Children's home run by RNIB Charity in Camden

Good

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

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The children’s home’s provision is good because:

 Young people make good progress across all areas of their development.

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The children’s home’s provision is good because:

 Staff know young people very well. They take time to understand their complex needs and provide highly individualised care.

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The children’s home’s provision is good because:

 Staff treat young people with dignity and respect.

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The children’s home’s provision is good because:

 Staff are well trained in meeting the complex needs of the young people in their care.

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The children’s home’s provision is good because:

 Staff work well together to manage young people’s behaviour.

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The children’s home’s provision is good because:

 The manager makes sure that care planning is individualised and enables staff to focus on each young person’s areas of need. Planning for admission is robust, and the manager carefully considers any new admissions and manages introductions effectively.

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The children’s home’s provision is good because:

 The manager makes sure that multi-disciplinary care is effective.

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The children’s home’s provision is good because:

 There are a few shortfalls in practice. These include staff recording of physical interventions that do not include steps taken to de-escalate the behaviour or whether a young person has been spoken to following the intervention. Staff recording of safety checks are incomplete. The complaints information for young people and parents is unclear and outcomes are not consistently recorded. The quality of care review is not informed by the views of young people, parents and other professionals.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meets 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

7: The children’s views, wishes and feelings standard

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Requirement Due date

In order to meet the children’s views, wishes and feelings standard the registered person must ensure that each child: (2)(b)(ii) has access to the home’s children’s guide, and the home’s complaints procedure, when the child’s placement in the home is agreed and throughout the child’s stay in the home. 16/01/2017

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Requirement Due date

In order to meet the protection of children standard, the registered person must ensure that: (2)(d) the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. This is in specific reference to safe-space beds. 16/01/2017

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Requirement Due date

35: Behaviour management policies and records

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Requirement Due date

(3) The registered person must ensure that: (a) within 24 hours of the use of a measure of control, discipline or restraint in relation to a child within the home, a record is made which includes: (v) details of any methods used or steps taken to avoid the need to use the measure; (c) within five 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. (Regulation 35 (3)(a)(v)(c)) 16/01/2017

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Requirement Due date

(3) The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (3)) 16/01/2017 45: Review of quality of care

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Requirement Due date

(2) In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating: (5) the system referred to in paragraph (2) must provide for ascertaining and considering the opinions of parents, placing authorities and staff. (Regulation 45 (2)(5)) 16/01/2017

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Information about this children’s home

This is a large children’s home that provides care and accommodation for up to 30 children in five purpose built bungalows. The young people have a visual impairment, learning and/or physical disabilities, or sensory impairment. One of the bungalows is also registered by the Care Quality Commission (CQC) and provides a specialist service to young people with high health and medical needs who require long-term ventilation or who have life-threatening or life-limiting conditions. This establishment is owned by a large national charity.

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Recent inspection history

Inspection date Inspection type Inspection judgement 18/03/16 Interim Declined in effectiveness 11/08/15 Full Good

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Good

Young people enjoy good, supportive and nurturing relationships with staff. Staff really care about the young people. They know them well and understand their preferred communication styles. Even if there is no specific style of communication, staff learn over time how to interpret behaviour, facial expressions and vocal tones that young people use to express themselves. All young people have communication passports developed by a speech and language therapist. This accompanies the young person at all times and is shared with family members and across the provision to make sure that there is a consistency of approach. A parent said, ‘Staff are so friendly and helpful. It’s their attention to detail that makes the difference, from making sure they order the specific brand of yoghurt she likes to ensuring her bedroom has familiar things in it.’ All young people who live at the home have complex needs and staff value and respect each individual.

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Good

The home has a warm and welcoming atmosphere. Bedrooms are decorated to reflect individual choice and interests. When specialist equipment is needed to meet young people’s needs, this does not detract from their enjoyment of their personal space. As one parent commented, ‘She is thriving and achieving things no one thought she could. I couldn’t ask for any better.’

