Children's home run by Action for Children in Watford

Inspection report children’s home: SC477151 1 SC477151 Registered provider: Action For Children

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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 is a short break home run by a charitable organisation. It offers residential short breaks for young people who have learning disabilities, sensory impairment and physical disabilities. It may only provide care and accommodation for up to five young people at any one time.

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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: 27 February 2017

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good

Overall judgement at last inspection: Sustained effectiveness

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Key findings from this inspection

This children’s home is good because Inspection report children’s home: SC477151 2  Young people make good progress from their starting points. Their individual targets are closely monitored and reviewed.  Young people receive effective care and support from staff who understand their particular needs.  Young people enjoy an extensive range of activities inside and outside of the home.  Young people are kept safe. Staff are guided by behaviour support plans that help reduce incidents.  Young people do not go missing. Sanctions and physical restraint are rarely used in the home.  All staff are trained to understand how young people communicate. This enables the young people to express their wishes and feelings and contribute during their short break.  Parents and professionals are very complimentary about the quality of care provided by the staff at the home.  Staff liaise closely with parents, carers and professionals to gain relevant

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Key findings from this inspection

information. This ensures that care plans are comprehensive.  Young people benefit from being cared for by staff who provide consistent individualised care and support.  The committed staff team is well established. Staff’s extensive knowledge complements the dedicated care and support provided to the young people.

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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

 Young people do not always benefit from living in a home environment that is well maintained. In addition, some areas of the home are not accessible to the young people, including the adapted bathroom and soft playroom.  Managers do not audit staff files regularly. This includes recruitment, supervision and annual appraisal records.  The young people’s written risk assessments fail to include all possible risks.

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Inspection date Inspection type Inspection judgement

27/02/2017 Interim Sustained effectiveness 06/06/2016 Full Good 27/10/2015 Full Good Inspection report children’s home: SC477151 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 with the given timescales.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2.

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Requirement Due date

This relates specifically to the need to obtain proof of identity, including a recent photograph. 31/08/2017

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Recommendations

 Children’s homes should be nurturing and supportive environments that meet the needs of the children. They will, in most cases, be homely, domestic environments. In particular, ensure that young people have access to the adapted bathroom and soft playroom. (‘Guide to the children’s home regulations including the quality standards’, page 15, paragraph 3.9)  Staff should continually and actively assess the risks to each child and the arrangements in place to protect them. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)  A record of supervision should be kept for staff, including the manager. The record should provide evidence that supervision is being delivered in line with regulation 33(4)(b). In particular, all supervision records should be signed by the author and supervisee. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.3)

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Recommendations

Inspection report children’s home: SC477151 4  All staff must have their performance and fitness to carry out their roles formally appraised at least once annually. In particular, all annual appraisals should be dated and signed by the author and supervisee. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.5)

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Overall experiences and progress of children and young people: good

Young people benefit from individualised care and support during their stay at the home. Individual placement plans identify the young people’s wishes, what makes them happy or sad, routines, health needs, communication preferences and support needs. The staff team’s considerable knowledge of the young people ensures that their short breaks provide them with a safe and enjoyable time when away from their parents and carers. A young person enjoys the home’s rocking chair for relaxation. When the rocking chair broke, the dedicated staff ordered a new one, ready in time for the young person’s next stay in the home. The young person’s parent said, ‘I feel confident that he is cared for by people that understand his needs and support him.’

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Overall experiences and progress of children and young people: good

The home is a large four-bedroom property in a quiet location. The young people’s large bedrooms are suitably equipped and furnished. However, because the move to this property was considered temporary, the decoration and internal maintenance of the home do not provide a welcoming homely environment. Photographic wall displays of the young people and their activities are limited. A young person dislikes the entrance hall wallpaper, describing it as ‘too busy’. Stair carpet is worn, one of the bathrooms is out of use, the garden soft playroom is not used and contains sensory water bubble apparatus, which is dirty. The registered manager is aware of these issues and some maintenance is under way.

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Overall experiences and progress of children and young people: good

Staff invest their time to understand the young people’s complex needs. They liaise closely with the young people’s schools and observe classroom activities. This approach, coupled with regular discussions between the care and school staff, results in good- quality care planning. A teacher said, ‘There is good communication with the care team.’ Staff learn the young people’s communication styles. As a result of one school visit, a staff member has created a bespoke communication resource pack for a young person. This meticulous approach ensures that the young person is able to express their wishes and feelings and contribute to their short-break care.

