Children's Home run by Liverpool City Council in Liverpool

Inspection report children’s home: SC035969 1 SC035969 Registered provider: Liverpool City Council

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The children’s home is managed by a local authority, providing short-term breaks for up to seven children at any one time. The home cares for children and young people who have learning disabilities and/or physical 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: 23 January 2017

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Good

Overall judgement at last inspection: Sustained effectiveness

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Good

Enforcement action since last inspection: None Inspection report children’s home: SC035969 2

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Key findings from this inspection

 Children continue to enjoy positive experiences that enrich their lives and provide them with excellent opportunities for personal growth and development. Strong, safe care practices protect these vulnerable children from harm.

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Key findings from this inspection

 A very high standard of personalised support from skilled and passionate staff is making a positive difference to the children’s lives. Children feel safe and enjoy trusting relationships with the staff. Staff enable children to express their wishes and feelings and make meaningful choices. Children are increasingly confident spending time away from their families and being around with other children. They have opportunities to make friends and do things that they may not be able to do with their families. Children are less anxious and upset and are significantly less likely to show their emotions through aggressive or self- harming behaviour.

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Key findings from this inspection

 Children’s stays are carefully planned in a very welcoming, supportive and safe environment. The registered manager and staff use effective relationships with children, their parents and carers, social workers, schools and health professionals to ensure that each child receives the best possible support. Parents and carers feel extremely supported by the staff. They enjoy open and trusting relationships and they are confident leaving their children in staff’s care.

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Key findings from this inspection

 Effective management and leadership have ensured that children have continued to receive a high standard of care that meets their individual needs. Managers have provided the right working environment for staff to feel valued and supported through challenging times, including not being able to offer short breaks between January and April 2017 and the establishment of a new staff team, following a review of the service by the local authority. Managers and staff have used the time available to them to take stock, highlight priorities for the development of the service and successfully re-introduce short breaks for children.

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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

 Broaden the range and variety of activities available for children to promote their interests and development.

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Key findings from this inspection

 Update and improve children’s records to include the most recent relevant plan and provide an analysis of children’s views and experiences to better understand and measure their progress and outcomes.

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Key findings from this inspection

 Provide sessional staff with opportunities for formal practice-related supervision and time to reflect on their performance. Inspection report children’s home: SC035969 3

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Inspection date Inspection type Inspection judgement

23/01/2017 Interim Sustained effectiveness 10/05/2016 Full Outstanding 02/02/2016 Interim Improved effectiveness 11/05/2015 Full Good Inspection report children’s home: SC035969 4

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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

9: The enjoyment and achievement standard: The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff help each child to develop the child’s interests and hobbies, participate in activities that the child enjoys and which meet and expand the child’s interests and preferences. (Regulation 9(1)(2)(a)(i)(ii))

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Requirement Due date

In particular, broaden the range and variety of activities available to children, both in the home and out in the wider community, to enjoy and try new things as a key part of their development. 30/06/2017

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Requirement Due date

33: Employment of staff: The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b))

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Requirement Due date

In particular, ensure that all sessional staff receive formal supervision, which allows them to reflect on their practice and development and the needs of the children in their care. 31/05/2017

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Requirement Due date

36: Children’s case records: The registered person must maintain records (‘case records’) for each child, which include the information and documents listed in Schedule 3 in relation to each child and are kept up to date. (Regulation 36(1)(a)(b))

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Requirement Due date

In particular, ensure that each child’s records include a copy of any education, health and care (ECH) plan or individual education plan, a copy of the child’s care or placement plan prepared by the placing authority and the date and result of any review of the placing authority’s plan for the child. 30/06/2017 Inspection report children’s home: SC035969 5

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Recommendations

 Ensure that staff identify, measure and record children’s developmental outcomes to make a significant contribution to the understanding of their progress. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.5)

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Recommendations

 Ensure that the review of the quality of care includes analysis of children’s views about the quality of care and support provided by the home, to show their experiences of staying there and the impact that the care is having on their lives. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.2)

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Overall experiences and progress of children and young people: good

Between January and April 2017, the service did not offer short breaks while staff were providing longer-term care and accommodation for one child who has extremely complex needs. This was a temporary measure, and he has now moved to his new home. Children have only being having short stays at the home again since 17 April 2017.

