Children's Home run by London Borough of Hillingdon in Hillingdon

Good

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

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The children's home provision is good because:

 Young people who have short breaks enjoy their stay and make progress. They learn skills for independence, and benefit from a range of positive activities.  Young people who stay full time in the home make exceptional progress. They improve their behaviour, enjoy positive relationships with staff, and improve their engagement with education and learning.  The staff are committed, passionate and knowledgeable. They provide nurturing care. Young people appreciate this, and feel that staff listen to them and care for them well.  The physical environment is of a high standard. The home is well maintained, and young people can personalise their rooms if they wish too. There is a great outdoor play area and young people make good use of this to have fun, exercise and stay healthy.  The home works effectively in partnership with parents/carers and other professionals. Parents report feeling welcome in the home and that staff share

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The children's home provision is good because:

information effectively. This ensures that young people have a consistent experience of care, and that staff know them well.  Staff are well trained in meeting the needs of young people with autism and learning difficulties, and those with complex health needs. Shifts are well planned to ensure sufficient staff are on duty to provide individual attention to each young person and to keep them safe.  Staff are skilled at managing challenging behaviour. Their interventions are informed by expert assessments from qualified child and adolescent mental health specialists. They use positive strategies to help young people learn positive behaviours.  The leadership team is effective, and has an excellent oversight of care practices, promoting a strong, child-centred, safeguarding culture.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation(s):  Medicines must be administered in line with a medically approved protocol. Records must be kept of the administration of all medication, which includes occasions when prescribed medication is refused. Regulation 23 requires the registered person to ensure that they make suitable arrangements to manage, administer and dispose of any medication. (‘Guide to the children's home regulations including the quality standards’, page 35, paragraph 7.15)

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Recommendations

 The registered manager should ensure that local care and support plans describe how the service provides care which meets each child's needs and promotes their welfare, taking into account the child's gender, religion, ethnicity, cultural and linguistic background, sexual identity, mental health, any disability, their assessed needs, previous experiences and any relevant plans. (‘Guide to the children's home regulations including the quality standards’, page 14, paragraph 3.2)

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Recommendations

 The registered manager should ensure that individual risk assessments demonstrate how staff continually and actively assess the risks to each child and the arrangements in place to protect them. Where there are safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any assessed risks on a day-to-day basis. (‘Guide to the children’s home regulations including the quality standards’, page 42 paragraph 9.5).

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Information about this children's home

This home is owned and operated by the London Borough of Hillingdon. It provides a short-break service for young people with learning difficulties. Currently, it provides short breaks for 38 young people and can accommodate up to eight young people at any one time. It also provides some short- to medium- term placements, and currently has two young people staying full time on this basis.

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Recent inspection history

Inspection date Inspection type Inspection judgement 17/03/2016 Interim Improved effectiveness 29/10/2015 Full Good 04/03/2015 Interim Improved effectiveness 14/01/2015 Full Adequate

p.5

Good

The home operates as a short-break service, though currently has two young people staying longer. This combination presents a challenge for both staff and young people. Having a lot of different young people staying for short periods makes it difficult to provide a stable, consistent experience of care for those young people staying longer term. One young person commented on this, and felt that it was ‘hard to make friends’. The young person also reflected that they didn’t like it when some young people presented challenging behaviour and ‘misbehaved’. Despite this, the young person enjoyed living in the home and described the staff as ‘really nice’. They said, ‘They play with me and look after me well.’ The young person particularly enjoyed the food.

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Good

Both young people staying longer term in the home are making excellent progress. They are settled, and have improved their behaviour dramatically since coming to the home. One placing social worker felt that the staff in the home had an excellent insight into the needs of young people. She described how staff had provided clear boundaries, structure and routine. She felt this had helped her young person feel more secure, reduced their anxieties and helped them develop positive relationships with staff.

p.6

Good

Managers give careful consideration when planning respite to ensure that young people get the most out of their stay, and have a positive experience. Staff provide a range of activities within the home and the local community. These include trips out, swimming and shopping. The home is equipped with a range of resources to help young people have fun and keep busy. There are sensory rooms for young people who enjoy and benefit from the space and stimulation that these provide. There is a large garden area with a range of play equipment and a sensory garden. Young people appreciate this, and talk enthusiastically about how much they enjoy playing in the garden. They especially enjoy playing on the trampoline.

