Children's Home run by Broadlands Hall Limited in Suffolk

Unique reference number SC060936 Inspector Louisa Bayley Type of inspection Full Provision subtype Children's home

p.1

Registered person Broadlands Hall Ltd Registered person address Garland House Garland Street Bury St. Edmunds Suffolk IP33 1EZ Responsible individual Keith Anthony Boulter Registered manager Sarah Louise Everett Date of last inspection 22/11/2013 2 of 13 Inspection date 21/05/2014

p.1

Previous inspection inadequate progress Enforcement action since last inspection There has been no enforcement action since the last inspection.

p.2

Overall effectiveness inadequate

Outcomes for children and young people good Quality of care adequate Keeping children and young people safe inadequate Leadership and management inadequate

p.2

Overall effectiveness

This home provides personalised care to young people with complex needs. Young people benefit from positive outcomes as a result of living in the home. However, a number of shortfalls identified at the inspection compromise safety. Shortfalls include; insufficient staffing, poor security of the home, ongoing maintenance repairs and inadequate resources, including heating and hot water on occasions. There is a consistent failure to respond to issues identified through monitoring of the home. This means the home is not operating in line with the Statement of Purpose and compromises young people’s rights to equality in that some basic resources and equipment are not always available. Additionally, although staff are aware of and understand safeguarding procedures, they do not all feel confident in receiving a positive response from the registered provider if they use the whistle blowing procedures.

p.2

Overall effectiveness

There are shortfalls relating to record keeping, in respect of restraints and sanctions, which do not directly impact on the outcomes for young people.

p.2

Overall effectiveness

Despite the shortfalls, young people do make good progress. Parents and external professionals are generally positive about the care provided, although some cite their concern about insufficient staffing. They identify the progress their children 3 of 13 make and are positive about the relationships between the staff and young people. Young people are positive about their care and living in the home. They are evidently happy and interact very well with the adults who care for them.

p.2

Overall effectiveness

Ofsted have received and investigated three complaints since the last inspection. The registered provider has co-operated with the investigations and put appropriate actions in place. The complaints are now closed.

p.3

Overall effectiveness

Young people are confident in the home and indicate that they feel safe. However, some aspects of the premises and practice, including failure to adhere to risk assessments, have the potential to put young people at risk. There are gaps in information in some recruitment records and, in some cases, a lack of clear evidence of assessment of suitability for staff working with young people. This does not promote safe practice and recruitment and puts young people at risk. Additionally, staff do not all have the training they need to ensure they are equipped with the skills and up to date knowledge to manage challenging behaviour.

p.3

Overall effectiveness

There is a disparity in the understanding of the registered provider and the Registered Manager of the weaknesses in the home. As a result, the registered provider has not taken action to address identified issues promptly. The lack of clear lines of communication and the perception of the staff team of feeling unsupported by the registered provider has led to low staff morale. Staff say they are limited in the extent to which they can support young people because of constraints placed on resources. 4 of 13

p.3

Information about this children’s home

This privately owned children's home provides care, accommodation and education for up to 11 young people with learning, emotional and behavioural difficulties.

p.4

Information about this children’s home

There is a large education building, which is inspected by Ofsted, in the grounds of the home.

p.4

Inspection date Inspection type Inspection judgement

22/11/2013 Interim inadequate progress 09/08/2013 Full good 22/02/2013 Interim good progress 03/10/2012 Full good

p.4

Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

p.4

Reg. Requirement Due date

4 (2001) ensure that the children’s home is at all times conducted in a manner which is consistent with its statement of purpose (Regulation 4 (6)) 01/07/2014

p.4

Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children’s home, a written record is made in a volume kept for the purpose of which shall include all matters detailed in Regulation 17B (Regulation 17B (3) (a) (b) (e) (f)) 01/07/2014

p.4

Reg. Requirement Due date

23 ensure that any activities in which children 01/07/2014 5 of 13 (2001) participate are so far as reasonably practicable free from avoidable risks, with specific regard to following individual risk assessments for young people (Regulation 23 (b))

p.4

Reg. Requirement Due date

(2001) ensure that there is at all times, having regard to the size of the children’s home, the statement of purpose, and the number and needs (including any needs arising from any disability) of the children accommodated there, a sufficient number of suitably qualified, competent and experienced persons working at the children’s home (Regulation 25 (1) (a)) 01/07/2014

p.5

Reg. Requirement Due date

(2001) ensure that staff working in the home have the qualifications, skills and experience necessary for the work he is to perform; and (d) full and satisfactory information is available in relation to him in respect of each of the matters specified in Schedule 2 (Regulation 26 (3) (b) (d) Schedule 2 (3) (6)) 01/07/2014

