Children's home run by Northamptonshire Healthcare NHS Foundation Trust in North Northamptonshire

Good

The children‟s home provides effective services that meet the requirements for good.

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

 Children experience short breaks in a home providing good, safe care, and enjoy a range of opportunities and activities.  Staff demonstrate an understanding of each child‟s needs, personality and preferred methods of communication. During their stays, children develop socialisation skills and positive peer relationships.  Staff have developed a range of consultation methods with children and families. Children‟s views and wishes influence decisions made about their stays and their care.  Staff are trained and skilled in managing complex behaviours, and they use low-level interventions to ensure that children are kept safe. There is a low number of incidents involving risks to children.  The developments since the last inspection, and embedded, excellent practice, demonstrate the outstanding leadership and management skills of the registered manager and the senior team.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Any individual appointed to carry out visits to the home as an independent person must make a rigorous and impartial assessment of the home‟s arrangements for safeguarding and promoting the welfare of the children in the home‟s care („Guide to the children‟s homes regulations including the quality standards‟, page 65, paragraph 15.5).

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Recommendations

 As the home will have a day-to-day understanding of young people‟s capabilities and needs, children‟s home staff will have a valuable contribution to make to the pathway planning process. They should actively seek to make the fullest contribution, working with other relevant persons („Guide to the children‟s homes regulations including the quality standards‟, page 17, paragraph 3.28). This is with specific reference to transition planning for children in need as well as looked after children.

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Information about this children’s home

This home is a six-bed residential short-break service managed by a healthcare foundation trust for children with learning disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement 09/02/2016 Interim Improved effectiveness 13/10/2015 Full Good 26/01/2015 Interim Sustained effectiveness 07/05/2014 Full Good 11/03/2014 Full Inadequate

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Good

This home provides good short-break care for children and young people with autism, and children with a dual diagnosis where autism is the primary need.

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Good

The home is bright, clean, organised and adapted in such a way as to provide an environment that is safe, with appropriate levels of stimulation. Since the last inspection, there have been a number of improvements. Staff and parent volunteers have been involved in improving the small sensory garden, and improved the larger garden with play equipment to provide a better play space. There are plans to make sure that the main garden area is weatherproof and can be used all year round. Children and young people are always supervised in the gardens. In the home, there are a range of child-friendly displays, alongside children‟s schedules.

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Good

Children have detailed health plans as part of the placement plan. Children maintain their general practitioner, dentist and any involved specialist services. Shared and up-to-date information ensures that there is continuity in meeting children‟s health needs.

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Good

Two members of staff are responsible for recording and co-signing each child‟s medication needs at the beginning of each stay and throughout the stay. Records have been improved to ensure accuracy, as medication can and does change between stays. Staff reported that being able to cross-reference with the health trust‟s database, where necessary, has improved the process.

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Good

Many children have dietary requirements. Staff maintain records of each child‟s diet during their stay. This evidences that each child is provided with a balanced diet and that often, as parents report, children‟s eating habits improve and their preferences expand, as a result of their stays in the home.

p.6

Good

Staff visit children at home when they have been referred. Detailed information is shared, particularly about children‟s routines and preferences. Staff also visit children in schools, to gather information about children‟s abilities and ensure that there is continuity in communication methods. Staff also recognise the importance of a good transition from school to the home. This means that there are positive transitions during their stays. Each child has a small number of targets that are incorporated in their care plans and follow on from targets in education plans. Staff are in the process of reviewing all children‟s targets to ensure that they are aspirational. They include developing learning skills, interests and independence skills. During the inspection, children were enjoying a range of activities with staff and demonstrating self-care skills. The inspector reviewed excellent video evidence of consultation with a child, with

p.6

Good

limited verbal skills, responding with use of Picture Exchange Communication System ( PECS) symbols. He was able to demonstrate very clearly his views about what made him happy in the home and to choose the staff that he wanted to do an activity with.

p.7

Good

There is improved evidence of staff capturing children‟s views and wishes, influencing decisions about menus and activities and staff providing a range of mechanisms for children to express how they are feeling.

p.7

Good

Diary planning meetings are used well to consider all children‟s stays, with a view to matching children‟s preferences, abilities and tolerances. Staff demonstrate an understanding of each child‟s needs, personalities and preferred methods of communication. They also know which friendship groups have developed. This means that children are able to get the most out of their stays, developing socialisation skills and positive peer relationships.

