Children's home run by The Chiltern Centre for Disabled Children Limited in South Oxfordshire

Inspection report children's home: SC060327 1 SC060327 Registered provider: The Chiltern Centre for Disabled Children Limited

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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 service provides short breaks for up to five young people who have learning difficulties, sensory impairment or physical disabilities. It is provided by a local registered charity.

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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 requires improvement to be good

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good

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

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good

Overall judgement at last inspection: Improved effectiveness

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Key findings from this inspection

 Young people are comfortable and relaxed during their stays and have positive relationships with staff. Inspection report children's home: SC060327 2  Staff adapt the environment to ensure that young people are safe and at ease.  Young people are able to take part in a wide range of activities and enjoy their time at the service.  Young people are able to try new things and develop their skills.  Staff support young people to express themselves and make choices.  Staff understand young people‟s behaviours to be a form of communication, and they respond to it as such.  Staff are suitably trained in safeguarding young people.  The manager has a good oversight of the quality of care and is taking action to improve the service.

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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 home is carrying a high number of staff vacancies, and is over-reliant on agency staff. Some staff training is not up to date, including for agency staff. Managers are not applying the same standard to their recruitment checks of agency staff as they do to others.  Some recording is not sufficiently maintained. Examples include missing person protocols, locations assessment (of the home) and the workforce development plan.  Some areas of the home are in need of redecoration.

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Inspection date Inspection type Inspection judgement

03/01/2017 Interim Improved effectiveness 26/07/2016 Full Requires improvement 24/11/2015 Interim Sustained effectiveness 16/06/2015 Full Good Inspection report children's home: SC060327 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

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that helps children aspire to fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff have the experience, qualifications and skills to meet the needs of each child and that the home has sufficient staff to provide care for each child; (Regulation 13 (2) (c) and (2) (d))

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Requirement Due date

In particular, to ensure that staff vacancies are addressed; that staff complete the required training and refreshers and to ensure all agency staff have the required training as required by regulation. 23/07/2017

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Requirement Due date

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. (Regulation 16 (1)) 23/07/2017

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Requirement Due date

The registered person must ensure that if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3). (Regulation 32 (1) (b)) 23/07/2017

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Recommendations

 Statutory guidance on children who run away or go missing from home or care sets out the steps local authorities and their partners should take to prevent children from going missing and to protect them when they do go missing. Children‟s homes should have regard to the relevant aspects of this guidance. („Guide to the children‟s homes regulations including the quality standards‟, page 45, paragraph 9.25). This is in regards to providing independent return home Inspection report children's home: SC060327 4 interviews.  The registered person must specify the procedures to be followed and the roles and responsibilities of staff when a child is missing from care or away from the home without permission and how staff should support the child on return to the home. („Guide to the children‟s homes regulations including the quality standards‟, page 45, paragraph 9.28). This is in regards to providing individual

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Recommendations

missing protocols for young people who are at high risk of going missing.  The registered person should have a workforce plan which can fulfil the workforce related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should cover all points referred to in paragraph 10.8. („Guide to the children‟s homes regulations including the quality standards‟, page 53, paragraph 10.8)  Under regulation 46, the registered person should review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home‟s location and strategies for managing these. Providers should refer to the non-statutory advice about the location assessment process: Children‟s homes regulation amendments 2014: Advice for children‟s homes providers on new duties under regulations that came in to effect in January and April 2014.

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Recommendations

(„Guide to the children‟s homes regulations including the quality standards‟, page 64, paragraph 15.1)  For children‟s homes to be nurturing and supportive environments that meet the needs of their children, they will be homely, domestic environments. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraph 3.9). This is in regards to ensuring all areas of the property are well kept and decoration is to a good standard.  Staff should be familiar with the home‟s policies on record keeping and understand the importance of careful, objective, and clear recording. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.4). This is in regards to ensuring that staff record by whom and when young people were supported with intimate care.

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Overall experiences and progress of children and young people: good

Young people experience a caring and stimulating atmosphere in which they feel relaxed. Parents described the manager and staff team as „very child-focused‟, and as a result, the well-being of young people is at the centre of their practice. Staff have a good understanding of young people, their personalities and needs. Staff are well attuned to young people‟s methods of communications and non-verbal cues, and are able to establish quickly young people‟s wants or feelings. As a result, staff are responsive, which allows young people to trust staff and feel at ease around them.

