Children's home run by Medway Council in Medway

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:

 There is a broad, inclusive and flexible approach to providing short breaks for children who have complex needs.  Children’s safety and well-being is regarded as paramount.  The registered manager and the staff team have a clear, shared understanding of the objectives of the service.  There is a planned and sustained effort to improve the quality of care and the overall experience of children.  Staff are strongly committed to establishing effective lines of communication with each child.  There is careful preparation for each break, and realistic goals are set for increasing independence, expanding life experiences and building positive memories.  Managers and staff understand the strengths of the service as well as areas for further improvement.

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Recommendations

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

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Recommendations

 The registered manager must develop and maintain a model of staff supervision in the home that consistently enables staff to reflect on their practice as well as to reflect and act upon how their own feelings and behaviour may be affected by the behaviour of the children they care for. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2, and page 39, paragraph 8.15)

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Recommendations

 The registered manager must ensure that record-keeping in the home is consistently carried out in accordance with a clear policy and to a good standard. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)

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Recommendations

 The registered manager must ensure that the record of restraints enables proper review of the use of control, with particular reference to the experience of the child as well as the user. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

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Information about this children's home

The home provides short breaks for up to five children at a time who have severe learning disabilities and who may have an associated physical disability and/or present challenging behaviour. Currently, there are 49 children registered with the service. The local authority, primary care trust and clinical commissioning group fund the home.

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Recent inspection history

Inspection date Inspection type Inspection judgement 02/02/2016 Interim Declined in effectiveness 09/09/2015 Full Requires improvement 04/03/2015 Full Adequate 05/08/2014 Interim Sustained effectiveness

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Good

When children come to the home, they are received by staff who are pleased to see them and have a good understanding of their individual needs.

p.6

Good

Children are familiar with the layout and facilities in the home, which are adjusted when appropriate to meet their specific interests and safety needs. They are encouraged to personalise their chosen bedrooms for each stay. These factors help children to settle quickly and feel a sense of belonging.

p.6

Good

Staff display an affinity for and interest in children who have complex needs, and celebrate their uniqueness. They are motivated to develop their understanding of how each child experiences the world, and to improve the quality of their communication with them.

p.6

Good

Children’s records include vivid pen pictures that demonstrate staff’s insight into the children’s inner lives. This understanding helps to reduce frustration for children and to make them feel accepted. The children observed appeared happy and contented, and warm and caring relationships between staff and children are evident.

p.6

Good

During stays, children are able to access their schooling with little interruption because staff make clear arrangements and communicate effectively with schools, parents and carers. This enables smooth transitions and minimises disruption to learning.

p.6

Good

Children increase their competency in self-care and life skills because they are helped to set achievable goals for stays, and are supported and encouraged by staff who provide appropriate incentives to achieve targets.

p.6

Good

A wide range of stimulating and enjoyable activities inside and outdoors at the home, as well as in the community, help children to have fun and expand their understanding and experience of the world.

p.6

Good

Stays are arranged to support and encourage the development of social skills and rewarding friendships through repeat group stays of compatible children. This contributes to them looking forward to stays and to developing long-term relationships outside their families.

p.6

Good

New referrals to the service are considered carefully, and when appropriate, children are introduced to the full service, at a pace with which children and carers feel comfortable. This helps to reduce anxiety, and promotes a positive experience for children, parents and carers.

p.6

Good

Although individual preferences are respected, children are also encouraged to expand their range of food choices, particularly to more healthy options when appropriate. New choices are celebrated, and families are informed of all significant progress and development that children make.

p.7

Good

The home maintains close contact with parents, carers and schools and key information is shared regularly. This facilitates continuity of care and enables the progress that children make to be transferred across all settings. Home visits are conducted for newly referred children, and also when this is required to improve the progress and well-being of children in the service.

p.7

Good

Staff are well-tuned to any issues that may pose a risk to the safety of each child. Detailed care plans guide staff in being proactive in averting circumstances that could lead to children’s safety and well-being becoming compromised. This helps to keep children safe and contributes to a positive stay.

p.7

Good

The registered manager and her staff display an uncompromising approach to the safety of children. For example, during this inspection period the home was closed for a week when a fire safety control panel was found to be faulty. This action was taken at a time when demand for the service was high, and required firm and clear leadership.

