Children's home run by Virgin Care Limited in Camden

Inspection report children’s home: SC458429 1 SC458429 Registered provider: Virgin Care 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 service provides short-break care for up to seven children who may have a physical disability, a learning disability or sensory impairment. It is managed by a national care provider.

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Information about this children’s home

Inspection dates: 11 to 12 December 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 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: 12 January 2017

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good

Overall judgement at last inspection: sustained effectiveness

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good

Enforcement action since last inspection: none

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Key findings from this inspection

 Children enjoy visiting this short-break service. Staff know the children very well and provide highly individualised care and support. Staff are caring and treat children with dignity and respect. Children are safe when they stay at the home. Parents and carers speak highly of the care and support that their children Inspection report children’s home: SC458429 2 receive.  Children enjoy a variety of activities and leisure opportunities when they come to stay. This includes social and leisure opportunities in the home, and in the wider community.  Staff collaborate well with parents and carers in order to provide children with support in accessing a wide range of healthcare professionals and specialist services. This ensures that children’s healthcare needs are met.  The arrangements to safeguard children are good. The registered manager is extremely proactive in acting on any concerns that relate to children’s safety

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Key findings from this inspection

and well-being.  The registered manager ensures that the staff team collaborates effectively with parents, carers, placing authorities and other agencies and professionals in order to meet the children’s needs.

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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 the records in relation to the use of restraint are in accordance with the regulations, and that the children’s views about the restraint are always sought, and recorded.  The registered manager must ensure that the use of visual monitors and the use of high-sided beds 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.  Leaders and managers must review the current arrangements for mealtimes to ensure that mealtimes are always positive experiences for all children.

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Inspection date Inspection type Inspection judgement

12/01/2017 Interim Sustained effectiveness 26/08/2016 Full Good 17/02/2016 Interim Sustained effectiveness 18/05/2015 Full Good Inspection report children’s home: SC458429 3

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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 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;  the child’s placing authority consents in writing to the monitoring or the surveillance;  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  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 visual monitoring device is based on the child’s assessed need and that the practice is regularly reviewed. 31/03/2018

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Requirement Due date

34: Policies for the protection of children

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Requirement Due date

Ensure that within 24 hours of the measure of control, discipline or restraint in relation to a child in the home, a record is made which includes:

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Requirement Due date

 the location and the duration of the measure.

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Requirement Due date

(Regulation 35(3)(a)(iii)(iv)) 31/01/2018 Inspection report children’s home: SC458429 4

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Recommendations

 Ensure that the design of the home should include any necessary adaption to meet the needs of children with disabilities or specific health issues. (‘Guide to the children’s homes regulations including the quality standards’, page 17, paragraph 3.24) In particular, review the current arrangements for mealtimes to ensure that children’s dining experiences are enhanced.

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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. A multidisciplinary team, with full involvement of parents, should regularly review this practice.

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Recommendations

 Ensure that any child who has been restrained is given the opportunity to express their feelings about their experience of the restraint as soon as practicable, ideally within 24 hours of the restraint incident, taking the age of the child and circumstances of the restraint into account. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.60)

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Recommendations

 Ensure that all staff are familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)

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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. They respect children and promote their privacy and dignity well.

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Overall experiences and progress of children and young people: good

Parents and carers speak highly of the care and support that their children receive. A parent said, ‘I cannot praise the staff enough; my daughter is kept safe and she is loved.’ Another parent said that they had no worries or concerns about their son and said, ‘We can tell he is happy.’

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Overall experiences and progress of children and young people: good

Children learn skills to become more independent; the approaches that staff use are individual to each child. A carer commented that their child is encouraged to gain more independence with life skills and another parent said, ‘My daughter is learning to dress herself and to brush her hair; these are significant steps.’ Inspection report children’s home: SC458429 5 Children enjoy a wide range of activities when they visit, both indoors and in the wider community. The many photographs displayed around the home show the fun that children have during the activities. A carer told the inspector about the importance of these activities for a child and said, ‘He benefits from socialising with other people and children; he goes into town and goes for coffee.’

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Overall experiences and progress of children and young people: good

Children are in good health and their clinical needs are well met. Staff collaborate effectively with parents and carers to support children to access a wide range of healthcare professionals and specialist services. The overall responsibility for the children’s health is the responsibility of their parents and carers. However, the support that staff provide means that they work in partnership with families to ensure that children’s health needs are well met.

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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. Because of this, children’s communication skills improve. A parent agreed and told the inspector, ‘My daughter’s communication skills have improved; she’s talking, and she’s secure’.

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

The arrangements to safeguard children are good. The registered manager responds effectively to any safeguarding concerns or suspicion of harm. She contacts the local multi-agency safeguarding team if she has any concerns in relation to the care and support of children. Records viewed at this inspection demonstrate a good audit trail of the action taken in relation to child protection concerns. The registered manager has not made any referrals to the designated officer since the last inspection.

