Children's home run by N H Care Limited in Birmingham

Inspection report children’s home: SC446152 1 SC446152 Registered provider: N H Care Limited 6038073

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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 home is part of a private children’s care organisation. The home is registered to accommodate up to three young people who have learning disabilities, sensory impairments and behavioural difficulties.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers requires improvement to be good

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good

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

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good

Date of last inspection: 20 December 2016

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good

Overall judgement at last inspection: Sustained effectiveness

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good

Enforcement action since last inspection: None Inspection report children’s home: SC446152 2

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Key findings from this inspection

 Young people make good progress from their starting points.  Managers and staff provide a good standard of care to young people.  Managers and staff work well together to support young people’s behaviour.  Professionals are positive about the difference the managers and staff make to young people’s progress.  Young people’s views and opinions are central to the running of the home.  Young people enjoy a range of activities in the home and in the community.  Young people participate in chores around the home, helping them to develop a sense of belonging and responsibility.  Staff work well with families and professionals, for the benefit of young people in their care.

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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

 Managers and staff do not always record complaints consistently.  Staff make some minor omissions in physical restraint records.  Some areas of the home require improvement to ensure that young people live in a homely and well-maintained environment.  Some areas of managerial monitoring are not effective.

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Inspection date Inspection type Inspection judgement

20/12/2016 Interim Sustained effectiveness 19/07/2016 Full Good 16/03/2016 Interim Sustained effectiveness 11/08/2015 Full Good Inspection report children’s home: SC446152 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 quality and purpose of care standard is that children receive care from staff who, in particular, to the standard in paragraph (1) requires the registered person to ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. (Regulation 6(1)(2)(c)(i)) 31/08/2017

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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, in particular, to the standard in paragraph (1), requires the registered person to use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(2)(h)) 31/08/2017

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Requirement Due date

Ensure that within 24 hours of a use of control, discipline or restraint in relation to a child in the home, a record is made which includes the effectiveness and any consequences of the use of the measure. In particular, include more detail and analysis of each event of physical intervention (Regulation 35(3)(a)(vii)) 31/08/2017

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Requirement Due date

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)) 31/08/2017 Inspection report children’s home: SC446152 4

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Overall experiences and progress of children and young people: good

Young people make progress from their starting points. They enjoy a good quality of life and develop positive relationships with staff. One young person told the inspector, ’The home is excellent and the staff are excellent. I am happy with my life here. I have things to do and I enjoy them.’ All young people attend school full time. One young person recently started school after a prolonged period without a school placement. Young people have 100% school attendance. School and home staff remain in close contact with each other and discuss any challenges and equally positive aspects of a young person’s school day. Consequently, staff promote young people’s academic progress and life opportunities. When young people arrive at the home, they receive a warm welcome from staff. The children’s guide is available in Makaton, which helps some young people to access important information about support available and how to contact other agencies if they

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Overall experiences and progress of children and young people: good

need to. Young people have complex needs and sometimes display challenging behaviours. Managers and staff work in partnership with specialist professionals and external agencies to devise support packages. They carefully review and analyse their strategies in managing these challenges, revising and changing them when necessary in order to support young people’s behaviour. Staff talk to young people in one-to-one sessions following incidents in order to understand why they happened, and what may have triggered them. This helps young people to reflect on the incident and to develop an understanding of the different ways to react to difficulties. Young people’s relationships with staff are positive. Staff engage with each young person to a level appropriate to their individual needs. Managers and staff have a good understanding of each young person’s needs. For example, staff recognise signs that may indicate overstimulation, or an increase in anxiety. This means that interventions

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Overall experiences and progress of children and young people: good

are timely and help young people to manage their behaviour. A social worker commented, ‘I am so pleased that staff really persevere with him and try different ways of helping him to understand his behaviour.’ Another said, ‘The manager has an impressive understanding of what autistic spectrum disorder is and how to approach him.’ Managers and staff support young people’s physical, emotional and psychological health. They identify additional services that may benefit young people, but are respectful if young people do not wish to participate with identified services, for example counselling. Managers and staff liaise with professionals if young people do not wish to engage with a service, and consider other approaches to meet their needs. One young person has worked with staff to devise a medication protocol for a new medication prescribed for him. This has improved his understanding about why a doctor prescribed it, and how it

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Overall experiences and progress of children and young people: good

can help him. Young people enjoy a healthy lifestyle with freshly cooked meals. A social worker commented on how this has had a marked improvement with one young person’s overall Inspection report children’s home: SC446152 5 health. Young people told the inspector that they enjoy a broad range of activities, both in the home and in the community. One young person told the inspector, ‘I go swimming, and to the arcade to play on the bikes. I like board games, too.’ Consequently, young people enjoy new opportunities and their horizons expand. Staff work with families to facilitate contact whenever possible. This enables young people to maintain important relationships with their families and those important to them. Managers and staff help young people to develop essential life skills. Young people are encouraged to help with chores, keep their bedrooms clean, and to bring their laundry downstairs. This encouragement helps young people to develop age-appropriate

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Overall experiences and progress of children and young people: good

independence skills and means that they are increasingly ready for their transition into independent living.

