Children's Home run by CareTech Community Services Limited in Staffordshire

Inspection report children‟s home: SC005041 1 SC005041 Registered provider: Daisybrook Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

The home is operated by a private organisation. It is registered to accommodate up to 10 children and young people who have a range of disabilities and complex needs. The provision may be for either settled care or short breaks.

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Information about this children’s home

Inspection dates: 21 to 22 November 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 requires improvement to be good

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good

The effectiveness of leaders and managers requires improvement to be 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: 3 February 2017

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good

Overall judgement at last inspection: improved effectiveness

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Key findings from this inspection

 The staff team provides a committed and passionate approach to the care that Inspection report children‟s home: SC005041 2 it provides to young people.  Staff support young people‟s transition from children‟s services to adult care very well.  Staff build strong and trusting relationships with children and young people.  Staff work hard to get to know each child and learn their preferred method of communication.  The manager and staff work in close partnership with external professionals to meet children‟s complex needs.  The manager responds well to safeguarding concerns.  Good matching decisions mean that children and young people get along well with each other.  Children and young people thrive in a nurturing environment.  Children and young people make friends easily and benefit from long-term placements.  Safe recruitment practice ensures that unsuitable people do not work with 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

 Although staff have competency certificates that enable them to use invasive techniques, these certificates are not specific to each child and should be.  Not all young people have a personal evacuation escape plan to follow in the event of a fire.  Managers and staff do not keep all records up to date.  On occasion, staff do not record how they provide care in line with young people‟s care plans.  The manager does not provide all staff, including agency staff, with supervision or an annual appraisal.  The manager does not ensure that staff receive all required training.  The manager does not ensure that staffing levels are always sufficient.  The manager does not maintain all areas of the home to a good standard.  Permission for staff to administer medication to children is not recorded on at least one child‟s files. Inspection report children‟s home: SC005041 3

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Inspection date Inspection type Inspection judgement

03/02/2017 Interim Improved effectiveness 07/06/2016 Full Good 10/03/2016 Interim Sustained effectiveness 14/10/2015 Full Good Inspection report children‟s home: SC005041 4

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Statutory requirements

This section sets out the actions that the registered person 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 standard‟. The registered person 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 ensure that the home‟s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12(1)(2)(b))

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Requirement Due date

In particular, ensure that each child has a personal evacuation escape plan, ensure that staff record specifically when they check on children during the night and that this is in line with children‟s individual risk assessments and plans and ensure that competency certificates in relation to invasive procedures are specific to each child. 31/01/2018

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Requirement Due date

The registered person must ensure that— staff have the experience, qualifications and skills to meet the needs of each child; and the home has sufficient staff to provide care for each child; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(2)(c)(d)) 31/01/2018

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Requirement Due date

The registered person must maintain records (“case records”) for each child which include the information and documents listed in Schedule 3 in relation to each child and are kept up to date. (Regulation 36(1)(a)(b)

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Requirement Due date

In particular, children‟s relevant plans are kept up to date and all children‟s records include permission for staff to administer medication for a person with parental responsibility for each child. 31/01/2018

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(a)(c)) 31/01/2018 Inspection report children‟s home: SC005041 5

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Recommendations

 For children‟s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraph 3.9) In particular, ensure that the home is well maintained throughout.

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Overall experiences and progress of children and young people: good

The staff team is committed to and passionate about improving outcomes for children and young people. Staff are skilled and knowledgeable and support young people‟s individual needs well. Consequently, young people make good progress from their starting points in different aspects of their development.

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Overall experiences and progress of children and young people: good

Children and young people thrive because they live in a home that provides them with love and nurture. A foster parent said about a child, „[The staff] are lovely and they look after her well. It‟s lovely here, we come to visit each Saturday and they always make us welcome. They do as much as they can to look after her.‟ During a quality assurance visit to the home a placing authority commissioner said that they were very satisfied with what they had seen and commented on the „good quality of nurturing care‟ evident in the home. This shows that families and professionals hold the service in high regard.

