Children's Home run by Barnardo’s in Oxfordshire

Good

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

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The children’s home’s provision is good because:

 New young people, along with their parents, are very well supported to become familiar with the home and staff. Young people settle quickly into their series of short-break stays.  There is effective planning for young people’s care in conjunction with other agencies.  Staff communicate well with young people and ensure that their wishes and feelings are known and understood.  Young people develop very good relationships with staff and are comfortable being cared for by them.  Young people have fun during their short-break stay and learn new skills.  Nursing and care staff are competent in meeting young people’s health needs, some of which are very complex, effectively.  Staff understand the risks posed to young people due to their highly complex needs and ensure that they are kept safe and protected from harm.  Staff work effectively with parents and other agencies and professionals to ensure that young people are provided with a high quality of care.

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The children’s home’s provision is good because:

 Staff are confident and competent in their roles. They are highly child- focused and ensure that young people’s best interests are met.  Leadership and management are strong, and they support and lead the staff team effectively.

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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.

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Requirement Due date

35. (3) The registered person must ensure that: (a) within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes: the name of the child; details of the child’s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (‘the user’), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’): has spoken to the user

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Requirement Due date

about the measure; and has signed the record to confirm it is accurate; and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(i) to (vii)(b)(i)(ii)(c)) This is with specific reference to ensuring that all records cover the above points or where they do not recording the reasons why this has not been possible. 13/03/2017

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Requirement Due date

16. (1) The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in Schedule 1. (3) The registered person must: (a) keep the statement of purpose under review and, where appropriate, revise it; and (b) notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (1)(3)(b)) 13/03/2017 The registered person must ensure that an independent person visits the children’s home at least once each month. The independent person must produce a report about a visit (‘the independent person’s report’) which sets out, in particular, the independent person’s opinion as to whether: children are effectively safeguarded; and the conduct of the home promotes children’s well-being. (Regulation 44 (b)(3)(a)(b)) 13/03/2017

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (3)) 13/03/2017

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 13/03/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

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Recommendations

 The registered person should evidence what they have done to obtain important information from the local authority such as the results of review meetings and transition planning meetings, including any actions taken to escalate concerns. (‘Guide to the children’s homes regulations including the quality standards’, page 11, paragraph 2.3)

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Recommendations

 Document how the registered person has worked 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 the children’s homes regulations including the quality standards’, page 57, paragraph 11.9) This is with specific reference to young people who are moving on to adult services.

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Recommendations

 When the home has questions or concerns about a child’s medication, they should approach an expert, such as a general medical practitioner, community pharmacist or designated nurse for looked-after children. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.15) This is with specific reference to ensuring that any advice given is clearly recorded.

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Recommendations

 Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4) This is with specific reference to ensuring that records of incidents, for example, are clear and easily understood.

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Recommendations

 As set out in regulations 31-33, the registered person is responsible for maintaining good employment practice. They must ensure that recruitment, supervision and performance management of staff safeguards children and minimises potential risks to them. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1) This is with specific reference to ensuring that all referees are contacted to verify the content of the reference they have provided.

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Information about this children’s home

The service caters for a maximum of seven children and young people at any one time, including one emergency bed. It provides a residential short-break service and a domiciliary care service that is registered with the Care Quality Commission. The service is provided by a national charity in partnership with a local authority and a primary care trust. Children and young people can therefore be provided with care and health packages. Most of the children and young people using the service have complex health needs, or have autistic spectrum disorder and associated challenging behaviour.

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Recent inspection history

Inspection date Inspection type Inspection judgement 31/05/2016 Interim Sustained effectiveness 28/10/2015 Interim Sustained effectiveness 19/05/2015 Full Outstanding 10/02/2015 Interim Sustained effectiveness

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Good

The arrangements for supporting families commencing a service are good. Introductions to the service are taken at the young person’s and their parents’ pace. A number of visits to the home are arranged before a young person stays overnight. These visits help the young person to get to know the staff, the surroundings and the routines in the home. Staff learn about the young person’s needs, likes and dislikes and are well prepared to care for the young person effectively. A professional said, ‘Staff seek additional advice and support as necessary from partner organisations to make sure that they can meet all the young person’s needs.’ A parent whose child has recently started staying at the home said, ‘They (the staff) have been brilliant, they have welcomed me into the home, let me stay until she settles and gradually got her used to being there. They offered me a room to stay for her first overnight so I could stay until she settled.’

