Children's Home run by Cheshire West and Chester Council in Cheshire West and Chester

Inspection report children's home: SC034849 1 SC034849 Registered provider: Cheshire West and Chester 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 home is run by a local authority and is registered to provide short-break care for up to six children who may have learning disabilities, physical disabilities or sensory impairment.

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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

Date of last inspection: 23 February 2017

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good

Overall judgement at last inspection: Improved effectiveness

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Key findings from this inspection

 Children receive care that meets their needs and promotes their enjoyment of life and their development. Children‟s needs are carefully assessed and set out in clear short-break plans and risk management plans, which staff implement. Inspection report children's home: SC034849 2  Children like having short breaks at the home. They enjoy the opportunities and activities offered and interact positively with the staff team. Their wishes and feelings are taken into account as much as possible and inform the care they receive.

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Key findings from this inspection

 Children‟s health and well-being are very well supported.

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Key findings from this inspection

 Staff follow good systems and procedures that protect children‟s welfare and promote their dignity. Children feel safe. They are cared for in a safe environment, and threats to their safety are swiftly addressed and rectified.

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Key findings from this inspection

 The senior leadership team maintains good oversight and has a sound understanding of the strengths and weaknesses of the home. There is a clear action plan to improve the service.

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Key findings from this inspection

 Extensive consultation with parents, social workers and staff has informed the development of plans to offer an improved and more individually focused service. Short breaks at the home are provided as part of an all-round package of support for children in need and further service developments are due to be implemented within the next six months.

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Key findings from this inspection

 Action has been taken to address the shortfalls identified at the last inspection so that improvements to practice have been introduced or are underway. The home has the capacity to improve further and is taking action to do so.

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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

 Not all of the recommendations made at the last inspection have been fully met and some are repeated. This is to ensure that there is a continuing focus on improvement in communicating with children through the use of communication aids and better consultation with parents to inform the manager‟s six-monthly review of the home.

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Key findings from this inspection

 Action taken to strengthen recruitment practice is still not robust.

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Key findings from this inspection

 Action taken to ensure effective leadership and management of the home in the manager‟s absence does not fully ensure strong management at these times.

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Key findings from this inspection

 The quality and frequency of staff supervision are not consistently good. This does not ensure that children are looked after by well-supervised staff or that children‟s plans are regularly reflected upon.

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Key findings from this inspection

 Monitoring of children‟s records is not yet good. Staff do not routinely sign children‟s plans to demonstrate they are familiar with them and actions by Inspection report children's home: SC034849 3 managers to address this have not proved effective. This means that staff may not all be fully up to date with changes in children‟s lives and their plans.

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Key findings from this inspection

 The home does not routinely play an active part in transition planning for those children moving on to adult services.

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Inspection date Inspection type Inspection judgement

23/02/2017 Interim Improved effectiveness 11/08/2016 Full Requires improvement 17/03/2016 Interim Improved effectiveness 02/12/2015 Full Requires improvement Inspection report children's home: SC034849 4

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Recommendations

 Ensure that each child is provided with support to communicate their views, wishes and feelings and participate as fully as possible in all aspects of their care planning and daily care. Where appropriate, use communication aids and equipment to encourage children to express themselves. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.6)

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Recommendations

 Seek the views and involvement of parents/carers and social workers frequently and use them to inform the development of the service. In particular, include their views in the six-monthly reviews of the home. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.8)

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Recommendations

 Ensure the registered person maintains good employment practice. Ensure that recruitment of staff safeguards children and minimises potential risks to them. In particular, continue to review staff files and ensure that they contain information that demonstrates the suitability of that person to work with children in the home. Ensure that information of concern is followed up and assessed. („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraph 13.1)

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Recommendations

 Ensure that clear arrangements are in place to maintain effective management when the manager is absent, off-duty or on leave. („Guide to the children‟s homes regulations including the quality standards‟, page 54, paragraph 10.20)

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Recommendations

 Staff must help each child to prepare for any moves from the service, whether they are moving to another short-break placement or adult care. („Guide to the children‟s homes regulations including the quality standards‟, page 17, paragraph 3.27)

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Recommendations

 Ensure that all staff consistently follow the home‟s policies and procedures for the benefit of the children in the home‟s care. Ensure that everyone working at the home understands their roles and responsibilities and what they are authorised to decide on their own initiative. In particular, ensure that staff sign to show they have read and are familiar with short-break plans, risk assessments and other relevant documents on children‟s files. („Guide to the children‟s homes regulations including the quality standards‟, page 54, paragraph 10.20)

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Recommendations

 Ensure that systems in place for the regular supervision of staff are followed and allow staff to reflect on their practice and the needs of the children assigned to their care. To this end, improve the regularity and quality of staff supervision and supervision records. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 13.2) Inspection report children's home: SC034849 5

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Overall experiences and progress of children and young people: good

Thirty-six children, who have a wide range of disabilities, currently receive a short-break service from this home. Short breaks are carefully planned, with consideration being given to children‟s individual needs. The home matches children well, taking into account their particular vulnerabilities and challenging behaviour as well as their friendship groups and interests. Although the home can accommodate six children, often, between two and four beds are occupied. This ensures that children with complex needs receive the care and support they need, and have a safe and enjoyable stay. Specialist beds and equipment are available for those who need them.

