John Greenwood Shipman Centre

Inspection report children’s home: SC465257 1 SC465257 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 12-bedded residential short-break service for children who have learning disabilities and children who have physical disabilities and associated healthcare needs. The service is managed by a healthcare foundation trust and is also registered with the Care Quality Commission, as care arrangements include regulated activities within the healthcare provision.

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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: 12 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 Inspection report children’s home: SC465257 2

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Key findings from this inspection

 Children with a range of complex needs and vulnerabilities receive safe care in this home.  Children are provided with support and opportunities to share their views. Children’s views are informing their stays and their care plans.  Children build positive relationships with familiar staff who know their needs, likes and dislikes.  There is a strong, experienced management team and a suitably skilled and qualified staff team delivering a good service.

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Key findings from this inspection

The children’s home’s area for development

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Key findings from this inspection

 The manager should ensure that there is an effective maintenance system in place to ensure that all areas of the home are safe for children to access and use. This is because part of the garden area was unclean, and a bench required repairs.

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Inspection date Inspection type Inspection judgement

12/01/2017 Interim Improved effectiveness 17/08/2016 Full Good 25/02/2016 Interim Sustained effectiveness 20/10/2015 Full Good Inspection report children’s home: SC465257 3

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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Requirement Due date

12: The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12(1) and (2)(d)) 19/05/2017

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Overall experiences and progress of children and young people: good

This children’s home provides short breaks for children who have learning disabilities and children who have physical disabilities and associated healthcare needs. It provides a comfortable, child-friendly environment that is fully adapted to meet children’s needs. The home is organised into two groups, and following consultation with children these have recently been named Woodside and Lakeside.

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Overall experiences and progress of children and young people: good

Children are admitted for short breaks following a carefully planned process. Staff visit families at home to capture essential information about the child and to share information about the service, the home and expectations about information necessary for each short stay. Families and children visit the home before an overnight break. Social workers share relevant information and up-to-date plans to inform the home’s placement plan. In this way, children are familiar with the home, and all essential information is gathered to ensure that staff can meet children’s needs and know their routines and preferences.

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Overall experiences and progress of children and young people: good

The managers give consideration to matching children’s needs for each stay, to promote friendships, and to take into account children’s abilities and tolerances. Staff and families inform these decisions, feeding back observations of developing friendships, likes and dislikes. This means that children enjoy their stays and are kept safe. Inspection report children’s home: SC465257 4 A child who was recently referred has specific health needs in addition to behavioural needs. Staff have had training in meeting those health needs prior to her admission. She has a detailed, complex health plan for staff to follow. The parent reported that she is confident in the staff meeting her daughter’s needs, and that she has been impressed with the careful planning and preparation prior to her staying at the home.

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Overall experiences and progress of children and young people: good

Each child has a detailed health plan that includes up-to-date, clear information regarding the administering of prescribed medications. Health plans also include advice to staff regarding personal care needs. Staff are trained and deliver care sensitively, involving children in decision-making where possible, and respecting each child’s need for privacy and dignity.

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Overall experiences and progress of children and young people: good

One parent reported: ‘I have spent time observing my daughter at the home. She has complex health needs and is non-verbal. Staff know her well, she can be mischievous and has a great sense of humour. Sometimes when I go to collect her she does not want to leave because she is enjoying herself. Staff listen to us, as parents. If they need to check anything they will ring and take on board our advice and knowledge.’

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Overall experiences and progress of children and young people: good

Home staff liaise closely with education and health professionals. There is a daily information book for each child that goes between family home, school and the short- breaks home. It is an effective tool for updating information. Staff visit schools to observe children and this provides helpful information, particularly about communication methods. A school nurse informed the inspector that partnership working is good and that sharing information across all involved means that children receive a consistent response to behaviours. Also, targets for progress are mutually agreed.

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Overall experiences and progress of children and young people: good

Staff support older children and their families with plans to transition to adult services. There is a lead transitions worker who is developing knowledge about the transitions process and about resources to help families. He has liaised with the social care transitions team and with the disabled children’s team to ensure that families receive helpful information prior to important planning meetings. All children are supported to develop independence skills. During this inspection, one child was enjoying helping to prepare dinner.

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Overall experiences and progress of children and young people: good

During the inspection, the inspector joined children for an activity involving feeding the ducks at a nearby park. Staff carefully prepared for this, ensuring that they had emergency information for each child, rescue medication and all essential equipment. There were safe staffing levels. During the outing, staff knew each child’s needs and personality, and communicated with them using a range of methods. This meant that children enjoyed the outing and were cared for safely.

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Overall experiences and progress of children and young people: good

Staff identify children’s preferred communication methods and develop good relationships and positive interaction. Staff use a range of methods of consulting with children and families, such as questionnaires, one-to-one consultations, social stories and digital technology. Using children’s views to inform daily care and planning is embedded in the home, but staff continue to think creatively about further developing this work. Inspection report children’s home: SC465257 5

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

Staff and managers are fully aware of the additional vulnerabilities of the children staying in this service. Staff receive training in safeguarding disabled children. Each child has personalised, detailed risk assessments and behaviour management plans that are regularly reviewed and updated, and information is added as new information becomes known.

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

Staff prepare for each child’s stay well. This includes having essential information, including their personal evacuation plan, in each child’s room.

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

Staff know each child’s individual needs and vulnerabilities. They are constantly updating information during a shift and in children’s records. There are high levels of staff monitoring due to children’s individual needs. As a result, there are no missing episodes and very few physical restraints and significant incidents. However, the police are aware of the home and the vulnerability of children and would respond appropriately to any missing incident. If children are going out, essential information to support an emergency response is taken for each child.

