Children's Home run by Institute of Integrated Systemic Therapy in Kent

Inspection report children’s home: SC454294 1 SC454294 Registered provider: Childhood First

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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 registered to provide care and accommodation for four young people who have emotional and/or behavioural difficulties. Education and therapeutic counselling are provided on-site. The home is operated by a charitable organisation.

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Information about this children’s home

Inspection dates: 28 to 29 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

Date of last inspection: 14 February 2017

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outstanding

Overall judgement at last inspection: improved effectiveness

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Enforcement action since last inspection:

None Inspection report children’s home: SC454294 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

 High-quality care planning results in young people’s needs being clearly identified and in effective strategies for their care being implemented.

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Key findings from this inspection

 The home’s therapeutic model of care is understood by staff and is implemented in practice. Consequently, young people benefit from consistency in the care they receive.

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Key findings from this inspection

 The quality of the relationships that young people develop with care staff is exceptional. Staff prioritise the emotional well-being of young people.

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Key findings from this inspection

 Staff provide young people with sensitive support to overcome past trauma, particularly when child protection concerns are being investigated.

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Key findings from this inspection

 Strong leadership and management ensure that the home is run effectively and efficiently and that meeting young people’s needs is paramount.

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Key findings from this inspection

 The monitoring of serious incidents is seen as an opportunity to identify weaknesses and promote continuous development.

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Key findings from this inspection

 The ongoing professional development of staff is viewed as key to ensuring that young people receive high standards of care.

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Key findings from this inspection

 Young people actively contribute towards the development of their care plans and staff are open to implementing new and creative ways of meeting young people’s needs.

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Key findings from this inspection

 Careful planning ensures that young people are well prepared for moving on from the home when it is appropriate for them to do so.

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Key findings from this inspection

 The home’s therapeutic ethos is embedded in the culture of the home. Young people engage well in therapeutic work and this has a positive impact on their emotional well-being.

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Key findings from this inspection

 Young people make exceptional progress across all aspects of their lives.

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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

 Some improvement is needed in the records pertaining to the management of allegations made against staff.

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Key findings from this inspection

 The quality of care reporting process should be developed so that it enhances Inspection report children’s home: SC454294 3 already well-established monitoring processes.

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Key findings from this inspection

 Young people’s awareness of and access to independent advocacy services needs to be strengthened.

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Inspection date Inspection type Inspection judgement

14/02/2017 Interim Improved effectiveness 15/11/2016 Full Outstanding 29/12/2015 Interim Improved effectiveness 27/08/2015 Full Good Inspection report children’s home: SC454294 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 procedure to be followed in the event of an allegation of abuse or neglect must, in particular– provide for records to be kept of an allegation of abuse or neglect, and the action taken in response. (Regulation 34(2)(d)) Specifically, ensure that a record is kept of all the actions taken when a child makes an allegation against a member of staff. 26/01/2018

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Recommendations

 Children’s home staff should complement any explanation given by the IRO by helping looked-after children to understand the role of an independent advocate and how they can access one. (‘Guide to the children’s homes regulations including the quality standards’, page 23, paragraph 4.17) Specifically, ensure that children are provided with information regarding the local and national advocacy services they could access.

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Recommendations

 The registered person should actively seek independent scrutiny of the home and make best use of information from independent and internal monitoring (including under regulations 44 and 45) to ensure continuous improvement. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24) Specifically, ensure that regulation 45 monitoring reports evaluate and analyse the quality of care being provided.

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Overall experiences and progress of children and young people: outstanding

The home’s therapeutic model of care is fully embedded in practice. This ensures that there is a consistent approach to meeting young people’s needs and maintaining boundaries. Over time, this provides young people with a sense of stability and security. They begin to form positive bonds and attachments with the staff, based on trust and Inspection report children’s home: SC454294 5 mutual respect. The sense of security that young people develop results in them feeling safe enough to begin addressing the negative impact of past trauma and disruption in their lives.

