Children's Home run by Footsteps Care Limited in Waltham Forest

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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The children's home provision requires improvement because:

 Children do not yet benefit from good outcomes due to the shortfalls across the safeguarding and leadership and management outcome areas.  Staff have not had training which focuses specifically on the vulnerability of disabled children. Staff care for a diverse group of children and have not had training in potentially harmful cultural or faith-based practices.  Policies for the protection of children do not fully reflect current guidance and legislation. They are outdated, referring to former safeguarding guidelines.  Children frequently sustain minor injuries during physical interventions. Restraint records do not detail briefings with staff after the use of each measure. They also fail to detail how an injury may have occurred. This makes it difficult to monitor trends and patterns and ensure that any action taken is effective.  Individual risk assessments do not detail the possible hazards to each child.

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The children's home provision requires improvement because:

An example is a child who self-harms and makes suicidal threats. Their risk assessment failed to identify all the hazardous items which they have previously used to potentially harm themself.  The statement of purpose does not include a description of the home’s approach to the monitoring and surveillance of children. This document also fails to clearly detail decision-making regarding new referrals and the potential impact on the children living at the home.  Care practices do not have a theoretical base. Staff have not received autistic spectrum disorder training. Practice in the home is not informed by research and developments in the field.  Staff care for children with secondary mental health needs. However, they have not received relevant training and are reliant on their existing skills.  Decision-making does not focus on actively supporting children in their schools. There is no strategy for children with a specific health need to

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The children's home provision requires improvement because:

attend education in accordance with the expectations in their relevant plans.  The home does not have a workforce development plan, as detailed in the quality standards. This means that a strategy to develop and support staff to meet children’s complex needs is not in place.

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The children's home strengths

 The registered manager is experienced. The recent appointment of deputy managers strengthens leadership arrangements. Staff are well supported and feel valued by the organisation.  Leaders and managers are implementing improvements so that the home is heading in the right direction. There is a good service development plan and a recognition of the strengths and areas requiring improvement. This positively contributes to the home’scapacity to further improve.  Parents value the service, and the majority of involved professionals are impressed with the quality of care. A parent describes the care as ‘excellent’ and further describes the home as a ‘wonderful place’.  The home caters for a wide range of children with differing needs. Relevant professionals provide them with bespoke training to meet health requirements. Examples are training in gastro feeding and diabetes.  All children attend education. Facilities within the home also promote a

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The children's home strengths

learning ethos. Children can access computers, books and educational games.  Children benefit from an experienced, culturally diverse, gender-balanced staff team. Staff are committed, adaptable and strive to promote the best interests of children.  Staff have previously undertaken or recently completed the required vocational training. They have also completed a learning difficulty specific qualification, which helps to inform their practice.  Young people are learning the skills necessary for independence. Where able, they confidently prepare light meals, budget, purchase their own shopping and undertake household chores, while a number travel independently.  Staff monitor children’s progress, and their achievements are noted. Children demonstrate improvements in developing socially acceptable behaviour. They are calmer, more social, confident and tolerant of others.  Improvements in children’s health contributes to their increased mobility,

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The children's home strengths

management of their continence and a decrease in hospital admissions.

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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 education standard, the registered person must ensure that staff: 2(a)(x) help each child to attend education in accordance with the expectations in the child's relevant plans. 1 January

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Requirement Due date

In order to meet the protection of children standard, the registered person must ensure that staff: 2(a)(i) assess whether each child is at risk of harm, taking into account information in the child's relevant plans, and make arrangements to reduce the risk of harm to the child. 1 January

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Requirement Due date

13. The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, the registered person must: (c) ensure that staff have the skills to meet the needs of each child, this specifically relates to autistic spectrum disorder and mental health training. 1 January

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Requirement Due date

13. The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, the registered person must: 2(a)(g) demonstrate that practice in the home is informed and improved by taking into account and acting on– (i) research and developments in relation to the ways in which the needs of children are best met. 1 January

