Children's home run by Milton Keynes City Council

Inspection report children’s home: SC463692 1 SC463692 Registered provider: Milton Keynes 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

This is a local authority run children’s home. It is registered to accommodate up to eight children. It provides long-stay residential care for children who have learning difficulties and may have concurrent physical disabilities. The home is currently operating at an occupancy of five. The manager of the home has been registered with Ofsted since October 2015.

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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: 15 November 2018

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good

Overall judgement at last inspection: good Inspection report children’s home: SC463692 2

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Inspection date Inspection type Inspection judgement

15/11/2018 Full Good 06/03/2018 Full Good 02/02/2017 Full Good 15/07/2016 Interim Sustained effectiveness Inspection report children’s home: SC463692 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 order to meet the protection of children standard the registered person must ensure: that staff assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. (Regulation 12 (2)(a)(i))

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Requirement Due date

In particular, ensure that there are risk assessments in place that cover the home’s garden, use of the internet and travelling in the home’s vehicle; that risk assessments contain sufficient detail to ensure that staff are aware of situations in which risks are likely to be heightened, and are reviewed and updated in the light of incidents and changing circumstances. 16/08/2019

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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 improvements in the quality of care provided in the home. (Regulation 13 (2)(h))

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Requirement Due date

In particular, ensure that errors in and omissions from records are identified and that there is improvement in the standard of recording sought. 16/08/2019

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must provide adequate means of escape from the home in the event of fire. (Regulation 25 (1)(b)) 31/07/2019

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Requirement Due date

The registered person must ensure that an individual who works in the home in a care role has the Level 3 Diploma for Residential Childcare (England) or equivalent by the date which falls 2 years after the date on which the individual started working or, in the case of an individual who was working in a home on 1st April 2014, 1st April 2016. (Regulation 32 (4)(5)) 16/08/2019

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any 16/08/2019 Inspection report children’s home: SC463692 4 investigation so that the process followed and how it has led to the outcome are clear. (Regulation 39 (3))

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Requirement Due date

In particular, the record should include whether the complainant was satisfied with the outcome.

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Requirement Due date

The registered person must ensure that the independent person carrying out visits to the home only inspects a child’s case records if the child and the child’s placing authority consent. (Regulation 44 (2)(b)) 31/07/2019

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. The system must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (2)(a)(c)(5))

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Requirement Due date

In particular the review should identify the outcome of consultations with children and others and how actions identified will be addressed. 16/08/2019

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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 the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)  The children’s guide should to help children to understand: − what the day to day routines of the home are (‘what happens in the home’); − the Statement of Purpose of the home (the care they can expect to receive while living there); − how to make a complaint in line with the home’s complaints procedure; − how they can access advocacy support or independent advocacy if eligible; and Inspection report children’s home: SC463692 5

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Recommendations

− how to contact the Office of the Children’s Commissioner. (‘Guide to the children’s homes regulations including the quality standards’, page 24, paragraph 4.22)  The registered person is responsible for ensuring that each child’s day to day health and well-being needs are met. Staff should work to make the children’s home an environment that supports children’s physical, mental and emotional health, in line with the approach set out in the home’s Statement of Purpose. (‘Guide to the children’s homes regulations including the quality standards’, page 33, paragraph 7.3) This includes ensuring that potential trip hazards are removed.  Children should be encouraged by staff to see the home’s records as ‘living documents’ supporting them to view and contribute to the record in a way that reflects their voice on a regular basis. (‘Guide to the children’s homes regulations including the quality standards’, page 58, paragraph 11.19)

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Recommendations

In particular, care plans should contain information about what is known of children’s views, even if they are not able to express these in a formal contribution.

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Overall experiences and progress of children and young people: good

Staff know children well. They listen to and observe them to find out their likes and dislikes and respond promptly to signs that they are unhappy. They find every way they can to promote children’s welfare. For example, one child struggles with having her hair brushed and can react adversely when it happens, but staff members noticed that she is calmer when lying down so take the opportunity then.

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Overall experiences and progress of children and young people: good

The manager and staff provide highly individualised care, which starts from when a child first comes to the home. A parent remarked on how swiftly staff prepared for her daughter to stay when a placement was urgently needed, saying, ‘They were absolutely brilliant. [They] decorated a room for her and they got everything ready over a weekend.’

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Overall experiences and progress of children and young people: good

Staff support children to attend school and to do well in their education. They frequently liaise with teachers and devise common approaches to behavioural issues and to helping children gain skills. Having staff take a consistent approach enables children to achieve sooner than they otherwise might. Children have made significant progress, considering their starting points and physical abilities, including with dressing, personal care and communication.

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Overall experiences and progress of children and young people: good

Children’s achievements are celebrated with children in the home and by the local authority. Managers and staff observed that children’s involvement in a ceremony for children looked after was not as positive it could have been, so they initiated a Inspection report children’s home: SC463692 6 successful alternative for children who have special needs. A participation worker was instrumental in its development and has contributed to developing the home’s practice in this area.

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Overall experiences and progress of children and young people: good

Staff encourage children, including those who communicate non-verbally, to make choices and make their views known. This extends to participating as far as possible in complex decisions, such as recruitment of new staff; children spend time with candidates in an activity and then indicate verbally or non-verbally who they like being with. Records of this, however, do not make clear the process by which staff seek children’s views or ways in which they are taken into consideration when making decisions.

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Overall experiences and progress of children and young people: good

Children enjoy a range of social and recreational activities, some of which would not be possible if they did not live at the home. One parent said that staff had taken her son to places the family could not get him to, such as the cinema.

