Children's home run by Barnardo’s in Redbridge

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 .

p.2

children and young people since the most recent full inspection

Young people enjoy their short breaks. Parents speak highly of the service and standards of care offered to young people. Three parents described how much their children look forward to coming to stay for a short break. They were happy that the staff provide a range of activities for young people to enjoy, both in the home and in the community. One parent commented that staff help her son to develop independence skills; she notices that when he comes back from short- break services he offers to help with tasks in the home such as clearing dishes, hoovering and making his bed. She felt that staff give young people a chance to learn new skills, but are also mindful to allow young people some downtime to relax. All of the parents who contributed their views described how they trusted staff to keep their children safe, administer medications prescribed and communicate any relevant information or concerns.

p.2

children and young people since the most recent full inspection

The young people who have recently started to use the service have all had a thorough introduction to the home. Staff make sure they understand each young person’s individual needs before they stay overnight. They also make sure that short breaks are planned to ensure that each young person stays with a well- matched group of young people. This means that young people stay with others they know and have shared interests with. Young people are closely consulted and involved in choosing the range of activities planned for their stays.

p.2

children and young people since the most recent full inspection

Each young person has a detailed care plan. This contains information provided by parents and relevant healthcare plans. Staff know the young people well and pay close attention to the things they like or dislike. Staff know what may cause a young person to become distressed and also what to do to help reduce their anxieties. This means that young people experience a nurturing environment, and situations that may cause them to become upset are usually avoided.

p.2

children and young people since the most recent full inspection

Young people are well behaved, and staff undertake training to reduce the likelihood of challenging behaviour. When incidents do occur, staff manage these well and calm things down without the use of physical restraint or sanctions.

p.2

children and young people since the most recent full inspection

The service has made progress in addressing the shortfalls highlighted at the previous inspection. All staff have undertaken a three-day first-aid course and are fully qualified first-aiders. The manager acknowledges that this is necessary due to the complex health needs of some of the young people. She has amended the home’s statement of purpose to this effect.

p.2

children and young people since the most recent full inspection

Managers have made progress in accessing education, health and care (EHC) plans for young people. This is to ensure that they have all the relevant information available to inform their care of the young people. EHC plans are not yet on file for all of the young people. On one occasion when the EHC plan was available, not all the information it contained was considered to inform care planning. This is a shortfall identified in the previous inspection, and is not fully met.

p.3

children and young people since the most recent full inspection

Each young person has a detailed risk assessment. This identifies clear strategies to reduce the risk of harm. The vulnerabilities for each young person are well known and understood by staff. This reduces the risk that they will suffer preventable harm. A small number of young people who use the service have complex health needs, and in order to meet their needs staff are trained in gastric- tube feeding and managing epilepsy. Some emergency protocols in relation to epilepsy have not been reviewed recently, and this runs the risk that staff will not be able to follow the correct procedures in the event of an emergency. The moving and handling plans for young people are not always informed by qualified health professionals. This runs the risk of accidents occurring. In practice, staff know the young people well, they have undertaken specialist training and no accidents have occurred as a result of moving and handling.

p.3

children and young people since the most recent full inspection

If necessary, young people have a detailed feeding protocol provided by health professionals. However, staff do not always record in a way that fully evidences that these protocols have been followed in practice. This reduces the capacity for the manager to monitor that practice in this area is robust. This means that if errors occur they may not be detected.

p.3

children and young people since the most recent full inspection

The manager related some challenges in securing specialist advice and support from health professionals within the local authority. This has the potential to undermine the safeguarding culture within the service. It is important that this is rectified to ensure that staff competencies are periodically assessed with the help of qualified health professionals. There have been no safeguarding concerns in relation to the care delivered to young people.

p.3

children and young people since the most recent full inspection

The registered manager of the home continues to make use of effective systems to monitor the quality of care for young people. She undertakes regular audits of recording and seeks feedback from parents, and uses the information gained to inform service development. The staff team is stable, staff know the young people well and the home does not use agency staff. This provides a consistent experience of care for young people. It also ensures that staff have the necessary training, skills and experience to maintain high standards of care.

