Children's Home run by Barnardo’s in Oxfordshire

Inspection report children‟s home: SC013144 1 SC013144 Registered provider: Barnardo‟s

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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 residential short-break service caters for up to six children or young people at any time. The service is provided by a national charity in partnership with a local authority and a primary care trust. Children and young people can therefore be provided with care and health packages. Most of the children and young people using the service have complex health needs, or are on the autistic spectrum and have associated challenging behaviour. The home is also registered with the Care Quality Commission as a domiciliary care agency that provides occasional support to families in their homes.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers requires improvement to be good

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good

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

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good

Overall judgement at last inspection: Sustained effectiveness

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Key findings from this inspection

This children‟s home is good because: Inspection report children‟s home: SC013144 2  Children trust and know the staff well.  Parents are confident that their child is very well cared for and has fun during their stay.  There is an impressive range of activities that children take part in during their stay.  Children increase in confidence and this enhances their life chances.  Safeguarding matters are dealt with effectively and children are kept safe.  Children‟s participation is seen as important and there is an innovative approach taken to looking at how children can be more involved.  Careful consideration is given to the grouping of children who have stays at the same time to ensure that all are safe and have fun.  Staff work well with other agencies in meeting children‟s needs.  Children who have complex health needs are cared for effectively.  The interim manager and her staff share the passion and commitment to ensure

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Key findings from this inspection

that children benefit from their time in the home.

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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 arrangements for monitoring care need improvement.  Notifications are not made in a timely way to Ofsted and lack detail.

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Inspection date Inspection type Inspection judgement

09/01/2017 Interim Sustained effectiveness 14/09/2016 Full Good 21/12/2015 Interim Sustained effectiveness 11/08/2015 Full Outstanding Inspection report children‟s home: SC013144 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 complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months. In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating: the quality of care provided for children; the feedback and opinions of children about the children‟s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. The system referred to must provide for gaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(1), (2)(a)(b) and (c), and (5)) 15/8/2017

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay of any significant event, in line with the regulation. (Regulation 40(4)) 18/7/2017

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Recommendations

 Records of restraint must be kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly when any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure it meets the needs of each child. („Guide to the children‟s homes regulations including the quality standards‟, page 49, paragraph 9.59) Specifically, ensure there is sufficient detail in each record about why the restraint was necessary.  Any child who has been restrained should be given the opportunity to express their feelings about their experience of the restraint as soon as is practicable, ideally within 24 hours of the restraint incident, taking the age of the child and the circumstances of the restraint into account. („Guide to the children‟s homes regulations including the quality standards‟, page 49, paragraph 9.60)

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Recommendations

Inspection report children‟s home: SC013144 4 Specifically, ensure that the child‟s feelings are recorded or alternatively if the child has not got the capacity to express them that this is recorded.  As set out in regulations 31 to 33, the registered person is responsible for maintaining good employment practice. They must ensure that recruitment, supervision and performance management of staff safeguards children and minimises potential risks to them. („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraph 13.1) Specifically, ensure that people providing a reference on behalf of an organisation are authorised to do so.  The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the

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Recommendations

needs of the children assigned to their care. („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraph 13.2) Specifically, ensure that „group supervision‟ for staff is not used over consecutive months as a substitute for the staff member‟s formal supervision.  Effective care planning and strong working relationships between the staff of the home and the placing authority are essential to the success of placements. („Guide to the children‟s homes regulations including the quality standards‟, page 56, paragraph 11.2) Specifically, ensure that minutes of meetings of reviews for children and strategy meetings are requested from local authorities.  Any individual appointed to carry out visits to the home as an independent person must make a rigorous and impartial assessment of the home‟s arrangements for safeguarding and promoting the welfare of the children in the home‟s care.

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Recommendations

(„Guide to the children‟s homes regulations including the quality standards‟, page 65, paragraph 15.5) Specifically, ensure that parents‟ views about how the home cares for their children are obtained periodically to inform the assessment.

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Overall experiences and progress of children and young people: good

Children and their families say that staff provide them with a warm welcome into the home and they quickly become comfortable with the idea of a short break. Introductions to the home are very carefully planned and are based on each family‟s needs and fears. Parents are confident that staff know their child and their needs and preferences exceptionally well and provide their child with a „home from home‟ service. A parent said she was „blown away‟ by how well staff had quickly got to know her child. Parents have high levels of confidence in the staff. Children settle well into their short-break stays, look forward to them and develop excellent trusting relationships with staff. A team manager from the local authority described how staff „reach out‟ to parents. Due to their complex needs, most children do not develop friendships with their peers. Staff are good at managing children‟s interactions with each other and when possible

