Children's home run by Royal Mencap Society

Inspection report children's home: SC020682 1 SC020682 Registered provider: Royal Mencap Society

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home provides short breaks/respite care for up to seven children and young people who have learning disabilities and/or physical disabilities and complex needs. Occupancy is normally limited to five. The service is provided by a national charity that has a contract with the local authority. 32 children currently use the service.

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Information about this children’s home

Inspection dates: 31 July to 1 August 2017

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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 requires improvement to be good

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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: 2 February 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: SC020682 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

 Care planning and review does not reflect the local authority plan, aims and goals for children‟s care, or their progress.  Out-of-date policies and risk assessments relating to fire safety do not describe the current systems to ensure that children and staff are safe.  Systems for staff vetting are not thorough.  Children‟s privacy is not guaranteed, because some bedroom doors have windows in them.  The written guide for children does not show them what to expect or who will be looking after them.  Not all staff get enough professional supervision. Records about staff training and induction are not accessible to the current acting manager.

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Key findings from this inspection

 Children and families have well-organised help and support during their short breaks.  The long-standing core staff have high levels of commitment and motivation. They develop their knowledge and skills within this specialist learning disability organisation.  Staff emphasis on alternative forms of communication and gathering children‟s views, including those who cannot speak, is much improved.  The placing authority and parents are very positive about the service and their children‟s enjoyment and progress.

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Inspection date Inspection type Inspection judgement

02/02/2017 Interim Declined in effectiveness 22/08/2016 Full Good 08/03/2016 Interim Improved effectiveness 13/10/2015 Full Requires improvement Inspection report children‟s home: SC020682 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 care planning standard is that children receive effectively planned care in or through the children‟s home.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that each child‟s relevant plans are followed. (Regulation 14(1)(a) and (2)(c)) 01/10/2017

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Requirement Due date

The registered person must ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home. (Regulation 25(2)(b)) This relates to ensuring a coherent fire safety policy, risk assessment and procedure that takes account of advice from the local authority fire service. 01/09/2017

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children‟s safety. (Regulation 32(1)) 01/09/2017

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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)) 01/10/2017

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Recommendations

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

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Recommendations

 Ensure that outcomes identified and progress made by children in building relationships and achieving socially acceptable behaviours can be recorded and measured. („Guide to the children‟s homes regulations including the quality standards‟, page 38, paragraph 8.4) This relates to up-to-date goals and aims in support plans and evaluation of progress against those aims.  Ensure respect for children‟s privacy and support the other children living in the home to do so. („Guide to the children‟s homes regulations including the quality standards‟, page 16, paragraph 3.17) In particular, ensure that any glass viewing panels are properly obscured or the rationale for their continued Inspection report children‟s home: SC020682 4 use is clear as a requirement to keep children safe in their support plan.  Ensure that the children‟s guide helps children to understand what the day-to- day routines of the home are („what happens in the home‟); the statement of

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Recommendations

purpose of the home (the care they can expect to receive while living there); and how to contact the Office of the Children‟s Commissioner. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.22)  Ensure that the workforce plan is updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home‟s manager. Ensure timescales for supervision of practice are met. Specifically, ensure that the records relating to the plan are available in the home. („Guide to the children‟s homes regulations including the quality standards‟, page 53, paragraph 10.8.) Specifically, ensure that the records relating to the plan are available in the home.

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improvement to be good

Staff provide individualised care and support to the increasing number of children visiting for short breaks. Care takes account of children‟s religious needs and their racial or cultural heritage. Staff make sure that children who celebrate different festivals, or none, do not feel different or excluded. Ofsted made a recommendation at the last full inspection in August 2016 to ensure up- to-date goals and aims in support plans and to evaluate the progress against those aims. The home‟s records still do not show how well staff are delivering the goals or aims set at statutory, or „child in need‟ reviews. The staff do not always document this in their reports to local authorities or their daily reports, or in the feedback to parents at the end of each stay. There have been occasions when staff have not asked children to try new skills, suggested at review, such as learning new skills with a knife and fork and flat

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improvement to be good

plates. Parents have told the staff that they would like more information about what happens at the home and which staff are caring for their children.

