Children's Home run by Esland South Limited in Bexley

Unique reference number SC387684 Inspector Barbara (Polly) Polain Type of inspection Full Provision subtype Children's home

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Registered person Esland South Limited Registered person address Unit 4, Ednaston Home Farm Brailsford ASHBOURNE Derbyshire DE6 3AY Responsible individual John Stamp Registered manager POST VACANT Date of last inspection 20/02/2014 2 of 11 Inspection date 03/06/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness inadequate

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

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Overall effectiveness

The overall judgement for this home is inadequate. A particular weakness of the home is the planning of placements and the risk assessment process, particularly in regard to matching considerations. Young people are being placed in the home without adequate analysis of their needs and the needs of the young people already resident.

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Overall effectiveness

Other weaknesses identified were maintenance and staffing issues: the home is accepting young people with very challenging behaviours and consequently a high level of need. As risk assessment and planning procedures are inadequate, staff levels are not being adjusted to reflect this. The resultant increase in damage to the home is also not reflected in a greater attention to maintenance and cleaning issues. As a result, the home is not being maintained to an adequate standard of either cleanliness or repair.

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Overall effectiveness

Young people do not feel safe in the home; there are many incidents of confrontation and challenge which are causing young people to be unsettled. This is reflected in an increase in the number of incidents, including restraints, sanctions and missing episodes as noted in the home's independent monitoring procedures. Staff have to be extra vigilant in order to prioritise young people's safety in the home. 3 of 11 Young people also report that there is 'no money' for the pursuit of interests and leisure activities and as a consequence 'it's boring'...

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Overall effectiveness

The home does have some considerable strengths however. One very positive aspect of the way the home operates is the keyworker arrangements. Key working sessions are held regularly and the notes from these indicate that staff really try to get to know the young people and encourage them to explore difficult emotions in a trusting relationship. Staff are dedicated, calm and capable. Overall, they are managing the behaviours of the young people competently and thus ensuring that the safeguarding within the home remains adequate in difficult circumstances.

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Overall effectiveness

The independent monitoring processes in place are also clearly effective. The home is visited regularly and reports are succinct, thorough and objective.

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Overall effectiveness

At this inspection, seven statutory requirements have been made in respect of the Children's Homes Regulations 2001. 4 of 11

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Information about this children’s home

The home is a residential home for six children and young people with emotional and behavioural difficulties. The home is operated by a private company and can offer planned, emergency and respite placements.

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Inspection date Inspection type Inspection judgement

20/02/2014 Interim good progress 24/05/2013 Full good 10/09/2012 Interim good progress 22/06/2012 Full inadequate

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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

(2001) (1) The registered person shall ensure that the children's home is conducted so as to -(a) promote and make proper provision for the safeguarding and welfare of children accommodated there; * 16/07/2014

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Reg. Requirement Due date

(2001) 23.The Registered Person shall ensure that :(a) all parts of the home to which children have access are so far as reasonably practicable free from hazards to their health or safety and:(b) any activities in which children participate are so far as reasonably practicable free from avoidable risks; 16/07/2014

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Reg. Requirement Due date

(2001) 18-(2) The registered person shall ensure that children accommodated in the home are- 16/07/2014 5 of 11 Encouraged to develop and pursue appropriate leisure interests; and Provided with appropriate leisure facilities and activities.

