Children's home run by Virgin Care Limited in Camden

Inspection report children’s home: SC458422 1 SC458422 Registered provider: Virgin Care Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is owned by a large national organisation. It provides care and accommodation for up to five children. However, due to many of the children’s needs requiring the use of large specialist equipment, and the communal space available, the home usually accommodates no more than four children at one given time. The home is equipped to provide care and support for children who have a physical disability, a learning disability and/or sensory impairment.

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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

Date of last inspection: 16 February 2017

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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: SC458422 2

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Key findings from this inspection

 When children visit this short-break service, they receive individualised care and support from staff who know them extremely well. Staff are caring, sensitive to children’s needs and professional. Staff treat children with dignity and respect.  Children were seen to be relaxed and happy in staff’s company. Parents, carers and social workers are delighted with the care and support given to children.  Children receive support from an experienced and a highly trained staff team. Many of the staff team have a formal qualification at level 3 or above. They receive specific training to meet children’s complex needs; this includes moving and handling, equality and diversity, assistive augmented communication, epilepsy awareness, gastrostomy care and feeding, and administering rescue medication.  Children are given choices in their day-to-day care and support, and enjoy a wide range of activities and leisure opportunities when they come to stay.

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Key findings from this inspection

 The arrangements to safeguard children are good. Leaders and managers take effective action to investigate allegations or suspicion of harm. Children are kept safe when they stay at the home.  The home is managed effectively and well led.

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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 registered manager must ensure that placement plans and risk assessments reflect the use of closed circuit television (CCTV), and the use of high-sided beds, and that this practice is regularly reviewed by a multidisciplinary team, in full consultation with parents and carers. In addition, a plan to reduce the use of this equipment must be established and based on children’s individual needs.  The registered manager must ensure that when updated, the home’s statement of purpose is sent to HMCI.  The registered manager must regularly review the opportunities provided to children, to clearly demonstrate the positive impact that staying at the home has on them. Inspection report children’s home: SC458422 3

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Inspection date Inspection type Inspection judgement

16/02/2017 Interim Sustained effectiveness 25/04/2016 Full Good 17/12/2015 Interim Sustained effectiveness 14/07/2015 Full Good Inspection report children’s home: SC458422 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

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to:

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Requirement Due date

assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and if necessary, plan to reduce the risk of any harm to the child.

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Requirement Due date

In particular, ensure that children’s individual risk assessments are detailed in relation to the use of high-sided beds and CCTV, that the documents also include the frequency of visual checks as well as CCTV monitoring, and how the risk is to be reduced. 31/12/2017

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Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision.

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if–

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children 31/01/2018 Inspection report children’s home: SC458422 5 the child’s placing authority consents in writing to the monitoring or the surveillance

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Requirement Due date

so far as reasonably practicable in the light of the child’s age and understanding, the child is informed in advance of the intention to do the monitoring or surveillance; and

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Requirement Due date

the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy.

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Requirement Due date

In particular, continue to consult with parents, carers and social workers to ensure that the use of a monitoring or surveillance device is based on the child’s assessed need, is recorded in the child’s placement plan, and the practice is regularly reviewed.

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Recommendations

 Ensure that children’s home staff seek to identify and provide appropriate opportunities for children to develop themselves in accordance with their wishes and feelings and as part of the home’s plan for their care. (‘Guide to the children’s homes regulations including the quality standards’, page 31, paragraph 6.4). In particular, regularly review the opportunities provided to children to clearly demonstrate the positive impact that staying at the home has on them.

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Recommendations

 Ensure that restraint also includes restricting a child’s liberty of movement. This includes, for example, changes in the physical environment of the home (such as using high door handles) and removal of physical aids (such as turning off a child’s electric wheelchair.) Restrictions such as these, and all other restrictions of liberty of movement, should be recorded as restraint. (‘Guide to the children’s homes regulations including the quality standards’, page 47, paragraph 9.42). In particular, implement plans for the reduction of the use of high-sided beds. This is to ensure that the least restrictive practice is being used. This practice should be regularly reviewed by a multidisciplinary team, with full involvement of parents.

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Overall experiences and progress of children and young people: good

When children visit this home for short breaks, they receive individualised care and support from staff who know them extremely well. The staff team is caring and professional. Staff respect the children and promote their dignity. Observations throughout the inspection confirmed that children feel secure in their relationships with Inspection report children’s home: SC458422 6 staff and that they are relaxed and happy in staff’s company. A member of staff said, ‘As well as caring for the children, we nurture them and love them.’ Parents and carers are very positive about the care and support their child receives. One parent said, ‘My daughter absolutely loves it there, they meet her every need.’

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Overall experiences and progress of children and young people: good

Staff help children who use alternative methods to communicate to make day-to-day choices and express their views and wishes. Staff have the right skills to communicate with them and are exploring how this can be enhanced further. At the time of this inspection, children were ‘testing out’ a sophisticated electronic communication system that may be purchased for the home.

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Overall experiences and progress of children and young people: good

Some children have complex healthcare needs. Although parents and carers are responsible for helping to access the appropriate healthcare provisions, staff collaborate well with them to support this process. As a result, children maintain a healthy lifestyle, and their clinical needs are met.