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improvement to be good

Care planning lacks detail. For example, although staff ensure that goal-setting focuses on independence, particularly in self-help skills, such as washing and personal care, less focus is given to emotional and social goals, including aiding communication. Specialist health plans for feeding devices have not been signed off by the nursing staff.

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improvement to be good

The registered person does not fully promote children‟s privacy and dignity. Three of the seven bedroom doors have glass viewing panels, with transparent net curtains on the outside. Staff have not documented the rationale for their need to see into children‟s bedrooms in risk assessments, as they do for use of audio monitors at night. This does not correspond with staff‟s careful delivery of intimate personal care, which is done Inspection report children‟s home: SC020682 5 respectfully and in accordance with children and their parents‟ wishes. The local authority disability team leads on the assessment and review of all children using the service. Staff have constructive relationships with schools, speech and language therapists, and child health nurses. They help children and their families when they need it most. A placing authority said that staff „have been flexible in supporting children, when unexpected events have affected them‟.

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improvement to be good

Staff cooperate with parents, occupational therapists and school nurses to support safe healthcare for children who need feeding devices, or have epilepsy, or who use wheelchairs and hoists. This means that children are included in opportunities and their learning, physical or health needs are not a barrier to their enjoyment. All children have an equal opportunity for active leisure activities and friendships away from their families and schools. Staff take children out regularly in the home‟s vehicles, or for walks locally. Children have good space to play in the home. They can play ball in the long corridors and other games in two large playrooms, in their spacious bedrooms and in the safe, well-equipped garden and playground. Staff have made good progress to consult with children and gather their experience of their visits. Children have asked for better games and toys, including more games that

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improvement to be good

they can play together, with staff. Staff are taking action to meet these requests. Recent training in communication has refreshed staff use of communication aids, symbols and Makaton. Staff use their observational skills to reflect the views of children who may not use speech to communicate. This ensures that staff can make changes to the way that they care for children, to increase children‟s enjoyment and learning. One parent said, „I don‟t have any worries about his safety, happiness or well-being.‟

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improvement to be good

Staff protect children well in their daily life. Staff know and understand children‟s risks and they use encouragement to help children increase their own personal safety. No child has gone missing, because staff are always with them. Doors to the outside car park are locked and the garden is secure. Children can use their own or the home‟s tablet device. They use the internet safely under staff supervision. Staff plan children‟s visits to ensure that they get on with other children staying at the same time. This makes sure that dominant behaviour does not become a difficulty or amount to bullying.

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improvement to be good

Staff help children to behave well. Restraint is rare. Staff are experienced in understanding children‟s learning disabilities, including the impact on communication and social relationships. The organisation has recently introduced a supplementary behavioural approach. This increases the staff focus on alternative strategies to reduce children‟s frustration and conflict. They offer choice and encourage positive behaviour through humour, deflection and offering alternative activities.

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improvement to be good

Staff manage any concern about children‟s safety well. They are trained and confident in the organisation‟s new child protection procedures, which now reflect current statutory guidance. Staff refer any concern to the local authority disability team and the Inspection report children‟s home: SC020682 6 safeguarding team. Records of safeguarding issues are much improved. They now make clear the chronology of events, as well as the decision-making around actions and lessons to learn. The local authority designated officer has no concerns about how staff protect children. She told the inspector, „They have followed procedures in making referrals and have been helpful in providing the required information to assist my decision-making.‟

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improvement to be good

Some organisational aspects of safety have the potential to compromise the care of children. The staff recruitment procedure is not thorough. Ofsted made a recommendation about this at the August 2016 full inspection and the registered person has not sustained the improvements made at the last interim inspection in February 2017. Choice of staff references, managers‟ verification of these and records of staff‟s previous working history are still not good enough. Poor information means that the registered person is not able to reach a rigorous assessment of applicants‟ suitability to work with children.

