Children's home run by Birmingham City Council in Birmingham

Good

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

p.2

The children's home provision is good because:

 Children and young people make good progress, with increased mobility, independence and confidence.  Wrap-around care, with joint working between care and nursing staff, effectively manages children and young people’s complex medical and behavioural needs.  Staff work alongside independent advocates to ensure that children and young people’s needs are met and their rights are promoted.  The short breaks service plays a pivotal part in supporting children and families during more challenging times. Extra respite takes pressure off families and lessens the likelihood of child protection issues arising.  The manager and staff listen and take action when children and young people express their ideas. For example, the installation of the internet provides greater opportunity for children and young people to use their computers and extend their knowledge.  The manager and staff are enthusiastic and motivated to drive ongoing

p.3

The children's home provision is good because:

improvements in the home. This is most evident in communication processes throughout the home  The majority of statutory requirements are met, and improvement is ongoing and well planned. However, efforts to combine the social care and nursing care planning framework require further improvement. Developments in more child-friendly and meaningful recording are also ongoing. While there are measured and meaningful steps towards progress, relevant recommendations remain to drive the improvement and monitoring of recording processes in the home.

p.3

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.

p.4

Requirement Due date

In order to meet the protection of children standard to ensure that children are protected from harm and enabled to keep themselves safe, the registered person must ensure that staff:

p.4

Requirement Due date

(2)(a)(i) assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. This is with particular regard to further improvement of robust recording strategies to safeguard children and young people’s complex medical needs. 18/11/2016

p.4

Requirement Due date

22: Contact and access to communications

p.4

Requirement Due date

The registered person must ensure that a disabled child accommodated in the home is provided with access to such aids and equipment as the child may require as a result of the child’s disability in order to facilitate the child’s communication with other persons. This is with particular regard to continuing the ongoing developments in the home. (Regulation 22 (4)) 18/11/2016

p.4

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Record information about the child in a way that will be helpful to the child (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14).

p.4

Recommendations

 Keep all children's case records up to date. This is with particular regard to streamlining and prioritising information in young people's care, risk and behaviour management plans (‘Guide to the children’s homes regulations including the quality standards’, page 62 paragraph 14.3).

p.4

Recommendations

 Support children and their parents to understand the nature of records kept in the home and how to access them. Staff should understand their role in encouraging the child to reflect on and understand their history, according to their age and understanding. Staff should keep, and encourage children to keep, appropriate memorabilia and help them record significant life events (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.5).

p.5

Information about this children's home

The home provides care and accommodation for up to 16 children and young people with physical and/or learning disabilities. The home provides 10 long-term placements and six short-break placements. The home is operated by a local authority. The home is also registered with the Care Quality Commission.

p.6

Recent inspection history

Inspection date Inspection type Inspection judgement 29/02/2016 Full Requires improvement 05/01/2016 Full Inadequate 27/03/2015 Interim Declined in effectiveness 22/01/2015 Full Good

p.6

Good

Individualised support packages provide children and young people with good quality care. Their support is bespoke due to the staff at the home working in partnership with health authority counterparts and a range of agencies. Children and young people living permanently at the home thrive, experience nurturing relationships with staff and have a strong sense of stability.

p.7

Good

The short breaks service gives children and young people the opportunity to try new activities and socialise with others. The service gives added value to their lives and provides an essential break for their families.

p.7

Good

‘All about me’ profiles help staff get to know children and young people who come for short breaks. Details about how they like to be supported, favourite objects and communication help staff, including agency staff, to make primary connections with children and young people. They experience familiarity and consistency, with an effective allocation of experienced and long-term care staff to complement new nursing staff.

p.7

Good

Children and young people make and enjoy friendships with each other. Compatibility assessments and good knowledge about their social networks enable staff to nurture and facilitate friendships. For example, when children stay in separate parts of the home, they are brought together to spend time before and after school so they can enjoy each other’s company.

p.7

Good

Children and young people live in an interchangeable environment. The home is vibrant and fun but also calm and relaxing, particularly at times of transition such as going to school.

p.7

Good

Personalised bedrooms and ongoing refurbishment meet the comfort and sensory needs of children and young people. They feel comfortable, safe and happy in their bedrooms because staff have made concerted efforts to decorate and add personal, sensory and favourite items. Decorating themes such an aquarium, forest, Lego and space give children and young people an instant sense of familiarity with their bedrooms when they come for short stays. Attention to detail, such as understanding children and young people’s favourite music and lighting preferences, means they can have private and meaningful quiet time in their rooms.

