Children's Home run by London Borough of Hillingdon in Hillingdon

Inspection report children’s home: SC068789 1 SC068789 Registered provider: London Borough of Hillingdon Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The local authority owns and runs this home for up to nine children staying for short breaks or long-term care. In the statement of purpose, the provider states that care is provided for children who may have physical and/or learning disabilities and emotional and/or behavioural difficulties.

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Information about this children’s home

The home was registered with Ofsted in December 2006. The manager registered with Ofsted in February 2017. However, as part of a planned change in management, there is a new manager in post who is in the process of registering with Ofsted.

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Information about this children’s home

There was a COVID-19 outbreak in the home at the time of the inspection. Therefore, the second day of the inspection was carried out remotely.

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Information about this children’s home

Due to COVID-19, at the request of the Secretary of State, we suspended all routine inspections of social care providers carried out under the social care common inspection framework (SCCIF) on 17 March 2020. We returned to routine SCCIF inspections on 12 April 2021.

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Information about this children’s home

We last visited this setting on 2 February 2021, to carry out a monitoring visit. The report is published on the Ofsted website.

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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 inadequate Inspection report children’s home: SC068789 2 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: 10 December 2019

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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: SC068789 3

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Inspection date Inspection type Inspection judgement

10/12/2019 Full Good 22/05/2018 Full Good 14/06/2017 Full Outstanding 16/03/2017 Interim Sustained effectiveness Inspection report children’s home: SC068789 4

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improvement to be good

Children who receive a short-break service or temporarily live in the home appear to be happy and comfortable. Most parents reported that they are happy with the service their children receive. However, one parent complained about the quality of the service. The manager is dealing with the complaint to resolve the issues raised.

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improvement to be good

Feedback from professionals is positive. They told the inspector that staff look after the children well and communicate with professionals, schools and families effectively. One professional reported that improvement is required in the manager and staff updating children’s health records and following medical advice and guidance. Another professional reported that behaviour support plans should include information about working with parents to ensure that children return home successfully when this is the agreed plan.

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improvement to be good

Care plans are detailed. However, they are not up to date. Medication information is not recorded in children’s care plans despite the manager requesting this. Furthermore, there have been some medication errors recently. However, the manager has arranged for staff to refresh their medication training and introduced new ways of working and recording medication to address the concerns.

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improvement to be good

There is limited evidence of the children’s views, wishes and feelings being sought by the manager and staff. There is a ‘you said, and we did’ visual board. The children’s voice is not otherwise evidenced in case files. There is no evidence of key- work sessions or the use of social stories and pictorial tools to communicate effectively with children. Additionally, there is no evidence of progress reports for children. Consequently, it is unclear what development opportunities are offered to children to help them to make progress.

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improvement to be good

Some children’s case records lack important documents, such as the local authority care plan and education, health and care plan. Potentially, this could have an impact on the ability of staff to care effectively for the children.

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improvement to be good

Children live in a clean, comfortable and spacious home.

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improvement to be good

Risk assessments identify the known and anticipated risks to children. However, risk assessments do not always include the strategies to help staff to manage the risks to keep children safe. Not all children have a behaviour support plan. Some behaviour support plans are of poor quality. They do not address how to keep children safe when they self-harm. Risk assessments and behaviour support plans are not always updated following significant incidents. Inspection report children’s home: SC068789 5 There was an incident where one child physically harmed another. The manager reported that the staffing levels and intervention from staff were sufficient and appropriate to manage the incident. However, the extent of the child’s injuries raises concerns about the supervision of children, how long the incident continued for and how effective the intervention from staff was. The injured child received appropriate

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improvement to be good

medical support following the incident and protective measures were put in place.

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improvement to be good

Records indicate that one child was observed to have a bruise on the inside of their arm. A body chart was completed to record this injury. However, the records do not hold enough detail to explain how the injury was caused. Furthermore, there was no management oversight of the record. The manager reported that it is likely that the bruise was caused by the child self-harming. The manager has taken action to address this shortfall by requesting that all body chart records are shared for management oversight.

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improvement to be good

During the inspection, an agency member of staff was at the home for an induction. The agency member of staff did not appear to have the necessary skills for the role.

