Children's Home run by The Together Trust in Stockport

Good

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

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The children’s home provision is good because:

 Children benefit from positive experiences that enhance their enjoyment of life and their development of self-care skills.

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The children’s home provision is good because:

 Their health and well-being is promoted and good auditing systems ensure that children receive the medicines and treatment they need. Medicine administration errors are rare and are quickly spotted and addressed, with action being taken on advice from medical professionals.

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The children’s home provision is good because:

 Children establish good relationships with staff, which helps them to feel safe and settled in the home.

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The children’s home provision is good because:

 Transition planning to and from the home is good and helps to ensure that children are well prepared for and benefit from the service.

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The children’s home provision is good because:

 The increased focus on understanding autism and communicating with children, means that the level of effective support provided to children is improving.

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The children’s home provision is good because:

 Help and protection of children is good. Children‟s safety and well-being are central to the home‟s practice.

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The children’s home provision is good because:

 Staff mostly manage children‟s complex and challenging behaviour effectively, using strategies that take account of their individual complex needs.

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The children’s home provision is good because:

 Staff follow good systems that protect children‟s dignity when delivering personal care. Children are kept safe both in the home and in the community.

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The children’s home provision is good because:

 The leadership and management of the home is outstanding. Strong, competent leadership drives continuous improvement in the service.

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The children’s home provision is good because:

 Staff are fully engaged in the development of the service and this engenders high aspirations, enthusiasm and a commitment to delivering the best possible care to each child.

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The children’s home provision is good because:

 Partnership working with parents and other professionals is very good.

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The children’s home provision is good because:

 Close and methodical monitoring of the operation of the home ensures that good standards of care are maintained and action is taken quickly to address any identified shortfalls in practice.

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The children’s home provision is good because:

 Individualised target-setting helps staff to focus on key aspects of each child‟s care and development so that each short stay is well planned and meets the child‟s needs.

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The children’s home provision is good because:

 The robust recruitment practices used to select permanent staff do not fully extend to agency staff. Consequently, the home cannot demonstrate from its records that those who cover staff vacancies are well vetted and have the expertise required to work at the home.

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The children’s home provision is good because:

 Staff need further training to develop expertise in understanding and communicating with children with communication difficulties. Leaders and managers recognise this and have set up relevant training events over the forthcoming months.

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The children’s home provision is good because:

 Not all children are supported in line with agreed targets because staff are not always vigilant in ensuring that they support children to develop self- care skills, as set out in their placement plans.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meets the Care Standards Act 2000, Children‟s Homes (England) Regulations 2015 and the „Guide to the children‟s homes regulations including the quality standards‟. The registered person(s) must comply within the given timescales.

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Requirement Due date

Ensure that full and satisfactory information is available in relation to each person who works at the home, including information listed in Schedule 2. This specifically relates to agency and relief staff. (Regulation 32(1), (2), (3)) 15/10/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Ensure that short breaks present an opportunity for children to achieve new things. In particular, ensure that staff encourage children to be more independent, where such targets have been set in partnership with children, parents and social workers. („Guide to the children‟s homes regulations including the quality standards‟, page 29, paragraph 5.22)  Ensure that staff further develop skills and confidence to communicate easily with children, and understand how children communicate non-verbally. In particular, continue to train staff so that they develop expertise in understanding and communicating with children who have communication disabilities. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.10)

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Information about this children’s home

The home provides short breaks for five children with physical disabilities and learning disabilities including autism spectrum conditions. It is run by a charitable organisation.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

05/02/2016 Interim Sustained effectiveness

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Recent inspection history

17/10/2014 Interim Improved effectiveness

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Good

Children enjoy their short breaks at the home and benefit from the many and varied positive experiences provided. They are encouraged to engage in activities of their own choosing, and many enjoy baking, art and craft work, using computers, televisions, DVDs and dancing to music. The sensory room is a relaxing space enjoyed by all and children have a lot of fun in the garden, which is equipped with a trampoline, swings, sandpit and a large grassy area. Many children enjoy outings, including trips to the airport, seaside, shops and parks, and going on trains. Trips are arranged to accommodate children‟s interests, wishes and needs. A parent explained: „They take them places we could not manage; like Disney on Ice, which she loves; or theme parks. It‟s a fantastic experience.‟ And another parent said: „They help them have mainstream experiences like going out for a meal. We can‟t do that with them; it‟s great.‟

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Good

Children receive one-to-one attention and care in a calm, relaxed setting that is suited to their needs. They are encouraged and assisted to share their views, through the use of social stories, picture communication systems and electronic communication in addition to the spoken word. Staff are developing their understanding of autism and are continuously improving their strategies for working with individual children, recognising that each child is an individual with their own complex needs.