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Overall experiences and progress of children and young people: good

Children continue to enjoy short breaks that improve the quality of their lives. They receive a very high standard of personalised care in an extremely safe environment. Staff are ambitious for every child, regardless of the complexity of their needs, to get the most out of their stays. Staff are friendly and enthusiastic and show a genuine interest in the lives of children and their families. Staff have a detailed understanding of each child and work hard to be in tune with children’s needs and interests. Their sensitive and consistent approach enables children to form meaningful relationships with them. Staff provide opportunities for children to try new experiences and to explore and feel comfortable in the world in which they live. Children are making progress with their communication, social and life skills, emotional well-being and managing their feelings.

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Overall experiences and progress of children and young people: good

Staff expertly support and encourage every child, including those who do not communicate verbally, to express their wishes and feelings and to make choices in a meaningful way. Staff understand the best way to communicate with each child so that the child can understand and process information. Staff use augmented communication tools, including signs, symbols and pictures, to promote children’s diverse and individual methods of communication. The whole environment is set up to promote better communication, with pictures and symbols freely available for children to pick up and use independently of staff. Staff also carry symbols with them, in plain sight, and encourage children to use them. Children are clearly benefiting from following simple picture schedules that help them to understand what is going to happen and what is expected of them. They are managing their feelings much better when it is time to get

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Overall experiences and progress of children and young people: good

ready for school in the morning, to move from an activity to have their tea or to go for a shower. As a result, significantly fewer incidents of difficult behaviour are taking place at Inspection report children’s home: SC035969 6 these times.

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Overall experiences and progress of children and young people: good

Children’s short breaks are carefully planned. Managers and staff work effectively with children, parents, social workers, teachers and health professionals to understand each child’s assessed needs, so that they can be confident that children will benefit from short breaks at this home, and the staff are able to meet children’s individual needs safely. Children’s introductions to the home are sensitively planned. They have an opportunity to visit the home to have a good look around and to meet staff and other children. This helps children to make an informed choice about wanting to come to stay, and provides staff with the time to make an assessment about how well a child will manage around other children and the physical environment. The manager and staff ensure that children staying at the same time have compatible needs and interests. They arrange, when possible, for children to stay with the same group to provide opportunities for children to

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Overall experiences and progress of children and young people: good

Managers and staff work collaboratively with children, parents, social workers and adult services to plan for children’s futures. They have a strong record of helping children to move on positively and settle well in their new homes. This includes children’s new staff spending time at the home to help them to get to know and understand children’s needs and share good practice about what helps them to feel safe and the arrangements for their care. Importantly, this also provides children with the opportunity to meet and build relationships with their new carers before they move.

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Overall experiences and progress of children and young people: good

Children’s short-break plans clearly pull together each child’s educational, health, social and communications goals to ensure that the arrangements for their care provide a consistent approach to meeting their assessed needs. However, some children’s case records did not include an up-to-date copy of their education,healthcare plan or their individual education plan, the local authority’s care plan, or the outcome of the review of their plan. This means that staff do not have access to all the relevant information about children that they need to make sure that children are getting the best possible support.

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Overall experiences and progress of children and young people: good

Children stay in a stimulating environment that promotes their learning and development. They have easy access to books, computers, art materials, toys, games and other educational resources. The staff ensure that the daily routine effectively supports participation in education and excellent school attendance. They work very closely with schools to understand children’s specific education targets and agree a common approach to achieving them while they are staying.

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Overall experiences and progress of children and young people: good

Staff ensure that the children’s disabilities are not a barrier to their taking part in leisure and cultural activities in the community. They carefully plan and assess that activities are safe and that children are properly supported. Children have enjoyed trips to the seaside, to the cinema and to different parks. However, recently they have not routinely had opportunities to try new things and take part in a broad range of leisure, cultural and sporting activities to challenge and promote their personal growth.