p.6

Good

Staff encourage young people to participate in activities as much as possible to develop independent skills. They are encouraged, to the best of their abilities, to manage their own personal care and contribute to tasks around the home, such as cooking and cleaning. One parent was very pleased that her son was able to undertake tasks such as hoovering, making his bed and putting his laundry in the washing machine. She said her son did not normally do these things at home. Another parent described how her daughter had become more independent with personal care. She was able to use the toilet with minimal support, and no longer needed to wear incontinence pads at night. The home has a proven track record of success in helping young people to move on to adult services effectively. Staff maintain close links with adult provision, and develop effective transition plans to help young people move on successfully.

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Good

Staff work closely with education providers to ensure that young people get the support they need to make progress at school. Both young people who are staying longer term are making good progress and demonstrate improved engagement with education. They have excellent attendance. They leave for school on time and well prepared for their studies.

p.7

Good

Staff know the young people well, and use a range of communication strategies. These include the use of visual or pictorial prompts, Makaton and some signing. Staff are alert to subtle clues so that they can ascertain the wishes and feelings of young people with profound learning difficulties. Staff also undertake specialist training called ‘Beyond Words’. This is aimed at providing staff with the skills to empower young people through play and drama. The staff are committed, enthusiastic and compassionate, and provide genuine, nurturing care to young people.

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Good

Each young person has a care plan, which describes in detail the things they like and dislike. Staff work closely with parents so that they understand the needs of each young person. This helps give young people a consistent experience of care so that they can maintain routines and have things around them that they are familiar with, such as a favourite game or toy. However, the quality of recording on care plans is not consistent, particularly for those young people staying longer term. The care plans do not contain all the relevant information for each child, or describe in detail how staff are supporting them to make progress in all areas. In practice, staff know the young people well and ensure that they receive the support that they need.

p.7

Good

Young people are safe. The home ensures that there are sufficient staff on duty at all times. Each shift is led by a senior member of staff. These staff members are very experienced, well trained and knowledgeable about safeguarding practice. Each shift is carefully planned to provide individual support for each young person. Staff are linked with young people based upon their relationships, knowledge and skills in meeting their specific needs. Young people are carefully matched to ensure that they can get along safely.

p.7

Good

All staff providing care for young people with complex health needs have regular training to ensure they can administer medication safely and move young people safely, and are competent in gastric feeding methods. Staff undertake training in managing epilepsy, and each young person has an epilepsy protocol that describes in detail how to care for them safely. However, there were some gaps in the recording of medication. These errors were not identified through management monitoring. In practice, all young people received the correct doses of medication, and there was no impact on their health or well-being. The registered manager of the home has undertaken a review to strengthen practice in this area.

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Good

Staff regularly consult with a clinical psychologist to develop behaviour plans that aim to understand the particular needs of each young person. They implement a range of strategies to help improve the experiences of young people, and to encourage positive behaviour. Staff undertake specialist training to help them understand how best to work with young people on the autistic spectrum. This means that interventions are well informed, effective and focused on the individual needs of young people. This helps build resilience within the staff team, and means that they can provide a good service to those with very challenging behaviour. Staff have recently undertaken training in behaviour-management techniques that focus on strategies to de-escalate situations. They are trained in the use of physical interventions, but these are rarely used. The registered manager monitors behavioural incidents, and ensures that staff use positive reinforcement and the

p.8

Good

least restrictive interventions when managing challenging behaviour. The staff are to be commended for their attitude and approach to managing difficult situations. They work hard to understand the reasons for behaviours, and are able to work through challenging situations with skill – always focusing on the needs of young people.

