Children's Home run by Horizon Care and Education Group Limited in Leicestershire

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:

 There is instability within the staff team due to a heavy reliance on the use of agency staff. This has a negative impact on both young people and the core staff members. Regardless of the steps taken to use the same regular agency staff, these arrangements have resulted in weaknesses in service arrangements. A recent example is that a 14-year-old was allowed to watch a film at the cinema, designated as suitable for over 15s, when supported by a temporary member of staff.  Temporary agency staff who are working regularly in the home are not receiving one-to-one supervision. Consequently, they may not fully understand their role in the care and protection of young people.  As a result of weaknesses in management oversight, shortfalls are not identified and acted upon promptly. For example, the manager was unaware of the shortfalls in the administration of medication noted in this inspection. Additionally, some areas of need identified in placement planning are not

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because:

fully supported. This links directly to gaps in staff knowledge and their understanding of their roles and responsibilities.  Young people are not learning to take increasing responsibility for their personal health and well-being and do not understand the importance of good health. This is associated, at least in part, to staff not setting effective boundaries which ensure young people attend health appointments. In addition, healthy living routines to support identified health needs are not fully promoted.

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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

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children's home. (Regulation 23(1)) 21/09/2015

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Requirement Due date

In order to meet the health and well-being standard the registered person must ensure that:

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Requirement Due date

(1) (a) the health and well-being needs of children are met:

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Requirement Due date

(b) children receive advice, services and support in relation to their health and well-being and

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Requirement Due date

(c) children are helped to lead healthy lifestyles.

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Requirement Due date

(i) achieve the health and well-being outcomes that are recorded in the child's relevant plan.

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Requirement Due date

(ii) understand the child's health and well-being needs and the options that are available in relation to the child's health and well-being, in a way that is appropriate to the child's age and understanding. 07/10/2015

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 22 (4) (b)) 07/10/2015

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Requirement Due date

The registered person must in order to complete a quality of care review establish and maintain a system for monitoring, reviewing and evaluating- (a) The quality of care provided for children; 07/10/2015 (b) The feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and (c) Any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. (Regulation 45 (2) (a)(b)(c))

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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 that staff have the relevant skills and knowledge to be able to: respond to the health needs of children and help children to manage long-term conditions and where necessary meet specific individual health needs including chronic conditions or other complex needs. (The Guide to the Quality Standards, page 34, paragraph 7.12)

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Information about this children's home

 The home is operated by a large private organisation and is registered to provide care and accommodation for two children and young people 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

This is the first inspection of this home since registration

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Requires improvement

Young people receive individualised care which is planned in consultation with placing authorities and involved professionals. A mental health professional working with the service confirmed that staff work proactively to support and advocate for young people and follow his guidance in caring for them. As a result young people’s emotional health improves.

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Requires improvement

Each young person has made progress in identified areas. A placing social worker recognised the reduction in missing from care episodes and the good progress a young person has made with their schooling when compared to their position on admission. Comments from young people include: ‘Even though there are some things I don’t like I do want to stay here so I can continue doing well at school and then go on to college.’ This demonstrates that young people recognise the difference the home has made to their progress within education. Comments from education staff include, ’This young person is one of our real success stories’, reflecting the commitment now shown by the young person to achieving and attending within education. Young people beyond school leaving age are supported to attend schemes such as the Prince’s Trust in the short term while they plan further education courses. This has resulted in them having aspirations for their

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Requires improvement

Comments from young people reflect differing perspectives about their care. Some comments show that they feel valued and that their views are seen as important. One young person spoke highly about the support received in relation to their evolving identity and personal preferences. Another young person reflects a view that only some staff genuinely care and made reference to staff looking at their phones when he has tried to talk to them.

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Requires improvement

Young people are supported to develop independent living skills such as budgeting, shopping and food preparation. Consequently, they are beginning to learn the skills they will need to live independently in the future. They are encouraged to take part in community groups and activities and are able to meet up with friends. Staff advocate for young people in relation to placement planning and ensure that their views are raised in relation to risk management. While arrangements are slow in progression, the staff are taking action to arrange an independent advocate for one of the young people.

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Requires improvement

Young people say that staff address conflicts between residents. Comments from young people show that since moving to the home they have learnt to become tolerant of difference and diversity and that they recognise this as progression. Young people confirm that they each have identified a member of staff they feel able to talk to should they feel upset or have an issue they wish to discuss.