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Overall experiences and progress of children and young people: good

Staff use the layout of the home well to separate children from others, when this is in the children‟s best interests. For example, children are encouraged to engage in activities that they like in different communal rooms. This means they can relax in their own ways without it impacting negatively on others. At other times, children are encouraged to engage in joint activities, learning to interact with others or simply engage in enjoyable activities alongside others.

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Overall experiences and progress of children and young people: good

Individual children‟s needs are well met and there are many good examples of children having positive, enjoyable short breaks and making progress in their development. For example, a parent explained how her child benefits from short breaks: „They have improved things for her by helping her to do more for herself. She likes to be independent as much as she can and they help her with that. They do a lot with her, and she can “chillax” there without being mithered by the little ones at home. I love the way she comes home happy and healthy and full of chat about what‟s gone on.‟

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Overall experiences and progress of children and young people: good

Staff are trained in therapeutic crisis intervention with a focus on working with children who have disabilities. They are also trained in supporting children who have autistic spectrum disorder, communication difficulties and children‟s individual behavioural needs. This helps them to competently supervise and support children, respond to children effectively and predict their behaviour, wants and needs. Consequently, children enjoy positive, enjoyable experiences during their short breaks.

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Overall experiences and progress of children and young people: good

Relationships between the home, parents, children and other professionals are good. They appreciate receiving case notes following each visit and detailed reports prior to children‟s reviews. These help them to understand how children are benefiting from their short breaks.

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Overall experiences and progress of children and young people: good

Social workers report that children‟s needs are well met. For example, one said: „I‟m satisfied with the work they do. They meet his needs. He lacks capacity. They encourage him to use communication aids, but he is reluctant. They read his behaviour well. They are working with a lot of health professionals, including CAMHS [child and adolescent mental health service], who are advising about behaviour management. I‟ve seen him engage well with staff, relaxed and happy.‟ Inspection report children's home: SC034849 6 Children‟s health is well promoted and protected. Good systems ensure that children receive the medicines and treatment they need. Staff make a courtesy call to parents 48 hours before a short break, during which they ascertain any changes to children‟s prescriptions and remind parents of the need to provide labelled medicines. They also find out about any challenges in children‟s lives or changes to their routines. This helps to ensure that staff

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Overall experiences and progress of children and young people: good

have up-to-date information about children and can meet their needs appropriately. It gives parents confidence that the home is safeguarding their children‟s health and welfare.

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Overall experiences and progress of children and young people: good

The home meets individual children‟s dietary needs and caters for food tolerances. A number of children have food allergies, eating disorders or restricted diets. These are well catered for. The staff are patient and supportive at mealtimes, preparing individualised meals as necessary and offering choices when children are reluctant to eat. A parent explained: „She goes through stages of not eating and I tell them about it and they make foods she likes. That encourages her to eat. They do a smashing job. I‟d like to go there myself!‟

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Overall experiences and progress of children and young people: good

The home supports children‟s education well, completing a home/school diary which provides teachers with pertinent information about the short break. Schools say that the home communicates effectively with teachers and follows up any issues. They report that children look forward to their short breaks.

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Overall experiences and progress of children and young people: good

Staff engage with children through friendly banter and provide warm, nurturing care that children respond to well. They enable children to do things at their own pace, without pressures of time. This helps children to relax and benefit from their short breaks. One child spoke extremely positively about the home, saying: „I enjoy coming. Staff make me laugh. I come once a month. I count the sleeps when I go home until the next time I come. I enjoy doing crafts and puzzles, and having pamper nights. I like to have a lie-in on a Saturday and to spend time out of my chair. I like using the iPads and having meetings so we can talk about what we want to do and what meals we want. I like watching the telly and listening to music and I like the bed here. I just like being here. It‟s peaceful.‟

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Overall experiences and progress of children and young people: good

Consultation with children is good. Children are given time and support to make their views known to staff and even those with very limited communication skills are given choices. Staff have good observational skills and this helps them to understand children‟s wishes and needs. They make limited use of communication aids such as symbols or sign language, although they are increasingly using these techniques with some children. Plans to upskill the staff team in using alternative communication methods are in place but the home has been slow to fully develop this important aspect of their work.

