Children's home run by CareTech Community Services Limited in Hertsmere

Inspection report children’s home: SC376211 1 SC376211 Registered provider: CareTech Community Services Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is registered to provide care and accommodation for six children who have learning disabilities. The home forms part of a large social care company.

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Information about this children’s home

Inspection dates: 15 to 16 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 good

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outstanding

The effectiveness of leaders and managers good

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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: 28 February 2017

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outstanding

Overall judgement at last inspection: sustained 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

 Children have excellent experiences that they thoroughly enjoy. Inspection report children’s home: SC376211 2  Children develop strong bonds with staff and the other children who they live with.  Staff respond well to safeguarding concerns when they arise, and this protects children from abuse and harm.  Staff work diligently to support children to overcome difficulties. As a result, children make huge improvements in managing their own behaviour .  Highly effective working relationships with parents, social workers and other external agencies support children’s progress.  Partner agencies and parents hold the service in high regard. They recognise the positive difference the service has made to their children’s and their families’ lives.  Children make significant progress based on their starting points.  The manager and staff work exceptionally well with teachers to ensure that all children continue to achieve the best that they can at school.

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Key findings from this inspection

 The home is maintained to an exceptionally high standard.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 The manager does not undertake debriefs with staff and children following incidents of physical intervention.  Staff duty rosters do not always accurately show the actual hours that agency staff work.  Not all staff receive an annual appraisal.  Staff have not received training to provide supervised contact.

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Inspection date Inspection type Inspection judgement

28/02/2017 Interim Sustained effectiveness 12/10/2016 Full Good 15/03/2016 Interim Sustained effectiveness 05/01/2016 Full Good Inspection report children’s home: SC376211 3

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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Requirement Due date

The registered person must ensure that within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so ("the authorised person") has spoken to the user about the measure and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35(3)(b)(i)(c)) 16/04/2018

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Requirement Due date

Ensure that the registered person maintains in the home the records in Schedule 4 and ensure that the records are kept up to date. (Regulation 37(2)(a)(b) Schedule 4(3)) In particular, this refers to a copy of the staff duty roster of persons working at the home, and a record of the actual rosters worked. 16/04/2018

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Recommendations

 Ensure that staff are suitably trained to meet the assessed needs of all children in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 51, paragraph 10.1) Specifically, this is in relation to supervising contact.  Ensure that all staff have their performance and fitness to carry out their role formally appraised at least once annually. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.5)

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Overall experiences and progress of children and young people: outstanding

Children love living at the home. They make friends quickly and form strong bonds with staff and the other children they live with. These friendships help the children to develop their social skills. For example, children who would not usually tolerate others in their space are now showing excellent improvement in this regard. They want to spend time with the other children and they manage this well. For children who have specialist Inspection report children’s home: SC376211 4 needs, this is a remarkable example of improvement.

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Overall experiences and progress of children and young people: outstanding

Staff build excellent relationships with children because they spend valuable time getting to know them. They observe behaviour, take note of children’s previous history and implement consistent boundaries. As a result, children who find it hard to establish trust, or become socially engaged, begin to develop skills that help them to feel a part of the home and the community. This significantly promotes children’s emotional well-being.

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Overall experiences and progress of children and young people: outstanding

The improvement children make is remarkable. For example, a child who arrived at the home without a good range of vocabulary is now enjoying conversations with other people. This has improved his social experiences. A staff member said, ‘He used to say the odd word. He can now have a conversation with more words and description.’ This progress has been supported by dedicated staff who have spent time with him and encouraged him with verbal prompts to talk to staff. The member of staff said, ‘School used PECS [Picture Exchange Communication System] cards but he does not need them in the home as his speech has improved so much.’ This example of progress is testament to the excellent quality of care children receive from skilled and knowledgeable staff.

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Overall experiences and progress of children and young people: outstanding

Staff ensure that all children attend school on a regular basis. The staff help and encourage the children to get up and prepare for school and have a positive start to their day. The manager and staff work exceptionally well with education professionals to ensure that all children continue to achieve the best they can from their learning environment. Staff are always on hand to offer support in class or support with school transport. When children experience difficulties, the staff work in partnership with others to look at ways to improve their educational outcomes. For example, the staff listened to a child who did not like his school and was really struggling with his attendance and behaviour. The staff worked together with other professionals and a new school was identified. The child’s attendance and behaviour has now improved. Furthermore, this shows that the staff listen to children and act on what they tell them. This helps the

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Overall experiences and progress of children and young people: outstanding

children to feel valued and contributes to trusting relationships between children and staff.

