Children's home run by London Borough of Harrow

Inspection report children‟s home: SC033919 1 SC033919 Registered provider: London borough of Harrow

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This local authority children‟s home provides short breaks for up to five children at any one time, who have learning, sensory and/or physical disabilities.

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Information about this children’s home

Inspection dates: 26 to 27 September 2017

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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 good

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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

Overall judgement at last inspection: Improved effectiveness

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Enforcement action since last inspection:

None Inspection report children‟s home: SC033919 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

 Children are at the centre of everything in the home.  Children‟s input into the home is encouraged and staff act on their requests.  Children make progress during their stay at the home.  Children‟s care plans include extremely detailed individual goals and targets that are regularly monitored and reviewed.  Staff understand the children‟s needs very well and provide highly personalised and individualised care of an outstanding quality.  Children benefit from trusting relationships with a highly skilled and committed staff team.  The positive relationships that exist between children and staff enrich the children‟s stay at the home.  Collaborative partnership working between the home‟s staff, parents, carers and professionals is a strength of the home. This enhances the children‟s lives and experiences.  The registered manager has overseen this outstanding home for 10 years and continues to innovate and develop the service further.

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Key findings from this inspection

 Staff team development and training are given a high priority.  Staff knowledge is continuously updated to ensure that they can meet the complex needs of children.  In surveys, parents „strongly agree‟ that staff communicate well, have good relationships with staff and support their children with independence skills.

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Inspection date Inspection type Inspection judgement

30/03/2017 Interim Improved effectiveness 09/11/2016 Full Outstanding 11/03/2016 Interim Sustained effectiveness 14/01/2016 Full Outstanding Inspection report children‟s home: SC033919 3

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outstanding

Children receive outstanding levels of care from staff who clearly understand their specific needs. Children experience an excellent introduction to the home that is comprehensively planned. Parents and staff take the child‟s lead to gauge when the child is ready and confident for a first overnight stay. Examples of sensitive planning include a gradual increase in the length of time of tea visits to help settle a child, staff photographs provided to a child to help familiarise them with new adults and a child bringing a comforting toy from home to decrease their anxiety. This approach is indicative of the home‟s ethos of being „child led‟, and ensures that children are well prepared before they move into the home. A placing social worker commented, „The staff clearly demonstrate a child-centred approach with positive outcomes for the children.‟

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outstanding

One of the home‟s notable strengths is the staff‟s collaborative work with parents, carers and all of the professionals involved in the lives of the children. Children‟s care plans are highly detailed and very clear. Children‟s needs are identified in thorough detail. Bespoke care plans identify health, social and emotional needs along with information regarding diet, routines, activity preferences and communication styles. Children contribute to their care plans and are encouraged to sign them when possible. Care plans offer meticulous detail, for example, a child‟s need to link arms with a staff member to settle in bed, a step-by-step guide to support a child‟s bathing routine and a child‟s use of a baby buggy to lessen any anxiety. This excellent approach recognises each child‟s unique needs and provides staff with comprehensive guidance that they follow in practice.

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outstanding

The home ensures that the dietary needs of children are met to a high standard. Dietary requirements and preferences, along with any food allergies, are recorded in detail. This informs the children‟s weekly menu choices. Parents and carers are welcomed into the home to provide the chef with the children‟s favourite food preparation. This provides the children with a home-from-home dining experience.

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outstanding

Care planning is dynamic and adaptable. Staff work cohesively to provide children with excellent joined-up care. They attend weekly team meetings and contribute and share updates about individual children. These detailed discussions on children‟s progress are captured and subsequently inform the updating of care plans. Examples include detailing how best to settle a new young person into the home and advocating for a professionals‟ meeting to increase support for a child‟s changing needs.

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outstanding

Excellent daily planning ensures that children enjoy safe and highly supportive stays. Staffing ratios are carefully planned to reflect the needs of children staying at the home at any one time. In addition, children are sensitively matched to their peers to enable them to stay at the same time as their friendship group. A child said, „One of Inspection report children‟s home: SC033919 4 the best bits here is meeting my friends.‟ When children arrive at the home, staff warmly welcome them. Shift leaders and key workers make detailed preparations for each child. Individual communication boards identify each child‟s preferences, including bedroom choice, favourite activity, meal choice and communication style. Highly effective shift discussions among staff ensure that each child receives appropriate and seamless care.

