Children's home run by Lioncare Limited in Epping Forest

Good

The children's home provides effective services that meet the requirements for good.

p.2

The children's home provision is good because:

 The therapeutic approach to caring for children, as described in the home’s statement of purpose, is embedded in practice. Children benefit from receiving consistency of care, and develop positive attachments with care staff.  Children receive the specialist support that they need to overcome past negative experiences. Their emotional resilience and well-being improve.  Children learn to express their feelings and increase their ability to manage their anger and frustration successfully. Over time, they acquire useful skills for managing conflict within their peer group.  Managers and staff have a thorough understanding of the vulnerabilities and associated risks of each child. This assists them to manage risk, and minimises the prospect of children coming to harm.  Attendance at the organisation’s school is consistently good, and children improve their ability to engage in lessons. Effective communication between

p.3

The children's home provision is good because:

school and care staff ensures that progress is monitored and that children receive additional support when required.  Excellent preparation work is undertaken with children who are moving to the home. This increases the chances of their settling quickly.  Children are encouraged to develop their individual interests and hobbies. Their bedrooms are highly personalised to reflect these. They are praised for their achievements and begin to take pride in their successes.  Managers and staff communicate effectively with professionals, parents and carers. This ensures that all relevant people are familiar with how the child’s needs will be identified and met.  Some shortfalls in the standard of practice were identified. These specifically relate to admission processes, physical restraint and staff supervision. Other recommendations have been made to improve practice in the home further.

p.3

Statutory requirements

This section sets out the actions which must be taken so that the registered persons meet 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 persons must comply with the given timescales.

p.4

Requirement Due date

6: The quality and purpose of care standard

p.4

Requirement Due date

In order to meet the quality and purpose of care standard, with specific reference to assessing the likely impact of new admissions to the home, the registered person must ensure:

p.4

Requirement Due date

(3)(b) that the care meets the child's needs. 24 June 2016

p.4

Requirement Due date

Restraint in relation to a child is only permitted for the purpose of preventing injury to any person (including the child) or serious damage to the property of any person (including the child). Restraint in relation to a child must be necessary and proportionate (Regulation 20(1)(a)(b) and (2)). 6 June 2016

p.4

Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience; specifically, ensure that staff supervision is delivered in accordance within the time scales outlined in the home's statement of purpose (Regulation 33(4)(b)). 24 June 2016

p.4

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

p.4

Recommendations

 Help children looked after to understand the role of an independent advocate and how they can access one (‘Guide to the children’s homes regulations including the quality standards’, page 23, paragraph 4.17).  Ensure that records are kept of the administration of all medication, including occasions when prescribed medication is refused. Specifically, ensure that the instructions for administration printed on prescribed medication packaging is followed (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.15).

p.4

Recommendations

 Lead and manage the home in a way that delivers the ethos, outcomes and approach set out in the home's statement of purpose. Specifically, ensure that each child receives weekly care coordinator sessions (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.4).

p.5

Recommendations

 Ensure that a workforce plan is kept updated to include any new training and qualifications completed by staff while working at the home, and is used to record the ongoing training and continuing professional development needs of staff, including the home's manager. Specifically, ensure that the record accurately reflects what training is available to staff, dates when training has been completed and dates when refresher training is due (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8).

p.5

Information about this children's home

The home is run by a private organisation and is registered to provide residential care for seven children who have emotional and behavioural difficulties.

p.6

Recent inspection history

Inspection date Inspection type Inspection judgement

p.6

Recent inspection history

26 January 2016 Interim Sustained effectiveness

p.6

Recent inspection history

10 March 2015 Interim Sustained effectiveness

p.6

Good

The therapeutic model of care, which underpins and informs practice, is well established and implemented in practice. Thus, children benefit from receiving consistency of care. They are familiar with how the home is run and with daily routines, such as house meetings, in which they are encouraged to express their feelings, discuss behaviours and celebrate successes. This helps them to develop a sense of security and stability. A social worker stated, ‘Staff are able to manage very challenging behaviour. They stay with the child and are meeting his needs.’ Recent challenges, such as staff shortages and the behaviour of one particular child, temporarily undermined the stable environment. These difficulties have now been resolved.

