Children's Home run by Hampshire County Council in Hampshire

Inspection report children‟s home: SC066277 1 SC066277 Registered provider: Hampshire County 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

The setting is owned and run jointly by a local authority children‟s services department and a National Health Service foundation trust. This service offers short breaks for up to nine children at any one time. Children who access the healthcare facilities of this service have complex health needs, which may or may not include severe physical disabilities, learning disabilities, sleep issues and/or challenging behaviours. Children who access the social care facilities of this service have learning disabilities that may include sensory and physical disabilities, complex health needs, or challenging behaviour. The provider notified Ofsted in November 2018 that the registered manager was no longer in post.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement

How well children and young people are helped and protected requires improvement

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requires improvement

The effectiveness of leaders and managers requires improvement

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requires improvement

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

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requires improvement

Overall judgement at last inspection: good

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requires improvement

Enforcement action since last inspection: none Inspection report children‟s home: SC066277 2

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Inspection date Inspection type Inspection judgement

10/07/2018 Full Good 24/05/2017 Full Good 13/12/2016 Full Good 19/05/2016 Interim Sustained effectiveness Inspection report children‟s home: SC066277 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

In meeting the quality standards, the registered person must, and must ensure that staff— if the registered person considers, or staff consider, a placing authority‟s or a relevant person‟s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child‟s needs are met in accordance with the child‟s relevant plans. (Regulation 5(c)) This specifically relates to effectively challenging delays to resolving outstanding health and safety issues and the maintenance of the premises. 14/06/2019

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Requirement Due date

In order to meet the protection of children standard the registered person must ensure— that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child‟s health. (Regulation 12(2)(d)) 14/06/2019

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Requirement Due date

In order to meet the leadership and management standard the registered person is required to— lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home‟s statement of purpose. (Regulation 13(2)(a)) 14/06/2019

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Requirement Due date

In order to meet the leadership and management standard, the registered person is required to— ensure that the home‟s workforce provides continuity of care to each child. (Regulation 13(2)(e)) In particular, ensure that placement plans are updated in the light of experience and as circumstances change. 14/06/2019

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Requirement Due date

In order to meet the leadership and management standard, the registered person is required to— use monitoring and review systems to make continuous 31/05/2019 Inspection report children‟s home: SC066277 4 improvements in the quality of care provided in the home. (Regulation 13(2)(h)) After consultation with the fire and rescue authority, the registered person must ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire. (Regulation 25(1)(d)) 11/05/2019

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(b)(c)) 31/05/2019

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Requirement Due date

The registered person must maintain case records for each child which are kept up to date. (Regulation 36(1)(b)) 31/05/2019

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Requirement Due date

The registered person must complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months and supply to HMCI a copy of the review report within 28 days of the date on which the quality of care review is completed. (Regulation 45(1)(4)(a)) 31/05/2019

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Recommendations

 For children‟s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. Children‟s homes must comply with relevant health and safety legislations (alarms, food hygiene etc.); however in doing so, homes should seek as far as possible to maintain a domestic rather than „institutional‟ impression. („Guide to children‟s homes regulations, including the quality standards‟, page 15, paragraph 3.9) In particular, the provider should promptly address elements of the internal and external environment that detract from the homely atmosphere of the service.

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Recommendations

 Staff should continually and actively assess the risks to each child and the arrangements in place to protect them. Where there are safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any assessed risks on a day-to-day basis, („Guide to the children‟s homes regulations including the quality standards‟, page 42, paragraph 9.5) In particular, staff should be aware of the nature of placing authority plans to protect children.