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improvement to be good

Staff have completed safeguarding training and know how to respond to safeguarding concerns.

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The effectiveness of leaders and managers: inadequate

The management team has been going through some changes. The new manager of the home has been in her role since June 2021 and is in the process of registering with Ofsted. The current registered manager has been covering the management of another home owned by the same local authority.

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The effectiveness of leaders and managers: inadequate

A number of staff have left during the COVID-9 pandemic and the local authority has struggled to replace them with skilled and experienced staff.

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The effectiveness of leaders and managers: inadequate

Overall feedback from staff is positive. Staff feel well supported and reported that they are happy with the changes the new manager is bringing to make improvement. However, all staff reported that the staff shortage put them under additional pressure. Some staff members have not had formal supervision for a long time. For example, one member of staff has not had formal supervision since the beginning of the pandemic in March 2020. The manager accepted that a culture has developed in the home where there is no record of formal supervision for staff. The manager is trying to change this culture. The manager has arranged supervision training for senior staff.

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The effectiveness of leaders and managers: inadequate

The new manager is hands-on and supports staff. However, she is involved in day- to-day care of children due to staff shortages. This has affected her capacity to lead and manage the home. This is evident in the poor level of formal supervision for staff and the lack of management oversight of children’s records. Furthermore, some information required and requested during the inspection was not received in a timely manner. Inspection report children’s home: SC068789 6 Quality assurance at the home is poor. Ofsted has not received some of the monthly independent quality assurance reports. The manager was not aware of this shortfall until it was raised at the inspection. Some of the independent monitoring reports do not include information about the safety of children. Additionally, the six-monthly quality of care report does not include feedback from all stakeholders.

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The effectiveness of leaders and managers: inadequate

Record-keeping is poor. Some records, such as incident records, are handwritten and are not always legible. The manager reported that action is being taken to improve the quality of records at the home. Inspection report children’s home: SC068789 7

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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—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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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

understand and apply the home’s statement of purpose;

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Requirement Due date

understand and apply the home’s statement of purpose;

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

treat each child with dignity and respect;

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Requirement Due date

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

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Requirement Due date

help each child to understand and manage the impact of any experience of abuse or neglect;

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Requirement Due date

help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult;

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Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably;

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Requirement Due date

provide to children personal items that are appropriate for their age and understanding; and 31 January 2022 Inspection report children’s home: SC068789 8 make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice;

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Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to—

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Requirement Due date

enable each child to participate in the daily life of the home; and

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Requirement Due date

ensure that any care that is arranged or provided for a child that—

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Requirement Due date

relates to the child’s development (within the meaning of section 17(11) of the Children Act 1989) or health; and

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Requirement Due date

is not arranged or provided as part of the health service continued under section 1(1) of the National Health Service Act 2006(1), satisfies the conditions in paragraph (3).

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Requirement Due date

that the care is approved, and kept under review throughout its duration, by the placing authority;

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Requirement Due date

that the care is delivered by a person who—

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Requirement Due date

has the experience, knowledge and skills to deliver that care; and

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Requirement Due date

is under the supervision of a person who is appropriately skilled and qualified to supervise that care; and

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Requirement Due date

that the registered person keeps the child’s general medical practitioner informed, as necessary, about the progress of the care throughout its duration. (Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(ix)(c)(i)(ii)(d)(i)(ii) (3)(a)(b)(c)(i)(ii)(d))

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Requirement Due date

This specifically relates to ensuring that key-work sessions and/or social stories, and pictorial tools are used to Inspection report children’s home: SC068789 9 effectively meet children’s needs and to support them to fulfil their potential. The children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due date

develop positive relationships with them;

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

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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

ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare;

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Requirement Due date

help each child to express views, wishes and feelings;

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Requirement Due date

help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child;

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Requirement Due date

regularly consult children, and seek their feedback, about the quality of the home’s care;

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Requirement Due date

help each child to understand how the child’s privacy will be respected and the circumstances when it may have to be limited;

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Requirement Due date

help each child to prepare for any review of the child’s relevant plans and to make the child’s views, wishes and feelings known for the purposes of that review; and

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Requirement Due date

is enabled to provide feedback to, and raise issues with, a relevant person about the support and services that the child receives. (Regulation 7 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(b)(i)) 31 January 2022 Inspection report children’s home: SC068789 10 This specifically relates to ensuring that the children’s views, wishes and feelings are sought by the manager and staff.

