Children's Home run by Portsmouth City Council in Portsmouth

Inspection report children’s home: SC037588 1 SC037588 Registered provider: Portsmouth City 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 for a maximum of six children and young people who have learning and/or physical disabilities. The home is owned and managed by the city council and provides short breaks, Tuesdays to Saturdays.

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Information about this children’s home

Inspection dates: 20 to 21 September 2017

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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 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: Sustained effectiveness

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Enforcement action since last inspection:

None Inspection report children’s home: SC037588 2

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Key findings from this inspection

 Children and young people have a good time in this home. Staff make them welcome. Children and young people enjoy the company of their friends and of staff. They enjoy a range of activities. They are confident that staff are there for them and will meet their needs.  Parents enjoy positive and constructive relationships with staff. They speak highly of the good communication and how they are made welcome, such as in the organised coffee mornings or when they drop in for a chat.  The registered manager has a development plan to improve the decor of the home. He recognises the weaknesses, such as the need to capture training in health care tasks on the training matrix and update some care plans.  The registered manager has developed a system to record restraints that meets the regulations, as required at the last inspection.  Staff are consistent, competent and motivated. The registered manager provides good support and training for them.

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Key findings from this inspection

 Staff work well with other professionals and parents. There is effective communication about each child’s and young person’s needs.  Children and young people have a good induction. Staff manage transitions from school very well. They welcome children and young people into the home. Children and young people enjoy a range of activities in the home and look forward to coming again.  Meals are a happy, sociable time. Children and young people enjoy a meal of their choice that meets their dietary requirements, even if each child or young person wants something different.  There is good planning to meet children and young people’s needs, especially those who have complex health needs.  Children and young people feel safe and secure. They trust the adults around them.

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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

 Bedroom doors and windows require modernisation to suit the specialised needs of the children and young people accommodated.  The use of door guards is not clearly documented in the child or young person’s care plan.  The current condition of the sensory room results in children and young people being unable to access it.  ‘As required’ medication protocols are not being authorised by a health Inspection report children’s home: SC037588 3 professional in every case. This important layer of safety is compromised in such examples.  The registered manager has not challenged health professionals to delegate health care tasks in accordance with Care Quality Commission/Ofsted guidance, especially signing off assessments when they deem staff competent in the particular clinical skill.  Staff have not always fully explored the precise communication methods of non- verbal children and young people, especially considering the methods used by

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Key findings from this inspection

other professionals.  Activities undertaken outside the home lack variety.

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Inspection date Inspection type Inspection judgement

28/03/2017 Interim Sustained effectiveness 02/11/2016 Full Good 23/03/2016 Interim Improved effectiveness 17/12/2015 Full Requires improvement Inspection report children’s home: SC037588 4

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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

6. In order to meet the quality and purpose of care standard the registered person is required to:

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Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child, especially bedroom doors, windows and the sensory room. (Regulation 6 (2)(c)(i)) 31/03/2018

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Requirement Due date

5. In order to meet the engaging with the wider system to ensure children’s needs are met standard the registered person is required to:

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Requirement Due date

challenge the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans, in particular health professionals. (Regulation 5 (c)) 31/03/2018

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Requirement Due date

Ensure that restraint that is used as a matter of routine is planned or provided for in the child’s EHC plan or statement of educational needs, in particular the use of door guards on bedroom doors. (Regulation 35 (4)) 30/11/2017

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Requirement Due date

Make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23 (1)) In particular, ensure that all ‘pro re nata’ protocols are approved by a health professional. 30/11/2017

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Recommendations

 Observe, notice and respond to children who are expressing their views, in particular consider shadowing the approach of the child’s school. (‘Guide to the children’s homes regulations including the quality standards’, page 22, paragraph 4.10) Inspection report children’s home: SC037588 5  Consider expanding the range of activities outside of the home. (‘Guide to the children’s homes regulations including the quality standards’, page 31, paragraph 6.5)

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Overall experiences and progress of children and young people: good

Children and young people look forward to their short break because staff make them feel very welcome. Friendships are maintained because their school friends are often present at the same time. Meals are a warm, sociable occasion where children, young people and staff enjoy each other’s company. The cook provides a variety of meals that meet all dietary needs. On occasion, this means cooking six different meals so that children and young people can have what they choose. A parent said, ‘My son always seems happy after a visit and he tells me what he has done. He always seems to have a good time’. A member of staff said, ‘It is like a big family home. All our children are happy’. A social worker said, ‘The child loves going to the short break, she gets excited about it and talks about it.’

