Children's Home run by Footsteps Care Limited in Waltham Forest

Inspection report children’s home: SC481293 1 SC481293 Registered provider: Footsteps Care Limited Interim inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately owned home provides care and accommodation for up to eight children and young people who have a learning disability. Some children and young people also have physical impairments and significant health needs.

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Information about this children’s home

Enforcement action since last inspection: none

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and young people since the most recent full inspection

This home was judged good at the last full inspection. At this interim inspection, Ofsted judges that it has sustained effectiveness.

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and young people since the most recent full inspection

The young people who have left the home since the previous inspection have done so in a positive and planned way. Three young people successfully moved on to live with foster families, and another young person moved on to a more appropriate long-term placement where he can remain into adulthood.

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and young people since the most recent full inspection

The young people currently living in the home are making good progress in all areas. A placing social worker commented that the home ‘is the best place for this child, they know her well and have helped her through some difficult times’. She described the staff team as being resilient and felt that the young person is now much more stable because staff stuck with her and provided clear structure and support.

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and young people since the most recent full inspection

All young people are engaged in education and have good school attendance. One young person commented that she now attends school more and is much happier Inspection report children’s home: SC481293 2 because staff provide transport and go with her to school. Staff liaise closely with schools to make sure that any worries or concerns are addressed, by providing consistent support both at home and at school.

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and young people since the most recent full inspection

All of the young people who were able to comment said that they were happy living in the home. They said that staff were ‘nice’ and that they felt safe in the home. The living accommodation is well maintained and generally homely, though one young person mentioned that she felt that the living room could be ‘more homely’. Two young people particularly liked their bedrooms, and they personalise their rooms with family photos, artwork, games and toys. The young people take part in a range of activities, both at home and in the local community. One young person commented that they really enjoyed the activities, particularly swimming and bowling trips.

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and young people since the most recent full inspection

Staff interact positively with the young people, and they demonstrate genuine warmth and affection. This helps young people feel safe and feel cared for. There are high staffing levels and most young people have one-to-one support at all times. Staff plan each shift well to ensure that young people receive close attention from staff who know them well and who are best placed to meet their needs.

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and young people since the most recent full inspection

The manager is visible within the service and has effective systems in place to monitor the quality of care. He ensures that staff have the support and training they need to meet the needs of the young people. Several of the young people living in the home have complex health needs, and staff provide a range of health interventions such as gastro feeding and administering oxygen. These interventions are delivered in line with protocols designed by healthcare professionals. Staff undertake training to ensure that they can deliver safe healthcare. Practice would be further enhanced by introducing competency assessments by qualified healthcare staff. This would provide an extra level of scrutiny to ensure that staff are delivering healthcare in line with agreed protocols.

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and young people since the most recent full inspection

The registered manager has taken action to address the shortfalls identified at the previous inspection. As a result, the home’s statement of purpose now reflects the range of needs provided for and staff have completed the necessary training to support young people who have complex health needs. Despite these improvements, there were a number of areas for improvement identified during this inspection.

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and young people since the most recent full inspection

For one young person, the home’s child-focused care plan clearly identified his cultural needs but had misleading information in respect of the young person’s capacity to communicate. In practice, the staff know the young person well and there was no significant impact on his care. For another young person, recently admitted to the home, a risk factor in relation to a potential choking hazard was not clearly identified in his risk assessment or fully understood by staff. Due to the one-to-one support and supervision provided, this oversight did not expose him to any significant risk. However, this does point to a need for the provider to be more effective at communicating potential hazards as soon as they are known.

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and young people since the most recent full inspection

Staff provide clear structure, close supervision and use a range of positive strategies to help reduce challenging behaviour. This means that young people become more settled Inspection report children’s home: SC481293 3 and learn to improve their behaviour. Staff record behaviour incidents and liaise closely with social workers and parents to keep them informed about concerns. Some incident records describe a level of physical contact with young people to help manage challenging behaviour. This is often described as ‘guiding’. The home’s policy and training in relation to physical intervention is not clear as to exactly what constitutes a ‘physical intervention’. This runs the risk that a physical intervention could be used but not regarded or recorded as such by staff.

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and young people since the most recent full inspection

The registered manager works effectively in partnership with the relevant agencies in response to safeguarding concerns and complaints. The provider has recently set up a number of forums consisting of key professionals across the organisation. This provides an extra level of scrutiny and independence. This means that concerns can be investigated by experienced professionals who are not directly involved in the running of the home.

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Inspection date Inspection type Inspection judgement

04/07/2017 Full Good 16/03/2017 Interim Sustained effectiveness 01/11/2016 Full Requires improvement 24/03/2016 Interim Sustained effectiveness

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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

12. (1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— 01/02/2018 Inspection report children’s home: SC481293 4 (i) assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child.

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Requirement Due date

In particular, the home must ensure that any identified risks for young people referred to the service are included in a written risk assessment and shared with staff. This should be done prior to or, in the event of emergency placements, at the point of admission.

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Recommendations

 The registered person is responsible for ensuring that all their staff have been adequately trained in the principles of restraint and any restraint techniques appropriate to the needs of the children the home is set up to care for as defined in the home’s Statement of Purpose. In particular, the provider should update the home’s physical intervention policy to clearly define what constitutes a physical intervention. Staff training should explore the legal frameworks and practice to ensure that they clearly record and describe their actions when, for example, young people are ‘guided away’ to manage behaviour. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.57)  A child’s care plan must form the basis of their care, any care plan must be relevant to the individual child. In particular, the home’s ‘all about me’ support plans must contain information that is accurate and relevant to the child. This

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Recommendations

must be a live document, informing staff how best to provide care and protection for that child. (‘Guide to the children’s homes regulations including the quality standards’, pages 55–56, paragraph 11.1)  When delegating any aspect of care the NMC states that each child should be clinically assessed and the most appropriate person appointed to deliver any subsequent care. If this is a health care support worker then the registered nurse delegating the care should ensure they are competent to undertake the task being requested of them. Given the complex health needs of some young people living in the home, the provider should actively seek input from health professionals to not only provide training but to assess that staff are competent to carry out delegated health interventions. This should relate to the care provided to individual children as part of their health care plan. (CQC and Ofsted guidance: Registration of healthcare at children’s homes, Annex 4, page 19) This

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Recommendations

guidance can be accessed in the ‘Guide to the children’s homes regulations including the quality standards’, page 19, paragraph 3.33. Inspection report children’s home: SC481293 5

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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

This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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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’.

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Children’s home details

Registered provider: Footsteps Care Limited

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Children’s home details

Registered provider address: 8 James Martin Close, Denham, Uxbridge, Middlesex UB9 5NN

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Children’s home details

Responsible individual: Anslim Narinesingh

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Inspector

Lee Kirwin, social care inspector Inspection report children’s home: SC481293 6 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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