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

Individualised risk management plans support staff to identify and assess risks to children‟s safety and welfare. This helps to keep children safe and protects their dignity. For example, the risk of a child putting unsuitable things in his mouth is managed through close observation, management of the environment and providing sensory play with edible materials including dough, food colouring and jelly. Inspection report children's home: SC034849 7 Children‟s dignity is protected and promoted. For example, bedroom windows and viewing panes in doors are fitted with suitable dressings that protect children‟s dignity. For a young person who frequently pulls down the window dressing in his bedroom, exposing himself to the risk of observation by persons in the car park, specialist glass has been installed which enables him to see out, but no one can see in from the outside. Plans are also in place for specialist blinds to be added to further protect his dignity on dark nights.

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

Sections of the large, enclosed garden are separated by low fences and gates, which limits access to areas that may be a hazard for some children. For example, the bike track is currently off limits until the moss has been removed from the perimeter of the track. Arrangements have been made for the area to be treated so that children can return to riding their bikes now that the weather has improved. This shows that the home‟s environment is continually assessed to ensure children‟s safety. A sunken trampoline has been installed, paid for by parents‟ fundraising. A suitable health and safety risk assessment was completed before children used it. Similarly, the interior of the home is subject to regular risk assessment and a comprehensive cleaning and maintenance programme. This ensures the home is kept safe for children‟s use.

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

No children have gone missing from the home. External doors to the car park are kept locked to ensure the safety of the vulnerable children who use this service, as many of them have little understanding of road safety and none would be safe in public, alone. These arrangements are clearly specified in children‟s short-break plans and in the home‟s statement of purpose. Children are very well supervised within the home and locked doors are no longer used to manage children‟s behaviour.

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

Clear plans are in place and are followed in respect of each child‟s access to the community. Children are kept safe because appropriate staffing levels are maintained both in the home and on outings. Arrangements for transition between the home‟s adapted vehicle and the home are appropriately managed in line with children‟s individual needs. When on the minibus, children are well supervised and seating arrangements take account of their individual needs and preferences. This protects children from being targeted by others and ensures they have the space they need to feel safe.

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

Children learn to behave in a socially acceptable and safe way in public areas. Staff always take a child‟s health passport with them on trips out. This is a really useful document that provides a photograph of the child and details of emergency contacts, basic health and medical information, and parental consent to medication and treatment, and outlines how to communicate with the child. The document would be invaluable in the event of a serious incident in a public area that threatened a child‟s health and safety.

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

Children feel safe in the home. A child explained: „I always bring my own sling to help me get out of my chair because staff can‟t lift me. I couldn‟t come without that so I always make sure I have it with me. I have a special bed here as well, so I won‟t fall out. I tell staff if anyone pinches me or hurts me. It happens sometimes, but they sort it out. I definitely feel safe here. They look after us very well.‟ Injuries are rare and behaviour management is effective in keeping children safe from the challenging behaviour from others. Inspection report children's home: SC034849 8 Restraint is rare and effectively protects children from harm. It usually takes the form of closing a door between different areas of the home for a short time to prevent one child from injuring or upsetting another. All children remain well supported and supervised at these times.

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

Staff know how to report child protection concerns and have been trained to recognise signs that a child may be at risk of sexual exploitation or other harm. There have been no concerns raised about staff, the quality of care provided, or children‟s safety.

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

Transitions to the home are very well managed, and proceed at the child‟s pace. Parents are fully involved and children have as many tea visits as they need before staying overnight. Transitions from the home are less well managed. The staff are not routinely contributing to children‟s future plans or engaging with adult providers to ensure they have a good understanding of children‟s needs. This does not enable a smooth and timely transition to adult services. As a result, some children leave the home with no clear arrangements for future care or short breaks within adult services.

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

Recognising the need to improve the quality of care, the local authority has implemented a Children‟s Home‟s Improvement Board, which is chaired by the director of children‟s social care. Through this, the senior leadership team closely monitors and reviews the home‟s development and promotes improvement. The board has set clear targets, which are laid out in the home‟s development plan. This has proved to be a driver in supporting the manager and staff members to meet the home‟s objectives and has led to improvements in the overall quality of care.

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

The senior leadership team has high ambitions for the home and has reviewed the offer for children with disabilities to expand the overall range of services and support available. A review of the home‟s future use has taken place and proposed changes have been agreed, following extensive consultation with parents and other stakeholders. Plans for a change in the service are likely to be implemented within the next six months.

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

Although staff recognise that the short-break service needs to change so that more children in need can receive support, they are anxious about the possible impact of proposals on children and families already receiving a service. Staff morale has dipped as they prepare for the change. Despite this, the staff team continues to provide a professional service and staff shield children from their anxieties. The home meets its overall aims and objectives, providing good-quality short-break care and positive experiences for children with diverse and complex needs.

