Children's Home run by Blue Mountain Homes Ltd in Nottinghamshire

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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Safeguarding

 Not all young people feel safe in the home. Recent significant incidents in the home mean that young people do not feel a sense of safety and protection.  The physical environment does not ensure that young people are appropriately safe or protected from harm or the risk of harm. A range of household issues pose potential risks to young people.

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Management

 Senior managers and the registered manager have not assessed the likely impact of new admissions to the home. Decision-making has failed to give priority to the safety and stability of the group environment. This does not take into account the needs of all of the young people.  The registered manager has failed to ensure that a placing authority has provided an up to date Placement and Care Plan for a young person at the point of admission. This means staff did not have up to date and accurate information on current risks and care needs of young people. This shortfall was raised at the last inspection and a requirement was set to address the issue. This is a repeat failure to obtain essential placement planning information.  The home’s statement of purpose does not comply with regulatory requirements and does not reflect how the home is operating. Information is inaccurate, inconsistent and fails to provide a true picture of the home’s

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Management

operation. Failure to submit an up-to date and accurate statement of purpose to HMCI means the regulator cannot monitor changes and does not give an overview of the home’s function and purpose.  Supervision arrangements for the registered manager and the staff group are not up to date. As a result, the manager and staff do not have the necessary support, guidance and knowledge to deliver safe care.

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Experience and progress of young people

 Individual health needs requiring specialist help and support are not made available at the point of admission.  Young people feel that they do not live in a stable environment. The behaviours of some young people cause disruption to the home and routines. Recent significant incidents of self-harm, physical interventions and challenging behaviours have unsettled the group.

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The children's home strengths

 The registered manager, deputy manager and staff team are resilient and committed to meet the needs of young people, regardless of some young people’s challenging and risk taking behaviours.  Over time, young people have improved their educational engagement, with some young people successfully starting mainstream school and completing college studies.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

In order to meet the protection of children standard the registered person must ensure:

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Requirement Due date

(2) (d) that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. 07/08/2015

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Requirement Due date

(1) The care planning standard is that children -

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Requirement Due date

(a) receive effectively planned care in and through the children’s home. Specifically to ensure that full and up to date referral information is sought at the point of considering placement suitability and that the home ensures that arrangements are in place at the commencement of the placement to meet specific health care needs. 07/08/2015

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Requirement Due date

(2) In order to meet the care planning standard, the registered person is required to ensure -

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Requirement Due date

(a) that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the homes statement of purpose. 07/08/2015

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Requirement Due date

the registered person must compile in relation to the children’s home a statement (“the statement of purpose”) which covers the matters listed in Schedule 1 (Regulation 16 (1)) 07/08/2015 the registered person must – (a) keep the statement of purpose under review and , where appropriate, revise it; and (b) notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision (Regulation 16 (3) (a) (b)) 07/08/2015

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Requirement Due date

the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose (Regulation 16 (5)) 07/08/2015

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Requirement Due date

The registered person must ensure that the privacy of children is appropriately protected. With specific reference to providing a staff office space which ensures confidentiality in relation to verbal discussions (Regulation 21 (a)) 07/08/2015

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Requirement Due date

ensure the registered person maintains records (case records) for each child which include the information and documents listed in Schedule 3 in relation to each child. (Regulation 36 1(a) Schedule 3, point 19) 07/08/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Ensure the registered person has systems in place so that all staff, including the manager, receive regular supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (The Guide to the Quality Standards, page 61 paragraph 13.2)

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Recommendations

 Children and young people must feel safe and be safe. Specifically staff should support young people to develop an increased sense of safety where they feel vulnerable. (The Guide to the Quality Standards, page 43 paragraph 9.9)

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Information about this children's home

 the home may provide care and accommodation for up to 4 children.  the home is privately owned.

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Information about this children's home

 may provide care and accommodation for children with emotional and/or behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

07/01/2015 CH - Interim sustained effectiveness

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Recent inspection history

08/10/2013 CH - Interim Satisfactory Progress

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requires improvement

Care provision in this home requires improvement because admission processes have not been robust. The wide range of young people’s needs outlined in the homes statement of purpose, combined with weak admission procedures result in poor compatibility of young people. High levels of disruption and incidents of challenging behaviour have resulted in young people feeling unsettled and in some cases unsafe. This means the group dynamics between some young people are poor. Managers are clear that immediate action is required to ensure the experiences and progress of young people improves in the medium and long term.

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requires improvement

Staff have demonstrated resilience during a highly stressful period. Young people are clear that relationships with staff are positive and beneficial for their well- being. One young person said ‘Staff are brilliant! I cannot fault them. Staff try their hardest. If it was not for this home, I would be dead!’

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requires improvement

All young people have educational plans that aim to improve their educational attainment and attendance. Some young people attend the providers own school, while others travel to college and local schools. Attendance levels are variable; however, staff are persistent in encouraging attendance.

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requires improvement

Young people benefit from routine and specialist health care. The home has good links with the child and adolescent mental health service and the nurse for looked after children in care. The home has had very positive results in helping young people reduce their self-injurious behaviours. However, some young people continue to have serious incidents of self-harm. All staff have appropriate training and experience to manage these incidents. Following serious incidents, staff support young people to access hospital care and mental health services. This means current risks are professionally risk assessed and young people kept safe.

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requires improvement

Although most young people benefit from improved health, some young people do not have their specific health care needs met at the point of admission to the home. A lack of planning for new placements means unnecessary delay for young people receiving specialist services. This causes undue distress on young people.

