Children's Home run by Anna House Limited in Havering

Inspection report children's home: SC058603 1 SC058603 Registered provider: Anna House 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

This privately operated children‘s home provides long-term care and short breaks for up to six children who have learning and physical difficulties. One young adult currently resides in the home.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children‘s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 22 February 2017

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requires improvement to be good

Overall judgement at last inspection: Sustained effectiveness Inspection report children's home: SC058603 2

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Key findings from this inspection

This children‘s home requires improvement to be good because

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Key findings from this inspection

 Although most children continue to achieve good outcomes, there are shortfalls in how children are safeguarded and protected and in leadership and management.

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Key findings from this inspection

 Managers have not consistently reported notifiable events to placing authorities or to Ofsted, which limits partnership working.

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Key findings from this inspection

 There are weaknesses in the recording of crucial records of restraint and sanctions.

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Key findings from this inspection

 Communication between staff and others is variable.

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Key findings from this inspection

 One child‘s challenging behaviour is affecting the atmosphere and other children‘s experience of the home.

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Key findings from this inspection

 Managers want to give the children a positive experience and individualised care during their stay. Their approach is that ‗children need to be loved‘.

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Key findings from this inspection

 Those children staying for a short break enjoy their time in the home and look forward to their stays.

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Key findings from this inspection

 Staff have helped children (some with very challenging behaviour) to settle, make progress and get into regular routines.

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Key findings from this inspection

 Children enjoy nurturing attachments to the managers and the core team of staff. One child said, ‗I like living here‘, and that they ‗feel safe and like the staff‘.

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Inspection date Inspection type Inspection judgement

22/02/2017 Interim Sustained effectiveness 03/08/2016 Full Good 03/03/2016 Interim Declined in effectiveness 13/07/2015 Full Good Inspection report children's home: SC058603 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

(d) full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. Specifically, sufficient proof of identity and a full employment history. (Regulation 32 (3)(d)) Schedule 2(1)) 31/07/2017

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

(c) have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(c)) 31/07/2017

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Requirement Due date

(3) The registered person must ensure that—

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Requirement Due date

(a) within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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Requirement Due date

(i) the name of the child; (ii) details of the child‘s behaviour leading to the use of the measure; (iii)the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the need to use the measure; (vi) the name of the person who used the measure (―the user‖), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure. (Regulation 35(a)(i–viii)) 31/07/2017

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Requirement Due date

(4) The registered person must notify HMCI and each other relevant person without delay if— 31/07/2017 Inspection report children's home: SC058603 4 (4) The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

(c) there is an allegation of abuse against the home or a person working there. Specifically, following protocol by referring any allegations against staff directly to the local authority rather than investigating internally. (Regulation 40(4)(c))

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Recommendations

 Ensure the design of the home includes any necessary adaptation to meet the needs of children with disabilities or specific health issues. Specifically, consider: the use of aids to assist some children when eating their meals; making a child‘s daily activity plan available to them; aspects of the environment such as appropriate and safe decor and furniture for those whose bedrooms are bare; noise levels in the home which may affect children; and organising the home‘s books and toys to assist children to make a choice. (‗Guide to the children‘s homes regulations including the quality standards‘, page 17, paragraph 3.24)

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Recommendations

 Ensure the behaviour management strategy is understood and applied at all times by staff and kept under review and revised where appropriate. Specifically, review behaviour management plans to make sure these give staff clearer guidance on the actions they should take and make sure the restraint policy refers to the current regulations and quality standards. (‗Guide to the children‘s homes regulations including the quality standards‘, page 46, paragraph 9.34)

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improvement to be good

At times it has been difficult for staff to manage one child‘s very challenging behaviour. Although staff do their best to manage his behaviour, the child is sometimes contained in his bedroom in order to protect him and other children: this creates potential deprivation of liberty issues. Noise from the challenging behaviour affects the other children and changes the home‘s usually calm, relaxed atmosphere and the quality of residents‘ lives. It appears that this child‘s needs have outgrown the staff‘s expertise and he is difficult to manage in a small setting. A teacher feels the home‘s staff ‗have done their utmost‘. The placing authority is reviewing this placement. Inspection report children's home: SC058603 5 Most children appear comfortable in their home and move about freely. Some have improved their tolerance of others and will now happily sit with children and staff in the lounge. Most professionals are appreciative of the service. A teacher said, ‗I have no

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improvement to be good

complaints or concerns in regards the care provided.‘ Children benefit from the positive partnership arrangements with external agencies such as the child and adolescent mental health service and the epilepsy specialist nurse.

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improvement to be good

Children benefit from settled placements. Staff and managers show commitment to keeping the children in their home and are reluctant to give up on any child. No placement breakdowns have happened recently, so children have experienced stability. For some children, this is their first and only placement and social workers are happy with their care, intending to keep them in their home until adulthood. One social worker said their child is ‗very happy with the home‘. A school nurse said a child seems to be ‗happy and contented when he comes to school‘.

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improvement to be good

To protect some children from self-harm, staff have made children‘s bedrooms safe, for example, by removing furniture, and in one case lighting, or by adding padding to walls. While staff did this with the best of intentions and with social workers‘ knowledge, it does create an institutional appearance in those bedrooms.

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improvement to be good

Educational progress varies. Most children attend school full time and are making good progress. One attends for only a short time each day, but this is an improvement from their starting point. Another child had tuition for a few days a week but has not received formal education for over a year, so is not making sufficient progress. Staff plan activities during the day to occupy the child and support his learning. The plan was not available at the time of inspection, so the child did not benefit from knowing what to expect during the day.