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Good

One parent said: ‟My child has developed a bond with another child, he talks about what this child likes. This is new. It is progress because he used to focus on what he liked. He is always happy to come to the home, he looks confident and relaxed. He has made progress with personal care such as brushing his teeth. Now he says “I will do it”. He has been on outings with the home and we feel more confident about taking him out because he does not run off like he used to.‟

p.7

Good

Staff and managers have significantly developed and improved consultation with children, young people and families. There is a consultation group and there are a range of methods used. For example, at each shift handover one member of staff takes responsibility during the shift for capturing observations of, or children‟s spoken views about, what they like or do not like. One child who was out on a walk was very excited about seeing a fire engine. Staff noted this and have arranged for a fire engine to visit the home during his stay. While the inspector was there, staff were planning for a young person to take a trip on a train, as he had said he would like this and has never been on a train. This had been recorded in the consultation book the week before. Other evidence included photographs of a child having a water-fight in the garden, and another child had been taken to see canal boats. The impact is that children and young people are influencing decisions about their

p.7

Good

Staff and managers understand that children require a structured environment and predictable routines. Staff demonstrated in shift planning meetings, and in their preparation for children‟s stays, that they know children‟s needs well. Routines are personalised to meet individual needs. Each child‟s day is well planned. The placement plan includes daily routines and risk assessments that inform the management of individual behaviours. Daily practice is inclusive and is informed by children‟s identities, abilities and heritages.

p.8

Good

When young people are moving on from this home, staff support families to consider and explore adult resources. They share information with resources as appropriate and agreed with professionals and parents. There is a recommendation about the planning for older children, moving on.

p.8

Good

The children‟s guide has been reviewed and improved and includes information about consultation. Staff regularly send out a child-friendly „This is me‟ leaflet for parents to update with new information, which may be new interests or different needs that have developed. For example, one parent shared that her child had recently developed an interest in touching plastic and if she saw a plastic object while out she would rush to touch it. This is important information for staff so that they can plan to manage this and they have incorporated it into risk assessments.

p.8

Good

Staff have a range of safeguarding training and have an understanding of the additional vulnerabilities of, and risks to, disabled children. There are detailed child protection procedures and guidance for staff.

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Good

Risk assessments for children include a measure of the risk and advice about managing and reducing it. The advice covers a description of the risk, the warning signs or triggers, impact, likelihood, precautions to take and improvements that could be made to prevent it happening again. Records include the use of a body map that identifies areas where children have been known to harm themselves.

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Good

Staff are trained in low-level intervention techniques to prevent children harming themselves or another child or member of staff. Staff are trained in communication skills and managing challenging behaviours. They have skills in assessing behaviours and preventing incidents. As a result, there are a low number of incidents involving risks to a child.

p.8

Good

Staff assess and record emerging behaviours and needs. They are skilled in observing behaviours, which is essential when children have limited verbal skills and require support to express their feelings, such as pain.

p.9

Good

Staff supervision includes sharing and discussing safeguarding information and this is audited as part of file audits and reported on by the independent visitor.

p.9

Good

There have been no missing incidents or unauthorised absences. However staff have clear procedures and a good understanding of how to respond, as this is included in training. All children have risk assessments about „running off‟ behaviours. There are detailed records prepared for emergencies and every staff member takes a portable profile for each child when they are going out.

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Good

There are good staffing levels in place for each group of children, to manage and support children‟s individual needs and behaviours.

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Good

Any incidents are recorded and reviewed by the manager, and they are also quality assured within the health trust. Social workers and parents are informed of any incidents. There are a proportionate number of incidents given the needs of the children and young people.

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Good

There have been no referrals to the designated officer about allegations of harm by adults working with children. All staff have received information and training about the relevant procedures, guidance and safe care. Safe care is also discussed regularly in supervision and team meetings.

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Good

There has been one safeguarding incident notified to Ofsted. All of the information is recorded and has been shared with the family and the case-responsible social worker. There has been a professionals‟ meeting to review the incident, which was about a young person‟s self-harming behaviours, and which confirmed that appropriate actions were taken to safeguard him and to prevent disruption to the other children. One parent said: „ My daughter is safe here, staff make sure it is a safe environment.‟

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Outstanding

The developments since the last inspection, and embedded excellent practice, demonstrate the outstanding leadership and management skills of the registered manager and the senior team. They have also benefited from the strong and highly effective support of the service manager.

p.10

Outstanding

The manager is an experienced and skilled leader, with enthusiastic, child-focused seniors in her team. One senior member of staff said: „This is a strong management team. The manager is firm but fair and always looking to improve the service. We have really developed consultation with children and young people. We have always observed and assessed as part of our daily practice. However, by ensuring that we record what children like and want, identifying views and wishes, capturing each child‟s voice is now embedded in staff practice. We will continue to work at this.‟

p.10

Outstanding

A strength of the team, that both professionals and families comment on, is its commitment to advocating on behalf of children. They share information about children‟s needs to ensure that they are receiving appropriate services and support families to identify advocacy, where needed.

