Children's home run by Mig House Residential Care Home Ltd in Waltham Forest

Inspection report children’s home: SC062785 1 SC062785 Registered provider: MIG House Residential Care Home Limited

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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 children’s home is privately owned. It is registered with Ofsted to accommodate up to nine children. It offers long-term care as well as respite care for children and young people who have a learning disability.

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Information about this children’s home

Inspection dates: 30 November to 1 December 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

Overall judgement at last inspection: Sustained effectiveness

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outstanding

Enforcement action since last inspection: None

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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

 Young people make exceptional progress from their challenging starting points.  Young people experience sustained improvements in the areas of their lives where they have complex needs.  Young people feel heard and valued, especially those who have limited verbal Inspection report children’s home: SC062785 2 abilities. They experience a strong sense of safety and well-being.  Young people engage in a wide range of activities that help them to develop their self-efficacy and to be a part of the community.  Young people fully benefit from clear, timely and purposeful partnership working among the staff, professionals and family members.  Young people receive excellent support in their transitions to adult placements.  A stable team of staff delivers a consistent, child-focused service to the young people, including the most vulnerable, resulting in excellent outcomes.  The registered manager is aspirational and ambitious for the young people and

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Key findings from this inspection

sets high expectations for staff.  Staff and managers care for the young people as if they are their own.

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Inspection date Inspection type Inspection judgement

02/03/2017 Interim Sustained effectiveness 30/11/2016 Full Outstanding 30/12/2015 Interim Improved effectiveness 03/06/2015 Full Outstanding Inspection report children’s home: SC062785 3

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Recommendations

 The registered person should ensure that a review of the quality of care, under Regulation 45, clearly identifies any actions required for the next six months of delivery within the home and how those actions will be addressed. (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.4)  Any individual appointed to carry out visits to the home as an independent person must make a rigorous assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the home’s care. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5)  The registered person should ensure that the review of the location of the home includes the identification of any risks presented by the home’s location and strategies for managing these. (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.1) In particular, ensure

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Recommendations

that the risks from gangs and substance misuse are included in the location risk assessment.  The registered person should ensure that the workforce plan includes a detailed process for managing and improving poor performance. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)

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Overall experiences and progress of children and young people: outstanding

Young people receive excellent care, both long term and in the short breaks service. Staff and managers demonstrate a thorough understanding of the young people’s needs and strengths. Regardless of their level of learning disability, young people flourish as a result of the purposeful and consistent care that they receive at the home. For example, a young person, who needed two-to-one supervision in the community due to his tendency to go missing, no longer needs this level of monitoring. He is now able to keep himself safe. Another young person chairs her looked after child reviews and can confidently express her wishes and feelings without any support from staff. This young person is also able to travel independently on public transport from the home to her college. Young people who have limited verbal abilities are supported to communicate with the use of the picture exchange communication system and Makaton signing. Young people

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Overall experiences and progress of children and young people: outstanding

are constantly encouraged to express their views, from choosing their clothes and food to identifying activities that they would like to participate in. Young people have a voice Inspection report children’s home: SC062785 4 in their care planning. Young people receive innovative individualised support that clearly meets their needs. For example, each young person has his or her own ‘communications book’ that contains photos of the young people signing or using symbols to communicate their wants, actions, likes or dislikes. Some young people have developed their own signs and staff believe that it is essential that everyone understands them. The communications books are shared with schools and parents. Consequently, the young people not only feel valued, but become less frustrated because they are well understood. Also, the young people are more integrated into functioning in a group as they feel less isolated.

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Overall experiences and progress of children and young people: outstanding

Young people’s health needs are well supported by staff. One young person lost 20kg through portion control and exercise. As a result, the young person has more energy, is more focused and overall much healthier. Another young person no longer needs his medication to help control his impulsive behaviour. Staff and managers are good at preparing young people for hospital procedures, resulting in positive outcomes. For example, a staff member created a social history book specific to the young person’s needs as he was anxious about his impending medical procedure. In their frequent key-working sessions, staff went through the social history book that explained, with pictures and in simple words, what the young person could expect, before, during and after the operation. Consequently, the young person complied with all the necessary steps for the procedure, reduced his apprehension and experienced a positive outcome in both his physical and emotional well-being.

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Overall experiences and progress of children and young people: outstanding

Young people are offered a wide range of activities that enhance their life experiences. These experiences also prepare the young people for life beyond this children’s home. For example, the young people enjoyed a week-long holiday in Somerset, engaging in various activities including swimming, dancing and climbing. Staff and managers prepared the young people for the trip very well. The young people had no incidents of aggression or anxiety during the seven-hour car trip to the camp, nor at any time during their stay. No young person went missing or even tried to move away from the staff’s and managers’ supervision. As much as possible, staff and managers normalise the young people’s disabilities so that they are not isolated from the rest of the community. This means that the young people do not miss out on the opportunities that are open to others who do not have special needs. This also means that many of the young people