p.5

Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate training, supervision and appraisal, with specific regard to regular supervision and restraint and managing self-harming and bullying behaviours training (Regulation 27 (4) (a)) 01/07/2014

p.5

Reg. Requirement Due date

(2001) maintain in the children’s home the records specified in Schedule 4 and ensure that they are kept up to date, specifically a copy of the staff duty roster of persons working at the children’s home, and a record of the actual rosters worked (Regulation 29 (1) Schedule 4 (11)) 01/07/2014

p.5

Reg. Requirement Due date

(2001) ensure that all parts of the children’s home used by children are secure from unauthorised access, of sound construction and kept in good structural repair externally and internally, kept clean and reasonably decorated and maintained and (Regulation 31 (2) (b) (d) (e)) 01/07/2014

p.5

Reg. Requirement Due date

(2001) ensure that all parts of the children’s home used by children are equipped with what is reasonably necessary, and adapted as necessary, in order to meet the needs arising from his disability of any disabled child accommodated in the home so as to enable him to live as normal a life as possible, with specific regard to provision of appropriate beds (Regulation 31 (2) (f)) 01/07/2014

p.5

Reg. Requirement Due date

(2001) provide suitable washing, kitchen and laundry facilities for use by staff and, where appropriate, by 01/07/2014 6 of 13 children accommodated in the home. (Regulation 31 (3))

p.5

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.6

Recommendations

 make clear the home’s protection procedures and how staff will be supported should there be an allegation and make available to staff and volunteers. The provider takes any comments on these procedures into account (NMS 20.3)  ensure all staff’s work is consistent with these Regulations and NMS, the hom policies and procedures, in respect of regular key work sessions with young people (NMS 21.3)  regularly monitor, in line with regulations, all records kept by the home to ens compliance with the home’s policies, to identify any concerns about specific incidents and to identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring (NMS 21.2.)  ensure the registered person takes action to address any issues of concern th they identify or which is raised with them. (NMS 21.9) 7 of 13

p.6

Outcomes for children and young people good

Young people have good attachments with staff; they build their trust and develop a strong rapport with the adults who care for them.

p.7

Outcomes for children and young people good

Young people develop their skills and confidence as a result of their experience in the home. They demonstrate improved social skills and confidence in their ability to communicate using a variety of signs, symbols and words. This empowers young people to participate in decisions about their lives that support their independence. A parent said: ‘My son has come on leaps and bounds. He is very happy there. His speech is coming on and he is doing well in every aspect.’ Another said: ‘He has definitely made progress; he is more confident, he socialises with the other boys and he is doing well in education.’

p.7

Outcomes for children and young people good

Young people access a wide range of activities, including horse riding, fishing, learning to ride a bike, visiting a local gymnasium, camping and caravan holidays. This promotes opportunities for young people who have faced barriers to inclusion and had limited experiences prior to their admission to the home.

p.7

Outcomes for children and young people good

All of the young people are proud of their progress and accomplishments; this supports them to develop their self-and build a positive self-image.

p.7

Outcomes for children and young people good

Young people’s attendance in school is excellent. They make good, assessed progress in relation to their individual starting points. Parents say they are pleased with their children’s achievements in education. Some young people were not attending education prior to their placement in the home and therefore full attendance and engagement is a significant accomplishment for them.

p.7

Outcomes for children and young people good

Young people benefit from regular daily routines. They understand what will happen throughout the day and evening, which means they reduce their levels of anxiety and frustration.

p.7

Outcomes for children and young people good

Young people make good progress in managing their behaviour. They become more able to express themselves and they utilise alternative strategies that decrease their need to resort to aggression. They become more able to acknowledge their feelings, using agreed releases that are socially acceptable. This means young people are able to go out with their families and benefit from experiences in the community. They enjoy going to restaurants, attending football matches and residential trips away from the home.

p.7

Outcomes for children and young people good

Young people develop life skills such as household tasks, shopping, cooking and preparing meals. These skills help to prepare them for further education and transition towards adulthood. A parent said: ‘It is fantastic; he is able to be like any 8 of 13 other 17 year old.’

p.7

Quality of care adequate

The relationships and rapport between staff and young people are a key strength of home. They support young people to develop their communication and to articulate or express how they feel. The staff understand signs and triggers that lead to negative behaviours. Consequently, individuals become more self-aware and learn to regulate and manage their own behaviour.

