Children's Home run by North Staffordshire Combined Healthcare NHS Trust in Staffordshire

Inspection report children’s home: 1243962 1 Registered provider: Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home provides short-break placements for children who have severe learning disabilities and associated complex needs. The service provides overnight short-break care for up to six children at a time. The home is operated by a Combined Health Care NHS Trust. The manager was registered with Ofsted in November 2017 and has a level 5 diploma in leadership and management for residential childcare.

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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 requires improvement to be good

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good

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

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good

Date of last inspection: 28 February 2019

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good

Overall judgement at last inspection: improved effectiveness

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good

Enforcement action since last inspection: none Inspection report children’s home: 1243962 2

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Inspection date Inspection type Inspection judgement

28/02/2019 Interim Improved effectiveness 15/05/2018 Full Requires improvement to be good Inspection report children’s home: 1243962 3

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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

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home.

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Requirement Due date

In particular, the standard in paragraph (1) requires the Registered person to ensure that staff have the experience, qualifications and skills to meet the needs of each child and understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home. (Regulation 13 (1)(2)(c)(f)) 30/08/2019

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Requirement Due date

The registered person may only employ an individual to work at the children’s home if full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (3)(d)) 30/08/2019

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Requirement Due date

The registered person must ensure that any individual who works in the home in a care role has achieved the appropriate qualification by the relevant date. The relevant date is, in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home; or in the case of an individual who was working in a care role in a home on 1st April 2014, 1st April 2016. (Regulation 32 (5)(a)(b)) 29/11/2019

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Requirement Due date

The registered person must ensure that 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)(c)) 30/08/2019

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home. The registered person must maintain in the home the records in Schedule 4; and ensure that the records are kept up to date. (Regulation 37 (1)(2)(a)(b)) This is with specific reference to keeping a register of children. 30/08/2019

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Requirement Due date

The registered person must review the appropriateness and 30/08/2019 Inspection report children’s home: 1243962 4 suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year taking into account the requirement in Regulation 12 (2)(c) (the protection of children standard). When conducting the review, the registered person must consult, and take into account the views of, each relevant person. (Regulation 46 (1)(2))

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Recommendations

 Beyond local authorities, there are other people, bodies and organisations that have responsibilities towards children in children’s homes. Many of these are referenced specifically in the Regulations and Guide. They might include health and education services, Local Safeguarding Children Boards, leaving care services, IROs, voluntary agencies, the police and youth offending teams. This list is not exhaustive. The important thing is that homes take the initiative in identifying others who must play a part for their children and engage with those relevant people proactively, advocating for the children in their care. (‘Guide to the children’s homes regulations including the quality standards’, page 12, paragraph 2.7)  Supervision of staff practice should ensure that individual adults in the home are engaged in the safeguarding culture of the home so they understand what they would need to do if they found other staff misusing or abusing their position to

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Recommendations

the detriment of the safety of a child. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.22) This is with particular reference to staff understanding the role of the local authority designated officer.  The home’s policies and procedures around the protection of children should reflect any requirements of other relevant legislation. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.22)  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’, page 61, paragraph 13.2)

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Overall experiences and progress of children and young people: good

Children benefit from a planned and tailored introduction to the home. This careful planning helps to ensure that staff understand children’s needs and preferences and that overnight stays only happen when the child is comfortable in their new environment. This means that when children eventually sleep overnight they quickly settle. Inspection report children’s home: 1243962 5 Staff ensure that children’s plans are personalised and that these plans take account of their abilities and routines both at home and at school. This provides continuity of care for children and helps them to continue to build key skills.

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Overall experiences and progress of children and young people: good

Managers have worked hard to ensure that children stay at the home with friends and class mates. Consequently, children are more likely to share their short break with children who have compatible needs. This gives children predictability and provides an opportunity for friendships to develop.

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Overall experiences and progress of children and young people: good

Children are involved in a wide range of activities that reflect their individual preferences and enhance their experiences. Children enjoy their short-break stays and have fun.

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Overall experiences and progress of children and young people: good

Staff take great care to ensure that they meet each child’s individual dietary needs, including the provision of gluten free and halal food. This helps to ensure that the health and cultural needs of children are met.

