Children's home run by Action for Children Services Ltd in Watford

Inspection report children‟s home: SC004429 1 SC004429 Registered provider: Action for Children

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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 care and accommodation for up to five children and young people. It is a short-break service for children and young people who have learning and/or physical disabilities. The home is operated and managed by an independent provider in partnership with the local authority.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children‟s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 14 February 2017

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requires improvement to be good

Overall judgement at last inspection: improved effectiveness

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: SC004429 2

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Key findings from this inspection

This children‟s home requires improvement to be good because:

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Key findings from this inspection

 The care planning framework is flawed because care plans have not been updated with essential information and do not set out clear guidance for staff to follow.  Behaviour plans and staff practice do not provide consistent boundaries or behaviour management strategies.  Communication processes do not fully support children and young people to access information.  The management team does not challenge poor practice by the placing authority and support agencies effectively.  Children‟s and young people‟s right to privacy is not consistently promoted.  Surveillance equipment is used without the consent of the placing authority, or consultation with children and young people.  The service is not fully staffed.  Staff do not consistently carry out day-to-day tasks as identified on staff handover records.  Staff training is not specific to the individual needs of the children and young people using the service.

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Key findings from this inspection

 Management monitoring does not identify shortfalls or promote consistent staff practice.

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Key findings from this inspection

 Staff are committed to children and young people and know them well.  Children, young people and parents are extremely positive about the care provided by staff and the progress made by children and young people.  Children and young people are looked after by an experienced core staff team.  Children and young people feel safe and well cared for due to the nurture and support provided by staff.  Well-organised routines ensure that children and young people have good support at bedtime and when they get up.  Effective transition planning means children and young people settle into their short-break routines and parents feel reassured.  The registered manager and staff are flexible in meeting the needs of children, young people and their families. Inspection report children‟s home: SC004429 3

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Inspection date Inspection type Inspection judgement

14/02/2017 Interim Improved effectiveness 28/11/2016 Full Outstanding 02/02/2016 Interim Sustained effectiveness 04/08/2015 Full Outstanding Inspection report children‟s home: SC004429 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

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child‟s placing authority effectively in the child‟s care, in accordance with the child‟s relevant plans

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Requirement Due date

if the registered person considers, or staff consider, a placing authority‟s or a relevant person‟s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child‟s needs are met in accordance with the child‟s relevant plans

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children‟s home is to provide care and accommodation. (Regulation 5(a)(c)(d)) 30/03/2018

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Requirement Due date

The children‟s views, wishes and feelings standard is that children receive care from staff who ensure that each child—

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Requirement Due date

is enabled to provide feedback to, and raise issues with, a relevant person about the support and services that the child receives

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Requirement Due date

has access to the home‟s children‟s guide, and the home‟s complaints procedure, when the child‟s placement in the home is agreed and throughout the child‟s stay in the home

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Requirement Due date

is given appropriate advocacy support. (Regulation 7(1) and (2)(b)(i)(ii)(ii)) 30/03/2018

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults. 30/03/2018 Inspection report children‟s home: SC004429 5 In particular, the standard requires the registered person to ensure that staff—

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Requirement Due date

meet each child‟s behavioural and emotional needs, as set out in the child‟s relevant plans

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Requirement Due date

help each child to develop socially aware behaviour

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Requirement Due date

encourage each child to take responsibility for the child‟s behaviour, in accordance with the child‟s age and understanding

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Requirement Due date

communicate to each child expectations about the child‟s behaviour and ensure that the child understands those expectations in accordance with the child‟s age and understanding

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Requirement Due date

help each child to understand, in a way that is appropriate according to the child‟s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful. (Regulation 11(1)(a)(b)(c) and (2)(i)(ii)(iii)(v)(vi)) 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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

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

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Requirement Due date

ensure that staff work as a team where appropriate

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Requirement Due date

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b) and (2)(a)(b)(f)(h)) 30/03/2018

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it. (Regulation 16(3)(a)) 30/03/2018 Inspection report children‟s home: SC004429 6 The registered person must ensure that the privacy of children is appropriately protected. (Regulation 21(a)) 30/03/2018

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Requirement Due date

The registered person must ensure that a disabled child accommodated in the home is provided with access to such aids and equipment as the child may require as a result of the child‟s disability in order to facilitate the child‟s communication with other persons. (Regulation 22(4)) 30/03/2018

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if 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 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. (Regulation 24(1)(a)(b)(c)) 30/03/2018

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Requirement Due date

The registered person must maintain records (“case records”) for each child which are kept up to date and are signed and dated by the author of each entry. (Regulation 36(1)(b)(c)) 30/03/2018

