Children's Home run by Bromley Healthcare Community Interest Company in Bromley

Inspection report children’s home: SC474543 1 SC474543 Registered provider: Bromley Healthcare Community Interest Company

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This home is run by a healthcare trust and provides short break services for children and young people aged from five to 17 years. Young people who use the home may present with a variety of complex needs, including sensory impairment, physical and/or learning disabilities and/or challenging behaviour. The home is registered to care for up to 12 young people.

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

Overall judgement at last inspection: Sustained effectiveness

p.1

Enforcement action since last inspection

None Inspection report children’s home: SC474543 2

p.1

Key findings from this inspection

 The staff team provide young people with a wide range of stimulating activities that increase their social interaction.  Young people have good relationships with staff who respond in a caring and supportive way.  Young people receive a high level of staff supervision that ensures their safety.  Staff have good working relationships with parents/carers, teachers and relevant professionals.  The manager works in partnership with other professionals to ensure that the staff team continues to learn how to provide good care for young people who have complex needs.  Young people receive good support to learn independence skills relevant to their age, understanding and abilities.

p.2

Key findings from this inspection

The children’s home’s areas for development:

p.2

Key findings from this inspection

 The manager must complete the level 5 diploma in leadership and management.  Staff do not always receive regular supervision in accordance with the home’s supervision policy.  Changes in staff key-working systems are not readily communicated to parents/carers.  The home’s revised statement of purpose has not been forwarded to Ofsted.  The recommendation made at the last inspection in relation to the workforce development plan has not been met.

p.2

Inspection date Inspection type Inspection judgement

23/03/2017 Interim Sustained effectiveness 01/11/2016 Full Good 25/02/2016 Interim Sustained effectiveness 03/11/2015 Full Good Inspection report children’s home: SC474543 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 revision and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16(a)(b)) 31/10/2017

p.3

Requirement Due date

A person may only manage a children’s home if a person has the appropriate experience and qualification and if the person has by the relevant date attained the Level 5 Diploma in Leadership and Management for Residential Childcare (England) ("the Level 5 Diploma"). The relevant date is – in the case of a person who starts to managing a home after 1 st April 2014, the date which falls 3 years after the date which that person started managing a home. (Regulation 28(2)(c)(i) (3) (a)) 30/04/2020

p.3

Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b)) 31/10/2017

p.3

Recommendations

 The registered person should have a workforce plan which can fulfil the workforce-related requirements of regulation 16, schedule 1 (paragraph 19 and 20) (‘Guide to children’s homes regulations including the quality standards’, page 53, paragraph 10.8)  Ensure that the registered person undertakes a review that focuses on the quality of care provided by the home. In particular, ascertaining the views of parents whose children receive a short break service on the impact the care is having on outcomes and improvements for children. (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.2)

p.3

Overall experiences and progress of children and young people: good

The staff team has a good understanding of each young person’s individual needs. This ensures that the young people are safely and effectively cared for. Those young people Inspection report children’s home: SC474543 4 who have little or no verbal communication feel able to seek staff out for help and reassurance. The staff team is exceptionally effective at recognising non-verbal and often complex cues from young people. For example, when a young person was showing signs of distress, a member of staff quickly recognised that it was because the young person wanted a snack, which he was immediately given. The interactions between young people and staff are warm and caring, which reflect the nurturing environment that the young people stay in. Much of this is due to an experienced and skilled team of staff who have worked in the home for a long time. It is evident that the young people are cared by staff who ensure that all aspects of their

p.3

Overall experiences and progress of children and young people: good

needs are met. A parent comments, ‘My child was non-verbal prior to staying at Hollybank. However, staff working closely with her school has meant she is now using single words and this has helped with her behaviour.’ This demonstrates that staff are positive and supportive towards young people, ensuring that they make progress in accordance with their abilities. Links with education professionals are exceptionally positive, most notably in terms of consistency in care, communication and health needs. For example, individual members of staff spend time in school working in partnership with teachers and the school nurse to assist them and to keep themselves updated on the individual routines, behaviours and medical needs of young people. For instance, staff are updated about the safe use of EpiPens and the insertion of ‘peg feeds’. Such positive collaborative working ensures that staff have current information on how to provide safe care. This is particularly

p.4

Overall experiences and progress of children and young people: good

important when working with young people who, on average, only stay at the home three nights per month. Individual targets and goals are set, with a ladder of steps to complete full achievement. Targets are individual, young person-centred and achievable. This enables young people to practise and achieve new skills and increases their confidence and self-esteem. Young people benefit from a plethora of activities in the home. Staff want young people to enjoy their stay, and assess each activity so that young people are safe but also have fun. These activities include arts and crafts, sand play and trips out in the community. Staff take many photos of activities, which give the young people happy memories of their stay. One young person took great pleasure in pointing out the many pictures of her taking part in activities. The mother of a young person who has complex needs said, ‘When he first started, he would stay alone in a dark space just sitting. Now, while he

p.4

Overall experiences and progress of children and young people: good

still prefers his own space, he will happily go into the garden, listen to music and play with a ball. Staff understand his non-verbal cues and they all work to engage him. This means that we as a family now see a decrease in his challenging behaviour. Staff understand him, keep him safe and this gives me peace of mind.’ Staff encourage young people to contribute their views and opinions on their stay. This takes the form of a differing pictorial tool, which enables them to say if they enjoyed a particular activity and their views on menu planning. Young people’s health needs are effectively supported. Staff work well with parents/carers to ensure improvements in young people’s health and dietary needs. Arrangements for dealing with the administration of medication are robust and safe and all young people have clear healthcare plans. Staff are competent in how to administer Inspection report children’s home: SC474543 5

p.4

Overall experiences and progress of children and young people: good

medication safely. Staff are rightly proud of the good progress that some young people make across all areas of their development. Some improve in personal hygiene skills, using cutlery and eating skills, and others in their sleeping patterns. These developments can have a major impact on the lives of young people and their family group. For example, when a young person develops good sleeping patterns, the whole family can sleep better. This increases their coping mechanisms, enabling young people who have complex care needs to remain living in the family home.