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Overall experiences and progress of children and young people: outstanding

Inspectors observed staff to be nurturing and sensitive in all their interactions with young people. Young people feel relaxed in the company of staff and thrive on the individual attention they receive. They are encouraged to pursue their individual interests and hobbies, such as music, dance and sport, and their achievements are celebrated. As a result, young people grow in confidence and increase their self-esteem. One young person took great pride in showing the inspector his trophy for being the most valued player at his local community football club.

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Overall experiences and progress of children and young people: outstanding

All of the young people maintain good attendance at the organisation’s on-site school. This is a major achievement for those young people who have had past negative experiences in school and have struggled to engage with education. Some young people have made significant progress in terms of their educational achievement. This includes part-time attendance at a local college. Staff have accompanied young people to the college and remained on-site throughout the day to offer support when needed. This has been instrumental in making the college placements successful.

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Overall experiences and progress of children and young people: outstanding

Staff demonstrate a strong commitment to listening to and acting upon the views of young people. Regular ‘community meetings’ provide the opportunity for staff and young people to discuss issues relating to the day-to-day running of the home, and young people are encouraged to bring their own agenda items to these meetings. There is open discussion regarding possible new admissions to the home, and an acknowledgment of the collective sense of loss when a young person moves on. Young people were consulted about and contributed towards the home’s development plan. Although practice is strong in this area, links have not been made with any local or national advocacy services. This means that young people are not consistently reminded how they can initiate contact with independent advocates.

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Overall experiences and progress of children and young people: outstanding

The standard of care planning in the home is excellent. Young people play an active role in developing their plans, and are provided with their own version of their care plan document. This ensures that they are familiar with the goals they are working towards. The support that young people are given to achieve these goals is exceptional. Key-work sessions are planned in advance and are focused on the support young people need to achieve the goals they have been set. An ‘interaction log’ is kept, and this enables staff to record any significant conversations they have with young people in relation to their overall plan, emotional well-being and safety. Consequently, all staff are familiar with the issues that young people might be struggling with.

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Overall experiences and progress of children and young people: outstanding

Staff are sensitive to the vulnerabilities of each young person, and anticipate situations that could cause them anxiety. For example, staff who are key workers prepare the young person for when they will be away on annual leave, and make sure that the young person has an identified member of staff who will be available to support them during the key worker’s absence. Staff handle complex situations sensitively. Through discussion and planning with his key worker, one young person has learned an effective Inspection report children’s home: SC454294 6 way to explain to friends outside the home that he is in care.

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Overall experiences and progress of children and young people: outstanding

Young people learn the importance of maintaining a healthy lifestyle, including what constitutes a balanced diet. They are encouraged to take regular exercise, and there is ample space for outdoor activities in the grounds of the home. In the organisation’s school, young people are taught about sexual development, sexual health and positive relationships. There is good communication between care and teaching staff, and this ensures that care staff are aware of how young people have engaged in these lessons, so that they can offer additional advice and guidance when needed.

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Overall experiences and progress of children and young people: outstanding

The mental health and emotional well-being of young people are prioritised. Young people have access to therapeutic counselling from the point of admission. There is an expectation that all young people will engage in therapy and there is positive acceptance of this. The therapy team plays an active role in supporting the staff to deliver care that complements the therapeutic ethos of the home.

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Overall experiences and progress of children and young people: outstanding

High-quality work is undertaken to support young people’s smooth transition from the home into new care placements. In partnership with young people, detailed plans are made for introductions to potential foster carers. Staff support young people on visits to potential carers and to schools they might attend if the placement goes ahead. When there is a plan for young people to move to a foster placement provided by the organisation, comprehensive preparation work with the potential foster carers is undertaken well in advance of the young person moving in. The careful and considerate planning that goes into transition work has recently resulted in a young person making a successful move to foster care, after living at the home for an extended period and making excellent progress.

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Overall experiences and progress of children and young people: outstanding

Overall, young people at the home make exceptional progress across all aspects of their lives. They develop good social skills and become less isolated. They learn to trust adults and respond positively to the care, therapy and education they receive. Young people significantly reduce the frequency and severity of their challenging behaviour and learn to manage their anger and frustration more effectively. They develop new skills and talents and gain a more positive outlook on life as they progress through adolescence.