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Overall experiences and progress of children and young people: outstanding

are supported to adapt to life beyond residential care. All of the eight long-stay young people are fully engaged in education. Young people who receive a short break service are also engaged in education and receive full support from the staff and managers. One young person’s teacher stated that he is ‘doing particularly well’ and that staff at the home are ‘always cooperative and helpful’. The young person has severe learning disabilities and he is ‘very well settled and doing better than last year’. Another school professional stated that her young person’s school attendance is 100% and that he has ‘made excellent progress’ in his learning and behaviour. Another teacher stated that his young person is ‘always well cared for’ and that there are ‘good lines of communication between the school and the home’. The teacher further stated that the home is ‘very keen to reinforce the steps taken at school’. The young

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Overall experiences and progress of children and young people: outstanding

Inspection report children’s home: SC062785 5 person has good attendance and is meeting the expected level of progress. The teacher described the young person as ‘very happy’ and that his ability to self-regulate his behaviour has improved. The progress made by the young people is reflected in their education, health and care plans. One teacher stated that her young person has ‘fantastic scanning skills’ and that ‘he has adapted to using the wall pictures quickly’. The young person is described as a ‘very popular boy’ and that his ‘smile and laughter are infectious to all staff members at the school’. The headteacher for another young person stated he has made ‘amazing progress’ since being placed at the home. Young people have high levels of school attendance, from 93% to 100%, and have authorised absences for health-related appointments which are planned and communicated to the school in advance. A parent, whose child attends the short break service, stated that the staff are

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Overall experiences and progress of children and young people: outstanding

‘absolutely amazing’. The parent stated that her child ‘has good relationships with all the staff’ and that there was good, detailed feedback on everything that he experienced during his short stay. A parent whose child is accommodated at the home stated that the staff and managers ‘do a brilliant job’ and that they care for her child as ‘one of their own’. The parent stated that she is ‘included in everything he does’, and that he is ‘very happy’ at the home. One social worker stated that her young person has ‘made incredible progress, he is now healthy, off his medication, and able to control his emotions’. Another social worker stated that she has had three young people placed in the home and has ‘always found the quality of care to be outstanding’. The registered manager ensures that a robust admission planning process is in place. This includes a thorough impact analysis, meetings with partner agencies and a series of

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Overall experiences and progress of children and young people: outstanding

visits with the young person and their family. This allows for a smooth transition for young people, as the staff are able to implement a strong support plan. Emergency referrals are more time-sensitive, but the manager nonetheless carries out a thorough impact risk assessment. Staff and managers are able to assess the needs of young people quickly and effectively. Consequently, young people, regardless of whether their admission is planned or an emergency, receive meticulous care and transition. One young person’s headteacher described the staff and manager as ‘really caring’ and said, ‘We were quite taken back by how well he looked as soon as he came to live at the home.’ The headteacher stated that the home is ‘very, very supportive’ and meets the young person’s complex needs. When young people leave the service, staff and managers diligently support them to experience a smooth transition. Young people also benefit from the independent living

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Overall experiences and progress of children and young people: outstanding

skills that they learned at the home. A social worker for one young person who moved to an adult care facility stated that he has settled well in his new placement thanks to the support of staff. The social worker described the staff and managers as ‘very good, very proactive and very supportive’. The social worker further stated that good communication with the new placement, sharing vital information on how to help the young person and how to work with him given his autism, was very helpful. Young people know how to complain. The home has a clear, child-focused complaints procedure. The children’s guide includes young people’s rights and a complaints procedure. Parents, carers and partner agencies are also aware of the home’s complaints policy. Complaints are rare and, when they are made, the registered manager ensures a Inspection report children’s home: SC062785 6 swift and child-centred resolution to the matter, with the outcomes clearly recorded.

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Overall experiences and progress of children and young people: outstanding

Young people new to the home are given a warm welcome by the staff and managers. They are treated with dignity and their achievements are celebrated. A young person said of the home, ‘This is the best place to be.’ Observations made of the young people engaging with the staff and managers demonstrate comfort, ease and genuine regard for one another.

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

Young people are consistently helped and protected by a dedicated staff team. Meaningful assessments and effective planning help to minimise risks inside and outside of the home. Staff and managers regularly update the health and risk assessments for the young people. This includes risks associated with self-harm, going missing, health and child sexual exploitation. One young person is subject to a Deprivation of Liberty Order for continually placing himself at serious risk of harm. Staff and managers worked closely with the placing authority and others who matter to the young person to undertake appropriate assessments. The evidence presented to the court was sufficient to secure the order. Consequently, the young person receives a high level of supervision and care to keep him safe. The home has a robust ‘missing’ policy and procedure in place. No young person has gone missing from the home since the last inspection. Staff are clear about and adhere

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

to the home’s child protection procedures. Any emerging risks are quickly identified and well understood. Staff and managers take appropriate action to protect the young people. For example, when a parent brought an unidentified adult male to her contact with her child, staff challenged the parent and immediately notified the social worker. This prompt action resulted in the local authority vetting the adults who visited the young person, and the parent being advised to be honest with the young person about the adults’ identity. Due to the home’s proactive safeguarding practice, the young people, including the most vulnerable, experience a sustained improvement in the key areas of their lives. For example, a young person’s risk of child sexual exploitation has significantly reduced since living in the home. The young person can identify for herself certain situations to avoid, and actively keeps herself safe.