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Inspection judgements

Inspection report children‟s home: SC066277 5

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improvement

Children‟s safety is compromised because of significant delays in making identified improvements to some areas of the home‟s safety. In addition, the exterior of the premises requires significant attention to improve the appearance, especially the car park, areas of the garden and the entrance. Internally, noticeboards held outdated information, including the „you said, we did‟ displays, and the kitchen shows signs of wear and tear. There is a small hole in the floor that an earthing cable drops through, which is not dangerous but unsightly. The manager and staff provide individualised care and support to children. For example, they are using social stories with a child who is having issues with another pupil to assist them. Children‟s views are sought and ways of meeting their wishes found. This includes the purchasing of a new electronic communication tool that allows non-verbal children to express themselves. Staff, as a matter of course, act on children‟s requests. For

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improvement

example, one child was being taken to his favourite „pie shop‟ for his evening meal during the inspection. Staff also consult others about children‟s wishes. One parent said, „The staff are really good at getting things the boys like, and ask me about food for breakfast and dinner and their bedding.‟ Staff act on what they know children enjoy, which has resulted in garden features that reflect the children‟s passion for dinosaurs or fairies, and in trips to places that develop the children‟s interests. Staff are enthusiastic about extending the range of activities. Children looked comfortable and relaxed with staff, who showed considerable insight into individual children‟s needs. Staff interpret non-verbal cues to understand children‟s moods or to judge how events may impact on children‟s behaviour. This allows staff to respond appropriately in different circumstances. There was a very relaxed atmosphere

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improvement

during the inspection, with the occasional incident managed promptly and calmly. Staff routinely offer choices to children, from what they want to watch on television to places to go for a meal out. This enhances children‟s experience of short breaks. Children benefit from health and social care staff being on the same premises, including the sharing of information about health conditions and some combined activities. There are firm plans to increase joint working, such as organising trips together. Children have also benefited from improvements since the last inspection. For example, a new vehicle has recently been delivered and will be used to increase the range of activities for the children. Staff know children‟s backgrounds well and talk to children about family members and events. Communication books effectively keep staff and families updated with what happens at home and in the setting. Parents spoken to say that their children look

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improvement

forward to their stays. One parent commented, „When I get the bags out to pack, my boys get excited as they know where they are going.‟ Staff set goals for children to improve aspects of their independence, social skills and education. There has been improvement in the processes for setting, recording and monitoring these goals, and evidence that children are achieving them. Children are Inspection report children‟s home: SC066277 6 making progress, especially with communication, both verbally and in the use of aids. Staff patiently assist children to be able to convey what they want to say. Staff prepare children to enter, and ultimately leave, the service well. Staff make detailed transition plans, which take into account individual needs. They are reviewed in the light of children‟s experiences and staff‟s own observations and adapted as necessary. Staff collaborate with families and professionals to achieve this, and one

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improvement

social worker said that they „go the extra mile‟ to alleviate any anxiety that there may be over such significant steps.

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improvement

The manager has been unable to get work done to improve the health and safety of the premises. An initial request to have door hinge guards and window locks was made a year ago, but they are not yet fitted. This is despite escalating concerns to senior managers of the health trust, which has responsibility for maintenance work of the premises. Although no harm has come to a child as a result, avoidable risks remain present. Staff had not conducted an emergency evacuation drill between June 2018 and January 2019 that, according to the service‟s fire plan, should be undertaken every three months. This means that staff and children may be unaware of, or lack practice in, what to do in the event of a fire. This has had the potential to significantly affect the safety and welfare of children. Staff have a good understanding of how to respond to safeguarding concerns and professionals praise staff for their contribution to the safeguarding of children. However,

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improvement

a staff member was not aware that a recent child protection conference had put a plan in place for two children. As there were no specific actions for the service, and all staff maintained their normal monitoring procedures, there was no adverse impact on children‟s safety. The manager assesses the potential risks of matching children staying together well. Those who may pose difficulties for each other do not stay on the same night, and workers are alert to keeping to agreed staff-to-child ratios. Inspectors observed how one staff member worked directly with a young person while colleagues were on hand if needed, thus avoiding higher than normal ratios becoming overbearing. Information and forms are available for children should they wish to make a complaint. Staff also have guidance on how they are to respond, including circumstances in which they should seek to advocate for a child who is unable to communicate unhappiness

