Children's home run by City of York Council

Inspection report children‘s home: SC034940 1 SC034940 Registered provider: City Of York Council

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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 is registered to provide care and accommodation for up to eight children and young people who have physical and/or and learning disabilities. It is owned and operated by a local authority.

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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 February 2017

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good

Overall judgement at last inspection: Declined in effectiveness

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Key findings from this inspection

 A high number of children and young people benefit from attending this short breaks provision. Inspection report children‘s home: SC034940 2  Children and young people receive a tailor-made introduction package to prepare them for coming to the home.  The knowledgeable and committed staff team provides high-quality care.  Children and young people who have disabilities, including those with complex health and physical needs, benefit from experiencing a whole range of activities at the home and in the community.  Effective partnership working with health professionals, education and parents ensures a consistent approach when caring for the children and young people.  Children and young people have close supervision in order to keep them safe.  The home‘s nurse has updated medical policies and procedures, particularly the medication administration, to ensure that staff have the necessary skills and

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Key findings from this inspection

training to provide a high standard of healthcare.  The employment of the manager and deputy manager, who both have experience in residential care and disabilities, provides a strong management team.  The manager has made improvements to the monitoring systems and procedures at the home.  There has been a delay in applying for the neighbouring home to be registered, together with a delay in the registration of the manager at both homes. This is still outstanding after being raised at the last inspection.

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Inspection date Inspection type Inspection judgement

20/02/2017 Interim Declined in effectiveness 06/07/2016 Full Good 29/01/2016 Interim Sustained effectiveness 14/10/2015 Full Good Inspection report children‘s home: SC034940 3

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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Requirement Due date

The independent person must produce a report about a visit (―the independent person‘s report‖) which sets out, in particular, the independent person‘s opinion as to whether— (a) children are effectively safeguarded; and (b) the conduct of the home promotes children‘s well-being. (Regulation 44(4)) 30/09/2017

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Recommendations

 Children who have disabilities or illnesses may have physical and/or emotional difficulties which mean that participation in leisure or cultural activities in the community is difficult to achieve. The registered person, in conjunction with any relevant person (such as a parent or school), should assess what would be safe, achievable and reasonable for each child, in line with their relevant plans, and ensure that appropriate opportunities are available for each child to have fun, form friendships and enjoy life, relative to their stage of development and individual needs. (‗Guide the children‘s homes regulations and quality standards‘, page 31, paragraph 6.10) Specifically, in respect of completing individual risk assessments for young people rather than taking a generalised approach to activities.  Staff should be familiar with the home‘s policies on record-keeping and understand the importance of careful, objective, and clear recording. Staff should

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Recommendations

record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‗Guide the children‘s homes regulations and quality standards‘, page 62, paragraph 14.4) Specifically, in respect of recording incidents and physical interventions to ensure that the account is accurately and consistently recorded across all documents.  When establishing the home, the registered person must ensure that it is suitably located so that children are effectively safeguarded and can access services to meet needs identified in their relevant plans (see regulations 12(2)(c)). Under regulation 46, the registered person should review the appropriateness and suitability of the location and premises of the home at least once a year. The Inspection report children‘s home: SC034940 4

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Recommendations

review should include the identification of any risks and opportunities presented by the home‘s location and strategies for managing these. (‗Guide the children‘s homes regulations and quality standards‘, page 64, paragraph 15.1) Specifically, to include any information about the area from safeguarding agencies, such as the police, together with services available that children and young people can use.

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Overall experiences and progress of children and young people: good

An excellent admissions process introduces children, young people and their families to the service. Introductions are individualised and go at the child or young person‘s pace. This helps them to become familiar with the home and staff prior to their stay. Children and young people settle and adapt quickly to the environment, making their experience more enjoyable. Equally, staff spend as much time supporting young people when they leave the service and move to adult provision. This includes young people working alongside staff at the new home until the young people feel confident to successfully transition to their new short breaks provider. Most of the staff have worked at the home for many years so have extensive knowledge and experience of caring for children and young people who have disabilities. Staff provide high-quality care and support. Children and young people have an individual detailed healthcare plan, which staff know well. Staff are competent to use the specific

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Overall experiences and progress of children and young people: good

equipment that is vital to the children and young people‘s quality of life. A nurse based at the home provides essential support to staff. She undertakes medical supervision and provides new and updated training for staff. Because of staff‘s expertise, parents feel confident about their children using the service, with some young people coming to the home for many years. Children and young people have fun doing a range of activities that they would not normally do at home. This promotes their social skills and confidence in their abilities. They are provided with a range of sensory and other positive stimulation to improve their life experiences. This includes a large garden with toys, equipment and different areas for them to explore. Alongside wanting children and young people to enjoy themselves, staff are keen to see children and young people‘s skills develop through setting small, achievable targets. This enriches children and young people‘s lives. For