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Good

Planning for visits is undertaken with due care to ensure the compatibility of young people sharing time in the home. A professional said, ‘I'm aware consideration is given to the cohort of young people staying at the same time taking into consideration their wide and varied needs.’ Thought is also given to arranging stays for young people who know and like each other or who share interests so there is the potential for friendships to form. A young person said that she has made new friends during her stays.

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Good

Young people build trusted relationships with the staff who care for them. A professional said that young people they work with talk fondly about individual staff who work with them in the home and a young person said they love going for their stay with the staff.

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Good

Some young people have significant and complex behavioural needs. Careful care planning ensures that young people’s needs are identified. Staff understand how young people’s difficulties, such as those relating to autism, have an impact on their behaviour. They plan well for this and use strategies known to be effective with each young person to minimise their more distressed behaviour.

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Good

Good attention is given to ensuring that young people can make their wishes and feelings known. Staff are skilful in using a range of communication systems, such as picture formats and they are good at interpreting children’s non-verbal cues. Because young people know that they are understood and their wishes are acted upon they feel that their views are valued.

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Good

The environment is welcoming and has been well planned. It provides a good balance between offering an interesting and stimulating space to play in and learn new skills and calmer spaces for young people who have sensory sensitivities. A professional said, ‘Staff ensure a calm environment. The environment is very comfortable and soothing and appropriate for the children they look after. The house has a warm and welcoming feel.’

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Good

There are an abundance of things that young people enjoy doing during their stay. Young people staying there during the inspection were comfortable with staff. They were enjoying taking part in activities of their choosing. One was playing in the ball pool with staff and was thoroughly enjoy this judging by his whoops of laughter and joy, another was relaxing in the jacuzzi with staff and a third was colouring and chatting happily with staff in the dining room. Staff were responsive to the young people and spent good quality time with them.

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Good

Trips out into the community are arranged from time to time so that young people have the same opportunities as their peers to have an evening meal out or to go shopping or for a walk. A parent said that the staff are, ‘Creative about what constitutes a break for teenage children. The staff work really hard to ensure my child is happy and occupied.’ A professional said, ‘The children are provided with stimulating and interesting activities according to their needs so they are learning in a fun way; it’s a fun place to be.’

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Good

Health issues remain the responsibility of the young people’s parents. Young people who have significant needs relating to their physical health have these met effectively during their stay by the nursing and care staff. When young people with significant health needs stay in the home there is always a nurse on duty and at other times there is a nurse on call to support staff to deal with medical emergencies. Staff are trained and assessed as competent to cater for young people who require complex medical interventions, such as gastrostomy feeding or those relating to respiratory difficulties. A health professional who works with the home said, ‘Staff are very good at identifying if extra training for health issues is needed. There is good liaison with the community children’s nursing team.’ They went on to say that staff have a good level of understanding of children’s complex health needs and have worked very well to support a child with palliative care

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Good

needs and who required complex medicines and respiratory support.

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Good

There have been two medication errors since the last inspection and these have been responded to seriously. Measures have been put into place to prevent further errors of the same kind. The record made of one of the errors was not comprehensive and was muddled. The record did not set out what had occurred, and while it identifies that medical advice was sought there is no record of the guidance given. Medication is carefully booked into the building when a child arrives and it is safely stored.

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Good

Education remains the responsibility of the young people’s parents but staff ensure that young people get to school in the morning. Their care plans include targets that have been set for them by their education provider. This provides a consistency of approach to support young people’s progress.

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Good

The staff work well to support the young people moving on to other services that will meet their needs more effectively. For example, they have worked well with a residential school to ensure that they had the equipment and knowledge about a young person’s needs prior to his move. They welcomed the school staff, the child’s parent and the social worker into the home so that his needs could be discussed, and held a leaving party for him so that he had a positive ending.

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Good

At the last inspection, a recommendation was made regarding the planning and arrangements for young people moving on into adult services. There have been no young people in this category since the last inspection so the recommendation has been restated and will be evaluated at the next inspection.

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Good

Overall, working with parents is a strength of the service. One parent said that the staff are ‘brilliant’. A social work manager said that parents are very appreciative of the service. Another professional praised the staff for the support they give to parents who are anxious about their child staying. This professional said, ‘The short breaks are a lifeline for caring families who want to do the majority of the care but need a regular break.’ They went on to say that parents feel their child is being excellently cared for and is having a great time during their stay and that they were, ‘Convinced that there would be more family breakdown among these families if we did not have this excellent service.’

