Children's Home run by Bromley Healthcare Community Interest Company in Bromley

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:

 Young people receive highly personalised care from a skilled staff team. As a result, they benefit from new experiences and make good progress during their stays.  Young people enjoy their time at the home. The short-break service provides the chance for young people to develop friendships and to experience social activities alongside their peers.  Young people are listened to, are encouraged to take part in decision- making and benefit from good levels of consultation in line with their capabilities.  Communication between the home and families is good and effective. Parents praise the staff and have confidence in their ability to keep young people safe. However, appropriate reviews of risk assessments are not evident for all young people.  Young people’s healthcare needs are clearly identified in individual healthcare plans, which enable staff to provide effective support.  The home is well maintained, with young people having access to a range of

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

facilities within the home during their short-break stays.  There are some areas for further improvement identified at this inspection, relating to records and completion of quality of care reports. These have not had a direct impact on the quality of care provided for the young people.

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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

In order to meet the protection of children standard, with particular reference to ensuring that children are protected from harm, the registered person must ensure: (a) that staff: (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. 31/01/2017

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Requirement Due date

The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once every six months. (Regulation 45 (1)) 31/01/2017

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year, taking into account the requirement in regulation 12 (2)(c) (the protection of children standard). (Regulation 46 (1)) 31/01/2017

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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

 The children’s home’s staff should seek to identify and provide appropriate opportunities for children to develop themselves as part of the home’s plan for their care. This is with particular reference to ensuring that goals and targets set for young people record achievements, progress and evidence of continual revision. (‘Guide to the children’s homes regulations including the quality standards’, page 31, paragraph 6.4)

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Recommendations

 The registered person should have a workforce plan which can fulfil the workforce-related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)

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Information about this children’s home

This home is run by a healthcare trust, and provides short-break services for children and young people aged five to 17 years. Children and young people who use the service may present a variety of complex needs, including sensory impairment, physical and learning disabilities and challenging behaviour.

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Recent inspection history

Inspection date Inspection type Inspection judgement 25/02/2016 Interim Sustained effectiveness 03/11/2015 Full Good 26/02/2015 Interim Sustained effectiveness 25/09/2014 Full Good

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Good

Young people benefit from their short break because they are looked after by staff who know them well. Staff speak fondly and knowledgably about them and work together with families to help young people grow in confidence. For instance, staff worked closely with a parent when a young person was showing signs of extreme anxiety and distress. His social worker said: ‘We had to move him following a crisis on an emergency basis. Staff sat in the car for 45 minutes, not only calming his anxieties, but also ensuring that at each step his father was fully included. Gradually he was able to wave goodbye to his father and happily enter the home.’

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Good

Young people using the service have a range of communication methods. They appear happy and relaxed with staff and can make their wishes known directly by asking for a particular meal, or indirectly by showing or taking staff to what they need. Managers have developed innovative ways to improve how young people participate in the running of the home and the activities offered. For example, the use of ‘emoji’ counters to express their views on activities, menus and relationships with staff members. A member of staff said, ‘We are very focused on ensuring we understand the wishes and views of our young people, to enable us to continually ensure they have new experiences and make progress during their stay.’

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Good

Managers make every effort to ensure that, when attending for their short break, young people receive care from staff that they know each time. To ensure this, agency staff are not used by the service. Additionally, staff endeavour to have the same group of young people, who are friends, staying together. This can be challenging, given that some young people have high levels of care package. However, the staff team is aware of the crucial importance for young people of developing consistent relationships and enjoying continuity of care. During the inspection, young people were observed giving and receiving hugs of affection with friends they recognised, and happily interacting. A parent commented, ‘I trust the staff and have been able to let go knowing that his routine will be maintained. It’s the little things that matter.’

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Good

The staff team ensures that young people have a fun and enjoyable short break. Young people experience a wide range of activities in the home and out in the community. These include trips to museums, activity parks, eating out and enjoying facilities in the home. Pictures celebrate activities, together with young people’s art and handicraft work, which populate all areas of the home. This has helped to create a warm and pleasant environment for young people to enjoy their stays. Good support is provided to young people to ensure that their health needs are met during their stays, and that this is safe and effective. A good level of training promotes a clear understanding of safe administration of medication. Nutritious, home-cooked meals, which meet individual dietary needs and food preferences, are available. Young people are helped to understand the social rules and boundaries of mealtimes, and these are gently applied by staff. As a result, young people,

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Good

some of whom are fully dependent on adults for their care, remain healthy and well during their stays.

