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

Inspection report for children's home: 1273658 1 Registered provider: Birmingham Children’s Trust Community Interest Company 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. The home provides 10 long-term placements and six short-break placements.

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Information about this children’s home

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.

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Information about this children’s home

The Care Quality Commission registers and inspects the healthcare that is carried out on the premises. The short-break element of this home is staffed by a nursing team alongside social care staff.

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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: 28 September 2021

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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 for children's home: 1273658 2

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Inspection date Inspection type Inspection judgement

28/09/2021 Full Good 25/02/2020 Interim Improved effectiveness 19/08/2019 Full Requires improvement to be good 07/02/2019 Interim Declined in effectiveness Inspection report for children's home: 1273658 3

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requires improvement to be good

The setting is made up of three linked bungalows. Two of the bungalows currently accommodate nine children. The third bungalow offers a short-break service to three children at a time.

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requires improvement to be good

The experiences of children are mixed. Children that live full time in the home have a better experience and level of care than those who access the short-break service. Staff do not consistently ensure that children who access short breaks are able to use their communication aids. Furthermore, they are not supported to make choices about their care. This reduces children’s ability to communicate and can also lead to children feeling frustrated.

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requires improvement to be good

Staff who support children during their short-break stays are not fully aware of children’s goals. Furthermore, goals are not aspirational. For example, one child has had the same goals for over a year, despite the child having already achieved the goal. For some children who live in the home, it is unclear how goals and progress are being monitored as information recorded about these is limited.

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requires improvement to be good

It is unclear how staff decide which children would benefit from their short-break stay together. For example, one child struggles with loud sounds but her stay takes place with a child that is very loud and vocal. As a result, she is distressed during her stay.

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requires improvement to be good

The nursing team that supports children during their stay always wear a nurse’s uniform, including when children are taken into the community. This increases the risk of stigmatisation.

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requires improvement to be good

Across the settings, some written plans and records about children’s care needs do not offer consistent information and clear guidance to staff. This has led to inconsistent or incorrect care being given.

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requires improvement to be good

Children who live in the home enjoy a good range of activities in the community. For example, children enjoy going shopping, on city trips and on holiday. Children also recently went to watch the Commonwealth Games, which they really enjoyed.

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requires improvement to be good

Children’s birthdays are celebrated. One child had a personalised call from a girl band that she loves. This has created a cherished childhood memory for her.

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requires improvement to be good

Children who live in the home enjoy positive relationships with each other and with staff. They light up with joy when they see their friends and the staff that they know well. A child told an inspector that she felt loved and cared for Inspection report for children's home: 1273658 4 because of living at the home. This has contributed to improvements in her mental well-being.

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requires improvement to be good

Children who live in the home have personalised their bedrooms, and there is a lovely range of photos around the homes that capture the fun times children enjoy with each other.

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improvement to be good

Staff care in the short-break provision is not always provided in line with the company’s expectations or children’s care planning. During the inspection, staff were seen to hoist and move a child in an unsafe way. In another example, staff were seen to physically intervene with a child without recognising this as a restraint. Therefore, this was not recorded or reviewed appropriately. This results in a risk to the safety of children. The manager has taken quick action to address these concerns.

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improvement to be good

Improvements are being made to the fire doors and decor of the home. However, prompt action is not always taken to identify and remove hazards to prevent risk of harm. A large, broken garden ornament with sharp edges was not removed for several weeks. This was only removed when highlighted by the inspectors.

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improvement to be good

There are protocols in place for the temperature control of medication. However, these are not always followed. Medication has not been promptly discarded. This could have a detrimental impact on children’s health.

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improvement to be good

More positively, there is good partnership working and information-sharing with parents and nurses. This allows for children’s health needs to be understood and appropriate healthcare put in place. Nurses are quick to act on any prescription errors.

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improvement to be good

One complaint has been raised by a parent. This has been thoroughly and promptly investigated, and staff practice has changed as a result.

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improvement to be good

Specialised equipment, for example hoists, is serviced and maintained to ensure that they are safe to use.

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improvement to be good

The registered manager ensures that staff who are recruited to work in the home are subject to all the necessary checks. This helps to ensure that staff who work at the home are safe to do so.

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good

The registered manager is passionate and wants the best for the children in her care. She is aware that there are areas for development and has plans to address Inspection report for children's home: 1273658 5 some of the issues raised. She is reflective and is committed to bringing about the necessary changes.

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good

There are systems in place for the delivery of core training, and staff are up to date. Staff are trained and assessed for competency for specific healthcare tasks. However, training is not consistent across the nursing and social care teams, impacting the safety and quality of care provided.

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good

Staff receive regular supervision. However, staff appraisals are not being completed and kept up to date, compromising the manager’s ability to assess performance and fitness of the staff team.

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good

Some terminology used by the short-break staff to describe how a child is doing at a particular moment in time can lead to confusion around what action staff need to take to support the child.

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good

The staff team is well established and experienced, with the majority being qualified. One staff member is being offered management training to support his development; staff feel supported by the management team. This makes staff feel valued.

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good

Feedback received during the inspection from professionals is positive. One social worker stated, ‘[Name of manager] really has helped. She will bend over backwards to place children. I don’t know what we would have done without her.’ Another professional stated, ‘I find the staff very polite, supportive and willing to work with professionals to meet the children’s needs.’ Inspection report for children's home: 1273658 6

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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; and

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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 ensure that staff—

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Requirement Due date

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. (Regulation 6 (1)(a)(b) (2)(b)(ix))

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Requirement Due date

This specifically relates to children receiving care in line with their plans and ensuring that communication aids are used when needed. 15 November

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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 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; and

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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)(b)(d))

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Requirement Due date

This specifically relates to ensuring safe moving and handling care. 15 November Inspection report for children's home: 1273658 7 It also relates to ensuring the prompt identification and removal of hazards.

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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

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; and

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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)(b)(c)(e))

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Requirement Due date

This requirement is restated from the last inspection. 15 November

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Requirement Due date

The care planning standard is that children–

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Requirement Due date

receive effectively planned care in or through the children’s home.

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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 each child’s relevant plans are followed. (Regulation 14 (1)(a) (2)(c))

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Requirement Due date

This specifically relates to the matching process for children in the home. 15 November

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23 (1)) 15 November

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Requirement Due date

The registered person must ensure that all employees—

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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)(c)) 15 November Inspection report for children's home: 1273658 8 The registered person must prepare and implement a policy ("the behaviour management policy") which sets out—

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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. (Regulation 35 (1)(b))

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Requirement Due date

This specifically relates to restraint being recognised, recorded and reviewed. 15 November

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Requirement Due date

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; and

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Requirement Due date

are kept up to date. (Regulation 36 (1)(a)(b))

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Requirement Due date

This specifically relates to ensuring that plans offer detail to allow for consistent care practice. 15 November

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Recommendations

 The registered person should ensure that staff record information about individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 62, paragraph 14.4)  The registered person should ensure that children’s homes are 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)

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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 for 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

Louise Battersby, Social Care Inspector Alison Snell, Social Care Inspector Inspection report for children's home: 1273658 10 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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Inspectors

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Inspectors

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Inspectors

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