Children's home run by The Qalb Short Break Services Ltd in Tower Hamlets

Inspection report children’s home: SC389781 1 SC389781 Registered provider: The Qalb Short Break Services Ltd

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

A limited company owns and runs this short-break service. The home provides residential short breaks, day care and after-school club services. The home admits up to a maximum of eight children at any time. The service is for children and young people who have a disability, including autistic spectrum disorders. The service also runs another short-break service in the host borough on a separate site and an outreach service in the community for young adults with complex needs and disabilities.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected outstanding

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Date of last inspection: 15 February 2017

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outstanding

Overall judgement at last inspection: sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC389781 2

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Key findings from this inspection

This children’s home is outstanding because:

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Key findings from this inspection

 It consistently offers exceptional care and opportunities for children in the local community. This includes a wide range of interesting and educational activities.  Experienced and highly skilled staff offer sensitive and individualised care.  The staff team reflects the diversity of the children who attend and offers extensive cross-cultural learning opportunities for all children.  The provider is inclusive and care is tailored sensitively to each child’s needs.  A high ratio of staff to children allows for excellent care, prevents difficulties escalating and safeguards children.  Effective information-sharing and communication ensure smooth and well- planned transitions for children in and out of the home.  Leaders and managers ensure that they meet regulations, but they also provide services over and above expectations to ensure children’s safety and to deliver high-quality care.  Observations of the staff in their interactions with children show an extremely

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Key findings from this inspection

high level of good-quality care and warm relationships.  Members of the staff team feel supported by leaders and managers and work together in a highly effective way that improves outcomes for children.  Staff are well prepared, patient and organised in their work. They give consistent messages to children, and children know what is expected of them.  Staff are highly skilled in working with children and managing behaviour effectively.  Children make choices about activities and menu planning. Staff listen to children’s suggestions about the service and make changes as a result of this feedback.

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Key findings from this inspection

The children’s home’s area for development:

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Key findings from this inspection

 Identify the key areas for development from the quality of care review and turn them into an action plan for the continuous development of the services for children. Inspection report children’s home: SC389781 3

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Inspection date Inspection type Inspection judgement

15/02/2017 Interim Sustained effectiveness 23/08/2016 Full Outstanding 03/03/2016 Interim Declined in effectiveness 25/09/2015 Full Outstanding Inspection report children’s home: SC389781 4

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Recommendations

 Ensure that the review of the quality of care clearly identifies any actions required for the next six months of delivery within the home and how those actions will be addressed. The whole review process and the resulting report should be used as a tool for continuous improvement in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.4.)

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Overall experiences and progress of children and young people: outstanding

Children experience exceptional care from a well-trained, committed and professional staff team. High staffing levels ensure that children receive constant supervision and staff are able to meet their needs quickly. For example, active and mobile children receive one-to-one supervision while additional staff offer personal care to others. This prevents children from waiting and limits frustrations. The staff team thinks of everything for the children’s comfort and safety. Every time that staff take children out, they ensure that they take drinks, snacks, picture exchange communication system books, medical supplies and details of emergency contacts with them. Staff understand high-level needs and ensure that they prepare for every eventuality.

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Overall experiences and progress of children and young people: outstanding

Excellent assessments are completed prior to any short breaks commencing. Staff understand the processes for assessing and introducing new children to the home. An assessment officer completes and coordinates all assessment work, which includes visits to the child’s home and place of education. Careful planning and transition ensure that children’s introductions to the unit are successful. For example, the manager will ensure that if a child has a significant medical need, staff will be trained properly prior to any agreement for that child to attend. One parent said, ‘The service is exceptional; my child is non-verbal but I get good feedback about what he has been doing over the weekend.’ She went on to say that she found the assessment process thorough, with workers visiting at home and at school, and then her child came for a series of visits, slowly building up for the whole weekend.

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Overall experiences and progress of children and young people: outstanding

Staff excel in their joint work and communication with other professionals and parents. Every detail is known about a child prior to their attendance for short breaks. Healthcare is one example of this. Staff are all first-aid trained and have all received training for gastrostomy feeding and the administration of emergency epilepsy drugs. Excellent links exist with the community nurse, who regularly visits the home and provides some of the training required.

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Overall experiences and progress of children and young people: outstanding

The staff work together as a team, with patience and good organisation. Staff carefully help the children with everyday tasks, such as getting safely onto the mini-bus. Staff are persuasive with children; they remain calm throughout each activity, despite children Inspection report children’s home: SC389781 5 being highly excited and presenting challenging behaviours. Staff give clear, consistent instructions and positive messages to affirm good behaviours. They work together extremely well and are impressive to watch.

