Children's home run by Knowsley Metropolitan Borough Council

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:

 Children who have disabilities and multiple complex health needs enjoy very positive experiences that enrich their lives and provide them with excellent opportunities for personal growth and development. Exceptionally strong safe care practices protect these vulnerable children from harm.  A very high standard of personalised support from skilled and passionate staff is making a significant different to the children‟s lives. Children feel safe and enjoy extremely warm and trusting relationships with the staff. Staff enable children to express their wishes and feelings and make meaningful choices. Children are increasingly confident in spending time away from their families, being around other children, joining in more, and taking part in different, interesting and meaningful activities. They have opportunities to make friends and do things that they may not be able to do with their families. They are

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The children’s home provision is good because:

less anxious and upset, and are significantly less likely to show their emotions through aggressive or self-harming behaviour.  Children‟s stays are carefully planned in a very welcoming, supportive and safe environment. The registered manager and staff use effective relationships with children, their parents and carers, social workers, schools and health professionals to ensure that each child receives the best possible support. Parents and carers feel extremely supported by the staff. They enjoy open and trusting relationships, and they are confident in leaving their children in staff‟s care.  Effective leadership and management ensure that children continue to receive a high quality of care that meets their needs. Managers understand what the service does well and continually strive to make further improvements to develop the service in children‟s best interests.  The quality of care would be further enhanced by making sure that children‟s

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The children’s home provision is good because:

wishes and feelings about using the service are systematically sought and evaluated to inform their care plans and influence the development of the service. Children‟s care plans do not always clearly show the outcomes that they are aiming to achieve, and information from health and education practitioners is not always included in the review of children‟s plans.

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendations:  Each child is provided with support to communicate their views, wishes and feelings and participate as fully as possible in all aspects of their care planning. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.6) In particular, this refers to the review of their short-break plan.  For children who are not looked after, the home should frequently seek the views of relevant people involved in the child‟s care. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.8) In particular, always ensure that the views of teachers and health professionals are included in the review of the child‟s short-break plan.  Children must be consulted regularly on their views of the home‟s care to inform and support the continued improvement in the quality of care,

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Recommendations

including being consulted about the development of the service as part of the service review. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.11)  The home‟s records should make a significant contribution to understanding the child's needs and development. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.5) In particular, that the child‟s records show in detail the specific outcomes that the service is aiming to achieve for the child, how it intends to achieve them, and the progress being made in achieving them.

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Information about this children’s home

The home is known to children and their families as „The Bungalow‟, and is managed by the local authority. It provides short-break care for up to four children who have physical and/or learning disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement 04/03/2016 Interim Improved effectiveness 07/01/2016 Full Good 30/03/2015 Interim Sustained effectiveness 24/10/2014 Full Adequate 25/02/2014 Interim Good progress

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Good

Children who have disabilities and complex health needs enjoy well-planned short breaks that improve the quality of their lives. They receive a very high standard of personalised care in an extremely positive and safe environment. Staff are ambitious for every child, regardless of the complexity of their needs, to get the most out of their stays. The opportunities to try new experiences and to explore and feel comfortable in the world in which they live are helping children to make sustained progress across all areas of their development. Often, things that appear small achievements are significant for individual children, for example eating a meal with other children, choosing the right piece of cutlery to use, going shopping and using money, or going to the park to play on the swings.

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Good

Children clearly love coming to stay. They are full of smiles when they arrive and excited to see staff and their friends. The staff have open and trusting relationships with children and their parents. One parent said, „He always has special smiles for the staff, especially the long-term staff who have known him for a while. He is happy to be around all the staff‟, and another commented, „My child likes the home, and the staff are lovely and very pleasant‟.

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Good

Staff understand how each child communicates, processes and manages information. They expertly support and encourage every child to express their wishes and feelings, and to make choices in a meaningful way. Staff are tuned into children who may share their feelings non-verbally or through their behaviour, and they respond suitably to these children‟s wishes and feelings. They use clear and precise language to communicate with children. They give children time to work out what they are saying and to respond to them. They use different formats, including pictures, symbols and signs, to seek children‟s views about what they want to happen during their stays. A parent said: „My son uses his PECS (picture exchange communication system) and visual schedules, which the staff maintain while he‟s on respite.‟ The staff are strong advocates for children‟s voices to be heard. They recognise that children‟s views may be different from those of their

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Good

parents, and help children to express their wishes, for example about which adult service to use.

