Children's home run by Knowsley Metropolitan Borough Council

Inspection report children‟s home: SC037647 1 SC037647 Registered provider: Knowsley Metropolitan Borough Council Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is managed by the local authority. It provides short-break care for up to four children who may have physical and/or learning disabilities.

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Information about this children’s home

Inspection dates: 30 November to 1 December 2017

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected outstanding

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

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

Overall judgement at last inspection: improved effectiveness

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Enforcement action since last inspection:

None. Inspection report children‟s home: SC037647 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

 Children who have disabilities and multiple complex health needs enjoy extremely positive experiences that enrich their lives and help them to make sustained improvements in their personal care, emotional well-being, safety and personal relationships. They have every possible opportunity to try new experiences and make sense of the world around them.  Children receive exceptional personalised care. Children and their parents enjoy strong and trusting relationships with members of staff. Staff are highly skilled, experienced and qualified. They are strongly motivated to help children to achieve their full potential. Their professional practice is insightful, and is informed by recognised research-based methods.  Children are increasingly confident spending time away from their families, being around other children, joining in more, and taking part in different, interesting and meaningful activities. They have opportunities to make friends

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Key findings from this inspection

and do things that they may not be able to do with their families. Children are less anxious and upset, and are significantly less likely to show their emotions through negative behaviour.  Children‟s stays are carefully planned and they enjoy a very welcoming, supportive and safe environment. The registered manager and staff use effective relationships with children, their parents and carers, social workers, schools, health and behaviour services to ensure that each child receives the best possible support. Parents and carers feel extremely well supported by the staff. They enjoy open and trusting relationships, and they are confident leaving their children in staff‟s care.  Effective leadership and management ensure that children receive an exceptionally high quality of care that meets their needs. Managers understand what the service does well, and they continually strive to make further improvements to develop the service in children‟s best interests.

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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

 Ensure that children are consulted regularly on their views about the home‟s care so that these views can inform and support continued improvement in the quality of care provided.  Education, health and care plans need to be available for each child.  The registered manager must inform Ofsted when he has serious concerns about children‟s welfare. Inspection report children‟s home: SC037647 3

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Inspection date Inspection type Inspection judgement

14/03/2017 Interim Improved effectiveness 14/12/2016 Full Good 04/03/2016 Interim Improved effectiveness 07/01/2016 Full Good Inspection report children‟s home: SC037647 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 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. (Regulation 36 (1)(a))

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Requirement Due date

In particular, ensure that there is a copy of any education, health and care plan or statement of special educational needs in relation to the child. 31/01/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person if without delay if a child protection enquiry involving a child is instigated or concludes (in which case the notification must include the outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40(4)(d)(e)) 01/12/2017

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Recommendations

 Children must be consulted regularly on their views about the home‟s care to inform and support continued improvement in the quality of care provided. Due consideration should be given to the child‟s cognitive ability in the development and implementation of any consultation processes. Children should be able to see the results of their views being listened to and acted upon. („Guide to the children‟s homes regulations including the quality standards‟, page 22, paragraph 4.11)

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Overall experiences and progress of children and young people: outstanding

Children clearly love coming to stay for short breaks. They are full of smiles when they arrive, and make themselves at home in the warm and friendly atmosphere. A parent said about their child, „He comes home refreshed. He likes his time away from us; it‟s a break for him as well as for us. He sleeps when he comes home, which shows that he is Inspection report children‟s home: SC037647 5 settled during his visit.‟

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Overall experiences and progress of children and young people: outstanding

Children stay in an extremely positive and stimulating environment. The registered manager and staff are very ambitious for every child, regardless of the complexity of their needs, to get the most out of their stays. They make sure that children always receive an exceptionally high standard of consistent personalised care and opportunities that add significantly to their experiences, development and independence. Children have opportunities to try new experiences, to explore and to feel comfortable in the world that they live in. Often, things that appear small achievements are significant for individual children, for example eating a meal with other children, eating new food, learning to play with toys, going shopping and using money, or going to the park to use the swings.

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Overall experiences and progress of children and young people: outstanding

Staff are skilled and experienced in engaging positively with children who have a wide range of different needs. They interact with children naturally. For example, a member of staff encouraged a child to balance building blocks through praise and smiles. Staff understand how each child communicates, and processes and manages information. They expertly support and encourage every child to express their wishes and feelings and to make choices about how they spend their time and what they have to eat. Staff are „tuned into‟ children who may share their feelings non-verbally or through their behaviour, and respond suitably to these children‟s wishes and feelings. Staff use clear and precise language to communicate with children. They give the children time to work out what they are saying and to respond to them. Staff use different formats, including pictures, symbols and signs, to seek children‟s views and let them know what is going to

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Overall experiences and progress of children and young people: outstanding

Children‟s care is carefully planned to ensure that they benefit from short breaks at this home, and the staff are able to meet children‟s individual needs safely. Children staying at the same time have compatible needs and interests. Where possible, children stay with the same group to provide opportunities for them to make friends. Staff also act on children‟s wishes to come to stay at the same time as their friends. A parent said, „The stays are essential for my son. Outside school, it‟s the only interaction he has with other children.‟ Staff help children to understand how to build friendships and feel comfortable around other children. They help children to share, to take turns, to develop understanding and empathy towards other children and to respect other children‟s personal space. For example, staff have successfully helped a child not to make derogative comments about other children.

