Children's Home run by Barnardo’s in Oxfordshire

Inspection report children‟s home: SC069128 1 SC069128 Registered provider: Barnardo‟s Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

The service caters for a maximum of seven children and young people at any one time, including one emergency bed. It provides a residential short-break service and a domiciliary care service that is registered with the Care Quality Commission. 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 have autistic spectrum disorder and associated challenging behaviour.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

good

How well children and young people are helped and protected good

p.1

good

The effectiveness of leaders and managers requires improvement to be good

p.1

good

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

p.1

good

Date of last inspection: 16 January 2017

p.1

good

Overall judgement at last inspection: Good

p.1

Enforcement action since last inspection

None Inspection report children‟s home: SC069128 2

p.1

Key findings from this inspection

 There is good support to help children to settle into the home.  Staff know the children well and understand how to meet their needs.  Children like the staff caring for them.  Staff understand children‟s likes and dislikes and make sure that their wishes are met.  Parents are confident that their children are well cared for while staying at the home.  Children enjoy their time in the home and have fun.  Staff work well with parents, each other and external professionals to make sure that children are well cared for.  Staff keep children safe.  The manager and staff are child focused and make sure that children‟s well- being is promoted.

p.2

Key findings from this inspection

The children‟s home‟s areas for development

p.2

Key findings from this inspection

 The statement of purpose does not contain all required information.  Some case records are not of a good quality.  Ofsted has not been informed about all significant incidents.  The views of relevant people have not been obtained as part of the monitoring process.  Strategies for staff to use when there is a risk that a child may run away are insufficiently detailed.  Children‟s views are not recorded after a physical intervention.  Not all discussions in staff supervision have been recorded.

p.2

Inspection date Inspection type Inspection judgement

16/01/2017 Full Good 31/05/2016 Interim Sustained effectiveness 28/10/2015 Interim Sustained effectiveness 19/05/2015 Full Outstanding Inspection report children‟s home: SC069128 3

p.2

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.

p.3

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) and (b)) In particular, ensure that all information is up to date and in line with schedule 1. 28/08/2017

p.3

Requirement Due date

The registered person must maintain records (“case records”) for each child which— include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. (Regulation 36(1)(a)(b)(c)) 28/08/2017

p.3

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)) 28/08/2017

p.3

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 in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(1)(2)(a)(b) (c)(5)) 28/08/2017

p.3

Requirement Due date

The registered person must ensure that an independent person visits the children‟s home at least once each month. When the independent person is carrying out a visit, the registered person must help the independent person— if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires; and (Regulation 44(1)(2)(a)) 28/08/2017 Inspection report children‟s home: SC069128 4

p.3

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

p.4

Recommendations

 Where there is a possibility that a child will run away or go missing from a children‟s home placement, their placement plan should include a strategy to minimise this risk. („Guide to the children‟s homes regulations including the quality standards‟, page 45 , paragraph 9.24)  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) Specifically, ensure that the child‟s feelings are recorded or alternatively if the child has not got the capacity to express these that this is recorded.  A record of supervision should be kept for staff, including the manager. The record should provide evidence that supervision is being delivered in

p.4

Recommendations

line with regulation 33(4)(b). („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraph 13.3) Inspection report children‟s home: SC069128 5

p.4

Overall experiences and progress of children and young people: good

Children using this short-break service are provided with good-quality individualised care. When a child is referred to the service, staff carry out thorough assessments of their needs. They develop an introduction plan to meet the child‟s and parents‟ needs and wishes. Staff involve the whole family in the introduction process, including the child‟s brothers and sisters, and this helps them to feel reassured about where the child is staying. Parents build confidence in the staff and their ability to care for their child to a high standard.

p.5

Overall experiences and progress of children and young people: good

As a short-break service, staff only work with each child on two to four occasions per month. However, as children attend the service over a number of years, staff come to know and understand each child well. Staff are skilled at meeting even the most complex children‟s needs and, over time, children develop strong and trusting relationships with staff. A social worker said, „they (the staff) really understand his complex needs‟.

p.5

Overall experiences and progress of children and young people: good

Staff are guided by care plans that detail how to meet children‟s needs. Children make progress. For example, they learn to clean their teeth or use cutlery. Although most of the children do not have the ability to understand the concept of boundaries, staff‟s patience and perseverance help some children to develop the ability to deal with their frustrations in a more appropriate way.

p.5

Overall experiences and progress of children and young people: good

Staff learn about how each child lets their wishes and feelings be known. Staff become skilled at interpreting each child‟s wishes and feelings through listening to them and reading their subtle non-verbal cues. Through this, staff are able to help children to take part in decision making about their stay.

p.5

Overall experiences and progress of children and young people: good

Staff have strong links to children‟s schools, and teachers and staff share information with each other about how the child has been during their stay or school day. Staff attend education and other meetings about children and are part of the wider planning for each child. Staff always ensure that children arrive at school on time.

p.5

Overall experiences and progress of children and young people: good

While children are staying at the home, their health needs are met to a good standard. Some children have very complex health needs and staff make sure that their health plans are complied with. Staff are meticulous in ensuring that they are aware of any changes in a child‟s healthcare needs or medication before each stay. Nurses work with children who have complex health needs, and they do so confidently and competently. A parent whose child has significant health needs spoke of his confidence in the staff‟s ability to care effectively for his child.

