Children's Home run by Barnardo’s in Oxfordshire

Inspection report children’s home: SC013143 1 SC013143 Registered provider: Barnardo’s Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This children’s home is registered to accommodate up to six children and young people who have a learning and/or physical disability. The service is delivered and managed by a national charitable organisation.

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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: 14 November 2016

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good

Overall judgement at last inspection: Good

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Key findings from this inspection

 Children are kept safe and trust staff.  Staff communicate effectively with children using children’s favoured means of Inspection report children’s home: SC013143 2 communication.  Children receive individualised care from a consistent team of care givers who understand them and their diverse needs well.  Children have opportunities to pursue their interests and have fun.  Children’s complex needs are not seen as a barrier by staff. Staff advocate for children so that they have similar opportunities to their peers.  Strong relationships with schools and other professionals ensure that children obtain the resources that they require to meet their needs to a good standard.  Staff support children effectively to develop appropriate coping strategies.

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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 The statement of purpose does not have all required information, and some of it is out of date.  The supervision of staff is not at the frequency set by the organisation.  Some training for staff has not been updated in a timely way and staff have not had training in supervising court-ordered contact.  Records of physical interventions do not include children’s views or, alternatively, that they are unable to comment due to their needs.  Medical advice regarding administration of medication is not always documented.  The arrangements for monitoring records and the practice at the home are not thorough.  Repairs to the home are not always carried out in a timely way.

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Inspection date Inspection type Inspection judgement

14/11/2016 Full Good 13/04/2016 Interim Declined in effectiveness 17/11/2015 Interim Sustained effectiveness 06/07/2015 Full Good Inspection report children’s home: SC013143 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 registered person must keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16(3)(a)(b)) In particular, ensure that all information is up to date and in line with schedule 1. 24/07/2017

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Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development, and receive practice- related supervision by a person with appropriate experience. (Regulation 33(4)(a)(b)) In particular, ensure that: staff receive updates to their training in a timely way; are trained in the supervision of court-ordered contact; and supervision of staff is at the expected frequency. 24/07/2017

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Recommendations

 Where the home has questions or concerns about a child’s medication, they should approach an expert such as a General Medical Practitioner, community pharmacist or designated nurse for looked-after children. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.15)  Any sanctions used to address poor behaviour should be restorative in nature, to help children recognise the impact of their behaviour on themselves, other children, the staff caring for them and the wider community. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.38) Specifically, avoid the use of seclusion.  Children should be encouraged to add their views and comments to the record of restraint. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.60) Inspection report children’s home: SC013143 4

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Recommendations

 Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene, etc.) (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9) Specifically, ensure that repairs are carried out in a timely way.  The registered person should oversee the welfare of the children in their care through observation and engagement with: each child; the home’s staff; each child’s family/carers where appropriate; and professionals involved in the care or protection of each child including their social worker, Independent Reviewing Officer (IRO), teachers, clinicians and other health professionals, etc. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.23) Specifically, improve the monitoring systems for appraising the support to staff in their caring responsibilities, and obtain the views of others about the quality

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Recommendations

of care being provided.  All children’s case records (regulation 36) must be kept up to date and stored securely whilst they remain in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.3) Specifically, ensure that children’s profiles and risk assessments are updated in a timely way and emerging triggers to behaviours are included in assessments.

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Overall experiences and progress of children and young people: good

There group of children living in this home have lived together for some time. All children have developed very good relationships with staff. Their relationships with each other are limited by their complex needs, but they do get along with each other overall.

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Overall experiences and progress of children and young people: good

Staff understand children’s needs well and view them as individuals. Children are provided with high levels of nurture, staff are patient with them and children feel comfortable with staff.

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Overall experiences and progress of children and young people: good

Children make good progress in all areas of their lives. Staff enable children to take part in day-to-day life at the home and in longer-term decision making about their care. Children have access to an advocate who comes to know each child well, and strongly represents their views and perceived feelings in all arenas, for example in their statutory reviews.

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Overall experiences and progress of children and young people: good

Children’s social skills develop exceptionally well. Some have progressed from making no eye contact with others, and seemingly being unaware of others around them, to making eye contact and responding to others. Staff are highly competent in communicating with children. Staff know and understand even the most subtle gestures that the children make in their attempts to communicate.

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Overall experiences and progress of children and young people: good

Children’s educational needs are very well met. They have good support to attend Inspection report children’s home: SC013143 5 school. Some children struggle with the transition into school and home again. Individualised strategies are used with patience by staff, and this limits the distress that the children experience at these times of the day. Staff work effectively with the schools that children attend to support them to achieve their educational targets as set out in their education plans. The manager is a good advocate for children whose schools are far away. She has challenged educational professionals to support a move for these children to a school nearer to the home.

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Overall experiences and progress of children and young people: good

Children’s routine health needs are met well. Healthy eating and exercise are promoted and, as a result, some children have benefited from losing weight and improved physical stamina. Medication is stored securely. Overall, the arrangements for administering medication are safe. However, in a limited number of cases, medicine had not been administered in line with the prescribing label. While a medical professional had been consulted about this, there was no written confirmation from them that these practices were acceptable. Children’s emotional and psychological needs are catered for very well. One child’s emotional well-being has improved to the extent that his medication had been reduced.

