Children's Home run by Action for Children Services Ltd in Buckinghamshire

children and young people since the most recent full inspection

This home was judged good at the last full inspection. At this interim inspection Ofsted judge that it has sustained effectiveness .

p.2

children and young people since the most recent full inspection

The manager has methodically addressed all the requirements and most recommendations made at the last inspection. This has led to improvement in practice, such as providing supervision for agency staff, and some creative work with children that includes the introduction of workshops to promote their understanding of safety issues. Staff have conducted one on road safety that included going to local crossings and guidance on their use. A display has been made which illustrates the work undertaken and serves as a reminder. Further workshops are planned on ‘stranger danger’, food safety and e-safety.

p.2

children and young people since the most recent full inspection

The home’s development plan and review of the quality of care report, under regulation 45, are thorough and effective documents, which promote continuous improvement. Actions identified build on the strengths of the home, particularly its successful links with education providers, and address identified weaknesses such as changes to the labelling of the fire panel to make it easier for staff to identify the location of ‘fires’ during drills. Children and young people, therefore have their well-being and safety promoted effectively.

p.2

children and young people since the most recent full inspection

Progress is yet to be made with developing guidance for staff on complaints by children and young people who are non-verbal and on recording the work done to help young people who leave the service. These recommendations have therefore been repeated.

p.2

children and young people since the most recent full inspection

A particularly beneficial development has been the thinking around ‘appropriate touch’, leading to training for all staff and to practice observed during the inspection to be entirely consistent with the highest standards of care. A ‘service co-ordinator’ explained that physical contact with a child or young person should be for an identified reason and because ‘you know that a child likes it not because you think they would - and you have the evidence.’ Following training, staff are more conscious about such matters as giving ‘side’ or ‘front hugs’ and are asking older children to sit next to them rather than on their laps. Greater attention is paid to what particular children and young people like in terms of contact and the kind of touch that helps to sooth them.

p.2

children and young people since the most recent full inspection

During the inspection this was observed to be well practiced, with a member of staff able to explain why they were, for example, stroking the arm of one young person. Staff gave careful attention to the sort of activities particular children and young people would benefit from depending on their abilities, known interests and mood on the day. These included being read to and looking at moving lights for some and a cinema trip for others. Staff noticed the smallest of indicators, so that the gaze of one young person was followed and the object he was looking at brought closer for him to see.

p.2

children and young people since the most recent full inspection

Care planning is good, with clear strategies and procedures in place to promote children’s health and welfare during, and enjoyment of, their short breaks. There is an emphasis on promoting the development and consolidation of new skills. ‘Goal arrows’ designate the target being worked towards, for example, ‘reaching for a toy placed at his side’ and record the steps made in reaching it. This illustrates the progress made. However, recording of work done on targets in daily logs is inconsistent so it is not clear how much input staff are making during each short break. The manager is aware of this and is planning workshops for staff on recording to raise overall standards.

p.3

children and young people since the most recent full inspection

Staff have made significant contributions to parenting assessments and helped parents to meet the needs of their offspring, so avoiding the need for children to be permanently separated from birth families. Child protection plans should under pin this work but neither these nor child protection conference minutes could be located for a child subject to a plan during the inspection. Without them the manager and staff cannot be sure they are undertaking all the actions they are responsible for or how they work together with those set for other professionals.

p.3

children and young people since the most recent full inspection

The home has generic risk assessments for on and off-site activities but those for individual children and young people lack the detail that would make them useful documents. Potential dangers are not specific enough to identify what needs to be avoided, for example merely stating ‘clothing’; the potential for harm is not re- assessed after control measures to be put in place are specified and assessments are not personalised so that what is required to keep a particular child safe is not stated.

p.3

children and young people since the most recent full inspection

The home is well designed to meet the needs of children and young people. It allows those children who are less mobile and have particular health issues to be safely cared for separately from those whose conditions are accompanied by behavioural issues. This does not prevent either group from benefitting from activities the other is participating in, as illustrated by a child from the former joining a cinema trip by the latter on the day of inspection.

p.3

children and young people since the most recent full inspection

A range of activities is available for children and young people to enjoy safely, including a well-appointed sensory room and enclosed garden. An activity room is currently being decorated and equipped using donations and the labour of volunteers to further enhance facilities.

