Children's home run by Birmingham Children’s Trust Community Interest Company

Inspection report children’s home: 1273658 1 Registered provider: Birmingham Children’s Trust 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 provides care for up to 16 children who have a physical and/or learning disability and/or a sensory impairment. Children are aged between five and 17. Children may stay beyond their 18th birthday while they finish their education. The home provides 10 long- term placements and six short-break placements. The home has been operated for over 20 years by a local authority. The service and the existing manager registered again under a children’s trust limited company in March 2018. The Care Quality Commission registers and inspects the healthcare that is carried out on the premises.

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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: 7 February 2019

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requires improvement to be good

Overall judgement at last inspection: declined in effectiveness

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requires improvement to be good

Enforcement action since last inspection: This home was subject to three compliance notices following an interim inspection on 7 February 2019. Inspection report children’s home: 1273658 2 To evaluate the home’s progress in addressing the three compliance notices, a monitoring visit was conducted on 10 April 2019. The inspector found that the provider had taken effective steps to meet all three compliance notices .

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Inspection date Inspection type Inspection judgement

07/02/2019 Interim Declined in effectiveness 12/09/2018 Full Requires improvement to be good Inspection report children’s home: 1273658 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 quality and purpose of care standard is that children receive care from staff who— understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. In particular, the standard in paragraph (1) requires the registered person to— ensure that the premises used for the purposes of the home are designed and furnished so as to— meet the needs of each child. (Regulation 6(1)(a)(b)(2)(c)(i)) 30/11/2019

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who— develop positive relationships with them; engage with them; and take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. In particular, the standard in paragraph (1) requires the registered person to— ensure that staff— help each child to express views, wishes and feelings. (Regulation 7(1)(a)(b)(c)(2)(a)(ii)) This relates to staff using children’s preferred communication styles and methods in their daily lives. 30/11/2019

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual respect and trust; 30/11/2019 Inspection report children’s home: 1273658 4 an understanding about acceptable behaviour; and positive responses to other children and adults. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans. (Regulation 11(2)(a)(i)) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person 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

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Requirement Due date

home’s statement of purpose; ensure that staff have the experience, qualifications and skills to meet the needs of each child; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. Regulation 13(1)(2)(a)(c)(h)) This relates to staff training in the core functions of the home and that staff in senior roles demonstrate proper leadership and best practice. 30/11/2019

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Requirement Due date

The care planning standard is that children— receive effectively planned care in or through the children’s home; and have a positive experience of arriving at or moving on from the home. In particular, the standard in paragraph (1) requires the registered person to ensure— that arrangements are in place to— manage and review the placement of each child in the home; and that each child’s relevant plans are followed. (Regulation 14(1)(a)(b)(2)(b)(ii)(iii)( c)) This relates to staff implementation of the placing authority plan, their contribution to and implementation of in-house risk and behaviour management plans, and the quality of their 30/11/2019 Inspection report children’s home: 1273658 5 review of progress to each child’s review. If the Regulatory Reform (Fire Safety) Order 2005(a) applies to the home— the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23

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Requirement Due date

(duties of employees), are complied with in respect of the home. (Regulation 25(2)(b)) 30/11/2019

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Requirement Due date

The registered person must prepare and implement a policy ("the behaviour management policy") which sets out— how appropriate behaviour is to be promoted in the children’s home; and the measures of control, discipline and restraint which may be used in relation to children in the home. The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (Regulation 35(1)(a)(b)(2)) This relates to management review of how staff implement the behaviour management approach to physical intervention and de-escalation. 30/11/2019

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Requirement Due date

The registered person must ensure that— within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure ("the user"), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure. (Regulation 35(3)(a)(iv)(v)(vi)(vii)) 30/11/2019

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Recommendations

 The registered person is responsible for maintaining good employment practice as set out in regulations 31-33. They must ensure that recruitment of staff, including agency staff, safeguards children and minimises potential risks to them. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1) This relates to the home’s records of staff recruitment checks. Inspection report children’s home: 1273658 6

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improvement to be good

Regulatory shortfalls in leadership and management, the quality of the environment, safeguarding, safer recruitment, and care planning are recurrent weaknesses from the last full inspection. Despite these ongoing shortfalls, children make progress and have a positive experience at the home.