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improvement to be good

The fire service visited in May 2017 and advised the registered person to update the service‟s fire risk assessment every year. It had not been reviewed since 2013. The acting manager immediately checked the policy and requested an urgent review. The fire service also advised the registered person to reflect within the risk assessment that the organisation chooses not to train staff in the use of firefighting equipment and not to fight the fire. Currently, two different fire policies are not consistent about this approach, implying a level of training that is not available at the home. Staff and children regularly practise emergency evacuations of the building. Each child has a plan that is unique to them and details exactly how staff should help them move to safety. Everyday fire precautions keep children safe.

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

The registered manager left in June 2017. The organisation has already recruited to the post. Parents, children and placing authorities are familiar and confident in the interim leadership of the experienced, qualified, long-standing deputy.

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

One professional told the inspector that management was, „Well coordinated. From the local manager, to the area manager, to the national manager. I consider management continuity also a strength.‟

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

The registered person understands the strengths and weaknesses of the service. Improved internal and external monitoring systems and reports assist their realistic view. The registered person has taken action to meet the six requirements made at the interim inspection in February 2016. However, recurrent issues around staff vetting and care planning mean that leadership and management have not been wholly effective.

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

This inspection identifies new areas for improvement. Not all new staff have supervision often enough to support their development in their role, especially where they have little experience of working with children. The acting manager is not able to access the organisation‟s full training records to ensure that the home‟s staff are up to date with skills and expertise. The children‟s guide lacks information about routines and Inspection report children‟s home: SC020682 7 opportunities and activities at the home and pictures of who will provide their care. Parents have told the staff that such information would help them talk to their children about their experience. Staff do not currently have the skills to create accessible leaflets or booklets to use with children, for example so that staff and parents can talk through and show children stories about moving in, or moving on to their next placement, or

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

The quality of some records is still not good enough; for example, one child has no local authority short-break plan. Pictorial gastrostomy guides and positive handling plans are not signed or dated. Children‟s memory books of events at the home are not up to date. Some entries in the child‟s memory book do not have any text to help the reader share the child‟s enjoyment. Daily records do not show which staff looked after children. Records about children‟s challenges are sometimes vague. For example, staff write that children had „behaviours‟ without saying what they did, or being specific about which staff did what in response. The registered person had already identified that improvement is required in the quality of records.

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

Despite these areas for improvement, this service is effective at its core function as a short-break service. One parent told the inspector that it gave them „invaluable respite‟.

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

Staff are enthusiastic about their work. They are well supported by managers and by their colleagues. The organisation has a creative approach to staff development through quarterly professional appraisals. This helps managers to create a clear strategy for staff development. However, staff supervision between these quarterly reviews is sometimes not kept up to date. This means that staff practice is not regularly reviewed.

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

Staff challenge partner professionals when necessary, to secure the training to meet children‟s health needs, or when the local authority does not supply sufficient information about children‟s needs or risks. They are clear that if they cannot meet a child‟s needs. However, they are committed to developing the service to meet children‟s needs and have renewed placement offers once staff skills are in place or risks are reduced. A local authority officer told the inspector, „It is very obvious to me that the welfare of children is paramount in any discussions and decision-making.‟

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

Consultation with children and their parents is a strength. This happened recently at the annual „Reflection Day‟. Families, staff and children celebrated achievements at this mini- festival event. The staff also took the opportunity to hold discussions and get feedback about the service. The area operational manager said that the plan to take the outcomes of this consultation forward would be a priority for the new manager. These discussions ensure a close focus on children and their family‟s needs. Parents told the inspector that they are glad of the service and confident that their children are well looked after. One told the inspector, „We are very happy with the service.‟

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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 Inspection report children‟s home: SC020682 8 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.

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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: SC020682 9

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Children’s home details

Registered provider: Royal Mencap Society

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Children’s home details

Registered provider address: Royal Mencap Society, Concordia House, 123 Golden Lane, London EC1Y 0RT

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Children’s home details

Responsible individual: Janine Tregelles

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Inspector

Christy Wannop, social care inspector Inspection report children‟s home: SC020682 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 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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