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 operated by a healthcare trust and provides short breaks for up to 12 children at a time, aged from five to 17 years.

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Information about this children’s home

In its statement of purpose, the provider states that care is provided for children who have a variety of complex needs including sensory impairment, physical and/or learning disabilities and/or challenging behaviour.

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Information about this children’s home

The registered manager was registered with Ofsted in April 2019. She has a qualification relating to adult care.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children‟s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 4 December 2018

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

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

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Inspection date Inspection type Inspection judgement

04/12/2018 Full Good 01/08/2017 Full Good 23/03/2017 Interim Sustained effectiveness 01/11/2016 Full Good Inspection report children‟s home: SC474543 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 protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

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 (1)(2)(d)) Specifically, ensure that plastic gloves are not available to children who may ingest them. 31/10/2019

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

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 (1)(2)(d))

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Requirement Due date

Specifically, follow up the independent visitor‟s advice regarding the lack of safety checks that are being recorded in the home. The registered person must— keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)(b)) 30/11/2019

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Requirement Due date

The independent person must produce a report about a visit (“the independent person‟s report”) which sets out, in particular, the independent person‟s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and 31/10/2019 Inspection report children‟s home: SC474543 4 the conduct of the home promotes children‟s well-being. (Regulation 44 (4)(a)(b)) Specifically, the independent visitor should make their opinion explicit in the report. The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

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;

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Requirement Due date

ensure that staff work as a team where appropriate;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child;

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Requirement Due date

ensure that the home‟s workforce provides continuity of care to each child. (Regulation 13 (1)(a)(b)(2)(a)(b)(c)(d)(e)) 31/10/2019

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Requirement Due date

The registered person must ensure that— the privacy of children is appropriately protected. (Regulation 21 (a)) Also, the provider should have a clear policy on how personal care is delivered in order to promote the welfare and protect the privacy of children. 30/09/2019

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out— The measures of control, discipline and restraint which may be used in relation to children in the home.

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Requirement Due date

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)—

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Requirement Due date

has spoken to the user about the measure; and 31/10/2019 Inspection report children‟s home: SC474543 5 has signed the record to confirm it is accurate; and

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Requirement Due date

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)(a)(b)(i)(ii)(c)) Specifically, ascertain the impact of the measure on children who are non-verbal and ensure it is recorded that their parent or carer is informed of the measure. The registered person must ensure that— at all times, at least one person on duty at the home has a suitable first aid qualification. (Regulation 31 (1)(2)(a)(b)) 31/09/2019

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Requirement Due date

The registered person may permit an individual to start work at the home despite the fact that the requirement in paragraph (3)(d) has not been met if—

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Requirement Due date

the registered person has taken all reasonable steps to obtain full information about each of the matters in Schedule 2 in respect of the individual, but the enquiries in relation to any of the matters in paragraphs 3 to 6 of Schedule 2 are incomplete;

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Requirement Due date

full and satisfactory information in respect of the individual has been obtained in relation to the matters in paragraphs 1 and 2 of Schedule 2. (Regulation 32 (7)(a)(b)(c)(d)(8)) Specifically, records held at the home, or those presented for inspection purposes, must confirm that all checks have been completed. 30/10/2019

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development;

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(a)(b)) 30/10/2019

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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 investigation. (Regulation 39 (3)) Specifically, ensure that the record is clear so that this may be scrutinised by the registered manager and the independent visitor as part of their monitoring. 30/10/2019

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Recommendations

Inspection report children‟s home: SC474543 6  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 home regulations including the quality standards‟, page 35, paragraph 7.15) Specifically, the provider should have in place a policy to cover the covert administration of medication.  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‟, page 55, paragraph 11.1) Specifically, ensure that all staff understand each child‟s targets and can evidence the progress children have made.

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improvement to be good

Some children‟s privacy is not sufficiently respected when they receive personal care from staff. The registered manager has not provided staff with clear guidance on how to deliver personal care which promotes children‟s welfare and protects their privacy.

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improvement to be good

Recent heavy rain has resulted in leaks and water damage to the premises. To prevent cancelling children‟s short breaks, children who usually stay in one unit in the home stayed in the other unit. However, this was not a suitable environment for those children whose behaviour is more challenging. This resulted in some challenging incidents, including minor injuries to some children.

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improvement to be good

Children‟s needs are usually well matched to others staying for a short break. Children have access to a variety of play equipment, garden and sensory areas. They enjoy trips out to places of interest and outdoor play when staffing (and weather) permit.

