a safe environment. This is particularly important as many of the children live with communication difficulties and struggle with social interaction with their peers and adults. They have trusted relationships with the staff team, who are passionate and sensitive in their care of children, and are familiar with their needs. Importantly, they understand the nature and impact of children’s disabilities and keep them safe. As a result, experiences are fun, exciting and creative. The service offers children opportunities they often would not have otherwise.

p.5

Outstanding

The engagement between children and staff is exceptional and both parties clearly enjoy working together. One parent comments via feedback form, ’I can’t thank you enough for the fantastic job you do looking after my special baby boy with such care and understanding and how you make it possible for me to actually switch off for a while and breath. Thank you.’ A staff member of staff told the inspector, ‘The best thing about my job? The young people, without a doubt. Sometimes I wish I could take them home. I feel a connection with autistic children in particular. They are all so very different, you can just see their personalities even if they’re non-verbal. I need them to feel loved.’ A child said of the team, ‘Staff are like family and make my stay happy.’

p.5

Outstanding

Staff are attentive to the identity needs of children. This attention extends beyond staff’s expertise in working effectively with children living with disabilities. For example, children eat meals that meet religious and cultural obligations; some are vegetarian or prefer Halal meals. Staff enquire with parents and children if they have a gender preference of staff providing intimate care. Children are able to participate in faith practices at the centre if they wish to do so.

p.5

Outstanding

Many of the children who attend the centre use alternative modes of communication than speech. Staff are skilled in communicating with children, familiarising themselves and making use of children’s preferred method of communication. Routinely staff use Makaton and interpret body language and facial expression of children to understand their wishes. Case files are explicit in offering staff guidance in understanding how to interpret individual children’s non-verbal cues. Staff use this expertise to encourage children to participate actively in making decisions about a range of issues. These include choice of activities, meal preferences, whether they are happy or dissatisfied with their current environment and with whom they wish to spend time. Feedback forms from children overwhelmingly indicate that they are extremely happy with services they receive from the centre. Monthly monitoring reports from independent personnel

p.5

Outstanding

consistently confirms this view to be widely held by children.

p.6

Outstanding

Children have positive experiences at the centre and the have been no complaints received from a child since the last inspection. Three complaints received from adults have been successfully resolved. Children have access to written and pictorial information about making complaints. Staff routinely check with young people that they are happy with what they are doing. Additionally staff make use of a facial pictorial board to gauge how young people are feeling. They take swift action if there is any indication of dissatisfaction.

p.6

Outstanding

In further efforts to provide children with choice and make their own decisions, children complete feedback forms to gauge their satisfaction with the service and to ensure they have influence on the running of the centre. This is to ensure that the development of the service takes into account children’s wishes and feelings. Typically, children’s views have influence on the centre’s play resources and the choice of activities and trips.

p.6

Outstanding

The registered manger’s recent training in person centred support and the recent introduction of the model to the staff team marks the beginning of the service’s increased efforts to strengthen children’s opportunity for consultation and choice.

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Outstanding

The introduction of this model of care demonstrates staff’s continued strong focus on target setting. Children and staff work towards achieving set targets, which forms the basis of short break plans. Some of these plans however, require updating. Staff are very familiar with the individual targets set for children and diligently work with children to achieve short break objectives. Staff use of the centre’s ‘progress tracker’ helps staff to gauge children’s success in meeting set targets. The inspector was able to see the clear progress made by one child across a number of short break stays in attending to his personal care tasks independently of others and his ability to tell the time. Field social workers and other involved professionals participate in children’s short break reviews and express satisfaction with services provided.

p.6

Outstanding

With regard to education, parents and carers remain responsible for the education of their children. Staff ensure however, that communication with educational professionals, in particular staff of the school adjacent to the centre is effective. In particular, to ensure learning objectives are consistent. This is to ensure care and support is in line with targets identified by school staff. Typically, these focus on development of communication skills, social interaction and increased independence. Staff complete school visits as a feature of children’s admissions process; they attend school reviews and remain in regular contact with school personnel to ensure the co-ordination of care is effective in meeting children’s individual needs. Children enjoy a creative range of social, educational and leisure activities. On site, children have access to an excellent range of play resources, including adapted

p.6

Outstanding

play apparatus in the centre’s garden area. They also have access to other adapted play equipment available through special arrangement with the school adjacent to the centre, which many of the children attend. Children enjoy the centre’s sensory and relaxation room, which has play equipment that creatively stimulate their senses. Children take regular trips into the community, including visits to the library, the local RAF museum and for bowling. They also travel further field to visit, for example the London Science Museum and an adventure playground some distance from the centre. A parent comments on a feedback form, ‘My son is autistic and not social at all, but the staff try very hard to get M to interact with his peers and staff, which is lovely.’