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Reg. Requirement Due date

(2001) Reg 28(1) The registered person shall maintain in respect of each child who is accommodated in a children’s home a record in permanent form which- Included the information, documents and records specified in Schedule 3 relating to that child;18.A copy of any plan for the care of the child prepared by his placing authority, and of the placement plan. 16/07/2014

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Reg. Requirement Due date

(2001) 31 (2) The registered person shall ensure that all parts of the children’s home used by children are (a)(b)©(d)Of sound construction and kept in good structural repair externally and internally;(e) kept clean and reasonably decorated and maintained; 16/07/2014

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Reg. Requirement Due date

(2001) (1) The registered person shall ensure that children accommodated in a children's home are provided with -(a) food which -(ii) is properly prepared, wholesome and nutritious;(iv) is sufficiently varied 16/07/2014

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Reg. Requirement Due date

(2001) (1) The registered person shall ensure that there is at all times, having regard to (b) the need to safeguard and promote the health and welfare of the children accommodated in the home, as sufficient number of suitably qualified, competent and experienced persons working at the children's home. 16/07/2014

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Reg. Requirement Due date

*These requirements are subject to a compliance notice

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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

 The Statement of Purpose is out of date and should be updated in light of rec changes to The Children's Homes Regulations 2001, as outlined in Schedule 1 also has the name of the previous Registered Manager and refers to the use o caravan at Poole in Dorset which is no longer available. 6 of 11

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Outcomes for children and young people adequate

Young people are being encouraged to engage as fully as possible in education. Esland has a school in Faversham and arrangements are in place to transport young people from Hadlow House to the school using the house car. Educational provisions are in place for all young people and they are encouraged to attend school or college. Where this has not proved possible, arrangements for home tuition are in place. All young people are in some form of education and one young person is in college. Aspirations and ambitions are being encouraged, one social worker commented that the nurturing environment of the home had given her young person the stability needed to continue with education.

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Outcomes for children and young people adequate

Young people benefit from good key working arrangements. Keyworkers meet regularly with young people and they are engaged with in a meaningful way that allows for discussion of difficult issues such as self harm, risk taking behaviour, drug misuse, managing emotions and more general topics such as self care , healthy diet, education, self care and independence. Young people are encouraged to feel good about themselves and the progress they are making. Steps to independence are encouraged.

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Outcomes for children and young people adequate

There is a stable team of experienced staff and keyworkers who provide nurturing and supportive care, enabling young people to build resilience and a positive view of themselves. Staff are also good at maintaining boundaries and behaviour is managed in a firm and calm manner with the emphasis on de-escalation rather than relying too heavily on sanctions or restraints. These are used as a last resort. Young people are supported to develop the ability to regulate their own behaviour.

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Outcomes for children and young people adequate

Young people are encouraged to have regular check ups at the dentist and G.P and supported to attend hospital appointments. However, the arrangements for young people to eat healthily, exercise and pursue leisure activities of their choice are limited. More needs to be done to ensure young people have access to leisure activities and can pursue their personal interests.

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Outcomes for children and young people adequate

Contact arrangements are facilitated either at the home or out in the community and young people are supported to manage difficult emotions arising from sometimes stressful family contacts.

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Quality of care inadequate

7 of 11 The young people in the home have a high level of need and therefore the requirement for adequate staffing is correspondingly high. The staff that are there are experienced and mostly of long standing, they work hard to ensure good quality care and are good at engaging with the young people. However they report long shifts (16 hours including overnight sleep in arrangements) and being very stretched due to the high level of monitoring required. Young people note being frightened or distressed by the behaviour of other young people in the home.

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Quality of care inadequate

Notes from key working sessions indicated that the young people's wishes and feelings are elicited and they are encouraged to explore difficult issues in a nurturing and understanding context. Social workers and other professionals noted the strengths of the keyworkers and one credited the good progress of young people to these nurturing arrangements being put in place at the very start of placement. She was unable to say if these arrangements were still the same more recently.

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Quality of care inadequate

The young people's medical needs are being met, files indicate that young people are encouraged to attend medical appointments as required and health issues are monitored and acted upon. For instance, files note that 'staff encouraged' young person to attend hospital appointment and 'made several calls' when 'young person left the home early'. Medicines are managed well, kept in a locked cabinet and are appropriately signed in or out and counted down correctly. Arrangements are in place for a pharmacist to come to the home to monitor and supply medicines. However, the health needs of young people are not being met in terms of access to healthy food and sufficient opportunities to exercise and enjoy leisure activities. The menu choices observed during the inspection were primarily frozen or processed food. There was little evidence of fresh fruit or vegetables being made available to the young people in the home.

