Children's Home run by Bromley Healthcare Community Interest Company in Bromley

Inspection report children’s home: SC474543 1 SC474543 Registered provider: Bromley Healthcare Community Interest Company

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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 home is run by a healthcare trust and provides short break services for children and young people aged from five to 17 years. Young people who use the home may present with a variety of complex needs, including sensory impairment, physical and/or learning disabilities and/or challenging behaviour. The home is registered to care for up to 12 young people at any one time. Currently, 54 children and young people access this service for periods of respite care.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Overall judgement at last inspection: good

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good

Enforcement action since last inspection: none Inspection report children’s home: SC474543 2

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Inspection date Inspection type Inspection judgement

01/08/2017 Full Good 23/03/2017 Interim Sustained effectiveness 01/11/2016 Full Good 25/02/2016 Interim Sustained effectiveness Inspection report children’s home: SC474543 3

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Recommendations

 The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care (‘Guide to the children’s homes regulations including the quality standards (2015)’, page 61, paragraph 31.2). In particular, the provider must ensure that all staff, including night staff, receive formal supervision in line with the frequency stated in the home’s policies and procedures.  Medicines must be administered in line with a medically approved protocol. Records must be kept of the administration of all medication (‘Guide to the children’s homes regulations including the quality standards (2015)’, page 35, paragraph 7.15). In particular, the provider should have in place a policy to cover the covert administration of medication.

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Recommendations

 In addition to the requirements of this standard, the registered person has specific responsibilities under regulation 34 to prepare and implement policies setting out arrangements for the safeguarding of children from abuse or neglect (‘Guide to the children’s homes regulations including the quality standards (2015)’, page 44, paragraph 9.19). In particular, the provider should have a clear policy on how personal care is delivered in order to promote the welfare and protect the privacy of young people.  A child’s plans should form the basis of their care, and providers should use their judgement as to what is relevant in each case (‘Guide to the children’s homes regulations including the quality standards (2015)’, page 55, paragraph 11.1). In order to improve practice, the provider should ensure that the home’s individual care plans clearly evidence how staff are providing support in order to help young

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Recommendations

people to make progress in relation to their identified targets.  Children using short break provision may have very complex health needs. Staff will need to be appropriately skilled to care for them and understand that safeguards may need to be greater than for other children (‘Guide to the children’s homes regulations including the quality standards (2015)’, page 35, paragraph 7.20). In particular, protocols in relation to meeting healthcare needs for young people with epilepsy need to be precise and easily accessible to staff.

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Overall experiences and progress of children and young people: good

Children and young people benefit from positive relationships with a stable staff team that knows them well. Staff display genuine warmth and care towards the children and Inspection report children’s home: SC474543 4 young people. This helps children and young people feel safe, secure and able to enjoy their stays in the home.

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Overall experiences and progress of children and young people: good

Children and young people who are able to verbalise their views reported that ‘staff are nice’ and that they love the home. Parents reported that their children look forward to staying in the home. Parents are happy with the standard of care provided in the home. One parent said, ‘I know the staff love my child.’ Parents consistently reported that the staff communicate well with them and respond positively to their wishes and ideas.

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Overall experiences and progress of children and young people: good

Children and young people learn new skills and make good progress due to staying in the home. They are encouraged to develop independence skills appropriate to their abilities and understanding. They make friends, learn social skills and try new activities.

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Overall experiences and progress of children and young people: good

Staff work closely with schools to make sure that children and young people have a consistent experience of care. Transitions into and out of the service are well planned. Staff arrange home visits and meet with parents to ensure that they understand how best to meet the needs of the children and young people and give them a positive experience of care.

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Overall experiences and progress of children and young people: good

Staff are very experienced in caring for children and young people with complex health needs. However, the written care and health plans do not consistently match the quality of care provided by staff. For example, healthcare plans do not always identify the actions that staff must take in an emergency. The home’s care plans do not always specify the help and support that young people receive to help them make progress.

