Children's home run by The Children’s Trust

Assurance inspection report for children’s home: SC062079 1 SC062079

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Inspected under the social care common inspection framework

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Information about this children’s home

This service provides residential care for children who have an acquired brain injury, multiple disabilities and/or complex health needs. The service is registered as a children’s home to accommodate up to 66 children across several separate houses. The types of residential care provided include long-stay care as well as short-break services. The home also provides rehabilitation services for children who have recently been diagnosed with an acquired brain injury. There is a non-maintained school on site, registered with the Department for Education (DfE), which some of the children attend. The home is also registered with the Care Quality Commission (CQC) because it provides nursing care. There were 49 children staying in the home at the time of this inspection.

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Information about this children’s home

The manager was registered by Ofsted on 1 May 2020.

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Information about this children’s home

Inspectors were aware during this inspection that a serious incident that occurred at the setting since the last inspection is under investigation by the appropriate authorities. While Ofsted does not have the power to investigate incidents of this kind, actions taken by the setting in response to the incident were considered alongside other evidence available at the time of the inspection to inform inspectors’ judgements.

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Information about this children’s home

Enforcement action since last inspection: none

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Information about this inspection

At this inspection, the inspectors evaluated:

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Information about this inspection

 the care of children  the safety of children  the effectiveness of leaders and managers. Assurance inspection report for children’s home: SC062079 2 Inspectors have looked closely at the experiences and progress of children, using the social care common inspection framework. This assurance 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’. Assurance inspection report for children’s home: SC062079 3

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Findings from the inspection

We did not identify any serious or widespread concerns in relation to the care or protection of children at this assurance inspection.

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The care of children

Children receive well-informed, thoughtful care that meets their needs. Staff are attentive and considerate in the ways that they care for children who may not be able to express their wishes and feelings clearly.

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The care of children

Staff know the children well and are attuned to recognise when a child may be unhappy or in need of additional support. Staff are mindful that as children grow older, their interests may change. They seek to introduce children to new experiences and think carefully about each child’s capacity to learn and develop in order to provide age-appropriate care.

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The care of children

Staff work with considerable skill and patience in order to provide individualised care that, as far as possible, gives children choices and allows them to spend time doing things that they enjoy.

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The care of children

Staff enjoy working in the home and are passionate about providing high standards of care for children. A number of staff raised concerns that although there are enough staff to provide safe care for children, they feel stretched. They told inspectors that the high staffing ratios required for some tasks reduces the capacity for them to have the space they would like to support children better. For example, they felt that, at times, children might have to wait for staff to be available for bathing or help with eating. Some staff also felt that there was some impact on the number and range of activities that they could offer to children.

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The safety of children

Due to their complex health needs, most children are particularly vulnerable and need constant supervision and expert intervention and care to ensure that they stay safe and well. A brief lapse in supervision or a slip in standards of care can have serious consequences for the safety and well-being of the children. Managers and senior staff have effective systems in place to ensure close oversight of the quality of care for children. Managers strike a good balance and take firm action in response to any slip in the standards of care. They are also mindful to create a learning culture in which staff feel safe to self-report any errors and raise concerns promptly if they witness unsafe practice.

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The safety of children

When incidents occur, managers work closely in partnership with relevant external safeguarding agencies. They make good use of the specialist practitioners working in the home to conduct detailed investigations when necessary. They take an approach to investigation and remedial action that is systematic and looks closely at how Assurance inspection report for children’s home: SC062079 4 health, care and education staff work together. The learning from these investigations reduces the risk that errors will recur.

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The safety of children

Detailed care plans are on hand to guide staff in relation to each child’s individual needs when they are undertaking delegated healthcare tasks and feeding children. Nursing staff carry out many of these tasks, and there is good support and oversight from senior healthcare staff to care staff to ensure competent, safe practice. However, some staff told the inspectors that they have not received training to equip them to meet the behavioural needs of one child who needs a very high level of care, or to understand the roles of the different staff members who provide the support and care.

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The safety of children

Staff and managers are adept at noticing changes in children’s presentation and behaviour that indicate that they may be experiencing pain. When this occurs, staff take swift and decisive action to ensure children’s safety and well-being. When children sustain injuries, managers make sure that the cause of the injury is explored, involving external health and safeguarding professionals as necessary. Learning from incidents is used effectively to reduce the risk of a recurrence.

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The effectiveness of leaders and managers

Leaders and managers have a sound awareness of the strengths and weaknesses of the home. They demonstrate a commitment to continuous improvement by addressing the shortfalls that they have identified as part of their recent review of the service. Changes to practice that have recently been implemented include the introduction of a 24-hour senior clinical team. This has strengthened management monitoring and support to staff during evenings and weekends, and it ensures that senior nursing support can be provided to children without delay at these times.

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The effectiveness of leaders and managers

Managers are in the process of introducing a new electronic system for storing children’s records. Steps are being taken to ensure that the storage system is streamlined, but in the meantime, some records are being stored in multiple places. For the majority of children, this is not having a negative impact on the quality of care that they receive; staff know the children well and are familiar with how to meet their complex needs, and key plans in relation to providing safe care are readily available.

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The effectiveness of leaders and managers

Leaders and managers have responded well to the requirements made at the last inspection. They have looked closely at the potential barriers for staff to report concerns promptly and have ensured that the need to do so is threaded through a wide range of staff training. Staff are now clear about their responsibilities to report concerns without delay. Managers have addressed a shortfall in relation to competency assessments for staff undertaking delegated health tasks. They have addressed the gaps and introduced a new system that is designed to respond more dynamically to individual needs rather than a requirement for all staff to undertake new assessments annually. Assurance inspection report for children’s home: SC062079 5

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Inspection date Inspection type Inspection judgement

18/05/2022 Full Good 24/08/2021 Full Good 21/01/2020 Full Outstanding 12/12/2018 Full Outstanding Assurance inspection report for children’s home: SC062079 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, The 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 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 the home has sufficient staff to provide care for each child. (Regulation 13 (1)(a)(b) (2)(d))

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Requirement Due date

This specifically refers to the need for staff to undertake behaviour management training in order to ensure that they can intervene effectively and safely to meet children’s behavioural needs. 3 July 2023

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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 the home has sufficient staff to provide care for each child. (Regulation 13 (1)(a)(b) (2)(d))

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Requirement Due date

In particular, managers should consult with staff in order to understand and respond to their concerns that there are 3 July 2023 Assurance inspection report for children’s home: SC062079 7 insufficient staffing resources to consistently provide the support children need to enhance their experience of care. Assurance inspection report for children’s home: SC062079 8

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Children’s home details

Provision sub-type: Residential special school

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Inspectors

Lee Kirwin, Regulatory Inspection Manager Helen Simmons, Regulatory Inspection Manager Ashley Edwards, Social Care Inspector Assurance inspection report for children’s home: SC062079 9 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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Inspectors

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

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