Children's home run by Sefton Metropolitan Borough Council in Sefton

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 who have disabilities and/or multiple complex health needs enjoy very positive experiences that enrich their lives and provide them with an excellent, wide range of opportunities for personal growth and development. Exceptionally strong, safe care practices protect these vulnerable children from harm.  A very high standard of personalised support is making a significant difference to the children‟s lives. They are making significant and sustained progress in every aspect of their development. Children feel safe and enjoy extremely warm and trusting relationships with the staff. They are increasingly confident in spending time away from their families, being around other children, joining in more in groups and taking part in different, interesting and meaningful activities. They have opportunities to make friends and do things that they may not be able to do with their families. They are less anxious and upset and are significantly less likely to show their

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

emotions through aggressive or self-harming behaviour.  Children‟s stays are carefully planned in a very welcoming, supportive and safe environment. The registered manager and staff use extremely strong and effective relationships with children, their parents and carers, social workers, schools and health professionals to ensure that each child receives the best possible support. Parents and carers feel extremely supported by the staff. They enjoy open and trusting relationships and they are confident in leaving their children in staff‟s care.  Effective leadership and management through in-depth monitoring are driving improvements in the quality of the care provided. The systematic monitoring of children‟s experiences and progress builds a detailed understanding of the impact on their lives and how to develop the service in their best interests.  The quality of care would be further enhanced through the continuous

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

professional development of staff‟s knowledge of children‟s sensory needs, autism spectrum disorder and a higher level of safeguarding training aimed at their level of experience and expertise, which is relevant to children who have disabilities and/or multiple complex needs.

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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

The registered person must ensure that all employees undertake appropriate continuing professional development, and have their performance and fitness to perform their roles appraised at least once every year. In particular, that staff have the opportunity to receive training appropriate to their developmental needs and relevant to specific needs of the children, including high quality training in autism, assessing and understanding children‟s sensory needs, child sexual exploitation and safeguarding children who have disabilities. (Regulation 33 (4)(a)(c)) 30/11/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

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Recommendations

 Ensure that staff have a clear understanding of the meaning of restraint as defined in regulation 2(1): that is, „“restraint” means using force or restricting liberty of movement‟. This relates to only recording interventions as restraint that meet this definition. („Guide to the children‟s homes regulations including the quality standards‟, page 47, paragraph 9.41)

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Recommendations

 Ensure that records of restraint always include details of methods used, or steps taken by staff to avoid the need to use restraint, to enable the registered manager and staff to review what happened to identify effective practice or to change practice to ensure that it meets the needs of each child. („Guide to the children‟s homes regulations including the quality standards‟, page 49, paragraph 9.59)

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Recommendations

 Ensure that staff understand how to record the specific type of restraint, set out in the child‟s plan, provided for use as part of the child‟s day-to-day routine, and restraint not for day-to-day use or that is used in serious situations to protect a child‟s safety, as set out in the guidance. („Guide to the children‟s homes regulations including the quality standards‟, page 50, paragraph 9.61)  Provide all staff with practice-related supervision that provides them with opportunities to reflect critically on their practice and the needs of the children. In particular, staff are encouraged to use reflective practice to understand the effectiveness of their work, identify and share good practice, and inform their professional development needs. („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraph 13.2)

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Information about this children’s home

This local authority children‟s home provides a short-break service for up to seven children at any time, who have multiple and/or complex disabilities, and/or complex health needs.

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Recent inspection history

Inspection date Inspection type Inspection judgement 30/03/2016 Interim Sustained effectiveness 08/12/2015 Full Good 17/03/2015 Interim Sustained effectiveness 22/12/2014 Full Good

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Good

Children who have disabilities and/or multiple health needs enjoy well-planned short breaks that improve the quality of their lives. They receive a very high standard of personalised care from friendly and resourceful staff. The registered manager and staff have created an extremely positive and safe environment. They are ambitious for every child, regardless of the complexity of their needs, to get the most out of their stays. The staff have open and trusting relationships with children and their parents. Children clearly love coming to stay. They are full of smiles when they arrive and excited to see staff and their friends. Parents also confirmed how much their children enjoy staying. They say, „It‟s a lovely place, he enjoys staying, lovely staff,‟ and: „I wasn‟t sure about it at first, but seeing how much he loves it changed my mind.‟ Children enjoy very positive day-to-day experiences, some of which may otherwise