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Quality of care inadequate

Young people's preferences for leisure activities and their talents and preferences are discussed in key working sessions, however not enough is being done to ensure they have the opportunity to pursue their interests or try out now activities. It is recorded in the weekly house meetings that young people requested activities such as: Go- Karting, a visit to a skate park, paint balling, fishing, the cinema and pool. Only pool sessions and the cinema were confirmed as activities that had taken place. Young person's feelings are recorded in the minutes as ranging from 'feeling good' to 'bored, nothing to do'. Young people also noted that the caravan which the homes in the group had the use of is now no longer available, further reducing the opportunities for leisure activities.

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Quality of care inadequate

Full engagement in education is encouraged. There are a variety of arrangements in place to meet the individual needs of the young people and if a young person is not able to attend school or college then tutoring arrangements are put in place. Esland has a school in Faversham, but as this is some distance away, a disadvantage is that a staff member is needed to drive the young person to and from the school, necessitating a lot of travelling for the young person each week and also limiting the time already stretched staff have to spend with other young people. 8 of 11 Plans are in place for young people to move to independence and they are encouraged to proceed at their own pace with these. However, as the budgeting, cleaning and cooking arrangements in the home are judged inadequate, the home is not doing enough to promote or model these key independent living tasks.

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Quality of care inadequate

Communication with social workers and other professionals could be improved. Social workers said they did not always get monthly updated and often found out about an incident after it had occurred: 'I only find out later'.

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Quality of care inadequate

The home is of a good design and layout for young people. Most of the rooms are large and there is ample space. However the home requires maintenance and upkeep in order to provide a homely environment. For instance, there is litter in the gardens, a broken cabinet in the sitting room, holes in the walls in the hall, a disused hot tub in the back garden, an extremely dirty laundry sink and a broken gate. There are also cigarette ends in the drain outside the front door and the door bell has been out of action for some time. There are also holes in the wall of one of the smallest rooms. The manager indicated that these are from where a flat screen television has been removed and replaced by a large television of dated design, which is placed on the carpet below where it takes up a considerable amount of already limited space and is liable to be a trip hazard.

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Quality of care inadequate

Young people have the opportunity to make complaints (there is a complaints book) but it is unclear whether there is a process for these to be discussed or acted upon.

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Keeping children and young people safe adequate

The home employs experienced and competent staff members. They are calm and confident in managing challenging young people and respond appropriately and effectively to safeguarding issues. For example, incidents of self harm are responded to promptly and measures put in place to ensure the safety of the young person going forward.

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Keeping children and young people safe adequate

Staff are trained in restraints: one staff member is qualified to instruct in 'team teach' and restraints are documented although more detail is required.

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Keeping children and young people safe adequate

Incidents of missing from care are reported to police and staff ensure young people are given the opportunity to discuss what has happened and explore their feelings in regard to each incident. They also liaise with police to ensure young people are interviewed on return.

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Keeping children and young people safe adequate

Staff actively engage with young people and are with the young people most of the time rather than gravitating to the office. In this way they are available to the young people and able to de-escalate situations and often defuse incidents which could 9 of 11 otherwise escalate.

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Keeping children and young people safe adequate

However, the lack of planning and risk assessment of new placements has meant that staff do not have information to inform their judgement and assist them to evaluate situations. As a result a disproportionate amount of staff time and attention is being diverted towards managing volatile situations. Young people report that the lack of planning around new placements has led to feeling unsafe within the home and a belief that other young people in the home are not safe either, although staff are doing their best to manage the risk.