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Good

For example, the home uses social stories to help children understand plans and routines. For some children, staff send personalised social stories via email to parents prior to a child‟s short break. This enables the parent to prepare the child for the visit and successfully reduces the child‟s anxieties as he knows which staff will be supporting him and what activities are planned during the visit.

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Good

Children whose propensity is to quickly become anxious and upset are able to relax in the home and enjoy their short breaks. A speech and language therapist is helping staff to use a wider range of communication methods and thereby communicate more effectively with children. This is work in progress.

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Good

The focus on improving communication with children is reinforced through the allocation of lead roles to a small team of staff. The home is developing individual and universal strategies that are helping staff to understand, communicate with and support children better. For example, the home has introduced a plastic storage box for each child, in which the things they like and make are stored, including their own personal communication aids, photographs, books, bedding and toys. These are beginning to be used regularly to assist children to feel comfortable during their short breaks and as tools to help staff interact more effectively with children.

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Good

Good person-centred placement planning underpins the care provided to each child. Placement plans are updated following consultation with the parent just before a child‟s short break. Each plan is reviewed by the staff member assigned to support the child immediately prior to their visit. This ensures that staff are fully up to date with children‟s needs and progress and are familiar with the child‟s targets and management strategies. Individually tailored behaviour support plans and detailed risk assessments clearly guide staff in how to care for children safely.

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Good

Most core staff have an excellent understanding of how to meet individual children‟s complex needs and how their autism impacts on their lives. For example, a member of staff explained how they help children to express themselves: „You can sometimes tell when they are getting anxious – e.g. they will do a pinching motion and you can see it in their faces; and we can see it with other children. We give them space or their picture communication keyrings or we use the “feeling fans” – some children really use them well so they can tell us how they are feeling. It‟s a great way for children to communicate with us.‟

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Good

Targets are set in collaboration with parents and social workers, aimed at supporting children to achieve new skills or to manage their emotions more effectively. Staff explained: „All young people have targets and outcomes based around their independence skills. These are tailored around the individual‟s levels of understanding and their own needs and identity.‟ While there is good evidence of staff supporting children to achieve their targets, this is not consistently applied. Some staff do not follow the agreed strategies, as identified by a member of staff and observed during inspection. A staff member commented: „Some members of staff help the young people too much, which results in them expecting staff to do everything for them.‟ Consequently, not all children receive good and consistent support to develop their self-care skills, as set out in agreed plans.

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Good

The group‟s reflection on incidents and the level of information-sharing is very good. It helps to ensure that all staff continue to expand their skills and in most cases, provide children with extremely good support. Reflecting on a serious incident in which a child assaulted several staff when he saw that another child was using the bathroom he usually used, a staff member explained: „Knowing the young person and his needs is key. It was his first overnight stay and each time he had visited before that, he had used the same bathroom. I learned a lot from that incident. We need to make sure that children use the different bathrooms – it‟s important to keep them flexible and stop them being fixated, if possible. We‟ve done that with him and we continually try to stretch him. He likes to shred paper but becomes distressed by it, so we give him squirty cream to divert him. It gives him something to do with his hands and keeps him calm. Then we move on.‟

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Good

Staff interact positively with children so that over time children build strong bonds with them. A parent explained that her child has identified eight staff he particularly likes and the home makes sure that he receives one-to-one care from among that group at each visit. This has made a huge difference to his enjoyment of his short breaks. The parent explained: „At first he was screaming and crying and saying “Why are you making me go?” Now, he is settled. They plan his next visit with him and they go above and beyond to make him want to come.‟

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Good

In accordance with decisions made at children‟s placement reviews, some children are cared for by a small, regular team of staff, in recognition of their need for consistent care from staff they know well. This is offered to children whose anxieties and consequent challenging behaviour are particularly demanding. It is proving effective in helping those children to remain calm and enjoy their short breaks more.

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Good

Children‟s health needs are prioritised and staff are trained to administer medicines safely and to recognise when a child is unwell. They use „feelings fans‟ to help children express what is wrong. For example, one child was able to tell staff he had a headache, which enabled them to give him the painkillers he needed. Good medicine administration systems ensure that children receive the medicines and treatment they need. Errors are rare and are quickly spotted and addressed, with action being taken on advice from medical professionals so that children‟s health is not compromised. Investigations are carried out following any medicine administration error and lessons learned are carried forward to improve practice.

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Good

Healthy eating is encouraged and nutritious meals are available for all children. However, the home takes account of individual children‟s restricted diets and meal times are kept relaxed and as stress-free as possible by providing children with food they enjoy.

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Good

Recalling their admission to the home, a child said: „I did tea visits and I spoke to staff‟ and another remembered, „I got a little pack.‟ Children have as many tea visits as they need to help them feel settled and relaxed before they stay overnight. Staff meet with parents and gather as much information as possible about their daily routines, likes and dislikes so that as much as possible can be done to help them enjoy the visit. One child said the best thing about the home is „having my personal space‟.