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Good

Children‟s care is carefully planned to ensure that they benefit from short breaks at this home and that the staff are able to meet children‟s individual needs safely. Children staying at the same time have compatible needs and interests. When possible, children stay with the same group to provide opportunities to develop friendships. Staff also act on children‟s wishes to come to stay at the same time as their friends. A parent said, „My child has had the opportunity to make friends from attending respite. He has developed a close friendship with a little boy and the staff now try to have them in together, so they get to enjoy sleepovers like other children would with their friends.‟

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Good

Children are introduced sensitively to the service. This usually includes coming to visit a number of times before coming to stay overnight. Staff work out with the children and their parents the best way to introduce them to the home at a pace at which they feel comfortable. The home is also sufficiently flexible to accommodate children‟s changing needs or short-term emergencies, such as family crisis or illness.

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Good

Children‟s short-break placements are reviewed at reasonable intervals to consider children‟s experience and progress, and how effectively their current needs are being met. Staff provide detailed reports and information to contribute to the plans for the child, including photographs to evidence children‟s progress and how they spend their time during their stay. However, the minutes from short-break review meetings do not always show children‟s views about the quality of stays and what they want to happen next. Likewise, information from education and health practitioners working with the child is not always evident in the discussions about the child‟s needs and the support that they require.

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Good

Staff promote children‟s learning and development. The daily routine supports children‟s participation in education effectively during their stays. Staff work very closely with schools to understand children‟s specific education targets and agree a common approach to achieving them while they are staying. Staff also ensure that there are plenty of challenging opportunities for children to enjoy and achieve new things. Children have access to plenty of books, computers, art materials, toys, games and other educational resources. This plays an important part in children‟s informal learning and development of their interests, skills and experiences of the world around them. Children have the chance to do things that they may not be able to do with their families. This includes opportunities to become more independent that are appropriate to their age, level of understanding and disability. As a result, they are becoming more confident with their personal care, cooking,

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Good

helping around the house, doing their washing, shopping and handling money. A parent said: „He is independent in taking his own shower, so we are waiting for a shower to be installed at home. Thanks to “The Bungalow” for bringing things to our attention to change things at home for him.‟

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Good

The staff actively promote children‟s physical health and emotional well-being. Children enjoy healthy and varied diets that meet their dietary needs, and they have plenty of physical exercise. The staff have an excellent understanding of children‟s individual health needs, and are suitably trained and competent to meet them. They are very knowledgeable about how to manage children‟s epilepsy and monitor their oxygen saturation levels, and take appropriate action when they are not at a healthy level. Staff work closely with parents and health professionals to ensure that children continue to receive the best possible health support and treatment during their stays. They also ensure that children have suitable emergency medical advice and treatment when they are feeling unwell, and always let parents know.

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Good

The arrangements for dealing with medication are safe and effective. This means that children always have the treatment that they require to promote their health and welfare. The staff have a detailed understanding of the medication procedures, the reasons why children take medication and its possible adverse effects. They carefully check with parents and doctors that they have the correct information about children‟s medication at the start of each stay.

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Good

„The Bungalow‟ is suitable to meet children‟s physical needs. Great care is taken to make sure that it provides a comfortable and homely environment. Bedrooms and bathrooms have hoists and include necessary medical equipment, but they are decorated to make them as pleasant places as possible for children to use. Before each stay, staff set up the bedrooms to reflect the character, interests and needs of individual children, including their favourite toys and pictures, so that children will have familiar things around them and feel at home.

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Outstanding

Children come to stay in an very safe and supportive environment. Parents are extremely confident that their children are safe and exceptionally well cared for during their stay. The staff‟s excellent safe care practices and the consistent routines help children to feel safe and promote their emotional security. Consequently, children become increasingly comfortable in being away from their families and spending time with other children. They appear very happy, relaxed and settled. A parent said: „Our son‟s reaction is priceless! Bouncing up and down, clapping and lots of squeals. This really does reassure us that he loves going.‟

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Outstanding

Staff listen to children‟s worries and take them seriously. They know the children extremely well and quickly pick up when something is wrong by noticing changes in behaviour, including self-harm, or their emotional health. When there are concerns about children‟s safety, staff work with other agencies to make sure that children and their families have the right support, reassurance and protection.

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Outstanding

The staff are highly vigilant to any signs and symptoms of abuse and neglect. They are fully aware of the children‟s vulnerability to sexual exploitation and use protective measures effectively to enable children to use social media and the internet safely. When assisting with personal care, they follow safe care practices that respect and promote children‟s dignity.

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Outstanding

Staff‟s skilled communication helps children to feel less frustrated and anxious. Staff, for example, help children to learn to take turns in using the computer. Children know when it is their turn and for how long, and when it is someone else‟s turn. Staff successfully use a countdown to help prepare children for the end of their turn. Importantly, staff are mindful to give children the time they need to understand what they are being asked, and not to rush them unnecessarily. Staff‟s well-informed and consistent approaches are helping children to understand and manage their own feelings and find their own ways to feel calm, including choosing to spend a little time in their room to help them to start to feel better. The occasions when children feel upset and show aggressive or self-harming behaviour are extremely rare. The registered manager and staff thoroughly evaluate these times and take appropriate action to reduce the risk of any further problems. They

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Outstanding

work closely with parents, schools and the positive behaviour support team to understand children‟s behaviour, and develop consistent and effective strategies for helping children to manage their feelings in different settings.