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Leadership and management inadequate

Leadership and management of the home is judged to be inadequate. The last Registered Manager left on 05.02.2014. Interim arrangements were made and the home was managed by the deputy manager until the post was filled approximately one month ago. A registration application has not been received for the new manager to date and therefore the home has been without a registered manager for four months. As a result, much of the responsibility for the management of the home has become the responsibility of more senior managers in the organisation who are not actually present on a day to day basis to evaluate the effectiveness or impact of decision making upon young people.

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Leadership and management inadequate

Upon arrival, I found the home locked and several telephone calls to the home rang out with no message available, or details of who to contact in an emergency. I was later informed by the manager that all staff had been out with young people and because of the staffing levels on the shift (two members of staff and one manager), there was no one available to remain in the home. This included the manager of the home who is described in the home's Statement of Purpose as 'supernumerary'. Staff expressed concern that proper procedures are not in place for ensuring staff levels are appropriate to the high level of need of the young people currently in the home. It was unclear from the staff rota exactly how many staff were available and which staff were working on each shift.

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Leadership and management inadequate

Placement planning, including for emergency placements, is inadequate and not being made in line with the homes Statement of Purpose: 'Hadlow House will take emergency admissions and offer respite care, provided this is not to the detriment of resident young persons'. Since the last interim inspection, there has been a lack of placement planning and absence of meaningful risk assessment both prior to and since admission.

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Leadership and management inadequate

The most recent risk assessment form being used is generic and does not address individual needs and requirements. A recent placement had been made with no documentation. There was no referral, placement plan or risk assessment on file. There was also no evidence of analysis of the potential impact of new arrivals upon already resident young people. As a consequence, the time and energies of staff are 10 of 11 being diverted to the management of behaviours about which they have little information. This leaves other young people with less immediate needs receiving less staff attention overall. In the most recent report by the home's independent monitor (visit date 23.04.14) it is noted that there has been a considerable increase (during the monitoring period) of incidents (14), missing from care episodes (7), sanctions (5) and restraints (3). Overall an ' Increase in number of incidents, the home has had

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Leadership and management inadequate

movement of young people and new manager which may have left the home feeling unsettled'.

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Leadership and management inadequate

Placement records are confusing in places and there are gaps in recording. For instance, one young person is recorded as still being present although he has actually left the home.

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Leadership and management inadequate

Arrangements for ongoing maintenance of the home are also inadequate. The manager informed me that the homes in the group used to have maintenance staff and any problems were fixed quickly. The arrangements under the new management are for quotes to be obtained from private companies and if these are judged to be too high by senior management, then further quotes will need to be obtained. The result is that repair work is delayed. Maintenance issues noted in March and April 2014 Regulation 33 reports were still not attended to at time of this inspection: no working doorbell ( mentioned in Regulation 33 report dated 25/03/2014), hallway has holes and chips, gate needs repairing, heating working intermittently. Manager noted two bed bases damaged, but he has replaced these (removed bases standing at side of drive waiting to be disposed of).

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Leadership and management inadequate

Arrangements for young people to eat healthy food are also inadequate. Although key worker sessions document that young people are asked their preferences and encouraged to eat healthily, there is no evidence that healthy food is being provided. There is no menu available and young peoples' files indicate that a lot of meals are of the burger and chips or sausages and chips variety. There is also no fruit available in the kitchen and the young people's refrigerator contained only packaged processed foods and condiments. Staff noted that there were no formal arrangements to cook for the young people. If a staff member on duty was able to cook and willing to do so, then they would have a home cooked meal, if this was not the case then the food would be either a takeaway or pre-packaged. Staff were also observed to be too busy managing challenging behaviour to spend time preparing meals.

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Leadership and management inadequate

Young people also noted that there was 'no money' for outings and leisure activities. The minutes of young person's weekly meetings record requests for outings and leisure activities outside the home, but staff and young people noted that there was no budget for such activities. Young people had also requested football goal posts, a basketball hoop and a trampoline for the back garden, but I was informed by staff and the manager that there was no budget for any of these either. 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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