Children's Home run by Five Rivers Child Care Limited in Wiltshire

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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because:

 The company decided to admit a young person full time when she finished school in July, believing that the stability they hoped to provide would enable her to settle. Managers took a significant but assessed risk when admitting the young person to the home. It is now clear that the staff team is unable to meet her very complex needs which place her and others at significant risk of harm. Staff are unable to control the young person. Although the manager and responsible individual act quickly to support the team in regaining control following a situation, the young person is not able to cope with this degree of power and it has a further detrimental effect on her behaviour.  The manager is responsible for two children’s homes 12 miles apart, both of which have young people with complex needs. Considerable time has been devoted to keeping the young person in this home safe and oversight of both homes is not possible. For example, some managerial and

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because:

administrative tasks are not undertaken and completed due to lack of management time.

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because:

 The manager and staff have not notified Ofsted of all the serious incidents since the previous inspection.

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because:

 Managers have taken swift action to give notice on the placement, which was set up on a trial basis. This culminated in the abrupt ending of the young person’s placement, and to her admission to secure provision.

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The children's home strengths

The home plans thoroughly for complex placements. The staff and manager work very hard to ensure that transitions to the home go smoothly and at the young people’s pace. For example, staff maintained contact with a young person during term time at her residential special school, by visiting and shadowing the staff there. This helped the young person adjust to the change of environment to her holiday placement at the home.

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The children's home strengths

The staff team delivers dedicated, nurturing and highly supportive care to young people whose needs they have been trained to meet. They remain professional and ensure that the young person’s needs remain the focus of their practice at all times.

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The children's home strengths

The manager and staff work exceptionally closely and effectively with the local police, as well as the local authority designated officer (LADO). The police are in frequent contact with the home and work alongside the staff to try to increase the young person’s perception of risk.

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The children's home strengths

The manager and staff are committed to improvement. This is well evidenced by the cleanliness, attractive decoration and refurbishment of the home since the interim inspection. The home now provides a pleasant and relaxing residence for young people.

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The children's home strengths

Leaders and managers are visible and show strong, clear leadership. They provide exceptionally good support when staff have worked hard but feel frustrated by lack of progress. Staff appreciate their managers’ interventions and value their contribution.

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The children's home strengths

Leaders and managers are highly effective and proactive in advocating for young people, for example, when care planning documentation is incomplete, or when there are case management concerns.

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The children's home strengths

Leaders and managers negotiate strong contractual arrangements to help safeguard young people, and work very effectively and flexibly with placing authorities and other agencies to promote the best possible outcomes for young people.

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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

6. The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard, children must receive care from staff who—

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Requirement Due date

(a) understand the children's home's overall aims and the outcomes it seeks to achieve for children; (b) use this understanding to deliver care that meets children's needs and supports them to fulfil their potential. (2) In particular, the standard in paragraph (1) requires the registered person to— (b) ensure that staff— (ii) protect and promote each child's welfare; (iv) provide personalised care that meets each child's needs, as recorded in the child's relevant plans, taking account of the child's background. 30/09/2015

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Requirement Due date

25.—(1) After consultation with the fire and rescue authority, the registered person must— (a) take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children's home; and (d) ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire. In particular, ensure that fire drills and fire safety checks on equipment and alarms are conducted at recommended intervals (Regulation 25 (1) (a) and (d)) 30/09/2015

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Requirement Due date

40. (4) The registered person must notify HMCI and each other relevant person without delay if— (a) a child is involved in or subject to, or is suspected of being involved in or subject to, (a) sexual exploitation; 30/09/2015 (b) an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; (c) there is an allegation of abuse against the home or a person working there; (d) a child protection enquiry involving a child — (i) is instigated; or (ii) concludes (in which case, the notification must include the outcome of the child protection enquiry); or (e) there is any other incident relating to a child which the registered person considers to be serious.

