Children's home run by Slough Children First Limited in Bristol, City of

Inspection report children’s home: 1183479 1 Registered provider: Slough Children’s Services Trust Limited (09487106) Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This service primarily offers residential short breaks for children and young people who have learning and/or physical disabilities. In exceptional circumstances, the home may provide known children with an extended or full-time care package. The home is registered to provide care and accommodation for up to six children.

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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 outstanding

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good

The effectiveness of leaders and managers good

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good

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

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good

Overall judgement at last inspection: good

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Key findings from this inspection

This children’s home is good because: Inspection report children’s home: 1183479 2  Safeguarding practice is exemplary. The manager and staff pay careful attention to gathering information; they promptly refer to and collaborate with other agencies, and continue to work with families to ensure that children are safe.  The manager and staff are creative in finding ways of meeting the needs of families, including the introduction of an outreach service, providing emergency day care and extending placements.  There is a strong ethos of responding to the views of children and young people, particularly in deducing the meaning of the behaviour of those with a limited ability to communicate. When this demonstrates discontent, consideration is given to whether it constitutes a complaint and is dealt with appropriately.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 The home is not consistent in conforming to regulations regarding the monitoring and reviewing of its service, this includes notifications, reports of the independent person and reviews of the quality of care.  Risk assessments regarding matters such as night-time emergency evacuation drills and the impact of newly admitted children and young people on those already using the service have not been adequately recorded.  Staff appraisals have been significantly delayed.

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Inspection date Inspection type Inspection judgement

09/08/2016 Full Good 04/02/2016 Interim Sustained effectiveness Inspection report children’s home: 1183479 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 registered person must ensure that all employees have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(c)) 30/09/2017

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Requirement Due date

The registered person must ensure that the independent person carrying out visits to the home only inspects a child’s case records if the child’s placing authority consent. The report must set out the independent person’s opinion as to whether children are effectively safeguarded and if the conduct of the home promotes children’s well-being. (Regulation 44 (2)(b) and (4)(a) and (b)) 30/09/2017

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if a child protection enquiry involving a child is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry). (Regulation 40 (4)(d)(i and ii)) 30/09/2017

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Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9.) In particular, ensure that facilities are in good condition and accessible by children and young people.  The registered person should only accept placements for children where they are satisfied that the home can respond effectively to the child’s assessed needs as recorded in the child’s relevant plans and where they have fully considered the impact that the placement will have on the existing group of children. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.4.) The impact risk assessment should consider and record the potential effect on children and young people who already use the service and

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Recommendations

actions or decisions that arise from this. Inspection report children’s home: 1183479 4  The responsible person must make and give effect to such arrangements as are appropriate, having regard to the size of his undertaking and the nature of its activities, for the effective planning, organisation, control, monitoring and review of the preventive and protective measures. The responsible person must record the arrangements referred to in paragraph (1) where he employs five or more employees. (The Regulatory Reform (Fire Safety) Order 2005 11(1) and (2)(a))

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Overall experiences and progress of children and young people: good

The manager is constantly looking to meet the needs of children and young people, utilising the resources, the services and skills of staff to best effect. A particularly successful development is the training of staff to be ‘intervenors’, assisting families with children with sensory impairments to access services or manage procedures, such as undergoing blood tests. Staff have identified that a young person’s family relationships were close to breaking down and made arrangements to offer him extended stays, adapting the service’s statement of purpose to include such placements. This has proved highly successful with relationships with parent and siblings now much improved, and the frequency of challenging behaviour within the home reduced to a quarter of what it was. Routines have been established that the young person is able to follow well and as a result the young person has become more independent.