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improvement to be good

Staff support children‘s health. Children attend their medical appointments regularly and staff prepare them for the experience. Staff help those who need to lose weight to follow healthy eating plans and encourage those who need to gain weight to increase their calorie intake. Children benefit from individually prepared meals, according to their likes and dislikes, as well as their dietary needs. There is one child who may benefit from special equipment to help them eat more independently.

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improvement to be good

Children are encouraged to do some things for themselves. Some children now help staff to clear away after meals. Some improve in the way they communicate and now say more words. Some children have progressed in assisting staff more with their personal care.

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improvement to be good

Staff support children‘s religious and cultural needs. Those who wish to attend church do so regularly. Staff celebrate cultural events and religious festivals with the children to help them feel involved. Staff make families feel welcome and encourage their visits.

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improvement to be good

Every summer, children enjoy the experience of a holiday, which is organised according to individual preferences. The home has two minibuses so staff can provide trips according to children‘s individual interests, such as visits to country parks. There are a Inspection report children's home: SC058603 6 reasonable variety of toys and activities in the home. Children particularly like using iPads and the trampoline in the garden. The toys and books stored in the conservatory would benefit from organisation to help children choose what they want to use.

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improvement to be good

Use of restraint, mostly for one child, has been high. The independent visitor monitors this situation and the use of restraint has decreased over some periods. There was an allegation of inappropriate restraint. Staff wrote an account of the overall incident, but did not record details of the actual restraint in the restraint log. On other occasions, staff have not recorded sufficient detail in the restraint and sanction logs, for example, how long a period of ‗time out‘ was and where this took place. Insufficient recording prevents managers from checking the details of the restraint or sanction to make sure it was appropriate.

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improvement to be good

Staff usually communicate effectively with social workers and families about serious incidents that affectthe children. On one occasion, staff did not tell social workers in a timely fashion about a small injury that a child gained during restraint. Managers have reviewed how the staff report any injuries or marks, and now send photographs and body maps as soon as possible. This ensures better information sharing among all people involved in the children‘s lives.

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improvement to be good

Managers are usually effective in reporting any allegations about staff to the local authority. On one occasion, at a stressful time in the home, the manager investigated an allegation against two members of staff internally and did not notify the local authority or Ofsted, which is the expected protocol. Not all staff have received safeguarding training, although this is booked. The registered manager attended training on child sexual exploitation and shared her knowledge with the staff team.

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improvement to be good

Staff work to behaviour management plans. However, the guidance in these for staff is not always clear, particularly around when it may be necessary to restrain a child.

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improvement to be good

In the home, staff manage medication well. A school made a complaint to the designated officer about how staff manage medication when children are away from the home. As a result, managers reviewed medication policy, changed procedures and arranged staff refresher training in medication to improve safety.

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improvement to be good

Checks on new staff are mostly sound. Managers check any criminal history with the Disclosure and Barring Service and obtain references. However, in one case managers did not obtain a detailed employment history. In another case, the applicant recorded years rather than specific dates of employment. Therefore, managers were not able to check where people have worked before, nor explore any gaps in their employment. In another file, proof of identity is insufficient and the right of the applicant to work in the UK is unclear.

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improvement to be good

Children have not gone missing while on trips out of the home. During the past Inspection report children's home: SC058603 7 inspection year there has been one incident of a child going missing from the home in a quite unexpected way. He was at high risk, but was found quite speedily. Managers put in place satisfactory measures to prevent a reoccurrence.

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

Managers have not met one requirement made at the last inspection with regard to recording restraint. This limits the home‘s progress.

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

Communication between staff and others is variable. A medical professional said, ‗Staff have very good communication with the school teacher and myself.‘ A social worker said, ‗Communication with the home is mixed.‘ A teacher said, ‗Communication is not always there although they always write in the home-school book.‘ Managers report frustration with a few of the children‘s schools, social workers and family members, who they feel fail to communicate clearly with the home. In some cases, miscommunication has affected children‘s care, which is reliant on all parties working together in children‘s best interests.

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

Staff receive supervision and attend regular team meetings, which they find useful in supporting their work with children. However, managers have not completed appraisals for all staff, which denies staff an opportunity to reflect on their performance and plan for their future development.

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

Staff are positive about management support. One said, ‗They do listen.‘ Staff describe morale in the team as ‗reasonable‘, but feel that some in the team ‗need more of a push‘ to use their initiative and assist others.

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

The manager ensures high staffing ratios of adults to children. There is a core team of experienced staff who know the children well. The deputy describes a struggle to recruit suitable staff. The manager tries to use the same agency staff, who are experienced in working in the home and know the children, although this was not the case during the inspection.

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

Staff have not had sufficient training in autism awareness. A social worker said, ‗Staff need to update their approach to autism and behaviour management.‘ Managers have made some efforts to update the staff‘s skills in working with children who have autistic spectrum disorder. For example, they established links with the National Autistic Society and occasionally discuss autistic spectrum disorder in staff meetings. Unfortunately, a training provider did not supply booked training, which was out of the managers‘ control. This has been rebooked with another trainer.

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

An experienced registered manager and her deputy lead this home. There has been no change to the leadership team, which provides the home with stability. Managers encourage children to regard the setting as ‗their home‘.

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

An independent person visits the home regularly to check what is going on. The Inspection report children's home: SC058603 8 manager finds her reports useful and responds to any suggestions for improvement, such as to make clear targets for children and record their progress. This will help children understand their achievements.

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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 the 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 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: SC058603 9

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Children’s home details

Registered provider address: 207 Chase Cross Road, Collier Row, Romford RM5 3YJ

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Children’s home details

Responsible individual: Margaret Akullo-Odiya

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Children’s home details

Registered manager: Margaret Akullo-Odiya

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Inspector

Jacqueline Graves, social care inspector Inspection report children's home: SC058603 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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Inspector

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