p.7

Outstanding

This summer staff have developed a small plot for planting in the garden. Children now have the opportunity to participate in gardening activities; for some this is a very new learning experience. The summer also saw the return of local youth volunteers via the National Citizen’s Service. The scheme promotes the involvement of local youth in engaging with children living with disabilities. The programme is proving to be a great success in having children participate in drama, sports and a Fun Day with peers they might otherwise not have the opportunity to socialise and have fun together. The centre continues to promote a strong sense of inclusion, which is of significant benefit to the children and all others involved.

p.7

Outstanding

Children lead healthy lifestyles while enjoying their short break. Staff comprehensively document all relevant medical information, including any diagnosis of disability, its management and the impact of the disability/condition on individual children. Staff record clear information about common and rare medical conditions outlining how children need and prefer care to be provided. Staff receive specialist training where this is required. A good illustration of this is staff’s care of a child living with acute diabetes. In this instance, the entire care staff team received training and guidance from the assigned community diabetic nurse. This ensures that children receive safe care that meets well their medical needs.

p.7

Outstanding

Staff is consistent in maintaining close communication with parents, and health care professionals such as GP’s, speech and language specialists and occupational therapists to ensure staff safely meet children’s medical needs. Staff continue to accommodate a weekly ‘surgery’ on site from staff the local Children and Adolescent Mental Health Service (CAMHS), which facilitates families easy access to support and advice from mental health specialists. All staff receive training in first aid. This is again ensure that children receive appropriate medical attention when needed.

p.7

Outstanding

Managers take effective action to address any shortfalls in children’s medical care. In response to recent issues highlighting gaps in staff medication practices, all staff have received further medication training from a pharmacist. Managers have subsequently increased the monitoring of staff’s practices and recording to promote the safe administration of medicine.

p.7

Outstanding

Staff treat children with respect and dignity. They make good efforts to ensure they enquire with children and their parents how children prefer to receive intimate care. Staff recording tools are child friendly and encourage young people to share their preferences in almost all aspect of their care and experiences at the centre. Case records, typically offer staff explicit guidance about what these preferences are.

p.8

Outstanding

Staff maintain excellent communication with the parents of children and staff encourage them to maintain good contact while children are at the centre. Staff keep parents very well appraised of the progress and experiences of their children and staff consult parents for advice about their children’s care if there are any issues or concerns. A parent comments, ‘I had a lot of trepidation about my son going to a placement for respite, but this is such an amazing place that all those concerns have gone away and I can relax like I have not done for 10 years.’ The registered manager’s recent amendments to the communication ‘link book’ reflects additional information parents indicate they now wish to receive.

p.8

Good

Children are safe and protected from neglect, harm and abuse. They benefit from the organisation’s clear and comprehensive child protection policies and procedures, which are familiar to the staff group. Staff receive regular training and guidance about safeguarding and this is in children’s best interest. A parent comments on a feedback form, ‘My son’s safety is a high priority at the home.’

p.8

Good

Since the last inspection, the registered manager has ensured the protection of children remains high on the service’s agenda. For example, in anticipation of newly appointed staff, future staff training is to focus on the protection of children living with disabilities. Staff make use of the recently implemented safeguarding recording tool that prompts them to record all safeguarding issues. Staff routinely receive training in manual handling, physical intervention and the safe administration of medication. Team meetings and shift handover meetings continue to have a consistent focus on child protection. This contributes to the safe care of children and staff’s ability to keep them from harm and abuse.

p.8

Good

Staff are consistent and clear about setting boundaries, which offer young people structure to help keep them safe. Staff understand the impact of children’s disability may have on their behaviour and so staff are careful and sensitive in working with children about their presentation and behaviour. Children benefit from documented positive handling/restrictive intervention plans that are explicit in offering staff strategies to help kerb unacceptable behaviour. Staff regularly use verbal praise to encourage positive behaviour. A parent comments, ‘My son has SIB and can on occasion have outbursts and try to harm himself or others. The staff are well aware and no (sic) exactly how to calm him and make sure he and others are safe and secure.’

p.8

Good

Children benefit from staff’s vigilance in Staff are highly vigilant in their supervision of children and this helps keep them safe. Staff record individualised risk assessments that address known and anticipated risks. This is to help reduce harmful behaviour. Some risk assessments require revision and more detail if they are to be fully effective. Since the last inspection, there have been no notifiable events. There have been no critical incidents, any restraint, children going missing, suspicion of child sexual abuse or allegations made against staff. Staff’s commitment to safe care practices, effective supervision of children and adherence to child protection protocols promote children’s safety.

