Children's Home run by Action for Children Services Ltd in Buckinghamshire

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:

 Relationships between children and young people and staff are strong and supportive. Parents and their children regard staff as very caring and protective. One mother commented, ‘The staff are here because they want to be.’  Children and young people are making good progress, often following collaboration between the staff of different agencies who work to the same ends. Sometimes, it is the result of patient perseverance by the staff of the home. A professional who completed an Ofsted questionnaire gave an example where ‘staff had succeeded in toilet training where parents and school had not’.  Managers and staff are open to learning, valuing the comments of parents and professionals as a way of improving services offered, whenever possible.  Children and young people enjoy a range of activities, including ones facilitated by staff in the community using public transport. This gives children and young

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The children's home provision is good because:

people the opportunity to have access to public services and amenities as a pleasurable experience in itself, and also to learn. This is because the opportunity is taken for some young people to come to know where to catch a bus or how to purchase their own tickets.  Staff are very adept at encouraging independence skills.  Levels of physical interventions and sanctions are very low in the home, and children’s and young people’s behaviour tends to improve over time. One young person became very excitable when first coming for short breaks, a feeling that was expressed by slapping anyone who she came across; in time she she was capable of containing herself well. Transitions are therefore much smoother.  The manager and staff work closely with those of other agencies, whether to ensure that children and young people are safeguarded or that their well-being and progress are promoted.

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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 ‘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

12. In order to meet the protection of children standard the registered person must ensure—

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Requirement Due date

(2)(d) that the premises used for the purposes of the home are maintained so as to protect each child from avoidable hazards to the child’s health.

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Requirement Due date

This includes obtaining daily records of fridge and freezer temperature checks and of the temperature of hot foods cooked on the premises. (Regulation 12(2)(d)) 14/09/2016

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Requirement Due date

The registered person must ensure that the independent person carrying out visits to the home only inspects a child’s case records if the child and the child’s placing authority consent. (Regulation 44(2)(b)) 14/09/2016

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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

 The children's guide should help children to understand how to make a complaint in line with the home's complaints procedure, how they can access advocacy support or independent advocacy if eligible, and how to contact the Office of the Children's Commissioner. (‘Guide to the children's homes regulations including the quality standards’, page 24, paragraph 4.22)

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Recommendations

 Children who cannot or choose not to verbalise have the right to have their views, wishes and feelings heard and respected in the same way as other children. This includes making a complaint that is dealt with in accordance with regulation 39. (‘Guide to the children's homes regulations including the quality standards’, page 24, paragraph 4.24)

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Recommendations

 Staff should support children to be aware of and manage their own safety, both inside and outside the home. Staff should help children to understand how to protect themselves. (‘Guide to the children's homes regulations including the quality standards’, page 43, paragraph 9.9)

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Recommendations

 The registered person must specify the procedures to be followed when a child is missing from care or away from the home without permission, and how staff should support the child on return to the home, including requesting an independent return home interview from the responsible local authority. (‘Guide to the children's homes regulations including the quality standards’, page 45, paragraph 9.28)

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Recommendations

 The registered person should have a workforce plan which details the process and timescales for supervision of practice. (‘Guide to the children's homes regulations including the quality standards’, page 53, paragraph 10.8)

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Recommendations

 The registered person should only accept placements for children if they have fully considered and recorded the impact that the placement will have on the existing group of children. (‘Guide to the children's homes regulations including the quality standards’, page 56, paragraph 11.4)

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Recommendations

 The registered person should work with the placing authority to ensure that each child's transition is planned and help each child to prepare for leaving, both practically and emotionally. This work should be adequately recorded. (‘Guide to the children's homes regulations including the quality standards’, page 57, paragraph 11.9)

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Information about this children's home

This is a short-break service for children and young people with learning disabilities, sensory impairment and physical disabilities. The home comprises two units that cater for children and young people, depending on whether they have challenging behaviours associated with their disability or complex health needs that require nursing input. The home is run by a national children’s charity and can accommodate up to 14 young people. At the time of the inspection, there were 40 children and young people on the register.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