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Overall experiences and progress of children and young people: good

Children benefit because this home is warm and welcoming. Communal areas are child- friendly and there are lots of photographs and pieces of artwork displayed around the home showing the activities that children have been involved in. Children bring their personal possessions when they come to stay. This includes items such as bedding, cuddly toys and photographs. This helps the children to feel comfortable during their visit. A newly developed sensory garden is providing the children with new experiences that they very much enjoy. During this inspection, one child showed the inspector around the home. The child clearly expressed her happiness with her bedroom and the home.

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Overall experiences and progress of children and young people: good

Children enjoy a wide range of activities when they visit, both indoors and in the wider community. Families recognise the benefit of the activities. A carer said, ‘She [child] likes the activities, I know she enjoys herself.’ A parent said, ‘My daughter likes gardening, cooking, painting and going to the garden centre.’

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

The arrangements to safeguard children are good. Leaders and managers take effective action to investigate allegations or suspicions of harm. They highlight safeguarding concerns, and refer these correctly to the appropriate agencies and authorities. Staff have a good awareness and understanding of safeguarding protocols. Their safeguarding knowledge is enhanced as they have undertaken level 3 multi-agency safeguarding training. Parents and professionals that were consulted during this inspection say that they feel that children are safe when they stay at the home.

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

Physical restraint and sanctions are not used, and children do not go missing. There are no concerns in relation to bullying.

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

Due to the children’s complex support needs, some children need to be monitored during the night, and some children currently need to use a high-sided bed. Detailed discussions took place with leaders and managers about the use of CCTV to monitor the Inspection report children’s home: SC458422 7 children and the continued use of high-sided beds. These invasive measures may be restrictive, and impose on children’s privacy and dignity. A small number of children’s plans do not identify the need for these measures. Although leaders and managers have now started to review this practice within a multidisciplinary setting, previous reviews have not taken place regularly.

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

Since the last inspection, the registered manager has revised the format of the body map template to ensure that entries are reviewed and countersigned. At the time of this inspection, the template was reviewed further to ensure that the registered manager can clearly record his evaluation of each entry and maintain a record of any subsequent action he takes in response.

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

Children stay in a home that is safe and well maintained. The registered manager ensures that regular checks are undertaken on the home’s utilities and that there is regular servicing of the overhead tracking and mobile hoists.

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The effectiveness of leaders and managers: good

The home is managed by a manager who has the qualifications, skills and knowledge to manage the service effectively. The staff team delivers high-quality care and support. Many staff members have worked at the home for several years and children benefit from the stability they receive from a staff team that has known them for many years. One parent agreed and said, ‘Staff are like an extended family. I know my daughter is happy and safe there.’

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The effectiveness of leaders and managers: good

The registered manager has a good awareness of the strengths and weaknesses of the service. His review of the quality of care provided at the home was detailed, enabling him to devise an action plan with realistic areas for improvement. However, the action plan does not clearly identify the priorities and timescales to achieve the desired improvements. The registered manager ensures that regular visits are undertaken by the independent visitor. These visits scrutinise the quality of care being provided, and the registered manager acts effectively on any recommendations that are made to improve.

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The effectiveness of leaders and managers: good

The manager responds effectively to concerns about the management of medicines. He ensures that thorough external investigations are undertaken and implements recommendations made. To improve the management of medicines further, leaders and managers have commissioned an independent review and they regularly remind parents and carers about their responsibility when providing medicines for when their children stay.

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The effectiveness of leaders and managers: good

The format of placement plans is under review. Placement plans provide staff with detailed guidance on how to meet children’s individual needs. However, outcomes and opportunities for children are not always clearly identified in these plans and neither are they reviewed regularly. As a result, records do not always demonstrate the positive impact that staying at the home has on children. Leaders and managers acknowledge this weakness and say that this is to be reviewed in conjunction with the placement plans. Inspection report children’s home: SC458422 8 The staff team consists of staff who are qualified nurses and carers. The nurses maintain their registration and receive clinical supervision and their skills complement the staff team; however, they are not employed as nurses. Children are supported by an experienced and a highly trained staff team. Eighty per cent of the staff team have a formal qualification at level 3 or above. As well as the required mandatory training, staff

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The effectiveness of leaders and managers: good

receive specialist training to meet the children’s needs.

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The effectiveness of leaders and managers: good

The manager supports the staff and provides them with regular supervision. He ensures that staff reflect on their performance and where concerns in relation to their performance have been identified, these are clearly acted on and recorded in their supervision records. All staff receive an annual appraisal. As a result of these systems, staff are supported well in their roles and understand their responsibilities.

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The effectiveness of leaders and managers: good

Relationships with parents and carers are effective. A carer agreed and said, ‘Staff are wonderful. They are very supportive and likewise the manager.’ A parent said, ‘Communication is good; this has been enhanced with the use of communication books. I have no concerns at all.’ A social worker also agreed and said, ‘Communication with the home is good. They work with parents really well.’

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The effectiveness of leaders and managers: good

The home’s statement of purpose is dated November 2017. It clearly sets out the aims and objectives of the service. However, the registered manager has not ensured that HMCI has received the most recently updated document.

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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: SC458422 9

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Children’s home details

Registered provider: Virgin Care Limited

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Children’s home details

Registered provider address: Lynton House, 7–12 Tavistock Square, London WC1H 9LT

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Children’s home details

Registered manager: Sian Buchanan and Andrew Levett

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Inspector

David Kidner, social care inspector Inspection report children’s home: SC458422 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 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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