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Good

not be available to them. The opportunities to try new experiences, and explore and feel comfortable in the world they live in, are helping children to make sustained progress across all the areas of their development. Children are becoming more resilient and confident in the community and in being away from their parents. Their emotional well-being is improving. Children who have struggled at night are more settled. Improvements in children‟s social, communication and personal skills are helping them to become more independent and to express their wishes and feelings. Often things that appear to be small achievements are significant for individual children. For example, being able to put toothpaste on a toothbrush without any help, eating a meal with other children or enjoying the feeling of the breeze on your face from an open car window. Children‟s care is sensitively and carefully planned based on thorough assessments

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Good

of children‟s needs, which inform comprehensive short-break plans. The quality of these assessments and plans means that everyone can be confident that children will benefit from short breaks at this home and the staff are able to meet children‟s individual needs safely. The registered manager and staff ensure that children staying at the same time have compatible needs and interests. They arrange, where possible, for children to stay with the same group to provide opportunities for children to develop friendships. The home is also sufficiently flexible to accommodate children‟s changing needs or short-term emergencies, such as family crisis or illness. The registered manager and staff use children‟s assessments and plans dynamically to promote children‟s welfare and development. Children‟s short-break plans are engagingly written from each child‟s perspective. They paint a colourful picture of the child‟s personality, interests and educational, health, social and communications

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Good

needs. The plans outline a consistent approach to meeting a child‟s assessed needs and personal goals. Children have individual, achievable and realistic goal plans depending on their needs, such as helping a particular child to use the toilet independently. His plan clearly sets out what he is trying to achieve and what he needs to help him. Detailed written records show the work he is doing with staff and measure his progress: they show that he is now able to transfer from his wheelchair to the toilet independently, he is letting staff know when he needs to use the toilet, and he is less likely to need to wear pads during the day. The written records clearly set out and evaluate children‟s experiences and progress in meaningful ways that contributes to an understanding of their lives and abilities. In addition to short-break plans, older children have dedicated independence plans, which show how they are being supported to develop life skills and the progress

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Good

they are making. These plans now include a detailed assessment of the child‟s existing skills and abilities to help inform their plan, the focus of the work, and to measure their progress over time from their starting points. Children have opportunities to become more independent, appropriate to their age, level of understanding and disability in preparation for adult life. For example, children are becoming more confident in cooking, helping around the house, doing their washing, shopping and handling money. For example, a child is using public transport and buying his own ticket. Staff also use photographs to evidence children‟s progress and how they spend their time during their stay. The staff are resourceful in developing their practice and improving the quality of care. They creatively use sensory profiling to better understand children, and tailor support to manage children‟s emotions and measure their progress. For example,

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Good

they have recently successfully helped a boy to reduce his distress around having his hands and feet touched, in order to enable him to feel comfortable enough to let his mum and staff cut his nails. Using this approach is helping to develop a better understanding of children‟s individual sensory needs and to support them to be more able to manage the environment around them. The use of this approach is still very much at an early stage, and as a result not every child has had an assessment of their sensory needs. Staff know the children very well and have a good understanding of how they communicate, and how they process and manage information. They expertly support and encourage every child, including those who do not communicate verbally, to express their wishes and feelings and make choices in a meaningful way. They use clear and precise language to communicate with children. They give children time to work at what they are saying and to respond to them. They frame

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Good

questions in different ways to help them to understand the children‟s responses and make sure that they get it right. The registered manager uses different formats, including pictures and symbols to seek children‟s views and what they want to happen during their stays. This has helped to get the most out of their stays. For example, by agreeing to leave a child‟s bedroom door open at night to help him feel safe and helping a child change groups so that he could stay at the same time as his friend. The registered manager and staff promote children‟s learning and development. Children have easy access to books, computers, art materials, toys, games and other educational resources. The garden is full of suitable play equipment, including a nest swing, a trampoline and a sensory pod where children enjoy relaxing. Staff ensure that the daily routine supports participation in education effectively and achieves excellent school attendance. They work very closely with