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Overall experiences and progress of children and young people: outstanding

Children benefit from keeping in touch with their families and people who are important to them. Staff are extremely good at facilitating contact if it takes place in or out of the home. They go to special lengths to collect parents and/or siblings so that children can maintain relationships with their families. The staff welcome visitors and there is ample space within the home to ensure that children can enjoy privacy when spending time with their families. Alongside this, they offer support by supervising contact when this is necessary and part of the child’s care plan. The children’s social workers receive reports from the staff to keep them informed about how well contact sessions are progressing. However, the staff would benefit from training to support them to improve their report writing skills.

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Overall experiences and progress of children and young people: outstanding

Children’s health improves because of the support that they receive from staff. For example, one child has lost weight, is more active and is fitter and healthier as a result. Staff worked with the child and his parents to achieve this excellent outcome. Inspection report children’s home: SC376211 5 The staff are rigorous in ensuring that children’s complex health needs are met. They are clear about how to meet the health needs of children, due to the support and training they receive from health professionals. This is further helped by good partnership work with parents and general practitioners. For example, staff follow specialist advice from health professionals about how to fit orthotics, use Epi-pens to administer emergency medication, and assist with children’s specific moving and handling needs. This helps to improve and develop the children’s health and well-being.

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Overall experiences and progress of children and young people: outstanding

Children have excellent opportunities. The staff ensure that all children have access to activities and positive experiences at the home and in the community. They enable children to access a wide range of enjoyable activities that give them positive social experiences, regardless of their disability. A parent said, ‘We are happy he is having access to the community; he loves to go out. We have seen lots of improvement. The home is fantastic.’

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Overall experiences and progress of children and young people: outstanding

Parents, staff and social workers speak highly of the manager and her team. They recognise the hard work and effort that goes into providing outstanding care for their children. A parent said, ‘The home provides very good care. It replicates wonderful family life. In six months you can see how happy he is has become, he has thrived. They meet his sensory needs, his bedroom is equipped with sensory items that are kept in line with his teenage years. They have given me my life back.’

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Overall experiences and progress of children and young people: outstanding

Since the last full inspection in October 2016, two young people have successfully transitioned to adult services and two children have moved into the home in an emergency. Staff ensure that children move into and out of the home in a sensitive manner. When emergency placements are made, staff ensure that the child is made to feel welcome on their arrival. As a result, children settle in extremely well.

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Overall experiences and progress of children and young people: outstanding

Children share their views during monthly meetings and regular key-work sessions. A variety of topics are discussed by using each child’s preferred communication style. One parent commented about how effective the use of a whiteboard is in helping her child to communicate and said, ‘Staff are brilliant; they have responded to requests to use a whiteboard. This has improved the messaging system.’

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

Investigations into allegations are managed efficiently and effectively. The excellent and prompt response from staff safeguards children who are at risk of harm. Staff receive effective training and clearly understand their role and responsibility in protecting children. They do not hesitate to protect children when they are at risk of harm. For example, the staff know the whistleblowing policy and have used this when necessary, to raise concerns about a staff member’s practice. A parent said, ‘I have no concerns. [Staff] were exemplary and exceptional in using the whistleblowing procedure when there were concerns.’ Children trust the staff and this helps the children to feel safe. Staff go the extra mile to understand the intricacies of children’s complex needs, Inspection report children’s home: SC376211 6 understand children’s histories and are sensitive to their disabilities. By taking these factors into account they are able to provide extremely safe care.

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

Children are safe in the home, and much of the staff’s practice is outstanding. High staffing levels ensure that children are protected from harm at all times. Staff manage risk well. Robust risk assessments ensure that staff know and understand how to provide the best level of care without hindering children’s social experiences. For example, staff worked exceptionally well with a child to keep him safe in the home’s vehicle while travelling. The child would remove his seat belt while travelling, placing himself at risk of harm. Staff explored and tried many ways to keep him safe. As a result, a product was purchased that made it more difficult for the seat belt to be undone. This means that the child is now able to travel safely and enjoy positive social activities within the community.

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

Children make huge improvements in managing their behaviour because staff are sensitive, innovative and skilled in recognising and responding to their needs. For example, a child’s obsessive behaviour affected his ability to enjoy social activities. Staff worked sensitively and persistently with the child to help him to overcome his difficulties. This hard work paid off and the child has learned to regulate and manage his behaviour in a way that enables him to participate fully in activities that he enjoys.

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

Staff implement consistent boundaries and look for other ways to reduce negative behaviour. A social worker said, ‘[Name of child] is a very complex boy. Since his placement began he is doing really well. The behaviour strategies are working. You can see the difference in him. The difference is massive.’

