Children's Home run by Benecare Limited in Kent

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.

p.2

because:

 Staff have not received specialist training related to the needs of the young people. Many do not have an in-depth knowledge of autism and cerebal palsy, conditions many of the young people have. Although a good standard of care is being delivered, it could be further improved through staff increasing their knowledge and skills.  Not all staff have received training on some communication techniques used by the young people, such as Makaton. Although communication skills is now being prioritised as an area for development, insufficient progress in delivering relevant training has been made since the last inspection.  Individual risk assessments are not subject to regular reviews and not updated according to young peoples’ changing circumstances. Young people who would require personal emergency evacuation plans have not been identified, and these plans have not been written.  Care planning is not robust, as all aspects of the plans are not reviewed and

p.3

because:

amended. Consequently, the goals and targets set for young people are not always relevant or appropriate. There are further shortfalls in the standard of health plans.  Not all staff have received adequate support and guidance to ensure their professional development. There have been inconsistencies in implementing the induction process and providing regular supervision.  A good standard of record keeping is not always maintained. Some errors have occurred in recording physical restraints, and reports sometimes lack detail.  Monitoring systems are not sufficiently developed to ensure consistently high standards of care.

p.3

The children's home strengths

 A new management team have quickly identified many of the weaknesses in the home and have started taking action to address these. The administration of medication system has been prioritised and a robust system implemented.  A committed staff team provide a good standard of care based on the individual needs of young people. Staff are vigilant and provide appropriate levels of supervision which helps safeguard the young people.  Opportunities are provided for young people to integrate into the local community. Management and staff take appropriate steps to ensure they do not become isolated within the home.  Young people make steady progress in their education. They are also developing their communication skills and making positive steps towards increased levels of independence.  Concerns and allegations about individual staff performance are now being identified promptly. These are thoroughly investigated and provision made for

p.4

The children's home strengths

safeguarding the welfare of young people.  Young people’s contact with their families is well planned and supported by staff where appropriate.

p.4

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.

p.5

Requirement Due date

In order to meet the protection of children standard, with particular reference to assessing risk and having personal emergency evacuation plans, the registered person must ensure that staff:

p.5

Requirement Due date

(2) (a) (i) assess whether each child is at risk of harm 25/09/2015

p.5

Requirement Due date

13: The leadership and management standard

p.5

Requirement Due date

In order to meet the leadership and management standard, with particular reference to providing trained skilled and qualified staff, the registered person must:

p.5

Requirement Due date

(2) (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child 25/09/2015

p.5

Requirement Due date

In order to meet the care planning standard, with particular reference to placement and health plans, the registered person must:

p.5

Requirement Due date

14 (1) (a) ensure children receive effectively planned care in or through the children's home. 25/09/2015

p.5

Requirement Due date

Ensure that each employee completes an appropriate induction. (Regulation 33 (1) (a)) 25/09/2015

p.5

Requirement Due date

Ensure that all employees undertake appropriate continuing professional development. (Regulation 33 (4) (a)). This specifically relates to supporting staff to maintain positive relationships with young people. 25/09/2015 Ensure all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4) (b)) 25/09/2015

p.5

Requirement Due date

Ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made. (Regulation 35 (3) (a)). This particularly relates to recording incidents of physical restraint. 25/09/2015

p.6

Requirement Due date

Ensure the independent person is helped to interview, if they consent, children living in the home. (Regulation 44 (2) (a)) 25/09/2015

p.6

Requirement Due date

Complete a review of the quality of care provided for children at least once every 6 months. (Regulation 45 (1)) 25/09/2015

p.6

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s): Identify other professionals who must play a part for the children, and engage with those relevant people pro-actively. (The Guide to the Quality Standards, page 12, paragraph 2.7)

p.6

Recommendations

 Ensure the children's guide is provided in an accessible format. (The Guide to the Quality Standards, page 24, paragraph 4.21)

p.6

Recommendations

Develop effective working relationships, where appropriate, with each child's parents; specifically, ensure parents are provided with up to date information. (The Guide to the Quality Standards, page 52, paragraph 10.3)

p.6

Recommendations

Ensure there is a workforce plan which details any further training required by staff; specifically, ensure the training matrix accurately records training that has been completed and what needs to be undertaken. (The Guide to the Quality Standards, page 53, paragraph 10.8)

p.6

Information about this children's home

This is a privately owned children's home, managed by a company which owns three other children's homes. This home is registered to provide care and accommodation for four children with learning disabilities and emotional and behavioural difficulties.

p.7

Recent inspection history

Inspection date Inspection type Inspection judgement

p.7

Recent inspection history

03/03/2015 CH - Interim declined in effectiveness

p.7

requires improvement

A stable and secure environment is provided for young people, and for many this has been a long term, settled placement. Staff know the young people well, and provide consistent and sensitive care. They are committed to protecting the young people, promoting their well-being and treating them with dignity and respect.