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Overall experiences and progress of children and young people: good

The home is well maintained and provides a high-quality physical environment for children and young people. They make good use of this space, which means that children and young people have a range of onsite activities. These include a soft play room, a sensory room and an outdoor play area.

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

Staff provide high levels of supervision, and careful consideration is given to matching children and young people for overnight stays. This ensures that staff can manage individual needs within the group and keep the children and young people safe.

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

The building is secure, and all equipment such as hoists and fire equipment is regularly maintained in order to provide a safe environment. Staff training in key areas of child protection, first aid and manual handling is regularly updated.

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

Staff are resilient, caring and skilful when managing challenging behaviour. When incidents occur, they are clearly recorded and investigated to inform practice learning. Sanctions are seldom used. On the rare occasions when it is necessary to use physical restraint, this is carried out with the minimum use of intervention for the least time necessary. Staff are trained to carry this out safely, and all such incidents are reviewed by the manager of the home. Inspection report children’s home: SC474543 5 The provider works in partnership with the professional network to respond to any safeguarding concerns. Incidents are rare, but when they occur, the provider leaves no stone unturned to ensure that they are thoroughly and independently investigated. Any learning points are used to improve practice. This reduces the possibility that incidents will reoccur.

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

Staff are considerate and careful when providing personal care, and the privacy and dignity of children and young people are the priority. Staff obtain the consent of parents when it is not possible to get this directly from the children and young people. However, the home’s policy does not specify how personal care is delivered, for example in terms of the gender or number of staff providing this care. This means that parents cannot be absolutely clear about what they are consenting to.

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

There are effective systems in place to ensure that children and young people receive medication as prescribed or in line with the homely remedies policy for prescribed medication. There are good communication systems in place to make sure that no errors occur between the provider, home and schools.

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

On occasion, for young people who refuse to take medication, staff put it in their food. This is done in consultation with parents. However, the provider does not have a clear policy in relation to the covert administration of medication. This runs the risk of infringing on the rights of children and young people. This practice could also reduce the effectiveness of some medication.

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The effectiveness of leaders and managers: good

The registered manager recently left the service. There is an acting manager in place and she has submitted an application to register with Ofsted. The acting manager is suitably experienced and has a level 5 qualification in managing social care for adults and has plans to enhance this qualification to increase her knowledge of managing children’s services. She was previously the deputy manager and therefore knows the service well.

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The effectiveness of leaders and managers: good

The acting manager has an excellent understanding of the strengths and weaknesses of the service. She has identified a number of areas to improve the service and practice. This includes a plan to deploy staff more effectively in order to ensure that the provision remains responsive and cost effective in the current commissioning climate.

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The effectiveness of leaders and managers: good

The acting manager has good oversight of the quality of care in the home. She uses the feedback from detailed independent visitor reports to maintain high standards of care.

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The effectiveness of leaders and managers: good

Staff are generally positive about the impact of the new manager. They feel she is supportive and open to their ideas and suggestions. However, despite some recent improvements, not all staff receive formal supervision within the timescales outlined in the home’s policies and procedures. Staff receive feedback on performance and development areas and have had annual appraisals. Inspection report children’s home: SC474543 6 The acting manager is close to practice and spends time working with children and young people alongside staff. This keeps helps her to understand how children and young people experience care and to understand the challenges the staff face in providing day-to-day care.

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The effectiveness of leaders and managers: good

Parents spoke positively about the way that the home is managed. The views of parents are sought at regular parent forums, and the acting manager uses their feedback to inform service development.

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The effectiveness of leaders and managers: good

The acting manager is passionate about the service and ensures that the best interests of children and young people remain at the heart of decision-making.

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The effectiveness of leaders and managers: good

The shortfalls identified at the previous inspection have mostly been addressed. The provider has improved the management monitoring of the quality of care, devised a workforce development plan and updated the home’s statement of purpose.

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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: SC474543 7

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Children’s home details

Registered provider address: Global House, 10 Station Approach, Bromley, Kent BR2 7EH

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Inspector

Lee Kirwin, social care inspector Inspection report children’s home: SC474543 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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