p.7

Good

Comprehensive assessments of children’s needs are undertaken when they are admitted to the home. These inform subsequent plans for therapeutic interventions and strategies for caring for the children. Effective assessment and planning ensure that children engage well in individual therapy. Managers and staff are kept informed of their progress in therapy, and this is taken into account when reviewing care plans. Over time, children who remain at the home for a significant period develop positive attachments with staff and begin to recover from past trauma. They begin to manage their anger more effectively, become less secretive and increase their ability to talk about how they feel. This often results in children becoming less destructive of their physical environment.

p.7

Good

Staff listen to children and seek to engage them in developing their care plans. They sensitively explain to children why their wishes may not always be met, and support them to manage their anxieties. Children know how to complain, and are reminded of their right to do so. Despite this commitment to valuing the voice of the child, access to independent advocates is not currently well promoted. No information, such as posters or leaflets about advocacy services, is available in the home, and the children’s guide does not inform children how to access an advocate.

p.7

Good

All children have a place at the organisation’s school, and attendance and engagement is good. This is a significant step for some children, who have previously struggled within mainstream provision. Effective communication between school and care staff takes place. This ensures that care staff are familiar with children’s academic progress and with what subjects they are having difficulties with. Children are able to access the internet at the home, under staff supervision, and they can use this to enhance their school studies and to pursue individual interests.

p.7

Good

Children develop trusting relationships with staff as they settle in the home. One child said, ‘It’s good living here. I like all the staff and they help me if I am not getting on with the other children.’ Staff understand the relationship between children’s past negative experiences and the challenging behaviour that they sometimes present. They maintain clear and consistent boundaries, ensuring that children become familiar with the expectations of staff, to behave well. One child expressed some concerns about how physical restraint is used to manage behaviour. This is addressed further in the help and protection section of this report.

p.8

Good

A range of activities, in and out of the home, helps children to keep fit and to develop their interests. One child has learned to swim since moving to the home. Others have learned to care for indoor plants before acquiring a pet. This helps children develop their ability to care for others. One child expressed delight and excitement at the prospect of owning his own fish tank. Children are encouraged to personalise their bedrooms, and they engage enthusiastically in the process. Their bedrooms reflect their interests and personalities, and provide them with a homely, comfortable space of their own.

p.8

Good

Staff ensure that children maintain a healthy diet and provide opportunities for them to begin learning basic cookery skills. All medical appointments are kept, and managers and staff communicate effectively with specialist mental health practitioners. The emotional well-being of children is prioritised. The registered manager ensures that children receive appropriate support from one of the therapeutic counsellors working with the organisation.

p.8

Good

Some shortfalls in the recording and administration of medication were identified. Children who occasionally suffer from minor allergies are taking prescribed medication when it is perceived that they require this, rather than as prescribed by the general practitioner. In addition, records do not always show when a child has refused to take prescribed medication. No children have come to any harm as a result of these shortfalls.

p.8

Good

Excellent preparation work is undertaken with children who are moving to the home. This includes visits, overnight stays and planned introductions to the other children. During these visits, the child is given information about daily routines and how they will be looked after. They also have time to play and to socialise with the other children. Consultation with relevant professionals takes place prior to the child moving in, ensuring that there is a common understanding of how the child’s needs will be met.

p.8

Good

Staff work proactively with parents and carers to ensure that contact is well planned and supervised when necessary. As a result, contact becomes a more positive experience for all concerned. Staff recognise that contact can evoke anxiety for some children. They offer sensitive support when preparing children for contact visits, and encourage them to talk about the experience after the event.

p.8

Good

Safeguarding children and protecting them from harm is prioritised by managers and staff. They have a thorough understanding of the particular needs, vulnerabilities and behaviours of each child. Consequently, each child’s individual risk assessment specifically addresses known areas of concern. For example, risk assessments contain effective strategies for protecting children who have demonstrated inappropriate sexualised behaviour.

