Children's Home run by Oracle Care Limited in Staffordshire

Unique reference number SC368982 Inspector Denise Jolly Type of inspection Full Provision subtype Children's home

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Registered person Oracle Care Limited Registered person address Unit 1 Dane Valley Mill Havannah Street CONGLETON Cheshire CW12 2AH Responsible individual Steven Bromley Registered manager POST VACANT Date of last inspection 21/02/2014 2 of 13 Inspection date 26/11/2014

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

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Overall effectiveness adequate

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

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Overall effectiveness

A suitably qualified manager is in post, who is overseeing improvement in the home. Their application to register with Ofsted has been delayed, but has now been submitted. They are eager to secure improvement in the home, and have already made inroads into some of the deficits they have identified.

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Overall effectiveness

The home provides an adequate quality of care, with individual plans for young people. Despite many changes in staff, the home provides care that promotes improved outcomes for young people. Staff are committed to offering consistent and appropriate care for young people. Young people are beginning to respond to the efforts of staff to promote positive relationships.

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Overall effectiveness

Staff work hard to ensure that young people are safe and secure in the home. However, some shortfalls identified in agency staff records compromise the effectiveness of safer recruitment processes, and this also applies to permanent staff.

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Overall effectiveness

Leaders and managers have a patchy awareness of the strengths and weaknesses of the home. This is because systems for monitoring the performance of the home have not been robust enough to identify all of the shortfalls found during this 3 of 13 inspection. Communications between senior managers about the shortfalls identified by monitoring, have not been adequately addressed. Recommendations are made to address this deficit.

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Overall effectiveness

There are several requirements to improve. These include the consistency of staffing arrangements; maintenance and layout of the environment; records maintained about staff; training opportunities for staff; records of restraint; and placing authorities' plans of care for young people. These shortfalls have mainly impacted upon the management and conduct of the home, and the environment, rather than directly impacting negatively on the welfare or safety of young people. 4 of 13

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Information about this children’s home

The home provides care and accommodation for up to three young people with emotional and/or behavioural difficulties. This is a privately owned children's home.

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Inspection date Inspection type Inspection judgement

21/02/2014 Interim good progress 14/11/2013 Full good 26/02/2013 Interim good progress 11/12/2012 Full good

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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) ensure the children's home is at all times conducted in a manner which is consistent with its statement of purpose, particularly that the home is therapeutic, and that the appointment of independent advocates are promoted for children (Regulation (4)(6)) 09/01/2015

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Reg. Requirement Due date

12A (2001) ensure the registered person co-operates with the placing authority in agreeing and signing the plan for the child's placement (Regulation 12A (1)) 09/01/2015

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any restraint, a written record is made in a volume kept for the purpose that includes all the detail required by the regulation, particularly the duration of the 09/01/2015 5 of 13 use of the measure, and details of any methods used to avoid the use of the measure (Regulation 17B (4))

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Reg. Requirement Due date

(2001) ensure the employment of persons on a temporary basis will not prevent children from receiving such continuity of care as is reasonable to meet their needs (Regulation 25 (2)) 09/01/2015

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Reg. Requirement Due date

(2001) ensure that for all persons employed to work at the home including agency staff, there is full and satisfactory information available in respect of each of the matters specified in Schedule2 (Regulation 26 (3)(d) Schedule 2) 09/01/2015

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate training, particularly in working therapeutically with children who have been abused, children who demonstrate sexually harmful behaviour, and children who have attachment and trauma needs (Regulation27 (4)(a)) 09/01/2015

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Reg. Requirement Due date

(2001) ensure the registered person shall maintain in the children's home the records specified in Schedule 4, in particular the records in respect of each person working at the home (Regulation 29 (1), Schedule 4 (2)) 09/01/2015

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Reg. Requirement Due date

(2001) ensure there is suitable washing facilities for use of staff and children accommodated in the home (Regulation 31(3)) 09/01/2015

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Reg. Requirement Due date

(2001) ensure each child is provided with sleeping accommodation which is appropriate for their need. (Regulation 31 (5)(a)) 09/01/2015