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outstanding

Creative and innovative activity planning enriches the children‟s experiences during their stay. Alongside wide-ranging community activities such as visits to safari parks, restaurants and museums, cultural events are celebrated, such as Chinese New Year, Diwali and Christmas. The children‟s involvement in arts, crafts and cooking contributes to these fun events.

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outstanding

The voice of the child is actively sought in the provision of services. Monthly children‟s meetings provide the children with further opportunities to broaden their experiences and contribute to their care. The children‟s meetings in the summer months included discussion topics such as the new football season and the recent solar eclipse. Children make requests to visit the zoo, go swimming or play (more) sport. Staff really listen to the children and unfailingly action these requests. A parent complimented the staff team, „They never say there is nothing they [can] do.‟ This response mirrors the staff‟s unquestionable „can do‟ attitude.

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outstanding

The home‟s children‟s charter is inspiring. Children contribute to a charter, which sets out what they expect during their stay. For example, „We expect the staff to be happy to see me and spend time with me just for fun‟, and „Show me new things and activities.‟ During the inspection, a child‟s „thumbs up‟ was evidence of staff‟s commitment to these wishes. Children ask, „When can I go again?‟ and a parent reported, „My child really enjoyed her last stay and is very excited about her next visit.‟

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outstanding

Children make excellent progress as a result of their short-break stays. A placing social worker wrote, „The staff have clear and ambitious outcomes in place for the individual children.‟ Every child has a skills-teaching programme. Age- and ability- based skill targets for each child are discussed with their parents and shared among staff during weekly team meetings. Targets can include learning to hang up a coat, choosing a snack, turn taking or dressing independently. With the aid of staff‟s highly effective support and communication skills, a child has experienced sleeping on his own for the first time, while another child has developed enough confidence to visit the cinema. Such progress is hugely significant given the children‟s starting points. A member of staff said, „Sometimes this [progress] can take weeks, sometimes months, but the child is always our focus.‟ Staff celebrate these achievements, and children receive personalised „star of the week‟ certificates.

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outstanding

The large five-bedroomed home provides a clean, well-maintained and bright environment. Photographic displays of the children‟s activities and achievements add to the homely atmosphere. The extensive communal spaces downstairs provide children with opportunities to share mealtimes around the large dining table, and the Inspection report children‟s home: SC033919 5 lounge area offers a wealth of games, books, music and films. The very large garden provides great opportunities for outdoor play, including basketball, a trampoline, a slide and a selection of bicycles and tricycles. For children who prefer quiet time, a well-equipped sensory room is always available.

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

Sadly, since the last inspection, a child passed away while staying at the home. The management team adhered to all the relevant protocols and procedures applicable to a child death in the home. The home reopened a few days later. The registered manager ensured that all parents, carers and children were informed in a sensitive manner. The registered manager provided her full support to the staff team. This included ensuring that a psychologist was available to the staff team to help them come to terms with the tragic event.

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

Physical restraint is rarely used in the home. There has been only one incident of restraint since the last inspection. This was appropriate and kept the child and staff safe. Staff successfully employ a positive behavioural support approach to manage any challenging behaviours. They identify behaviour triggers such as a noisy environment or communication barriers. These are then adapted or minimised for the individual child. The inspector observed a member of staff very clearly demonstrate her understanding of a child‟s behavioural challenges linked to the environment and the child‟s highly complex communication style. This child‟s keyworker invested purposeful time meeting with parents and other professionals to understand the child‟s additional needs. The findings from these meetings were used effectively to inform the development of a detailed communication profile. This profile considered every element of the child‟s needs, breaking them down into the

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

style of language, the environment and the time the child needs to process new information. The staff‟s application of positive behavioural support ensures that children maximise their enjoyment of opportunities during their stays.

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

Children are kept safe in the home. Children do not go missing during their stays. A key pad secures the front door, and there is a thorough vetting process for all visitors to the home. A robust staff recruitment process helps to keep the children safe. Training supports staff in all aspects of safeguarding vulnerable children. Appropriate staffing ratios and waking night staff monitor all of the children‟s welfare at all times during the day and night.

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

Staff are risk aware, but not risk averse. All activities in the community are thoroughly risk assessed and include farm visits, horse riding and trampolining. Appropriate staffing levels are considered alongside comprehensive risk reduction plans. This enables the children to enjoy community activities safely while taking full advantage of these experiences.

