Children's Home run by Keys Group Progressive Care & Education Limited in Hampshire

Unique reference number SC412476 Inspector Keith Riley Type of inspection Full Provision subtype Children's home

p.1

Registered person New Horizon Centre Limited Registered person address European Care Group 2 Parklands, Rednal BIRMINGHAM B45 9PZ Responsible individual Amanda Elizabeth Morgan-Taylor Registered manager POST VACANT Date of last inspection 31/10/2013 2 of 10 Inspection date 13/06/2014

p.1

Previous inspection satisfactory progress Enforcement action since last inspection none

p.2

Overall effectiveness inadequate

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

p.2

Overall effectiveness

Individual placement plans inform staff of the specific needs of each young person in the home. There are some positive outcomes, such as the progress young people are making in their personal care. The views of young people with communication difficulties are taken into account, for example when choosing meals or an activity within the home. The possible uses of technology to aid communication have been identified but is not fully embedded into practice.

p.2

Overall effectiveness

Overall young people are kept safe. However, on occasion, behaviour management plans are changed without the relevant agreements being in place. This has happened on one occasion when an unapproved plan was in place for a short period of time.

p.2

Overall effectiveness

Young people form good relationships with a small group of key staff. Other attachments are difficult to form due to an insufficient number of consistent staff. The main weaknesses of the home are a lack of leadership and staff shortages. There is no Registered Manager in post and staffing levels are insufficient. This has an impact on young people, in particular limiting their opportunities to access community activities on a regular basis. Senior managers are aware of the staff shortfalls. However, recruitment to achieve the right number and mix of qualified and experienced staff is currently unsuccessful. 3 of 10 A number of other shortfalls were identified arising from the lack of leadership and management, such as not following up on health referrals, medication management and some poor recording of restraints.

p.2

Overall effectiveness

The environment is generally well maintained and homely. However, one further requirement is made to improve one of the shower facilities. 4 of 10

p.3

Information about this children’s home

The home offers small group living to four young people with learning disabilities. It is privately owned.

p.4

Inspection date Inspection type Inspection judgement

31/10/2013 Interim satisfactory progress 16/04/2013 Full good 23/01/2013 Interim good progress 03/07/2012 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

7 (2001) appoint an individual to manage the children's home (Regulation 7 (1)) 08/08/2014

p.4

Reg. Requirement Due date

(2001) ensure that there is at all times, a sufficient number of suitably qualified, competent and experienced persons working at the home (Regulation 25 (1)) * 08/08/2014

p.4

Reg. Requirement Due date

(2001) ensure that all persons employed by the registered person receive appropriate supervision and appraisal (Regulation 27 (4)(a)) 08/08/2014

p.4

Reg. Requirement Due date

(2001) ensure that the children's home is conducted so as to promote and make proper provision for the safeguarding and welfare of children accommodated there; in particular ensure all changes to behaviour management plans are 08/08/2014 5 of 10 agreed by all relevant parties (Regulation 11 (1)(a))

p.4

Reg. Requirement Due date

(2001) ensure that each child has access to such medical advice, treatment and other services as he may require (Regulation 20 (2)(b)) 08/08/2014

p.5

Reg. Requirement Due date

(2001) provide suitable washing facilities for use by children accommodated in the home, in particular the downstairs shower (Regulation 31 (3)) 12/12/2014

p.5

Reg. Requirement Due date

(2001) ensure that children accommodated in the home are provided with appropriate leisure facilities and activities (Regulation 18 (2)(b)) 08/08/2014

p.5

Reg. Requirement Due date

17B (2001) ensure that written records of any measure of control, restraint or discipline include an accurate description of the measure used (Regulation 17B (3)(c)) 08/08/2014

p.5

Reg. Requirement Due date

(2001) ensure there are suitable arrangements for the recording, handling, safeguarding, safe administration and disposal of any medicines received into the children's home. (Regulation 21 (1)) 08/08/2014

p.5

Reg. Requirement Due date

*These requirements are subject to a compliance notice

p.5

Recommendations

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

p.5

Recommendations

 ensure contingency plans are in place in the event of a shortfall in staffing lev (NMS 17.3)  ensure there are clear arrangements for staff to deputise in the registered person's absence (NMS 17.4)  consider how children communicate their views on all aspects of their care an support, this particularly applies to the use of electronic devices. (NMS 1.3) 6 of 10

p.5

Outcomes for children and young people adequate

Individual placement plans inform staff of the specific needs of each young person in the home. There are some positive outcomes, such as the progress young people are making in their personal care. The views of young people with communication difficulties are taken into account, for example when choosing meals or an activity within the home. The possible uses of technology to aid communication have been identified but is not fully embedded into practice.

