Children's home run by Bristol City Council

Inspection report children‟s home: SC067151 1 SC067151 Registered provider: Bristol City Council

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This children‟s home is registered to provide short breaks for up to five children who have physical disabilities and/or learning difficulties. It is operated by the local authority.

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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 inadequate

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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: 19 January 2017

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requires improvement to be good

Overall judgement at last inspection: Declined in effectiveness

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Enforcement action since last inspection

None. Inspection report children‟s home: SC067151 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

 Leadership and management is inadequate. There has been no registered manager in post for 26 weeks. Staff shortages have meant that the three deputy managers have spent much of their time working on shift.  A lack of dedicated management time has resulted in the home not been monitored effectively. Consequently, there has been limited progress towards meeting the requirements and recommendations from the last inspection.  This is the third consecutive inspection where the home‟s managers have failed to meet statutory requirements.  Managers have not made sure that fire safety checks are carried out at recommended intervals. Staff do not always receive supervision in line with the employer‟s policy.  Key policy documents, such as the statement of purpose and children‟s guide, are not always kept up to date. The children‟s guide contains information which is not relevant for children and young people who have disabilities.

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Key findings from this inspection

 Improvements to the home have not been completed. As a result, some areas of the home appear institutional in character.  Although risk assessments are in place to help keep the children and young people safe, they are not always followed. The inspector found an example of a member of staff working alone with a young person who should be supported by two members of staff at all times.  The staff have not recorded all restraints in the physical intervention log. The current log omits important information about restraints. This information is necessary to meet the regulation.  Managers have not made sure that recruitment checks on employees are complete.  Ofsted have not received any regulation 44 reports since November 2016.

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Key findings from this inspection

 The home provides an invaluable service to the children, young people and their families in this local authority area. This flexible and responsive service supports families to stay together.  The staff use picture symbols and other specialised techniques. These help the children and young people to express their needs and choices.  The home has a dedicated and experienced staff team. Team members worked hard on their „away day‟ to clean an item of play equipment for the children.  The staff consult well with the children and young people. As a result, the children and young people have learned about fire safety through pictures, videos and games. The staff also helped them to share their views about the sensory equipment that they would like in the home.  Social workers say that the home welcomes children and young people to the home and plans their admissions sensitively.  The children and young people enjoy their short-break experiences.

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Key findings from this inspection

 The staff manage challenging behaviour well. They make sure that all other staff Inspection report children‟s home: SC067151 3 and young people around the child or young person are safe.  There has been only one restraint since the last inspection. No children or young people have gone missing from the home. There have been no complaints or safeguarding concerns.  Staff have built trusting relationships with parents. Some parents use the home to have contact with children and young people who are unable to live with them. Other parents rely on the home to provide much needed breaks.

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Inspection date Inspection type Inspection judgement

19/01/2017 Interim Declined in effectiveness 23/08/2016 Full Good 02/02/2016 Interim Sustained effectiveness 14/09/2015 Full Good Inspection report children‟s home: SC067151 4

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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Requirement Due date

The quality and purpose of care standard

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who understand the children‟s home‟s overall aims and the outcomes it seeks to achieve for children and use this understanding to deliver care that meets children‟s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to provide to children living in the home the physical necessities they need in order to live there comfortably; provide to children personal items that are appropriate for their age and understanding; make decisions about the day-to-day arrangements for each child, in accordance with the child‟s relevant plans, which give the child an appropriate degree of freedom and choice; ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child; and enable each child to participate in the daily life of the home.

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Requirement Due date

This is with particular reference to ensuring that the home is decorated and furnished in a homely manner and that the remaining refurbishment work is completed.

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Requirement Due date

(Regulation 6 (1)(a) and (b), (2)(b)(vii)(viii) and (c)(i) and (ii)) 11/08/2017

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure that staff assess whether each child is at risk of harm, taking into account information in the child‟s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child.