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

Staff help young people who present challenging behaviour to reflect on incidents and help them think about alternative ways of reacting to situations. This works well and young people learn to become safer. Staff work well together to reinforce consistent boundaries. They use a variety of de-escalation approaches to try to avoid using restraint, and they use physical intervention only as a last resort. Since the last inspection, the recording of physical interventions has improved. However, some shortfalls remain. For example, staff are still not describing the different holds used and the effectiveness of the measure used. The absence of detail compromises the accuracy of the record. Managers and staff regularly discuss young people’s safety with relevant professionals, allowing the team to make important decisions at the earliest opportunity. Managers refer any allegations made by young people to relevant agencies for investigation.

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

Managers and staff cooperate fully with all agencies to prioritise young people’s safety. Staff work well with young people to reinforce safety messages in one-to-one sessions, including behaviour in the home and in the community, getting to know the home and staff, and relationships with others. In addition, staff employ a variety of incentives to reinforce positive behaviour. Young people can save for a treat, such as a day out or being able to buy a DVD. Young people review their incentive charts with staff and feel proud when they have achieved their goals. Managers and staff work closely with local police, who visit the home to talk to young people. This helps break down barriers, as young people become familiar with the police presence and have more of an understanding of their role in the community. Managers carefully vet new staff to ensure that they are suitable to work with vulnerable young people. In addition, staff undertake regular health and safety checks around the

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

home in line with organisational expectations, and undertake regular checks of electrical, gas and fire equipment. In addition, all young people are familiar with the fire evacuation routine, maintaining vigilance and safety for all. Since the last inspection, there have been no incidents of young people going missing Inspection report children’s home: SC446152 6 from the home or being absent without permission. Young people are not at risk of child sexual exploitation or radicalisation. This is because staff ensure that individual risk assessments and the home’s locality risk assessment consider any potential risks for young people, and putt in place strategies for managing these potential risks. Staff have all undertaken training in child sexual exploitation and anti-radicalisation, equipping them with the necessary skills and knowledge to recognise risks and support young people if this arose.

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

The registered manager left the home in April 2017 and a new interim manager is in post. She has applied to Ofsted to become the registered manager of the home. Since the last inspection, a number of staff have left and new staff have joined the team. A small group of bank staff cover any gaps in shifts. This ensures that young people receive consistent care from staff. The manager and staff strive to make sure that young people make progress. Managers monitor plans and lead discussions in team meetings and in supervision sessions. Ongoing review and reflection means that progress is maximised as managers and staff identify and put in place appropriate plans. The manager is proactive in identifying shortfalls in young people’s plans, and takes appropriate action to secure services for young people in her care, such as therapeutic support. Consequently, young people have relevant help and support to move forward

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

with their lives. Managers and staff develop good relationships with other professionals. A social worker commented positively about the manager by saying, ‘She does everything she can to get services for him.’ A teacher said, ‘Staff are straight on the phone and want to make sure that we are all working together.’ Staff receive regular training to ensure that their knowledge and skills meet the young people’s needs. Staff say that they feel supported and can approach senior staff for advice when necessary. Supervision sessions are up to date and in line with the organisation’s expectation. Annual appraisals are undertaken every 12 months. Managers have made sure that staff have the level 3 diploma in residential childcare, or are undertaking the course within the relevant timescales. Young people benefit as suitably trained and knowledgeable staff care for them. The statement of purpose informs local authorities, parents and young people about

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

what the service sets out to do and what they can expect from it. Managers review this document at least annually. The registered manager monitors the quality of care offered by the home, the progress young people are making and the overall development of the service. However, some monitoring has not been effective, in particular the manager’s monitoring of the environment. The garden area and some other areas of the home have fallen short of the standard expected. The manager’s development plan prioritises repairs and redecoration of the property, and some of these repairs are underway. However, areas of the garden are untidy, with rubble, and nettles down one side of the home. Tiling in one of the showers is discoloured and a vent is broken in one young person’s bedroom. Inspection report children’s home: SC446152 7 These matters require attention to ensure that young people retain a sense of pride in

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

their home. There are shortfalls in the recording of a small number of complaints. The manager records the majority of complaints in the complaints log, but she records a small number of complaints elsewhere. This is confusing and it is difficult for the regulator to see whether they have been handled effectively. Managers have met some of the requirements made at the last inspection. All young people now attend school, helping their life chances. When young people arrive at the home, staff explain to young people how they can make a complaint if they want to. In addition, the children’s guide is available in other written forms, including Makaton, making information more accessible for all.

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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: SC446152 8

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Children’s home details

Registered provider: N H Care Limited 6038073

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Children’s home details

Registered provider address: 3 Shetland Close, Birmingham B16 0RF

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Inspector

Julia Wright, social care inspector Inspection report children’s home: SC446152 9 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for 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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