Children's Home run by Plus One South West Ltd in Somerset

Unique reference number SC467115 Inspector Sharron Escott Type of inspection Full Provision subtype Children's home

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Registered person Plus One (South West) Ltd Registered person address Plus One Ltd The Mount 21 High Street WELLINGTON Somerset TA21 8QT Responsible individual Lou El Gilany Registered manager Brian Harold Solman Date of last inspection 12/11/2013 2 of 12 Inspection date 17/07/2014

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Previous inspection adequate Enforcement action since last inspection none

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Overall effectiveness inadequate

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

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Overall effectiveness

The overall effectiveness and all outcome areas are judged as inadequate. Ten breaches of regulation are identified as part of this inspection, all of which impact on the safety and well-being of young people.

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Overall effectiveness

The monitoring arrangements of the home lack rigour and have not been effective in identifying the breaches of regulations. The senior leadership team and manager are not sufficiently aware of the inadequate areas of practice. The home has a development plan in place. However, there is no clearly defined strategy to improve the service. Necessary improvements are not prioritised and actions fail to ensure continuous practice development to address weaknesses and development opportunities.

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Overall effectiveness

The service was last inspected in November 2013 when it was judged as adequate. The home has demonstrated that it has the capacity for improvement by addressing six out of the seven recommendations made during that inspection.

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Overall effectiveness

Young people say that they enjoy living at this home; they like living in the countryside and say that they find it quiet, peaceful and calming. Young people take 3 of 12 full advantage of the home’s location and enjoy daily walks. They admire the views and are learning about living in the countryside.

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Overall effectiveness

The manager and staff say that they enjoy working with the young people and that they want their time at the home to be enjoyable and full of positive memories. Relationships between young people and staff are at the early stages of development as a result of young people being in placement for a short period of time. Young people speak fondly of individual staff members with whom they enjoy spending time and whom they say make them smile and laugh. 4 of 12

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Information about this children’s home

The home, which is operated by a locally-based private company, provides care and accommodation for up to two young people who may have emotional or behavioural difficulties.

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Information about this children’s home

The provider also operates other homes in this area and education can be arranged using other private care organisations which provide small specialist schools.

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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.

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Reg. Requirement Due date

4 (2001) provide an (amended) copy of the statement of purpose to HMCI (Regulation 4 (2)) 29/08/2014

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Reg. Requirement Due date

(2001) ensure that the children’s home is conducted so far as to promote and make proper provision for the welfare of children accommodated there. Specifically, ensure that emergency referrals do not impact on young people already placed at the home (Regulation 11 (1) (a)) 29/08/2014

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Reg. Requirement Due date

(2001) co-operate with the child's placing authority in agreeing and signing the plan for the child's placement prepared in accordance with the provision in regulation 47C(2) (Regulation 12 (a)) 29/08/2014

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Reg. Requirement Due date

17B ensure within 24 hours of the use of any measure 29/08/2014 5 of 12 (2001) of control. restrain or discipline in a children's home, a written record is made in a volume kept for the purpose ( Regulation 17b (3)(b)(e)(f)(G)(h)(i))

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Reg. Requirement Due date

(2001) ensure that the routine of the home is organised so as to further young people's participation in education, including regular attendance at school and particularly ensuring that reasons why a young person is not attending school are robustly addressed without delay (Regulation 18 (1)(b) 29/08/2014

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Reg. Requirement Due date

(2001) make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home (Regulation 21 (1)(2)(a)(c)) 29/08/2014

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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 of the children accommodated there; and the need to safeguard and promote the health and welfare of the children; a sufficient number of suitably, qualified, competent and experienced persons working at the home (Regulation 25 (1) (a) & (b)) 29/08/2014

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Reg. Requirement Due date

(2001) ensure that all staff employed have full and satisfactory information available in relation to all matters specified in schedule 2 (Regulation 26 (3) (d)) 29/08/2014

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Reg. Requirement Due date

(2001) ensure monthly visits by the independent regulation 33 visitor are unannounced and the visitor interviews with their consent and in private children accommodated there and persons working at the home, and supplies a copy of the report to HMCI (Regulation 33 (3)(4)(a)) 29/08/2014

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Reg. Requirement Due date

(2001) ensure the report reviewing the quality of care details the information as set out in Schedule 6 and shall provide systems for consultation with children, their parents and placing authorities. (Regulation 34(1);Regulation 34(3)) 29/08/2014

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Recommendations

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

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Recommendations

 ensure children have access to and exercise choice with food that is free from contamination (NMS 2.4 )  encourage young people to take age-appropriate risks and help them to 6 of 12 understand how to keep themselves safe when using the internet or social media (NMS 4.4)  ensure the home provides a comfortable and homely environment and is well maintained and decorated (NMS 10.3) 7 of 12

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Outcomes for children and young people inadequate

Outcomes achieved by young people in this setting are variable. This is as a result of young people being placed at the home in an emergency with a staff team that does not have the required skills and experience to meet their needs. In addition, there has been insufficient consideration of young people’s specific needs and associated behaviours which has the potential to impact on others already living in the home. Decisions made to admit young people whose presenting behaviours conflict has increased their vulnerability and raises the potential for safeguarding concerns to occur.