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Requirement Due date

1 The registered person must ensure that the statement of purpose covers the matters listed in Schedule 1. This relates specifically to the home's approach to the monitoring and 1 January surveillance of children. (Regulation 16 (1)) 35. Behaviour management policies and records

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Requirement Due date

The registered person must ensure that within 48 hours of the use of a measure of control, discipline or restraint, the registered person or a person authorised by them, has spoken to the staff member about the measure. (Regulation 35 (3)(b)(i)) 1 January

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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

 Staff appraisals should take into account, where reasonable and practical, the views of other professionals who have worked with the staff member over the year. (‘The Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.5)

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Recommendations

 Compile a detailed workforce development plan. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)

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Recommendations

 Ensure that records of restraint enable the registered person and staff to identify effective practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure it meets the needs of each child. This relates specifically to the sustaining of injuries. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

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Recommendations

 Policies for the protection of children should be reviewed regularly and revised where appropriate. This specifically relates to the need to reflect current guidance and legislation. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.22)

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Recommendations

 Ensure that staff have the knowledge and skills to recognise and be alert for any signs that might indicate a child is in any way at risk of harm. The registered person should ensure that skills in safeguarding are gained and refreshed. This specifically relates to the wider elements of safeguarding in relation to disabled children and harmful cultural or faith-based practices. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.12)

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Information about this children's home

This privately owned home provides care and accommodation for eight children with a learning disability. The organisation has another children’s home which also caters for children with similar needs.

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Recent inspection history

Inspection date Inspection type Inspection judgement 24/03/2016 Interim Sustained effectiveness 12/11/2015 Full Requires improvement

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Requires improvement

Children receive an adequate level of care. A lack of specialist training, of coordinated educational planning and of a more considered referral process are preventing the home from enhancing children’s experiences. The majority of children are on the autistic spectrum. However, staff are still waiting to attend specialist training. Children who have a secondary mental health need are also living at the home. Staff have not had training in this area and are reliant on their existing skills. Leaders and managers must ensure that staff have the ability to effectively meet the needs of each child.

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Requires improvement

Staff generally promote children’s education, and there are designated staff to lead in this area. There is an issue with balancing the health and school attendance of particular children. For example, during the inspection a child did not attend school, although they had not been exhibiting any poor health symptoms that morning. The decision to keep them at home had been made the evening before. Academic work was not received from their school and there was limited evidence of formal learning. Decision-making does not focus on actively supporting children in their schools. There is no strategy helping each child to attend education in accordance with the expectations in their relevant plans. This is an isolated incident, as all other children have good school attendance.

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Requires improvement

Children have positive relationships with staff. The key-work system provides purposeful, individualised support for each child. Care planning generally focuses on promoting positive outcomes. Children are able to contribute, expressing their individuality and preferences. Regular house meetings enable young people to inform decision-making. They positively influence menu and activity planning. Meetings also provide an opportunity for children to be formally praised. Staff monitor children’s progress, and their achievements are noted. Children demonstrate improvements in managing their continence, and a decrease in unacceptable habits, for example spitting. They are calmer, more social, confident and tolerant of others. Children are also more independent, with some now able to travel independently on public transport.

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Requires improvement

Health outcomes are improving, an example being a child who is now able to mobilise independently. There has also been a decrease in hospital admissions. Staff receive bespoke training which enables them to undertake gastro feeding, administer insulin and assist children with their physiotherapy exercises. A specialist nurse compliments staff, stating that feeding tubes are ‘very clean’, confirming that they are very impressed with the care. Staff positively liaise with a range of health professionals to promote the child’s best interests. These include a dietician, diabetic nurse, psychiatrist and the child and adolescent mental health service. There has been an issue regarding medication errors, although no harm was caused to children. Leaders and managers learn from incidents, ensuring that staff receive training, keep accurate records and securely store medication.

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Requires improvement

Children have amicable relationships with staff. One child highlights the best thing about the home as ‘the staff and food’. Another child received the opportunity to meet a celebrity through staff referring her to a charity which focuses on granting the wishes of disabled children. Parents express satisfaction with the service, and one describes the care as ‘excellent’ and feels that the home is a ‘wonderful place’.