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

Staff and managers are finely attuned to the young people’s needs, and recognise changes in behaviour that may indicate concern. In one case, a health issue was identified and resolved as a result of staff noticing behaviour that was out of character in one young person. Detailed behaviour support plans are in place for the young people. There is clear evidence of the effectiveness of such plans. For example, one young person is now able to go shopping without having emotional outbursts. He is also able to exercise greater control over his toileting needs. Inspection report children’s home: SC062785 7 Investigations into serious incidents or allegations of harm are shared with the appropriate agencies and are handled in line with the statutory guidance. Since the last inspection, there has been no allegation made against adults who work at the home. The designated officer expressed no concerns with the home’s safeguarding practice.

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

The systems in place for recording restraints and sanctions are appropriate. Young people’s views are recorded. There have been no restraint incidents since the last inspection. The use of sanctions is rare. Positive reinforcement is consistently utilised to improve young people’s behaviour. The location risk assessment is comprehensive and fit for purpose. However, it lacks relevant information on the risks from gangs and substance misuse in the area. The home’s safeguarding policy is thorough and meets the requirements of relevant legislation. Young people indicate that they feel safe and can identify trusted adults whom they can confide in.

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The effectiveness of leaders and managers: outstanding

The manager of this home is suitably qualified and has ample experience in caring for vulnerable young people. She ensures that the home is appropriately staffed and that safe recruitment practice is in place. Two deputy managers support the registered manager in overseeing the day-to-day operation of the home. The registered manager is ambitious for the young people and has high expectations of her staff to improve the lives of the young people. The manager also leads by example. For example, when the adult placement identified by a placing authority for one young person was deemed unsuitable for his needs, the manager took the initiative to locate a more appropriate placement for the young person. The young person is now well settled and happy in his new home. The manager’s aspirations for the young people are shared by the staff team, who work together to achieve positive outcomes for the young people. Young people make

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The effectiveness of leaders and managers: outstanding

exceptional progress given their challenging starting points. For example, a young person became the first pupil in the school to sit for a general certificate of secondary education (GCSE) qualification. The young person earned a mathematics GCSE in August. Another young person has made significant improvements to their behaviour at school as a result of excellent partnership working between staff at the home and other professionals. A social worker described the staff and managers as ‘extremely professional’ and that she is ‘most impressed with their ability to make the young people feel part of a family’. One parent described the registered manager as ‘a second mum’ to her child. A deputy headteacher described the home as ‘quite simply the best children’s care provision I have ever encountered – excellent in every respect’. An independent reviewing officer described the registered manager as ‘an enthusiastic professional who inspires

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The effectiveness of leaders and managers: outstanding

confidence’ and offers the young people a ‘bespoke approach’ to their care. Staff receive regular supervision that is focused on meeting the young people’s needs Inspection report children’s home: SC062785 8 and receiving feedback on the quality of their practice. Managers are keen to promote accountability. There is evidence of staff being challenged and developed through supervision. Staff members state that they find supervision helpful. Learning points from serious case reviews and other relevant current events in child protection are discussed in team meetings. This helps staff and managers to explore any areas of risk within their service. The manager’s assessment of the home’s strengths and areas for improvement is thoughtful and considered. The manager underpins her evaluation by cross-referencing with the quality standards and has a plan in place to further develop the service. The written report does not include a detailed action plan for the next six months, although

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The effectiveness of leaders and managers: outstanding

this has not affected the quality of the service being delivered to the young people. The manager demonstrates a thorough understanding of the service and has a purposeful plan to continue to deliver excellent care. The manager is also keen to promote practice development through research and innovative ideas. The independent visitor’s reports are comprehensive. However, the visits to the home are announced and the independent visitor does not routinely communicate with parents, carers or the young people to help form his evaluation of the home’s arrangements to promote the young people’s well-being. The registered manager is aware of this and is taking steps to improve the quality of this independent scrutiny. The home’s workforce development plan is good and the training plan covers the required and supplementary areas for staff learning. Managers attend training offered by the local authority to keep abreast of current child protection issues. Staff state that they

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The effectiveness of leaders and managers: outstanding

find the training that they receive helpful to their practice. The workforce development plan lacks a detailed process for managing and improving performance. However, staff are fully aware of the performance management process. The registered manager has developed a strong culture of accountability through effective performance management and professional development. Staff and managers work diligently to maintain a homely environment. Moreover, staff and managers create an environment that fosters the normalisation of young people’s disability without underestimating their needs. Staff and managers are truly dedicated to significantly improving the lives of young people.

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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. Inspection report children’s home: SC062785 9 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

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Information about this inspection

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: SC062785 10

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Children’s home details

Registered provider: MIG House Residential Care Home Limited

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Children’s home details

Responsible individual: Khairoonessah Dustagheer

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Inspector

Linda Kim-Newby, social care inspector Inspection report children’s home: SC062785 11 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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