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Requirement Due date

In particular, the registered person must ensure that incidents involving the police and others which could reasonably be deemed serious are notified to Ofsted within 24 hours (Regulation 40 (4) (a) to (d))

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Requirement Due date

45.—(1) The registered person must complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months. (2) In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating— (a) the quality of care provided for children; (c) any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

In particular, the manager must ensure that staff always complete key worker records, that care planning documents include up-to- date information about the young person’s cultural choices and that local authority documents are printed and filed promptly. There must be effective monitoring and oversight of staff recording, for example, restraint records must include the reason for the intervention and incident reports must tally with the relevant log. (Regulation 45 (1) and (2)) 30/09/2015

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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

 The registered person should ensure that children are provided with nutritious meals suitable for each child’s needs (Guide to the Children’s Homes Regulations 2015, paragraph 3.8)

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Information about this children's home

This is a privately-owned children’s home, operated by a national organisation. It is registered for up to two children or young people who may have emotional and behavioural difficulties. The home is situated on a small residential estate in a village. The company has its own school, approximately 10 miles away. 

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

02/03/2015 CH - Interim declined in effectiveness

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requires improvement

The home offered a long term placement to a young person who was already known to the service. The young person had several concerning incidents during her holiday placements in this home, so the service was aware that this was potentially a high-risk placement. However, her identified needs as stated at the time were in line with the home’s statement of purpose.

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requires improvement

The full extent and seriousness of the young person’s psychological and behavioural need were not recognised by either the placing authority or their own internal child and adolescent mental health service (CAMHS) as they did not have access to full placement planning information. It was, therefore, not possible for the placing authority or the provider to predict the young person’s response to finding herself in an open setting after a year in the more structured environment of a residential school.

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requires improvement

During the periods of holiday care at this home prior to their full time admission, the young person was showing unsettled and challenging behaviour, the consequences of which contributed to the shortfalls found at the interim inspection. The service decided to allow the young person the opportunity to settle after her change of environment and disrupted attachments with staff at her school.

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requires improvement

Following the young person’s long-term admission, the number and severity of serious incidents increased and staff were unable to manage the young person’s behaviour. These include numerous episodes of going missing, assaulting staff in the home and in the car, and incidents with children in the community which have led to aggression and frustration. Local parents have voiced their concerns to the home and to the police. The young person’s approaches to strangers make her exceptionally vulnerable to sexual exploitation.

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requires improvement

Staff devote considerable time, care and attention to trying to engage the young person in constructive activities, in order to distract her from leaving the home. They allow children she has met to visit the home, under supervision. Staff also encourage the young person to help with meal preparation, to bake cakes and participate fully in the running of the home.

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requires improvement

Staff help the young person to engage with the community in positive ways. They take her swimming, climbing, horse riding, golf, shopping for clothes, ice skating and promote a wide range of other activities outside the home. The young person did not have ready access to community activities before coming to live at this home, so this is positive progress.

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requires improvement

The young person’s physical healthcare needs can be met in this home, but her emotional needs cannot. When the young person left school, this disrupted the relationship that she had with the local CAMHS service. Although the home’s staff work in a therapeutic manner and receive training in understanding trauma and attachment disorders, this home is not a therapeutic community. The young person has struggled to engage with staff she is still getting to know, and so she cannot yet benefit from the staff team’s monthly consultations with the company’s clinical psychologist. A CAMHS referral in her new area is planned, but the placement will be terminated before this has come to fruition.

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requires improvement

The young person helps staff to plan a nutritious diet, but snacking on junk foods while missing and absent from the home has had an impact on her willingness to adhere to her plan. The young person frequently skips meals or eats high-sugar foods and chocolate that may exacerbate her medical condition, for which she is taking controlled medication. Some members of the staff team tried to reinforce boundaries around snacking during the inspection, and the inspector observed the consequences of this for her behaviour.

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requires improvement

Staff interact with the young person in a warm, nurturing and supportive manner. They have tried hard to build relationships with a young person who is not yet ready to respond. Positive behaviour is consistently rewarded and the young person has received 17 gold stars, and a CD for her efforts.