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Overall experiences and progress of children and young people: good

Children take part in a range of activities. Staff do not view children’s complex needs as being a barrier to them taking part in similar things to their peers. One child was supported by his key worker to go on a school visit to Barcelona. This is something that would not have been possible during the early days of his placement. Children enjoy playing in the home doing art and crafts, or in the garden on the trampoline. They also enjoy trips out. Activities are well planned and used to support children to develop many new skills. Children’s concentration increases, their dexterity improves, they learn self- care skills and they have fun.

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Overall experiences and progress of children and young people: good

Staff support children to see their family. Staff follow local authority contact plans to enable children and their parents to maintain their relationship. Staff are skilful in ensuring that the visits meet each child’s best interests. However, staff have not received the recommended training in the supervision of court-ordered contact to ensure that they understand their role in this.

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Overall experiences and progress of children and young people: good

When children move on from the home, staff ensure that they are well prepared for the move. For one child who moved into a foster placement, the planning was exceptionally well planned and supported by staff. This ensured that the child settled well, and he is now building on the progress that he made at the home.

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

Children are safe living at this home. They have trusting relationships with staff who care about them. Risks are identified and managed effectively. As risks increase, assessments are amended, but in the event of a decrease in risk the assessments are not always adjusted, so strategies that are no longer required remain in place.

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

Children’s behaviour, some of it extreme, is managed effectively. Staff skilfully use the de-escalation strategies detailed in children’s behaviour management plans, yet these Inspection report children’s home: SC013143 6 plans do not include triggers to a child’s behaviour that are emerging so that these can be avoided.

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

In one case, it was noted that seclusion had been used to enforce a child’s compliance with instructions. This was only used on one occasion, but was detailed as a short-term measure on the behaviour management plan. Alternatives had not been adequately considered. Records of interventions do not show that the manager has spoken to the child following an incident and, although for some children this would not be possible due to their level of understanding, there are some children who could express their views, if asked.

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

Children have high levels of supervision, due to their complex needs, so they do not go missing from the home. There are links to the local police, who have visited the home.

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

There have been no safeguarding concerns, but staff are clear about how to deal with these, should there be any. Issues of self-harm are monitored and analysed to ensure that there are no patterns or trends that require attention.

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

The environment the children live in is kept safe through routine health and safety checks. There are some issues when things needing fixing lead to repairs that take an unacceptable length of time.

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

Staff recruitment is thorough and ensures that staff working with the children are suitable people.

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

The manager has been registered to manage this home since March 2014. She holds a level 4 diploma in leadership and management, and she is a qualified social worker. The manager manages the home effectively. She knows each child’s diverse needs well and ensures that these are met.

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

The work of the home is underpinned by a clear statement of purpose. However, the current statement does not fully meet regulations and contains references to withdrawn guidance and agencies that no longer exist. This is confusing for the reader.

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

The staff are qualified and experienced, and care for the children with confidence and warmth. Shortfalls in staffing levels have generally been effectively managed through staff working extra hours. This ensures that people providing care to the children are known to them. There are regular staff meetings during which children and their needs are discussed. Thorough handover sessions for staff coming on duty ensure that staff know and understand any difficulties that children may be experiencing, and these are catered for effectively. The frequency of supervision given to staff has not been in line with the expectations of the organisation, and updates to training are not always made in a timely way. All staff either hold a level 3 qualification in caring for children, are taking one or are waiting to be enrolled on a course. Two staff are undertaking a level 5 qualification. Inspection report children’s home: SC013143 7

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

The work of the home is monitored regularly, but there are some shortfalls in the effectiveness of these arrangements. For example, the shortfalls found in the frequency of supervision and updates in training for staff had not been recognised before this inspection. Also, while an external person carries out monitoring of the quality of care, there is no evidence that they attempt, periodically, to obtain parents’ views about how their child is getting on.

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

There are strong relationships with other professionals involved in the lives of the children. This effective collaborative working ensures that children’s needs are well met and their welfare is promoted to a good standard.

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

Care planning is overall of a good quality, but children’s profiles have not been formally updated to ensure that out-of-date information has been removed. This has the potential to confuse people working with the child.

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

There were two requirements made as a result of the last inspection. One has been met, and this means that it is now evidenced that staff working with the children are suitable people. The requirement not met relates to the training of staff, and this has been restated as a result of this inspection. Of the three recommendations that were made, two have been met. It is now better evidenced how children progress in meeting their targets, and body maps are being completed accurately, monitored and analysed. The third recommendation, which has not been met, is in relation to staff being trained in the supervision of contact. This is now subject to a requirement.

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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: SC013143 8

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Children’s home details

Registered provider address: Barnardo’s, Barnardo House, Tanners Lane, Barkingside, Ilford, Essex IG6 1QG

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Inspector

Rosie Dancer, social care inspector Inspection report children’s home: SC013143 9 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

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Inspector

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Inspector

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