p.9

Good

Staff are aware of strategies to prevent bullying and children do not experience this. There are clear policies in place, which include information about cyber- bullying. In matching groups of children to attend the centre, staff are mindful of the needs and behaviour of each child and are careful to avoid groupings that may give rise to conflict between children. A parent comments, ‘Although my son is not very social, the home tries to match children who have similar likes and social skills, which is really quite difficult, but they do an amazing job.’

p.9

Good

The building premises is a purpose built centre, geared to meet the needs of children and young people living with disabilities. Specialist adapted equipment is maintained safely and there are effective fire precautions in place. For example, each young person has a personal emergency evacuation plan. The building is physically safe and very secure; there are no health and safety concerns.

p.9

Outstanding

The leadership and management of this short breaks service is exceptional. The previous full inspection judged the service as overall outstanding, and resulted in no requirements or recommendations. The registered manager is inspirational and since the last inspection has continued to improve the quality of care children receive. The registered manager and senior managers ensure they has ample opportunity to meet with children and parents to understand their views about the effectiveness of the service. The registered manager welcomes and encourages feedback from all stakeholders. Staff’s distribution of feedback forms to stakeholders and regular ‘coffee’ morning with parents, ensures their views and opinions influence the shaping of the service and promotes improvement.

p.9

Outstanding

The Registered Manager is a highly qualified, experienced practitioner and manager, with an extensive background in working effectively with children, young people and adults living with disabilities. She has been a registered manager of short break services for children and for several years. She is an effective and influential leader, with clear and realistic ambitions for the centre and the children who attend.

p.10

Outstanding

The registered manager is committed to the further development of the service. Good illustration of this is her recent training in person centred support model of care. In turn, she has facilitated introductory training to the staff team in an effort to embed this approach to quality, safe care at the centre. The registered manager is an effective leader who firmly leads by example. She continues to promote staff’s safe care of very vulnerable children. For example, she supports staff’s understanding the Signs of Safety model and is responsible for devising safeguarding recording tools to support safe practice.

p.10

Outstanding

The service’s monitoring systems are highly efficient and effective. These systems support continued improvement and is to the benefit of children. An independent person consistently conducts monthly monitoring visits. Subsequent reports highlight strengths and any gaps in the service and support development and improved outcomes for children. The registered manager completes quality of care reviews, which provides effective overview to help identify shortfalls that require remedial action.

p.10

Outstanding

Since the last inspection, the registered manager has introduced both an audit tool for managers’ use and self-auditing tool for staff to assess for themselves the quality of case files they are responsible for and file documentation. Staff’s completion of some audit forms highlight gaps in staff’s recording of key information. These include for example, the need for detailed completion and update of risk assessments, and placement plans. This is important to ensure that, despite staff’s keen knowledge of individual children, that records reflect the most current information about children and their care needs.

p.10

Outstanding

The registered manager has very recently been successful in appointing permanent staff to a number of longstanding vacancies. Experienced agency staff, with additional shift support from existing permanent team members, previously filled gaps in shifts. Newly recruited staff offer children a stable permanent team with consistent continuity of care.

p.10

Outstanding

Staff training opportunities are good and there is a renewed focus on specialist disability training. Newly employed staff undergo an induction and thereafter, training that meet their development needs. The registered manager ensures staff are aware of new legislation and guidance, and there remains an emphasis on staff’s understanding and compliance with the Quality Standards and regulations. Individual team members are responsible for championing key Quality Standards, ensuring relevant research and practice influence service improvement and promote positive outcomes for children.

p.10

Outstanding

Staff receive good support and supervision to enhance the quality of care children receive. The registered manager is making use of the organisation’s new corporate appraisal system that considers the views of the staff member and those who work alongside them. This is to obtain a better view of individual work performances and staff development needs. The staff team work effectively together and in successful collaboration with both internal and external partners to improve the experiences and progress of children.

p.11

Outstanding

The service’s statement of purpose is a detailed, comprehensive document that accurately outlines the aims and objectives of the short break service. The children’s guide is available in both the written word and pictorial form for easy access. The guide provides a creative summary of the services provided.

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Outstanding

This short breaks service is outstanding. A parent says of the service, ‘The staff are lovely and caring and have taken the time to understand my son and create the best environment for him to be happy and content in, which as a parent of a special needs child, is..…priceless.’ Managers and leaders have a clear vision for the service’s developmental path and demonstrate a continued strong commitment to ensuring outcomes for children are exceptional. The service has ambitious yet realistic plans in place to support its efforts to continue to offer high quality care, ensuring the experiences and progress of children are excellent.

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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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