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Overall experiences and progress of children and young people: good

Young people are given every opportunity to visit the home before they stay overnight. This sensitive planning provides the young people with reassurance while they familiarise themselves with new peers, adults and their new environment. A teacher described a young person’s increased confidence in staying at the home as ‘huge progress’. When the young people wish to stay with their friends, who also use the service, the registered manager makes significant efforts to ensure that the young friends are offered the same short-break dates. This develops and sustains their friendships. Inspection report children’s home: SC477151 5 Staff complete a ‘my stay’ record for every young person when they visit the home. These detailed recordings of the young people’s achievements, activity participation and general health and well-being enable staff and parents to plan for the young people’s future visits. Regular staff key working sessions with the young people also enhance the

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Overall experiences and progress of children and young people: good

young people’s individualised care. These are pivotal in the successful progress of the young people in the home.

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Overall experiences and progress of children and young people: good

The staff team’s systematic use of ‘outcomes ladders’ to monitor each young person’s progress works very well. Progress can be in small ways. However, for many young people and their families, these small steps are highly significant. Staff actively monitor and review the young people’s progress during every short break. Staff consult and agree targets with parents and carers. The dedication of the staff team has enabled one young person to progress from choosing sandwich ingredients to independently making their own sandwich and then successfully cooking a simple meal. Another young person is making good progress in learning to tell the time. Staff facilitate progress creatively. For example, one young person uses hand-held musical instruments to encourage improved physical strength.

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Overall experiences and progress of children and young people: good

Staff understand the young people’s communication styles. Staff’s knowledge of the young people, coupled with the use of bespoke communication materials, ensures that young people’s needs and wishes are understood. For example, when a young person leads staff by the hand to the kitchen, they know that he is thirsty and provide him with a drink.

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Overall experiences and progress of children and young people: good

The young people are provided with their food preferences during their short breaks. Menus are planned in advance of the young people’s stay at the home. Staff take care to provide meals that meet the young people’s dietary requirements and cultural choices, for example, ensuring that young people receive a Halal diet.

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Overall experiences and progress of children and young people: good

Staff ensure that the young people’s health needs are met during their stay at the home. All staff are first aid trained. Medicines are securely stored, and staff update young people’s prescription directions during every stay. Observant staff swiftly contact parents or carers if there are any health concerns. A parent said, ‘Staff communication is brilliant,’ adding that she is ‘confident that staff know him, because if he is getting excited or not feeding they understand he may be becoming unwell.’

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Overall experiences and progress of children and young people: good

Young people have fun during their visits. A young person said, ‘I feel excited when I come to stay.’ Young people benefit from access to a large outdoor area with suitable safety matting. Staff help the young people to grow vegetables in the raised garden beds. Young people participate in stimulating learning opportunities: messy play, arts and crafts and cultural celebrations that all enhance the young people’s experiences.

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Overall experiences and progress of children and young people: good

The staff team is not risk averse and plans numerous activities outside the home. Staff carefully risk assess travel arrangements and supervision levels according to the individual young people’s needs, which ensures their safety. The young people enjoy regular trips to the seaside, riding stables, parks, football matches and the cinema, which further broadens their social opportunities. All young people, their parents and Inspection report children’s home: SC477151 6 carers said that they particularly appreciate the home’s annual summer picnic ‘get together’.

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Overall experiences and progress of children and young people: good

Parents and carers receive a ‘what I did during my stay’ record at the end of each short break. This records in detail the young people’s participation in activities, medication record, sleeping patterns, personal care support and welfare observations. Parents and carers appreciate this information, which informs future short-break planning.

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Overall experiences and progress of children and young people: good

A young person described his stay at the home. ‘Me and S have lots of fun, fun, fun.’ When staff asked what they could do to improve their stay, the young person replied, ‘More days with you.’

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

Staff keep young people safe in the home. The home has comprehensive and appropriate risk assessments in place, which cover all health and safety matters. All statutory fire, health and safety checks are current, providing a safe environment for the young people. Staff further enhance the safety of young people with their knowledge of their individual detailed personal emergency evacuation plans.

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

The registered manager completes impact risk and placement matching assessments prior to young people coming to stay at the home. She carefully evaluates referral information from schools and social workers. Such meticulous consideration of the young people’s needs ensures a positive transition to the home. Simultaneously, the stability and safety needs of all the young people are properly considered to ensure appropriate matching. This process ensures that staff have all the necessary skills and knowledge to support the young people during their stays at the home.

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

Not all of the young people’s risk assessments are complete. For example, while individual risks arising from manual handling or challenging behaviours are assessed, the risks of radicalisation and child sexual exploitation are not recorded. Inconsistent recording limits staff’s understanding of all of the risks to the young people and what safeguards to put in place. This shortfall does not place young people at significant risk of harm.

