Children's Home run by Nottinghamshire County Council in Nottinghamshire

Good

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

p.2

The children’s home provision is good because:

 Young people are well cared for during their short breaks. They are provided with a range of stimulating activity that is appropriate to their age and level of disability. The enthusiasm of staff ensures that there is a pleasant atmosphere in the home with lots of laughter and fun.  Staff respond to challenging behaviours very well. They are sensitive to the frustrations experienced by young people who have limited verbal communication. They intervene confidently and assertively when young people are unable to regulate their own emotions. Staff are extremely resilient to the behaviours displayed by young people as a result of their disabilities. They do not give up on young people who are difficult to manage safely. One parent described the work of staff as ‘inspirational’.  The personal and intimate care needs of each young person are well understood. Intimate care tasks are carried out efficiently and carefully so

p.3

The children’s home provision is good because:

that young people do not become distressed.  Very complex medication regimes are managed well so that errors are minimised. When errors do occur, staff respond promptly and effectively to protect young people from any potential harm.  Staff and managers have very strong working relationships with parents. These relationships are based on open and honest communication.  Risk management systems are effective. When young people display behaviours that have not previously been identified, managers promptly update risk assessments and share information with partner agencies.  Improvement is required in the way that fire drills are planned and carried out, and in recruitment practice. It is recommended that monitoring by the independent visitor should be more robust and that arrangements for staff training in safeguarding should be better organised.

p.3

Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meet(s) the Care Standards Act 2000, the 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.

p.4

Requirement Due date

After consultation with the fire and rescue authority, the registered person must ensure, by means of drills and practices at suitable intervals, that persons working at the home and, so far as is reasonably practicable, children are aware of the procedure to be followed in the case of fire. (Regulation 25(1)(d)) 06/02/2017

p.4

Requirement Due date

The registered person must recruit staff using recruitment procedures that ensure that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32(3)(d), Schedule 2(3)(4)) 06/02/2017

p.4

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Any individual appointed to carry out visits to the home as an independent person must make a rigorous assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the home's care. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5) This is with particular reference to ensuring, whenever practical, that visits take place at times when young people are taking their short breaks, so that their care can be observed and their views sought.  The registered person should have a workforce plan which should detail processes and agreed timescales for staff to achieve any core training (such as safeguarding training). (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8) This is with particular reference to

p.4

Recommendations

ensuring that managers have a clear understanding of the content of safeguarding training undertaken by staff, whether it is relevant to children who have disabilities, and how often it should be refreshed.

p.4

Information about this children’s home

The home is run by the local authority and is registered to provide short breaks for a maximum of eight children who have learning disabilities and physical disabilities.

p.5

Recent inspection history

Inspection date Inspection type Inspection judgement

p.5

Recent inspection history

29/03/2016 Interim Improved effectiveness

p.5

Recent inspection history

25/02/2015 Interim Improved effectiveness

p.5

Good

Children and young people enjoy their short breaks in a modern, well-decorated and well-maintained home. The experienced staff provide good-quality care. They are skilled at communicating with groups of children and young people who have different levels of disability. They move easily between symbols, Makaton and the spoken word. This fosters a nurturing and inclusive environment. For children and young people who have limited speech, symbols are used effectively so that they understand the routines of the home. This reduces anxiety levels and enables children and young people to make some decisions. All children and young people have access to tablet computers that enable them to listen to music of their own choice or to watch their favourite television programmes. Staff use reassuring touch to provide comfort. For example, foot massages are particularly enjoyed by children and young people. There is a pleasant and welcoming atmosphere. Children and young people are

p.6

Good

greeted enthusiastically when they arrive and quickly settle. A good range of activities are available. Garden play equipment is of a high standard and a wide range of art and craft supplies mean that children and young people are able to develop their creative talents. One young person particularly enjoys ‘messy play’. Staff enthusiastically join in with this activity so that it is enriching for the young person. An older, more able young person prefers to spend time in the company of staff rather than the other young people. Good shift planning ensures that his needs are not overlooked. Some children and young people enjoy singing, and staff join in. This contributes to the consistently stimulating environment. Meal times are positive, social occasions because group dynamics are managed very well. A young person who has limited verbal communication pointed to a happy face to describe his feelings about the staff. Another young person said that he enjoys his time at

p.6

Good

the home because ‘the staff are nice’. A parent commended staff on doing a ‘fabulous job’.