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Good

schools to understand children‟s specific education targets and to agree a common approach to achieving them while they are staying. Staff also ensure that there are plenty of challenging opportunities for children to enjoy and to be able to achieve new things. This plays an important part in children‟s informal learning and the development of their interests, skills and experiences of the world around them. They have helped and encouraged, for example, a child to develop his skills in taekwondo. Children have the chance to do things that they may not be able to do with their families. A parent said that her son, „is having positive experiences with a lasting impact. He learns new skills: he has learned to pedal a go-kart. He also has the space, freedom and time to play with foam and bubbles in the bath that he can‟t get at home.‟ Staff ensure that the children‟s disabilities are not a barrier to them taking part in

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Good

leisure and cultural activities in the community. They carefully plan and assess that activities are safe, that children are properly supported and make sure that they have fun. They routinely enjoy youth clubs, swimming, food shopping, baking, sensory and soft play, playing ball games in the garden, going out for meals, going to the cinema, walks in parks, going to see horses and being out and about in the local community. Children love the different activities and get the chance to use their independence, social and communication skills in lots of different environments and to build their confidence. The registered manager and staff actively promote children‟s physical health and emotional well-being. Children enjoy healthy and varied diets that meet their dietary needs and they get plenty of physical exercise. The staff have an excellent understanding of children‟s individual and complex health needs. They are suitably

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Good

trained and competent in moving and handling children safely, managing medication, tube-feeding, oxygen therapy and epilepsy. They are very knowledgeable about how to support children when they have seizures, when to administer rescue medication and when additional medical assistance is required. They competently monitor children‟s oxygen saturation levels and take appropriate action when they are not at a healthy level. Children have easy access to appropriate community and specialist healthcare. Staff work closely with parents and health professionals to ensure that children continue to receive the best possible health support and treatment during their stays. They also ensure that children get suitable emergency medical advice and treatment when they are feeling unwell, and always let parents know. The arrangements for dealing with medication are safe and effective. This means that children always get the treatment that they require to promote their health

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Good

and welfare. The staff have a detailed understanding of the medication procedures, the reasons why children take the medication and the possible adverse effects. They carefully check with parents and doctors that they have the correct information about children‟s medication at the start of each stay. They keep detailed records of the medicines received and stored in the home, the amounts given to children, and the amounts returned to parents when children go home. They make sure that they administer medication to children, including giving medicines through a gastric tube, in ways that respect the children‟s privacy and dignity and do not isolate them from other children. The physical environment is suitable to meet a wide range of emotional and physical needs. It is accessible to all children who may have physical disabilities. The registered manager and staff have taken great care to make sure that they

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Good

provide a comfortable and homely environment for children. Bedrooms and bathrooms that have hoists and include medical equipment are decorated to make them as pleasant as possible places for children to use. Before each stay, staff set up the bedrooms to reflect the character, interests and needs of individual children, including their favourite toys and pictures, so that children will have familiar things around them and feel at home.

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Outstanding

Children who have disabilities and/or complex health needs come to stay in an extremely safe and supportive environment. The registered manager and staff have created a culture of openness and trust. Consequently, parents are extremely confident that their children are safe and extremely well cared-for during their stays. The registered manager and staff use exceptional safe care practices to ensure that extremely vulnerable children feel safe and are always protected from bullying, abuse, neglect and exploitation. The staff have a comprehensive understanding of the risks to individual children‟s safety associated with their disabilities, levels of understanding, communication and health conditions. They use very thorough and up-to-date written risk assessments to guide them successfully to manage and reduce these risks. Staff carefully consider each activity for every child. For example, staff thoroughly planned taking

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Outstanding

a child to a birthday party: they were aware that he may struggle to cope with the level of noise and being around a large number of children. They had contingencies in place in case he became upset and needed to do something different. However, he loved the party and enjoyed the music and dancing. Because of the high quality assessment of risk, children can safely explore new experiences and challenges, including being away from their family, taking part in activities in the community and making friends, which help to promote their opportunities and personal development. The staff are extremely alert to any signs and symptoms of abuse and neglect. They are fully aware of the children‟s vulnerability to sexual exploitation and use protective measures effectively to enable children to use social media and the internet safely. They follow safe care practices when assisting with personal care that respect and promote children‟s dignity. They listen to children‟s worries and