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Good

Parents spoken to said that they were confident that their children are safe during stays and that their complex needs are understood by staff. A professional working with young people who use the service said, ‘The welfare of the children in the broadest sense is paramount for the staff.’

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Good

The work with the young people is underpinned by detailed risk assessments that are known to staff and parents and now clearly set out descriptions of young people’s behaviours that are of concern. A professional said, ‘When children may on occasions display risky behaviours the team works with other services to ensure a consistent approach and response.’ Another professional said, ‘It is a minority of children who attend the home who are able to protect themselves, but protective behaviours work is undertaken with those who have the cognitive ability to benefit.’

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Good

Behaviour management plans provide staff with clear guidance about how to prevent disruptive and dangerous behaviours occurring. Staff use these strategies effectively to minimise the impact of behaviours such as self-harm and violence. A professional said, ‘Antisocial behaviour is managed appropriately with an understanding that some children do not have the capacity to understand that their behaviour is antisocial.’

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Good

The use of physical intervention in the home is low and only used when necessary to safeguard people or property. The quality of the records made and maintained is variable and not all contain all required information as set out in the regulations.

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Good

Staff work closely with the local authority in supporting families who are experiencing problems and may be subject to a support or protection plan. This work has improved some families’ circumstances and in turn enhanced the well- being of these young people, for example in relation to their physical health and personal hygiene.

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Good

Safeguarding issues are taken seriously and referred to the appropriate professionals. Staff have a good knowledge and awareness about how to deal with child protection issues. They know how to to refer concerns, and understand the role of the professionals within the local authority who have the responsibility for dealing with safeguarding matters.

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Good

Staff recruitment overall ensures that staff are suitable to be working in the home. Not all references are verified to ensure the authenticity of the referee and the contents of the written reference. This means that an opportunity to scrutinise information about an applicant is missed. Visitors to the home are required to sign in and out of the building and to have a valid reason for their visit.

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Good

The premises are maintained to a high standard. Regular health and safety checks of the premises and fixtures and fittings are carried out and deficiencies are dealt with effectively.

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Good

The manager has been in post since 2011 and is registered with Ofsted. She is a qualified nurse and holds the required level 5 qualification in management.

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Good

The work of the home is underpinned by a statement of purpose that sets out the aims and objectives and what people can expect from the home. Ofsted has not been provided with copies of the most recent statement following it being updated in June 2016. Interagency working is strong and team managers from the local authority describe the manager and her staff as having a flexible and open relationship with them and the manager as being, ‘A person that finds solutions to problems.’

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Good

A recommendation made at the last inspection about the quality of the monitoring reports made by the manager has been met. These reports now include clear action points and are more evaluative. There are arrangements for monitoring the quality of care in the home by an independent person who visits and makes a report monthly. The reports of these visits lack evaluation and do not provide the reader with a clear view about the visitor’s opinion as to whether young people are safeguarded and whether their well-being is promoted.

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Good

There are low levels of complaints made and these are taken seriously and investigated thoroughly. However, the records of the investigations were incomplete. It was stated that the findings of complaints are discussed with staff and used to inform future practice, but in one case there was no evidence that this had occurred.

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Good

There has been some instability in the staff team. A number of staff have left, some are on long-term sick leave and some are on maternity leave. This situation has been difficult but has been well managed to ensure that the impact on young people has been limited. Shifts have been covered by staff known to young people, for example bank staff and part-time staff working additional hours.

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Good

There have been some new staff recruited and they say that they have felt well supported and that they feel part of the team. Likewise, longer-standing staff said that they feel well supported by the managers through good quality supervision, regular team meetings and generally because they feel able to approach the managers should they want to discuss any issue. A parent said, ‘The staff have a can-do attitude, which is very energising for everyone. I have witnessed first-hand the team working to ensure that staff are on duty at the times of the young people they know well… it is the quality of the staff that is outstanding.’

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Good

Staff training is of a good quality and ensures that the staff team is able to care for the young people’s varied and complex needs effectively. All staff hold a level 3 qualification in caring for children or are studying for one.

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Good

While any significant incidents are dealt with effectively, not all have been notified to Ofsted. This means that the regulator has not been able to monitor that the actions taken have ensured that young people have been kept safe.

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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 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 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, 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,

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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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