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Good

Young people make progress across all areas of their development. Staff at the home have developed excellent links with a local GP and a dental practice. Both provide bespoke services reflecting the individual needs of young people. Alongside these, young people’s needs are assessed and reviewed by an on-site multi- disciplinary team, including physiotherapists, nurses, speech and language therapists and mobility specialists. Staff demonstrate a good awareness of young people’s health needs and receive a comprehensive training programme, for example in autism and epilepsy, to make sure that they have the appropriate knowledge and skills to meet their healthcare needs effectively.

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Good

Young people’s care plans are highly individualised and give staff clear guidance on how each young person is to be cared for over a 24-hour period. These plans make sure that a consistent and good level of care is given to each individual. Staff are dedicated, passionate and skilled in delivering high-quality care. Staffing levels make sure that young people receive bespoke care in a sensitive and respectful manner. Personal care is undertaken by staff with the utmost respect. Doors are closed and privacy is protected. Staff members’ knowledge and understanding of how young people communicate allows them to keep young people informed about the care that they are receiving. This keeps young people safe. Young people with high health and medical needs, who require long-term ventilation, or have life-limiting or life-threatening conditions, are supported in their own bungalow by a team of nursing and health and social care workers who are

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Good

specifically trained to meet the needs of each young person. Young people currently living here have packages of care overseen by a nurse. This inspection took place in conjunction with the Care Quality Commission (CQC) who considered nursing provision. This is the subject of a separate CQC judgement and report.

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Good

All young people attend education. Most attend the school on-site, while others are supported by staff to attend local schools in the community. Their attendance is excellent and they are making good educational progress, supported by effective partnership working between care, health and education staff. Those young people who have previously not attended school because of complex healthcare needs or emotional challenges are now accessing education. They are offered flexible timetables that take into consideration their physical and emotional healthcare needs.

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Good

The manager makes sure that planning for admissions and transitions is robust and sensitively managed. Staff are acutely aware of the impact of change on young people and take considerable time to prepare young people and those around them. As one parent of a newly arrived young person said, ‘I am amazed how smoothly her move has gone. Staff are open to any suggestions. They listen and I know they have her best interests at heart.’ Staff help young people to move in and move on with considerable insight and respect. A placing social worker commented, ‘Staff really made considerable efforts to get to know her before she moved in. I have been very impressed.’

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Good

Young people enjoy a variety of activities in the home and community, reflecting individual choice and interest. Young people enjoy holidays away with staff and take part in exciting activities, such a zip-wiring and horse-riding. Other young people regularly attend community sporting events, such as rugby matches, while others enjoy playing games and completing craft activities with staff. The outdoor areas are spacious and there is a variety of adapted play equipment available. Young people have fun, and develop confidence and friendships with peers.

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Good

Staff encourage and support young people to develop appropriate life skills. They support young people to keep their rooms tidy and develop self-care skills, such as washing and dressing. Some young people are now able to walk independently to the on-site school. Staff support young people to make choices and exercise control in their lives. For example, staff have adapted a television remote control for one young person with restricted mobility in his hands so he can operate the television independently. Young people develop self-respect as their self-confidence increases.

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Good

Staff support young people to maintain contact with their families and friends. A relative said, ‘I am always made to feel welcome, staff are kind and attentive…’ Young people retain contact and connections with important people in their lives reinforcing their sense of security and belonging. This happens even when families are at some distance from the home.

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Good

Staff make sure that young people are well protected through the development of clear and well-assessed risk management strategies. All young people have individualised risk assessments that identify areas of potential risk and identify how staff should manage young people’s behaviour in order to minimise those risks. Staff have a strong understanding of how to keep young people safe and implement strategies consistently, which reduces risk.

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Good

Some young people present with challenging behaviour. The specialist behaviour nurse makes sure that effective behaviour management strategies are developed to address presenting behaviour. These strategies are actively reviewed and evaluated by her and shared in team meetings. This makes sure that any new incidents are considered and staff are aware of presenting concerns. Staff are consistent in their approach and firm boundaries are in place. Staff know that young people’s challenging behaviour is sometimes due to frustration. Staff respond calmly and take time to understand their needs. Positive behaviour is rewarded and young people learn that staff listen to them. Staff support young people to develop strategies to manage their emotional frustrations. As a result, young people become increasingly able to manage their emotions and behavioural outbursts decrease.