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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

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;

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Requirement Due date

help each child to understand how to keep safe;

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have the skills to identify and act upon signs that a child is at risk of harm;

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manage relationships between children to prevent them from harming each other;

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understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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take effective action whenever there is a serious concern about a child’s welfare; and

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are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(b))

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Requirement Due date

This specifically relates to ensuring that :-  risk assessments include the strategies to help staff to manage the risks to keep children safe.  That all children have a behaviour support plan in place. These plans must address how to keep children safe when they self-harm.  Risk assessments and behaviour support plans must be updated following significant incidents. 31 January 2022 Inspection report children’s home: SC068789 11 The registered person must maintain records (“case records”) for each child which—

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Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

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Requirement Due date

are signed and dated by the author of each entry. (Regulation 36 (1)(b)(c))

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Requirement Due date

This specifically relates to ensuring that –  records such as incident records are always legible.  information about medication is captured in children’s care plans 31 January 2022

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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 that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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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;

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Requirement Due date

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; 31 January 2022 Inspection report children’s home: SC068789 12 demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

research and developments in relation to the ways in which the needs of children are best met; and

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Requirement Due date

feedback on the experiences of children, including complaints received; and

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(a)(b)(c)(d)(e)(f)(g)(i)(ii)(h))

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Requirement Due date

This specifically relates to ensuring that agency members of staff have the necessary skills for the role.

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home; and

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Requirement Due date

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

The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (Regulation 35 (1)(a)(b) (2))

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Requirement Due date

This specifically relates to ensuring that records have better evaluation on length of an incident and how effective the intervention from staff was. 31 January 2022

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Requirement Due date

The registered person must ensure that an independent person visits the children’s home at least once each month.

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person—

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Requirement Due date

if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires; and

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Requirement Due date

to inspect the premises of the home and such of the home’s records (except for a child’s case records, unless the child and the child’s placing authority consent) as the independent person requires. 31 January 2022 Inspection report children’s home: SC068789 13 A visit by the independent person to the home may be unannounced.

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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

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Requirement Due date

the conduct of the home promotes children’s well-being.

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Requirement Due date

The independent person’s report may recommend actions that the registered person may take in relation to the home and timescales within which the registered person must consider whether or not to take those actions.

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Requirement Due date

The independent person must provide a copy of the independent person’s report to—

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Requirement Due date

upon request, the local authority for the area in which the home is located;

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Requirement Due date

the registered provider and, if applicable, the registered manager; and

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Requirement Due date

the responsible individual (if one is nominated). (Regulation 44 (1) (2)(a)(b) (3) (4)(a)(b) (5) (7)(a)(b)(c)(d)(e))

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Requirement Due date

This specifically relates to ensuring that information about the safety of children is captured in reports.

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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.

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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—

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Requirement Due date

the quality of care provided for children; 31 January 2022 Inspection report children’s home: SC068789 14 the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1) (2)(a)(b)(c) (5))

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Requirement Due date

This specifically relates to ensuring that the six-monthly quality of care report includes feedback from all stakeholders.

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Recommendations

 The registered person should ensure that any placing authority is challenged to provide a complete and current relevant plan. In particular, the home should ensure that case files contain up-to-date looked-after children care plans and education, health and care plans from the placing authority. This will inform care planning for the children concerned. (‘Guide to the children’s homes regulations, including the quality standards’, page 56, paragraph 11.5)  The registered person should ensure that all staff 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. A record of supervision should be kept for staff. The record should provide evidence that supervision is being delivered in line with regulation 33(4)(b). (‘Guide to the children’s homes regulations, including the quality

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Recommendations

standards’, page 61, paragraphs 13.2 and 13.3)

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, 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: SC068789 15

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Children’s home details

Registered provider address: London Borough of Hillingdon

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Children’s home details

Registered provider address: Civic Centre, High Street, Uxbridge UB8 1UW

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Inspector

Gulcin Ardic, Social Care Inspector Inspection report children’s home: SC068789 16 to 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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