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Overall experiences and progress of children and young people: good

Staff continue to develop their skills for communicating with children, including using communication methods such as now and next boards, picture exchange system and Makaton.

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Overall experiences and progress of children and young people: good

Parents say that they are confident about the care provided and that staff involve them in the plans for their child.

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Overall experiences and progress of children and young people: good

The home is clean and tidy and improvements to the environment continue. New play equipment has helped to enhance the outdoor space for children. Eye-catching displays in communal areas and artwork to children’s bedroom walls have all helped to create a more child-friendly environment.

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

There has been one safeguarding concern since the last inspection. The registered manager ensured that this was responded to in keeping with adult safeguarding procedures.

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

Staff take great care to ensure that each child has an individual risk assessment that is informed by parents and guardians and is reviewed at each stay. This helps to keep staff up to date and enables them to be able to respond well to any changes in children’s individual needs. The registered manager has recently introduced risk assessments for transporting children. These informed assessments are helping to increase safety.

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

Physical intervention is rare. When physical intervention has been necessary, the registered manager has reviewed the records made by staff and held discussions with them to help reflect on their practice. However, there is no system in place to seek feedback from children when they have been physically held. This means that children do not have an opportunity to influence the learning following incidents. Inspection report children’s home: 1243962 6 Staff benefit from a range of training to help them understand their responsibilities to safeguard the children in their care. However, the organisation has been slow in sourcing online safety training. In addition, there is currently no training planned for staff to raise their awareness of female genital mutilation. This means that staff have not received essential training to help inform their ongoing professional development.

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

Staff have a detailed knowledge of the health needs of children and how these needs should be met. Training is provided to staff to help them meet children’s complex health needs. Procedures for the safe handling of medication are in place and regular external and internal audits reduce the potential for errors and increase safety.

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The effectiveness of leaders and managers: requires improvement to be good

Staff who do not hold a level 3 diploma or an equivalent qualification continue to work towards achieving the level 3 diploma in residential childcare within the timescales set at the February 2019 inspection.

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The effectiveness of leaders and managers: requires improvement to be good

Staff receive regular supervision. However, their supervision records do not evidence how they are able to reflect on their practice. In addition, staff supervision has not helped staff to understand the role of the designated officer. This creates a missed opportunity to help the staff think about how they safeguard children and how well they are meeting children’s individual needs.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has acted to address previous shortfalls in staff vetting for permanent members of staff. However, this has not extended to bank staff or student nurses who can also work at the home. This creates a potential risk that unsuitable adults could get to work with children.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager is a good advocate for children. For example, the registered manager helped to secure funding for a child’s family to be able to purchase him a specific school uniform.

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The effectiveness of leaders and managers: requires improvement to be good

Teachers and social workers are positive about the communication that they receive from staff and managers. However, the registered manager’s relationship with the designated officer is not yet well developed and means that she does not benefit from advice and support.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has developed an information pack about the home. This includes an up-to-date statement of purpose and children’s guide. However, she has not reviewed the suitability of the location of the home. This means that the level of risk posed to children by the local area is not up to date.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager does not make full use of all the information available to her to identify the progress that children make or how their experiences are being extended as a result of their short breaks. This limits her understanding of the strengths and development areas for the home.

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The effectiveness of leaders and managers: requires improvement to be good

The organisation has policies and procedures in place that help staff to safeguard Inspection report children’s home: 1243962 7 children. However, managers have not reviewed these policies and procedures to reflect changes in statutory guidance, in particular ‘Working together to safeguard children 2018’.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager does not keep a register of children’s admissions. This compromises having a formal audit trail of all children who have used the service for short breaks that meets regulation.

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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: 1243962 8

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Children’s home details

Registered provider address: North Staffordshire Combined Health Care and NHS Trust, Lawton House, Bellringer Road, Stoke-on-Trent ST4 8HH

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Children’s home details

Responsible individual: Alastair Forrester

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Inspector

Alison Cooper: social care inspector Inspection report children’s home: 1243962 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 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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