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Overall experiences and progress of children and young people: good

promote the development of friendships. Great care is taken in considering which Inspection report children‟s home: SC013144 5 children stay at the same time, to ensure their needs are compatible. The staff have been proactive when children are not getting on with each other. For example, if there is bullying behaviour or other risks emerging, they rearrange children‟s stays to ensure that the most vulnerable children are kept safe. Due to the frequency and length of children‟s stays being at most four days a month, it is not possible for the staff to work in a sustained way to help children achieve high numbers of targets. They focus on small achievable targets that children meet, and new ones are set. Since the introduction of education and health plans for many of the children, staff are developing targets based on these. This means that increasingly across the child‟s day the same areas are being worked on, which improves consistency

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Overall experiences and progress of children and young people: good

of care across the child‟s day. Staff are very skilled at communicating with children, including those who have no verbal skills. This means that children‟s preferences are known and catered for well. A parent commented that staff know her child well and „notice things that are unusual for him‟. Staff encourage children to try new experiences to ensure they develop skills and broaden their outlook. Children develop in their social skills and some make significant steps, such as improving their personal care skills or achieving improvements in their sleep patterns. For some children who have an intense focus on a particular object or interest, such as the extensive use of a tablet, staff support them to take part in other pastimes and try new things, and this helps to minimise their repetitive behaviour. Children know how to complain (subject to their level of understanding), although there have been no complaints since the last inspection.

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Overall experiences and progress of children and young people: good

When possible, there is good attention to enabling children to actively participate in day- to-day decisions about their lives. There is extensive development work taking place to develop children‟s participation further. It is clear that staff value children‟s views and are totally committed to ensuring that children are enabled to have control over their lives as far as they are able. A parent said, „It‟s a happy place; all children are really valued.‟ The responsibility for children‟s education remains with their parents. However, staff ensure that children get to school on time. Staff work proactively with teachers to ensure that children‟s educational achievement is promoted. The development of education and health plans is aimed at enriching this already good work. The responsibility for children‟s overall health remains with their parents. However, during their stay children are cared for by staff who really know and understand their

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Overall experiences and progress of children and young people: good

health needs and meet these to a good standard. Care is taken to ensure that children are treated with dignity and respect. For example, children‟s personal care needs are carefully thought through to ensure their dignity is assured. For children who have more complex health needs, these are ably met by nursing and, when appropriate, care staff. When children have specific dietary needs, these are known about and met. For example, one child has a complex diet which contributes to limiting their seizures, and this is carefully catered for. More generally, a social worker commented how healthy eating is promoted and this is teaching their child a valuable lesson about the impact food can have on your health. The arrangements for medication are sound. All medicines are signed in and out of the building, checked and administered in a safe way. There have been two medication Inspection report children‟s home: SC013144 6

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Overall experiences and progress of children and young people: good

errors since the last inspection. These have been fully investigated and some changes made to improve practice. Children are safely and positively engaged in a range of activities. Some of these are educational and some just for fun. A parent spoke about how she is impressed at the things her child gets to do during their stay – including new and interesting activities that would not be possible otherwise – and that she feels activities are very well planned and organised. During the inspection, children were happily engaged in various activities: one young person was doing drawing and cutting out; another was teasing staff and later went out for a walk around the park; and a third was enjoying spending time chatting happily with staff. Staff clearly understand the importance of keeping children gainfully occupied, doing things they enjoy during their stay. There are very strong working relationships with parents. Parents spoken to were all

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Overall experiences and progress of children and young people: good

very complimentary of staff. They said that staff show genuine concern for them as a family and try to do anything they can to help them as well as their child. For example, extra visits have been arranged during family crises. One parent said of staff, „Nothing is too much trouble for them.‟ Another said staff were „totally amazing‟, and a third said, „It will be a sad day when he leaves.‟ Even though children do not have stays of long duration or frequency, they do develop in their independence skills over time, for example in meeting their personal care needs more effectively or making improvements in their behaviour so they can enjoy trips into the community. Staff advocate for young people and their families to obtain a new service when it is time to move on to adult services. If one is found, staff are fully involved in ensuring the staff at the new service are fully aware of the young person‟s needs and help the young

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Overall experiences and progress of children and young people: good

person to voice their wishes and feelings. They have supported young people and their parents to visit new placements so they are familiar with their new service. This cannot always be arranged for the young people in a timely way due to local resource issues beyond the control of the home. A parent whose child had left the home and had no alternative placement said the support that staff had given them in trying to access a service was „amazing‟.

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

It is clear that children feel safe with staff and trust them. Parents expressed their confidence in staff to keep their child safe. Staff have an in-depth understanding about the vulnerabilities of each child they care for, and through this risks have been identified and assessed, and are managed effectively. This ensures that all children are safe during their stay and that their well- being is promoted. When needs change, staff ensure that any new risks or vulnerabilities are assessed and managed. Staff use behaviour support plans which help children to manage conflicts and maintain boundaries more effectively. Staff have a real understanding about what makes children anxious and what the triggers for this are. They use the strategies detailed in the plans effectively to help children reduce behaviours that are harmful to themselves and others, such as self-harm or hitting out at others. A social worker commented on how staff