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Overall experiences and progress of children and young people: good

Children and young people develop strong and trusting relationships with staff. Staff use specific communication systems tailored to each child or young person to gain their views and wishes. Staff are skilled at recognising how eye-pointing, vocal tone and use of objects of reference are used by children and young people to communicate. Because staff spend valuable time getting to know each child and young person, they are tuned-in to the intricate details of how they each communicate differently. This helps children and young people to build trust and make their needs and wants known to others. A staff member said, „Young people like the staff. For example, when they come home from school they are happy to return and they make sounds that show you they are happy, you can tell by the vibes they give off. You get used to each sound they make and learn to understand what each one means. This is how we know what they

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Overall experiences and progress of children and young people: good

Children and young people experience the joys of making friends with each other. Managers and staff ensure that young people are matched well and so are compatible with each other. This helps children and young people to get the best out of their stay. For example, one young person happily engaged with another child by singing to him Inspection report children‟s home: SC005041 6 and encouraging him to join in. This delightful demonstration of kindness and friendship- building shows how, regardless of their differences, children and young people accept each other for who they are. A staff member said, „There is a really nice mix of young people. They all get on really well. The siblings all get on with the others, as well as each other. It is like a little family.‟

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Overall experiences and progress of children and young people: good

Staff are skilled and knowledgeable in managing the complex health needs of each young person. Staff work in close partnership with health professionals and follow guidance to ensure that young people‟s health needs are met. A staff member said, „We have training in medication administration, epilepsy and suction training. Young people are helped to attend all routine appointments. We link in with the doctors and the school nurse. The dietician, consultants and social workers are all working in partnership with us to promote the health of young people.‟

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Overall experiences and progress of children and young people: good

Staff transition young people well from children‟s services into adult care. The focus on making sure that the most suitable placement is found for those young people who are moving on is a priority for the manager and his team. As a result, young people move to suitable adult placements that can meet their physical, emotional and psychological health needs.

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Overall experiences and progress of children and young people: good

Children and young people benefit from positive experiences and access activities that meet their needs and interests. Young people go on holiday and enjoy time with their friends during short breaks. When circumstances, such as illness, prevent children and young people from going on holiday, staff are quick to re-book so that they do not miss out. As a result, young people gain valuable social skills and have positive experiences, which builds their self-esteem and confidence.

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Overall experiences and progress of children and young people: good

Managers and staff do not regularly review young people‟s short-break care plans. Although staff show a good understanding of each child‟s needs, this is not underpinned by up-to-date plans. To date this has not directly affected young people but has the potential to do so.

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improvement to be good

Children and young people are helped and protected from abuse because staff are trained in safeguarding and child protection. Staff understand their responsibilities and report any concerns to the manager. The manager acts on concerns promptly. Staff follow safeguarding procedures and this helps to keep children and young people safe.

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improvement to be good

Staff provide invasive care to some children and young people. For example, some children and young people need to be fed through a gastrostomy, and others need to be assisted with suction. Where nasal gastric tubes or gastrostomies are in place, medication is administered via the invasive care technique. Although staff have received training, the certificates of competency do not identify the child the training is specific to. This does not guarantee that the staff are competent in the invasive practice particular to each child. This has the potential to place children at risk of harm. Inspection report children‟s home: SC005041 7 Children and young people take part in regular fire drills to make sure that they can evacuate the home safely in the event of a fire. However, not all children and young people have a personal emergency evacuation plan on file. This compromises the safety of children and young people who require assistance to evacuate the home in an

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improvement to be good

Staff work together with parents and social workers to share information about children‟s needs. For example, most records show that parents communicate with staff about their children‟s medication needs and routines, which staff then follow. One child‟s file does not contain permission for staff to administer medication to the child, in the event that this is needed. This could lead to confusion and delays in the child receiving medication.

