Children's Home run by Bristol City Council in Bristol

Inspection report for children’s home: SC031504 1 SC031504 Registered provider: Bristol City Council Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned by a local authority. It is registered to provide a short-break service and longer-term care for up to six children who may have learning disabilities and/or physical disabilities. At the time of the inspection, one child was living at the home. Two children were staying overnight on the first day of the inspection, and two were staying overnight on the second day.

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Information about this children’s home

The manager has been registered with Ofsted since 2007.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers requires improvement to be good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Overall judgement at last inspection: good

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good

Enforcement action since last inspection: none Inspection report for children’s home: SC031504 2

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Inspection date Inspection type Inspection judgement

07/03/2023 Full Good 18/05/2021 Full Good 12/11/2019 Full Good 04/12/2018 Full Good Inspection report for children’s home: SC031504 3

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Overall experiences and progress of children and young people: good

Children make good progress at this home from sometimes difficult starting points.

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Overall experiences and progress of children and young people: good

Children visiting for short periods of time receive good-quality, warm and responsive care. Staff understand children’s needs and how they communicate.

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Overall experiences and progress of children and young people: good

One parent spoke positively about the progress made by her child and the care provided to them during their visits. They reported that their child’s independence skills and ability to manage new situations have improved. As a result, the parent said they have been able to take their child shopping and, recently, on holiday abroad, which would have been more difficult in the past.

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Overall experiences and progress of children and young people: good

One child made excellent progress during their time living here. With support from staff, they were able to significantly develop their independence and self-care skills. They were also helped to make changes to their eating and exercise habits. This resulted in the child losing a large amount of weight and a health condition related to their weight being reversed.

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Overall experiences and progress of children and young people: good

This child’s move from the home was well planned. Staff and managers advocated strongly for them throughout the move to ensure the right care and support were in place.

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Overall experiences and progress of children and young people: good

One child recently moved into the home on an emergency basis. This child has complex medical needs, and during the inspection, they needed emergency medical treatment. Medical professionals advised that the response from staff was appropriate, and that the incident was a result of this child’s condition rather than any omission in their care. However, this incident did highlight several gaps in the information and processes within the home that are specific to this child.

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Overall experiences and progress of children and young people: good

While some planning did take place before their move, communication between the home and medical staff should have been more robust. Once concerns were highlighted, action was taken by managers, on the advice of health professionals, to address the identified shortfalls, although these were not all in place by the end of the inspection.

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Overall experiences and progress of children and young people: good

The home environment is tailored to the needs of the children with toys and sensory equipment throughout. Some areas of the home need refreshing, and one bathroom is not fully accessible for children who have mobility issues. Managers advised that funding has been agreed on to invest in improving the appearance of the home and updating this bathroom, although no specific date has yet been set for this work.

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Overall experiences and progress of children and young people: good

Storage for medical equipment and supplies for one child is not yet organised with a clear system that staff understand. Inspection report for children’s home: SC031504 4 Due to this child’s health needs, some medical equipment and supplies need to be kept in their bedroom. However, the storage of these at present appears untidy, and some used and empty packets have been left in the room. This impacts on the homeliness of the child’s bedroom.

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Overall experiences and progress of children and young people: good

Personal protective equipment is used by staff when working with some children due to them displaying physically challenging behaviours that could place staff at risk. These measures are recorded in children’s care plans and discussed with professionals and parents in child-in-need meetings. However, care plans do not clearly include consent for the use of these measures or timescales for their review within the home.

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How well children and young people are helped and protected: good

One child living in the home has significant and complex health needs. Agency nursing staff are being used to ensure this child’s medical needs are met. Managers have used block booking of these staff as far as possible to try and provide some consistency for the child.

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How well children and young people are helped and protected: good

Safer recruitment procedures have been followed in relation to agency staff, with additional checks and information requested and recorded on file.

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How well children and young people are helped and protected: good

When incidents take place, staff generally provide children with empathetic and appropriate responses consistent with the strategies in their support plans.

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How well children and young people are helped and protected: good

Since the previous inspection, 31 incidents of restraint have taken place across both services, involving six children. Restraint is used in appropriate circumstances and, for the most part, in line with children’s care plans. However, on one occasion, a restraint was used with a child on the ground. While staff were trained in this hold, this was not an approved strategy for this child. Managers identified this issue and promptly addressed this with staff on an individual basis.

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How well children and young people are helped and protected: good

Records of restraint are detailed and debriefs are offered to staff. Management oversight is good, with incidents being reflected on and lessons learned recorded. However, following physical intervention, children are not always asked about their feelings.

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How well children and young people are helped and protected: good

One medication error has taken place. This was identified and followed up; however, medical advice was not sought until several days later. Managers have taken action to address issues in staff practice relating to this incident.

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How well children and young people are helped and protected: good

Reports from professionals were largely positive regarding the management of incidents and safeguarding concerns within the home. Some concerns were raised by medical staff about the planning of care for one child with significant medical needs. However, they were clear that there were no immediate safeguarding concerns for this child and that their health needs are currently being met. Inspection report for children’s home: SC031504 5

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good

At the time of the inspection, the home’s manager was unavailable. Therefore, discussions regarding the management and development of the home were held with the responsible individual and the local authority team manager who oversees the home.

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good

Management oversight is evident in records and is of good quality, with issues around staff practice being identified and addressed.

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good

Practice is underpinned by detailed risk assessments and care plans for most children. These plans provide staff with clear guidance about how best to support children.

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good

However, sections in one child’s care plan were incomplete. For another child, information and guidance for staff around their health and care needs are not clear or specific enough.

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good

Staff enjoy working at this home and were positive about the support and visibility of managers. However, some staff expressed anxiety about being able to appropriately care for this child, given the complexity of their health needs.

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good

One medical professional expressed concern about elements of this child’s care and the planning and documentation at the home being disorganised. However, due to agency nurses being present in the home to meet this child’s medical needs, no immediate concerns were raised about this child’s safety.

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good

Managers accept that communication and planning could have been improved when planning for this child’s move into the home, and during the inspection, some action was being taken to address identified shortfalls.

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good

Some children visiting for short breaks have complex needs and can display behaviour that can pose a significant physical challenge to staff.

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good

Managers understand the changing needs of children accessing the setting and the potential impact of this on staff. A clear training plan is in place for the next 12- month period to support the continuing development of the staff team in the long term.

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good

There are several vacancies for staff in both services, and therefore, agency staff are used regularly. Some attempts have been made to mitigate any impact on children by booking the same agency staff wherever possible. Inspection report for children’s home: SC031504 6 Managers reported that ongoing attempts are being made to recruit for these positions. Due to the reduction in staffing numbers, the home is also currently offering short breaks to a reduced number of children. Inspection report for children’s home: SC031504 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, 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

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.

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Requirement Due date

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)(f)(g)(i)(ii)(h))

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Requirement Due date

In particular, ensure that support plans and risk assessments for each child are in place and up to date and that guidance for staff on how best to support children is clear and reflects children’s needs. 10 January 2024 Inspection report for children’s home: SC031504 8

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Recommendation

 The registered person should ensure that medical supplies and equipment are stored appropriately and are accessible. Where it is necessary to store items in children’s bedrooms, efforts should be made to keep these spaces as homely and comfortable as possible. (‘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: SC031504 9

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Children’s home details

Registered provider address: City Hall, College Green, Bristol, BS1 5TR

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Inspector

Janet Jauregui, Social Care Inspector Inspection report for children’s home: SC031504 10 regulates and inspects 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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