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Overall experiences and progress of children and young people: good

Staff implement „intensive interaction‟ effectively to interact with young people. Staff use Inspection report children's home: SC060327 5 actions, sounds and touch to engage young people. Intensive interaction is clearly enjoyed by young people, as demonstrated by their increased eye contact and communication with staff, as well as their smiles and laughter. As a result, young people feel valued by staff who enhance their self-esteem.

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Overall experiences and progress of children and young people: good

A number of parents spoken to said that their children „love coming to the service‟. This is due to the wide range of activities available inside and outside of the home. Staff encourage young people to use their communication aids, as well as objects of reference, to ensure that young people are able to choose how they would like to spend their time at the service. The manager has arranged for local community groups to visit, offering young people a chance to experience different activities while enabling them to be a part of their wider community.

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Overall experiences and progress of children and young people: good

Whole families benefit from the service provided by the home, not just because short breaks provide respite, but also due to the support in assisting young people to develop their skills. One parent commented, „without the (service) life for (her child) would have been more limiting.‟ Young people are learning to perform daily living tasks independently such as washing themselves and helping with meal preparation. The patient and persistent support from staff has enabled a young person to use the toilet independently, resulting in them ceasing to rely on incontinence aids. This is a significant achievement.

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Overall experiences and progress of children and young people: good

The Award Scheme Development and Accreditation Network‟s programme continues to be offered by the service. This programme aids young people to become more independent and to enjoy a wider range of experiences. A particular example is encouraging young people to use public transport. Staff celebrate young people‟s achievements and display evidence of young people‟s progress on the „achievement wall‟. As a result, young people feel pride in their accomplishments, building on their self-confidence and self-esteem.

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Overall experiences and progress of children and young people: good

The service continues to provide day care to young people to ensure that they and their families have a choice in the resources they are able to access; the service is able to tailor the support to meet their needs.

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Overall experiences and progress of children and young people: good

Parents commented that managers completed thorough assessments of their child‟s needs before they accessed the service. Parents explained that staff are „open to suggestions‟ and have very good communication with them. Staff also work closely with other professionals involved with the young people, including their schools, to inform their plans of care. This has enabled the service to develop comprehensive and individualised plans, and to ensure that all staff have a good knowledge of, and apply a consistent approach to caring for, each young person.

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Overall experiences and progress of children and young people: good

Staff recognise the importance of positive transitions into the service. Staff ensure that the environment is adapted to support the safety and well-being of each young person. For example, staff rearranged a bedroom and placed a radio and lamp in the room to make it more homely for a young person. As a result, the young person‟s parent commented that their child had settled into the service and began sleeping throughout Inspection report children's home: SC060327 6 the night far quicker than they had predicted. Young people have opportunities to visit the service and have tea visits prior to staying overnight. Work towards staying overnight is done at the pace of the young person, ensuring that transitions into the service are well managed and are successful.

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Overall experiences and progress of children and young people: good

The service supports young people with diverse and, in some cases, very complex needs. Staff receive specialist training to meet individual health needs when required, ensuring that they have the skills and knowledge to provide competent care. However, in some cases staff are not recording which staff members have carried out intimate health care tasks with young people. This inhibits the manager‟s ability to monitor young people‟s welfare.

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Overall experiences and progress of children and young people: good

There have been two medication errors since the previous inspection. One incident was as a result of a member of staff not following procedures. The other was a result of the young person‟s health care plan not being updated. The manager has taken action to address these concerns and has used the learning from each incident to improve practice.

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Overall experiences and progress of children and young people: good

Some young people travel a long distance to use the service because there is no similar provision within their local area. This demonstrates the value and importance of the service to the young people and their families. Staff regularly speak to young people‟s parents to keep them informed of their child‟s stay.

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

Young people‟s demeanour indicates that they are comfortable and experience positive relationships with staff. Staff are skilled in understanding each young person‟s vulnerabilities, and work proactively to reduce individual risks. Young people‟s risk assessments focus on risk reduction, while enabling young people to be involved in age- appropriate activities.

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

Comprehensive risk assessments and highly individualised care plans advise of strategies so that staff can care for young people in the best way and protect them from harm. These risk assessments are regularly updated and shared appropriately. There are no concerns regarding child sexual exploitation or radicalisation of young people within the service. Staff have undertaken training to identify the signs and symptoms of these risks, and to report any concerns to the necessary agencies.

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

The home has had no child protection concerns since the previous inspection. Systems in the home for recording and managing incidents evidence that staff act on safeguarding concerns swiftly. Concerns are recorded, reported and referred to others, when required. The manager keeps a detailed log allowing him to oversee and monitor incidents.