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Overall experiences and progress of children and young people: good

Children stay in a healthy environment that actively promotes their physical health and emotional well-being. Children have healthy and varied diets that meet their dietary Inspection report children’s home: SC035969 7 needs and they enjoy plenty of physical exercise. The staff have an excellent understanding of children’s individual health needs. They are suitably trained and competent in managing medication, tube feeding, oxygen therapy and epilepsy. They are very knowledgeable about how to support children when they have seizures, when to administer rescue medication and when additional medical assistance is required. Children have easy access to appropriate community and specialist healthcare. The staff work closely with parents and health professionals to ensure that children continue to receive the best possible health support and treatment during their stays. They also ensure that children receive suitable emergency medical advice and treatment when

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Overall experiences and progress of children and young people: good

they are feeling unwell, and they always let parents know.

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Overall experiences and progress of children and young people: good

The arrangements for storing and managing children’s medication are safe and effective. Children always receive the treatment that they require to promote their health and welfare. The staff have a detailed understanding of the medication procedures and carefully check with parents and doctors that they have the correct information about children’s medication at the start of each stay. They often attend reviews of medication to share information and ask questions about children’s care and treatment plans.

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Overall experiences and progress of children and young people: good

Great care is taken to make sure that children stay in a comfortable and homely environment that meets their needs. Bedrooms and bathrooms that have hoists and include medical equipment are decorated to make them as pleasant as possible places for children to use. Before each stay, staff set up the bedrooms to reflect the character, interests and needs of individual children, including their favourite toys and pictures, so that children have familiar things around them and feel at home.

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

Children stay in a safe place where staff’s consistently high level of care protects them from harm. Staff ensure that the environment is safe for children to use and explore. Staff understand and meet children’s emotional needs. As a result, children appear happy and relaxed and have a strong sense of safety. They are comfortable being away from their families. Many children now spend much more time with other children, sit at the dining table for meals and join in with group activities.

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

Staff have a comprehensive understanding of the risks to individual children’s safety, including those associated with their disabilities, levels of understanding, communication and health conditions. Thorough and up-to-date written risk assessments guide them effectively to manage and reduce these risks. Consequently, children have become less likely to show feelings aggressively or through self-harm. Staff’s effective management of risk means that children safely explore new experiences, including being away from their family, taking part in activities in the community and making friends, which all help to promote their development.

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

The staff are very well trained in safeguarding and alert to any signs and symptoms of abuse, neglect and exploitation. They are fully aware of the children’s vulnerability and take suitable precautions to ensure that children are always properly supervised and Inspection report children’s home: SC035969 8 supported. This means that children do not go missing and staff can act quickly when they have concerns about a child’s health. Managers and staff always take decisive action to protect children, including reporting any concerns to the appropriate safeguarding agencies, and ensuring children receive emergency medical help when they need it. Staff’s safe care practices when assisting with children’s personal care ensure that each child is treated with sensitivity, respect and dignity.

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

Staff know each child extremely well and quickly pick up when something is wrong, by noticing any injuries or changes in children’s behaviours, energy levels, moods or health. They are very aware of distinctive behaviours associated with a particular child’s medical condition. For example, smiling and frequent laughter may mean that the child is happy or upset or in pain. They can tell the difference and respond appropriately. Staff are developing a better understanding of children’s sensory needs and how these needs affect children’s behaviour. Staff collate their observations and knowledge of each child in comprehensive written plans, which help them to provide a consistent and appropriate support that meets that child’s needs and keeps them safe from harm.

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

Effective planning and communication enable staff to help children to manage their feelings in situations that they find challenging. For some children, this may be getting ready for school, having a shower, going to bed and settling at night, or becoming overly stimulated by a particular activity. Staff’s use of clear language, visual aids and signs helps children to know what is happening and what will happen next. Their consistent and calm approach, especially in difficult situations, helps children to manage their feelings and worries and control their behaviour safely. The times when children are distressed or show aggressive behaviour are rare, and staff do not need to use restraint techniques to support children to manage their feelings.