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Overall experiences and progress of children and young people: outstanding

Children and staff sit together to eat meals. There are two choices on the menu every day. There is a wide variety of choice, including traditional meals as well as culturally appropriate meals. Staff pay close attention to children’s dietary needs to ensure that these are met; for example, some children are allergic to fish, dairy or gluten and others eat halal meat or follow a vegetarian diet. Children fed via p ercutaneous endoscopic gastrostomy have close support and supervision and are fed at regular mealtimes by staff trained in this procedure.

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Overall experiences and progress of children and young people: outstanding

The manager employs a cook, who prepares all food from scratch and ensures that fresh ingredients are used. She provides healthy options for children and is aware of individual dietary needs. Staff sit and eat with the children at the table in the kitchen. They encourage children to make healthy choices and supervise them well during mealtimes. This ensures that children eat carefully and not too fast and that they have support to feed themselves if needed. Staff offer good supervision, but also encourage independence with eating. For example, all the children, if they are able, are encouraged to clear their plates, dispose of unwanted food, wash up and wash their hands. The manager and the responsible individual sit and eat with the children on a regular basis. Children know them well and there were many positive interactions observed during the inspection, including high fives, hugs, kisses and laughter. Staff make mealtimes a

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Overall experiences and progress of children and young people: outstanding

sociable and learning experience and it feels like eating in a large family environment.

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Overall experiences and progress of children and young people: outstanding

Children experience fantastic opportunities to try a wide range of activities when they come for a short break at the home. For example, there are lots of indoor activities such as arts and crafts, computers, an Omi projector, sensory room, trampoline or simply watching television or relaxing. Staff continually look for new activities outside the home, where they can take the children for new fun and learning experiences. Some of the places visited since the last inspection in February this year include trips to Southend-on- Sea, the Cutty Sark, Crystal Palace, the London Transport Museum, Orpington Fruit Farm and the Greenwich cable cars. In addition, more local activities such as trips to the city farms and parks, going bowling, shopping, fun rides at the shops or the local playground are regular events.

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Overall experiences and progress of children and young people: outstanding

High-quality case records give staff a clear understanding of children’s needs, wishes and feelings. Staff routinely use photographs in files, for care planning and review. These are fantastic tools for communication and detail children’s activities and progress while staying at the home. One of the children showed the inspector the activity folder pictures, pointed out many of the children and staff, and he knew most of them by name. He was very excited to show the inspector pictures of himself baking, decorating and eating his own birthday cake, which led to staff singing ‘Happy Birthday’ to him again, which he loved. The staff at the home offer opportunities for the children to participate in activities which are often too difficult for parents to manage, when they have other commitments and other children to consider. Inspection report children’s home: SC389781 6 Children share excellent relationships with staff and present as happy and relaxed in the

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Overall experiences and progress of children and young people: outstanding

company of staff. One child told me that he loves coming to the home and plans to work here when he is old enough and to take the manager’s job. Children like their rooms and say that they have comfortable beds and duvets. Children choose the room that they want to sleep in when they arrive. One child said, ‘When I arrive, I choose the room I want; I choose a different one every time and I like them all.’ He suggested that the rooms should have names on them. When the staff heard this idea, he was encouraged to make some room signs and the staff agreed to put them on the doors.

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Overall experiences and progress of children and young people: outstanding

Staff write high-quality, individualised care plans for children. If children have the ability, they are encouraged to contribute to these plans. For example, staff identified one child as a poor eater and his parent was concerned that he needed to improve his diet. Staff spent time with this child, explaining about healthy eating and together they made an eating plan. The child was encouraged to stop eating jam sandwiches through careful work with him. He chose gammon steak and pineapple as a food preference and staff made big efforts to ensure that his eating improved during his stay at the home.

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Overall experiences and progress of children and young people: outstanding

Children are encouraged by staff to make continuous improvements. Staff set simple targets in care plans by liaising closely with parents, schools and children. Children make excellent progress within their own limitations and from their starting points. Often, simple, small improvements, such as being able to get dressed with limited support or improve self-care skills, are making massive differences to children and their families. Staff operate exceptional care planning and review processes. This ensures that regular monitoring takes place of children’s progress. This in turn enables managers to have oversight of their progress, so that they can take action if there is any concern.

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Overall experiences and progress of children and young people: outstanding

In addition to care and placement planning, children benefit from equality and diversity plans. Staff are aware of children’s individual needs for religious, language, dietary needs and cultural identity. This ensures a range of appropriate menu choices and activities across the diversity of the group. Children attending this short-break service have fantastic opportunities to learn about a wide range of cultural and religious events, including Easter, Christmas, Diwali, Eid, Ramadan, Chinese New Year, Halloween and many other celebrations.

