Children's Home run by Nottinghamshire County Council in Nottinghamshire

Inspection report children’s home: SC036737 1 SC036737 Registered provider: Nottinghamshire County Council Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a local authority children’s home providing residential and short-break services for up to 16 children and young people who have disabilities and complex healthcare needs.

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Information about this children’s home

Inspection dates: 16 to 17 November 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 outstanding

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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 Inspection report children’s home: SC036737 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 and young people thrive while living here or visiting for short breaks. They make significant progress, especially with regard to their communication, confidence, understanding of their own safety and their self-esteem.  The ethos of this home is child centred and inclusive. Staff strive to ensure that children and young people have the best opportunity to reach their full potential. To achieve this, they ensure that they know and understand the children and young people very well, and work in partnership with parents, carers and professionals. Staff have warm, attentive and supportive relationships with children and young people.  The voice of the child is listened to and valued, regardless of their learning or communication needs. Helping children and young people to put their views and opinions across, and responding to these, is a priority. The management team and the staff team understand that aiding children’s and young people’s

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Key findings from this inspection

communication is closely linked to keeping them safe.  Safeguarding is at heart of the home. Clear and effective safeguarding systems ensure that children and young people are kept safe.  A highly effective and supportive management team leads a committed, qualified and competent staff team. Staff provide individualised and resourceful care for children and young people.  The registered manager fully understands the home’s strengths and areas for development. Although the service has been judged as outstanding for a number of years, she is committed to continuing the development of the home to further improve outcomes for children and young people.

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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

 Restrictive sleeping arrangements, such as high-sided beds, are used for a small number of children and young people to help promote their safety at night-time. Their use is regularly reviewed and rigorously risk assessed and alternatives are regularly considered. However, reviews do not always consider the views of parents, carers or other professionals. This is an oversight and it does not have a negative impact on children and young people. Inspection report children’s home: SC036737 3

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Inspection date Inspection type Inspection judgement

17/03/2017 Interim Improved effectiveness 23/11/2016 Full Outstanding 21/03/2016 Interim Sustained effectiveness 21/10/2015 Full Outstanding Inspection report children’s home: SC036737 4

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Recommendation

 It is crucial that the home works in close partnership with all those who play a role in protecting and caring for the child (‘Guide to the children’s homes regulations including the quality standards’, page 11, paragraph 2.3). This specifically relates to ensuring that there is a multi-agency approach to reviewing the use of restrictive sleeping arrangements.

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Overall experiences and progress of children and young people: outstanding

This home continues to provide an outstanding standard of care and support to the children and young people who live there or stay for short breaks. Staff know the children and young people exceptionally well, and are fully committed to meeting their needs creatively, sensitively and in a child-centred way.

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Overall experiences and progress of children and young people: outstanding

A strength of this home is the managers’ and the staff team’s commitment to ensuring that children and young people have access to as many opportunities as possible to enhance their life experiences. Children and young people have opportunities to take part in activities outside the home, such as attending a disco, much like other children and young people. Staff are also committed to ensuring that children and young people don’t miss out if they have complex health needs which make venturing further afield more problematic. Recently, the seaside was brought to the home, with donkeys included. Other projects, such as ‘independence weekends’, are planned well, and are used as a way of gathering children’s and young people’s views and opinions about their care. For example, one young person was able to give staff feedback about his clothing choices and this has helped to support his dignity.

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Overall experiences and progress of children and young people: outstanding

Care is highly personalised. Pictorial care plans are used to assist staff in correctly positioning children and young people. Subtle changes in a child’s or young person’s presentation or demeanour are noticed. For one young person, this has meant that he is positioned on his preferred side when sleeping, as sleeping on his other side appears to cause distress. The staff identified this need in collaboration with the home’s occupational therapist. Children and young people are encouraged to write their own care notes if they wish, and contribute to their own pictorial plans, for example by making staff aware of their preferred way of having a bath. These are examples of highly attentive and personalised care which supports children and young people to feel settled and secure.

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Overall experiences and progress of children and young people: outstanding

Staff are highly committed to providing a tailored service for each child and young person. Staff know and understand the children and young people very well, so much so that some parents consider the care to be as good as the care that they themselves Inspection report children’s home: SC036737 5 provide for their children. A parent said: ‘I can go home knowing my child is safe.’

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Overall experiences and progress of children and young people: outstanding

All children and young people have educational placements and attendance is good. Staff support this fully by ensuring that they have good communication with schools, and by attending meetings and social events. This means that staff are fully aware of the progress that children and young people make in their education.

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Overall experiences and progress of children and young people: outstanding

Children and young people who are new to the home settle quickly because of good communication with parents and carers, well-planned transitions and detailed and child- centred care planning. Staff are sensitive to the needs of parents and their children. One parent who had been unable to hug or hold her son for a long time, due to his health needs, described to the inspector her gratitude towards staff who had sensitively enabled this to happen. This time was invaluable to both the parent and her son.