p.8

requires improvement

The young people have limited, or no verbal communication. Developing young people’s communication skills, particularly through the use of the pictorial exchange communication system (PECS), has become a priority following the appointment of a new management team. This is having positive results, and some young people have increased their vocabulary range in recent weeks.

p.8

requires improvement

Staff are familiar with PECS, and have recently attended a workshop to enhance their knowledge. However, not all staff have received training on Makaton, which is used as a communication tool by some of the young people. This means some staff are not able to communicate confidently using this approach

p.8

requires improvement

There is a commitment to enabling young people to express their views, and regular meetings take place to facilitate this. However, the young people’s guide to the home does not reflect this overall approach to empowering young people, as it is not available in a format that can be understood by the residents.

p.8

requires improvement

Although staff provide good quality care on a day to day basis, further shortfalls in the training programme mean some staff are not sufficiently knowledgeable regarding disability. Only generic training on autism, a condition affecting most of the young people, has been delivered. Young people are likely to receive care that better meets their needs and improves their overall experience, from staff who have received appropriate training.

p.8

requires improvement

Young people indicate that they like the home and enjoy the activities provided. One young person said the food was nice and she liked going on outings. A young person enthusiastically gave the inspector a tour of the home, and demonstrated a range of games and recreational facilities available. Young people were also able to identify staff they enjoy being with.

p.8

requires improvement

All young people attend a local special needs school. Attendance is excellent, and young people make good progress according to their abilities. There is an education room in the home, providing young people with an appropriate space to pursue their interests and learn from accessing educationally based games and toys. Management are developing links with the school and the speech and language therapy service, as these have not been particularly productive contacts in the past.

p.8

requires improvement

Care planning has not been given sufficient priority since the last inspection. Young people’s placement plans have not been regularly reviewed, and consequently the progress they make towards meeting their goals is not effectively monitored. There has been a lack of aspiration for the young people. Young people have clearly made progress in a number of areas, but because this is not monitored and recorded goals and targets remain the same and do not reflect progress made.

p.9

requires improvement

Health plans also need improving. In some cases these contain factual inaccuracies regarding medical conditions, and all the plans viewed contained out of date medication lists. Correct information regarding young people’s current medication is kept on other files, but the existence of two different lists gives the potential for mistakes to occur. Immediate action was taken by the deputy manager on the day of the inspection to rectify this shortfall.

p.9

requires improvement

The new management team promptly identified the administration of medication as one of the weaknesses of the home. A new system for recording and administering medication has been introduced. This is robust and minimises the risk of errors occurring.

p.9

requires improvement

Young people enjoy a range of community based activities, such as swimming, meals out and trips to the theatre. This helps integrate them into the local community, often provides good exercise and gives them the opportunity to develop new interests.

p.9

requires improvement

The development of young peoples’ independence skills has become another priority in recent weeks. Greater emphasis on improved communication has assisted young people improve these skills. They are better able to understand instructions and requests from staff, and complete tasks such as helping to clear the table after mealtimes. One young person has become more independent using the bathroom and no longer requires assistance with some aspects of personal care. He has received a reward from school in recognition of this achievement.

p.9

requires improvement

Staff members provide practical support for young people’s contact with their families, making this a more positive experience. Parents are welcomed into the home and arrangements are also made for young people wishing to have friends visit them. This further mitigate against the possibility of young people becoming isolated and helps them build on their social skills. Judgement grade

p.9

requires improvement

Staff are familiar with the day to day needs of the young people, who are all particularly vulnerable as a result of their disabilities and limited verbal communication. The young people require constant supervision to ensure they do not inadvertently harm themselves. Staff are vigilant and familiar with the behaviours each young person could display, and quickly respond to prevent the young people coming to harm.

p.10

requires improvement

The high level of supervision ensures young people do not go missing from the home, although all have risk assessments which identify actions to be taken in the event of an incident. Trips away from the home are planned with sufficient staffing to maintain appropriate support for young people.

p.10

requires improvement

The current emphasis on developing young people’s communication skills is providing them with better opportunities to express any concerns they may have. Young people are becoming more adept at using PECS, and developing sign language skills. Consequently, young people are more able to communicate how they feel when staff ask this question.

p.10

requires improvement

Risk assessments are undertaken which take into account individuals vulnerabilities and behaviour. However, these have not always been reviewed in a timely manner and consequently do not always reflect particular incidents and changing circumstances. Some risk assessments do not always accurately reflect medical conditions.

p.10

requires improvement

The new management team is now systematically reviewing risk assessments, although this task is yet to be completed. The risk assessment process has not considered whether young people require personal emergency evacuation plans. Some young people would need help and assistance to evacuate the building in an emergency. Consequently personal emergency evacuation plans should be kept for these young people.

p.10

requires improvement

This shortfall in the standard of risk assessments has not had any detrimental effects on young people, although has the potential to do so if not corrected.