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Requirement Due date

This is with particular reference to ensuring that young people 31/07/2017 Inspection report children‟s home: SC067151 5 are staffed at all times in line with their risk assessments.

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Requirement Due date

(Regulation 12 (1), (2)(a)(i)) Leadership and management standard

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that helps children aspire to fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home‟s statement of purpose; ensure that the home has sufficient staff to provide care for each child; understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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Requirement Due date

This is with particular reference to management monitoring, staffing levels, fire safety checks, frequency of staff supervision and recording actions from team meetings.

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Requirement Due date

(Regulation 13 (1)(2)(a)(d)(f)and (h)) 11/08/2017

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Requirement Due date

The registered person must compile in relation to the children‟s home a statement (“the statement of purpose”) which covers the matters listed in Schedule 1.

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Requirement Due date

This is with particular reference to a description of the location of the home and an explanation of how a person or organisation involved in the care or protection of a child can access the home‟s child protection or behaviour management policies.

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Requirement Due date

(Regulation 16(1) and Schedule 1). 31/07/2017

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Requirement Due date

The registered provider must appoint a person to manage the children‟s home if there is no registered manager in respect of the home; and the registered provider is an organisation or a partnership; does not satisfy regulation 28; or is not, or does not intend to be, in day-to-day charge of the home. 11/08/2017 Inspection report children‟s home: SC067151 6 (Regulation 27 (1)(a)(b)(i) to (iii)) Fitness of workers

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children‟s safety. The registered person may only employ an individual to work at the children‟s home; or if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3). The requirements are that the individual is of integrity and good character; the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and 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

In particular, ensure that all staff files have a full employment history, photograph, two written references and identity information.

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Requirement Due date

(Regulation 32 (1)(2) and (3)(d)) 31/07/2017

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Requirement Due date

Behaviour management policies and records

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Requirement Due date

The registered person must ensure that 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

- the name of the child; - details of the child‟s behaviour leading to the use of the measure; - the date, time and location of the use of the measure; - a description of the measure and its duration; - details of any methods used or steps taken to avoid the need to use the measure; - the name of the person who used the measure (“the user”), and of any other person present when the measure was used; - the effectiveness and any consequences of the use of the measure; - a description of any injury to the child or any other person; and - any medical treatment administered, as a result of the measure.

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Requirement Due date

Within 48 hours of the use of the measure, the registered 31/07/2017 Inspection report children‟s home: SC067151 7 person, or a person who is authorised by the registered person to do so (“the authorised person”) has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure.

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Requirement Due date

In particular, ensure that all restraints are recorded in the restraint log and that the log details all the elements listed above including the location, the effectiveness of the measure and the debrief carried out with staff and young people.

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Requirement Due date

(Regulation 35(3)(a) and (b)) Independent person: visits and reports

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Requirement Due date

The registered person must ensure that an independent person visits the children‟s home at least once each month. The independent person must provide a copy of the independent person‟s report to HMCI.

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Requirement Due date

(Regulation 44(1) and (7)(a)) 31/07/2017

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Recommendations

 Ensure that children‟s homes are nurturing and supportive environments that meet the needs of their children. They will, in most cases, be homely, domestic environments. Children‟s homes must comply with relevant health and safety legislations (alarms, food hygiene etc.); however, in doing so, homes should seek as far as possible to maintain a domestic rather than „institutional‟ impression. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraph 3.9)

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Recommendations

 Ensure that, when reviewing and revising the statement of purpose (Regulation 16(3)(a)), the registered person reviews and updates the children‟s guide as necessary. In particular, ensure that the children‟s guide includes information that is meaningful to children who have disabilities and special communication needs. („Guide to the children‟s homes regulations including the quality standards‟, page 24, paragraph 4.23)

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Inspection judgements

Inspection report children‟s home: SC067151 8

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improvement to be good

The children and young people enjoy good quality day-to-day care. The children and young people who use this short-break service usually live at home. They are introduced to the home gradually. They may visit for tea with their parents. This helps to make sure that they are comfortable before they come to stay for the first time.