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Overall experiences and progress of children and young people: good

All children and young people have targets set to increase their independence and capacity to enjoy life. When they reach the age of 14, these are converted to ‘pathway plans’ to focus on areas that will help young people to manage once they are adults. Since the last inspection, steps towards the targets have been introduced, from ‘beginner’ to ‘proficient’; children and young people physically move their photograph up the steps when it is deemed that they have reached the next level. This marks their achievement and gives some young people great pleasure. The majority of children and young people are making progress across a range of developmental areas, some significantly so. These include accepting being away from family, making sandwiches, self-care and toileting. Staff have successfully used strategies to reduce one young person’s obsessive behaviours and helped her to manage difficult situations without them. Some skills have been transferred to other settings; one

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Overall experiences and progress of children and young people: good

parent described how her son will now ‘put his bag away, puts dirty things in the laundry and clothes not used in his wardrobe,’ on returning from his short break. She has also noted, ‘He is more confident with other people now; I can tell the difference in him.’ ‘Table top’ activities, each with their own bag, have been introduced that children and young people can undertake with staff. This provides them with a focus, widens their repertoire of activities and gives them opportunities for social interaction. Some areas of the premises, the sensory room and the garden, are looking worn, but the manager has not been able to implement improvements due to a lack of funding. This means that some areas of the garden are no longer accessible to children and young people because they are unsafe. Bedrooms are being refurbished, with staff and Inspection report children’s home: 1183479 5 volunteers undertaking the decorating.

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Overall experiences and progress of children and young people: good

Staff conduct admissions at a pace that children and their parents are comfortable with so that they are confident that they can manage the next stage of introductions, from initial visits, through tea visits and extended day care, to staying overnight. Children’s and young people’s health is methodically monitored. Staff responded well to a medical emergency, following protocols, administering emergency medication and providing paramedics with pre-prepared information. The child’s health was effectively safeguarded, but the manager was keen to learn lessons and has implemented further precautions to make the child’s stays even safer.

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

Staff have been highly vigilant in monitoring and gathering information that led to concerns about a young person. This was promptly referred to the appropriate agency with a clear presentation of the evidence, together with what the team had already done to identify potential causes. Other professionals were most complimentary of the role that staff members played in the subsequent enquiry, including the confidence that they had in their information, the recalling of conversations and their insight into the family situation. One professional said, ‘Strategy discussions with the home were key; it was a very good piece of work.’ The standard of this work, in terms of its thoroughness, proficiency and effective collaboration with other agencies, led to the successful safeguarding of a young person. In doing so, staff did not lose sight of the need of the family for continued support. This is exemplary.

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

Parents spoken to believe that their children are safe while staying at the home. A mother commented, ‘They are the only people I trust with my son. Once, [when he put himself in danger] the staff member dealt with him like he was her own child. He is 100% safe with them.’ Health and safety are a high priority for the manager who has instituted a new monitoring system for fire safety that ensures staff conduct tests and evacuation drills within the recommended frequency. However, on the day of the inspection an external fire exit was blocked on the outside. This was immediately rectified and new signs put up on the exterior before the end of the inspection to identify all fire doors and pointing out the need to keep them clear. The manager has instilled a culture in which all staff seek and value children’s and young people’s views. This is exemplified by the recent practice of identifying when the behaviour of those who have limited ability to communicate indicates that they are

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

complaining about an aspect of the service. Staff act as an advocate for the child or young person, recording the behaviour and making the link to the grievance. The manager treats and records this as a complaint. Outcomes have been tangible for the young person, such as changing the day that they stay, and when this has been explained to them a typical response has been a ‘thumbs up’. There is a high level of supervision of children and young people so that they are unlikely to be at risk of going missing or being subject to exploitation while in the care of Inspection report children’s home: 1183479 6 the home. Nevertheless, staff take opportunities to explain the risks of such things as running off from staff when out and what to do if the fire alarm goes off, as far as the individual child or young person is able to understand the concepts. Interactions of staff with young people are characterised by patience, humour and

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

perseverance. There is an obvious affection that many young people reciprocate; some ask for hugs or seek out members of staff to greet. The warmth and trust of these relationships often leads to challenging behaviour reducing over time. Since one young person’s stays have been extended, to prevent a breakdown in family relationships, he has been increasingly settled. He is able to follow routines that reduce his anxieties and incidents have dropped to a quarter of what they were.

