Children's home run by Middlesbrough Borough Council

Inspection report children’s home: SC033840 1 SC033840 Registered provider: Middlesbrough Borough Council

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This local authority short-break service is registered to provide care and accommodation for up to nine children or young people who have learning and/or physical disabilities.

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Information about this children’s home

Inspection dates: 20 to 21 February 2018

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected outstanding

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Date of last inspection: 16 February 2017

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outstanding

Overall judgement at last inspection: improved effectiveness

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outstanding

Enforcement action since last inspection: none

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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

 The manager and the staff provide highly structured and individualised care to the children and young people accessing the short-break service. Inspection report children’s home: SC033840 2  The vulnerabilities, complex health needs and disabilities of the children and young people are clearly known and understood. This informs the delivery of high-quality care, with their needs being well met by the manager and staff team.  The staff team is well-established, stable and very experienced. Children and young people accessing the service have effectively grown up in the care of the same staff team, adding to their sense of belonging and home-from-home experience.  Parents and carers have absolute confidence in the quality of care provided by the manager and staff. Transitions in and out of the home are well-planned and undertaken sensitively. Parents are reassured and feel included in the care- planning process.

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Key findings from this inspection

 Children and young people are provided with a wealth of opportunities to have positive experiences both in the home and through community activities. Peer relationships are nurtured and promoted due to the careful matching process that takes place.  Consultation and the participation of the children, young people and their families in all aspects of their care are key strengths of the home. Giving the children and young people choices, while valuing the importance of routines and consistency of care, has ensured that children and young people are protected and their well-being is given priority.  Staff are exposed to a range of training opportunities that consolidates their learning and underpins their ability to meet the complex health needs of the children and young people. Regular communication and liaison with health professionals ensures that staff are equipped to administer medication and attend to the individual health conditions and feeding processes.

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Key findings from this inspection

 The manager has a wealth of experience and knowledge, and has managed the home for a number of years. She knows the children, young people, their families and the staff team exceptionally well. She remains highly motivated in what she describes as an ever-changing and evolving service.

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Inspection date Inspection type Inspection judgement

16/02/2017 Interim Improved effectiveness 23/08/2016 Full Outstanding 09/03/2016 Interim Improved effectiveness 03/11/2015 Full Outstanding Inspection report children’s home: SC033840 3

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Overall experiences and progress of children and young people: outstanding

The children and young people who receive short-break care do so from a well- established, highly motivated and committed staff team. The children and young people receive consistency of care and have effectively ‘grown up’ with the same staff team. For many, this spans a number of years. Trusting and secure relationships have been developed and the diverse and complex health, disability and learning needs of the children and young people are well understood and clearly met. The children and young people have a warm and welcoming experience during their stay and unequivocally experience a sense of belonging. A parent commented: ‘Staff are brilliant. All of my son’s personal care needs are being met, and their link worker has even come to my home to help me establish routines.’ This confidence in the staff team reassures parents and carers, knowing that the staff invest time with their children in all aspects of their care.

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Overall experiences and progress of children and young people: outstanding

Since the last inspection, the home has experienced a number of children and young people transitioning from the home into adult services. Evidence of forward planning and a well-documented multi-disciplinary approach has seen young people experiencing a smooth transition. Individual fears and anxieties are assessed and managed well. For many young people, they leave having acquired some independence and life skills commensurate with their level of learning disability. A social worker said: ‘For [Name], she just didn’t want to leave. However, she was well supported in her transition to adult services. It was like a second home, as it is for many of the children and young people. It is a friendly and warm environment and she made so much progress. [Name] still keeps in touch and has made many friends.’

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Overall experiences and progress of children and young people: outstanding

A key strength of the home is the involvement of the children and young people in making choices about what they want to do. The children and young people were consulted when monies were donated to the home, and they chose to purchase iPads, an Xbox and portable televisions for their bedrooms. The home is well equipped with a sensory room and a ‘rumpus room’, which has computers, games, books, toys and an abundance of craft activities. Regular trips out on the minibus have enabled children to enjoy sporting activities such as badminton, rock-climbing and cycling, and day trips to the seaside. The fortnightly ‘out and about’ club has seen the children and young people helping out at a fun run and visiting the local fire station. These activities help to promote social inclusion and give the children and young people opportunities to develop and maintain friendships in safe environments.

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Overall experiences and progress of children and young people: outstanding

Parents, family members and children and young people past and present are all welcome at the home. The forthcoming annual achievements award ceremony is just one example of everyone getting together to celebrate success, progress and achievements, however small they might be. The feedback from parents and professionals cannot fault the home in any way, with comments such as:

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Overall experiences and progress of children and young people: outstanding

 ‘Excellent service, where I know [Name] is safe and very well looked after.’ Inspection report children’s home: SC033840 4  ‘[Name] loves his short break. It’s his second home.’  ‘The staff set clear and achievable outcomes for the young people they work with, and work with other agencies to provide consistency in their approach in promoting these.’

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Overall experiences and progress of children and young people: outstanding

The home environment is particularly welcoming and cheerful, and is decorated with murals, pictures and memorabilia that remind the children and young people of their fun times and special memories. Photographic displays such as the ‘Sea of Success’ record all of the children and young people’s achievements, however small they might be. Parents are encouraged to bring some home comforts to keep at the home such as their child’s favourite duvet cover, game or cuddly toy. One child’s furniture is arranged to replicate their bedroom at home and staff follow a similar bedtime routine, which has significantly reduced heightened anxieties and disruptive behaviours. The child said, ‘I have a bed and a wardrobe that is special to me and it keeps me safe.’