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Good

One parent commented that staff really understand her child, and manage his behaviour well. She felt that without the respite care provided, her son may not have been able to stay at home. Another parent described how staff would always give a balanced view, talking a ‘glass half full approach’. She appreciated this.

p.8

Good

Staff are mindful to treat young people with respect and protect their dignity. Personal care is planned and delivered with this in mind, and staff undertake specialist training in this area. There have been no significant child protection concerns.

p.8

Good

Staff know young people well, and are alert to particular risks and vulnerabilities. Each young person has a risk assessment that identifies risks and guides staff interventions to keep them safe. However, the quality of information is not consistent in these risk assessments. Some vulnerabilities are not clearly recorded. In one example, a young person had previously absconded when living at home. This was not mentioned in their risk assessment. In practice, due to high levels of supervision and an experienced staff team, young people are not at risk of harm and do not go missing. Staff undertake regular training in child protection. They know how to act on concerns, and ensure young people are not at risk of harm. Staff work effectively in partnership with placing social workers and parents. They regularly review placements where there are concerns, to ensure that they can continue to meet the needs of young people safely. The registered manager is

p.8

Good

visible and accessible to staff and young people. She has good oversight of safeguarding practice within the home. She promotes a strong safeguarding culture that keeps the welfare of young people at the heart of service provision.

p.9

Good

The registered manager of the home is experienced, knowledgeable and extremely competent. She leads a management team and a core group of experienced senior staff in a way that is inclusive, creative and collaborative. This creates a cohesive team that works together effectively to provide excellent, consistent care for young people. The registered manager works closely with a colleague from adult services who also has good knowledge and oversight of care practices in the home. This is of particular benefit to young people who are making the transition to adult services. It also reduces the risk that the registered manager may become isolated in the role, as she has the support of another manager who also has excellent skills and knowledge.

p.9

Good

The deputy manager of the home is an excellent role model to staff, and is closely involved in care practice. He has excellent administrative skills, and plays a key role in monitoring the quality of care in the home. He ensures there is a clear record of checks and vetting for all agency staff, and that all staff receive a detailed induction. The staff induction ensures that all staff understand the needs of young people, and that they have the skills and knowledge necessary to keep them safe and provide high standards of care.

p.9

Good

The registered manager of the home knows the strengths and weaknesses of the service. She regularly gauges the feelings of the staff team through team meetings, daily contact and formal supervisions. This helps her to spot potential problems early, and to intervene to reduce risks and strengthen practice. The registered manager allocates resources in a way that focuses on the needs of individual young people. This helps young people to keep safe, make progress and have a positive experience of care. The registered manager is mindful of the impact on young people staying longer term in a short-break service. She has plans in place to make better use of the physical space, and to allocate staffing to provide a more settled, consistent experience of care.

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Good

The registered manager has strong links with the senior management in the local authority. She contributes to the strategic agenda, and is able to advocate strongly for the service. This ensures that senior leaders have a good understanding of the needs of the service, and that they provide the resources necessary to support service development. She works effectively in partnership with placing social workers and the professional network. She is able to advocate strongly to make sure that the team around the child is focused on the things that matter most to young people and their families.

p.9

Good

Parent’s report that they feel able to raise concerns with the registered manager and that these are addressed. This prevents concerns escalating, and, as a result, there have been no formal complaints about the standards of care. Parents comment that they have noticed significant improvements in the service since the current registered manager took up her post. They feel that the service is much more accessible and responsive to their needs. One parent described how she felt this had allowed her to ‘get her life back’ because she was able to exercise more choice when booking respite care. Another parent commented that the physical environment had improved, the atmosphere was better and that this had improved staff morale.

p.10

Good

The service has a clear workforce development plan. This ensures that core staff- training in safeguarding, first aid, manual handling, behaviour management and administering medications is regularly updated. Staff are supported to undertake further specialist training to help them meet the needs of young people on the autistic spectrum and those with learning difficulties. Staff appreciate the support they get from managers. All staff receive regular supervision, and undergo annual appraisals to promote their learning and development.

p.10

Good

The registered manager makes use of feedback from young people, staff, parents and placing social workers to inform service development. She has a clear, ambitious vision, and continually stretches the team to improve and provide high standards of care. Staff know what is expected of them, and engage positively with the child-centred ethos and culture within the home.

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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

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

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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