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

Staff prioritise the safety and well-being of young people effectively. Strong safeguarding practice is evident across all aspects of the service being provided to young people. Managers and staff demonstrate a thorough understanding of each young person’s needs and vulnerabilities. For example, one member of staff gave a clear description of the circumstances that would result in a particular young person becoming anxious, and the likely emotional impact that this would have. The member of staff explained the range of unsafe behaviours that the young person might subsequently demonstrate.

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

The detailed knowledge and understanding of young people’s vulnerabilities informs the risk assessment process. Young people’s individual risk assessments are evidence-based, succinct and provide clear strategies for minimising the potential for young people to Inspection report children’s home: SC454294 7 come to harm. Risk assessments clearly demonstrate the rationale behind strategies for minimising risk. For example, the missing from care risk assessment for one young person explains how and why, in certain circumstances, the young person should be physically prevented from leaving the premises.

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

Risk assessments are frequently reviewed and updated. They give careful consideration to how young people can safely engage in community-based activities, develop friendships and visit friends in their own homes.

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

There have been no incidents of young people going missing from the home since the last full inspection in November 2017. Staff know which young people have the highest potential to go missing, and effective strategies are in place to prevent this happening. As a result, one highly vulnerable young person, who had a significant history of going missing before she was admitted, has not been left unsupervised by staff for any significant period. Staff consistently act in accordance with agreed protocols and procedures should any young person attempt to leave the home without permission.

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

There is a well-coordinated response to child protection concerns. Issues raised by young people are promptly referred to the relevant social worker and all decisions are acted upon. Practice in relation to young people who make disclosures of historical abuse is excellent. They receive sensitive, nurturing support as child protection investigations are undertaken. Staff ensure that young people are provided with the information they need to understand processes and procedures, and consistently prioritise young people’s emotional well-being as they recall past traumatic events.

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

Overall, there is a high standard of record-keeping in relation to safeguarding matters. Detailed transcripts are made of the conversations that staff undertake with young people during child protection investigations. However, one shortfall was identified in relation to records pertaining to an allegation made against a member of staff. The young person quickly retracted the allegation, but this was not recorded in a timely manner.

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

In recent months the registered manager has led on the development of a more restorative approach to behaviour management. Young people have engaged well in formalised restorative meetings. These meetings address the negative aspects of the young person’s behaviour, provide opportunities for reflection and begin the process of rebuilding relationships with peers or staff who may have been negatively affected by the challenging behaviour.

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

There is a focus on de-escalating challenging behaviour, and staff only resort to using physical interventions in accordance with the regulatory framework. Physical restraint is only undertaken by trained staff, and for the minimum period, to ensure that the young person is safe. Any incident resulting in physical restraint of a young person is carefully scrutinised by leaders and managers. During this process, the views of the young person are carefully considered, and practice is often amended as a result of what the young person says. Leaders and managers view physical restraints as an opportunity to reassess how the young person’s needs are being met, and whether new approaches Inspection report children’s home: SC454294 8 and strategies for caring for the young person could reduce the need for physical restraint in future.

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

The high-quality relationships that young people build with staff promote a culture in which young people feel safe enough to express their fears and anxieties. All the young people were able to say, without hesitation, which member of staff they would speak to if something was worrying them. Young people say that they feel safe at the home, and have confidence in the ability of staff to ensure that they do not come to any harm.

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

Highly effective systems for monitoring health and safety matters are in place. Regular checks are made to ensure that potential hazards are rectified promptly. Fire safety equipment and electrical appliances are checked and maintained regularly. Preparations are being made, in advance of building work that is to be undertaken next year, to ensure that all potential risks are identified in advance. This thorough and detailed approach to health and safety matters ensures that young people live in an environment where risks to their physical safety are minimised.