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

Each child and young person has an individualised healthcare plan that ensures that the staff are fully appraised with their complex health and medical needs in the administration of safe and consistent care. Staff are fully trained in a range of medical procedures. Updates in relation to prescriptions, diet and physical and emotional welfare are meticulously recorded. Controlled medication is stored securely and the disposal of medicine and medical equipment is done safely. The recording and administration of medicines is exemplary and free from errors. Healthcare professionals are regular visitors to the home and offer on-site training and advice in the administration and management of medical conditions such as epilepsy, diabetes and gastronomy feeding techniques. A member of staff said: ‘We have so many opportunities to learn different ways of engaging with the kids. A speech and language therapist recently came to give training

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

on how to introduce different foods.’ For one young person, he has gone from only drinking protein shakes to eating a healthy, well-balanced diet.

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

The manager acknowledges the additional vulnerabilities faced by the children and young people in her care, and uses innovative and creative ways of helping them to understand the risks associated with child sexual exploitation and radicalisation. Residents’ meetings have covered a range of safeguarding issues such as bullying and fire and internet safety. The recent session on child sexual exploitation was based on the television game show ‘Who Wants to be a Millionaire?’ One young person said: ‘It was fun, just like a quiz, but I am better at knowing what is right or wrong.’

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

A number of the children and young people accessing the service are non-verbal. Due care and effective planning ensures that staff ratios and skills exactly match the needs of each child and young person during their stay. Staff know the children and young people very well, and the relationships that children and young people have established with their link worker have ensured that staff are responsive to their individual communication styles. Staff are immediately able to respond to non-verbal cues and gestures, and constant familiarity and trust has seen many children and young people make sustained progress. Accidents very rarely happen, and there has been no need for Inspection report children’s home: SC033840 5 physical intervention. Daily recording activities and shift-handover discussions advise on any welfare concerns. This high level of detail guarantees that children and young people continue to receive well-informed and high-quality safe care.

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

The physical environment is safe and secure, with all statutory fire, health and safety checks and certificates in order. Each child and young person has an individual personal evacuation plan that is known and signed by each member of staff. Measures are in place that protect the children and young people from harm. Risks and vulnerabilities are clearly understood, and the staff are adept at anticipating predictable behaviours and implementing techniques that have avoided any form of physical restraint.

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

Protective measures are in place to ensure that the children and young people are safeguarded effectively, both in the environment of the home and in the community. The impact on behaviour pertaining to each child and young person’s level of learning need and/or disability is assessed and managed by an experienced and well-trained staff team. Staff supervise and support the care and activities of the children and young people exceptionally well, enabling them to enjoy and participate in a range of activities and experiences. Staffing levels and additional bespoke risk assessments increase the children and young people’s safety in the community, enabling them to participate and enjoy a diverse range of activities.

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The effectiveness of leaders and managers: outstanding

The registered manager is suitably qualified and highly respected, and has extensive experience spanning a number of years working in residential care. She leads a highly motivated and committed staff team. Parents have absolute confidence in her management of the home and the high standards of care she aspires to. Parents describe her as ‘accessible’, ‘caring’, and ‘reassuring’, and being very clear about her responsibilities towards the children and young people in her care.

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The effectiveness of leaders and managers: outstanding

The manager and staff go above and beyond in delivering a service that is both holistic and inclusive. During a conversation, the manager said: ‘We look at the bigger picture. We don’t just provide respite care for children. We have resources to work with parents in their own home, and we support parents at hospital appointments or give parents a break when their child is in hospital.’ Equally, the manager and her staff team have developed effective and meaningful relationships with partner agencies, schools and professionals involved with the children and young people. The manager’s passion and determination is inspirational, having a significant impact on the staff, children and young people in her care. A social worker said: ‘A fantastic placement for [Name] and his family. I can’t fault it at all. Good communication with staff. They always contact if there are any issues.’

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The effectiveness of leaders and managers: outstanding

The longevity of the staff team is testament to how well they feel supported. The delivery of regular supervision, training and annual appraisals ensures that staff remain skilled to fulfil their roles. Staff say that training is ‘exceptional and varied’. All staff hold the NVQ level 3 in health and social care as a minimum. The manager keeps a matrix of training completed by all the staff, and all mandatory training is refreshed regularly in Inspection report children’s home: SC033840 6 line with guidance.

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The effectiveness of leaders and managers: outstanding

The manager actively sources additional staff training to complement staff’s existing skills. Staff have received specialised training in the use of visual aids, autistic spectrum disorder and restorative practices. During discussion with staff, one member of staff said: ‘[Name] is definitely a strength of the home. Basically, whatever the home needs to develop or progress on she addresses this. She is all for the children. She is a manager you can trust. Children pick up on the fact that we [staff] are happy and relaxed, and parents pick up on this ethos too.’

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The effectiveness of leaders and managers: outstanding

Robust monitoring and auditing processes are in place. This underpins the delivery of high-quality care. Questionnaires completed by the children and young people, parents and professionals are used to scrutinise the quality of care and to develop the service in what the manager describes as ‘an ever-evolving service, a service we cannot get complacent with.’ Survey reports, feedback from stakeholders and the external independent visitor are given high priority in evaluating the service provision, and contribute to the safety and well-being of the children and young people.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people whom it is trying to help, protect and look after.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC033840 7

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Children’s home details

Registered provider: Middlesbrough Borough Council

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Children’s home details

Registered provider address: PO Box 99, Middlesbrough TS1 2QQ

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Inspector

Cath Sikakana, social care inspector Inspection report children’s home: SC033840 8 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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