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Overall experiences and progress of children and young people: good

one young person, the use of an electronic tablet has opened up a whole area of communication for him. He is now able to communicate with staff and make choices at the home. Although parents and carers are responsible for ensuring that their children attend education, staff work effectively with providers to ensure that all aspects of their education is promoted. This includes ongoing communication with school staff about their approach or methods of communication used. This promotes consistent practice across different settings, with staff mirroring strategies used. This is particularly important for children and young people who need clear routines. There are excellent links between home and school. The use of an information book ensures that essential Inspection report children‘s home: SC034940 5 information is shared, particularly for children who have communication difficulties. Excellent partnerships forged over time between the home, professional stakeholders

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Overall experiences and progress of children and young people: good

and parents leads to excellent information sharing. This facilitates good multi-agency working. Parents, carers and professionals are fully consulted and their views sought. The manager uses this information to make improvements to the service for children and young people.

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

Children and young people are kept safe and protected at the home because staff know their complex needs, vulnerabilities and the issues that these may bring. Staff provide a high level of supervision for children and young people to keep them safe, alongside giving them opportunities to engage in activities both at the home and in the community. This provides children and young people with new experiences, for example going out to restaurants. Children and young people‘s behaviour is well managed due to detailed behaviour management plans that outline strategies for staff to use. With some young people, their behaviour can be unpredictable, but physical interventions are low as staff have good de-escalation skills. Staff respond swiftly to self-harming behaviours, often predicting these before they worsen. This keeps children and young people safe. Individualised risk assessments outline children and young people‘s vulnerabilities and

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

help staff to understand how to keep them safe. However, for some activities, staff have been taking a generic approach to risk management rather than looking individually at whether children or young people can participate, for example going swimming. The manager has been challenging this approach, resulting in children and young people now beginning to experience new activities and adventures. A complete overhaul of the healthcare policies and procedures means that there is a clear and robust system in place for medication storage, recording and administration. Children are further safeguarded because staff receive training and competence testing before they administer medication. The nurse also regularly audits procedures to ensure continued safe administration. The nurse and manager meet regularly with a medical professional to monitor practice, training and to review service needs. This ensures that

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

staff are up to date with the latest procedures and maintain a high standard of healthcare. This practice keeps children and young people safe, particularly given their complex medical needs. Staff have refresher training if an issue is raised about their practice. A staff member said: ‗Procedures are more robust and more protective. Competence and evidence basing shows that managers know staff are safe to administer medication.‘ Recruitment processes are now robust enough to ensure that staff have the necessary skills and are safe to work with children and young people. A change of independent visitor has resulted in a thorough examination of the home. However, the independent visitor fails to give an opinion of whether children and young people are safeguarded. This means that the provider and the regulator cannot be assured that children and young people are safe. Inspection report children‘s home: SC034940 6

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

An application is still outstanding from the local authority for the unregistered children‘s home sited close to the short breaks provision. The manager is still to be registered, leaving both homes without a registered manager for several months. Consequently, registration procedures are incomplete for the proposed premises and manager. The manager has significant experience in residential care in managerial positions and has the required leadership qualification. A deputy manager, who has a social care qualification, now supports her. This strengthens the leadership team, which is keen to move the service forward for the benefit of children and young people and their families. Since working at the home, the manager has already made positive changes to monitoring systems and procedures. This includes reducing the amount of duplication of paperwork in order to prevent inaccuracies in recording. The manager has a good

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

knowledge of the children and young people who come for short breaks through observation, shadowing and working shifts. The manager speaks of the confidence she has in staff, acknowledging their hard work by nominating them for a local authority team of the month award, which they recently won. The manager has been empowering competent staff to make decisions. Staff talk of receiving good levels of support, supervision and training. A staff member said: ‗I feel that (name of manager) has a good approach to the staff team, she is very supportive. She listens to ideas and has completely different ideas on staff responsibilities. Networking has improved – we are getting more young people in and more parents want to access the service.‘ The longstanding staff team is passionate and committed, which is evident from the low staff turnover. One of the strengths of the home is that, because the team is so stable,

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

children and young people benefit from a consistent team caring for them. A professional reported: ‗Staff are incredibly knowledgeable regarding (name of young person‘s) needs, him as a person, his likes, dislikes and his level of understanding. They clearly have his needs at the centre of all that they do.‘ The manager has met the requirements from the last inspection and taken on board the recommendations made. A detailed and evaluative report gives an honest and reflective view of the home and details the actions necessary to improve the quality of care provided for children and young people. Some of these changes have already begun, such as the introduction of new monitoring forms.

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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 Inspection report children‘s home: SC034940 7 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: SC034940 8

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Children’s home details

Registered provider address: City Of York Council, West Offices, Station Rise, York YO1 6GA

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Inspector

Tina Ruffles, social care inspector Inspection report children‘s home: SC034940 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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