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Overall experiences and progress of children and young people: outstanding

Children and young people who use this service or who live in the home often have complex healthcare conditions. Staff are trained to ensure that they are able to safely administer healthcare procedures such as gastrostomy care. Staff work in partnership with parents and healthcare professionals, such as nurses and physiotherapists, to ensure the best outcomes.

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Overall experiences and progress of children and young people: outstanding

Children’s and young people’s goals in relation to their independence, communication, choices and activities are considered daily by staff. Opportunities for children and young people to work towards their individual goals are planned as part of their stays. For example, one young person is successfully learning how to lay the table for dinner. Another, with considerable perseverance from both the young person and the staff, is learning how to use cutlery to feed themselves. Children and young people are encouraged to be as independent as possible.

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Overall experiences and progress of children and young people: outstanding

Staff manage to maintain a homely, warm and welcoming environment, despite the specialist equipment and resources needed. Children and young people have all the specialist equipment they need and staff are tenacious in sourcing new equipment if it will better meet the child’s or young person’s needs. The specialist equipment used in the home is regularly maintained to ensure safety.

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

Safeguarding children and young people from harm and promoting their welfare are at the heart of this service. Children and young people who have highly complex needs are protected from harm due to high staffing ratios, the qualified and well-trained staff team, building security and staff having a thorough understanding of safeguarding practice.

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

The manager and staff also demonstrate an in-depth knowledge of the additional vulnerabilities that children and young people who have disabilities may be exposed to. The communication needs of children and young people are given high priority. The manager has created a culture where staff understand how communication is intrinsically Inspection report children’s home: SC036737 6 linked to children’s and young people’s safety. Communication is threaded through every part of the children’s home and the way in which staff work with children and young people. Staff are determined in their approach to gaining the views of children and young people, despite the significant learning and communication needs of the children and young people. A parent said: ‘My child is making so much progress there. He can now communicate a lot better. They get it 100% right for my child, and they understand him. I know that he’s happy there. He has a voice there, he can always communicate

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

Staff follow the appropriate safeguarding procedures. They have warm and trusting relationships with children and young people. This enables children and young people to feel safe and secure. Each child or young person has a detailed residential support plan which addresses how to recognise vulnerabilities and triggers for behaviour, and how to prevent the escalation of behaviour. Incidents of difficult behaviour rarely happen. Physical intervention carried out by staff in order to help young people manage their behaviour has not been used for a significant length of time.

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

Any risks to children and young people are carefully considered. Detailed risk management plans provide staff with the necessary strategies for minimising potential dangers. Trips out are planned in detail. For their own safety at night-time, a small number of children and young people use high-sided beds or sleeping areas such as a ‘safe space’. These restrict children’s and young people’s ability to leave their beds and the need for their use is rigorously risk assessed by the home’s occupational therapist, overseen by the management team. To further enhance this safeguarding process, parents, carers and other professionals involved in the lives of children and young people should have the opportunity to have their views and opinions recorded when plans are reviewed. This has not happened, and is an oversight. It has not had a negative impact on children or young people as, in practice, parents, carers and other professionals are

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

aware of the use of the beds and the reason they are used.

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The effectiveness of leaders and managers: outstanding

The registered manager is highly experienced and appropriately qualified. She is supported by an experienced and qualified team of assistant managers. Together, they provide highly effective and supportive leadership for a committed, qualified and competent staff team. A parent said: ‘I know my child is wanted by the carers there.’

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The effectiveness of leaders and managers: outstanding

Staff provide a strong, consistent and caring approach towards children and young people, who are at the centre of all practice. Staff are highly motivated and enthusiastic about providing an outstanding service for children and young people, and continually strive to improve the service that they offer. A parent stated: ‘Staff are always at the end of the phone. I can rely on them. That gives me reassurance. Nothing’s too much trouble for them. They go the extra mile.’

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The effectiveness of leaders and managers: outstanding

The manager has effective monitoring systems that enable her to understand the progress that children and young people are making, and how the home needs to Inspection report children’s home: SC036737 7 develop. These include her own monitoring of children’s and young people’s records through a monthly case-management system. Staff feel well supported. New staff benefit from a good-quality induction. A new member of staff commented very positively about her first few weeks in post. Staff benefit from one-to-one supervision, team meetings and management meetings. An advocate visits the home regularly, and has developed a positive rapport with children and young people. Any comments or concerns are fed back to the manager either through the advocate or directly from children, young people or parents. These are acted on immediately and a successful resolution is sought.

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The effectiveness of leaders and managers: outstanding

There are effective relationships with partner agencies and social workers. Communication is consistent. This ensures that all of those who work with the children and young people have an up-to-date understanding of what is happening, and can work together. A community nurse made the following comments about staff: ‘They work extremely well with us. They are good at asking for advice. They are always accommodating about our visits. There are really good lines of communication. The standard of care they give is amazing.’

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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: SC036737 8

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Children’s home details

Registered provider address: Nottinghamshire County Council, County Hall, Loughborough Road, West Bridgford, Nottingham NG2 7QP

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Inspector

Catherine Honey: social care inspector Inspection report children’s home: SC036737 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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