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Good

Staff are appropriately trained in physical intervention, which is only used as a last resort. For some young people, incidents of physical intervention have significantly reduced. Staff recording of incidents, however, do not clearly reflect practice and do not consistently record de-escalation strategies or reflect young people’s responses. This significantly reduces the effectiveness of the manager’s evaluation and monitoring of incidents.

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Good

There are no instances of children and young people going missing from care due to the high level of supervision they receive from staff. Staff know young people well and are alert to any changes in their presentation or behaviour that may signify health difficulties. Good relationships with health professionals mean that medical support is promptly sought.

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Good

Medication arrangements are safe. Because of the complexity of young people’s needs, a significant amount of medication is stored. Managers have good systems in place to avoid medication errors. Staff training means that those staff administering medication are confident and competent. Equipment is routinely checked and monitored to make sure that it is fit for purpose. However, staff recording of daily monitoring checks on safe-space beds is not consistently completed. This compromises young people’s safety.

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Good

Complaints about the home are not consistently managed and recorded. The guidance for young people and parents is not clear and distinct. It is not incorporated in the children’s guide. The manager does not make sure that when complaints are investigated that they are recorded in a clear and consistent way that shows when they have been completed and why. This lack of transparency compromises young people’s safety. The manager makes sure that any allegations against staff are referred to the responsible agency and are appropriately managed. This keeps young people safe from harm or abuse.

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Good

The home is well maintained. Regular health and safety monitoring and routine fire drills and equipment checks keep all that live at, work at and visit the home safe.

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Requires improvement

The registered manager is a qualified social worker and holds the level 4 registered manager’s award. She is an experienced manager who has high standards and aspirations for young people. Staff report feeling supported and that the manager is readily available to them. An experienced deputy manager supports the registered manager and they work well together and have a good level of communication regarding all areas of the service.

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Requires improvement

The internal and external monitoring of the home is completed regularly and the reports are forwarded to Ofsted. Quality assurance systems are weak because managers do not routinely consider or seek feedback from professionals, staff or young people. Consequently, stakeholder feedback is not used to shape and inform the home’s development or improvement. This shortfall was also identified at the last inspection.

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Requires improvement

Processes for the recruitment of staff are robust. This minimises the possibility of young people being harmed by those in a position of trust. The management team focuses on continuously improving the care offered to young people. This includes ensuring that staff receive annual appraisals and regular supervision to evaluate their performance and identify development needs. Staff are supported to develop their practice through monthly team meetings, which review young people’s progress. The registered manager places a high priority on staff training. All permanent staff either have achieved or have planned to complete the level 3 diploma in residential childcare within the statutory timescales. This makes sure that staff have the right skills and knowledge to work effectively with young people.

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Requires improvement

Staff benefit from a thorough induction and a comprehensive training programme that supports them to develop the necessary skills and knowledge to meet the complex needs of the young people they care for. Additional specialist training relating to young people’s needs, such as gastrostomy feeding, is provided to staff undertaking these procedures. Consequently, young people’s safety is protected, as staff are knowledgeable and confident in their role.

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Requires improvement

The home has a clear statement of purpose, and is achieving its aims and objectives as set out in the statement. This provides useful information to interested parties, such as placing authorities and families, on what services and support can be expected of the home.

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Requires improvement

Staff have developed good collaborative relationships with other professionals, ensuring seamless care for young people. Staff utilise partnership relationships to advocate and challenge on behalf of young people to make sure that they receive appropriate support to meet their needs. A social worker commented, ‘The competence of the staff instils confidence in myself and the parents. A very competent and professional establishment. Staff are on the ball and provide immediate action plans for any changes.’

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against ‘Inspection of children’s homes: framework for inspection’.

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What the inspection judgements mean

An outstanding children’s home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children’s home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children’s home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children’s home is not yet delivering good protection, help and care for children and young people. A children’s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children’s home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, 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. This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the Children’s

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Information about this inspection

Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. the guidance ‘Raising concerns and making complaints about Ofsted’, which is available from Ofsted’s website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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Information about this inspection

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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