p.6

Good

Each short break is well planned. Managers do all that they can to balance the wishes of parents to use the service at particular times with the need to ensure the safe matching of children and young people. This means that group dynamics are generally well managed. Care plans are detailed. They clearly set out the nature of the children’s and young people’s disabilities and care needs. They also enable staff to understand children’s and young people’s preferred communication methods, interests, favourite activities, routines, behaviour management strategies, sensory needs and food preferences. Moving and handling protocols are well understood and carefully followed by staff. Education targets are also well understood and mirrored in the home’s care plans. Records are clear, up to date and stored securely. They contribute to an understanding of the children’s or young people’s lives, experiences and plans for the future. Updated information from parents and

p.6

Good

schools is carefully reviewed to ensure that all emerging needs can be addressed. The personal and intimate care needs of each child and young person are well understood. Intimate care tasks are carried out efficiently and carefully so that children and young people do not become distressed. Many children and young people have complex medication regimes. The staff take great care to ensure that they administer each medication as prescribed. Errors are rare, quickly identified, and responded to appropriately. Staff are confident in the management of conditions such as epilepsy. They demonstrate a good knowledge of individual seizure protocols. This means that children’s and young people’s healthcare needs are well met during their short breaks. Staff are good at consulting with children and young people and seeking their views. Children and young people are supported to make choices whenever possible. For instance, they are able to select activities and have a choice of meals.

p.7

Good

Young people’s meetings are well organised. They are tailored to the abilities and levels of understanding of the children and young people accessing the service. Sensitive subjects, such as bullying, are dealt with very well so that children and young people develop their knowledge without becoming frightened. Social and cultural issues are also explored well through young people’s meetings.

p.7

Good

Each child and young person has a detailed risk assessment, which takes account of their particular vulnerabilities and their potential to accidentally harm staff or other young people. This guides the allocation of staff. When children or young people require constant monitoring, they are allocated two members of staff to care for them. When children or young people display behaviours that have not previously been identified, risk assessments are quickly updated and new strategies are developed to minimise potential risk. Since the last inspection, one particularly serious incident has taken place in which a member of staff was injured by a young person. Following the incident, the risk assessment and care plan were updated so that the risk of further injuries was reduced. This enabled the staff to continue to care for this young person and enabled a planned transition into adult care. All appropriate notifications were made in a timely manner, including to the Health

p.7

Good

and Safety Executive. Staff do not give up on children who display harmful behaviours as a result of their disabilities. They understand that young people are often unable to regulate their emotional responses. They show great compassion and empathy towards young people. This is exemplified by the response of staff and managers following the incident in which a member of staff was seriously injured. Core staff continued to provide the young person with high-quality care, undeterred by the experience of their colleague. The same staff made themselves available to care for the young person when his school felt that it was unable to safely teach him and ended his school placement at very short notice. Staff and managers were thanked and praised by the young person’s family. The manager commended the ‘amazing commitment’ of her staff. Although no other child or young person witnessed the incident, those who were having a short break at the time were all provided with a

p.7

Good

social story to help them to understand why the atmosphere in the home may have changed. Each affected family was contacted so that family members could monitor their child.

p.8

Good

Staff understand their safeguarding responsibilities. They know how to report any concerns about the safety or well-being of residents. They also demonstrate a good understanding of the particular vulnerabilities of children and young people who have disabilities. An independent advocate regularly visits the home, observes care practice, and spends time with children and young people. This further enhances the safeguarding systems. Careful monitoring of children and young people in the home and in the community means that they do not run away from the home. However, staff and managers have a comprehensive understanding of local missing-from-care protocols and know how to respond should a child or young person go missing. Physical intervention is used appropriately to protect children and young people from harm. All staff are trained in approved restraint techniques. The recording of physical intervention is of a high quality and enables very effective monitoring of