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

Inspection report children‟s home: SC013144 7 „manage very challenging children well, with calmness and structure‟. Physical interventions are rarely used, and when they are they are very low level, such as taking a child‟s hand away when they are pulling another‟s hair. Not all of the records made of these incidents provide the reader with a clear view about why the intervention was necessary. Additionally, the interim manager is not recording, in every case, what the child‟s feelings are about their experience or if the child is unable to express their view. Children do not go missing from this home. Children are individually supervised throughout their stay and this ensures that the opportunity for a child to go missing is mitigated. Children do not have access to the internet during their period in the home but some children bring in tablets. In one case, a child wanted to take pictures of staff and other

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

young people. Staff dealt with this in a calm and measured way to ensure that people‟s privacy was not compromised. Staff are trained in dealing with safeguarding issues, including issues relating to different forms of exploitation. Staff demonstrated a good awareness of what to do if they had concerns about a child. Since the last inspection, a safeguarding matter that arose was fully investigated. The interim manager worked closely with safeguarding professionals and ensured that the matter was dealt with effectively. Staff working in the home undergo a vetting process before they are allowed to work with children. This is generally good but in one case a reference had been accepted from a referee who stated they were a colleague. This had not been followed up with the organisation to ensure that this person was qualified to provide an employment reference on behalf of the company. The environment is safe, and well equipped and maintained. There are lots of pictures of

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

the children having fun while taking part in activities. Many of the children do not like a highly stimulating environment due to their sensory needs. However, staff have achieved a good balance between meeting these children‟s needs and ensuring that other children are provided with a pleasant environment.

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

The home has been without the registered manager since the beginning of the year. The deputy manager has been managing the home in the interim. She did not submit an application to register with Ofsted until 16 June 2017. This will now be progressed by Ofsted. This has been a difficult time for the staff as it has been uncertain if or when the registered manager will return to work. The interim manager and staff remain totally committed to ensuring that children are safe and have fun during their stay in the home. The interim management arrangements have ensured that there has been no impact on the quality of care to the children, but there have been some shortfalls in the management of the home, such as the monitoring arrangements. The interim manager has provided Ofsted with a review of the quality of care as required by regulations. However, the review lacks evidence to show that patterns and trends

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

Inspection report children‟s home: SC013144 8 have been analysed and that the opinions of others, such as parents and professionals, have been sought and fed into the review. There is very little reference to areas of development required to ensure that the care provided to the children remains of a high quality and practice develops. The report provides a reasonable view about the progress of children and some of the issues the home has faced in providing care to them. There is an independent visitor who carries out monthly visits to the home. She spends time with children and staff and views the home‟s records. From this she forms a view about the quality of care. However, her assessment is not regularly informed by the views of parents. The requirement and recommendations made at the last inspection have been met. There is now clear policy guidance about staff recruitment processes, especially relating

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

to overseas checks. Staff are strong advocates for young people moving on to adult services and as far as possible support this process well. Risk assessments are developed prior to a child spending an overnight stay in the home and when possible these are explained to the child. Notifications of significant events are not always made in a timely way and lack detail of the concern. This means that Ofsted is not fully appraised, at an early stage, about safeguarding matters in the home. This limits the regulator‟s ability to monitor the progress of safeguarding issues. There have been long-standing difficulties in recruiting suitable staff, which the organisation is attempting to address. The impact of this on children has been minimal because there is a pool of casual staff who cover shifts when required. In addition, permanent staff work extra hours. This ensures that staffing difficulties do not impact on

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

the consistency of care provided. Staff are very child-focused, and they have a very good understanding of each individual child‟s needs and see them as individuals. Staff are competent and confident in their roles. A social worker said, „A strength of staff is their persistence; they invest in children and are part of our team.‟ Staff induction, training and appraisals support them to provide a high quality of care to the children. All staff either have or are studying for a level 3 qualification in caring for children. One area of shortfall is a practice of using team meetings as supervision sessions. The organisational policy allows, in exceptional circumstances, for three of these to be classed as supervision per year. However, some staff have not had individual supervision for over two months due to this arrangement. This has not allowed them to be able to express their views and feelings during a formal supervision session, in

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

private, with their supervisor. Care planning is child-centred, individualised and reviewed to ensure that care meets children‟s current needs. The interim manager ensures that any concerns about care planning are escalated to the local authority. Partnership working is strong overall and children‟s respite stays support their wider care plan. There have been improvements in challenging local authorities when staff feel that an aspect of care planning is not meeting or may not meet the needs of the child. However, the interim manager and staff have not strongly challenged other agencies when records of meetings between them are not forwarded to the home in a timely way. Due to this, there is a risk that actions that have been identified for the staff to do may not be known about by all of them. However, overall the case records for children are informative and provide a good Inspection report children‟s home: SC013144 9

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

view about their time in the home should they or their parents want to access them.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children‟s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people whom it is trying to help, protect and look after.

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Information about this inspection

Using the „Social care common inspection framework‟, this inspection was carried out 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: SC013144 10

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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: SC013144 11 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children‟s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children‟s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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