Children's home run by The Children’s Trust

Inspection report children’s home: SC062079 1 SC062079 Registered provider: The Children’s Trust

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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 service provides residential care for children who have acquired brain injury, multiple disabilities and/or complex health needs. There has been a change in registration since the last inspection, with the rehabilitation homes now being inspected by Ofsted. The residential accommodation comprises eight separate houses, accommodating up to 66 children. The registered manager has been registered with Ofsted since December 2014.

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Information about this children’s home

There is a non-maintained school on site, registered with the Department for Education, that some of the children attend depending on the type of placement.

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Information about this children’s home

The site is also registered with the Care Quality Commission (CQC), who conducted an inspection in November 2017. The CQC have published this inspection report.

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Information about this children’s home

Inspection dates: 12 to 13 December 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. Inspection report children’s home: SC062079 2 Date of last inspection: 20 February 2018

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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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Inspection date Inspection type Inspection judgement

20/02/2018 Interim Sustained effectiveness 16/10/2017 Full Good 20/09/2016 Full Requires improvement 25/01/2016 Full Good Inspection report children’s home: SC062079 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’, paragraph 13.2, page 61)  The registered person is responsible for ensuring that each child’s day to day health and well-being needs are met. (‘Guide to the children’s homes regulations including the quality standards’ paragraph 7.3, page 33) In particular, review the catering arrangements.

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Overall experiences and progress of children and young people: outstanding

Children and young people live in a warm, caring environment where they are supported by an exceptional staff team that clearly places children and young people’s needs at the centre of their practice. The sensitive and nurturing relationships mean that children and young people enjoy their time in the home, even when placed a long distance from their family.

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Overall experiences and progress of children and young people: outstanding

Staff are competent and diligent in meeting the needs of the children and young people, including healthcare tasks performed by non-nursing staff. Staff help children and young people personalise their rooms according to their taste and need, for example bold, bright colours for a child with visual impairment and customising their wheelchair with lights. Another example is the use of individual assessments to identify the correct sleep systems to maintain posture and comfort throughout the night.

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Overall experiences and progress of children and young people: outstanding

Children and young people make exceptional progress. An example is a young person who was not able to walk can now do so after rehabilitation. Other examples are a young person able to have a full diet from a starting point of gastrostomy feeding and another young person accessing the community from a starting point of social isolation. A young person with respiratory difficulties was able to use a climbing wall with an instructor holding his ventilator.

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Overall experiences and progress of children and young people: outstanding

Care staff understand and manage children and young people’s complex health needs well. They work closely with the nurses and other clinicians to ensure that they have a full understanding of the specific needs of each child and young person. Staff are skilled in recognising and understanding children and young people’s non-verbal communication, which include noises, gestures and facial expressions. This ensures that children without recognised speech can make their views and wishes known. Staff use innovative practice, such as an aromatherapy station, for children and young people to Inspection report children’s home: SC062079 4 remember and recollect positive experiences.

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Overall experiences and progress of children and young people: outstanding

The voice of the child is strong. Staff use bespoke methods of communication, so that each individual is heard no matter how severe their communication need. Children and young people give their views on a wide range of issues such as policies, job applicants and how they want staff to address them. They gave mixed views to inspectors on the quality of the food. Inspectors noted that there were not always healthy choices. The catering arrangements will benefit from a review.

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Overall experiences and progress of children and young people: outstanding

Children and young people benefit from changes made by the management since the last inspection. For example, therapists are now based in the homes. They are available for immediate assistance and advice. Therapy is now part of a 24-hour programme. Staff report an increased confidence in supporting the children and young people effectively. The appointment of a youth worker has significantly enhanced the development of children and young people’s social skills as well as providing another opportunity for their voice to be heard. A head of therapy has been appointed, who works in an integrated way, considering the experiences of children, staff and parents. She has a clear vision for future development, such as improving community participation, development of aquatic services and strengthening existing staff training relating to dysphagia.

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Overall experiences and progress of children and young people: outstanding

The play team and therapy team ensure that children and young people enjoy a range of activities. Staff see children’s ability, not their disability. Working with a local artist, children and young people’s movement was incorporated into paintings and a sculpture. The art pieces were later sold for a considerable sum to raise money for the trust. Other children and young people enjoy horse riding, while others, including those with a tracheostomy, enjoy swimming. Staff have a range of ideas to develop the activity programme further and to increase the number of sports available.

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Overall experiences and progress of children and young people: outstanding

Managers have comprehensive systems in place to manage medicines. They ensure that any errors are quickly addressed, investigated and lessons learned to prevent recurrence. The registration of a pharmacy on the site has aided this process. This means that the percentage of errors is small.

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Overall experiences and progress of children and young people: outstanding

Staff work closely with parents to both understand, and explain, a child or young person’s needs. Parents can use a family flat, where they gain confidence in meeting their child’s complex needs in preparation for a return to the family home. A parent said, ‘They do a brilliant job.’ Another parent said that there is a consistent staff team and commented on how much he trusts them.