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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 independent advice and support from adults who they can contact directly and in private about their problems and concerns (NMS 1.5)  ensure suitable arrangements exist for the professional supervision of the registered person, in particular that appropriate support is provided during their induction and probationary period (NMS 19.3)  ensure the registered person takes action to address any issues of concern that the Regulation 33 visitor identifies, or the manager raises with them, particularly regarding the maintenance of the home, and washing facilities for staff (NMS 21.9) 6 of 13  ensure there are effective procedures for monitoring and controlling the activities of the home, including the impact of inconsistent staff, and staff training needs upon the progress of young people (NMS 21.1) 7 of 13

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Outcomes for children and young people adequate

Young people are now taking small steps to understand their background. They are beginning to develop an awareness of past difficulties and trauma that prevent them from making good progress in their lives. From their starting point, young people are improving the relationships they have with staff. This has helped them to settle into the routines of the home. Progress has been slower than it may otherwise have been, due to frequent changes in management and staff over the last few months.

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Outcomes for children and young people adequate

Young people have more stable placements than they have previously experienced. This helps young people to break the negative cycle of frequent moves, disrupted relationships and deteriorating patterns of behaviour. Due to the impact of past trauma and abuse, young people take small steps to improve their lives. This means that some begin to talk about their feelings. Others are less prone to violent outbursts or antisocial behaviour. Although progress is fragile, young people develop trust and confidence in staff. This enables them to accept support from staff, and acknowledge areas in their lives that can improve.

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Outcomes for children and young people adequate

The organisation’s therapeutic team supports young people, although their engagement with therapists and counsellors is inconsistent. Additionally, some young people have lost support from the child and adolescent mental health service (CAMHS) because they moved from one local area to another. Due to the need for a new locality referral, this has disrupted the continuity of oversight of their mental health needs. This means that when young people refuse to take prescribed medication, they do not have prompt access to mental health professionals. This delays any opportunity for young people to understand the full impact of such a refusal on their emotional and mental health.

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Outcomes for children and young people adequate

Young people demonstrate inconsistency in their interest in the life of the home, and their willingness to participate in making decisions about it. This extends from being unwilling to participate in plans for their future, to avoiding opportunities to discuss with staff the types of activity they would like to engage in. However, staff persist in offering young people support and guidance, and some young people have attended professional meetings about reviews of their care plan. At other times, young people gain support from staff to participate in hobbies such as ice skating, and activities such as playing football or building brick models.

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Outcomes for children and young people adequate

Young people have declined in their participation in education since the start of the Autumn academic year. Some young people have found the transition to college extremely challenging, and are reluctant to attend. They have participated in planning and problem-solving meetings with staff and tutors, but have not overcome their difficulties. Other young people benefit from the effective communication that exists between the organisation’s school and staff. Teachers regularly visit young people to 8 of 13 encourage them to attend school. They create plans that staff and young people can follow, to build up attendance and confidence. This prevents young people from developing patterns of school absenteeism that will impact on their future lives.

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Outcomes for children and young people adequate

Young people have limited contact with their families, due to circumstances outside of their control. This reduces their sense of identity and belonging. Due to their starting point, they have limited opportunity to develop friendships outside of the home, although where possible, staff support them in social situations. Although recently identified as necessary, young people do not have independent advocates or visitors. Young people are therefore unable to talk others to gather independent oversight of their plans and targets. Over time, some young people have begun to talk more openly with those who visit on behalf of the provider, and confirm that they like living in the home.

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Quality of care adequate

The recently appointed manager has begun to identify a clear direction about the importance of consistent and nurturing childcare to underpin relationships within the home. Through work with the organisation’s therapeutic team, the newly formed staff team is learning about a framework for understanding the impact of early life experiences of young people on their levels of resilience and trust. However, change is less effective because of inconsistency in the team who work in the home. While the home has a substantive staff team, individuals are redeployed to cover shifts within other children’s homes. In turn, agency or bank staff cover their shifts. This is unpopular with both staff and young people, because it disrupts the fragile attachments that young people are making with staff.

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Quality of care adequate

Staff offer clear, consistent and appropriate boundaries for young people. Due to the trauma of young people’s past experiences, the effectiveness of this approach is not always immediately evident, because young people demonstrate a continuing range of antisocial behaviour. Staff provide carefully detailed reports on the progress young people make, and provide programmes that help young people to identify the small steps they can take towards improving their social behaviour. They have supported young people to reduce the intensity and frequency of damage to the property, and have reduced threatening and violent outbursts. Key workers maintain regularly reviewed behaviour management programmes that support the diversity of needs demonstrated by young people.

