Children's Home run by The Together Trust in Stockport

children and young people since the most recent full inspection

This home was judged good at the full inspection. At this interim inspection, Ofsted judges that it has sustained effectiveness . Children usually settle very well at the home because their placements are well planned in advance of their first overnight stay. The home gathers detailed information, which informs comprehensive placement plans and assists staff to meet each child’s individual needs. Children get to know the home by visiting over a period of time, initially with their families. They develop confidence in the staff team and only stay overnight when parents, professionals and, where possible, children themselves agree they are ready. One child has begun to have short stays since the last inspection. He has settled in well. Person-centred placement plans give staff comprehensive guidance and clear targets, which support them to provide good-quality, individualised care that focuses on supporting children to enjoy their time at the home and to develop their

p.2

children and young people since the most recent full inspection

independence. This is in accordance with a recommendation made at the last inspection. Children have a lot of fun. They enjoy activities and outings in accordance with their own interests. These range from trips to the seaside, theme parks and Christmas markets, to playing on the trampoline or the computer at the home. Some children particularly enjoy time in the sensory room, while others like doing arts and crafts and messy play. Consultation with children has significantly improved and is central to the home’s practice. Staff meet with each child, usually once a month, and help the child to express their wishes and feelings, including which bedroom they wish to sleep in, which staff they would like to support them and what activities and meals they would like. Staff successfully use social stories to help children plan their time, understand safeguarding matters and encourage the development of independence

p.2

children and young people since the most recent full inspection

skills. Better communication between staff ensures that staff who are supporting a particular child clearly understand what aspect of the child’s behaviour or skills they are working to improve. Since the last inspection, and in accordance with a recommendation made, the staff team have been trained to use sign language and have further developed their skills in using picture symbols as a method of communicating with children. They practise their new skills in team meetings and recognise that they are developing a much better understanding of children’s needs and wishes. Consequently, children are more relaxed and are pleased that staff can understand what they are telling them. For example, one child used symbols to explain to staff that he was in pain and needed medicine. This meant staff could administer his medicine and reduce his pain sooner. Another child used sign language to tell staff what he wanted to eat in a restaurant. He was very pleased when staff understood

p.2

children and young people since the most recent full inspection

him and this has encouraged him to share his thoughts and feelings more with staff, who can now understand him better. The home recognises it needs to do more to meet its ambition of being a total communication environment. For example, managers are striving to ensure that signing is better embedded with all children, so that children can learn to interact better with each other. Overall, parents express satisfaction with the quality of care, which they describe as good. Parents are particularly pleased that their children like going to the home and are happy there. Consultation with parents is improving and parents report that staff are responsive and listen to them, are careful about matching children, and provide good-quality care. Staff agree individual goals for children with parents and these inform their placement plans. The home is increasingly providing parents with feedback after their child’s stay, either verbally or in writing. This practice is

p.3

children and young people since the most recent full inspection

not yet fully embedded and some parents say the home is not yet good at providing information about the whole of a child’s short break. For example, staff do not routinely report on children’s food intake or bowel movements, even when these are pertinent issues to report on for a particular child. Two children have left the home since the last inspection. Both have been very well supported by the home to have a successful transition. For a child who had visited the home over several years, the home provided a photograph album, recording the child’s journey and his positive experiences at the home. This is a lovely gift that helps the child to remember the happy times he had at the home. Managers intend to provide similar albums to others who leave in the future. Management overview of children’s experiences and progress is extremely good. Strong and improved management systems enable effective monitoring of

p.3

children and young people since the most recent full inspection

children’s progress, experiences and outcomes. These provide useful information that enables managers to detect patterns and trends and to take action to address any emerging concerns. In addition, managers audit each child’s file every three months, thus ensuring that files are up to date and children’s progress is being properly documented. Staff develop good relationships with children and get to know them very well, over time. They receive good guidance from the organisation’s psychotherapist. This helps them to better understand children’s complex behaviour and to reduce obsessive behaviour. Other professionals, such as a speech and language therapist and an occupational therapist, have recently become involved in training and advising the staff team. Staff are enthusiastic about their involvement, and the positive difference it is making to their day to day engagement with children. For example, staff are managing children’s behaviour better. They recognise triggers

p.3

children and young people since the most recent full inspection

that cause children to become anxious and, at times, aggressive, and are intervening earlier and using distraction more purposefully and effectively. The use of restraint has reduced in line with improvements in the staff team’s ability to communicate with and understand children who are non-verbal. Restraint records are mostly well recorded and indicate that most restraints relate to children being guided away from harmful situations. Occasional shortfalls in restraint records are reported by the independent visitor and action is taken to improve this. There have been four errors in the administration of medicines since the last inspection. Errors have been quickly recognised and addressed due to the good auditing systems in place. No children have suffered harm as a result. The home investigates each error and takes action to review and improve practice and to retrain staff who have made the error.