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improvement to be good

Families value the positive relationships some staff have formed with their children. Staff show a good understanding of the children‟s needs. However, not all staff are clear about what targets the children are working towards or their progress in meeting these.

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improvement to be good

The introduction of coffee mornings has provided parents with opportunities to meet other parents for support and to establish networks.

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improvement to be good

Children and their families benefit from a good introduction to the home. Following assessment, children are welcome to visit for as long as they need to before staying overnight. Staff mark children‟s transitions from the home when they reach the age of 18, to help them understand the change. Inspection report children‟s home: SC474543 7 All parents spoken with said that their children enjoy their short breaks. They said that their children get excited to attend and are then reluctant to return home afterwards. Parents value the time their children spend away from the family home, with the opportunity to meet other children and adults.

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improvement to be good

Mealtimes are very well organised. Children help staff, for example, by laying the table. Staff and children sit together in a relaxed atmosphere to enjoy their meal, with lots of chatting and shared good humour. Some of the children even enjoy breakfast in bed as a treat. Other children, who ate only restricted foods, have now been willing to try new foods, improving their diet.

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improvement to be good

The building is not ideal, but as a parent said, „staff do their best‟ with it. Damage caused to the building is repaired swiftly. However, some safety aspects related to the premises have lapsed. For example, the independent visitor report highlighted that fire and health and safety checks of the premises are not being completed every day as required by the home. This causes potential risk to the children and the staff.

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improvement to be good

Staff generally have a good awareness of how to keep children safe, and of how to report any safeguarding concerns. Staff welcome any complaints so that these can be thoroughly investigated. However, records shown by the registered manager to the inspector failed to provide a clear audit trail of the complaint investigation and outcome.

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improvement to be good

During the inspection the inspector found a box of plastic gloves that were accessible to children in a bathroom. This presents a choking hazard to children.

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improvement to be good

Although some staff are trained in first aid, there are not enough to ensure that someone trained in first aid is on each shift. In addition, the home has yet to implement a policy on the use of covert medication to ensure staff are clear about the use of such practices.

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improvement to be good

Staff use positive management strategies to help children manage their behaviour. Although use of restraint is low, reports of some incidents do not explore what the child felt about being restrained as the child is „non-verbal‟. Neither do records show that all the parents of the children involved were informed of the measure. This does not ensure that the views of children and their families are sought in order to ensure children‟s safety.

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improvement to be good

The staff team is stable, with no staff leaving during this inspection year. This provides children with consistency in those caring for them. Staff files relate to people recruited a few years ago. However, the records shown by the registered manager to the inspector did not contain full evidence of the checks required by regulation.

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improvement to be good

Parents reported that they had confidence that their children feel safe and secure. Regular communications from the staff team keep parents informed about their Inspection report children‟s home: SC474543 8 children‟s well-being.

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

Staffing is the main issue affecting the home‟s progress. The registered manager frequently covers shifts to ensure that children‟s short breaks are not cancelled. However, this limits her time for management tasks. For example, the levels of formal staff supervision are not taking place in line with the homes own policy of once every four weeks, while training in first aid has lapsed.

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

The registered manager intends to change shift patterns to provide more staff when children are present. This should also allow an increased staff presence when children are in the home, to facilitate more trips out for the children. It should also provide further opportunities for management tasks, staff development and support.

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

In some parts of the home there can be excessive noise, which may affect those children who have autism spectrum disorder. This includes doors banging, staff speaking loudly and noise from the television when no one is viewing it. Those staff who have not received training in autism spectrum disorder for some time may benefit from further training in creating low-arousal environments.

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

The registered manager finds reports by an independent visitor useful in defining what needs to be done to improve the service. Reports are generally more geared to health services but, nevertheless, have a clear focus on safety. However, reports do not make explicit the visitor‟s opinion about whether children are safeguarded and their well-being promoted. Some of the independent visitor‟s suggestions to improve safety have not been actioned in a timely manner.

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

Only one of five recommendations made at the last inspection has been met. Two recommendations are repeated in this report. Two recommendations relating to staff supervision and children‟s privacy are now requirements. A few staff do not ensure that children‟s privacy is respected when they are receiving personal care.

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

The home does have a statement of purpose and operates to this. However, an old version appears on the home‟s website and the provider has not supplied Ofsted with a revised version as required.

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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 Inspection report children‟s home: SC474543 9 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 10

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Children’s home details

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

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Children’s home details

Registered manager: Melanie Revel-Burroughes

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Inspector:

Jacqueline Graves, social care regulatory inspector Inspection report children‟s home: SC474543 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 looked after children, safeguarding and child protection.

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Inspector:

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Inspector:

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Inspector:

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

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