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Outstanding

take them seriously. They know the children extremely well and quickly pick up when something is wrong by noticing any injuries or changes in their behaviour, energy levels, moods or health. The registered manager and staff always take decisive action to protect children and promptly report any concerns about their welfare to the appropriate safeguarding agencies. They work openly and honestly with families, social workers, the police and the designated officer to find out what happened, and understand and manage risks to the children. The registered manager worked effectively with a social worker manager to ensure that an injury was examined by the community paediatrician. Staff took the child to the hospital and supported him throughout the process. The registered manager and staff work together exceptionally well with schools, health professionals and social workers when there are concerns about children‟s safety to make sure that children and

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Outstanding

their families get the right support and protection. They have the relevant information about safeguarding concerns to enable them to assess the risks to each child continually and to strengthen further the arrangements to support and protect the child. The staff actively promote children‟s sense of safety and emotional security through clear and consistent boundaries and expectations. Children appear very happy, relaxed and settled. They are increasingly comfortable being away from their families and spending time with other children. A parent said that, „He was not used to staying away from home, but his confidence has grown.‟ Children make exceptional progress since they first came to stay, engaging with other children and joining in group games and activities. Another parent identified that her daughter benefits greatly from her stays, „as she gets to socialise and interact with other children. She is full of smiles when she knows she is going to stay.‟

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Outstanding

Staff are highly skilled at identifying and anticipating when children are struggling with their emotions and intervene effectively to help and reassure them. The staff‟s effective communication helps children to feel less frustrated and anxious. Their use of communication that children understand means that children feel listened to, know that the staff understand what they are saying and explain what is going to happen next. The use of picture and symbol sequences helps children to understand that it is the end of the activity they are enjoying and time for the next one. For example, it is now time for tea or time to get off the school bus. Importantly, staff are aware of giving children the time they need to understand what they are being asked and not rushing them unnecessarily. Staff‟s well- informed and consistent approaches are helping children to understand and manage their own feelings, and to soothe themselves when they feel upset, for

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Outstanding

example by listening to music. Invariably, the occasions when children show aggressive or self-harming behaviour when they feel upset reduce over time. Staff very rarely need to restrain children and, when they do, they use it appropriately to protect children from harm. They are suitably trained and supported around the use of restraint. The registered manager thoroughly evaluates serious incidents involving children, including restraint. However, the records do not always clearly show what staff did to try to avoid the need to use restraint, or details of methods used to restrain the child. This lack of detail impedes the registered manager‟s and staff‟s abilities to review what happened, to identify effective practice or to change practice to ensure that it meets the needs of each child. In addition, one incident was inappropriately recorded as a restraint when a member of staff held a child‟s hand to help him to

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Outstanding

get down safely from a work surface. This did not meet the definition that restraint involves „using force or restricting liberty of movement‟. The records also do not make a clear distinction between restraint that may be necessary as a consequence of a child‟s disability, set out in their plan and applied to the child‟s day to day routine, and restraint used in exceptional circumstances to protect a child. The registered manager ensures that people wishing to work at the home go through an exceptionally rigorous selection procedure and their suitability is carefully checked. She only employs people who have the right personal qualities, enthusiasm, experience, skills and values to work with children who have disabilities and complex health needs.

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Good

The vastly experienced and suitably qualified registered manager provides highly effective leadership. She ensures that the service consistently and efficiently meets the objectives set out in the home‟s statement of purpose. The statement of purpose provides parents and social workers with helpful information about how to access the service and how children will be supported in line with the quality standards. It also now includes up-to-date information about the responsible individual for the service and how to contact the Children‟s Commissioner for England. Information about the service is also available for parents on the local authority‟s website as part of the local offer, setting out the support available for local children who have special educational needs and/or disabilities. The registered manager ensures that children who have disabilities and/or multiple complex needs receive high quality short breaks. A culture of high expectations and