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

Medication arrangements are good. Regular audits and a recently introduced internal „competency test‟ increase staff knowledge and skills, which supports the safe administration of medicines. Inspection report children‟s home: SC033919 6 Regular health and safety checks ensure that the building is safe for children. Fire evacuation drills are undertaken regularly and include the involvement of children who are present in the home. For children who may find this experience upsetting, clear safety planning is in place, combined with individual personal evacuation plans.

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The effectiveness of leaders and managers: outstanding

Leadership and management of this short-breaks service are exceptional. All survey responses from parents, carers and care professionals „strongly agree‟ that the management team makes decisions about the home that are in the children‟s best interests. Comments include, „Without doubt, the entire focus of the home is to this end.‟ One member of staff said, „It‟s all about the children. They are prioritised.‟ The home is recognised as an exemplar of outstanding practice by the local authority. Leaders, managers and staff are proud to have won the recent local authority „team of the year‟ award.

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The effectiveness of leaders and managers: outstanding

The registered manager is a highly skilled and knowledgeable practitioner. Along with the staff team, the registered manager makes significant contributions to the local authority children and young adult disability panel and the children‟s annual education and healthcare planning. The registered manager‟s detailed understanding of the complex needs and vulnerabilities of the children who use the service contributes to a highly effective overview of children.

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The effectiveness of leaders and managers: outstanding

The registered manager is uncompromising in her vision for the service. Her ethos of „everything we do here goes back to the child‟ is embedded and practised throughout the home. The registered manager is very clear that „Our time should be spent with the children. The time should be about developing the children, and improving their outcomes.‟ She notes, „If staff are sending emails or making telephone calls, staff should ask themselves, “Is this about the child, and if not, why are you doing it?”‟

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The effectiveness of leaders and managers: outstanding

The registered manager continues to drive the service forward and completes a regular home development plan. Staff receive training in „positive psychology‟ and consider child-focused research updates during their weekly team meetings. This supports a strong learning culture in the staff team.

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The effectiveness of leaders and managers: outstanding

Children benefit from an excellent approach to supporting their needs and enhancing their lives. The home secured funding for an adapted bathroom upgrade and introduced innovative „sensory storytelling‟ practice and audio-visual annual children‟s reviews. These actions confirm that this is a service looking to grow and improve the children‟s experiences and care during their stays at the home.

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The effectiveness of leaders and managers: outstanding

Staff development is prioritised. The fifty-two week staff probation period is unique in this local authority. The registered manager is of the view that „recruitment does not stop at interview‟ and has „high expectations of the staff‟. New staff receive excellent levels of support and a comprehensive training package to fulfil their roles Inspection report children‟s home: SC033919 7 to a very high standard. With „retention being just as important as recruitment‟, the registered manager has enabled the staff team to create their own unique staff charter. The charter‟s values encompass communication, a learning culture and positive contributions. These examples provide the staff team with clear principles, which in turn support a cohesive and dedicated team. One staff member commented, „I have had the most amazing support‟, adding, „We have amazing training [and] good regular supervision and managers are open to ideas.‟ Another

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The effectiveness of leaders and managers: outstanding

member of staff noted, „Working at the home is the best experience. I have learned so much.‟

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The effectiveness of leaders and managers: outstanding

Managers regularly join shifts to observe and role model good practice with staff. This enables leaders and managers to gain first-hand knowledge of the work of the staff and experiences of the children. As a result, staff receive constructive feedback. This promotes the proactive learning culture of the staff team.

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The effectiveness of leaders and managers: outstanding

Robust internal and external monitoring systems are in place. The registered manager demonstrates a comprehensive appreciation of the strengths and weaknesses of the home. She completes regular reviews of the home‟s quality of care. The registered manager monitors the home‟s progress against the quality standards. Her reviews are wide ranging and result in detailed actions plans to further embed the exceptional care offered to the children and young people. The external independent visitor visits the home once a month. The subsequent reports are detailed and highlight areas of strength and good practice. The registered manager actions any constructive advice for improvements.

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The effectiveness of leaders and managers: outstanding

A care professional described the home as „exemplary‟ and considers this home to be „the gold standard‟ of children‟s homes.

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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 observed how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they spoke with 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: SC033919 8

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Children’s home details

Registered provider address: Civic Centre, Station Road, Harrow, Middlesex HA1 2XF

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Children’s home details

Responsible individual: Christopher Spencer

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Inspector

Victoria Jones, social care inspector Inspection report children‟s home: SC033919 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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