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Requires improvement

Young people’s good health is not fully supported. Required medication is not always administered as directed. Their dietary intake is not closely monitored, and while young people are very involved in selecting products when food shopping, this sometimes results in high fat choices and a reliance on ready-made convenience foods which goes unchecked. For example, a record sampled showed that a young person was taken out for breakfast at a fast food restaurant then had fish and chips for their main meal, with no other entries on dietary intake recorded for the day. This weakness had not been identified and therefore could be repeated as a matter of routine.

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Requires improvement

During the initial period of operation, events occurred in the home which demonstrated a failure by staff to fully safeguard young people. For example, young people accessed the office, which enabled them to gain access to poorly secured petty cash and medication. While no direct poor outcomes for young people occurred, the events clearly put them at risk of serious harm. Actions were subsequently taken by the registered manager to improve practice within the home and there have been no further similar incidents.

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Requires improvement

Risk management strategies guide young people’s protection. However, there is at times a lack of clarity within risk assessments which means that staff may be unclear as to how best to safeguard young people. For example, ‘regular room searches will be undertaken’ is potentially open to interpretation as to how often this should be.

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Requires improvement

Young people say that they feel the environment is safe and that they understand what steps to take if there were a fire in the home. Young people know how to raise a complaint and they record low-key issues of concern in the ‘Bug Bear Book’ which are responded to by the manager.

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Requires improvement

Staff do not consistently set firm boundaries. For example, some young people refuse to attend health appointments and other pre-arranged visits with external agencies. Observations were made during the inspection of frequent abusive language being used towards staff. While staff pointed out this as unacceptable, it continued, which shows that staff are not always able to maintain good discipline. Young people with histories of frequent self-harm and others who have historically regularly gone missing have become increasingly safer since moving to this home. Placing social workers and young people themselves identify the number of incidents as notably reducing. There has been only one incident of young people leaving the home without permission since the home opened. Staff responded to this by going in search of the young people and reported them as potentially missing to the police. The young people returned to the home within approximately

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Requires improvement

Staff understand the risks posed to young people through the use of the internet. Some restrictions are in place for general use of the internet and staff educate young people about their vulnerabilities and potential risks. Young people say that they have learnt how to keep themselves safe in relation to the internet.

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Requires improvement

A manager, who became registered with Ofsted when the home opened in March 2015, leads the operation of this home. She was appropriately qualified at that time and is currently undertaking additional training to bring her qualification in- line with the since-adjusted requirement to hold a Level 5 Leadership and Management qualification.

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Requires improvement

There have been shortfalls in the numbers of staff permanently employed since the home opened. Some staff have moved on, which has led to a heavy reliance on agency staff. This has been managed by the use of the same individuals in order to promote consistency; however, this has still had an impact on the quality of care that young people receive. Full-time staff speak about the restrictions of working with agency staff, for example, not being able to use the computer systems to record and also not fully understanding the young people’s needs in the same way as permanent staff. Poor decision making has been presented as linked to the use of agency staff, which resulted in a 14-year-old young person being able to watch a film restricted to those aged 15 years and above at the cinema. The service also faces further imminent staffing moves as additional permanent staff are leaving. Ofsted is working with the provider organisation to understand how it intends to

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Requires improvement

manage this situation in the best interests of young people and to ensure that regulatory requirements are met.

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Requires improvement

There are identified shortfalls in the way the service is monitored, which has led to a failure by leaders and managers to fully understand service weaknesses. As a result, the necessary actions have not been taken to improve practice. For example, the registered manager was unaware that staff do not understand the medication needs of young people or fully understand their role in ensuring the health and well-being of young people. As a result, medication has not always been administered as required and identified needs relating to healthy lifestyles are not fully supported.

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Requires improvement

The organisation provides new staff with a core training programme and refresher training when required. Staff say that they feel supported by the registered manager and receive supervision and guidance. However, agency staff working regularly in the home are not receiving this same one-to-one supervision. Consequently, they may be unclear about their roles and responsibilities in meeting the needs of young people.

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Requires improvement

Involved professionals and families have provided variable feedback about the quality of communication. Some comments reflect having to make several requests for information, while others say, ‘communication is exemplary’.

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Requires improvement

The registered manager and staff are proud of the progress young people have made since moving in and demonstrate a commitment to advocating for young people’s best interests. For example, they have raised issues with placing teams in order to ensure that individual needs and wishes are fully heard and understood.

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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

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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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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