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

Since the last inspection, the registered manager has ensured that records are maintained that clearly record the action taken when children have injuries or bruises that have an unknown cause.

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

Staff have a good awareness and understanding of safeguarding protocols. Their safeguarding knowledge is enhanced as they have undertaken multi-agency safeguarding training. In addition, safeguarding is a regular agenda item at team meetings. A member of staff said, ‘We have safeguarding scenarios at our meetings; it makes you think, and tests your knowledge.’ Parents and a social worker that were consulted during this inspection said that they feel that children are safe when they stay at the home. One parent said, ‘My child would not stay here if I did not think that they were safe.’

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

Due to some children’s support needs, they need to be monitored by visual monitors during the night, and some children currently need to use a high-sided bed. The registered manager ensures that these practices are risk-assessed and recorded in the child’s placement plan, and that consent to use the items is obtained. Detailed discussions took place during the inspection with the registered manager and responsible individual about the use of visual monitors, and the continued use of high-sided beds. Inspection report children’s home: SC458429 6 These invasive measures may be restrictive, and impose on children’s privacy and dignity. Although the registered manager has been proactive and has now started to review this practice, reviews within a multidisciplinary forum have not taken place regularly. However, the registered manager has consulted with the parents of one child and because of this, the child no longer uses a high-sided bed.

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

Staff are promoting positive behaviour effectively. They are provided with behaviour support plans that guide them well about how to support children to manage their emotions and feelings. A parent agreed and said, ‘My daughter’s behaviour has improved. The staff set boundaries; they have done wonders: they understand her, she is more relaxed.’

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

Since the last inspection, there has been an increase in incidents and overall, a significant increase in the use of restraint. Restraint is only used as a last resort and records seen showed holds that were predominantly ‘low level’, consisting of breakaway techniques and staff guides. The registered manager reviews and evaluates incidents, and looks for triggers and trends. As a result, the use of restraint has reduced in recent months and continues to decline. However, not all records in relation to the use of restraint meet the regulations. Some records do not identify the actual location of where the restraint took place, or the duration. In addition, children’s views about the intervention used are not recorded.

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

There are currently no concerns in relation to bullying, child sexual exploitation and there are no recorded incidents of children going missing from the home.

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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 there is regular servicing of the overhead tracking systems, mobile hoists and the fire system and firefighting equipment. In addition, all staff have undertaken fire practices.

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The effectiveness of leaders and managers: good

A registered manager, who has the qualifications, skills and knowledge to manage the service effectively, manages this home. She ensures that children receive high-quality care and support, and that staff place the needs of the children at the centre of their practice.

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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. She reviews the quality of care provided at the home effectively. This enables her to devise an action plan in response to areas for improvement. In addition, she ensures that the independent visitor undertakes regular visits. The independent visitor scrutinises the quality of care that is provided, and the registered manager acts effectively on any recommendations the visitor makes.

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The effectiveness of leaders and managers: good

The registered manager and responsible individual engage effectively with other agencies and professionals to ensure that children’s identified needs are met. A good example of this work relates to the effective management and support of a child who is Inspection report children’s home: SC458429 7 currently living successfully at the home, alongside other children who visit for short breaks, while a permanent home is being found. The registered manager and responsible individual regularly review this arrangement with the child’s parents, the placing authority and the child’s social worker. The focus on ensuring positive outcomes for this child is clear. The parents and social worker speak highly of the care and support that is being provided.

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The effectiveness of leaders and managers: good

The format of placement plans is currently under review. Placement plans and associated documents, such as moving and handling assessments and medical intervention protocols, provide staff with detailed guidance on how staff are to meet the children’s individual needs. These documents are regularly reviewed and parents sign their agreement of such plans. This demonstrates good collaborative working. However, some records completed by staff use overly official language that is not typically child- friendly.

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The effectiveness of leaders and managers: good

A properly staffed and resourced staff team meets the children’s needs. The team is well qualified, knows the children well and provides them with stability. As well as mandatory training, staff receive specialist training to meet children’s needs. Staff speak highly of the support and direction that they receive from the registered manager.

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The effectiveness of leaders and managers: good

Children stay in a home that is child-focused, well maintained and is decorated to a good standard. The home is equipped with aids and adaptations to meet the individual and collective needs of the children.

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The effectiveness of leaders and managers: good

Leaders and managers have been proactive in exploring options to make structural changes to improve the dining facilities. However, to date this has been unsuccessful. Currently, staff make physical adaptations to the environment when needed, to ensure that children’s dining experiences are family orientated and positive. However, discussions with the registered manager and responsible individual have identified that a detailed review of the current arrangements should be undertaken to ensure that children’s dining experiences are further enhanced.

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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 Inspection report children’s home: SC458429 8 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: SC458429 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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Inspector

David Kidner, social care inspector Inspection report children’s home: SC458429 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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