p.7

Good

Ongoing improvements to the physical environment mean that children and young people, including those who come for short breaks, stay in a more homely and meaningful building. Signage throughout the home means that they can better orientate themselves. Personalised noticeboards, and laminated photo and name plaques on doors further help their sense of belonging and ownership in the home. Display boards in symbol and picture form give them more access to information about their rights, how to complain and independent advocacy. There is also a range of visual reference points so that children and young people can let others know about their emotions by referring to emotion faces. These improvements enable children and young people to have greater participation in their care.

p.7

Good

Joint assessment with the occupational therapist regarding the suitability of beds for children and young people has a positive impact. They have far greater freedom of movement in their bedrooms because they can get out of bed independently. They develop good physical stamina as they have more freedom of movement. Children and young people grow in confidence as they are able to move around the floor, begin to make crawling steps, and independently explore their environment.

p.8

Good

Varied activities keep children and young people occupied and able to try new things. Significant improvements in sensory play include a new sensory room and a developing sensory garden. Children and young people’s artwork is displayed throughout the home. Collecting leaves from the sensory garden to make a collage combines a number of experiences. For example, they have a sense of adventure and exploration, they also enjoy fresh air, and get to make contributions to the decor in the home.

p.8

Good

This celebration of artistic flair and expression is now being channelled into homemade Christmas cards. These will be printed and sold at the Christmas fayre. This is a great way for children and young people to participate in the running of the home.

p.8

Good

Festival celebrations are an important way to bring children, young people and families together. All enjoyed the recent Eid celebration. Children and young people also participate in trips. Children, young people and staff alike thoroughly enjoyed a recent holiday in Wales.

p.8

Good

Children and young people’s medical and health needs are met with total dedication from staff and close working partnerships with parents. Supporting children in hospital and ensuring continuity of care on their return gives children stability and reassurance.

p.8

Good

Staff support parents to work together with medical professionals to ensure that they feel competent and confident about caring for their children. Partnership working creates wrap-around care and facilitates some children’s reunification with their families.

p.8

Good

Emotional and mental health is a key focus in promoting children and young people’s well-being. Again, joint working enables staff and parents to access mental health services to assess significant changes in behaviour and seek out meaningful strategies to support children and young people.

p.8

Good

Children and young people can express their needs and can feel confident that staff will understand and respond. Staff understand the body language and non- verbal communication of children and young people. Their needs can be quickly met and discomfort relieved as staff can quickly respond to physical, as well as verbal, indicators.

p.9

Good

Sensitive insight into communication contributes to good levels of respect for, and dignity of, children and young people. Staff use gentle and responsive approaches to support children and young people with their feeding and personal care. For example, when children and young people are unable to use a napkin at mealtimes, staff explanation gives some level of self-determination to children and young people. Communication such as ‘I am doing this because… is that OK?’ and ‘Just one more bit here’ shows good consultation and respect for children and young people.

p.9

Good

Current work with the local authority children’s rights and participation team drives improvement. For example, children from the home have been represented in a recent recruitment panel by one of the children from the home. Comments such as ‘One of the best things I’ve seen. Definitely do it again’ sums up the manager’s motivation to continue with developments in children and young people’s participation in the running of the home.

p.9

Good

Children and young people are empowered because staff seek out and support independent advocacy for them. For example, children and young people have been supported to access medical care according to their needs.

p.9

Good

All children and young people attend full-time education. Staff work with families, transport services and a range of schools to ensure good connections to support all children and young people, including those who come for short breaks, to attend and enjoy school.

p.9

Requires improvement

The management of complex medical and health needs lies at the centre of safeguarding children and young people at this service. While managers and staff show good insight into children and young people’s needs, the care and safeguarding frameworks lack connectivity and practical direction. Records are not cohesive. They focus on assessment rather than clearly stating what staff need to do on a day-to-day basis. Shortfalls in combining nursing and social care recording result in delays in providing a combined recording framework. This development becomes more urgent as more new staff come on board and the problem is perpetuated, highlighting the need to promote a benchmark of care for all children and young people.

p.9

Requires improvement

Other core safeguarding procedures are well managed. Children and young people are kept safe, with effective risk management.

p.10

Requires improvement

The registered manager and staff have a good understanding of child protection procedures. Close monitoring, accountable recording and good liaison with education ensure that concerns are mapped out, discussed and then assessed regarding any need for child protection referral or change in practice.

p.10

Requires improvement

Children and young people do not go missing, due to the secure environment and staff vigilance. There are no concerns about sexual exploitation of the children and young people. There are no other child protection concerns at the service at this time.