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requires improvement

Key worker sessions take place frequently. Staff speak with young people about risk-taking and how to manage relationships with peers. Police officers visit the home at the manager’s request, and speak with young people about how to avoid dangerous situations. This work was observed during the inspection, but records do not support the fact that any of this work is actually taking place. There is therefore limited evidence to reflect the quality of the interventions and the young person’s experience of this home.

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requires improvement

The home works well with individual differences and provides everything required to enable young people from minority ethnic and religious backgrounds to maintain their cultural values and practice their chosen religion. Young people’s religious needs are recorded at the start of each placement, but these are not always updated when the situation changes. For example, some young people choose not to adhere to religious dietary rules, but the menus show the original instructions from the placing authority rather than the young person’s wishes. Judgement grade

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requires improvement

The manager undertakes robust risk assessments to provide staff with important safeguarding information and strategies for keeping young people safe. These documents have been prioritised and are regularly revised to a high standard.

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requires improvement

There have been no child protection referrals since the previous inspection. The requirements from that inspection included the need to follow correct safeguarding practice with regard to reporting incidents and liaising with the LADO. The manager ensures that effective safeguarding practice is incorporated into staff practice. Staff are confident about child protection processes and confirm that they have received appropriate training in this area.

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requires improvement

Managers recruit sufficient staff for the home. The home now has its own consistent staff team, whereas previously, the staff as well as the manager worked across both this home and its sister establishment.

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requires improvement

Restraints are increased, due to the admission of a young person whose behaviour has challenged staff. There has been 17 physical interventions since the previous inspection, all involving the same young person. Although staff do not always record the reason for physical interventions in sufficient detail in the log book, restraints have all been of short duration. When cross referenced with the incident records, it is clear that they were done for appropriate reasons.

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requires improvement

Other agencies request staff to contain the young person routinely day and night, and if necessary restrain her to prevent her from leaving. The manage correctly resists this pressure. This shows that he understands the legal framework in which the home operates, and respects young people’s dignity and rights.

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requires improvement

The young person is absent and has been missing on numerous occasions. In spite of the fact that there is two-to-one staffing in place, on many occasions the young person evades staff and disappears, usually just for a few minutes, but on a few occasions, for several hours. Although there is no evidence that the young person comes to any direct harm during these absences, Staff are anxious because they are well aware that they cannot keep her or other children in the community safe. Parents are understandably concerned about their own children and have contacted the home, as well as the police, to set out their concerns.

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requires improvement

The home’s qualified and experienced registered manager has been in post since 2011, but has been on maternity leave since October 2014. During this time, the former deputy manager has managed this home and another establishment situated approximately 12 miles away.

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requires improvement

The registered manager’s return date is agreed as 2 October 2015. She is currently the registered manager for two homes, but the company is reviewing this arrangement. For example, during the past year, the complexity of the young people’s needs at both homes is increased and there have been times when the interim manager is needed in the two locations at the same time. As a result, some management monitoring tasks slipped, specifically some notifications to Ofsted, the recording matters described above, fire safety checks and drills, and ensuring that multi-agency meetings are noted for future reference.

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requires improvement

The interim manager is a skilled childcare practitioner who holds a level 5 qualification in leadership and management. He is well qualified, with a foundation degree in therapeutic practice, sponsored by the company. He is supported by a very able and experienced deputy, who also works across both homes, and through regular, high-quality supervision and guidance from senior colleagues.

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requires improvement

The interim manager has grown and developed in his role since the previous inspection. He has established a consistent staff team in this home and provides them with strong leadership and support through challenging times. The manager ensures that relationships between the home, the police and the local authority designated officer are exceptionally robust.

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requires improvement

Leaders and managers act in a sensitive and professional manner during the unplanned ending of placements. For example, they have brought in waking night and other extra staff to maintain the young person for an additional night to allow the placing authority to make plans. Now that a crisis point has been reached, the placing authority, the home and the police are working together in an exceptionally child-centred and compassionate manner to find a safe and effective resolution.

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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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