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

The staff ensure that children’s medication is reviewed, when necessary. For one child this has led to a reduction in the amount of medication he needs to take. This has resulted in a marked improvement in his behaviour. As a result, the need to use physical intervention to keep him safe has significantly reduced, and there have been no incidents since October 2017.

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

Staff sometimes need to use physical intervention to keep children safe from harm. Following incidents of restraint, the manager does not always carry out debriefs with children and staff involved. This makes it difficult to assess how effective the restraint was and whether different strategies can be used to prevent future situations from escalating.

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

The home is maintained to an exceptionally high standard. The manager ensures that all health and safety arrangements are managed well. Equipment used for hoisting, bathing, moving and handling is serviced regularly. This keeps the home safe and free from hazards. Children take part in routine fire drills and have personal evacuation plans in place to help them exit the building safely in the event of a fire.

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

Children do not go missing from the home, but the staff are proactive in working with the police to ensure that they are fully aware of the needs of the children should they go missing. For example, staff have robust missing from home profiles that are shared with Inspection report children’s home: SC376211 7 the police. The police know about the complex needs of each child living at the home and their vulnerabilities.

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

Children live in harmony with each other. Bullying does not occur, and relationships are appropriate, respectful and trusting. There is a strong sense of belonging in the home that makes children feel safe and protected.

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

The manager safely recruits staff to work at the home. The vetting process is thorough and makes sure that all required checks are undertaken before people begin employment. This prevents unsuitable people from having access to the children.

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

Staff ensure that each child receives a children’s guide to the home that explains how they can make a complaint and how to access advocacy services. The manager has not received any complaints about the home since the last inspection.

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

Staff continuously offer praise and rewards that encourage children to behave well. The children enjoy receiving praise and rewards and feel proud of their achievements. Sanctions are rarely used. However, when they are used they are fair and proportionate.

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The effectiveness of leaders and managers: good

The home is led by a qualified, experienced and knowledgeable registered manager who holds a level 5 diploma in leadership for health and social care and children’s and young people’s services. She has been in post for four years and is well supported by a qualified deputy manager. As a manager she is passionate, dedicated and committed to her role. Her approach is to lead by example and to continually strive to improve children’s outcomes. The registered manager works exceptionally well with parents, social workers, children and other external agencies.

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The effectiveness of leaders and managers: good

Staff are suitably qualified to a level 3 diploma or equivalent in the care of children and young people. Those who do not have a suitable qualification yet are expected to achieve one within the required timescales. Staff receive a wealth of training, which equips them with the skills and knowledge to care for children effectively. New staff receive a thorough induction that helps to prepare them for their role.

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The effectiveness of leaders and managers: good

Staff receive regular supervision which enables them to reflect on their practice. However, the manager has not completed the staff’s annual appraisals. Consequently, staff do not receive an annual review that focuses on their performance and development needs.

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The effectiveness of leaders and managers: good

On the rare occasions that the manager uses agency staff, she does not update the staff rosters to show who has worked in the home and when. Although the manager used timesheets to show the inspector which agency staff had worked in the home, the rosters had not been updated accordingly. If not addressed, this information could be lost and may not be available should it be required in the future. Inspection report children’s home: SC376211 8 The home is visited monthly by an independent visitor. She shares the report and recommendations about what needs to improve with the manager, who then takes action to address these. The manager also undertakes monthly auditing activities, and this helps her to critically analyse the impact of the quality of care on children’s progress and experiences. Good monitoring systems enable the manager to identify shortfalls quickly and take steps to address them. This supports ongoing improvement and helps

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The effectiveness of leaders and managers: good

to maintain high standards of care at the home.

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The effectiveness of leaders and managers: good

The manager uses the feedback she receives from parents, children and social workers to improve the quality of care. She reflects on practice and works to implement change when needed. The manager works in excellent partnership with parents as well as external professionals. A social worker said, ‘The staff are exceptionally good. You can always get hold of the manager, deputy or staff. They are always attending meetings. The staff have excellent relationships with parents.’

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The effectiveness of leaders and managers: good

The manager has met the three requirements made at the last inspection. When medication is administered, this is appropriately recorded. Records of physical intervention now document the length of time a child is restrained for. The manager ensures that significant events are reported in a timely manner to Ofsted.

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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: SC376211 9

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Children’s home details

Registered provider: CareTech Community Services Limited

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Children’s home details

Registered provider address: 5th Floor Metropolitan House, 3 Darkes Lane, Potters Bar, Hertfordshire EN6 1AG

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Inspector

Michelle Spruce, social care inspector Inspection report children’s home: SC376211 10 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for 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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