Children's home run by Together For Children Sunderland

Inspection report children’s home: 1254838 1 Registered provider: Together For Children Sunderland 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

The home provides short breaks for up to seven children and young people who have a sensory impairment and/or a learning or physical disability. The home is owned by Sunderland City council but controlled by an independent board.

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Information about this children’s home

Inspection dates: 19 to 20 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 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

Overall judgement at last inspection: not applicable

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good

Enforcement action since last inspection: not applicable

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Key findings from this inspection

 The parents are well supported by the home with advice and relevant, regular communication.  The management team is flexible in the provision of stays in emergency or unusual situations. Inspection report children’s home: 1254838 2  The young people are comfortable in this environment and engage positively with their peers and staff during their stay.  The staff team is experienced and stable. It provides continuity of care and consistency of approach.

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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 care plans and risk assessments need to be more detailed.  The management oversight and development of the service require more attention.  Safeguarding practice needs to be a priority in the home.

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Inspection date Inspection type Inspection judgement

No previous inspections Inspection report children’s home: 1254838 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 health and well-being standard is that— the health and well-being needs of children are met; (Regulation 10 (1)(a)) In particular, that specialised care needs are outlined in care plans, monitored and evaluated. 31/01/2018

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(a)(h)) 31/01/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child— is instigated; or concludes (in which case, the notification must include the 31/01/2018 Inspection report children’s home: 1254838 4 outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. A notification made under this regulation— must include details of— the matter; the other persons, bodies or organisations (if any) who or which have been notified; and any actions taken by the registered person as a result of the

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Requirement Due date

matter must be made or confirmed in writing. (Regulation 40 (4)(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. Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene etc.); however in doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9) In particular, the kitchen area needs to be repaired and made safe. This relates to the sealant around the sink and the flooring with regard to infection control.  The registered person should ensure that children are offered a wide range of activities both inside and outside of the home (where appropriate) and are encouraged to participate in those activities. Staff should support children to take part in school trips, out of school and other clubs, volunteering and leisure

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Recommendations

activities. (‘Guide to the children’s homes regulations including the quality standards’, page 31, paragraph 6.5)  The registered person should build a strong safeguarding culture in the home where children are listened to, respected and involved in both the development of the home and decisions about the home. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.8) In particular, safeguarding should be a standard agenda item for team meetings.  Supervision of staff practice should ensure that individual adults in the home are engaged in the safeguarding culture of the home so they understand what they would need to do if they found other staff misusing or abusing their position to the detriment of the safety of a child. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.14)  Sufficient staff means a home having enough suitably trained staff (including

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Recommendations

someone in a management role) on duty to meet the assessed needs of all children in the home. (‘Guide to the children’s homes regulations including the Inspection report children’s home: 1254838 5 quality standards’, page 51, paragraph 10.1)  The registered person is responsible for deciding what each review should focus on, based on the specific circumstances of the home at that particular time and any areas of high risk to the children that the home is designed to care for, such as missing or exploitation. They will also consider what information or data recorded in the home will form part of the evidence base for their analysis and conclusions. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.4)

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Overall experiences and progress of children and young people: good

The young people are well prepared for transitions to and from the home. Admissions and subsequent stays are carefully planned to reduce any stress or distress that may be linked to a young person staying away from home. Introductory visits gradually increase in duration, with the staff carefully monitoring the young people and their interactions with staff and peers. Planned stays take account of the needs of both the young people and their parents. This ensures that the young people create friendship groups that have, on occasion, lasted long after they have left the service. Parents are fully included in all transitions to support their child and alleviate any concerns they may have. A parent said: ‘They are very accommodating if I need a change of date. I get feedback after every stay.’ This, along with regular updates and good communication, gives parents reassurance about the care of their child. A parent said: ‘They are all brilliant.

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Overall experiences and progress of children and young people: good

They listen to what I have to say and work with any suggestions I have.’ The young people leave the home with thorough, well-planned and good introductions to new placements, which support a smooth, positive transition.

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Overall experiences and progress of children and young people: good

Part of the planning for such positive transition includes working closely with parents on managing medication. The staff are fully aware of the medication needs of the young people and the processes for the receipt and storage of medication are clear. Records seen during the inspection were up to date and accurate. During each stay, the staff team respects the privacy and dignity of the young people when dispensing and recording medication. Procedures for staff to follow, in circumstances such as Percutaneous endoscopic gastrostomy (PEG) peg feeding, are clearly recorded within care plans. However, the monitoring of such activities in the daily records is not recorded in a detailed enough way for the management to ensure that such procedures are followed correctly. This could lead to further health complications for young people .