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Outcomes for children and young people inadequate

Although young people enjoy a varied diet and comment positively about the meals provided at the home, there is insufficient consideration given to food hygiene. The storage of fresh food is unsafe; cooked and uncooked foods are stored incorrectly and therefore there is potential for contamination.

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Outcomes for children and young people inadequate

Young people’s health care needs are not suitably met because of a failure to ensure that controlled medications are stored safely and securely. This poor practice increases the risk of incidents related to medication. The administration of medication and the associated records are not maintained in line with Royal Pharmaceutical guidelines. However, young people are registered with a General Practitioner, dentist and optician. Health care plans detail individual health care needs and how these are to be met. Regular attendance at the local clinic ensures young people’s specific health care needs are responded to and monitored. Consequently, young people are receiving the treatment and advice they require. Staff have received training in first aid and the administration of medication.

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Outcomes for children and young people inadequate

The home provides a stable, consistent and calm environment in which young people say that they enjoy living. Young people have started to form positive relationships with the staff team which has helped them reduce high-risk behaviours. As a result, young people have not gone missing from home, they have not engaged in high-risk behaviours and physical interventions have not been used.

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Outcomes for children and young people inadequate

Young people are offered the opportunity to participate in a variety of activities in the community and at the home. They are encouraged to embrace the opportunities available to help develop their social skills, form friendships and promote physical exercise.

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Quality of care inadequate

8 of 12 Prior to all new placements being offered, the home completes an impact risk assessment using information provided by the placing local authority. These assessments identify individual current and historical behaviour. However, the home has failed to consider the potential impact that the existing young people have on new placements and/or if the staff team has the skills and experience to meet their needs. Young people with a history of potentially exploitative behaviours are placed with others who are vulnerable to exploitation and abuse.

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Quality of care inadequate

Not all young people have an up-to-date local authority care and placement plan. In the absence of receiving these documents, the manager has compiled care plans and risk assessments for the young people in placement. These detail individual needs, risks, and behaviour management strategies which have contributed to young people being supported to develop. However, because these are compiled without reference to the local authority’s care plan, they do not reflect the placement’s aim and objectives as defined and agreed by the placing authority.

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Quality of care inadequate

The education arrangements for young people are inadequate. Some young people’s educational plans require them to receive 25 hours of education a week, tutored at the home. The independent education provision has failed to provide these services which results in young people’s educational needs not being met. The home has challenged this poor practice with the school and has introduced an informal alternative learning programme which includes taking young people to historical sites, museums and attending the gym. This ensures young people are provided with learning opportunities which maintain some routine and structure in the young people’s day. However, they are likely to be falling further behind in their academic progress. This impedes academic achievement and limits their opportunity to secure further education placements and/or employment opportunities in the future.

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Quality of care inadequate

The young people and staff team have access to a cognitive behavioural therapist who is commissioned to provide training, therapy and advice for the whole organisation once a week. Introductions with young people have commenced, consultation for staff is ongoing, and, as a result of this inspection, specialist training is now being identified.

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Quality of care inadequate

Young people said that they liked their bedrooms and have personalised them with their belongings. The home is large and spacious. Most areas of the home are well decorated and maintained. However, soft furnishings and personalisation of the environment is limited. This detracts from the home being warm, welcoming and a pleasant environment for the young people to live in. The gardens surrounding the home accommodate seating areas and a trampoline. Young people say that they enjoy spending time in the gardens as it is quiet and relaxing. Young people enjoy a range of purposeful and enjoyable activities and are supported to maintain personal hobbies and interests. For example, they play the guitar, go to the gym and local parks. Staff members acknowledge how this helps young people develop healthy lifestyles and a better sense of their own identity. 9 of 12 Young people are empowered to express their wishes and feelings informally and

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Quality of care inadequate

within keyworker sessions. Discussions include health and well-being, education and young people’s aspirations for their future. They have access to an independent advocate who visits monthly and is contactable by telephone.

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Keeping children and young people safe inadequate

Safeguarding is inadequate because the home has failed to ensure consistent safe recruitment practices are maintained. This means young people at this home are not effectively safeguarded from harm.

