Children's home run by Northamptonshire Healthcare NHS Foundation Trust in North Northamptonshire

Inspection report children’s home: SC465279 1 SC465279 Registered provider: Northamptonshire Healthcare NHS Foundation Trust

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is a six-bed, residential short-break service managed by a healthcare foundation trust for children with learning disabilities.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

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

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good

Date of last inspection: 11 January 2017

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good

Overall judgement at last inspection: Improved effectiveness

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good

Enforcement action since last inspection: None

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Key findings from this inspection

 Children develop positive relationships with staff and peers that support them to enhance their social skills and enjoy new experiences.  Children are cared for in a safe environment, they receive structured care and benefit from familiar routines.  Children are supported to achieve goals that are linked to education targets. Inspection report children’s home: SC465279 2 Their life skills are enhanced.  There is an experienced and stable staff group. Staff are supported to develop their own skills and knowledge.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 The manager should ensure that all staff understand policies and procedures in respect of reporting and responding to allegations against staff who work with children.  The manager should ensure that all staff understand regulations and procedures in respect of notifying HMCI and relevant persons about serious events, including allegations against staff who work with children.  There should be regular opportunities for the registered manager to receive formal supervision.

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Inspection date Inspection type Inspection judgement

11/01/2017 Interim Improved effectiveness 31/08/2016 Full Good 09/02/2016 Interim Improved effectiveness 13/10/2015 Full Good Inspection report children’s home: SC465279 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet 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

(2)(a)(vii) The registered person should ensure that staff should be familiar with and act in accordance with the home’s child protection policies. 26/05/2017

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Requirement Due date

(4)(c) The registered person must notify HMCI and each other relevant person without delay if there is an allegation of abuse against the home or a person working there. 26/05/2017

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Recommendations

 The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice, from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2.)

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Overall experiences and progress of children and young people: good

This home provides good quality short breaks for children and young people who have autistic spectrum disorder. The home provides a child-friendly environment that is tailored for the needs of children who have autistic spectrum disorder. The bedrooms are decorated and arranged to provide a low stimulus environment. Children are encouraged to choose personal items that will support their stay. Communal areas are accessible. They include photos of the children enjoying activities, and artwork by the children and staff. There is a sensory area and a large garden that has been improved by volunteer parents and staff. The Inspection report children’s home: SC465279 4 atmosphere in the home is calm because care is delivered in a planned and structured way. All children experience a planned admission to the home. Staff visit the family home to ensure that parents and carers have all relevant information about the service, and

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Overall experiences and progress of children and young people: good

expectations are discussed. Children visit the home prior to an overnight stay. In this way, staff have all essential information prior to a child arriving for a short stay, parents are confident about the care that their children will receive, and children are supported to settle and feel safe. The home has very clear routines. When children arrive for their short break there are schedules prepared that include photos and pictures. These explain the room they will be sleeping in, which member of staff is working with them, and any targets that they are being supported to achieve during their stays. There is also a schedule in their room about night-time routines. Their room will be ready with favourite bedding and familiar soft toys, if appropriate. Predictable routines, and the provision of clear information by staff, mean that children experience positive transitions and feel secure. Staff ensure that children’s placement plans include information about their culture and

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Overall experiences and progress of children and young people: good

identity and their preferred way of communicating. Staff also ensure that they have health information to inform healthcare plans. Healthcare plans include any changes to medication or health needs for each stay. Staff have up-to-date information about health professionals involved in the child’s care. Staff are also able to confirm information within the health trust if necessary. This means that when children come to stay, their health needs are known and they receive medication as required. Staff are proactive in responding to children’s health needs. For example, staff followed up with the school nurse about a child’s reactions to medication. This has resulted in changes to the timing of his medication. This has had a positive impact on his behaviours. There are clear policies and procedures for staff to book in and administer medication for each child. Practice is quality assured by the managers during weekly and monthly audits

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Overall experiences and progress of children and young people: good

and at every monthly visit by the independent visitor. As a result, there are very few errors, and none that have had an impact on the health or well-being of children. Staff ensure that they have all of the relevant information about children’s dietary and nutritional needs as well as their likes and dislikes. Staff have developed placemats for each child which have key information, such as allergies, as well as child-friendly favourite pictures. These encourage children to respond positively to mealtime routines. Good sharing of information with parents and carers also applies to sleep routines. All bedtime routines are followed to minimise disruption to children. Staff have also supported parents to improve sleep routines for the children by feeding back observations and advice about what works during a short stay. Staff have contact with each child’s school prior to short breaks, so that school staff are

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Overall experiences and progress of children and young people: good

aware of the child’s stay and can share relevant information about each child’s abilities and areas for development. School staff can supplement information with home staff when necessary. Staff attend and contribute to school progress meetings and education planning meetings. They identify targets or goals with children and families. This means that children are well supported to make progress. Inspection report children’s home: SC465279 5 Staff regularly consult with children and families about the service they are providing. Staff consult with children, using each child’s preferred method of communication, to update views about activities, menus, and key staff. The inspector observed a consultation session with the member of staff using pictures and sign language. She skilfully engaged the child, who was initially distracted. She was able to elicit his views about why he liked to visit the home, what he liked to do most when he was there and

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Overall experiences and progress of children and young people: good

what he did not like doing. These views will inform his placement plan and are regularly updated. This is working very well and a parent commented that her child was participating in ‘lots of activities including things he has not tried before’.