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Overall experiences and progress of children and young people: good

The young people have good relationships with staff. The young people are relaxed in their company and interact well. The young people are regularly consulted, taking into account their age and their level of understanding. The staff use a range of communication aids, and they are skilled in understanding the young people’s gestures and their body language. One-to-one sessions are held during each time they stay to enable topics of interest and safety to be discussed and to develop skills for independence. This way of working encourages the young people to make decisions and express their views. It also promotes their equality by offering them choices. Inspection report children’s home: 1254838 6 The young people are provided with a range of activities which offer a wealth of opportunities to engage with their friends during their stay. Photographs are displayed throughout the home, showing happy faces enjoying experiences with staff and their

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Overall experiences and progress of children and young people: good

peers. A review of records relating to activities showed that there is an over-reliance on trips out to local shops, fast food facilities and parks. This limits the opportunities offered to young people to widen their experiences.

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Overall experiences and progress of children and young people: good

Behaviour is well managed in the home through a large group of committed, caring staff. The use of sanctions and physical interventions is low. The staff team is appropriately trained to use such interventions should they be necessary to protect young people.

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Overall experiences and progress of children and young people: good

The home is well decorated and equipped throughout. However, the kitchen is showing signs of needing repair. The flooring and sealing around the sink area have deteriorated and need repair to ensure good standards of infection control.

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improvement to be good

The staff are able to verbalise the immediate risks associated with the young people in the home and in the community. However, the risk assessments and the support plans are not consistently robust in relation to individual young people’s known and unknown risks. Records reflect the information provided by parents and professionals to assess impact and to progress outcomes for the young people. This information is not always transferred across to the relevant care plan or risk assessment. In addition, plans and assessments are not always updated following incidents. This could affect the care provided during each stay.

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improvement to be good

Safeguarding records indicate that a notifiable incident that should have been reported to HMCI was not notified. This means that the regulator cannot assess whether all required actions have been undertaken to keep the young people safe. There needs to be an increase in the understanding of the management and staff team around safeguarding practice in its widest form, and when to report incidents. Training has been provided for most, but not all staff, in relation to this. It is important for all staff to recognise that this group of young people have additional vulnerabilities and the role that the short-break provision holds in keeping them safe.

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improvement to be good

The inspector found that in several plans the word ‘monitoring’ was used in association with risks and delivery of care to young people. This has many interpretations when talking about individuals. The staff team needs to be specific about the actions it takes to address risk-associated behaviours and carry out care tasks to ensure that robust support is provided to the young people. In addition, the monitoring by the management team needs to address this shortfall where it occurs.

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improvement to be good

No young people have gone missing, and none are at risk of exploitation, radicalisation or extremism. There have been no incidents of bullying, and no young people or their parents have made a complaint. Inspection report children’s home: 1254838 7 Environmental health and fire safety is regularly checked to keep the young people, staff and visitors safe when they are in the home. Annual environmental risk assessments are undertaken to ensure that known risks are reduced. Weekly fire drills prepare the young people and the staff in the case of a genuine fire emergency.

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improvement to be good

All visitors to the home are checked and vetted and they sign the visitors’ book. This allows the registered manager to be satisfied that the young people are not exposed to unsuitable adults.

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

The registered manager is suitably qualified and has significant experience of working with disabled young people. She is supported by a long-serving deputy and a senior team. Staffing levels are good and offer individual support to the young people during their stay.

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

Staff meetings are held monthly and the young people are discussed through the use of reflective practice. The agenda does not routinely include a discussion around safeguarding, which would help create a culture where this is a focus of practice.

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

The system of supervision has now been embedded fully and is regular. However, there is an over-reliance on the use of group supervision in some cases, which conflicts with the relevant policy. In addition, safeguarding was not included in individual supervision sessions to re-enforce the need to keep this as a primary task.

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

Managers and staff unquestionably work well in partnership with parents and other professionals. A social worker said: ‘I have no issues with staff. They go above and beyond. I receive regular updates. They juggle everything around to help and accommodate what is needed.’ Communication with schools, social workers and families is regular and comprehensive. This ensures the continuity of the service offered to young people and their families.

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

Management monitoring systems are developing but are not yet robust enough to ensure that practice achieves the aims of the individual placements. These systems are often delegated throughout the senior team without additional oversight by the manager to ensure their effectiveness. The six-monthly quality report required of managers does not include data or relevant evaluation to assist continued service development.

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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: 1254838 8 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: 1254838 9

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Children’s home details

Registered provider: Together For Children Sunderland Limited

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Children’s home details

Registered provider address: PO Box 102, Sunderland SR2 7DN

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Inspector:

Susan Atkinson-Millmoor, social care inspector Inspection report children’s home: 1254838 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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Inspector:

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