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

Every young person receives a good-quality children’s guide. The guide sets out very well, in pictorial and written language, what the young people can expect during their stay in the home. The guide provides the young people with helpful information on how to complain or seek advocacy support. Parents and carers receive a similar guide, which enhances their knowledge of the young people’s support in the home and of how to raise any concerns. If they need to complain, parents and carers benefit from an open and transparent process.

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

Staff have a thorough understanding of child protection policies and procedures. They are confident about how to report any concerns or allegations made. This further promotes the young people’s safety. Inspection report children’s home: SC477151 7 Young people benefit from a positive behaviour model of support in the home. Individual behaviour support plans identify any vulnerabilities or behavioural challenges with recommended strategies to minimise incidents. Parents and carers agree behaviour support plans. Staff successfully utilise strategies, such as role modelling and bespoke communication styles, with the young people to de-escalate any incidents. Incidents are accurately recorded and reviewed by the registered manager. After any incident, staff are appropriately debriefed and the young people engage in ‘life space’ interviews. During these interviews, staff successfully engage with the young people, enabling them

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

to express their feelings. Staff then review and update behaviour support plans. This ensures that staff respond to the changing needs of young people with appropriate support strategies.

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

Excellent staffing levels ensure that young people receive appropriate supervision during their short breaks. As a result, young people do not go missing from the home. Physical restraint and sanctions are rarely used in the home. There have been no restraints or sanctions recorded since the last full inspection.

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The effectiveness of leaders and managers: good

The registered manager displays a comprehensive appreciation of the strengths and weaknesses of the home. She completes regular reviews of the home’s quality of care. Monitoring and progress against the quality standards are comprehensive. As a result, action plans are drawn up that further embed the professional and nurturing care that staff offer the young people.

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The effectiveness of leaders and managers: good

The proactive registered manager has actioned all previous inspection requirements and recommendations. She has identified and implemented additional evaluation tools, such as regular telephone interviews with parents and carers. This process provides the registered manager with a very good oversight of the home’s effectiveness in delivering good-quality care. This approach ensures that the specific needs of young people are met, while simultaneously identifying where improvements can be made.

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The effectiveness of leaders and managers: good

Staff receive regular supervision and annual appraisals, which evidence ongoing professional development. However, management auditing of staff files is not consistent. Not all appraisal and supervision documentation is signed and dated by managers or the member of staff. In addition, one staff file did not contain photographic identification. These omissions do not negatively impact on the good quality of care provided to the young people.

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The effectiveness of leaders and managers: good

All staff are qualified in the level 3 diploma in residential childcare. The staff team receives comprehensive core training and specialised training to meet the specific needs of the young people. Core training includes safeguarding young people, risks of child sexual exploitation and radicalisation. Clinical training to meet the health needs of the young people includes gastrostomy feeding, medication administration, epipen use and sickle cell support. The registered manager and staff identify further bespoke training to support the young people’s needs. For example, a specialist nurse provides epilepsy Inspection report children’s home: SC477151 8 support and training to the staff team. All training is refreshed regularly in line with guidance.

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The effectiveness of leaders and managers: good

Some staff team members are qualified as trainers. For example, staff receive in-house training in positive behaviour support strategies and a range of non-verbal communication tools. This training and knowledge ensure that staff have the competencies and skills to support the complex needs of the young people in their care. They also ensure that the young people receive a consistent approach during their short breaks. A parent complimented the staff, saying, ‘The service is quite exceptional and met M’s needs very well.’

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The effectiveness of leaders and managers: good

The registered manager recognises the challenges for the staff team as the service is due to be transferred to a different registered provider in the future. A member of staff described the team as ‘stable’. The long-serving staff team continues to demonstrate dedication and commitment to the young people who stay at the home. A parent said, ‘They work tirelessly and lovingly with our child,’ and added, ‘Staff go above and beyond in every aspect of their care for my son.’

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The effectiveness of leaders and managers: good

Good monitoring systems are in place. The external independent visitor visits the home once a month. The detailed reports highlight areas of strength, good practice and constructive advice for improvements. The registered manager swiftly actions any recommendations, ensuring the home’s continuous improvement.

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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: SC477151 9

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Children’s home details

Registered provider: Action For Children

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Children’s home details

Registered provider address: Action for Children, 3 The Boulevard, Watford WD18 8AG

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Children’s home details

Responsible individual: Shelagh Frankcom

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Inspector

Victoria Jones, social care inspector Inspection report children’s home: SC477151 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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