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

The risks of young people going missing are limited due to the close staff supervision levels. Staff are fully aware of the young people‟s vulnerabilities, and use strategies that Inspection report children's home: SC060327 7 minimise the risks. As a result, there have been no incidents of missing since the previous inspection. However, young people with a high propensity to go missing do not have an individual missing protocol. This may hinder staff‟s response, as they are not sufficiently informed of what actions they need to take to alert the police or successfully find and support the young person to return to the service. The missing person policy provides incorrect information on who should provide return interviews.

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

Young people benefit from support from staff who understand their behaviours to be a form of communication, and they respond to it as such. Staff are watchful without being overbearing, and allow young people to express themselves safely. Staff have a good understanding of the best approaches to distract and reassure young people, and use consistent approaches to reduce their anxieties. As a result, there has been only one low-level physical intervention since the previous inspection, demonstrating the success of the staff‟s approach.

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

The service‟s location assessment evidences that staff have considered some of the risks the immediate local area may present and have taken action to minimise them. However, there is limited consideration of the risks presented by the wider area around the service. There is no evidence of consultation with other agencies or professionals to inform the assessment.

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

All required health and safety checks are completed on a regular basis to ensure that the service and environment remain safe. However, some areas of the home are looking tired and are in need of redecoration to ensure that the service remains welcoming and homely.

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The effectiveness of leaders and managers: requires improvement to be good

Parents describe staff and managers as „child focused‟, „extremely friendly‟ and „responsive‟. The manager was registered in respect of this service in 2014 and has obtained a level 4 qualification in childcare and a level 5 award in leadership and management. The manager has high expectations of the service and has successfully developed a service which provides young people with positive experiences and a supportive environment in which they are able to develop new skills.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has a good insight into the needs of the young people he supports. He works proactively with other professionals and regularly liaises with young people‟s local authorities, schools and health care professionals to safeguard young people and promote positive outcomes. Parents feel supported by the manager, who advocates and challenges on behalf on the young people and their families to ensure that they receive the necessary care and assistance to promote their well-being and maintain their family life.

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The effectiveness of leaders and managers: requires improvement to be good

The independent quality assurance visits and the manager‟s own monitoring of the home have been effective tools in overseeing the service and driving improvement. The manager fully understands the strengths and shortfalls of the service, and is using Inspection report children's home: SC060327 8 quality assurance systems effectively to develop it. The change in the service‟s independent visitor has had a positive impact, and now provides additional scrutiny and challenge to further promote good quality care.

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The effectiveness of leaders and managers: requires improvement to be good

Young people and their parents are able to contribute to the running of the service through regular consultation. Parents feel confident in raising concerns if necessary. The manager take complaints seriously and is committed to learning from them. His log of complaints, and any other occasions when children or their parents are dissatisfied, allow him to identify trends and take action to improve and develop the service.

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The effectiveness of leaders and managers: requires improvement to be good

The statement of purpose ensures that those using the service, or who are associated with the service, are informed of its aims and objectives. However, the statement of purpose does not advise of the surveillance methods the service uses to monitor children at night, as required by regulation.

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The effectiveness of leaders and managers: requires improvement to be good

Staff have regular supervision that supports their practice and professional development. Team meetings also provide for effective support and are used as an arena to discuss individual young people and their needs and goals.

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The effectiveness of leaders and managers: requires improvement to be good

Staff have not had the required training and have not completed refresher training as outlined in the service‟s „staffing‟ policy. A minority of the staff have not completed the level 3 qualification, as they are required to. As a result, staff do not have all the necessary up-to-date knowledge and skills to care for the young people.

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The effectiveness of leaders and managers: requires improvement to be good

The service does not have a workforce development plan that covers all the required areas by guidance. This means that there is not a clear plan outlining expectations around induction, probation, supervision and training, as well as the management structure and process for managing and improving poor performance.

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The effectiveness of leaders and managers: requires improvement to be good

The service is experiencing a shortage of permanent workers. There has been a reliance on agency workers, which has resulted in some shifts having a majority of temporary staff. The manager has not ensured that all agency workers employed have had the required employment checks or the level of mandatory training required by regulation.

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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 differences 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 Inspection report children's home: SC060327 9 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: SC060327 10

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Children’s home details

Registered provider: The Chiltern Centre for Disabled Children Limited

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Children’s home details

Registered provider address: Chiltern Centre, Greys Road, Henley-on-Thames, Oxfordshire RG9 1QR

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Inspector(s)

Melissa McMillan, social care inspector Inspection report children's home: SC060327 11 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 looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

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