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

The home is managed by a permanent, suitably experienced manager who has a clear action plan for the continuous improvement of the home. She has a good understanding of the home‟s strengths and areas for development. Her six-monthly reports to the provider demonstrate a good overview and evaluation of the home, but lack input from consultation with parents and children. This means that the reports do not demonstrate how the views of Inspection report children's home: SC034849 9 parents and children have contributed to the development and improvement of the service. Independent monitoring of the home on behalf of the provider has significantly improved and reports demonstrate that children‟s safety and welfare are promoted through good- quality care.

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

The arrangements for the management of the home in the manager‟s absence are still not strong. A senior residential care worker (RCW) leads and manages the staff team while the manager is on holiday, but is not responsible for the day-to-day management of the home. That duty is shared between the responsible individual and another manager, both of whom are available for phone consultations and short visits to the home. The senior RCW is unable to access much of the management information and this was evident through delays in accessing the manager‟s files during the inspection. The current arrangement does not ensure good day-to-day management of the home by a person appointed to deputise for the manager.

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

A comprehensive rolling training programme is available to staff and most staff are well trained and suitably qualified. The home takes action to address any delays in staff obtaining the required qualification for working with children and young people. This helps to ensure that staff have the skills required to look after children who have a wide range of complex disabilities and health problems.

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

The home has good relationships with parents and partner agencies. Parents and professionals speak highly of the quality of care given and the competence and dedication of the manager and staff team. For example, the views of many parents are captured by a parent, who said: „It‟s a marvellous service and the staff are wonderful. They have helped my son to go out in the community without incidents. He is less fearful of noises and other things, as he is used to going out with the staff. He has no peer group at home so it‟s really good for him to be in a group with other children. He looks forward to going and we count down to his next visit. He likes the way they consult him and give him choices.‟

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

The home is proactive in challenging other professionals who are not meeting their obligations to children, and in advocating for children. For example, a parent explained that she had complained about poor communication between the social worker, the home and herself. She said the manager addressed this immediately and advocated successfully on her behalf with the local authority. Since then, communication has been good.

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

Consultation with children informs the choice of activities, outings and facilities. For example, a sunken trampoline has been installed following consultation with children about the best way to spend a donation from parents. A child‟s short-break arrangements were altered after she asked staff if she could visit at a different time to another child. As a consequence, she is happier, more relaxed, and enjoys her short breaks more. This shows how the home readily makes changes to ensure children have the best possible experience during their short breaks.

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

Recording systems have been improved and case notes are more detailed so that they provide a good picture of each child‟s visit. Parents value the case notes they receive following each visit as they help them to understand what their children have been doing Inspection report children's home: SC034849 10 during their short breaks. One said: „We get case notes by email at the end of the visit, detailing all they have done: meals, activities and any incidents. It‟s a thorough report and arrives immediately. That allows me to follow things up with him and we can talk about what he has done there. He likes that. Some parents get paper copies if they don‟t like email.‟

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

The home has introduced direct work records which show some very good key-worker sessions, based on children‟s particular needs. For example, through individually tailored story boards and practical support, staff helped a child to learn to brush his teeth. They have followed this up at subsequent visits as a target for staff to focus on. This has been successful in helping the child to tolerate the toothbrush in his mouth and he is beginning to brush his teeth regularly.

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

Shortfalls in monitoring children‟s experiences and progress, and in the recruitment of staff, were highlighted at the last inspection. Action taken to address these has not been vigorous. There are currently no arrangements for collating and assessing children‟s experiences and progress as a group, and using that information to inform the strategic development of the home overall. Management oversight of individual children‟s progress is not yet strong because each child‟s experiences and progress are not considered routinely during staff supervision and/or team meetings. This does not ensure good management scrutiny of children‟s experiences and progress, and does not promote best outcomes. In addition, file monitoring has not recognised that many staff have not signed important documents, including short-break plans and risk assessments. This does not ensure that staff have read and fully understand the plans for individual children or how to fully meet children‟s needs.

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

Shortfalls in the recruitment, supervision and performance management of staff do not ensure that staff are fully assessed, supervised and supported to meet children‟s needs. For example, comments made in recruitment references are not always followed up. This does not ensure robust recruitment of staff. Staff supervision records are variable and some lack detail. They do not show that children‟s progress is routinely discussed and reflected upon. Some staff have received no one-to-one supervision from a manager for several months, which is contrary to the home‟s policies and procedures. Although staff feel well supported and have ready access to the manager, should they wish to discuss matters of concern, the lack of regular supervision means that children‟s progress and experiences, and the staff‟s skills and competence, are not regularly reviewed.

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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 Inspection report children's home: SC034849 11 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: SC034849 12

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Children’s home details

Registered provider address: 58 Nicholas Street, Chester CH1 2NP

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Inspector

Sharon Lloyd: social care regulatory inspector Inspection report children's home: SC034849 13 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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