p.8

Quality of care adequate

Staff spend time with young people after school and engage them in healthy activities. The range of activities and engagement is good. However, staffing shortages can impact on the availability of some activities, limiting opportunities for young people.

p.8

Quality of care adequate

The established routines of the home are conducive to good school attendance. However, repeated changes of staff can confuse young people. This does not provide consistent adults or continuity of care. This signifies a particular shortfall for young people with autism who benefit from familiarity.

p.8

Quality of care adequate

Care planning is comprehensive; it guides staff in respect of individual backgrounds, behaviours and routines. Specific health plans support young people with identified health needs and staff receive training to provide appropriate medical interventions. Staff support young people to address specific health issues, such as weight. This improves individual’s physical health and their emotional wellbeing. Staff use key working to focus on a range of issues with young people. However, there is lack of equity as sessions are irregular.

p.8

Quality of care adequate

Evening meals provide sound nutritional value and are prepared on site by the cook. They are homemade with care, from fresh ingredients. The midday meals are adequate; they are cooked off site and delivered to the home. Young people enjoy meals and staff support them to make healthy meal choices. However, the cloths on the dining tables are torn and some items are served in catering size containers. The presentation of some food is institutionalised and not conducive to a homely dining environment.

p.8

Quality of care adequate

The extensive grounds provide ample space for cycling, football, basketball and walks; young people enjoy using the hot tub and the trampoline.

p.8

Quality of care adequate

There are ongoing problems with the water and this has impacted on young people’s routines and safety. The plumbing system is not adequate, resulting in times when there is no hot water. The young people benefit from very clear daily routines related 9 of 13 to their individual needs and autism diagnosis. Any departure from these routines as a result of lack of water causes them distress.

p.8

Quality of care adequate

Some domestic equipment including beds and mattresses are not fit for purpose. Some of the mattresses are thin, dirty and torn. There are planks and boards under some of the beds. Young people do not access equality in the level of furnishings; those with particular difficulties do not have the beds they need to give them appropriate support and comfort.

p.9

Quality of care adequate

The appearance of the onsite school and grounds has significantly improved over time. The interior, however, is dirty, with worn and shabby furniture in places and stained paintwork. Rubbish and weeds are common place on the hard-court patio surrounding the house. This does not encourage young people to take pride in their surroundings and it does not set a good example about expected standards of cleanliness.

p.9

Keeping children and young people safe inadequate

The inspection identified a number of issues in the home that have the potential to compromise young people’s safety. These include the entrance door being left open, giving the possibility of unauthorised entry to the home, and staff not consistently following risk assessments. An example of this is a young person riding a bicycle without a helmet. Staff had left an iron and ironing board in one of the lounges that young people have access to, presenting an unnecessary safety risk.

p.9

Keeping children and young people safe inadequate

Observation of the premises during the inspection demonstrates a significant number of maintenance issues. The inspection acknowledges that the manager has plans in place for some refurbishment and decoration, and that young people have contributed to these plans. However, the home is not clean; there is a boarded broken window, exterior window frames are weathered, dirty windows throughout, a hole in a bathroom ceiling and no lock on one of the toilets used by young people. Despite regular and thorough health and safety checks of the premises by staff, a number of identified issues remain unaddressed. For example, hazards identified in the January 2014 monitoring report remain an issue in the May 2014 reporting. This is concerning as a failure to address maintenance issues means that young people do not live in a well-maintained environment and at worst, means there are potential safety risks.

p.9

Keeping children and young people safe inadequate

Discussion with staff and the manager during the inspection established that there have been periods of time in winter months without heating. On one occasion the boiler broke down, however, the second occasion was due to heating oil running out. This is unacceptable as young people were not sufficiently warm.

p.9

Keeping children and young people safe inadequate

Staff say that there are issues with the cars used to transport young people, stating that one loses power intermittently. Staff report faults with cars but the records in 10 of 13 the home do not provide clear information to show that faults have been rectified. This does not enable staff who drive the cars to ensure that the vehicles are safe.

p.9

Keeping children and young people safe inadequate

There have been no recorded incidents of bullying since the last inspection. Staff and parents do not cite bullying as an issue. Staff supervise young people at all times and therefore the scope for bullying is limited. However, staff have not accessed training in managing or understanding bullying for young people who have autism. Consequently, they are not well equipped to respond effectively if this does occur.

p.10

Keeping children and young people safe inadequate

There have been incidents of young people self-harming, often in response to their frustrations and as a result of their autism. However, the registered provider has not made training in this area available to staff, limiting the scope of their knowledge and responses.