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Outstanding

Staff and managers attend multi-agency meetings, contributing to assessments and decisions about care plans and education plans. There is a process in place to escalate concerns if care and education plans are not shared with the home in a timely way, as these inform the home‟s short-break placement plan for each child.

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Outstanding

The management team has supported staff to transfer information onto the health trust database. This was a significant task and has been achieved in a timely way as a result of excellent leadership. This means that staff have access to up-to-date information and they can share information with key professionals in each child‟s network. In this way, staff ensure that placement plans are up to date.

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Outstanding

The registered manager knows the strengths of the home and the service and there is a detailed plan in place that has been developed by the team, and is informed by feedback from children, families and professionals. For example, since the last inspection there has been the development of a group that focuses on ensuring that the service is underpinned by equality, inclusion and diversity. Recently this has included celebrating events such as the Olympics and Paralympics, and there have been theme days to raise awareness and enhance children‟s knowledge about a range of cultures.

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Outstanding

There is a lead member of staff responsible for ensuring that the child‟s voice is captured. One of the mechanisms to do this is a lead person on each shift with responsibility to record the views of children and young people and their observed preferences.

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Outstanding

The statement of purpose has been updated. It is a detailed, helpful document for families and professionals and meets the regulations. It provides an explanation about the care approach underpinning the practice of the staff group in meeting children‟s needs.

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Outstanding

Staff are all trained, or are in the process of being trained, in this practice and there is improved and consistent use of schedules and visual aids for children. The home is organised in such a way as to deliver consistent care with calm areas, with limited stimulation.

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Outstanding

There have not been any complaints from children, parents and carers or professionals since the last inspection. Parents are encouraged to raise concerns, and share anything that they believe the home can do differently. „I want great care‟ questionnaires are regularly sent to parents for children and parents to provide feedback. This service received 100% positive feedback for July. The seniors also proudly shared that the team has been nominated for a team award in the health trust annual awards.

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Outstanding

There was a range of compliments shared by parents, evidencing their trust in the staff group to meet their children‟s complex needs and celebrating their children‟s progress and achievements. One parent reported that staff had helped her to take her child to a hospital appointment by developing a schedule for her to use with her child. When the appointment became difficult, she felt able to ask for, and receive, the support of a member of staff who joined her at the appointment.

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Outstanding

Social workers also report that staff are receptive to children and family‟s needs if there is a family crisis, and to supporting professionals. For example, one social worker was collecting a child from school for an appointment, and staff provided information about what would help in this transition, then gave support by accompanying the social worker and child for the appointment.

p.11

Outstanding

Staff have contacts in the community and use resources that are able to offer safe spaces for disabled children. Staff continue to develop contacts and to work with a children‟s advocacy group to influence increased resources and opportunities for disabled children.

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Outstanding

The manager is committed to improving the quality of the service and to continuous improvement of staff skills and knowledge. She responds to recommendations in the reports provided by the independent visitor. The quality of the visits would be enhanced by ensuring that the majority of visits take place while children are present and during important points of the day, such as breakfast or dinner routines. A recommendation is made to improve this.

p.11

Outstanding

Staff fed back that they are positive about the difference they are making in the progress and achievements of children using the service, and that team morale is good.

p.12

Outstanding

A parent said: „Our child can socialise with other children. She is enjoying different life experiences. For example she recently went to the cinema and this gave us the confidence to take her to the cinema. She has made lots of progress using schedules and PECS, and staff have helped us to develop this at home.‟

p.12

Outstanding

The local authority that commissions placements in this home have made some changes to the referral process, that may have some impact on sharing of information. The registered manager and senior managers are in the process of addressing these. This inspection identified a concern about the timing of reviewing and agreeing plans and arrangements for young people in receipt of short breaks, who will continue to require services and support beyond 18 years of age. There is a recommendation that the manager, with senior managers, seeks to address this with the relevant stakeholders to ensure that staff have the opportunity to share information about their experience of caring for those young people, to inform plans in a timely way.

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Outstanding

A social worker said: „Partnership working has been excellent. We want to continue to have a good flow of information between our team and the home. It is invaluable, so that we can respond to children‟s needs appropriately.‟

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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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