p.3

children and young people since the most recent full inspection

Some young people regularly, but unnecessarily, pull the emergency cords placed in bathrooms. Some staff therefore hook them up out of young people’s reach, but this then makes them inaccessible to all. The balance between preventing false alarms but ensuring genuine emergencies are responded to quickly is hard to achieve but has not been risk assessed to determine best practice.

p.3

children and young people since the most recent full inspection

The manager and staff have developed their procedures and practice in other areas to improve their safeguarding of children, particularly in the checking and recording of hot food temperatures and the home’s fridges and freezers, and conducting fire drills.

p.4

children and young people since the most recent full inspection

A sample of medication records and the observation of administration of one young person’s drugs demonstrated that staff are following safe processes and accurately recording them. Nursing staff oversee and train others in the procedures that children may require.

p.4

children and young people since the most recent full inspection

Children’s behaviour tends to improve over time. No sanctions have been implemented since the last inspection. Levels of physical interventions remain very low: there has been only one restraint in this inspection period, which was reasonably well recorded but did not show the timescale for a staff debrief or evidence of monitoring by the manager. Measures to avoid children absconding have been successful and there have been no instances since the last inspection.

p.4

children and young people since the most recent full inspection

The missing child policy now references the need for an independent return to care interview and the manager has updated the review of the premises to include the benefits of the home’s location, such as local amenities – although these do not include health facilities.

p.4

children and young people since the most recent full inspection

The manager is keen that staff develop their skills and promotes training as a means to achieve this. The matrix of mandatory training, however, does not accurately reflect the courses staff have attended and suggests that many have not, for example, updated their first aid and safeguarding training within required timescales. It does not differentiate between the different types of first aid course attended, nor between those staff that require particular training and those who do not. The spreadsheet is therefore of little benefit to anyone who is not aware of the reasons for these discrepancies.

p.4

Information about this children's home

This is a short-break service for children and young people with learning disabilities, sensory impairment and physical disabilities. It can accommodate up to 14 young people at a time, although the needs of children means that occupancy rarely reaches this level. A national children’s charity runs the home. It comprises two units that cater for children and young people depending on whether they have challenging behaviours associated with their disability or complex health needs that require nursing input.

p.5

Recent inspection history

Inspection date Inspection type Inspection judgement 17/08/2016 Full Good 15/01/2016 Interim Improved effectiveness 28/07/2015 Full Good 19/03/2015 Interim Sustained effectiveness

p.5

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 with the given timescales.

p.6

Requirement Due date

In order to meet the protection of children standard the registered person must ensure:

p.6

Requirement Due date

that the premises used for the purposes of the home are, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (2)(d))This includes reviewing the use of emergency pull cords. 17/02/2017

p.6

Requirement Due date

The registered person must ensure that a record is made within 24 hours of the use of a measure of control or discipline within 48 hours that the user has been spoken to about the measure; and signed the record to confirm it is accurate; and within 5 days an addition is made to the record that the child has been spoken to about the measure (Regulation 35 (3)(a-c)); in particular records must show that these timescales have been adhered to. 17/02/2017

p.6

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.6

Recommendations

 Children who cannot or choose not to verbalise, have the right to have their views, wishes and feelings heard and respected in the same way as other children. (Guide to Children's Homes Regulations, page 24 paragraph 4.24) This includes making a complaint that is dealt with in accordance with regulation 39.

p.6

Recommendations

 Staff should 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 homes regulations including the quality standards', page 42, paragraph 9.5).

p.6

Recommendations

 The registered person should work with the placing authority to ensure that each child's transition is planned and help each child to prepare for leaving both practically and emotionally. (Guide to Children's Homes Regulations, page 57 paragraph 11.9) This work should be adequately recorded

p.6

Recommendations

 The workforce plan should be updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home's manager. ('Guide to Children's Homes Regulations, including the quality standards', page 53 paragraph 10.8) This requires records to reflect accurately the training staff have undertaken.

p.7

Recommendations

 All involved professionals should work together to safeguard the child from harm in the future, taking timely, effective action according to the plan agreed. The core group should implement the child protection plan and take joint responsibility for carrying out the agreed tasks, monitoring progress and outcomes, and refining the plan as needed. (Working together to safeguard children, pages 44 and 46) This requires that staff have ready access to the plan and understand the actions they should be taking to implement it.

p.7

What the inspection judgements mean

At the interim inspection we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the Inspection of children's homes: framework for inspection.

p.8

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 focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

p.8

Information about this inspection

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 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.8

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.9

Information about this inspection

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

p.9

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.9

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.9