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

The home continues its exemplary record of keeping children safe while on short breaks. No children have gone missing from this home and high levels of staffing ensure excellent supervision. Staff can pre-empt and prevent behaviours that could place children at risk because the ratio of staff to children allows this high level of monitoring.

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

Excellent risk assessments begin prior to children’s admission for short breaks. Careful assessment ensures that no risks are unknown. Parents authorise staff to write to general practitioners about medical diagnosis, needs and care. Liaison with doctors and other health professionals ensures that staff receive appropriate training to meet medical needs prior to a short break. Risk assessments include observations of children in a school setting and staff talk to all involved professionals about potential behaviours, Inspection report children’s home: SC389781 7 triggers and strategies to manage them. Risk assessments are clear; they cover key areas and help staff to understand how to manage risk. Regular reviews take place throughout children’s time at the home and the risk levels are revised, depending on needs or progress.

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

Managers ensure safe recruitment practice when employing new staff or volunteers. This helps to prevent and deter unsafe adults from gaining access to work at the home or having unsupervised contact with children.

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

Excellent precautions reduce the risk of fires. Safety equipment is in place and there is evidence of regular and compliant checks and fire drills. The registered manager recently re-evaluated the fire risk to the home. The backdoor has a device fitted that unlocks instantly when the fire alarm is triggered. Two further doors will have this device fitted very soon. This helps to increase safety and speeds up evacuation in the event of a fire. Staff complete morning and evening checks on fire equipment every day. All children have safe evacuation plans and staff regularly practise these routines.

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

In addition to fire safety, the registered manager completes a risk assessment of the home and there is regular monitoring of mechanical equipment such as the lift and hoists. Staff have received training about what to do in the event that the lift breaks down with staff and children inside, to prevent distress or a medical emergency. The registered manager has completed a further risk assessment of the local area to establish local risks.

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

Staff receive safeguarding training, which is refreshed regularly to ensure that they keep up to date with changes in procedures and practice. All staff undertook training recently on the risk of radicalisation. They are alert to other risks that children face in the community. For example, when children have protection plans, close monitoring and work with other professionals help to keep them as safe as possible.

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

At staff meetings, staff regularly discuss safeguarding scenarios that they may face in the workplace. The registered manager is fully on top of updating policy and procedures and team meeting minutes indicate that staff receive regular updates on their responsibilities to be vigilant and report anything that raises concerns.

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

Staff understand the vulnerability of the children they work with and the processes within the home offer additional safeguards to keep children safe. For example, staff complete body maps when children arrive for short breaks, at every shift change and when children return home. This keeps a clear record of any injury, mark or accident, together with its cause. Parents, carers and professionals are aware of this process and staff contact them immediately if there is any accident, injury or illness while children are on a short break.

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

Leaders and managers keep safeguarding at the centre of their practice. Children benefit from clear written procedures which help staff to feel confident to report or whistle-blow if they see or suspect any form of abuse. Parents, carers and children who are more able have copies of the children’s guide, which gives them contact numbers for advocates Inspection report children’s home: SC389781 8 and the regulator.

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The effectiveness of leaders and managers: outstanding

The leaders and managers run an exceptional service where there are no breaches of regulation. Leadership and management are consistent and strong. The manager is a qualified social worker with many years of experience and a comprehensive understanding of safeguarding issues. In addition to a social work qualification, the manager has a level 5 qualification in leadership and management and is continually updating and improving his knowledge. An experienced, responsible individual fully supports the manager and is a visible presence to staff, parents and children using the service.

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The effectiveness of leaders and managers: outstanding

Leaders and managers are ambitious for the service and have high expectations of their staff team and for the quality of service that they provide. They have high ambitions for children using the service and build excellent relationships with parents, professionals, commissioners and children. Leaders and managers constantly look for ways to improve practice and work closely with commissioning authorities, parents, the independent visitor and others to achieve this. One commissioner said, ‘This is an incredibly responsive service. The service is stepping up; their focus is on children and family needs. They challenge me in terms of wanting to constantly improve their service.’

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The effectiveness of leaders and managers: outstanding

Leaders and managers see inspection and feedback as an opportunity to improve. They find constructive criticism helpful in terms of developing their service. Recommendations made by the independent person who visits monthly are followed up and help to improve practice. In addition, leaders and managers acted effectively on both the recommendations made at the last inspection in February.