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Overall experiences and progress of children and young people: outstanding

Staff creatively help children to build positive relationships with their brothers and sisters. They invited a child‟s brother and sister to visit him during some of his stays and to do things together, including pumpkin carving and playing on the slide and climbing frame. The child‟s social worker said, „This was extremely positive for him, as he was able to share his experience with his brother and sister, and this changed their perception of him and his disability.‟

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Overall experiences and progress of children and young people: outstanding

Children are introduced to the service sensitively. This usually includes coming to visit a number of times before coming to stay overnight. Staff work out with the child, their Inspection report children‟s home: SC037647 6 parents and the professionals working with the family the best way for the child to find out about the home at a pace with which they feel comfortable. The staff and the positive behaviour support team are working extremely closely to help a child become used to visiting the house. They introduced her to more of the space at each visit and arranged a small number of different activities so as not to overwhelm her at a new place. Staff have allowed her to explore the environment at her own pace so that she can make sense of it and choose what she does. Their consistent and painstaking approach is allowing them to assess the child‟s progress and responses to the people caring for her, as well as the physical environment. It also allows the staff to identify any

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Overall experiences and progress of children and young people: outstanding

potential risks to her safety. As a result, staff have identified that she is starting to play with toys, eat a wider range of food and listen more to what staff are saying to her. This information is being used to plan her first overnight stay and match her needs to those of other children.

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Overall experiences and progress of children and young people: outstanding

Children‟s plans set out clear objectives for their stays, including joining in activities with other children, improving personal care skills and developing skills in the kitchen. Their records show in detail what needs to happen to help children to achieve their goals and an analysis of their progress. This is helping to develop a comprehensive understanding of children‟s progress, as well as how the staff are meeting children‟s individual needs effectively and the home‟s impact on their lives. Children‟s short-break plans are reviewed at reasonable intervals to consider children‟s experience and progress and how effectively their current needs are being met. Staff provide detailed reports and information to contribute to the plans, including photographs to evidence children‟s progress and how they spend their time during their stay. The reviews of children‟s plans consider information from all aspects of their lives, including school and their health

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Overall experiences and progress of children and young people: outstanding

needs. Social workers and staff encourage children to share their wishes and feelings about the care that they receive. Although the different partner agencies share information about children effectively, staff do not always have access to children‟s education, health and care plan, which contains essential information about children‟s developmental needs and the arrangements for meeting them.

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Overall experiences and progress of children and young people: outstanding

Staff actively promote children‟s learning and development. The daily routine supports children‟s participation in education during their stays. Staff work very closely with schools to understand children‟s specific education targets and agree a common approach to achieving them while children are staying. Staff also ensure that there are plenty of challenging opportunities for children to enjoy and achieve new things. Children have access to plenty of books, computers, music, art materials, toys, games and other educational resources. This plays an important part in children‟s informal learning and the development of their interests, skills and experiences of the world around them. Children have the chance to do things that they may not be able to do with their families. This includes opportunities to become more independent, appropriate to their age, level of understanding and disability. As a result, they are becoming more confident

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Overall experiences and progress of children and young people: outstanding

in personal care, cooking, helping around the house, doing their washing, shopping and handling money. A parent said that her son: „enjoys going on the bus to the airport; he loves watching the planes. He also enjoys going to the fairground and seaside, and loves being out and about and being with other people. The activities are meeting his needs and he does things he can‟t do at home.‟ Inspection report children‟s home: SC037647 7 The staff promote children‟s physical health and emotional well-being exceptionally well. Children enjoy healthy and varied diets that meet their dietary needs, and have plenty of physical exercise. The staff have an excellent understanding of children‟s individual health needs and are suitably trained and competent to meet them. Staff are very knowledgeable about how to manage children‟s epilepsy and monitor children‟s oxygen saturation levels, and they take appropriate action when, for example, oxygen levels

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Overall experiences and progress of children and young people: outstanding

change. Staff work closely with parents and health professionals to ensure that children continue to receive the best possible health support and treatment during their stays. They also ensure that children receive suitable medical advice and treatment when they are worried about children‟s health or children are feeling poorly. The arrangements for dealing with medication are safe and effective. This means that children always receive the treatment that they require to promote their health and welfare. The staff have a detailed understanding of the medication procedures, the reasons why children take the medication and the possible adverse effects. The staff carefully check with parents and doctors that they have the correct information about children‟s medication at the start of each stay.