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Overall experiences and progress of children and young people: good

Children and young people enjoy a range of activities in the home and garden. Staff utilise the local toy library so that there is an ever-changing array of playthings. Children and young people are able to cycle, using the specialist adapted bikes, no matter what their disability. Staff create bespoke activities, such as three-dimensional snakes and ladders. A parent said, ‘He will play this over and over again, which he loves.’ Children and young people are delighted to be able to do what they enjoy. Some children and young people have sensory needs. They are currently unable to access the sensory room, as the specialist equipment needs maintenance or updating. Staff reported that it has been in this condition for a considerable length of time and have been fundraising to purchase new equipment. Children and young people access the local community, for example through trips to the recreation ground or pond. Staff are aware of other

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Overall experiences and progress of children and young people: good

experiences that children and young people could have in the local area but are not routinely accessing them. One parent said that she would like to see her child taken out more regularly.

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Overall experiences and progress of children and young people: good

Staff place children and young people at the centre of their practice. They arrange the short breaks so that friends are together as much as possible. In one case, a young person who finds it difficult to tolerate others in the setting is able to access the short- break placement on her own. Staff said how positive this has been. Challenging behaviour has significantly reduced and relationships are far more constructive. A parent said, ‘It is a brilliant place, very supportive.’

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Overall experiences and progress of children and young people: good

Children and young people experience a well-planned introduction to the home. Staff visit the family home. Children and young people have a visit for tea. Staff write a care plan and assess risks with the parent. This maximises the opportunity for a positive short break. A parent said that their child is always very excited about coming to the home. Another parent said that her child would move in permanently if that were possible, as Inspection report children’s home: SC037588 6 her child enjoys it so much.

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Overall experiences and progress of children and young people: good

Children and young people have a voice, including those who have severe communication difficulties. Staff utilise communication aids, such as picture exchange communication symbols. In one case, for a child recently admitted, staff had not considered approaching the school for advice on the best way to communicate to ensure a consistent approach. While most children and young people who use the service may not understand the concept of what constitutes a formal complaint, staff understand how each child and young person makes their displeasure known. Children and young people trust the adults around them to meet their needs.

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Overall experiences and progress of children and young people: good

Staff treat children and young people with dignity and respect. Staff are undeterred by children and young people’s disabilities and promote their independence as much as possible.

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

Staff are acutely aware of each child or young person’s vulnerabilities and provide close, nurturing support to them. Staff are trained in safeguarding and child protection; they know what to do and who to inform if there are concerns about a child or young person’s welfare.

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

Staff prepare individual behaviour management plans and risk assessments, using their multi-disciplinary knowledge and expertise as well as talking to parents. Staff use these documents to outline how each child or young person prefers to be supported and cared for. Staff promote positive behaviour, and significant incidents are rare. None have been reportable to Ofsted since the last inspection. The registered manager has addressed the requirement from the previous inspection. He has introduced a new incident reporting system. This includes the necessary information for an incident of physical intervention as outlined in the regulations. There have been three such incidents since the last inspection, and staff have documented these incidents well.

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

On occasion, staff use door guards to keep children and young people safe at night. Although they agree their use with parents, staff do not detail the approach in care plans, such as when to use them and for how long. They do not routinely review the strategy. In one case, there was disparity between how staff said the door guard is used and what the care plan states. The door guards are homemade and detract from the homely environment. The doors have no protector strips to prevent children and young people trapping their fingers in the hinge cavity of a closing door. The registered manager has not considered installing modern doors to meet children and young people’s specialist needs.