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Recommendations

 Keep all children‟s case records up to date. This is with particular regard to streamlining files and prioritising information in children and young people‟s short-break care plans. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.3)  Record information about the child in a way that will be helpful to the child. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.4)  The registered person should plan staffing levels to ensure that they meet the needs of children and can respond flexibly to unexpected events or opportunities. Staffing structures should promote continuity of care from the child‟s perspective. („Guide to the children‟s homes regulations including the quality standards‟, page 54, paragraph 10.15)

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improvement to be good

Children and young people clearly enjoy their short breaks and make progress. However, shortfalls in care planning and day-to-day care practice, and lack of effective monitoring by the registered manager, compromise children‟s and young people‟s overall experiences. Inspection report children‟s home: SC004429 7 Children‟s and young people‟s rights are not fully promoted in the home. Information about how to complain is not prominently displayed. On arrival at the home children and young people receive a young people‟s guide, which contains information in symbol form about being happy and sad. This guide also includes a written list of contact agencies, but most children and young people would not be able to understand this information. There is no evidence that information about children‟s and young people‟s right to complain is accessible for children and young people who have learning disabilities.

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improvement to be good

Crucial information about the role of the independent visitor is also poorly displayed and in a format that most children and young people would not be able to understand. The photocopied letter from, and photos of, the visitors are on display, but they are small, black and white, and are not accessible to children and young people. This shortfall is repeated with information about staff working in the home. There are sixteen photographs of staff randomly displayed, and the font used to write staff‟s names is small and difficult to read. It is not clear to children and young people when staff are working, or which staff will be supporting them during their stay. Information is not accessible to children and young people who have visual impairments.

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improvement to be good

Children and young people make good progress. They become more confident and make friends while visiting for their short breaks. Children and young people are able to choose and enjoy a range of activities. They and their parents are extremely pleased because going out on trips gives children and young people new opportunities and new- found confidence. Children and young people have enjoyed exciting trips to parks, farms and science and space centres. Going out to eat has become a firm favourite with children and young people. This helps their social and independence skills and gives them opportunities that parents and carers are not always able to provide in the family setting.

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improvement to be good

Bedtime routines are clear, and help children and young people to settle. Children and young people often sleep better during their stays than when at home. Children and young people who have attention deficit hyperactivity disorder respond well because the physical environment provides a safe space for children and young people to expend their energy. Their behaviours are safely managed as a result of effective staffing levels and activities that help to manage children‟s and young people‟s anxieties and subsequent behaviours.

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improvement to be good

Children and young people also improve their independence skills. They improve their self-care skills; for example, some children and young people now tolerate having their hair washed and accept guidance with brushing their teeth. Children and young people‟s diets improve, as well as their tolerance of different foods, due to encouragement from staff. Staff have good insight into children‟s and young people‟s likes and dislikes, and promote good choices.

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improvement to be good

Children and young people enjoy each other‟s company and there are no concerns about bullying. Good assessment of group admissions to the service ensure that children and young people are suitably matched. The management and the staff team are flexible and will change booking dates and group arrangements should concerns arise. Inspection report children‟s home: SC004429 8 Children and young people stay in a comfortable and well-maintained environment. They like their personalised bedrooms. The sensory room is well equipped and provides space for children and young people to relax and meet their sensory needs. The home has been recently extended to provide additional space, and this will give children and young people a choice of rooms and play opportunities.

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improvement to be good

Records do not help staff to understand or meet the needs of children. For example, healthcare plans are not updated with essential and significant medical conditions or details of medication. Outdated photographs on files do not facilitate accurate identification of children and young people who are using the service.

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improvement to be good

There is a lack of clarity about behaviour management plans, with two formats in place. Information is basic, with little detail about how the individuality of children and young people informs behaviour management strategies. Boundaries and agreed strategies are not consistently implemented by staff. This causes confusion, and impacts on other children and young people. For example, one young person was inconsistently reminded not to take food from other individuals‟ plates, and this made another young person anxious.

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improvement to be good

Good practice was observed by the inspectors when staff kept another young person occupied, listening to music, enjoying a snack and interacting well with staff on her return from school. However, the previous day this same young person was placed in front of the television and was very preoccupied. This reduced her interaction with others, and conflicts with the wishes of her parents.

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improvement to be good

Children and young people do not receive focused support about how to keep themselves safe. For example, there is little evidence of work with children and young people about the dangers that strangers may pose. Staff do not have specialist training to meet the needs of some young people. For example, staff have not received training about how to support a young person who has a visual impairment, and there are no adaptations in the home to meet his needs.