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Good

A member of staff leads on transition planning and works extremely effectively with social workers, parents and other providers. This is leading to better decision making around transition to adult services. A parent said: „We are transitioning to adult services. Rob comes with us and he supports us well. He comes to all the meetings with us and to all the places we are looking at. He always looks at things from the child‟s point of view. We want her to have the same nights in adult services to reduce the impact of the change on her brother and keep routines the same. Rob is supporting that.‟ Judgement grade

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Good

Good behaviour management strategies are consistently applied so that children benefit from clear routines and boundaries. This helps to reduce their anxieties so that they feel safe and secure. For example, staff follow individual bedtime routines, which successfully support most children to settle well at night. For those children who continue to struggle at bedtime, extra staffing is allocated to ensure that they are well supported and supervised through the night. Their care plans are reviewed, with social workers and the organisation‟s clinical psychologist. This ensures a multi-professional and effective approach to addressing children‟s needs. A parent explained: „I can ask them anything and they will work out a way to help. My child was presenting with mental health problems and they had to increase the staff at night. There was no question of her not coming. They supported us really well. They provide a lifeline.‟

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Good

Effective, individual risk assessments support staff to provide safe care to children who are extremely vulnerable and whose safety needs are high. This helps to ensure children‟s safety, both in the home and in the community. For example, children who might remove their safety belts in the car are accompanied by an escort when travelling, and the home uses special harnesses to ensure that they are safely and legally restrained during car journeys.

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Good

Staff have been well trained to help children reduce self-injurious behaviour and to intervene appropriately to protect children and staff from assault. For example, staff are alert to children‟s changing moods and take action to prevent their anxieties escalating, wherever possible. They divert children or give them the opportunity to calm down in a relaxing space such as the sensory room, their bedroom, the garden or the „chill-out room‟, in accordance with their own particular needs and wishes. In many cases, this prevents the escalation of challenging behaviour and assault. A parent explained: „The work they put in to make him feel safe is remarkable. They arrange activities that he enjoys, like cooking and trips out, and they use bedding he has chosen and put posters on his walls that he likes. They know what to say to him to calm him: they recognise his fears and anxieties and then move on. They do it really well.‟

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Good

Gentle physical interventions, including „touch support‟ are used effectively to guide children away from challenging situations. Restraint is used as a last resort and only to protect children and adults from harm. Similarly, restricting a child‟s liberty is a tactic used rarely, and only when all other behaviour management strategies have failed to reduce a child‟s anxieties and harmful behaviour. It has been used once since the last inspection, for a short period, and was successful in helping the child regain equilibrium and in preventing serious assaults on others. The home provides staff with protective clothing, which reduces the impact and severity of injuries from children who express their anxieties through assault.

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Good

Children are continuously supervised and all incidents are fully recorded in detail. They include good reflection by staff and the management team so that it is clear how lessons are learned from each event. Strategies for supporting the child involved are updated accordingly.

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Good

In line with care plans and children‟s needs, external doors are kept locked, with the exception of those leading to the garden. This ensures that children who are extremely vulnerable are protected from traffic and the dangers of leaving the home unaccompanied. Safe caring practices ensure that children‟s dignity is promoted when they receive personal care or when they remove their clothes. For example, children who leave their bedroom naked are provided with a towel to protect their dignity and receive positive encouragement to dress appropriately. Staff keep other children away from the landing area until the child is appropriately dressed or is in the privacy of the bathroom or their own bedroom.

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Good

Staffing levels are high and, for the most part, enable children to enjoy activities and outings that meet their needs. When children‟s safety is a concern in the community, the home approaches children‟s placing authorities to provide additional funding so that, with extra staffing, children can access the community safely. Sadly, the required funding is not available for all children. Consequently, some children cannot engage in the full range of community-based activities safely. This reduces the home‟s capacity to support those children to learn how to stay safe in the community.

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Good

Staff respond appropriately to allegations or disclosures of abuse and agreed safeguarding strategies are followed in relation to individual children who make frequent allegations, including notifications to the child‟s social worker. This ensures that a multi-agency approach to child protection is agreed and implemented. Allegations against staff are shared with social workers, parents and the designated officer, and are appropriately investigated. None have been founded.

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Good

Staff observe children closely and log all accidents. They recognise when a child may be in pain and take action to address it. They record any bruises observed and provide details to parents and social workers. Staff are trained to recognise when children who have varying levels of communication disabilities may be at risk of physical and/or sexual abuse or exploitation. They work in partnership with families and other agencies to safeguard children at risk.