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requires improvement

Staff encourage and support young people to participate in activities suited to individual choice and interests. Young people can routinely access community groups such as cadets or going to the gymnasium. Some young people are of an age where they prefer to meet with friends outside of the home. Since the last inspection, two young people have enjoyed an overseas holiday, while others have had a holiday in the provider’s holiday accommodation in Wales. This range of recreational and social activities expands young people’s horizons and helps to build social skills.

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requires improvement

Young people admitted to this home have known challenging and risk-taking behaviours. In such circumstances, staff implement written risk management strategies. However, there have been incidents where staff have been unable to anticipate issues and prevent serious incidents. This has meant some young people have not felt safe due to the behaviours of other residents. Staff monitor interactions and provide consistent levels of supervision.

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requires improvement

The manager has measures in place to improve the maintenance and decoration of the home. However, there are areas of the home that require urgent attention due to potential safety issues. For example, hazards of uneven and damaged floor covering posing potential trip hazards, hygiene issues with mould in showers and dirty floors in the dining room, damp areas and malodour in parts of the home.

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requires improvement

Staff all have up to date training in the use of physical interventions and restraint techniques. Restraint is used as a last resort and to safeguard young people. Since the last inspection, there have been a high number of restraints with a young person. Staff have utilised intensive restraint methods to manage highly challenging behaviours. The registered manager monitors each incident of restraint and evaluates its effectiveness. This has resulted in some intensive techniques no longer being used due to potential risks to young people.

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requires improvement

Incidents of young people who go missing from the home have reduced since the last inspection. Where young people go missing from the home, action is taken to ensure the safety and wellbeing of young people and all relevant parties are updated. In circumstances of young people missing from the home, staff adhere to the guidance in the local authorities Runaway and Missing from Home and Care protocols (RMFHC). This means the home work in partnership with safeguarding agencies and effectively protect young people.

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requires improvement

There have been two allegations against staff since the last inspection. One investigation has concluded, with the other is currently under investigation. The records for the concluded allegation are clear and comprehensive. They demonstrate how the allegations are progressed; contain details of actions taken and decision-making. All required checks on fire safety equipment, electrical and gas appliances are up to date. However, a missing fire strip on the kitchen door potentially compromises fire safety. All young people and staff have participated in recent drills. This means emergency escape procedures are known and would ensure safe evacuation in the event of a fire.

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requires improvement

The manager became registered in this post in April 2008. She has a National Vocational Qualification at Level 4 in health and care with children and young people and Level 4 in leadership and management. These are suitable qualifications for the post of registered manager. A deputy manager supports the registered manager. She has appropriate qualifications, skills and knowledge to provide managerial support and to manage the home in the Registered Managers absence.

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requires improvement

Recent unplanned changes in the senior management structure within the organisation have led to some changes in the home. The registered manager has been providing management support as the Interim Care Director, with the deputy manager directly managing the home. These unforeseen changes have further compounded the young people feelings of being unsettled. Managers and staff are working with young people to help them cope with these unexpected changes. The registered individual has reacted in a timely manner to ensure the home benefits from long-term succession plans. Consequently, management arrangements remain firm.

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requires improvement

There were three requirements made at the last inspection. The manager has successfully ensured relevant self-harm training for the staff team. This provides greater levels of knowledge and insight within the staff team. Plans to provide a more confidential office space have not been wholly effective. Building work has been completed, however managers’ report that conversations are still heard in communal areas. Lastly, the requirement to ensure all young people have relevant care and placement planning documentation remains a shortfall, with the most recent resident not having this paperwork since admission.

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requires improvement

Supervision arrangements for the registered manager and staff continue to be inconsistent and are not in line with the home's own policy. This does not support staff appropriately and fails to ensure that staff performance is monitored and young people safeguarded.

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requires improvement

The statement of purpose provides a guide about the aims and objectives of the home and care provided. The management team have reviewed the homes statement of purpose, but failed to provide an up to date copy to the regulator. The registered manager said that the current statement of purpose is flawed and she plans to develop a new version. The current statement of purpose is very generic and proposes care for young people with a wide range of competing needs with short to long term care. Information about the admission of young people admitted in an emergency is lacking in detail. The document uses the term ‘therapeutic’ throughout. This is misleading as neither management nor staff are therapeutically trained. The home does have access to commission a psychotherapist on a ‘needs led’ basis, but the home do not currently use this service. The statement of purpose states that it can provide care for young people

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requires improvement

with ‘severe mental health issues as the staff members and the managers have the expertise to be able to carry out care.’ Staff and managers do not have the required level of training or experience to care for young people with severe mental health issues. The document does not list the qualifications or experience of the staff team and the description of supervision arrangements are ambiguous. This document means that parents and local authorities do not gain a true picture of the homes purpose or function.

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requires improvement

Since the last inspection the home has been going through a period of instability with staff managing the competing needs and behaviours of young people. Leaders and managers have not been able to demonstrate how new admissions to the home are assessed for compatibility. This is compounded by the provider’s failure to keep records of decision making in regards to admissions to the home and suitability. Managers admit that they have had a very challenging time, but they remain committed to care for the young people.

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requires improvement

The registered manager undertakes routine monitoring activities and comprehensive monitoring visits by an independent visitor provide a further level of quality assurance. These combined quality assurance systems identify areas of strength and development, which enable the manager to make improvements where necessary. The registered manager is clear about action necessary to improve care provision.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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Information about this inspection

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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