p.3

children and young people since the most recent full inspection

The few notifiable incidents that have occurred at the home since the last inspection have been well addressed and managed. The home has taken robust action to improve children’s safety. In addition, it has worked with safeguarding agencies and placing authorities and has effectively protected children whose safety in their own homes has been compromised. It has provided emergency short breaks to several children to reduce stress in the family, and has provided an extended stay to a child when care proceedings were initiated. The home appropriately supported the child through transition to a permanent placement. Its intervention provided the child with stability and security in a familiar setting at a time of crisis in the child’s life. The home works well with partner agencies and parents. For example, staff visit children’s schools and, as far as possible, ensure that intervention strategies and communication methods are replicated. At times, staff advise schools on

p.4

children and young people since the most recent full inspection

appropriate and successful ways of working with particular children. This reduces possible confusion and anxiety for children and helps them to develop confidence. Staffing levels are high and most children have one-to-one or two-to-one support, in accordance with their particular needs. This helps to ensure that children have a positive experience and their individual needs are well catered for. Two new staff members have joined the home since the last inspection and agency staff provide additional support, as required. Recruitment files for agency staff are not well maintained. They are not kept in accordance with regulation. They do not demonstrate that agency workers have the required knowledge and skills, or have been appropriately trained to support and manage the behaviour of children with autistic spectrum disorder. The requirement made at the last inspection to address this has not been met. This

p.4

children and young people since the most recent full inspection

means that children are sometimes cared for by staff who may not have a good understanding of their needs. These staff work alongside permanent staff so they are not left in sole charge of a child. This reduces the impact of their lack of expertise. The amount of staff training provided since the last inspection is disappointing. For example, there are gaps in mandatory training, and plans to ensure that all staff receive training in looking after children with autistic spectrum disorder, and helping them to understand how to stay safe from grooming and sexual exploitation, have not yet come to fruition. Although training programmes are being developed, progress is slow. This means that children are looked after by staff who do not all have a basic understanding of the challenges of having autistic spectrum disorder. To mitigate against the lack of training, staff are using recognised workbooks to increase their knowledge and understanding, and

p.4

children and young people since the most recent full inspection

managers are working individually with staff in one-to-one supervision sessions, which is helping them reflect on their own learning. The statement of purpose is a lengthy, generic document, covering all of the homes run by the provider. Consequently, it does not give a good flavour of the service offered by this particular home. It has been reviewed ten times since the last full inspection and updated copies have been sent to Ofsted. However, the home does not notify Ofsted of what changes have been made to the document, which makes it difficult for the regulator to assess the appropriateness of any changes to the service. This does not impact on the quality of care to children. A stairgate blocks some children’s access to communal areas on the top floor. Lockable cupboards have recently been installed on the landing for the storage of children’s belongings. This is institutional practice and is not based on risk

p.5

children and young people since the most recent full inspection

assessments of whether children are able to use the stairs safely, or to have their clothes and possessions in their bedrooms. Most toys are stored in the basement and are inaccessible to children, unless staff bring a small selection into the communal areas for a child’s use. These practices undermine the home’s otherwise good work in helping children to make choices.

p.5

Information about this children’s home

The home provides short breaks for five children who may have physical disabilities and/or learning disabilities. It is run by a charitable organisation.

p.6

Recent inspection history

Inspection date Inspection type Inspection judgement 01/09/2016 Full Good 05/02/2016 Interim Sustained effectiveness 05/11/2015 Full Good 21/01/2015 Interim Not judged

p.6

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 within the given timescales.

p.7

Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. (2) The registered person may only— (b) if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3). (3) The requirements are that— (a) the individual is of integrity and good character; (b) the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; (c) the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and (d) full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. In particular, this relates to the employment of agency staff.

p.7

Requirement Due date

The registered person must— (b) notify HMCI of any revisions to the statement of purpose and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16) 12/03/2017

p.7

Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child. In particular, this relates to training both permanent and agency staff members to understand and meet the needs of children with autistic spectrum disorder. (Regulation 13 (1)(2)) 28/04/2017

p.7

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation(s):  Ensure that the home provides a homely, domestic environment as far as possible, rather than an institutional environment. Just as in a family home, ensure that children can easily access all shared areas of their home, unless there are specific reasons why this would not meet a child’s needs. Any decision to limit a child’s access to any area of the home, and any modifications to the environment of the home, must only be made with the intention of safeguarding the child’s welfare, and should be informed by a rigorous assessment of that child’s needs, be properly recorded and kept under review. In particular, this relates to decisions about the use of the stairgate and storage of children’s clothing in the locked cupboard on the landing. (The ‘Guide to the children’s homes regulations including the quality standards’, page 15, para 3.9, 3.10)

p.8

Recommendations

 Ensure that each child’s talents and interests are understood and nurtured. In particular, enable children to select activities based on their personal preferences and abilities by offering them, where appropriate, a choice of activities inside the home. This relates to allowing those children, who will not be distressed by it, to choose toys and games to play with. (The ‘Guide to the children’s homes regulations including the quality standards’, page 31, para 6.4)

p.8

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.9

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.9

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 0300 123 4234, or email enquiries@ofsted.gov.uk .

p.9

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 children looked after 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.10

Information about this inspection

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

p.10

Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates at http://eepurl.com/iTrDn .

p.10

Information about this inspection

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

p.10