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improvement to be good

Essential care-planning documents, including risk and behaviour management plans, are difficult to locate due to the size and organisation of children and young people‟s files. Live documents are stored with archived records and are not at hand to provide staff with easy access to essential information.

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improvement to be good

Styles of recording and the lack of use of symbols in children‟s and young people‟s files gives little meaning to children and young people about their looked after journey, experiences and achievement.

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improvement to be good

Children‟s and young people‟s scope to explore their potential is compromised due to a lack of child-centred and bespoke communication programmes and consistent use of Inspection report children‟s home: SC004429 9 symbols and visual referencing. While the registered manager states that each child and young person has a care and communication passport displayed on the back of their bedroom doors, these were not evident during this inspection and could not be located in care plans. Information relating to a child who had since left the short-break service was displayed in a room now occupied by a new child.

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improvement to be good

Door alarms are fitted to all bedroom doors. Some placing authorities, parents, children and young people have not consented to these measures.

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improvement to be good

Children and young people are kept safe by staff who keep up to date with regular training in safeguarding. There are no current safeguarding or child protection concerns at the service. The registered manager works with families and social workers to provide support when child protection concerns arise.

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improvement to be good

There are no concerns about children and young people going missing. Staff supervision levels are high, risks are clearly identified and partnership working with police promotes good safeguarding strategies for children and young people.

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improvement to be good

There are no concerns about children‟s and young people‟s exposure to the risk of radicalisation or child sexual exploitation, and relevant training provides staff with guidance should such concerns arise.

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improvement to be good

Children‟s and young people‟s self-injurious behaviours are identified, and care planning provides staff with guidance about protective equipment and diversion tactics to keep children and young people safe.

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improvement to be good

Children and young people are protected from, and made aware of, the risks of using the internet. Security settings, parental consent, signage in symbol form, and close supervision of children and young people promote children‟s and young people‟s safety when using the home‟s computer.

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improvement to be good

Incidents of physical intervention are rare. Staff use a range of distraction techniques and only use physical intervention as a last resort to guide children and young people to safety. Records are detailed, with good managerial oversight in order to monitor staff practice.

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

The management team does not challenge poor practice by the placing authority, or the lack of service from supporting agencies such as child and adolescent mental health agencies. For example, the registered manager has failed to challenge a lack of up-to- date placement plans, a social worker‟s non-attendance at a review meeting and the withdrawal of essential support for children‟s and young people‟s mental health and behaviour. The registered manager and staff do not provide advice or support to children, young people or families about how to access independent advocacy.

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

Management monitoring has failed to pick up some shortfalls, including misleading Inspection report children‟s home: SC004429 10 information in children‟s and young people‟s care plans.

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

Parents and social workers do not have accurate information about the home because the home‟s statement of purpose is not up to date. Changes in staffing arrangements and the use of door alarms on children‟s and young people‟s bedroom doors are not included.

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

Supporting children‟s and young people‟s transitions is a key strength of this service. Children and young people receive bespoke support as they assimilate into the short- break setting. Parents are reassured about their children‟s care due to close partnership working between parents and the staff team. However, the registered manager has failed to utilise some opportunities for consultation. For example, parents who currently access the service have not been asked about what information new parents and carers may find useful.

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

Children and young people are looked after by a core team of experienced staff. While the registered manager and the provider endeavour to recruit new staff, there has been little success in recruiting and retaining new staff, particularly staff who are able to work at night. Existing staff cover some additional shifts, reducing the impact on children and young people.

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

The registered manager has managed this home since December 2014. She has extensive experience and has a level 5 qualification in management.

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

Staff training in some areas is well organised. Staff receive good inductions and all staff are supported with regularly refreshed core training and supervision. Training and liaison with health agencies means staff are well equipped to meet the sometimes complex medical needs of young people. However, a lack of staff training in caring for children and young people with visual impairments limits staff‟s understanding of how best to support one young person.

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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 Inspection report children‟s home: SC004429 11 children‟s homes regulations including the quality standards‟. Inspection report children‟s home: SC004429 12

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Children’s home details

Registered provider: Action for Children

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Children’s home details

Registered provider address: 3 The Boulevard, Ascot Road, Watford WD18 8AG

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Children’s home details

Responsible individual: Michael O‟Sullivan

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Inspectors

Elaine Cray, social care inspector Annemarie Parker, social care inspector Inspection report children‟s home: SC004429 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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Inspectors

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Inspectors

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Inspectors

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