p.7

Good

Thorough planning and finely tuned risk assessments help staff to protect children from self-injurious behaviour. Medication regimes for each child are confirmed independently with general practitioners, and medication administration procedures are followed scrupulously. Medication errors are very rare, but when these occur they are taken very seriously and result in decisive management action. The specialist needs of individual children are met through targeted staff training by health professionals.

p.7

Good

Staff are vigilant and protective towards the children who use the service, and have undergone specialised training in the safeguarding of children who have disabilities. They display rigour and clarity in their safeguarding practice, and will raise and escalate any concerns about the safety and well-being of children before, during and after stays readily and appropriately. Body maps are completed routinely to record all visible marks and injuries, and any concerns are followed up appropriately. This helps to keep children safe and to monitor their well-being, both during and between stays.

p.7

Good

Risk-reduction plans are in place for each child, and these guide staff in helping children to increase their resilience and their capacity for self-protection. Staff recognise the vulnerability to sexual exploitation of children who have complex needs, and will take appropriate action should concerns arise.

p.8

Good

Physical intervention is applied sparingly, and with great care and consideration, and is usually employed to prevent or reduce self-injurious behaviour. Actions taken are proportionate and in accordance with regulation.

p.8

Good

Consistently safe care is provided for children who have complex health and nutritional needs through highly attentive care and the specialised training of staff. Children do not come for stays until the registered manager and staff are satisfied that everything is in place to meet a child’s needs.

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Good

Although children do not go missing from this service, due to the high level of supervision, staff are alert to this possibility and the required procedures are in place.

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Good

Staff recruitment is of a good standard and great care is taken to select candidates who not only understand the nature of this specialised care but who also feel drawn to this setting. Safe recruitment is practised, and induction and probation procedures are followed. This helps to protect children from exposure to unsuitable adults, and also helps to ensure the employment of committed staff who are likely to provide a good quality of care.

p.8

Good

The service is led by an experienced and qualified manager who is in the process of registering with Ofsted. Her leadership is strong and clear. Since the relaunch of the service in mid-2016, she has engaged in a systematic process of rebuilding a permanent, core staff team that is skilled and committed to providing a consistently high quality of care for children who have complex needs. This process is now in its final stages and the use of part time bank staff has reduced considerably.

p.8

Good

Groups of children who have highly variable needs at different levels are able to consistently enjoy and profit from stays through the carefully planned and selective use of the staff pool. This ensures that the required skills and knowledge are matched to the needs of each group. The registered manager displays a good understanding of individual staff skills. The staff’s training and development needs are addressed systematically in order to maintain a workforce that is consistently able to provide a good level of care. Unscheduled, specialised training is also commissioned when required – for example, for particular medication, feeding or hygiene regimes for individual children.

p.8

Good

Various systems are employed to monitor the success of stays. This includes seeking feedback from professionals, parents and carers. Learning from experiences, both positive and negative, is a strength of this service.

p.9

Good

Efforts to rebuild this service in a short space of time while adhering to requirements has, however, led to some over-complications and duplication in recording and administration practice. This has placed additional burdens on staff and has detracted from their efforts to focus on the care and experience of children. Consistency in record-keeping has also not yet been achieved, including providing debriefing details in restraint recording.

p.9

Good

A positive team-work ethic is apparent in this service, and staff display a positive and committed attitude towards changes and new developments. Staff comments included: ‘There has been a complete change here.’ ‘I feel positive and more settled but it’s still a work-in-progress.’ ‘There is a team now and we work together.’ ‘We have a plan now, a goal.’

p.9

Good

Staff receive supervision, but consistency in quality and frequency has not yet been achieved. Other practices for supporting staff and promoting team cohesion, such as regular staff and planning meetings, are in place and are helping to build resilience and consistency in the service.

p.9

Good

The registered manager and staff maintain good communication with parents and carers, whose views are sought regularly through various mechanisms, including questionnaires and annual surveys. They consistently express confidence in the service, and peace of mind when their children stay. One parent said, ‘It has been a difficult year but things seem really settled now.’

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Good

Parents expressed appreciation for the flexibility and commitment shown by the service during the closure due to the faulty fire safety equipment. This was in response to day outings in the community arranged by staff for some of the children affected by the closure.

p.9

Good

The provision’s statement of purpose is under review. This process is engaging leaders and staff to refine and clarify the objectives and ethos of the service, and communicate these to users effectively.

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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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