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improvement

other than through behaviour. No complaints have been recorded, but there is evidence of good practice of staff responding to negative feedback to improve things for children. A log is kept of this so that, for example, over-stimulating environments or particular foods can be avoided. Risk assessments and behaviour management plans are detailed, giving clear strategies for staff to assist children. These include careful consideration of the need to secure the building for one particular child who could harm himself if able to access certain areas of Inspection report children‟s home: SC066277 7 the premises. The need to lock some doors has been agreed with family and social workers, and is a risk reduction measure for the purposes of safeguarding. Furthermore, this measure is only used when no other children are in the setting. It was not possible for the service to provide short breaks for children who were due to

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improvement

stay while an emergency placement was accepted. This was highly disruptive to them and their families but maintained children‟s safety. Staff worked well with the child, developing goals for him, even though his stay was for just a few days. Managers implement safer recruiting processes and ensure that all required checks are completed prior to a person working at the home.

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The effectiveness of leaders and managers: requires improvement

An interim manager is in place while a permanent post holder is recruited. This is now in its final stages and a person has been appointed. However, the home has been without a registered manager in day-to-day charge of the home for over four months. This means that the home has not been managed by a person whose fitness for this setting has been assessed by the regulatory body. A regulation 45 review has not been sent to Ofsted since February 2018. It was not made clear to inspectors, during the inspection, if a regulation 45 report had since been completed. The service‟s development plan focuses almost exclusively on building up the staff team, but work has also been done to address requirements and recommendations raised at the last inspection, including helping children move on to adult provision and processing complaints. An aspiration at the last inspection to convert a „messy play room‟ into a quiet area, to better meet the needs of children currently placed, has been

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The effectiveness of leaders and managers: requires improvement

pursued and a date to start alterations has been set. The interim manager demonstrates an ambitious vision for the service and has taken action to address some, but not all, of its weaknesses. Her priority has been to improve staff morale and build a „one team‟ approach to the work, whether employed by the health trust or the local authority. The training she has organised, which included bespoke training around the development of the service, has been instrumental and universally praised by her team. However, staff are not receiving supervision at the frequency stated in the statement of purpose and appraisals have not been completed in the past year. The interim manager has achieved her aim of creating a cohesive team, but has not addressed other important areas. This has meant that shortfalls in the service have remained unresolved. This includes improving case files and the structure of placement

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The effectiveness of leaders and managers: requires improvement

plans, a comprehensive development plan, and annual appraisals for staff. A lack of review and monitoring of the home has failed to identify, and remedy, a number of shortfalls. Plans and assessments in case files do not evidence that reviews have been conducted in a timely way, nor updated when there are significant changes. Staff use emails and/or handover meetings to inform each other of developments rather than use the specific forms contained in files. This means that agency workers or staff not present may not be aware of significant changes and contributed to confusion over the status of local Inspection report children‟s home: SC066277 8 authority plans for children. The independent person who conducts visits under regulation 44 has identified both strengths and weaknesses of the service and has tracked progress after making recommendations. This includes the need to undertake a fire drill and how health and

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The effectiveness of leaders and managers: requires improvement

safety issues have been escalated. However, the lack of timely reviews of plans and assessments was not raised. Family members and other professionals report a good relationship with staff and particularly appreciate excellent levels of communication from them. The manager and staff collaborate well with them to meet children‟s needs. Parents have confidence in the care that their children receive. One parent commented, „If they say they are going to do something, they will follow through.‟ The manager and staff promote a positive view of children with disabilities and are keen to make activities and facilities available to as many children as possible.

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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: SC066277 9

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Children’s home details

Registered provider address: Hampshire Council, 3rd Floor, Elizabeth II Court North, The Castle, Winchester, Hampshire SO23 8UG

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Inspectors

Chris Peel, social care inspector Dan Healy, social care inspector Inspection report children‟s home: SC066277 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 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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