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

Some children and young people will not sleep at night without blacking out the light. They will not tolerate black-out blinds due to their disability. Staff have made makeshift blackout boards attached to the outside of some windows. These are unsightly and not a long-term solution. The registered manager has not considered installing more modern Inspection report children’s home: SC037588 7 specialist windows.

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

Overall, the arrangements for medication are good. Staff are aware that they should not change medication solely at a parent’s request but also seek ratification from a health professional. The registered manager has a clear policy not to administer herbal remedies without guidance from health professionals. Health professionals approve ‘as required’ medication protocols but, in one case, a parent had advised when to administer such medication and staff had not sought endorsement from a health professional.

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

Children and young people are safe and secure. They have adults around them who are attentive to their needs and understand their unique traits. Staff follow up on any concerns, such as completing body maps for any unknown marks. They document the decision-making process that leads them to conclude that a child or young person is not at risk of harm.

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

Designated staff take responsibility for fire precautions. They have devised a good evacuation plan, including the use of personal emergency evacuation plans where necessary. They check equipment regularly and act swiftly to rectify any issues.

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

The registered manager adopts safer recruitment practice. There have been no new staff since the last inspection.

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The effectiveness of leaders and managers: good

The home has an experienced and qualified registered manager who has been in post for many years. He supports staff well. He has provided good leadership during a period of change. He ensures that the staff have regular supervision, as per the requirement at the previous inspection. Staff said that they feel supported and well trained. They are confident in what they do. They demonstrate a competency in caring for children and young people who have a variety of needs. The registered manager arranges for specialist training, such as in autism. He deploys suitably trained staff to be on duty at the right time to meet the specific needs of children and young people.

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The effectiveness of leaders and managers: good

Staff spend a considerable length of time preparing care plans. They do a home assessment visit as well as meeting parents in the short-break home to discuss the plans. Parents’ consent to the use of equipment, such as a specialist bed, is obtained. They agree moving and handling plans with staff. Staff host meetings, such as with the oncology nurse and community nurse, to draw up short-break plans. They ensure that important documents are on file, such as a letter from the paediatric neurologist. Staff know how to care for children and young people who have complex needs.

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The effectiveness of leaders and managers: good

Staff work very well with health professionals to discuss and agree the delegation of health care tasks. Staff are clear on their responsibilities. In some cases, a community nurse oversees the health care while the child or young person is in the home, including overnight care. Staff said that the training they receive is good. The registered manager has recognised the need to improve the quality of health training records. He does not Inspection report children’s home: SC037588 8 ask staff to do tasks in which they are not confident. Staff said that the school nurse or a community nurse are always available for advice, even after hours if necessary. Staff competence, in specific clinical skills for each child or young person, is not signed off by health professionals. This is not in strict accordance with Care Quality Commission/Ofsted joint guidance on delegated health care tasks. The registered

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The effectiveness of leaders and managers: good

manager has not challenged the relevant authorities and compelled them to do this.

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The effectiveness of leaders and managers: good

Communication is a strength. Parents and professionals said that staff keep them updated. Parents said that they are free to drop in anytime for a chat and enjoy the organised coffee mornings. Staff stay in contact with the parents when their child or young person is having a short break at the home. Staff are sensitive to the impact on the child or young person of overhearing a conversation. Staff agree with the parent on the best approach, such as using text messaging. Staff communicate well with each other, for example they use the handover time effectively to ensure that oxygen has been ordered to coincide with the planned short breaks.

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The effectiveness of leaders and managers: good

The registered manager uses monitoring techniques, such as the statutory regulation 45 reporting, to improve the quality of care. He follows up on any recommendations in the independent visitor’s report. Senior managers in the local authority have recognised the need to improve the independent scrutiny and have clear plans for training of independent visitors. The registered manager has a development plan to improve the home’s decor in the near future.

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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 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: SC037588 9

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Children’s home details

Registered provider address: Portsmouth City Council, Civic Offices, Guildhall Square, Portsmouth PO1 2BG

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Children’s home details

Registered manager: Clive Pfeiffer-Richardson

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Inspector(s)

Keith Riley: social care inspector Inspection report children’s home: SC037588 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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