15/01/2016 Interim Improved effectiveness

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Recent inspection history

19/03/2015 Interim Sustained effectiveness

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Good

During the inspection, children and young people were observed watching television. It would have been easy for staff to have left them in front of the screen, but instead every child and young person had a member of staff who was interacting with them, involving them by singing along or following the actions, or just stroking a hand. Such attention epitomises the care given by staff, which is individual and engaging. Children and young people are sensitively welcomed. Parents commented on how relieved they were when initial visits to the home showed that it exceeded their expectations. One said that she was ‘taken aback by how smooth the admission process was’. It is done at the child’s or young person’s pace. There is also good anecdotal evidence from staff and other professionals about assistance given to young people who move on from the home. A range of activities are available for children and young people to enjoy,

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Good

enhanced by a newly equipped sensory room. A large garden provides plenty of opportunity for exercise and enjoyment of a trampoline, bikes and other play facilities. An old laundry is being refurbished as an activity room. Several professionals, family members and staff commented on the difficulty in keeping the side of the home that is used by children and young people with behavioural difficulties looking homely. Some of those who have short breaks here find it difficult to tolerate the stimulus of decoration or artwork on the walls and others may target pictures as a way of venting frustrations. Nevertheless, the manager and staff continue to think of different ways to ‘soften’ the environment and keep putting up new pictures. The manager and staff ensure that children and young people have an enjoyable, even a life-enhancing, experience of short breaks. In addition, over recent years care planning has developed to promote the learning of new skills from the point

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Good

of admission onwards and is embraced by all staff. Team members are conversant with the targets set for the children and young people who they are working with and could describe areas of particular achievement. Many children and young people make progress in different developmental areas, some significantly so. Those who experience anxiety at being separated from their families gain confidence and are happy to be cared for by others. Children and young people who have not socialised with peers are able to tolerate longer periods in the company of others or even enjoy friendships. Many who have been used to parents providing all their care can now shave or prepare their own breakfasts. Others help by putting their own socks on or pulling a jumper down. Health needs are well met, with nursing staff able to oversee and train others in the procedures that children and young people may need. The manager and staff promote the ability of children and young people to express

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Good

their wishes and feelings, particularly regarding their experience of being in the home. An example is the taster sessions that the cook organised in which different foods were sampled by children and young people. Their responses, given verbally, by signing (pointing to ‘yes’ or ‘no’ symbols) or facial expression, were recorded and led to children and young people trying new foods and menus that are tailored to their preferences. A young person, responding to an Ofsted questionnaire, answered the question ‘What does this children’s home do well?’ replied ‘FUN’ (their capitals). The reply to ‘What could be done better?’ was ‘They keep losing my things, even when named.’ This is not an uncommon issue and managers have put strategies in place to avoid the problem. It has been reduced, but not eliminated.

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Good

Observations made during the inspection are that the relationships forged by staff with children and young people are very strong. Adults are supportive and protective of those in their charge. These observations are shared by others. One parent, who often sees interactions when she picks her daughter up, said, ‘I see staff putting children in the taxis, and it is as though they are their mums.’ Knowing that their children are so well cared for is a great comfort for families. It allows them precious time to recuperate and give their other children (if they have any) much-needed attention. Consequently, the plan to close the home for short periods, particularly over Christmas, is regarded with dismay. The close collaboration between staff and parents also helps to promote the learning of new skills. These give children and young people a sense of achievement, as well as helping the routines in the family home. Learning how to

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Good

put their arms through the sleeves of a jumper can be a significant development – although not all children transfer what they have learned during short breaks to their own homes. Staff are very observant, and review minutes often include these being passed on to others, for example how having more to drink reduced one young person’s headaches. One parent commented, ‘staff think of things that I don’t.’ Such thoughtful contributions can make important differences to the experiences of children and young people and to their families. Staff spoken to are well aware of what to do if they have concerns about a child or young person. Professionals commented that staff ‘have always reported’ appropriately, and subsequently provided information and reports, and attended meetings. They work with parents so that children and young people might be better safeguarded. A social work manager said, ‘They don’t draw attention to it in

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Good

front of other parents, but staff still address child protection issues.’ Staff who have been given responsibility for health and safety matters, such as fire precautions, undertake their duties with admirable commitment. However, although the cook is meticulous in conducting temperature checks of fridges, freezers and hot cooked food, records are often missing at weekends when she is not on duty. If a significant deviation in temperature were to be missed, it could have serious implications for the health of children and young people, many of whom already have significant medical issues. A perusal of personnel files demonstrated that safer recruitment practices are rigorously followed. The separate provision for children and young people who have significant behavioural issues from those who have impaired mobility and physical abilities is regarded by parents and professionals as a significant reason for the low incidence