p.10

Requires improvement

Managing risk and pushing boundaries are new and emerging themes for the staff team. The team now acknowledge that erring on the side of caution may enable them to feel safe but may not help children and young people reach their full potential. For example, staff fears about reducing the height of beds have not come to fruition. Children and young people benefit from this considered approach to risk management. They enjoy more freedom of movement, while still being kept safe. As a result, children and young people grow in confidence and enjoy far greater independence.

p.10

Requires improvement

Staff have a good understanding of self-injurious behaviours. They are dedicated in exploring and assessing the reasons for such behaviour. Children and young people are kept safe because staff are quick to intervene, as they understand triggers and anxieties. Protective equipment is used accordingly, to help children and young people feel safe.

p.10

Requires improvement

For those young people for whom the reasons for self-injurious behaviours are not so clear, managers and staff work with a range of agencies to explore and better manage behaviours. For example, children have been referred for dental care, hormonal remedy, pain relief and, most recently, mental health assessment, in order to identify and attempt to understand and resolve self-injurious behaviours.

p.10

Requires improvement

Improvements in behaviour enhance the experiences of children and young people. They enjoy a stable environment with calm and measured management of behaviour. Children and young people are not only kept safe because staff can identify and understand the triggers for anxiety, but are helped to develop their communication skills. Staff are motivated by a clear understanding of the frustration children and young people feel when unable to express their views and be understood.

p.10

Requires improvement

Positive relationships are a key part of effective behaviour management. Insight into the quirks of children and young people enables staff to channel positive behaviours, which can be proactive and resourceful. For example, young people who like to rip up magazines will later be supported to make a collage from their efforts. This redirection gives a positive outcome for young people, helping their sense of achievement, and also enabling them to make a contribution to the home through their artwork.

p.11

Good

The registered manager has managed this home since November 2004. She has extensive experience and is suitably qualified to carry out her role, with a level 4 national vocational qualification in management. All staff are qualified in caring for children and young people. The children and young people receive good care from well-trained and regularly supervised staff.

p.11

Good

The manager is proactive and resourceful in her management style. Connecting with a variety of agencies and services enables the manager to be creative with her budgets. For example, networking with different departments, and access to additional financial support, has resulted in the installation of a new internet connection.

p.11

Good

Ongoing improvement continues because staff are well led and motivated to embrace and bring new ideas to the service. With support from managers, they are making concerted efforts to refine their recording and share information more effectively.

p.11

Good

Staffing arrangements meet the needs of children and support the home’s statement of purpose. Partnership working between the nursing and social care components of the service is much improved. New nursing staff and visible senior leadership have led to the re-opening of the short breaks service. Changes in nurse management and refining clinical expertise make a significant contribution to the ongoing improvements in the home.

p.11

Good

Leaders and managers are open to and embrace feedback. They are willing to learn from complaints and use audits to look at practical changes that have the most impact on children and young people. For example, improvements in handover meetings in the short breaks service lead to more effective information sharing. A greater consistency in the quality of care is therefore afforded to children and young people.

p.11

Good

Managers have clear insight into the strengths and needs of the service. They are more outward-looking and welcome feedback. A recent audit of communication processes by the health sector recognises good practice and also opens up useful areas for development. For example, signage around the building is much improved. While staff still use numbers for the four separate units, children and young people can use brown bears, green turtles and purple elephants as points of reference to find their way around.

p.12

Good

However, staff attendance on sign language training is yet to fully impact on practice. Currently, few staff use sign language. In addition, the care planning framework is yet to fully embrace the individual communication processes for children and young people.

p.12

Good

Working in partnership with schools, to include the sharing of young people’s communication passports, drives improvement. This networking provides more consistency for children and young people and also broadens staff knowledge and skill base. Staff enthusiasm to develop and learn new skills is key to unlocking the potential for children and young people via communication processes in the home.

p.12

Good

Good partnership working promotes greater scope for meeting the individual needs of children and young people. For example, negotiating school transport arrangements now means that children and young people have better-timed feeds. Working with a speech and language therapist will hopefully lead to some children having the option to taste and sample more kinds of food.

p.12

Good

There have been no complaints about the operation of this service since the last inspection. Developments in communication mean that children and young people now have meaningful information about their rights, including how to complain and use independent advocacy.

p.12

Good

Reports for independent monitoring visits are positive and highlight ongoing development. Robust management drives improvement, as any shortfalls are quickly addressed.

p.12

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’.

p.13

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

p.13

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.

p.13

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 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

p.14

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 .

p.14

Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

p.15

Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.15

Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.15

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

p.15