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

If children display behaviour that can be harmful to staff and to other children, the risk assessment and behaviour management plans are prescriptive in monitoring and managing such behaviours. Staff take precautions such as wearing headscarves to protect from hair pulling. Shifts are carefully planned to ensure that children are kept safe. Any incidents are recorded in detail and reviewed by a manager, and any action is followed up as appropriate. Incident reports are audited and analysed to identify any themes or emerging trends that can be responded to. As a result, there has been a low number of incidents of children harming themselves, other children or staff. One child had a range of social stories as part of his care plan that support him to understand his daily routine. They reinforce boundaries to prevent incidents of negative behaviour. As a result, his stays are more positive and his anxieties about change are reduced.

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

Staff discussed with the inspector an incident that happened on the previous shift, where a member of staff had been targeted by a child who has been very anxious and displaying aggressive behaviours. Staff talked through how this had been managed to prevent further incidences and how the following morning had been organised to distract the child, so that the member of staff was not targeted again. They are also planning a whole team discussion, sharing information with family and agencies to identify any new needs and agree strategies to prevent or manage further incidents.

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

Staff are conscientious in recording any marks on body maps as some children, due to their needs, use self-harming behaviours or have frequent accidents. Staff check any new information out with family and agencies and refer on any concerns.

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

There are very robust procedures for administering medication. Two staff carefully record medication information at the beginning of every child’s stay. Medication records Inspection report children’s home: SC465257 6 are audited during shifts. There has been one medication error, which was investigated by the manager and resulted in staff performance measures. The staff team has learned lessons from this and reviewed and amended procedures to prevent this happening again. There was no harm to a child as a result of the error.

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

Managers have developed clinical competencies for staff to undertake, for newly developed medical interventions for children, which are subject to approval by the health trust. Managers have also shared their knowledge and experience with another authority to support the development of a short-breaks service in their area. This demonstrates staff expertise in supporting children having their needs met in the community.

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

Staff and managers are proactive, and appropriately refer child protection and child welfare concerns to social workers and the local authority designated officer. Managers follow these up until they are satisfied with a resolution and that children are safe. Staff supervision always covers safeguarding issues and training and development to address skills and knowledge in child protection.

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

Following a serious incident, which did not identify any concerns about the home’s care, a ‘lessons learned’ exercise was undertaken with a range of professionals. All children’s healthcare plans in the home were reviewed, and the information regarding sensitivity to medication carefully worded. This demonstrates agencies working well together to promote effective responses to children’s health needs.

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

There are health leads for sexual exploitation, radicalisation and female genital mutilation, with whom managers and staff liaise and receive joint training.

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

The inspector observed a shift handover which demonstrated staff knowledge of children’s dietary and nutrition needs, safeguarding needs, and the level of monitoring required to keep each child safe.

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

The home environment is organised to keep children safe, and equipment is regularly serviced. However, part of the garden area that children have access to did require attention to make it safe. A seating area had splinters and the area needed cleaning. The manager addressed this immediately and made the area safe. A requirement is made to ensure that maintenance monitoring systems are improved and made effective.

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The effectiveness of leaders and managers: good

There is a very experienced registered manager and senior management team within the home. This home covers a range of children’s needs, providing services for two groups of children, and has a separate emergency provision. The management team has developed an integrated service with an increasing number of staff working across the two service areas. There have been joint development days and team meetings. This means that staff are sharing skills, experience and knowledge, and there is capacity and flexibility across the staff team, delivering a more a cohesive service. Inspection report children’s home: SC465257 7 Progress made since the last inspection includes a member of staff having lead responsibility for developing the home’s practice in supporting transitions for children. He has received training and has developed links with colleagues with similar responsibility, across short-breaks services and with the local authority transitions team. There have

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The effectiveness of leaders and managers: good

also been effective links with school nurses, resulting in improved care and progress for children. Staff are able to access information on the NHS trust database, so have access to information in a timely way. Managers have also worked hard to make constructive links with transport providers to resolve any issues promptly, so that children have robust and safe transport arrangements in place.

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The effectiveness of leaders and managers: good

The registered manager sends a monthly newsletter to all staff with updates and helpful information regarding practice. It includes an evaluation of management information that supports staff to respond to children’s needs.

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The effectiveness of leaders and managers: good

Managers provide an effective on call system for out-of-hours advice. The manager is clear that staff on duty follow child protection procedures in the first instance, where appropriate.

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The effectiveness of leaders and managers: good

The managers invest in staff skills, providing training and development opportunities, and are good at identifying and supporting talent within the team. There is generally a stable team. However, there have been some challenges. There has been some staff sickness, and some staff are subject to performance management. There are a number of staff undertaking the required care qualification. There are always safe staffing levels for the number and needs of the children staying in the home. Managers cover shifts if necessary and use staff from within the service if they require staff cover. This means that children have familiar care staff and are kept safe.

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The effectiveness of leaders and managers: good

The manager believes that the strength of the service is the commitment of all staff to be child-focused and child-centred in their practice. They have children’s meetings every month that review children’s needs, providing an opportunity for staff to update each other on key children. Each child’s identity informs their care plans.

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The effectiveness of leaders and managers: good

There was evidence of good staff supervision taking place, providing opportunities for staff to reflect on their practice. The frequency of supervision sessions has improved since the last inspection.

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The effectiveness of leaders and managers: good

Managers work very well with families. They are prompt to respond to any concerns or niggles, and as a result there are very few formal complaints.

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The effectiveness of leaders and managers: good

Managers respond to recommendations in the independent visitor’s reports, and the information from a range of quality assurance mechanisms informs the home’s development plan. Inspection report children’s home: SC465257 8

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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: SC465257 9

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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: SC465257 10 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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