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improvement to be good

Improvements in children’s care planning have been slow. Records vary in quality and sufficiency. This can range from good to poor. Staff do not always have copies of children’s statutory plans or information from statutory reviews on which to base their care. Staff do not always set meaningful goals for children to achieve. Reports written by staff about children’s progress sometimes lack detail against the purpose of the placement and the child’s starting point. Not all staff use children’s preferred form of communication in their day-to-day interactions. A lack of planning on shifts, particularly around mealtimes, results in inconsistency and creates a missed opportunity for positive communication between staff and children. However, a few staff have good insight into children’s needs and form affectionate and helpful relationships. There are some lovely examples of really good communication with children about significant events in their lives. This can include staff

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improvement to be good

using photographs, symbols and signing to children. These varied methods of communication help children to be better informed and to be able to express their wishes. One social worker described staff care practice as ‘most sensitive and child- centred’. The provider has invested in the environment so that children who have a physical disability or a sensory impairment can fully enjoy the outdoor play area and have indoor comfort. However, two of the children’s bedroom are not of a satisfactory standard. Both bedrooms lack comfortable furnishings and are not personalised to reflect a child’s interests or wishes. This does not show how staff respect each child as an individual. Staff maintain positive relationships with health professionals, teachers and parents. Children go on holidays and enjoy varied day trips. Staff have helped one child to make a successful move to foster care.

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improvement to be good

Managerial monitoring does not always pick up weaknesses in how the service keeps children safe. In one case, it was difficult to determine if the action taken by managers after a child had unexplained bruising was sufficient to address concerns. The service generally works well with safeguarding professionals. The children’s social care team manager told the inspector, ‘The team links well with our services on safeguarding and help and protection.’ Inspection report children’s home: 1273658 7 Children’s behavioural and risk management plans do not always contain sufficient information. For example, they do not describe how staff should respond to key behaviour that poses a challenge to staff and other children. Some staff do not always follow children’s behavioural plans. Staff occasionally move children using unauthorised techniques of physical intervention. When physical restraint takes place, staff do not always make a full record of what happened. Consequently, the

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improvement to be good

manager is not always aware of potential weaknesses in staff practice. Fire safety is broadly satisfactory. The provider is investing in a new fire alarm system. All staff are trained in fire safety. However, the manager has been too slow to implement the advice of the fire service to improve fire signage. The manager took action during the inspection to improve the safe storage of oxygen cannisters in a child’s bedroom. Records of agency staff recruitment do not always clearly show the staff’s suitability to work with children. Despite the shortfalls, the service is safer than it has been. Incidents of harm have reduced. Protection for children who may go missing from home is much better. Regular checks of the environment now help to reduce hazards.

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

Shortfalls continue to occur in the managerial monitoring of the service. There are still no embedded systems that help managers to review the quality of care and to drive ongoing improvement in care practice. The manager and the responsible individual had identified the broad issues found at this inspection in their development plan. They have begun to take action in respect of safeguarding, care planning and restructuring management. Formal managerial review of significant incidents continues. The manager is increasingly identifying and acting on learning that she has drawn from events and complaints. The manager is now ensuring that any emerging learning is taken through to staff supervision. This is helping to ensure that staff are accountable for their practice, improvement is achieved, and that support is given. Plans for improvement in the short-break service are also underway with a new deputy

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

manager. The overall review of the short-break service by Birmingham Health Trust and the Children’s Trust is in the final stages. Many staff are long standing and experienced with children who have a learning and/or physical disability. However, as the issues identified in this report indicate, not all staff have experience, training or demonstrate the necessary skills in the core requirements of a disability service. In some cases, senior staff ignore children’s goals and plans. Training records do not easily evidence staff skills and competencies. Staff do not have training in preventing extremism or self-injurious behaviour. Consultation with staff, children, their parents and the placing authority is now in place and forms part of the manager’s review of the quality of care. Her plans for improvement address the issues about shortfalls in communicating with children and the quality of Inspection report children’s home: 1273658 8

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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: 1273658 9

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Children’s home details

Registered provider: Birmingham Children’s Trust Community Interest Company

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Children’s home details

Registered provider address: Third Floor Zone 16, 1 Lancaster Circus, Birmingham B4 7DJ

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Inspectors

Christy Wannop, social care inspector Debbie Bond, social care inspector Inspection report children’s home: 1273658 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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