p.6

Outcomes for children and young people adequate

Overall young people are kept safe. However, on occasion, behaviour management plans are changed without the relevant agreements being in place. This has happened on one occasion when an unapproved plan was in place for a short period of time.

p.6

Outcomes for children and young people adequate

Young people form good relationships with a small group of key staff. Other attachments are difficult to form due to an insufficient number of consistent staff. The main weaknesses of the home are a lack of leadership and staff shortages. There is no Registered Manager in post and staffing levels are insufficient. This has an impact on young people, in particular limiting their opportunities to access community activities on a regular basis. Senior managers are aware of the staff shortfalls. However, recruitment to achieve the right number and mix of qualified and experienced staff is currently unsuccessful.

p.6

Outcomes for children and young people adequate

A number of other shortfalls were identified arising from the lack of leadership and management, such as not following up on health referrals, medication management and some poor recording of restraints.

p.6

Outcomes for children and young people adequate

The environment is generally well maintained and homely. However, one further requirement is made to improve one of the shower facilities.

p.6

Quality of care adequate

A strength of the home is the small group of core staff who are dedicated to meet the individual needs of young people with complex needs. A parent said, 'the staff are trying to do the best they can under difficult circumstances'. Young people benefit from positive and constructive relationships with the core staff group, who are in tune with the individual needs of the young people they are supporting.

p.6

Quality of care adequate

Placement plans inform staff how to effectively support each individual. Senior staff are very knowledgeable about each young person's level of understanding and comprehension. This includes the way each child communicates and the response of 7 of 10 staff to certain behaviours. They provide a role model to less experienced staff to engage with the young people they are caring for appropriately. Young people receive the reassurance they need to reduce their anxieties.

p.6

Quality of care adequate

There are systems in place to seek the views, wishes and feelings of young people in the home. The core group of staff demonstrate an intimate knowledge of each young person and how they communicate. Following discussion with parents, the use of modern technology, such as electronic devices, has been considered. Some issues with these methods have been identified but not been resolved into practice. This means that the potential of modern communication aids is not yet utilised practice.

p.7

Quality of care adequate

Staff are supportive of education, for example by providing support to and from school alongside taxi drivers. All young people are in education.

p.7

Quality of care adequate

In general the arrangements for medication are effective. However, in a recent review of the procedures, identifying certain medication for disposal, a controlled drug was not accounted for. There was no impact on young people in this instance. All young people are registered with a general practitioner and receive regular optical and dental checks. The approach to support young people's general health is appropriate.

p.7

Quality of care adequate

The promotion of equality and diversity is acceptable. Key staff understand young people's individual strengths and needs. They show a good understanding in relation to the emerging sexuality of disabled young people.

p.7

Quality of care adequate

The home is generally comfortable and well decorated without an institutional feel. Young people benefit from specialist areas, such as a sensory room. However, the downstairs shower is in poor condition and detracts from the otherwise homely environment.

p.7

Keeping children and young people safe adequate

Staff receive safeguarding training. There is an acceptable procedure, that staff are aware of, in the event of any concern, for example staff are diligent in completing body maps for any marks observed on young people and ensure there is an explanation. The senior management team ensures that all the relevant agencies are informed of any safeguarding issues. Professional relationships ensure that strategies and plans are developed in the event of any concerns being identified. This means that young people are supported and protected.

p.7

Keeping children and young people safe adequate

Satisfactory policies and procedures are in place for managing behaviour, including strategies in de-escalation and distraction, for example by using physical exercise. Staff are trained in physical intervention techniques which are used in agreed circumstances. However, in one case, a behaviour management plan was changed, by a member of the organisation's management team, without the consent of 8 of 10 interested parties. This means that young people with challenging behaviour were supported, for a short period, without clearly-defined agreed strategies. Some physical intervention records are not clear, in accordance with the children's homes regulations, as to the type of restraint or guidance used.