p.3

children and young people since the most recent full inspection

Staff speak highly of the registered manager. They feel she is supportive, and that she regularly consults them on matters relating to the running of the home.

p.3

children and young people since the most recent full inspection

The physical environment is well maintained and well equipped to meet the needs of the young people who stay there. The short-break service is on the second floor of the building. This presents some challenges in that providing young people access to outdoor areas is not straightforward. Because some young people who use the service have physical impairments, high staffing ratios are maintained in order to be able to safely evacuate the building in the event of a fire. Staff frequently practise fire drills, and carry out checks to ensure that the fire safety equipment is in good order. All young people have evacuation plans to be followed in the event of fire. The manager has recently appointed a member of staff to oversee fire safety. There is, however, a lack of clarity about how checks that relate to the whole building are monitored, and this needs to be resolved.

p.4

children and young people since the most recent full inspection

Young people leaving the service do so in a planned way. This is usually as a result of reaching 18 years of age. When needed, staff contribute to transition plans and help to identify resources for service users to support them into adulthood.

p.4

Information about this children's home

This is a short-break service operated by Barnardo’s children’s charity. It is registered to provide short breaks for up to four children and young people who have physical disabilities, learning difficulties and sensory impairment. Under the terms of their current contract with commissioning authorities, young people have a maximum of 16 overnight stays per year.

p.5

Recent inspection history

Inspection date Inspection type Inspection judgement 03/08/2016 Full Good 04/02/2016 Interim Sustained effectiveness 14/07/2015 Full Good 26/03/2015 Interim Improved effectiveness

p.5

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.6

Requirement Due date

25. Fire precautions (1) After consultation with the fire and rescue authority, the registered person must— (a) take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home; (b) provide adequate means of escape from the home in the event of fire; (c) make arrangements for persons working at the home to receive suitable training in fire prevention; and (d) ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire. (2) If the Regulatory Reform (Fire Safety) Order 2005(a) applies to the home— (a) paragraph (1) does not apply; and (b) the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of

p.6

Requirement Due date

the home. (3) In this regulation, ‘the fire and rescue authority’ means the fire and rescue authority under the Fire and Rescue Services Act 2004(b) for the area in which the home is located. 31/03/2017

p.6

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation(s):  For children who have special educational needs and disabilities, staff must establish whether the child has an EHC plan. If the child does, staff must take account of the health objectives it specifies. (For further information on EHC plans see paragraph 5.4.) (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.6)  Children using short-break provision may have very complex health needs. Staff will need to be appropriately skilled to care for them and understand that safeguards may need to be greater than for other children. In order to meet this quality standard, the provider must ensure that epilepsy protocols and moving and handling plans are informed by health professionals. These should be regularly reviewed and, if necessary, updated. (‘Guide to the children’s homes

p.6

Recommendations

regulations including the quality standards’, page 36, paragraph 7.20)  The specific responsibilities of the home towards supporting the health and well- being of each child should be agreed with the placing authority and recorded in the child's placement plan. It is the joint responsibility of the registered person and the placing authority that this is agreed at the time of placement. In order to meet this quality standard, the home must ensure that health resources are identified clearly and utilised to inform staff interventions in relation to complex health needs. The home’s expectations in this regard should be stated clearly as part of the admission and placement review process. (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.7)  Staff should have sufficient understanding of relevant health services, including the functions of the designated nurse for children looked-after in their area. They

p.7

Recommendations

should support children to navigate these services, advocating on their behalf when necessary and appropriate. In order to meet this quality standard, the home must establish effective partnership with health services to obtain advice and support to ensure complex health interventions are robustly monitored and periodically assessed. (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.8)

p.7

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.8

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.8

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 0300123 4234, or email enquiries@ofsted.gov.uk .

p.8

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.9

Information about this inspection

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

p.9

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.9

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.9