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improvement to be good

The staff offer a range of fun activities to enhance the children and young people‟s stay. They may visit the community farm next door to the home, go bowling or go to a range of other attractions.

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improvement to be good

The staff understand the children and young people‟s needs very well. They spend dedicated time playing with each individual. The children and young people are happy and relaxed in their company.

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improvement to be good

The children and young people are taken to school after their short break. This helps to make sure that there is no disruption to their education.

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improvement to be good

The staff support parents who visit the home. They show empathy and insight into the challenges of family life. Some parents, who are not able to look after their children at home, use the home to spend time with them.

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improvement to be good

The home keeps adequate records to help the staff to provide safe and consistent care. Care plans are written from the child or young person‟s point of view and are easy to understand. The format for writing care plans has not changed for many years.

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improvement to be good

The children and young people sometimes become very anxious or distressed. The staff are well aware of the triggers for this and manage these situations well. As a result, there is very little need for physical intervention.

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improvement to be good

Each child and young person has a detailed healthcare plan. This highlights their individual needs and how the staff should support them. Medication is very well managed and recorded. It is safely administered by trained, registered nurses.

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improvement to be good

The deputy managers have arranged several children and young people‟s meetings. These included fire safety training and how to improve the home‟s sensory room.

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improvement to be good

The children and young people are safe in this home. The staff have access to detailed risk assessments on each child. These provide clear strategies to help them to manage their day-to-day care.

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improvement to be good

However, staff safety is a concern. One young person‟s risk assessment states that they Inspection report children‟s home: SC067151 9 need two staff to be with them at all times. One member of staff, who wanted to help out a family in a difficult position, escorted a young person in a taxi on their own. There was no incident, but this young person‟s volatile behaviour meant that this was a clear risk. The staff member explained that this was an exceptional situation. The inspector has made a new requirement.

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improvement to be good

The children and young people in this home do not go missing or engage in deliberate risk-taking behaviour. There have been no complaints or allegations against staff.

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improvement to be good

The staff are trained in child protection and have access to the local authority‟s safeguarding procedures. They understand the need to monitor any children and young people at risk. The staff communicate well with social workers and other professionals. This means that any concerns about a child or young person are passed on.

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improvement to be good

Some staff recruitment files inspected do not contain enough information. None of the three files inspected contained a good quality, clear photograph. One member of staff has large gaps in their employment history. There was no identity information and there were no references available for this person. Although managers audited this file in June 2014, these shortfalls were not identified. A requirement has been made.

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improvement to be good

The home manages the young people‟s behaviour well. All staff are trained in physical intervention, although they rarely need to use it. There has only been one restraint since the last inspection. This took place in February 2017. The staff recorded this on the young person‟s file, but it was not logged in the restraint book. The last restraint recorded in the book took place on 7 April 2015.

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improvement to be good

The restraint log book does not meet regulatory requirements. Specifically, the format does not include the location and effectiveness of the measure. There is no detail about the staff, child or young person‟s debrief. A requirement has been made.

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improvement to be good

Health and safety in the home is generally good. However, fire alarm tests are not always completed every week. For example, there were only three fire alarm tests in February and two in April.

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improvement to be good

The interim inspection found that fire evacuations were not timed. The deputy managers now make sure that this is done.

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improvement to be good

The home has held a children and young people‟s meeting to help them to understand fire safety. The staff showed the children and young people pictures of fires. They gave them shaving foam so that they could have fun spraying the „fires‟ with it. They all watched a film about fire safety together. This is a good example of how the staff use their communication skills to include the children and young people in the home‟s safety training.

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The effectiveness of leaders and managers: inadequate

Inspection report children‟s home: SC067151 10 There has now been no registered manager in post for 26 weeks.

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The effectiveness of leaders and managers: inadequate

The home‟s three deputy managers, who are all qualified nurses, have tried hard to provide some management time. None of these three people, all of whom work on shift, has official responsibility for the conduct of the home. One of the deputy managers was appointed to be the interim manager. She has since decided to return to her substantive post. Staff shortages meant that there was insufficient time to carry out both roles. The deputy managers have done their best to cover as many management tasks as possible, but it has not been possible to action them all.