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Good

an aspirational ethos that prioritise children‟s welfare and their personal growth are embedded throughout the service. Children, regardless of the complexity of their needs, stay in a welcoming, safe and stimulating environment. They have opportunities to develop their personal, social and life skills, interests and independence. They consistently make significant and sustained progress across all aspects of their development. Thorough assessments, care planning and accurate recording systems provide leaders and managers with a comprehensive understanding of how effectively the staff are meeting children‟s individual needs and the impact on children‟s lives. An experienced, qualified, enthusiastic, compassionate and highly competent staff team provides children with an excellent quality of care and positive experiences. The staff‟s skills, knowledge, values and personal qualities are tailored to the needs

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Good

of children who have disabilities and/or multiple complex needs. They work in a cohesive and well-organised way to ensure that they meet children‟s needs and that children have a safe and enjoyable stay. They are supported through regular one-to-one supervision and team meetings that focus on children‟s experiences, needs, progress and staff practice. However, the staff supervision records do not always show that staff have opportunities to reflect critically on their practice and the needs of the children, including in-depth discussions about things that go well as well as serious events. Also, staff have not had their performance and fitness to perform their roles appraised at least once every year. These are missed opportunities for managers and staff to use reflective practice to understand the effectiveness of their work, identify and share good practice, and inform their professional development needs. The registered manager is starting a programme

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Good

of staff appraisal to inform the team‟s training plan. Overall, staff receive good quality training in relation to the management of medication, behaviour and children‟s specific health needs, including appropriate moving and handling, gastric tube feeding and the use of oxygen. However, training in child sexual exploitation and safeguarding is not specifically tailored to the staff‟s high level expertise, experience and skills, or to children who have disabilities and/or complex health needs. In addition, the staff team has not had training opportunities to build its understanding of autism spectrum disorders. Some staff are using their training in understanding and supporting children‟s sensory needs successfully to improve the quality of children‟s lives, but at present this work is only being used with a limited number of children because of the small number of staff who are trained. The registered manager is fully aware of the need

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Good

to develop staff‟s skills in these areas and is including them in their training plans. In the meantime, the registered manager and deputy manager are identifying suitable training programmes and have arranged a two-day team training day to update staff‟s knowledge around medication and to develop the plans for helping children to manage feelings that may lead to harmful behaviour. The registered manager and the local authority use the monitoring systems effectively to improve children‟s experiences and the quality of care they receive. An independent person carries out a very detailed monthly assessment of the service‟s effectiveness in promoting children‟s welfare and safety. The registered manager‟s thorough review of the quality of care clearly shows the service‟s strengths, measures children‟s progress and identifies priorities for developing the service, such as staff‟s training needs and the effectiveness of behaviour

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Good

management plans. The review clearly shows improvements in consultation with children and parents, understanding children‟s sensory needs, care planning, arrangements for medication and the facilities for children to use during their stays. The registered manager systematically finds out children‟s views about the support they receive, observations of how they experience the quality of care provided and consultation with parents. The registered manager and staff build exceptionally strong relationships with parents. Open communication between staff and parents ensure that children have positive experiences and parents are fully involved in the support that their children receive. Parents are comfortable about leaving their children in the staff‟s care and are confident that they receive a high quality of care and support. The registered manager acts upon parents‟ ideas and suggestions. For example, the introduction of a link book between staff and parents is giving

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Good

parents a more detailed picture of their children‟s experiences and achievements during their stay. Likewise, parents are using it to let staff know about their lives at home. A parent let staff know how their child was loving using the baking skills, which they have learned during their stays, at home. A parent said, „We have learned from what staff do to manage his behaviour to improve things at home. Staff let us know he loves flying a kite and we do it with him now.‟ The registered manager and staff also have strong partnerships with social workers, schools and health workers to ensure that children get the right support to meet their needs. The linking of dedicated staff to children‟s schools is helping to share information effectively about children and to strengthen the working relationships between schools and the service. A parent said, „He has improved his language skills because of the good work between the service, school and home.‟

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Good

The registered manager continually looks to improve the effectiveness of relationships with other services. For example, to improve the quality of young people‟s transitions to adult services. She has started to meet with the local authority transition team to share information about children‟s needs and to clarify the support they will need in the future. She recognises that this is also a difficult time for parents and works hard to provide them with advice, support and reassurance.

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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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