p.10

requires improvement

Staff maintain consistent boundaries and respond in a calm, sensitive manner when young people challenge these. They understand the likely triggers for young people’s anxiety and distress and adopt individual approaches when this occurs. For some young people, mealtimes can be particularly troublesome. Seating plans, PECS cards and distraction techniques are all used to overcome these challenges. Physical restraint is used when young peoples’ behaviour places them at risk of harming themselves or others. Staff members receive training in recognised and approved restraint techniques. However, the standard of recording physical restraint incidents is not consistently good. One incident report has ‘not applicable’ on the section for recording physical restraint. However, it goes on to describe a physical intervention being used. Some reports also lack detail regarding de- escalation techniques that have been adopted.

p.10

requires improvement

This shortfall has not previously been identified due to insufficient monitoring. Many restraint report forms do not have management comments. The manager is now addressing this situation.

p.11

requires improvement

Staff members are observant and monitor relationships between young people. They quickly respond to any signs of antagonism between the group. Young people were observed to get on well together. A Social Worker stated that the group are ‘well matched’ and give the impression of being ‘a little family’.

p.11

requires improvement

The organisation’s whistle blowing policy is understood by staff, who acts upon it when necessary. A recent concern about a staff members practice was quickly drawn to the attention of managers, and a thorough investigation was undertaken. Consultation took place with the Local Authority Designated Officer, and detailed records were kept.

p.11

requires improvement

There are robust policies and procedures for the recruitment of staff. Background checks are undertaken to minimise the risk of unsuitable adults being employed in the home. Interviews for applicants are appropriately challenging and explore the applicant’s career history and motivation for working with young people.

p.11

requires improvement

The home provides a safe environment, with regular health and safety checks being undertaken. Staff are familiar with young people’s individual mobility difficulties, and ensure they are given support and guidance to move safely and unhindered around the house.

p.11

requires improvement

An experienced new manager came into post on 6 June 2015. He is currently in the process of submitting his application for registration to Ofsted. The organisation has also appointed a new deputy manager, who commenced work at the home on 15 June 2015. The new management team have quickly identified the strengths and weaknesses of the home and have produced a development plan which focuses on areas for improvement.

p.11

requires improvement

Action has been taken to in response to some of the requirements made at the interim inspection in March 2015. There is now a sufficient number of staff at the home. All staff are either suitably qualified, or have embarked on relevant training courses. However, management have not ensured staff receive specific training to meet the complex needs of the young people since the last inspection, and the requirement made in relation to this has not been met. As a result, not all staff are fully competent to care for young people with autism and cerebal palsy.

p.12

requires improvement

The current manager recognises the shortfalls in monitoring processes. The quality of care has not been reviewed in a timely manner, and visits by the independent visitor have often taken place when the young people are at school. This means young peoples’ views are not incorporated into the independent visitor monitoring process.

p.12

requires improvement

All young people have placement plans, but some have not been comprehensively reviewed for significant periods. This results in young people’s goals and targets not being updated, and hinders clear monitoring of the progress they make. There has been a lack of aspiration for the young people, but this is beginning to be addressed.

p.12

requires improvement

The manager is now developing links with other agencies involved in the care of the young people. Initial meetings have been arranged with schools, the child and adolescent mental health service (CAMHS) and with speech and language therapists. Pro-active steps have been taken to build relationships with parents. This approach needs to become embedded in practice, as some parents feel that communication and information sharing has been ineffective in recent months.

p.12

requires improvement

Under the leadership of the new management team, greater emphasis is being placed on community integration. Links with external support agencies and local recreational facilities underpins a shift in the ethos of the home. There is now a greater emphasis on a social model of care for young people with disabilities, as opposed to a medical model.

p.12

requires improvement

Steps have been taken to ensure that staff are well supported and motivated to develop their practice. Prior to the introduction of the new management team, some staff were not receiving regular supervision and one new member of staff did not have an induction into the role. Group and individual supervisions have begun to address this issue, but the approach needs to be consistently maintained.

p.12

requires improvement

The transition process that is currently underway has been well managed. Staff are responding positively to the new approach, and state that their ideas are listened to and valued. There is a sense of team cohesiveness, and this ensures there is consistency in the approach and care young people receive.

p.12

requires improvement

Managers ensure the home’s statement of purpose is regularly reviewed. There are currently some minor factual inaccuracies in the document, which managers are aware of and will be addressing. Overall the document is an accurate reflection of the services delivered by the home.

p.13

requires improvement

There have clearly been some shortfalls in the standard of leadership and management in recent months. However, this decline has been recognised and is now being addressed. The manager is motivated to ensure consistently high levels of care for young people, delivered by trained and skilled staff. The recent improvements need to become embedded in practice and actions identified in the development plan need to be driven forward.

p.13

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.

p.14

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

p.14

What the inspection judgements mean

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

p.14

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

p.15

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 .

p.15

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,

p.16

Information about this inspection

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

p.16

Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.16

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

p.16