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The effectiveness of leaders and managers: good

The manager has brought drive and passion to the role with a willingness to think beyond the current provision to meet the needs of children and young people. This has led to staff visiting family homes to help parents to implement strategies and methods that work in the short-break service and to extending placements. There has been a significant reduction in the number of short breaks that have been cancelled due to insufficient staff being available. In addition, an extra member of staff has been deployed in the holidays to provide more opportunities for children and young people to undertake activities. The provider is making efforts to recruit to vacant posts but, in the meantime, has been employing agency staff to cover. Although the manager attempts to engage the same workers so that there is continuity for children and young people, this has led to some shifts having more agency staff than permanent staff,

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The effectiveness of leaders and managers: good

contravening statutory guidance. Care planning is strong, making excellent use of information from schools and parents to formulate risk assessments, behaviour support plans and targets for children and young people. Impact risk assessments are drawn up but they do not address the potential risks to others already using the service nor do they make clear the connection between the outcome of the assessment and decisions made, such as where to offer a place and who to match the young person with. Placement plans are generally well written and the manager and staff ensure that there is no drift in implementing them. However, they lack any information as to how young people have been able to contribute to them, or how their cultural background has been taken into account. The majority of files viewed were in good order and evidence an auditing process. However, this had not identified anomalies including the lack of consents from placing

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The effectiveness of leaders and managers: good

authorities for the independent person to view them and risk assessments on one file which were not completed in the correct format. Staff engage well with wider networks to pool resources, share information and coordinate efforts to increase the ability of different agencies to meet the needs of particular young people. This includes making joint visits with social workers and assisting parents with health appointments. The provider has plans to strengthen formal links to the local safeguarding children’s board but already makes good use of the local authority’s designated officer, consulting her on safeguarding issues and making Inspection report children’s home: 1183479 7 appropriate referrals. The manager has not been sufficiently diligent in ensuring that Ofsted are informed about developments in the home, failing to notify HMCI of a child protection enquiry and only belatedly producing a review of care under Regulation 45. Regulation 44 reports do

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The effectiveness of leaders and managers: good

not state the independent person’s view as to whether children are effectively safeguarded and if the home promotes children’s well-being, despite this being a requirement at the previous inspection. Other monitoring systems have been significantly improved, including medication records, fire checks and tests and training that staff undertake. Staff have meticulously recorded information for each of these so that it is unlikely that processes to ensure the safety of children and young people would be compromised. One error in the administration of medication has occurred, but the staff involved immediately identified the error. The manager has re-enforced the necessity to get medication right every time it is given, although on this occasion it had no observable effect on the child concerned. Another agency has adopted the home’s system of recording the administration of medication and stock recording to strengthen their own procedures.

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The effectiveness of leaders and managers: good

Logs of physical intervention do not universally contain all the information required to make it clear why staff used a restraint, although the information may be available elsewhere. There was no record of when staff had been debriefed and recent entries in the log had not been subject to monitoring by the manager. This could lead to opportunities to learn from practice not being taken. Staff spoken to commented on the manager and her deputy ‘seeing the bigger picture’ and ‘we know much more about where we are going, making the service bigger and better’. They report that, ‘Support is good, but with a busy unit supervision does not always happen on time.’ Appraisals were late at the time of the last inspection and have not been conducted since. The manager has made good use of research to develop the service. One example is finding out that children and young people with autistic spectrum disorders are less likely

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The effectiveness of leaders and managers: good

to pull curtains and blinds down if they are the same colour as the walls that they are on. Some redecorated rooms have incorporated this and experience has born the research out. This means that occupants of those rooms have not been overstimulated, have a nicer environment and have their privacy maintained.

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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 differences 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 Inspection report children’s home: 1183479 8 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: 1183479 9

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Children’s home details

Registered provider: Slough Children’s Services Trust Limited (09487106)

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Children’s home details

Registered provider address: Ground Floor West, St Martin’s Place, 51 Bath Road, Slough, Buckinghamshire SL1 3UF

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Inspector(s)

Chris Peel: social care inspector Inspection report children’s home: 1183479 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 looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

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