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

Children appear very happy and settled when they come to stay in this extremely safe and supportive environment. The daily routines and safeguarding arrangements protect children from harm and promote their emotional well-being. Children are comfortable coming here and spending time away from their families. Parents are confident about leaving their children, knowing that they receive a high quality of care and support. One parent said, „We trust the staff and feel he is safe here. The staff are supportive‟ and another said, „I am very happy with the care he gets. It takes a lot to trust other people, especially when your child has additional needs.‟

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

The staff have a comprehensive understanding of the risks to individual children‟s safety associated with their age, disabilities, level of understanding, communication and health conditions. They continually assess the risks to each child and take considered and reasonable precautions to make sure that children are protected. When assisting children with personal care, they follow safe care practices that respect children‟s privacy and dignity. The staff have changed the arrangements for children‟s stays and the level of staff support in order to address concerns around children‟s behaviour. This has helped to promote children‟s safety and to make sure that they continue to benefit from their stays. The staff team‟s effective management of risk is enabling children to explore new experiences and challenges, including being away from their family, trying new things and taking part in activities with other children in the community. This approach greatly

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

enhances the children‟s personal development, Staff are fully aware of the children‟s vulnerability to sexual exploitation, and use protective measures effectively to enable children to use social media and the internet safely. They provide children with the right level of supervision to enable children to take some risks as part of their development yet also ensure that children are protected and do not going missing. Members of staff come to know children and their families exceedingly well. This means that they have been able to alert other professionals to concerns about children‟s welfare Inspection report children‟s home: SC037647 8 and living conditions which may not have been otherwise recognised. For example, staff worked with social workers to support a child when his emotional health and well-being caused significant concerns. This led to joint training for staff and social workers around

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

mental health and disability. The registered manager and staff take prompt and decisive action when they are worried about children‟s health and well-being, and they have identified when families are struggling. They have developed a positive working relationship with social workers, schools, health services and a specialist behaviour support service to support families and reduce the risks to children‟s welfare. The registered manager and staff ensure that their concerns are taken seriously by making sure that senior social work managers are aware of the issues and that the local authority takes appropriate action. The existing positive relationships that the registered manager and staff have with families have helped parents to accept support when their children have been on a child protection plan. A social worker said that the staff „enabled better working relationships between the family and social workers, which was

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

previously difficult to achieve. This helped the ongoing work in regards to the child protection plan.‟

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

The registered manager and staff worked constructively with children, parents and professionals to overcome problems and to make positive decisions about children‟s care. They have worked together effectively to support parents to continue to look after their children at home safely, and therefore to reduce the risk of children not being able to live at home.

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

The registered manager and staff always report their concerns in line with the statutory guidance to make sure that children are protected. However, on two occasions the registered manager did not let Ofsted know his serious concerns about children and that they needed support from a child protection plan. This information enables Ofsted to monitor the effectiveness of the service and local authority‟s safeguarding arrangements.

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

Staff‟s ability to build warm and constructive relationships with children and to understand their individual needs enables them to support children to manage their feelings and promote positive behaviour. Staff are also increasingly working with the positive behaviour support service to use recognised research-based practice. This is providing staff with crucial insights into children‟s behaviour and how to help them to find constructive ways of communicating their feelings. Staff are enthusiastic about using this approach. Their use of well thought out and dynamic positive behaviour plans is helping children to feel safe and emotionally secure and reduce their levels of anxiety and frustration. For example, staff have helped a child to become more settled at night and not to try to go into other children‟s beds. In another case, staff are successfully using a countdown of „three, two, one‟ to help a child not to climb in unsuitable places.

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

Children are now managing situations calmly that previously caused them a great deal of anxiety and often resulted in negative behaviour. For one child, for example, a member of staff has worked closely with his parents and school to help him to make the transition from school at the end of the day less stressful for him. His mother said, „The support we have got from school and the staff working together with us has made a huge difference. Consistency has been the key.‟ The arrangements for his transition are Inspection report children‟s home: SC037647 9 carefully planned and managed sensitively by his staff and teacher. They provide him with the information about where he is going after school in ways that he can understand. They remind him during the day about what will happen, and show him photographs of where he is going, who will be taking him there and the vehicle that he will be travelling on. The home‟s staff and the school teacher manage his transition onto

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

the vehicle assertively and efficiently, and he leaves slightly earlier than other children to avoid being in a busy environment. The plan is helping to improve the child‟s outcomes. He is more settled in school and he is starting to widen his experiences. His mother said, „During his last few stays he has been going out to the park and shopping to buy DVDs – this is a huge change.‟

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

The staff‟s expertise and insight into children‟s needs and behaviour mean that occasions when children feel upset and show aggressive behaviour are extremely rare. Since the last inspection, staff have used restraint with a child on only one occasion. The registered manager and staff thoroughly evaluated this and took appropriate action to help the child to manage his feelings safely.