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How well children and young people are helped and protected: good

Staff and managers are aware of the additional vulnerabilities and safeguarding needs of disabled children. Each individual placement plan includes detailed risk assessment and risk management plans. These are useful working records for staff because they are regularly reviewed and updated as new information emerges. They support staff to measure risk and respond appropriately. They provide advice about what may work and what does not help in responding to behaviours. For example, one plan detailed the risk of a child eating non-food items. It referred to likely scenarios, how to distract and how to carefully monitor in order to reduce and manage the risk. Children’s records include detailed body maps for each stay, so that staff can record and respond to any marks. One child staying in the home during the inspection displayed self-harming behaviours. Staff explained how they carefully and sensitively record and

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How well children and young people are helped and protected: good

check out any marks, so that assumptions are not made and safeguarding risks are carefully monitored. For some children, it is agreed with the case-responsible social worker that chronologies are maintained so that patterns in behaviours or concerns can be identified. Staff consistently use positive reinforcement in their interactions with children. Staff are all trained in behaviour management techniques, which can include low-level physical interventions. Staff are skilled at assessing each child’s mood and levels of anxieties, and ensuring that strategies are in place to distract children and reduce the potential for aggressive or harmful behaviours. Each behaviour management incident is recorded and then reviewed by a member of the management team. As a result of effective interventions and planning there have been no physical restraints and a low number of incidents. These are also reviewed by the independent visitor monthly to provide an

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How well children and young people are helped and protected: good

additional level of scrutiny. Staff carefully monitor peer relationships and friendships. A significant part of the admission process includes assessing children’s likes, dislikes, abilities and tolerances. This informs decisions about which children have stays together, to encourage positive relationships and experiences. Children who have previously been isolated as a result of their needs and behaviours develop positive relationships and are supported to take part in activities with peers. Each child has emergency information prepared. This includes an up-to-date photograph, and clearly outlines individual vulnerabilities and medication needs. Staff are Inspection report children’s home: SC465279 6 familiar with missing child procedures and all know how to respond to unplanned events, such as an emergency health need. They carefully prepare for outings and activities. As a result of careful monitoring, high staff ratios and detailed planning when children are

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How well children and young people are helped and protected: good

going out, no children have gone missing. The home is subject to daily health and safety checks and maintenance checks to ensure that it is a safe environment. Some children require a level of audio monitoring at night. These arrangements are subject to consent from carers and social workers and are regularly reviewed. The manager adheres to robust recruitment procedures, as part of the health trust. There has been a recent allegation made about a member of staff. There was a delay in the reporting of this to the designated officer and a delay in notifying HMCI. Because the member of staff had not been in work during this time, there was no impact on the safety or welfare of children as a result of the delay. An investigation is now being undertaken as agreed with the designated officer. The manager has learned lessons from this incident, and is revisiting training and arrangements for seeking advice out of

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How well children and young people are helped and protected: good

hours with all staff. Requirements are made about staff and managers adhering to child protection procedures and notification regulations.

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The effectiveness of leaders and managers: good

The registered manager is experienced and suitably qualified. She has recently gained a practice assessor’s qualification. This will provide capacity within the service to support staff to complete care qualifications in a timely way. The management team continues to work well together. They complement each other in skills and experience, and share aspirations for the children, the staff and the service. The stable staff group benefits from regular supervision and training opportunities. There has been a change in senior management arrangements, which has resulted in reduced access to supervision for the registered manager. This has had limited impact at this stage. However, if reduced supervision arrangements continue there may be an impact on the registered manager’s professional development and accountability. A recommendation is made to address this. There is a detailed development plan for the service. Managers and staff have continued

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The effectiveness of leaders and managers: good

to develop good practice in consulting with children about their preferences and views. They have continued to develop and improve their understanding of equality and diversity to identify and meet the individual needs of children. Since the last inspection, they have made a good start at developing their practice in supporting children through the transition process to adult services. There is a child-friendly transitions information board identifying the member of staff with lead responsibility, and explaining the aims for supporting the transitions process for staff and families. Staff have received training in transitions and contacts have been made with transitions services. A parent said: ‘I cannot fault the home staff in supporting us at what has been a difficult time. We want to make sure our son receives good services as he goes through this big change. They Inspection report children’s home: SC465279 7

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The effectiveness of leaders and managers: good

have shared information with us and supported us in contacting the right people to help.’ There are a range of quality assurance mechanisms in place to assess the progress children are making and the difference the service is making to children’s outcomes. Families regularly receive questionnaires about the service. Parents and carers are encouraged to use the complaints process and there is a ‘niggles’ process in place to address any concerns at an early stage. There have been no formal complaints from families or professionals since the last inspection. There are a range of communication opportunities and staff have regular contact with families so that any concerns are shared and responded to immediately. A social worker reported: ‘I have been impressed by the accessibility of staff. They provide regular information to me but are also very accessible to families, for example visiting families, and they are flexible in their

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The effectiveness of leaders and managers: good

response to families’ and children’s needs.’ There are monthly visits by an independent visitor who provides detailed reports, covering the home’s practice in respect of meeting regulations and quality standards. The registered manager has reported that these are helpful reports and she responds to the recommendations made. The visits and reports would be strengthened by including timings of visits and consistently involving observations of children’s experiences in the home.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, 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’. Inspection report children’s home: SC465279 8

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Children’s home details

Registered provider address: Sudborough House, St. Marys Hospital, 77 London Road, Kettering, Northamptonshire NN15 7PW

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Inspector

Cathey Moriarty, social care inspector Inspection report children’s home: SC465279 9 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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