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The effectiveness of leaders and managers: outstanding

There have been no direct complaints to the manager since the inspection in February 2017. A complaint made to the host borough included concerns about equality and diversity issues in the home. The complaint covers this home, another short-break service and an outreach support service, all run by the parent company. Leaders and managers have cooperated fully with all enquiries made as part of the complaint investigation. The outcome of the investigation was that the complaint was unsubstantiated. The agency has a clear policy about how to make a complaint and a whistle-blowing policy to ensure that staff understand the importance of speaking out about poor practice or concerns. This helps to ensure that parents, professionals, staff and children can freely complain and have those complaints properly investigated and addressed.

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The effectiveness of leaders and managers: outstanding

The staff team includes both permanent and bank (sessional) staff. Permanent staff have full-time contracts and they undertake the assessment and key work with children. Bank staff have zero hours contracts and work on a more flexible, sessional basis to cover the areas of higher need over the weekends and school holidays. Despite bank staff having more flexibility in contracts, there are expectations that they attend supervisions, training events and team meetings. If bank staff do not fulfil this expectation, leaders and managers do not offer them further shifts. Most staff hold the Inspection report children’s home: SC389781 9 level 3 diploma in residential childcare or an equivalent qualification. In three cases, staff are working towards this qualification within expected timescales, as set out in the Regulations.

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The effectiveness of leaders and managers: outstanding

There is effective monitoring of this service. An independent person visits the home once each month and writes a report, which he submits to the regulator. He communicates with children, parents, professionals and staff about progress and these views inform his report. These reports have become more robust and challenging towards the provider, for example in diversity, target-setting and care planning. The independent person attends team meetings on occasions to give his feedback directly to staff. This helps to improve practice and the services provided. A recommendation at the last inspection in February was to ensure that the independent person gave his own analysis of the home’s capacity to safeguard children and promote their welfare. This analysis is now included in the reports provided to the regulator. This autonomous look at the processes and running of the home is invaluable in safeguarding children and provides an

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The effectiveness of leaders and managers: outstanding

additional level of scrutiny to practice.

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The effectiveness of leaders and managers: outstanding

The registered manager undertakes his own quality of care review once every six months. This takes into account feedback provided to the home by young people, staff, parents and professionals. This report helps the manager to have an overview of the running of the service and the progress or areas of development from the preceding six months. However, the manager does not write an action plan and this would focus ongoing development for the forthcoming six-month period.

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The effectiveness of leaders and managers: outstanding

Staff love working at this home. There is a diverse mix of ethnicity within the staff team, which is reflective of the children referred to the service. Leaders and managers ensure a high ratio of staff to children. Staff say that they feel well supported in their role with regular supervisions, yearly appraisal and sharing knowledge and information at regular team meetings. Staff receive regular and relevant training, which they say helps them to do their jobs effectively. For example, all staff recently completed training on the emergency administration of medication for epilepsy. One sessional staff member said, ‘I only work at weekends and during holidays, but the communication is excellent. I always know what is happening and never feel excluded or outside the staff team.’

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The effectiveness of leaders and managers: outstanding

Informative and regular staff forums run at this home. Staff discuss and reflect on key areas of practice, for example by discussing various safeguarding scenarios, quality standards, diversity and equality, and considering research in practice. Leaders and managers use team meetings as a training opportunity and an area for reflective practice. There is an expectation on staff to participate, contribute and take responsibility for their learning. Leaders and managers lead these team meetings and learning forums. In addition to learning, they regularly reinforce expectations on staff behaviour and conduct, and update on relevant information. Recent examples include fire safety and evacuation procedures, staff breaks and safety in the community.

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The effectiveness of leaders and managers: outstanding

Leaders and managers have good links to the local community and try to support children in as many ways as possible. The Usha Mohila Somity group, also known as The Dawn group, use the home’s premises to run their group meetings. This is an Inspection report children’s home: SC389781 10 independent group for mothers who have children with a disability. The meetings take place during the day in the term time and not when children are present.

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The effectiveness of leaders and managers: outstanding

The leaders and managers meet their stated aims and objectives effectively and go over and above what is expected of a short-break service. They are fully integrated into the community, hold quarterly meetings with their commissioning authorities and have strong partnership working. The registered manager shows a strong skill set and is consistently looking to develop his staff team.

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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 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: SC389781 11

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Children’s home details

Registered provider: The Qalb Short Break Services Ltd

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Children’s home details

Registered provider address: 35 Beaufort Court, Admirals Way, South Quay Waterside, London E14 9XL

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Inspector

Christine Kennet, social care inspector Inspection report children’s home: SC389781 12 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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