p.10

Keeping children and young people safe inadequate

The majority of staff files reflect the recruitment information required. However, there are gaps in records for some staff. These include absence of required references for one member of staff, and some unexplained gaps in employment history. There is a lack of documentary evidence to demonstrate assessment of an individual’s competence to carry out the specific roles of working in the home in a direct caring capacity. This pertains, in particular, to staff recruited to other positions within the organisation who act as bank staff. They have police checks in place and receive safeguarding training. However, this in itself does not demonstrate they have sufficient knowledge and experience to effectively care for young people. Additionally, there have been occasions where those staff have worked in the home and it is not reflected on the rota. This does not contribute to safe working practice.

p.10

Keeping children and young people safe inadequate

There have been two incidents of missing since the last inspection, for a minimal length of time. There are no concerns about the numbers of incidents of missing from care.

p.10

Keeping children and young people safe inadequate

Staff use restraint as a last resort, to prevent harm to young people and others, where lower level de-escalation techniques are unsuccessful. Parents and social workers do not raise any concerns about restraint. Staff complete records, seek young people’s views and offer medical assistance following any restraint. However, the records do not reflect the full information required. The manager has failed to identify these issues when monitoring the records. This is also the case in the records of sanctions used in the home. While there are no concerns about the way staff manage behaviour, the inaccurate recording does not provide a clear account of these incidents. Additionally, the majority of staff require refresher training in restraint techniques in order to ensure their knowledge and skills are up to date.

p.10

Keeping children and young people safe inadequate

Staff know and understand safeguarding procedures and their responsibility to report concerns. However, the consensus from staff is that they do not believe they will be treated well if they whistle blow. This does not contribute to an open and transparent culture where staff can be confident in their actions to protect young people. 11 of 13

p.10

Leadership and management inadequate

The home has an experienced manager who was registered by Ofsted to manage this home in February 2014. The effectiveness of the home is compromised, however, because repeating issues and safety concerns identified through internal and external monitoring are not addressed.

p.11

Leadership and management inadequate

The staff unanimously say they feel supported by the manager but not by the registered provider. Staff do not feel they are listened to; there is poor communication between the manager and registered provider. This has led to staff feeling thwarted in their attempts to personalise the home for young people. Staff, in consultation with young people, decided on a London theme for their part of the home. Staff began painting a mural on the wall but, half way through, were told it would have to be painted over as the registered provider wanted the walls a specific colour. This does not inspire staff to use their initiative and is confusing for young people. Young people and staff chose a colour scheme for the dining room. However, the registered provider overruled the decision. This sends a message to young people that their opinions and preferences are not valid.

p.11

Leadership and management inadequate

The lack of sufficient staffing on shift at times means that staff are unable to have comfort breaks and there is a lack of contingency in the event an incident occurs. This does not contribute to staff wellbeing and limits their ability to meet young people’s needs. It also means that placing authorities are not receiving the service they commission for their young people.

p.11

Leadership and management inadequate

The manager has addressed six of the seven requirements raised at the previous inspection. Young people’s information is no longer displayed in public areas, promoting their rights to confidentiality. The registered provider has updated the safeguarding policy in respect of allegations against the registered persons and reporting procedures. Staff all demonstrate a clear understanding of the procedures to follow, which promotes young people’s safety. Staff maintain up to date records for young people, providing the required information that reflects a helpful picture of the young people’s lives and the care they receive. The manager has ordered magnetic closers for fire doors, that, when fitted, will improve fire safety.

p.11

Leadership and management inadequate

Senior staff have not provided supervision for staff in line with organisational policy. This shortfall compromises robust oversight of performance and does not provide staff, who are managing challenging behaviour and difficult incidents, with the support they need.

p.11

Leadership and management inadequate

The manager conducts internal monitoring of the home. However, it does not identify patterns and trends in incidents or monitor the progress young people make. The monitoring is not wholly effective, as aspects such as gaps in supervision and shortfalls in record keeping are not consistently identified. The development plan identifies a number of areas for improvement, some of which the inspection has identified as shortfalls. This demonstrates that the manager has knowledge of some 12 of 13 of the weaknesses of the home and has plans in place to address some of them.

p.11

Leadership and management inadequate

The manager has notified significant events to Ofsted within appropriate timescales. Website: www.ofsted.gov.uk

p.12

Leadership and management inadequate

This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

p.13

Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

p.13

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.13

Judgement Description

Adequate A service that only meets minimum requirements.

p.13

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.13

Information about this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

p.13

Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

p.13