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

The home is able to meet children‟s physical needs safely. Great care is taken to make sure that it provides a comfortable and homely environment. Bedrooms and bathrooms have hoists and medical equipment. They are decorated to make them as pleasant as possible for children to use. Before each stay, the staff set up the bedrooms to reflect the character, interests and needs of individual children, including their favourite toys and pictures, so that they will have familiar things around them and feel at home. The home and the equipment used in it are well maintained to protect children from avoidable hazards. Staff use regular fire practice to ensure that children know what to do in case of a fire and that each child‟s evacuation plan is effective. Staff took action when a recent practice identified that a child with a hearing impairment appeared not to recognise the alarm .

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The effectiveness of leaders and managers: outstanding

The registered manager and the senior member of staff provide confident and inspirational leadership. Both of them are very experienced, knowledgeable and suitably qualified. They are very ambitious for disabled children who have complex health needs to enjoy their short breaks and to have every opportunity to achieve their full potential. This ethos is firmly embedded in the organisation of the service, and the values of the members of staff and their professional practice. Together, the managers and staff provide children with an extremely high quality of care that is having a significantly positive impact on children‟s lives.

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The effectiveness of leaders and managers: outstanding

Since the last inspection, the registered manager has taken on additional responsibilities as the manager of another children‟s home. Even so, the quality of leadership and management remains highly effective. The registered manager and the senior member of staff are a well-established and successful management team. Their working arrangements are cohesive and consistent. They communicate extremely well with each other and the staff team to make sure that everyone has the information that they need to support children and to plan and manage children‟s stays safely and successfully. Inspection report children‟s home: SC037647 10 The members of staff are highly motivated, passionate, experienced, knowledgeable and qualified. They receive excellent support, guidance and encouragement from their managers. Staff have regular opportunities through practice-related supervision and team meetings to reflect on children‟s progress and their own and the team‟s

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The effectiveness of leaders and managers: outstanding

performance, and to share and develop their skills and knowledge. The registered manager supports and encourages staff to develop expertise through providing quality training relevant to the needs of the children. For example, the staff have had training about different ways of communicating, safeguarding and the risks of sexual exploitation, online safety and the management of different children‟s health needs. Regular staff development days and meetings with behaviour analysts are providing additional opportunities for staff to develop their understanding, expertise and confidence in working with children.

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The effectiveness of leaders and managers: outstanding

The staff team has worked together for some time and provides children and their families with consistency and stability. Children come to know the people looking after them when they come to stay, and develop positive relationships with them. Importantly, the managers and members of staff build exceptionally strong relationships with children‟s parents and carers. Open communication between the members of staff and parents ensures that children have positive experiences and that parents are fully involved in the support that their children receive. A social worker said, „There is good staff consistency, and this offers a quality service and allows parents to build a good rapport, which enables trust and partnership working.‟

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The effectiveness of leaders and managers: outstanding

The registered manager and local authority use monitoring systems effectively to improve children‟s experiences and the quality of care that they receive. An independent person carries out a detailed monthly assessment of the service‟s effectiveness in promoting children‟s welfare and safety. The registered manager‟s thorough review of the quality of care clearly shows the service‟s strengths, measures children‟s progress and identifies priorities for developing the service further, including a focus on identifying and improving measurable outcomes and communication with children. The registered manager‟s evaluation of the effectiveness of the positive behaviour support service shows that it is achieving better outcomes for the children who are coming for short breaks. It is also helping staff to develop a better understanding of children‟s behaviour and ways of helping individual children. However, the registered manager‟s assessment

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The effectiveness of leaders and managers: outstanding

does not include children‟s views about their experiences and the support that they receive. Many of the children‟s communication needs and cognitive ability may present challenges to finding out their views, but they still need to be consulted in a meaningful way to understand their experiences and to inform the continued improvement of the quality of care that they have. Inspection report children‟s home: SC037647 11

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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 difference 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: SC037647 12

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Children’s home details

Registered provider address: Knowsley Metropolitan Borough Council, Children‟s Services, Huyton Municipal Buildings, 6th floor, Huyton, Knowsley, Merseyside L36 9YU

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Children’s home details

Registered manager: James De Turberville

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Inspector

Nick Veysey, social care inspector Inspection report children‟s home: SC037647 13 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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