p.5

Overall experiences and progress of children and young people: good

Some children have very complex medication plans. Staff are trained and assessed as competent in dealing with medicines. If errors are made in medication administration, these are fully investigated. However, in one case, the discussions with a staff member about an error made had not been fully recorded in the supervision session. Inspection report children‟s home: SC069128 6 Children get to do plenty of fun things during their stay at the home. During the inspection, children were doing arts and crafts, playing with bubbles and watching DVDs. Children were relaxed with the staff and there was much laughter. Mealtimes are social occasions, and children and staff sit down together and talk about the day. Trips out are arranged for the children, such as going shopping, having a walk or going for a pub meal. Children staying at the home have the same opportunities as their peers to relax and enjoy life. A parent said that, as a family, they were confident that their child enjoys

p.5

Overall experiences and progress of children and young people: good

his stays because „he is smiling and having a good time‟.

p.6

Overall experiences and progress of children and young people: good

Staff and parents have strong relationships with each other. Families have high levels of confidence in the staff. Staff keep families well informed about their child‟s stay, and attend and take part in meetings about children‟s wider care planning.

p.6

Overall experiences and progress of children and young people: good

Staff support parents and children wherever they can in progressing transition plans. If meetings have not been arranged, staff chase the local authority to set up a meeting. Parents report that they are happy with the support that staff have provided to them in considering placements and in compiling information about the child that will be useful to a new provider.

p.6

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

Young people develop very strong relationships with the staff and trust them. Children are dependent on staff to meet all of their needs. Staff are skilful in recognising the non- verbal signs that a child may be in distress or unhappy about something, and are quick to act.

p.6

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

Risks to children are identified, planned for, reviewed and managed effectively. Due to high staffing ratios, children are fully supervised during their stay, and this limits the opportunity for a child to come to harm. For example, children do not go missing from the home, because staff are with them at all times. In one case, where there is a risk of the child running off while getting onto the school transport, there is not sufficiently detailed instructions for staff about what they can do to prevent the child from running off.

p.6

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

Some children self-harm. Staff use the approaches set out in the behaviour management plans to minimise these incidents. The manager has arranged for a speaker to come to talk to the staff to help to increase their understanding of this.

p.6

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

Staff work with children with patience and understanding, and they promote positive and safe behaviour. Staff use lots of verbal praise for things that children have done well and continually encourage children to achieve. Physical interventions are not used very often and are minimal, when used, such as guiding a child away from danger. The records of these incidents provide a good view about what has happened. However, the child‟s feelings about their experience of the hold is not being recorded, nor is it recorded that a child is unable to express their view.

p.6

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

Staff are trained to deal with child protection issues and safeguarding children. They Inspection report children‟s home: SC069128 7 have a good awareness of what they should do if they were concerned about a child. They understand the roles that other safeguarding professionals have in this process and if they know how to apply the whistleblowing policy.

p.6

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

Staff recruitment processes are thorough and ensure that staff are suitable people to be working with the children. Health and safety checks of the premises ensure that the building is safe for children to stay in and staff to work in.

p.7

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

The manager has managed this home since 2011 and is registered with Ofsted. She holds a level 5 qualification in leadership and management, and is also a qualified nurse. The manager is passionate about her role and is determined to ensure that children have the best possible chances in their lives.

p.7

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

The manager has developed strong working relationships with other professionals and agencies involved in the care of each child.

p.7

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

The arrangements for monitoring the home are adequate. A shortfall in the manager‟s and the independent visitor‟s monitoring is that there is no consultation with parents or other stakeholders. The breadth of the manager‟s monitoring of the quality of care is narrow, and issues such as accidents and incidents were not analysed during the last review.

p.7

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

The requirements and recommendations that have been met since the last inspection have meant the following. The quality of record keeping of physical interventions has improved, complaints records are well maintained, and the independent visitor provides a clear statement about her view of the quality of care and safeguarding. Staff now challenge other agencies to ensure that the minutes from meetings are on file and are used to develop care planning, and there is greater challenge to the local authority to ensure that children‟s transitions are well planned. Medical guidance provided is being recorded and references for staff are being verified with the writer. The statement of purpose requires some further amendments and one significant incident has not been notified to Ofsted.

p.7

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

Staff share the manager‟s passion for helping children to develop and achieve, and to keep them safe. A social worker commented that the child she works with „is very much loved by his carers‟. Staff work closely with parents. Staff also work well together and with other agencies and professionals. There have been some long-standing staff shortages and this has put pressure on the team. A recent improvement to this situation is that all the vacant posts for nurses have been filled and interviews for care staff were being held during the inspection.

p.7

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

Supervision of staff is regular and staff feel well supported. Supervision is recorded but, in one case, important discussions about a medication error had not been documented.

p.7

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

There are regular team meetings, during which staff have detailed discussions about the Inspection report children‟s home: SC069128 8 children and their needs. Appraisals are held annually and help to support staff‟s professional development. Training opportunities are good, and staff put their training into practice. All staff are either qualified or are studying for a level 3 qualification in caring for children.

p.7

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

Care planning is child centred. The short-break service is an important part of the overall care plan for the child, and staff understand how the short-break arrangements contribute to the child‟s overall care.

p.8

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

Not all case records are of a high standard. For example, some records are written in pencil, some incident records do not include the timing of issues such as a medical emergency and some records are not updated in a timely way.

p.8

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

The home is achieving its stated aims and objectives as set out in the statement of purpose. The statement does not contain all information detailed in schedule 1 and has some out-of-date information which could be misleading to the reader.

p.8

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.

p.8

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: SC069128 9

p.8

Children’s home details

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

p.9

Inspector(s)

Rosie Dancer, social care inspector Inspection report children‟s home: SC069128 10 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children‟s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children‟s services, and inspects services for looked after children, safeguarding and child protection.

p.9

Inspector(s)

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, 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 http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.10

Inspector(s)

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

p.10

Inspector(s)

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

p.10