p.7

Keeping children and young people safe adequate

Records, such as sanction logs, are reviewed by an independent visitor. Sufficient challenge is given as to the appropriateness and effectiveness of sanctions.

p.8

Keeping children and young people safe adequate

Due to their disabilities, on occasion, young people may present with behaviours that can cause distress to other young people in the home. In such instances, staff deploy individual behaviour management strategies to manage the situation. Recent changes to the environment, including providing alternative seating in another room, minimises the potential for these encounters. A professional reported that there has been some improvement in the management of behaviour.

p.8

Keeping children and young people safe adequate

There is good provision for the management of risk associated with individual behaviours, the premises, and activities undertaken by young people. Clear written risk assessments provide strategies for managing risks in the community. However, young people are not accessing the community on a regular basis as agreed in their placement plan due to staff shortages.

p.8

Keeping children and young people safe adequate

The home provides a safe environment for young people and there are sound arrangements for addressing all health and safety matters, including fire safety. Personal emergency evacuation plans guide staff how to support young people how to leave the building in an emergency.

p.8

Keeping children and young people safe adequate

There is a good vetting process in place to ensure only suitable adults work with vulnerable young people.

p.8

Leadership and management inadequate

The Statement of Purpose does not reflect the current management and staffing situation in the home. Young people live in a home where there is no current manager. There are not clear arrangements to demonstrate who is to take responsibility for the leadership of the home in the absence of a manager. The interim arrangements are unsuitable. For some time the manager of a home in the north of England was also trying to manage this home, which was not viable and resulted in poor guidance to staff. A professional said that they cannot work effectively with the current interim management arrangements. Staff lack guidance and support from senior managers within the organisation, in the absence of clear leadership within the home. A parent said, 'if I had real concerns I would not know who to go to'. Another parent described the communication from 'upper management' as 'atrocious'.

p.8

Leadership and management inadequate

There is a lack of sufficient trained and experienced staff. This means there is not, on 9 of 10 duty on a regular basis, an adequate number and mix of staff with the necessary competence and expertise to support young people in line with their agreed placement plans; for example, young people are not supported with the agreed staffing ratios. This means that they are unable to access community activities or leisure facilities. Regular staff are required to work long hours and additional shifts. They report feeling exhausted. There is the potential for mistakes to occur, such as, in one case, a medication was administered late. A complaint about the lack of experienced staff has not been satisfactorily addressed.

p.8

Leadership and management inadequate

Contingency plans for staff shortages are poor. The arrangements in place to notify the management of absences, such as due to sickness, leave no time to organise alternate staff. Agency staff have insufficient induction and training including in the behavioural management techniques that the home adopts. Young people are at risk of being cared for by staff who do not have sufficient knowledge of them or their individual needs.

p.9

Leadership and management inadequate

There is a good induction programme in place which new staff are expected to undertake. However, staff are appointed onto a shift pattern before their competencies have been sufficiently assessed during a probation period. Permanent staff have a good ongoing training programme with regular refresher training.

p.9

Leadership and management inadequate

Documents are in place to provide staff with guidance to support the young people they are caring for. There has been some recent changes to the way things are recorded and monitored. However, there are insufficient opportunities for staff to give their views on changes that are imposed on them. This means there is a risk that staff do not fully understand the reasons for change and morale is lowered. Staff say they feel devalued. A parent said, 'they need to value the staff to keep them'.

p.9

Leadership and management inadequate

Staff do not receive regular supervision or appraisal. There is insufficient reflection on practice. In the absence of a Registered Manager or close support from the organisation's senior management team staff resort to raising issues of practice with other professionals external to the home, such as the behaviour management instructor.

p.9

Leadership and management inadequate

The previous requirement to ensure there is a sufficient number of suitably qualified, competent and experienced staff working at the home is not met. A staff member said that staffing has got worse since the last inspection. A parent said that there is no manager and this is having a big impact. Staff say they are exhausted from working additional hours. Unrealistic delegation of management responsibilities are made on staff who have no formal management training. This means there is not a robust response to action plans made, for example, as a result of an independent visitor's report. Website: www.ofsted.gov.uk

p.9

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.10

Judgement Description

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

p.10

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.10

Judgement Description

Adequate A service that only meets minimum requirements.

p.10

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.10

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.10

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.10