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Quality of care adequate

Staff persist when young people fail to respond to invitations to discuss their plans and wishes, or the life of the home. With varying degrees of success, young people are encouraged to record their views about life in the home, their relationships with each other and staff, and their short-term goals. Progress is evident in the improvements some young people have made in talking to others such as their social workers or therapy professionals. This has enabled young people to ask for contact with previous carers, and to request a change of social worker, when they felt unable 9 of 13 to work with them. This helps young people to engage with their pasts and their futures.

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Quality of care adequate

Keyworkers maintain very clear, detailed and multi-disciplinary internal placement plans for young people. The joint care, education and therapy team within the organisation regularly reviews them. Where possible, young people’s views are incorporated into any review of those plans. However, because there are no records of agreed placing authority plans of care, and no records of reviews about those plans, it is not possible to ensure that the home is supporting the placing authority’s plan of care for each young person. There have been occasional requests for the missing documents, but due to the change of managers in the home, this has not been consistently followed up. This has led to a lack of action, for example, in meeting an identified need for some young people to have an independent advocate. A minority of health records for young people are also missing, such as their immunisations. This prevents young people from receiving the appropriate level of

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Quality of care adequate

Staff work hard to engage young people in productive and pleasurable activity. Currently, young people’s level of engagement in both education and leisure activity has dipped. Staff have identified some emotional and practical factors that may have contributed to this decline, such as disruption to continuity of staffing, and the increasing awareness that young people have about the impact of their past.

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Quality of care adequate

Staff make the most of positive responses from young people. They remain undaunted by the setbacks young people experience, and are willing to provide a flexible response to young people’s needs and moods. Staff carefully supervise relationships between young people, to ensure that they remain appropriate. They act as effective role models by demonstrating highly skilled social exchanges that help young people to identify the features of positive relationships.

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Quality of care adequate

Due to the needs of young people, the home suffers a high degree of wear and tear, and deliberate damage. Systems for maintenance are not sufficient to ensure that repairs are consistently made in good time. In the case of some bedroom and bathroom areas, the environment is unsuitable to the needs of young people who occupy them. This means that young people do not have clean and comfortable accommodation to meet their needs. The manager has identified several areas for improvement, including the creation of a wet room, and improved bedroom areas. The provider has already identified major work to improve waste management, and to landscape the untidy garden area. This work began during the inspection.

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Keeping children and young people safe adequate

10 of 13 Young people are developing a sense of security within the home, although their needs and starting points mean that they have a limited sense of how this impacts upon them. However, young people say that they like living in the home. As staffing has stabilised, they are beginning to indicate preferences for the company of some staff. Because of developing attachments, young people have been able to begin to talk about their experiences, and some of their anxieties. This has helped staff to work with therapists to plan approaches that provide further support to meet their needs.

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Keeping children and young people safe adequate

Staff use skilled and tolerant approaches to young people’s behaviour. Staff recognise individual vulnerabilities, and identify proactive and caring strategies to help young people increase their sense of well-being and safety. Staff use a highly consistent and non-judgemental approach to challenge negative behaviour. They are trained to address the anxieties and stresses that underlie destructive and damaging outbursts. This helps young people to respond, over time, and identify less harmful ways of expressing their difficulties. Staff praise and reward young people for demonstrating helpful and positive behaviour and relationships. This helps young people to learn, and to adopt strategies that increase their range of acceptable behaviour.

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Keeping children and young people safe adequate

Staff very rarely restrain young people because they are skilled at de-escalation and diverting stress and unhealthy relationships. Staff maintain records about incidents in electronic and hard copy. Staff will always talk to young people about the feelings and behaviour that led to the use of restraint, but the record of restraint does not always confirm the measures staff took to avoid the use of restraint, or the duration of the restraint. This causes delay when an independent person assesses the appropriateness of the restraint, because some the information is missing.

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Keeping children and young people safe adequate

Young people do not go missing from the home. Each young person has a plan of action, agreed with the local police, that would be implemented should the need arise. Staff remain aware of the risks posed by and to young people who go missing, and take clear action, such as increased supervision, should they be concerned that a young person is feeling unsettled.