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The effectiveness of leaders and managers: inadequate

Key management tasks are not always completed on time. For example, the statement of purpose and children‟s guide both need updating. In recent months, staff supervision has slipped. Some staff have not been supervised in line with the local authority‟s policy. The last inspection found that team meetings are poorly recorded. There has been some improvement, but it is still not always clear who is to take action on specific points, or the timescale for completing tasks.

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The effectiveness of leaders and managers: inadequate

Internal monitoring is adequate. The latest regulation 45 report has been completed and sent to Ofsted, so this requirement is now met.

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The effectiveness of leaders and managers: inadequate

Other requirements are being repeated for the third time. For example, Ofsted has not received a regulation 44 report since November 2016.

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The effectiveness of leaders and managers: inadequate

The home‟s statement of purpose was last updated in February 2017. It now needs updating again to reflect current staff and management arrangements. The statement of purpose broadly complies with the Children‟s Homes Regulations 2015. At least two areas have been omitted. This requirement has also been repeated.

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The effectiveness of leaders and managers: inadequate

The children‟s guide is not written in child-friendly language. For example, it makes reference to care planning and review. This has been translated into symbols. The content is neither interesting nor relevant to the children and young people. A recommendation has been made.

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The effectiveness of leaders and managers: inadequate

At the interim inspection, the home was asked to improve the quality of the environment. Soon after this, the local authority took urgent action to manage expenditure. They froze development funding for several weeks. The new budget was released in April. As a result of the spending restriction, the kitchen has still not been refurbished. New furniture has not yet arrived, but it is now on order. Garden improvements are under way. A new sensory garden with a water feature is planned, but has not yet been completed.

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The effectiveness of leaders and managers: inadequate

Parents were consulted in February and commented that the home required redecoration. The children and young people‟s bedrooms are lacking in colour and appeal. There are no pictures on the walls. Only one bedroom has animal stickers on the walls to make it more interesting. Inspection report children‟s home: SC067151 11 Televisions are behind a protective cover. This is necessary for some children and young people, but not all. All the rooms have hospital-style, high-low beds. Some children and young people need hospital-style beds. Others need low-stimulation decoration. This is not the case for everybody who stays at the home. The deputy managers should consider providing some rooms that are homely and welcoming. This would provide more choice. The rooms are due to be redecorated later this month. The requirement under quality standard 6 has been repeated.

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The effectiveness of leaders and managers: inadequate

The staff do not personalise rooms in readiness for each child or young person who comes to stay. They are free to bring in their own items if they wish to do so. To support parents who are already under pressure, the home may wish to think about taking the lead on this.

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The effectiveness of leaders and managers: inadequate

The interim inspection found that team meeting records were poor. Minutes still lack clarity in places. They do not identify which person is to take action on the points raised. This shortfall was also raised at the full inspection in August.

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The effectiveness of leaders and managers: inadequate

A recommendation was made about tracking the children and young people‟s progress. Progress in a short-breaks service is not easy to quantify. This is because the child or young person usually lives at home and has contact with many other services. The deputy managers and staff do not currently have the time to record achievements in specific terms, nor have any spare capacity to think creatively about how this might be done.

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The effectiveness of leaders and managers: inadequate

Social workers report that the home maintains very good communication with them. The deputy managers take part in the children and young people‟s reviews. This helps to promote good quality information-sharing.

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Information about this inspection

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

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Information about this inspection

Using the „Social care common inspection framework‟, this inspection was carried out under 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: SC067151 12

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Children’s home details

Registered provider address: Bristol City Council, Director of Legal Services, City Hall, College Green, BRISTOL BS1 5TR

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Inspector

Heather Chaplin, social care inspector Inspection report children‟s home: SC067151 13 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children‟s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children‟s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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