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Requires improvement

Children enjoy a range of social and recreational activities within the home, the local community and further afield. Staff help to stimulate their learning and interests at museums. Children have fun going to the seaside, safari and theme parks. They interact with their peers at after-school clubs and specialist social clubs linked to their disability. The organisation has also funded a holiday club for a young person. Children regularly enjoy going to the park and the cinema. A healthy lifestyle is encouraged through diet and exercise. Activities include swimming, trampolining and bike riding. Within the home they enjoy using the computer, to safely access the internet or to play games.

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Requires improvement

The home caters for a diverse range of children from different faiths and ethnic backgrounds. Children are able to follow their traditions, for example reading books on their chosen faith. Children enjoy eating a culturally reflective menu. A social worker gave an example of a child being able to enjoy ‘traditional Nigerian home- cooked food’.

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Requires improvement

Staff focus on children’s abilities, and independent living skills are appropriately encouraged. Older children take pride in being able to prepare their breakfast, light meals, snacks and hot drinks. A budget is also available for those who wish to purchase their own groceries and take responsibility to cook for themselves. Children take responsibility for daily living tasks, helping to wash up, make their bed, tidy their room, attend to their laundry and assisting with household chores. They also make a positive contribution to society through voluntary work.

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Requires improvement

An ethos of the home is to help children reintegrate into their family home, where possible. Children maintain contact with their families through visits and telephone calls. There is a commitment to empowering parents and helping them develop their care skills. An example of this is inviting parents to participate on relevant staff training courses. A social worker highlights that staff have ‘established a very good relationship’ with family members.

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Requires improvement

The premises blends into the residential close. Effort has been made to provide a more homely atmosphere. Children helped to choose new furnishings, which contribute to the modern, domestic environment. They benefit from their own ensuite bedrooms, which are suitably furnished. Children can personalise their rooms to reflect their individual preferences. They also have a television in their room, enabling them to watch programmes of their choice. Children can socialise together in the main television lounge, which has a wide range of channels. A popular pastime is watching the music channels.

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Requires improvement

Facilities within the home promote a learning ethos. Children can access computers, books and educational games. The kitchen-dining room is a hub of social activity for children. The separate building in the garden also accommodates a cinema-lounging room. This space can also alternate as a sensory room. Children have access to a paved garden where they can play. A child commented that they enjoyed barbecues there in the summer. The garden has bordered areas for growing flowers, vegetables, and herb beds. Children have the opportunity to develop their gardening skills, and they take pride in their ability to grow organic produce.

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Requires improvement

Children receive an adequate level of protection. Practice could be more robust to better promote the welfare of children. Shortfalls relate predominately to restraint records and risk assessments. These shortfalls do not place children at a significant risk of harm. Therefore requirements and recommendations focus on the need to strengthen practice and update policies and practice.

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Requires improvement

S taff benefit from training in relation to de-escalations and physical interventions. To protect children or others from harm, staff occasionally have to use physical interventions. At times this may result in a child sustaining a minor injury. Records do not clearly outline how an injury may have occurred. The records also fail to detail whether the registered manager or another authorised person has spoken to the staff members involved. This means that it is difficult to confirm whether effective practice has been used and, therefore, where any issues or trends of concern emerge.

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Requires improvement

The home has a range of risk assessments related to the environment, fire safety and individual children. The latter relates to specific circumstances and hazards concerning the particular child. The majority of risk assessments are sound. One risk assessment contains insufficient detail regarding the various dangers surrounding a child’s self-harm and suicidal threats. For example, a child had attempted to tie a scarf harmfully around their neck. However, their risk assessment did not identify the need to protect the child from similar items.

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Requires improvement

Staff receive training which helps to enhance their safeguarding knowledge and skills. This includes recognising and being alert for any signs that might indicate that a child is in any way at risk of harm. There is a whistle-blowing procedure, and the majority of staff knew the external personnel to whom they could take concerns. Staff training includes child sexual exploitation and countering the risk of radicalisation.