p.8

Good

practice. Opportunities to improve practice are quickly identified through this monitoring. For example, staff were supported to reflect on how they cope when a restraint is required during personal care procedures, or when a child or young person is not clothed. This has improved their practice. The home has extensive and well-maintained fire safety systems that provide young people with high levels of protection in the event of fire. Staff carry out daily, weekly and monthly checks of evacuation routes, fire alarms, fire extinguishers and emergency lighting systems. Any faults are addressed quickly. Each member of staff has recently been provided with training in fire safety, which includes guidance on supporting young people who have disabilities, in the event of a fire. However, fire drills do not take place at the frequency set out in the home’s fire risk assessment. This means that some staff have not regularly rehearsed fire

p.8

Good

evacuation. Careful consideration has not been given to how children and young people who have disabilities can participate in fire drills. As a result, some have not done so. This lack of detailed planning for the evacuation of young people who have complex health needs reduces the effectiveness of fire safety procedures. Staff recruitment processes are effective in ensuring that children and young people are not exposed to unsuitable adults. They include criminal record checks, review of personal and professional references and careful evaluation of previous experience. In some cases, the manager has gone to considerable lengths to gather relevant information about staff prior to offering them employment. However, the vetting of staff should be more robust. For example, it is not always clear that references have been provided by the applicant’s previous employer. In addition, formal verification of employment references does not always take place.

p.8

Good

An experienced and suitably qualified registered manager leads this home. She is well supported by her assistant managers. Staff report that they are managed well, and that they find their supervision and annual appraisal to be helpful in developing their practice. When shortfalls are identified, such as errors in medication administration, these are addressed promptly and proportionately. The registered manager is able to identify the key strengths and weaknesses of the service. Her development plan, although not particularly ambitious or aspirational, is used appropriately to address any perceived weaknesses. She confidently describes her plans to enhance the home environment, improve care provision and develop the staff team. The registered manager monitors the progress that children and young people make. This means that she can demonstrate the impact that the service has on them. For example, by monitoring the ability of one young person to cope with

p.9

Good

group activities, she provides concrete evidence of his social progress. The staff and managers collaborate well with a wide range of external agencies and professionals. This ensures that each child and young person has access to all the services that they need. Complex transport arrangements are well organised so that children and young people do not experience unnecessary anxiety in their transition to and from the service. Very effective communication takes place with schools each day to ensure that all relevant information is shared. The staff also provide an out-of-hours telephone advice service, which is available to social workers and parents of children and young people who access the service. The service has received no complaints since the last inspection. This reflects the open and transparent management culture. A parent stated that she has not needed to make any complaints because any issues are resolved quickly.

p.9

Good

Since the last inspection, there has been an increase in the proportion of staff who are suitably qualified. This demonstrates the commitment of managers to staff development. All staff undertake a wide range of training that equips them to meet the care needs of each child and young person. This includes specific training that enables them to provide good care to young people who experience seizures and have other complex health conditions. Staff talk positively about their training and feel that it equips them well for their roles. In general, managers have a clear understanding of the training that each member of staff requires. For example, they plan carefully to ensure that training in physical restraint, food hygiene and first aid is regularly refreshed. However, the same attention to detail has not been applied to safeguarding training. Although each member of staff has undertaken some recent training in this area, managers do not demonstrate a clear

p.10

Good

understanding of which aspects are mandatory, whether it is relevant to children who have disabilities, or how often it should be refreshed. Quality assurance systems are generally strong. Managers undertake daily checks of critical functions, such as health and safety, staffing levels, medication administration, safeguarding notifications and records of physical intervention. The registered manager then carries out regular and detailed monitoring of staff practice and the quality of care provided. An independent person is also commissioned to carry out a monthly visit to the home with the purpose of evaluating the safety and welfare of children and young people. These visits involve regular review of records, health and safety systems and care planning arrangements. However, because such visits do not routinely take place at a time when children and young people are in the home, the visitor rarely observes care

p.10

Good

being provided and does not ascertain the views of those being cared for. In some cases, even when children and young people are at the home at the time of the visit, their views are not sought. This shortfall means that the visits are not sufficiently robust. In addition, there is little evidence that the independent visitor seeks the views of parents or other professionals.

p.10

What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors 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’.

p.11

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, 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 ensure that their welfare is 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

p.11

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.

p.11

Information about this inspection

Inspectors 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 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 whom 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

p.12

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 .

p.12

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.13

Information about this inspection

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

p.13

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.13

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.13