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

A dedicated, experienced and passionate safeguarding lead heads up a team that provides training and consultation to managers in safeguarding practice. Safeguarding is embedded in the culture of the home that places the child at the centre of practice. In addition to the strong internal safeguarding ethos, senior staff maintain strong external links with key safeguarding agencies. Key individuals represent the voluntary sector on the local safeguarding children’s board. Inspection report children’s home: SC062079 5 The home managers comprehensively review all incidents, analysing them to identify the root cause. Staff take effective action to avoid a repeat of similar circumstances. The registered manager reviews the incidents, maintaining a culture where the response to any safeguarding concerns or incidents is of the highest standard.

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

Safeguarding training and awareness is an exemplar of outstanding practice. It is appropriately prioritised and is systematic, so every employee, trustee and volunteer who enters the site has safeguarding training. Those with increased levels of responsibility and authority are trained to higher levels of competency. Competency levels are monitored, reviewed and refreshed when necessary. Training is consolidated in team meetings, appraisals and supervision. Staff are confident at raising concerns, including about each other’s practice. They have confidence that the safeguarding leads will promptly, sensitively and proportionately address their worries.

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

Safer recruitment standards are being met at a consistently excellent level, such as in the recording of employment history and addressing of gaps. There have been improvements in the levels of screening and managing the progress of an application. Recruitment staff recognise the need to improve their assessment of the mental and physical well-being of candidates. The selection of volunteers follows the same high safer recruitment standards.

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

An able and competent estates team manages health and safety across the entire site. Its members ensure that all the necessary health and safety certification is in place. The team ensures that there is an ongoing maintenance programme as well as identifying any projects requiring considerable investment. They work with the staff to ensure that children and young people who need assistance to evacuate in an emergency can do so.

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

The risk assessment process is exemplary. For example, moving and handling assessments are meticulously detailed, with contributions from the multidisciplinary team. Sleeping risk assessments for children and young people, who may have respiratory difficulties at night, provide clear guidance on the type of check or intervention required as well as the frequency. Managers check the record sheets daily, ensuring that the required support is happening in practice.

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

Inspectors became aware during this inspection that a serious incident that occurred at the setting since the previous inspection is under investigation by the appropriate authorities. While Ofsted does not have the power to investigate incidents of this kind, inspectors considered the actions taken by the setting in response to the incident, alongside other evidence available at the time of the inspection, to inform judgements.

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The effectiveness of leaders and managers: outstanding

The registered manager has positive working relationships with a variety of people. She communicates effectively with parents, health professionals, education professionals and placing social workers. She attends multi-agency meetings to discuss young people’s emerging risks and behaviours. This provides young people with holistic support specific Inspection report children’s home: SC062079 6 to their developmental needs.

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The effectiveness of leaders and managers: outstanding

Recruitment staff have completed a detailed analysis of recruitment and retention and how this can be improved. This has been successful. The home’s manager reports a significant improvement in the quality and calibre of staff employed and retention rates are improving.

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The effectiveness of leaders and managers: outstanding

Staff work in depth with partner agencies and external professionals. They keep abreast of the latest research as well as leading in national and international research into acquired brain injury. They conducted a presentation to an international brain injury conference on how they have developed their risk assessments around self-injurious behaviour. Staff have worked with other professionals and volunteers in a child-centred way. For example, staff consulted with an occupational therapist in a hospital a considerable distance from the home to arrange for a young person to be able to visit friends as well as family during the holiday season. They arranged for some volunteers to act as drivers so that care staff can be with the young person during the long journey.

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The effectiveness of leaders and managers: outstanding

On occasion, agency staff are used to support the full-time staff. The arrangements are proportionate so there is not an excessive use of agency staff. Recruitment practice does not currently consider if agency staff have the level 3 qualification in care. Managers also recognise the need to improve how they assess mental and physical fitness for the role.

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The effectiveness of leaders and managers: outstanding

Managers provide regular supervision to staff. Although staff say that this is helpful and supportive to them, the quality and format of supervision across the homes vary. Senior managers have recognised this and have formed a working group to assess how the necessary improvement will be implemented. Staff report an open culture. They said that they can raise any concerns and feel listened to.

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The effectiveness of leaders and managers: outstanding

Care plans are well structured and indexed. The pertinent information is readily available. Staff understand their specific role in meeting the complex needs of each child and young person. Managers maximise the opportunities for learning, for example using special interest groups to share learning. There is excellent communication between the multidisciplinary teams, as well as at handovers, so all are aware of the current needs of each individual.

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The effectiveness of leaders and managers: outstanding

A large team of dedicated volunteers provides additional support to the core staff team. For example, they drive the mini-bus, so that children and young people can see individuals who are important to them. Senior managers value the volunteers and celebrate their contribution at an annual awards evening. Inspectors observed staff supporting children and young people to make Christmas cards for the volunteers, thanking them for their efforts.

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The effectiveness of leaders and managers: outstanding

The senior management team has clear plans to further develop the service, for example widening the amount of therapy support at weekends to extend the range of activities that children and young people can do. They are exploring how augmentative communication and assistive technology can be developed to further support the children and young people in their care. They donate unused specialist equipment to Inspection report children’s home: SC062079 7 children in developing countries.

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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: SC062079 8

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: The Children’s Trust

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Inspectors

Keith Riley, lead social care inspector Liz Driver, social care inspector John Pledger, social care inspector Suzy Lemmy, social care inspector Inspection report children’s home: SC062079 9 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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Inspectors

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Inspectors

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Inspectors

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