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Keeping children and young people safe adequate

Staff maintain detailed, relevant and up-to-date risk management plans that the multi-disciplinary team regularly reviews. Areas of concern are clearly highlighted, alongside plans and actions identified to reduce the risk. The plan focuses on ensuring safety and promoting positive action, rather than creating barriers to keeping young people safe. This ensures staff operate a proportionate and enabling approach to risk that enables young people to be better prepared for independence.

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Keeping children and young people safe adequate

Following a thorough independent audit of recruitment practice in the organisation, the provider operates robust recruitment methods to ensure that only those assessed as suitable to work with children and young people are permanently employed. However, the provider has not addressed all actions identified for improvement. Records for agency staff did not consistently demonstrate that sufficient checks are 11 of 13 completed prior to the home using them. This included no criminal records check for one member of agency staff, and incomplete records of employment for another. This does not protect young people from unsuitable people working in the home. In addition, when the home uses staff from other settings within the organisation, managers do not ensure that they maintain all the records necessary to identify their suitability to work with young people, including their qualifications and experience.

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Keeping children and young people safe adequate

These shortfalls impact on the safety and protection of young people, because additional support needs are not identified for staff who work in the home on a temporary basis.

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Keeping children and young people safe adequate

All staff complete generic child protection training as part of their induction. Senior staff have been trained in safer recruitment practice. Staff are supported by the therapy team for the organisation, but have not received training in supporting children who have been abused, nor in supporting children who demonstrate sexually harmful behaviour. This means that staff do not feel confident that they can respond effectively to the needs of some young people, and this causes delays in consistently addressing, for example, sexually harmful behaviour. The new manager has identified this as a staff development need, but dates have not yet been identified to provide training to improve staff knowledge and understanding.

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Leadership and management inadequate

The home has undergone a change in manager. A new manager replaced the previous manager in August 2014, but failed to submit an application to register with Ofsted in good time. This means that the home has been without a Registered Manager for 12 weeks. The application has now been received from the manager, and their suitability can now be assessed. The development of the home has been inhibited due to many changes in staff, and a vacancy for the deputy manager of the setting. Insufficient support for the manager during her induction and probationary period has resulted in many of the shortfalls identified within this inspection.

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Leadership and management inadequate

The manager has identified many shortfalls within the service, and has an action plan in place to address some of them. Due to the number and range of tasks identified, not all areas have been monitored for improvement. The action plan lacks the detail necessary to secure improvement, such as expected dates for completion, and who is responsible for taking the next step. For example, the manager has overseen a reorganisation of records kept in the home. As a result, records about young people are more accessible, effectively maintained and regularly updated. However, shortfalls still exist, such as missing placing authority agreements and plans, and health and education records have not been obtained to provide a complete picture of plans for the child.

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Leadership and management inadequate

Some shortfalls relate to the home’s Statement of Purpose. This describes a therapeutic home, although staff have received only introductory training in the therapeutic approaches used by the organisation. In addition, some shortfalls found 12 of 13 within the environment and in the lack of independent advocates for young people are contrary to the service outlined within the document. This means that placing authorities are unclear about the services provided by the home.

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Leadership and management inadequate

There are many audits regarding the performance of the home. The line manager for the home completes quarterly quality audits. The manager completes monitoring of most areas required by regulation, but neither process is sufficiently robust to identify the shortfalls found by this inspection. For example, the lack of detail in records of restraint, or gaps in agency staff information.

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Leadership and management inadequate

The manager recognises that the fabric and layout of the home requires significant improvement. However, the provider has not responded effectively to identified shortfalls, such as limited bathroom facilities for staff. Visitors on behalf of the provider add their regular review of the home. They have made significant progress in consulting with young people, and they regularly feature maintenance issues. The organisation has failed to identify the themes and patterns identified by visitors, to take action to improve bedroom and bathroom environments, or improve the response of the maintenance team to some repairs.

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Leadership and management inadequate

The manager provides staff with improved supervision and support, and involves them in regular staff meetings. Staff value the opportunity to reflect on their work, and make plans to improve the support they offer young people. As a result, staff offer a child-centred service that helps complex and vulnerable young people to improve their self-esteem and security. They are limited by lack of training in key areas, and by the constraints of the environment. However, this does not prevent them from making every effort to secure improvement in young people’s lives. 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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