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Keeping children and young people safe inadequate

The manager has not undertaken safer recruitment training. Consequently, he is not involved in the selection and recruitment of staff and is reliant on the task being undertaken by senior managers. All recruitment files are held centrally at the nearby head office. The Registered Manager has not ensured that recruitment practice meets the requirements of the children’s homes regulations. As such, there are gaps in employment histories, references from people who are not disclosed on employment histories and interview notes that do not consistently identify who conducted the interview. Young people are actively involved in the recruitment and selection of new staff, their views are considered of to ensure they are suitable to work with vulnerable young people. Young people are not safeguarded effectively from harm due to the poor recruitment, selection and vetting of new staff.

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Keeping children and young people safe inadequate

Young people’s welfare is compromised by a lack of robust and meaningful pre- placement assessments. Staff lack the necessary skills and knowledge to care for young people with complex needs. In addition, the impact of young people placed together with competing and conflicting needs compromises their safety.

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Keeping children and young people safe inadequate

Some young people are prohibited from taking age appropriate risks in line with their peers. Assessments are reliant on restrictions imposed at the request of placing authorities. The home has failed to challenge these restrictions or determine the level of risk by considering the young people’s presenting needs and behaviours. Key worker sessions identify staff discussing risks with young people, the impact these have on individuals’ safety, health and well-being and what can be done to reduce them. For example, the risks associated with strangers providing illegal substances and tobacco products in local parks. Young people have successfully recognised this and requested staff to restrict how much pocket money they are given when enjoying activities in the community. This assists and supports them in not being tempted to purchase tobacco and illegal substances if offered the opportunity.

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Keeping children and young people safe inadequate

Health and safety checks are completed regularly. These include fire drills, maintenance of fire equipment and electrical checks. The manager has completed a location risk assessment which identifies risks presented within the local area.

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Keeping children and young people safe inadequate

Young people report that they feel safe living at the home and could identify a 10 of 12 member of staff whom they would go to with any concerns. Records indicate that there have been no child protection concerns or incidents of bullying. Young people said that bullying is not a concern for them.

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Keeping children and young people safe inadequate

Records reviewed show that young people have not been missing from the home. The home’s policies and procedures which have been approved by the local police provide staff with clear instruction and guidance to follow in the event that young people should go missing. Staff members are suitably trained in de-escalation and physical intervention techniques, which are effective. As a result, young people’s behaviour is effectively managed without the use of physically intervention. Sanctions imposed are rare. Recording of sanctions is poor and does not detail what events led to a sanction being imposed, their effectiveness and the views of the young people. These shortfalls have not been identified by the manager and independent visitor who conduct monitoring reviews of the home.

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Leadership and management inadequate

The leadership of the home is inadequate. The home has placed young people who have specialist needs, outside its approved registration criteria. The Statement of Purpose requires urgent review as the content is misleading to stakeholders. The document states that the home can meet the needs of young people who have mild learning disabilities and will consider young people who have severe learning disabilities and diagnosed mental health needs. The home is registered to provide care and accommodation for young people with emotional and behavioural difficulties. It is not registered to care for people with these specialist needs and the staff team does not have the necessary skills, training and experience to adequately support them.

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Leadership and management inadequate

Staff are not competent or trained to look after the young people in their care. Specialist training supporting young people with diagnosed behaviour and learning difficulties has not been provided. However, the core staff team who work at the home hold a level 3 qualification in child care and have undertaken mandatory training inclusive of child sexual exploitation and the role of an appropriate adult. The Registered Manager has been in post since June 2013 and is suitably experienced in residential care. He holds a level 4 qualification in care and has recently commenced the Level 5 diploma in leadership for health and social care.

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Leadership and management inadequate

External and internal monitoring of the home’s records and quality of care provided to the young people are ineffective and failed to recognise the shortfalls and deficiencies identified at this inspection. All monitoring visits are announced. Reports do not consistently identify if young people, social workers and parents have been consulted with regard to the quality of care provided and reports are not forwarded to Ofsted within the timescales required by the Children’s Home Regulations. 11 of 12 Overall, there is a poor understanding of the strengths and weaknesses of the service. Development plans do not identify targets to improve the quality of care provided to young people and do not identify areas of development for the home.

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Leadership and management inadequate

Young people are looked after and benefit from stability and continuity of care by a consistent and regular staff team. Staffing levels are high and reflect the needs of young people. Young people are looked after by a staff team who are motivated and keen to make a difference in their life. However, this is not being achieved due to their lack of understanding, knowledge and skills. Staff said that they felt well supported by the manager and receive regular supervision. Documents reviewed confirm that comprehensive supervision is provided which enables staff members to reflect upon, learn and develop their skills.

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Leadership and management inadequate

The home has met six out of the seven recommendations raised at the last inspection in November 2013. Consequently, young people are not restricted from accessing specific areas within the home. Electronic devices do not restrict their privacy and they have access to the internet. The recommendation relating to sanctions has been reinstated as a result of records not being clear and which do not meet regulatory requirements. Website: www.ofsted.gov.uk

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Leadership and management inadequate

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Judgement Description

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

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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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.

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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.

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