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Requires improvement

Staff have not received training which focuses specifically on the vulnerability of disabled children. Staff care for a diverse group of children and have not had training on particular cultural issues, for example female genital mutilation. Staff should have their skills in safeguarding increased and refreshed. This specifically relates to the wider elements of safeguarding in relation to disabled children and harmful cultural or faith-based practices.

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Requires improvement

Children know how to complain and positively use the procedure to address their concerns. The involvement of advocates also helps to promote their rights. Children receive support to engage in age-appropriate risks, an example being going out independently. There are currently no concerns related to going missing, bullying or exploitative relationships. Protective measures are in place to support safe internet use to safeguard children from online grooming.

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Requires improvement

Staff impose clear boundaries, and plans detail children’s key behaviours, triggers and management strategies. Some children have obsessive behaviour and others have challenging needs. Staff use a positive behaviour model, which enables children to individually earn meaningful rewards.

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Requires improvement

There are satisfactory links with the local authority safeguarding personnel. Leaders and managers appropriately manage quality of care concerns. They actively apply the disciplinary procedure and use the lessons learned to improve the home’s practice.

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Requires improvement

The home promotes safe recruitment. New staff members do not start working until all regulatory checks are in place. Certificates and regular checks confirm the safety of the physical environment.

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Requires improvement

There is an acknowledgement that practice needs to improve. The registered manager is an experienced practitioner within the organisation. The recent introduction of two deputy management posts strengthens the leadership arrangements. This will enable the effective delegation of tasks. Regular management meetings assist with sharing and coordinating a unified way of working.

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Requires improvement

The statement of purpose has been updated. However, further work is needed to comply with regulations. This document does not include a description of the home’s approach to the monitoring and surveillance of children. The decision- making process regarding new referrals does not clearly detail consideration of children’s ages, needs and their abilities. There are examples of a child being admitted and then damaging sensory equipment and hitting other children. As a result, other children already living at the home potentially had their well-being negatively affected.

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Requires improvement

The registered manager acknowledges the need to have a theoretical base for care practices. Practice in the home should be informed by research and developments in the field to promote best practice. The home does not have a workforce development plan, as detailed in the quality standards. Therefore, there is a lack of a strategic plan to confirm how staff will develop their skills and receive support to meet children’s complex needs.

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Requires improvement

The requirements and recommendations from the last inspection have been addressed. The appointment of a new independent visitor with relevant regulatory experience contributes to the improved quality assurance system. Ofsted regularly receives the independent monthly monitoring reports in accordance with regulation 44. The registered manager completes their own quality of care review every six months. Children benefit from a more homely domestic living environment and were instrumental in choosing some of the soft furnishings and pictures.

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Requires improvement

Children benefit from an experienced, culturally diverse, gender-balanced staff team. Staff are committed, adaptable and strive to promote the best interests of children. Staff work well with other professionals. A teacher describes them as being ‘really helpful’, highlighting that ‘communication is good’. Staff say that they feel ‘valued’ and appreciate the registered manager’s approachable leadership style. Staff recruitment is in progress to ensure that children receive care from a permanent staff team. Staff have commenced or recently completed the required vocational training. They have also completed a learning difficulty specific qualification, which helps to inform their practice. The organisation is also introducing electronic learning to complement the mandatory programme. Staff receive regular supervision and appraisals. Appraisals include feedback from children. Leaders and managers do not currently seek comments from involved professionals to enhance the appraisal

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Requires improvement

process and provide an opportunity for independent external feedback. Leaders and managers have a sound awareness of the positive aspects of the home and the areas requiring further attention. The service development plan appropriately details the actions required to promote improvement. This plan demonstrates that the home is moving forward in the right direction and has the capacity to further improve.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against ‘Inspection of children's homes: framework for inspection’.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or that result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference that adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people 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, 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,

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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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