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Good

of harm cause by peers to each other (even if unintentional), compared to their experience of other settings. Staff respond quickly and appropriately to situations in which there is a potential for safety to be compromised, largely by heading off incidents through distraction. The use of physical restraint is rare (limited to the very occasional need to intervene with one young person), but careful attention, including the honing of record keeping to capture information, helps to reduce it further. However, during the inspection it was noted that a bathroom emergency cord had been hooked up out of reach. A staff member did this so that it could not be pulled by a young person who was repeatedly doing so. It was not then in position for someone to use in a genuine emergency and could have led to a delay in getting assistance. One young person managed to abscond from the home by climbing a garden fence. The immediate response from managers and staff was rapid, and was

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Good

focused on his safe return, which was achieved. Subsequently, the perimeter of the premises has been secured and policies, risk assessments and behaviour management plans strengthened. In this way, lessons have been learned so that all children and young people are now safer. Judgement grade

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Good

A new manager has been appointed following the promotion of the previous post holder. The former registered manager is still based on site and this has facilitated an effective handover period. Together, they lead an enthusiastic and skilled staff team that is focused on meeting the needs of children and young people. Staff tend to work predominately on one of the two units. Their commitment to meeting the particular needs of the children and young people has given rise to some contention between the groups. Also, some agency workers feel that they do not work as a team with the permanently employed staff. However, the parents spoken to indicated that their appreciation of the work done extended to all of the team, whether they were permanent, casual or agency staff. One commented, ‘I can pick up the phone and ask away with any member of the staff. They are all so professional, but friendly, too. The staff are here because they want to work here.’

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Good

Managers have recently introduced a new contents front sheet for case files to improve the consistency of document filing and have reformatted some templates to prompt for signatures and dates to be included in all records. Families are encouraged to sign paperwork in the home rather than it take away, when other priorities then crowd out its completion. Placement plans, risk assessments and reports for reviews tend to be well written and up to date, with precise information about children’s and young people’s needs, strategies to meet them and their experience of short breaks. Daily records are less clear, with inexact descriptions that do not allow a reader to understand what a particular child has been doing. This is particularly important to being able to gauge what progress is being made towards targets that have been set. There is strong evidence of collaborative working with parents and education

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Good

providers to ensure that they are working towards common aims. Support given to children and young people is therefore consistent across different settings. Professionals frequently commented on staff being accommodating or welcoming, and appreciated the collaborative and open approach of the home. One spoke of how managers and staff had ‘bent over backwards’ to assist in a recent case, and added, ‘This is not abnormal, as they are always cooperative and work with us.’ Managers have responded robustly to significant events, which have included a young person going missing and misadministration or mis-recording of medication. These are rare occurrences, but lessons have been learned and actions taken. This includes amending risk assessment and placement plans for individual young people and updating the home’s policies and procedures. However, those for missing children do not include requesting an independent return to care interview

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Good

from the placing authority. Some staff feel diffident about taking responsibility for dispensing medication and these times are seen as ‘pressure points’ on shifts, but training, oversight and procedures are all proportionate to the importance of ensuring that it is accurately done for all children and young people. The workforce plan does not specify the frequency with which staff should be supervised. Changes of shift patterns have led to some supervision sessions being missed. Nevertheless, all staff spoken to feel well supported by managers. One commented that initially he had found constructive criticism hard to accept, but now views this as an opportunity to develop. This typifies the approach of the team, which is one of openness to learning and examination of practice. It has led to creative responses to the recommendations of the independent person undertaking regulation 44 visits. A notable example is how to help children and

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Good

young people understand what ‘appropriate touch’ of others might be in social situations. This is being developed in collaboration with different agencies. Transitions in or out of the home are not well recorded. ‘Matching assessments’ do not indicate how information leads to the decision to admit, or which existing children and young people a new child could be placed with. Recording of the help given to those who are moving on might or might not be incidentally recorded in minutes of meetings or in emails, but is not otherwise written up. Staff do see the importance of evidencing the work that they are doing, particularly if that has been the focus of training. A good example is a scrapbook that a key worker is making of the achievements of a young person and of activities that she enjoys.

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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’. 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

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What the inspection judgements mean

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 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 ‘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

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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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