p.5

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

Staff demonstrate excellent knowledge of how to safeguard vulnerable young people, and are experienced in safer care practices. Young people who stay in the home generally have little understanding of danger. Comprehensive risk assessments provide clear direction to staff to enable young people to experience safe fun, to play in the home, and spend time in the community. These are regularly updated and accurately reflect the current risks for young people. A strength of the home is the manager’s commitment to safeguarding. In order to ensure the continuing competence of staff, the health trust safeguarding lead provides three monthly group supervision for all staff. This ensures that staff are kept informed of any changes in safeguarding procedures, and gives staff members the opportunity to share any concerns that they have for any individual young person. As a result, staff are better able to identify triggers in behaviour and implement sensory activities to help

p.5

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

young people to self-regulate their own behaviours. This leads to a greater sense of security and lessens self-harming behaviours. High staffing levels ensure that young people do not go missing from the home. Sanctions are not used to modify behaviour. There has been one physical intervention since the last inspection. Records show that this was a low-level intervention to prevent a young person from hurting himself. There is a satisfactory location risk assessment in place and the home’s security is effective in keeping young people safe. Routine health and safety checks are effectively completed and any identified concerns are dealt with. For example, the managers have recently increased the height of the garden fencing to prohibit young people from climbing over it. All young people have personal emergency evacuation plans that detail how the staff team should approach assisting the young people to evacuate the building in the event

p.5

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

of a fire. There are regular fire drills to familiarise the young people in the process and calm any anxieties. This promotes young people’s physical safety. There have been no safeguarding concerns or complaints about the staff since the last inspection. Parents/carers confirm that effective communication exists between themselves and the staff team. A parent comments, ‘The staff are very approachable and keep me informed on all matters. They will often take the time to remind me of my short break days, as they know l am often overtired caring for a new baby. I have every confidence in them. My child is always smiling and l know she looks forward to her stays. I would not leave her with staff if l had the slightest concern.’ Inspection report children’s home: SC474543 6 Safer recruitment practice is in place and staff receive thorough inductions and shadow shift sessions. This helps to keep young people safe and protected during their short

p.5

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

break. Young people live in a physically safe and secure environment. The home is clean and comfortable. Recently, the health trust has approved a re-decoration programme for the home.

p.6

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

The manager is a Registered General Nurse. She holds a district nursing certificate and a BSC specialist practice school nursing qualification. In addition, the manager has a level 6 diploma in performance management in health and social care. She has been head of school nursing, a leadership role, since 2011. The manager has been in post since April 2017. She is in the process of registering with Ofsted and enrolling on a suitable level 5 diploma course. Supervision of staff has recently changed. One senior member of staff is now supervising all of the care staff. Staff report that this development, although recent, is having a positive impact on the team. However, the manager is not ensuring that all staff receive regular supervision. The statement of purpose clearly sets out the ethos and objectives of the home. However, it is not kept under review in line with regulations. This has not had a negative

p.6

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

impact as young people continue to make small and measurable progress because they receive good-quality and stable care. Of the two requirements made at the last inspection, one has been met. One of the two recommendations has been addressed, while one recommendation concerning the workforce development plan has yet to be fully addressed. The manager is using her experience gained as a children’s school nurse to aid her understanding and development of working with complex young people in a residential setting. She has a focused, child-centred approach to aid her learning and is adapting her skills to further this. The manager maintains a visible presence in the home. She will assist with everyday care and routinely spends time with young people to gain a better understanding and develop warm relationships with them. This enables her to gain a good overview of the quality of care provided. Staff comment that the manager is approachable, listens, is

p.6

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

open to learning and has positive new ideas. This has had a beneficial impact on the team members, who had found the recent management changes unsettling. Monitoring and review systems are generally good. These help the manager to understand much of the home’s strengths and weaknesses. More importantly, these systems have enabled the manager to track the experiences and progress young people make during their short break. These monitoring and review systems, therefore, develop the skills and competencies necessary to understand and meet the complex needs of the young people that the staff care for. Staff work collaboratively with schools. As a result, staff knowledge improves notably on Inspection report children’s home: SC474543 7 procedures that they may not carry out regularly. Staff said that this had improved their knowledge of individual young people, which has had a positive impact on the care that

p.6

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

they provide and improved communication between schools and the home. Monthly monitoring reports provided by the independent visitor give a good review of the home’s performance and the young people’s progress. Robust action plans provided by managers are used to further develop and inform the quality of care provided for young people. Staff have a good rapport with families and professionals. Overall, parents/carers gave positive feedback of the care provided and the communication with staff. However, some parents have said that they are not regularly updated on changes in the home, such as when their child has a new key worker, and they would like more information on how their child has used their short break stay.

p.7

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.

p.7

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: SC474543 8

p.7

Children’s home details

Registered provider address: Global House, 10 Station Approach, Bromley, Kent BR2 7EH

p.8

Inspector

Juanita Mayers, social care inspector Inspection report children’s home: SC474543 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.

p.8

Inspector

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.9

Inspector

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

p.9

Inspector

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

p.9