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Good

Robust staff recruitment procedures ensure that, in most cases and as far as possible, staff are fully vetted and suitable to work with vulnerable children. However, agency staff files do not demonstrate that all checks have been carried out in accordance with legislation. For example, for some agency staff, references are not verified, a full employment history is not held and information about a person‟s suitability does not always show that the staff member has the skills and experience required to work at the home. This means that the home cannot evidence that agency staff are fully vetted and suitable.

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Outstanding

The registered manager has extensive experience of working with children in social care and has been in post for over four years. She is suitably qualified and manages the home competently. She is well trained and knowledgeable about autism spectrum disorders. A new assistant manager has been in post for three months. She, too, is suitably qualified, experienced and knowledgeable about autism spectrum disorders. Together, the leadership team provide inspirational support to staff. This promotes the delivery of high-quality, individually focused care, which meets the aims of the service as set out in the statement of purpose. Excellent monitoring systems clearly demonstrate that the home is providing children with positive, enjoyable experiences that enhance their lives and promote independence.

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Outstanding

The capacity to improve is strong. The home has met all recommendations made at the last inspection and this has enhanced the quality of care to children. The home‟s development plan is regularly reviewed and evidences steady and consistent progress in achieving targets. The home has made significant, beneficial changes since the last inspection. A greater focus on training staff to develop skills in caring for children with autism is expanding the confidence and competence of staff, and generating high aspirations for the children who use the service. Consequently, the home is continuing to improve and is delivering ever-better, person-centred support that meets children‟s individual needs well.

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Outstanding

Almost 90% of the staff team are qualified in caring for children and young people. New staff undertake a suitable qualification course on successful completion of an informative induction and well-supervised probationary period. Together, the managers and staff form a mutually supportive, cohesive and dedicated team, with a clear focus on delivering high-quality care. This inspires staff to go the extra mile to meet children‟s individual needs. A member of staff commented: „I have just started and I already feel I can go to any one of my co-workers and management team to discuss whatever is needed. I already feel it‟s like a family.‟ Another said: „All the staff are extremely passionate. We genuinely love our job and enjoy coming to work -which also reflects on the young people.‟ Fortnightly team meetings and quarterly team development days ensure that staff are fully engaged in the development of the service. A member of staff explained:

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Outstanding

„We create new action plans and see what we have achieved over the past three months. This also highlights what we need to improve.‟ Feedback from children, parents and social workers is regularly sought and taken into account in the development of the service. For example, in response to a comment from a parent, photographs of all staff have been sent out to children and their families so that they are familiar with the current staff team. In addition, the statement of purpose is kept under regular review and provides brief profiles of each staff member. This helps parents and others to know and trust the people who are looking after their children. Parents welcome the recent introduction of a quarterly newsletter which provides an informative and family-friendly overview of the home, recent changes and children‟s achievements.

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Outstanding

The manager receives and delivers good-quality one-to-one supervision, which enables reflection on performance and on children‟s progress. In addition, the home seeks and receives support from partner professionals, including a clinical psychologist, speech and language therapist, specialist health professionals, schools and the child and adolescent support team. This enables a multi-agency approach to ensuring that children get the best possible service. The home is accredited with the National Autistic Society, demonstrating that it meets the required standard for delivering care to autistic children.

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Outstanding

The quality of relationships with partner agencies and parents is very good. A social work team manager explained: „We place a lot of children there. The service is very good. They work well with us and the families. Any concerns are immediately addressed. Each child had a key worker and all the social workers know the manager and key worker. We have no concerns.‟ Equally, parents express high levels of confidence in the home. For example, one said: „The service is a life-saver. The children are happy and well looked after. There is a lot of communication, which helps to meet my need for information. They ring us before each visit to catch up on any changes and the children‟s moods. We discuss and agree the targets, which help the children with independence.‟

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Outstanding

Staff make effective and valuable contributions in person and through reports to placement and education reviews and Team Around the Child meetings, and to pathway and transition planning meetings. They are fully engaged in ensuring that children get the services to which they are entitled and challenge local authorities appropriately if a child is not getting a level of service that meets their needs. For example, they have repeatedly challenged a local authority to increase its offer to a child who needs additional support in the community, and this is currently under review.

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Outstanding

Staff turnover is relatively high. Eleven of the 25 staff have left since the last inspection. Exit interviews are conducted and the organisation is aware that, in some cases, low pay is a feature. It is taking action to improve staff retention. The home currently has 21 permanent staff and supplements the rota with four regular relief or agency staff members. New staff are very well supported and encouraged, so they develop their skills quickly. Despite the staff changes, the team is well- gelled and responsive to the strong and inspirational leadership. This produces an excitement, enthusiasm and interest in the children that is clearly beneficial to all. With high expectations of the staff team, the home creates an environment where children and their families truly benefit from the short breaks provided.

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Outstanding

The premises are in need of refurbishment and arrangements are in place for renovation work to begin in September 2016.

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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 that 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 that 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 whom 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 0300 123 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 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

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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