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The effectiveness of leaders and managers: outstanding

The registered manager holds the level 4 diploma in leadership and management for care service and health and social care, and other qualifications relevant to the therapeutic care of vulnerable young people. He is a highly efficient and effective manager who prioritises the professional development of the staff team, recognising the positive impact that this will have on the young people. The registered manager is supported by two senior members of staff who take responsibility for maintaining and developing good practice and compliance with regulations and quality standards. The committed and stable team of care staff is strongly focused on achieving the best outcomes for young people.

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The effectiveness of leaders and managers: outstanding

A comprehensive induction and training programme ensures that staff quickly gain the knowledge and skills required to practice in accordance with the home’s therapeutic model of care. A member of staff, who is fairly new in post, explained how the principles behind the home’s model of care assisted her to gain an understanding of young people’s behaviours and build positive relationships effectively with the young people. A range of group meetings and practice forums enable staff to reflect on their practice and examine the emotional impact the work has on them personally. Individual supervision assists staff to identify their learning needs and to examine ways in which they can develop and improve their performance.

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The effectiveness of leaders and managers: outstanding

Leaders and managers demonstrate a commitment to ensuring that care plans clearly identify young people’s needs and specify the work that will be undertaken to ensure that they are met. The information gained from psychological assessments and well- being measuring processes are used to develop the strategies that are most likely to have a positive impact on a young person’s psychological development. Young people’s progress is closely monitored and their strengths and weaknesses are clearly defined. These detailed assessment and planning processes result in young people being set highly relevant and achievable targets. When young people struggle to meet their Inspection report children’s home: SC454294 9 targets, strategies are reviewed and amended. An independent reviewing officer said: ‘Staff are always looking for new approaches to meeting young people’s needs.’

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The effectiveness of leaders and managers: outstanding

There are well-embedded and effective systems for monitoring the quality of care being provided. The registered manager has developed a check-list system to ensure that high standards of care are maintained. Any serious incidents that occur are closely scrutinised and are seen as learning opportunities. For example, one incident report reviewed during the inspection had identified that staff could have anticipated when a young person’s anxieties were likely to peak, and taken steps to ensure that maximum support was available at this time. Leaders and managers are quick to identify weaknesses and take remedial action, demonstrating a commitment to continuous improvement.

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The effectiveness of leaders and managers: outstanding

The registered manager recognises that his six-monthly quality of care monitoring reports could become a more effective tool for raising standards. These reports do not consistently evaluate the information that is collected or analyse the impact that the care being provided has on young people. The registered manager had identified this as an area for development prior to the inspection taking place.

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The effectiveness of leaders and managers: outstanding

Managers and staff develop positive working relationships with placing authorities and other professionals concerned with the safety and well-being of young people. This has resulted in effective partnership working in relation to child protection investigations and transition planning for young people who are ready to move on. Leaders and managers challenge other professionals effectively when they perceive them not to be working in the best interests of the young person. This has resulted in changes being made to transition timescales and so ensures that young people are given the best opportunity to adapt to major changes in their circumstances.

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The effectiveness of leaders and managers: outstanding

The registered manager has a clear vision for the home, which is reflected in the development plan. Plans for developing the service and increasing the number of beds in the future have been given careful consideration. The need to maintain stability for the young people who are already settled in the home has been prioritised. The registered manager has had the full support of the registered individual in terms of the process and timescale for achieving these aims.

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The effectiveness of leaders and managers: outstanding

Staff recognise the need for young people to fit in and engage positively with the local community. Staff have made good links with local sport and recreational facilities, and this ensures that young people can participate safely and in a planned way. Partnership working with an external college has enabled young people to attend and expand their educational opportunities within a supportive environment.

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The effectiveness of leaders and managers: outstanding

Leaders and managers are highly positive role models for the staff and young people. They have created a culture in which young people are valued and respected as individuals. Staff are consistently motivated to provide excellent standards of care and have high aspirations for the young people they look after. Inspection report children’s home: SC454294 10

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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: SC454294 11

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Children’s home details

Registered provider address: 210 Borough High Street, London SE1 1JX

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Inspector

Stephen Collett, social care inspector Inspection report children’s home: SC454294 12 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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