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Outstanding

The staff have a comprehensive understanding of the risks to individual children‟s safety associated with their disability, level of understanding, communication and health conditions. They use this expertise to alert other professionals to concerns about children‟s welfare which may not otherwise have been recognised. For example, staff worked with social workers in the emergency duty team to support a child when his emotional health and well-being caused significant concerns. This piece of work has led to joint training for staff and social workers around mental health and disability.

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Outstanding

The staff continuously assess the risks for each child and take considered and reasonable precautions to make sure that children are protected. They have changed the arrangements for children‟s stays and staff support to address concerns around children‟s behaviour. This helps to promote their safety and ensure that they continue to benefit from their stays. The effective management of risk is enabling children to explore new experiences and challenges, including being away from their family, trying new things and taking part activities in the community.

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Good

A very experienced and suitably qualified registered manager provides highly effective leadership. He ensures that children receive high-quality short breaks that are tailored to meet their assessed needs and circumstances.

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Good

Passionate, experienced, qualified and highly competent staff provide children with an excellent quality of care. The staff‟s skills, knowledge, values and personal qualities are tailored to the needs of children who have disabilities and multiple complex needs. The registered manager ensures that people wishing to work at the home go through a rigorous selection procedure, and their suitability is carefully checked. He employs only people who have the right personal qualities, enthusiasm, experience and skills to work with children who have disabilities and complex health needs.

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Good

Staff work in a cohesive and well-organised way to ensure that children have a safe and enjoyable stay. The management team ensures that staff are appropriately guided and supported on a daily basis. They provide opportunities through regular one-to-one supervision and appraisals for staff to reflect on children‟s progress, their individual performance and professional development. Staff receive very good support regarding the emotional impact of their work. The managers and staff use the regular team meetings effectively to consider children‟s experiences, needs and progress. They often use team meetings for training and sharing skills with practitioners from the positive behaviour support service and the health services. Staff receive good-quality training in relation to the management of medication, behaviour, understanding autism, communicating with signs and pictures, and children‟s specific health needs, including appropriate moving and handling, gastric

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Good

A recent review of the service and an assessment of the needs of all the children using it have helped the local authority to provide focused and targeted support for children and their families. As a result of the review, the vast majority of children continue to have the same level of support, and a third of them are now receiving a higher level of support. The local authority consulted sensitively and thoroughly with parents and staff about how best to use the service to support families. The registered manager and staff build exceptionally strong relationships with parents. Open communication between the registered manager, staff and parents ensures that children have positive experiences and that parents are fully involved in the support that their children receive. Parents are comfortable about leaving their children in the staff‟s care and are confident that they receive a high quality of care

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Good

and support. However, children‟s views about the quality of the support that they get have not been sought or evaluated systematically to inform the development of the service.

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Good

The manager and staff work engage in strong partnership in the wider system, including early help services, the local offer for children with special educational needs and disabilities, social workers, schools and health workers. This helps to ensure that children have the right support to meet their needs. A dedicated member of staff has established strong links with adult short-break services to assist children‟s transition. This is very well coordinated, and appropriate information is shared to clarify the support that children will need in the future. It is recognised that this is also a difficult time for parents, so staff and work extremely hard to provide them with advice, support and reassurance.

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Good

The registered manager and local authority use the monitoring systems effectively to improve children‟s experiences and the quality of care that they receive. An independent person carries out a detailed monthly assessment of the service‟s effectiveness in promoting children‟s welfare and safety. The registered manager‟s thorough review of the quality of care clearly shows the service‟s strengths, measures children‟s progress and identifies priorities for developing the service. It includes a focus on identifying and improving measureable outcomes.

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Good

Children‟s plans set out clear objectives for their stays, including joining in activities with other children, improving personal care skills and developing skills in the kitchen. However, their records do not always show in detail what needs to happen to help children to achieve their goals with an analysis of their progress. For example, the records show that a child had made Christmas cards, but did not show how she had done this, which tasks she had completed and how much support she had needed. This is a missed opportunity to develop a comprehensive understanding of children‟s progress, as well as how effectively the staff are meeting children‟s individual needs and its impact on their lives.

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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‟. 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 looked after children is safeguarded and promoted. Minimum requirements

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What the inspection judgements mean

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 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 0300 123 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 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

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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