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Good

There is a stable, enthusiastic and confident staff team. They enjoy their work and strive to make each short-break stay the best it can be. Staff are skilled at offering young people individualised care, tailored to their likes and dislikes. For example, on return from school, staff understand that some young people would like quiet time, others want to interact and play football in the garden and, for one young person, a walk in the community to settle some anxiety feelings. Care is respectful and dignified, young people are spoken with not spoken about and are included in all decision-making. Personal needs are appropriately managed. Young people and staff enjoy positive and trusting relationships. Staff are nurturing and warm towards young people, who indicate that they feel safe and secure in their care.

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Good

Staff learn about young people’s individual needs quickly and know them well, so they do not become anxious or frustrated. Young people quickly settle into the home reassured by positive routines and clear boundaries. High levels of supervision by a staff team which is familiar with their individual needs helps to ensure that young people are not vulnerable in the home or out in the community. However, appropriate reviews of risk assessment are not evident for all young people.

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Good

Managers have not ensured that the home’s location risk assessment is regularly reviewed and updated. The policy, in addition to being out of date, lacks reference to any understanding of the area profile for child sexual exploitation or extremism and any strategies for preventing risks to young people.

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Good

The matching of young people’s needs, abilities and relationships with each other is taken into account when arranging their short breaks. This helps to contribute to a positive overall experience when staying in the home.

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Good

Young people benefit from clear routines and positive behaviour support plans. Challenging and complex behaviours are well understood and managed. As a result, there is limited and proportionate use of physical intervention, which in the main takes the form of low-level interventions to divert behaviours. Effective and consistent strategies de-escalate challenging behaviour to ensure young people’s safety. Incidents are well recorded and examined by the management team to ensure that practice in this area remains effective and to consider lessons learned.

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Good

Managers respond swiftly and appropriately to any complaints or concerns raised about the home. They are transparent with parents and supporting agencies about the care provided to young people during their stays. Individual staff members are confident in their understanding of safeguarding, and staff and managers who place young people at the centre of their practice implement the health authority’s whistle-blowing procedures. As a result, young people are protected by well- implemented complaint and safeguarding systems.

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Good

The home environment is attractive and comfortable, and rigorous maintenance and fire assessment protocols ensure that young people are safe. Staff are recruited using the health authority’s rigorous practices and managers ensure that staff have the right levels of qualifications, experience and aptitude for this demanding work.

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Good

Since January 2016, the registered manager has been on secondment to another service within the health authority while maintaining day-to-day oversight of the service for two days of the week. The experienced and highly competent deputy manager, together with an interim, part-time acting manager, supports the home on a daily basis. This has enabled the continual smooth running of the home. The acting manager is a registered nurse and a service manager for community nurses. She is suitably qualified, and is currently undertaking a master’s degree in management.

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Good

The changes in the management of the home have been well managed. Staff report positively on the new arrangements. A member of staff commented, ‘The acting manager is a positive role model. She praises and acknowledges the positive work that we do.’ Another member of staff said, ‘She fully supports us and has a positive attitude to learning, maintains an open-door policy and she is approachable and welcomes new ideas.’

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Good

An experienced and knowledgeable staff team cares for young people. All staff hold a minimum of a level 3 qualification in residential work or an appropriate disability nursing qualification. Staffing levels at the home are in the main appropriate to meet the needs of young people, with any shortfalls filled by appropriately trained bank staff. Staff have opportunities for in-depth handovers and regular informal discussions, as well as staff meetings. There is a training plan to ensure that staff remain as up to date as possible to meet the individual needs of the young people in their care. However, managers do not have a workforce development plan in place. As a result, they do not have strategic oversight of the developmental needs of the staff team.

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Good

The home has a detailed statement of purpose, providing information on the aims and objectives of the service to enable parents and professionals to have an overview of the service provided by the home. The children’s guide is available in written and visual guides. Both have been reviewed as required to reflect any changes to the service.

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Good

Positive feedback was received from parents, carers and social workers consulted during and after the inspection. They gave positive accounts of their engagement with the home, young people’s progress and experiences, and levels of consultation with them. A parent stated, ‘It is homely, where children learn to interact, make friends and become accustomed to being cared for by others… a formidable and dedicated service.’

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Good

Monthly independent monitoring of the service evaluates the care provided. The ensuing report goes some way to enabling managers to take approplement steps for improvement. However, these visits would benefit from rigorous scrutiny of risk assessments and other care records. In addition, managers have failed to complete six-monthly evaluative quality of care reports of the home. As a result, parents, professionals and Ofsted do not have an up-to-date view on the progress that the home is making. This shortfall, however, has not had a negative impact on the care provided to young people.

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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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