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Overall experiences and progress of children and young people: good

Staff help children to manage lifelong conditions and maintain good health. Specialist help is sought according to individual needs, and staff chase provision when necessary. Excellent collaboration with, and involvement of, health professionals has led to healthier, more engaged children.

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Overall experiences and progress of children and young people: good

Although managers and staff keep the internal environment clean and well maintained, the otherwise homely environment is compromised by storage of medical supplies in open cardboard boxes in children’s bathrooms and bedrooms. Outside, managers and staff have not removed refuse (some, but not all of it ‘posted’ by children out of bedroom windows) that has accumulated in the side passages. This is unsightly rather than a health and safety risk.

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Overall experiences and progress of children and young people: good

A programme of garden maintenance has not prevented weeds from spreading unchecked, particularly in the patio area. However, managers were seeking quotations for more extensive work at the time of the inspection.

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Overall experiences and progress of children and young people: good

Children experience care and help that are sensitive to their identity and family history. Managers and staff treat them with dignity and respect, supported by helpful information about children’s cultural and religious background in their care plans.

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

The inspector observed positive relationships between children and staff. Adults engaged children in playing musical instruments and singing to them and activities that helped them to meet their targets, such as being able to say their names.

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

The level of supervision of children and security of the building mean that risks such as exploitation or going missing are small. However, staff demonstrated that they know how to respond in these and other safeguarding situations and that they would take the action needed until they believed a child was safe. This includes contacting the designated officer or using the authority’s whistleblowing procedures, if necessary.

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

Children receive support to manage their behaviour and feelings safely. As a result, Inspection report children’s home: SC463692 7 several children are far more able to regulate themselves than when they first came to live at the home. Staff enable children to make their own choices whenever possible; one young person prefers to spend most of his time in his own bedroom, as many teenagers do, but he is not left to his own devices, as staff make timely checks, spend time with him and encourage him to use communal areas, particularly if other children are elsewhere.

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

Individual risk assessments do not appraise the likelihood or severity of risk or evaluate the effectiveness of control measures. They do not indicate the circumstances staff should be aware of that may heighten risks for children. Staff have not routinely updated assessments following incidents. As a result, the documents do not provide a comprehensive understanding of each child’s risk profile or sufficient guidance for staff to follow.

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

The home has several general risk assessments but lacks assessments for use of the internet, travel in the home’s minibus or the garden.

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

The home has a designated fire exit from the rear of the property, but a locked gate impedes the route to the muster point, which staff could not initially open when demonstrating how an evacuation would be conducted. Managers had prioritised the need to ensure that children could not leave the garden on their own but had not considered introducing a mechanism that prevented this and allowed for a quick exit in an emergency. The inspector ensured, during the inspection, that the registered manager was aware of this potential risk.

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

Management arrangements for homes in the authority, including this one, have been under review for some time. However, the registered manager has not always been in full day-to-day charge of the home. A deputy manager has essentially been managing the home with the oversight of the registered manager and has made an application to register with Ofsted. This is a factor in some of the deficits identified in this inspection.

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

The review of the quality of care describes the process of consultation with children but not other relevant people, such as parents. The report did not methodically present or evaluate the outcomes that followed on from the consultation. It listed areas for future development but without identifying what improvements were being sought or specific actions managers were to take.

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

As children do not have the capacity to give consent for the regulation 44 independent person to view their files, the home has relied on notifying parents that this will happen unless they object, rather than obtaining explicit agreement. Staff have not asked the local authority to give consent.

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

The log of complaints is rarely clear about whether the complainant is satisfied at the end of the process, and sometimes the outcome itself is unclear. This means it is not possible to ensure that managers have taken opportunities to improve the service. Staff are alert to children expressing concerns through non-verbal communication. These are Inspection report children’s home: SC463692 8 recorded in a ‘wishes and wonders’ log and have resulted in improved care for the children concerned.

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

The home has produced an excellent video that illustrates what children and families can expect of the care and the support provided. This is particularly appropriate for the children referred to or living at the home. However, the video does not cover all the matters a children’s guide should, as stipulated by statutory guidance, and there is no current paper version in use.

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

Managers have recently introduced a new format for recording incidents in order to improve the level of information they contain. This has not resulted in all records covering essential particulars, and monitoring by managers has not identified when information is missing. In addition, there is no process to ensure that further action is taken as a result of incidents, such as the review of relevant risk assessments. This means there is no systematic way to ensure that managers and staff learn any lessons that arise from incidents.

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

The home’s care plans detail the way in which staff should meet the needs of children very well. However, staff do not include a contribution from children in these plans, despite an evident close understanding of children’s wishes and preferences. Parents and social workers are asked to sign documents to show they have read and agree with them, but not all plans show this.

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

Managers support staff extremely well to undertake their work. Relevant training is offered to all staff, whether full-time, bank or agency. However, not all workers have obtained the required level 3 qualification nor had the opportunity to undertake it if they are not permanently employed. Supervisors and supervisees prepare for sessions using a proforma that ensures that `they consider essential elements on each occasion. There is a clear sense of a team having an approach that focuses on enhancing children’s experience of living in the home. One member of staff said, ‘This is the best place I’ve been; since I stepped in the door I’ve not wanted to go anywhere else.’ Inspection report children’s home: SC463692 9

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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: SC463692 10

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Children’s home details

Registered provider address: Milton Keynes Council, Saxon Court, 502 Avebury Boulevard, Milton Keynes MK9 3HS

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Inspector

Chris Peel, social care inspector Inspection report children’s home: SC463692 11 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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