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The effectiveness of leaders and managers: good

The registered manager is currently absent from the service. The local authority has appointed two interim managers with suitable experience and qualifications to take day- to-day charge of the home. Together, they are providing clear, strong and effective leadership and management and demonstrate a drive to improve the quality of the service. They have successfully managed the reintroduction of short breaks for children. Thoughtful and careful preparation has ensured that children’s needs continue to be met and have meant that children have settled straight back into coming to stay.

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The effectiveness of leaders and managers: good

Managers and staff demonstrate a passionate and ambitious vision to provide children who have disabilities and complex needs with a high quality of individualised care that improves and enriches their lives. They deliver this through strong relationships with children and their families and a strong focus on understanding children as individuals. Children enjoy extremely positive experiences that enable them to continue to make significant progress across all aspects of their development.

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The effectiveness of leaders and managers: good

Senior managers have supported the managers and staff to reflect openly on recent changes to the service, including the impact of caring for one child who has extremely complex needs and challenging behaviour, starting to provide short breaks for children Inspection report children’s home: SC035969 9 again, and the establishment of a new staff team after a service review. The managers and staff have used this opportunity constructively to take stock, clarify the expectations of their roles, responsibilities and professional relationships and identify the priorities for developing the service. They are working to improve the range of activities available to children, using reflective practice to identify and measure children’s progress and outcomes and to develop staff’s skills, knowledge and confidence. It is still too early to show the effect of this work on children’s experiences and development.

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The effectiveness of leaders and managers: good

Leaders and managers are providing the right supportive working environment for staff. Through supervision, development workshops, team meetings and training opportunities, staff have been able to reflect on the professional and emotional impact of recent changes. Staff feel valued and supported. They are positive and energised about the plans to develop the service and improve further what they offer children and their families. Staff have been through a rigorous selection process to ensure that they have the right skills, values and motivation. All the staff have appropriate qualifications, are vastly experienced in working with children and make use of the opportunities to develop their skills and practice. Some of the staff members are relatively new to caring for children who have disabilities. They are building their expertise and confidence through a comprehensive induction programme, which includes training and support tailored to the

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The effectiveness of leaders and managers: good

particular needs of the children using the service. They work alongside staff who have experience of working with children who have disabilities. Effective communication and sharing of skills and knowledge are helping staff to work together cohesively to provide each child with the best possible support and continuity of care.

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The effectiveness of leaders and managers: good

All the permanent staff have regular practice-related supervision from a suitably qualified manager. This provides them with the opportunity to reflect on children’s progress, reflect on their practice and the emotional impact of the work, and identify areas for their development. However, not all of the sessional staff currently working at the home have received the same formal supervision.

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The effectiveness of leaders and managers: good

Managers and staff have exceptionally strong and supportive relationships with children’s parents and carers. Parents and carers trust the staff and are confident leaving their child for their stays. The strength of these relationships was clearly shown during the period when the service was not providing short breaks for children. Parents received the information they needed to help them to understand the reason that their child would not be able to come to stay and offers of alternative support.

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The effectiveness of leaders and managers: good

An independent visitor provides impartial and rigorous scrutiny of the home’s arrangements for safeguarding and promoting the welfare of children in the home’s care. The recent development work and review of the service have helped leaders and managers to build an accurate understanding of the strengths of the service and areas for improvement. They have a clear understanding of children’s progress and take appropriate action to ensure that when children are struggling they receive the support that they need. Although the most recent review of the quality of care clearly shows how staff find out children’s views, it still does not provide analysis of their views in order to show the impact of the quality of care on children. In addition, evidence of children’s progress and outcomes is not always reflected in written records to help build up a Inspection report children’s home: SC035969 10 systematic picture of the difference that the service is having on children’s lives.

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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 whom 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: SC035969 11

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Children’s home details

Registered provider address: Liverpool City Council, Municipal Buildings, Dale Street, Liverpool L2 2DH

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Children’s home details

Responsible individual: Bernadette Brown

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Inspector

Nick Veysey, social care inspector Inspection report children’s home: SC035969 12 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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Inspector

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