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improvement to be good

Staff do not always follow the guidance contained in young people‟s individual risk assessments. For example, one risk assessment highlights that a child should be checked on every hour during the night. Although the staff record that they check on the child „regularly‟ through the night this does not guarantee that the child is receiving the correct support during the night. This has the potential to compromise the child‟s safety and welfare.

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improvement to be good

Since the last full inspection, the use of physical intervention has been used five times. However, not all staff are suitably trained. For example, during a restraint, three staff intervened and used physical intervention. One member of staff employed from an external agency was not trained in the use of the measure. This places the children and young people and staff at risk of injury.

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improvement to be good

Staff use positive praise and rewards to promote positive behaviour. This encourages children and young people to be kind and courteous to each other. As a result, children and young people do not experience bullying.

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The effectiveness of leaders and managers: requires improvement to be good

The home is led by a qualified and experienced registered manager. The manager holds a level 4 NVQ in leadership and management. He is supported by a qualified deputy manager.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has safely recruited staff since the last full inspection. This helps to prevent unsuitable people from working with the children and young people. Staff benefit from a good induction programme that helps them to understand their role and the aims and objectives of the service. Staff that do not have a suitable qualification are enrolled on a training course. These staff are set to complete their qualification within the required timescale.

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The effectiveness of leaders and managers: requires improvement to be good

The manager works well with external agencies. Managers and staff communicate with young people‟s social workers and families regularly. Staff provide valuable updates about children and young people and this keeps relevant people informed. A social worker said, „[Name of child] is having the best care. I receive good information. I am Inspection report children‟s home: SC005041 8 thankful they are there.‟

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The effectiveness of leaders and managers: requires improvement to be good

The manager has not appraised all staff annually. Additionally, not all staff, including agency staff, are given regular supervision. For example, some permanent staff have not had supervision for three months. As a result, staff do not benefit from the opportunity to reflect on their performance and receive feedback to enhance their practice and development.

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The effectiveness of leaders and managers: requires improvement to be good

The manager provides permanent staff with core training to keep their skills up to date. Training is refreshed on a regular basis. However, the manager does not provide staff with training to help them understand self-injurious/harmful behaviour. This means that staff are not skilled or knowledgeable enough to provide the best care to children or young people who self-harm. Furthermore, not all agency staff are trained to use physical intervention. A requirement is raised to ensure that all staff working at the home receive the necessary training to support children‟s needs safely.

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The effectiveness of leaders and managers: requires improvement to be good

On occasions, the manager does not ensure that staffing levels are sufficient to provide two-to-one care to young people at critical times of the day. For example, each young person requires one-to-one staffing. During the day, some children and young people need two staff to undertake duties, such as manual handling and medication administration. This sometimes leaves one member of staff to care for two children for short periods of time. In addition, staffing levels sometimes determine when children go out on an activity. It is not always clear whether or not this is in line with children‟s wishes.

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The effectiveness of leaders and managers: requires improvement to be good

Some areas of the home are in need of repair. The home generally is looking tired and is in need of redecorating. A play-house in the garden was also needing repair at the time of inspection. It was noted that once this was bought to the attention of the manager, the repair was completed immediately.

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The effectiveness of leaders and managers: requires improvement to be good

The manager keeps the statement of purpose up to date. The home continues to operate within its statement of purpose. Children and young people benefit from settled care and short-break stays that overall enhance their lives and experiences.

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The effectiveness of leaders and managers: requires improvement to be good

The manager provides a quality of care review report following his monitoring of the home. However, the monitoring activity is not wholly effective. For example, it has not identified shortfalls in record-keeping. This lack of attention to detail shows that the manager does not always use monitoring to maintain and improve the quality of care.

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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 Inspection report children‟s home: SC005041 9 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: SC005041 10

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Children’s home details

Registered provider address: 5th Floor, Metropolitan House, 3 Darkes Lane, Potters Bar, Hertfordshire EN6 1AG

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Inspectors

Michelle Spruce, social care inspector Sue Young, social care inspector Inspection report children‟s home: SC005041 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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Inspectors

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Inspectors

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Inspectors

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