p.9

Good

Staff are vigilant and recognise the potential for children to come to harm in and outside of the home. They monitor the relationships between the children and intervene effectively to address bullying and discriminatory attitudes. Excellent practice supports the children to empathise with their peers and to develop positive relationships. Children’s access to the internet is closely monitored, and they receive advice and guidance on keeping themselves safe online, mainly through lessons at the organisation’s school.

p.9

Good

As a result of these practices, children generally feel safe in the home and have the confidence to share their worries with staff. However, one child expressed concern about the use of physical restraint and stated he had been hurt during one particular incident. Records of physical restraint indicate that, on this occasion, restraint was used when there was no imminent danger of a person being injured or property damaged. During the incident, a restraint technique was used, which did not follow the guidance provided in the organisation’s restraint training programme. The child had not previously spoken to anyone about this. During the inspection the incident was brought to the attention of the registered manager, and an undertaking was given to address the matter with relevant staff. Some restraint records have not been fully completed: notably, the record of a de-brief session with a child following a physical restraint.

p.9

Good

Other aspects of behaviour management are more robust. Consistent boundaries are maintained, and children are given clear messages about what is acceptable behaviour. Positive behaviour is recognised, praised and rewarded. Restorative approaches are implemented, and this compliments the overall approach to promoting good relationships between the children.

p.9

Good

Child protection concerns are dealt with in a timely manner, and effective communication is maintained with relevant professionals during investigations. Clear and comprehensive records are kept of all actions taken following an allegation of abuse. Children receive excellent support from staff while child protection investigations are being undertaken. They are given information, reassurance and opportunities to express their fears and worries, by staff who are sensitive to their needs and committed to ensuring their well-being.

p.9

Good

Children do not go missing and rarely leave the home without permission. When this does happen, staff search for them and follow the procedures laid down in the organisation’s policy on missing children. Consequently, no child has been absent for a significant period since the last inspection. Children who have left the home without permission for very short periods have received immediate support and guidance from the registered manager and police community support officers on their return.

p.10

Good

Staff receive appropriate safeguarding and child protection training. This ensures that they have the skills and knowledge to recognise and intervene if a child is at risk of harm. This includes the potential for children to become sexually exploited. Recently, staff have begun to access online training in relation to radicalisation. This has further raised their awareness of emerging risks that children face in the community or through social media. Training records are not consistently kept up to date. Leaders and managers are confident that all staff have regularly updated their safeguarding training, but the shortfall in record-keeping means that this cannot always be evidenced.

p.10

Good

Minor shortfalls in the recording of staff recruitment procedures, relating to explanations given for gaps in a candidate’s employment history, were acknowledged by leaders and managers. They demonstrate a commitment to rectifying the shortfall, and this has not resulted in any unsuitable adults being employed at the home. Recruitment interviews fully explore potential employees’ values and motivation for working with children. This enables leaders and managers to assess how effectively the candidate will be able to work within the therapeutic model being delivered.

p.10

Good

Health and safety checks, including fire safety procedures are regularly undertaken, ensuring that children live in a safe environment. One safety hazard was identified in a child’s bedroom. The registered manager gave an undertaking to address the issue promptly, when this was pointed out.

p.10

leaders and managers

The home has an experienced registered manager, who has been in post for over seven years. She holds the level 5 diploma in leadership and management for residential childcare, and is an experienced therapeutic practitioner. She leads a stable staff team, the members of which either hold the level 3 diploma for residential childcare, or are working towards this. Since the last full inspection, there have been periods when the home was not fully staffed. During these periods, some children presented as less stable, and many staff increased their working hours to cover staff absences. These issues have been dealt with effectively, and children now benefit from having a consistent team of adults caring for them.

p.11

leaders and managers

At the interim inspection in January 2016, a requirement was made in respect of the leadership and management standard. Action has been taken to address the requirement, but recent changes in practice have not yet resulted in all aspects of the requirement being met. Staff are not yet receiving individual supervision with the regularity described in the home’s statement of purpose. The frequency of supervision is currently being reviewed by leaders and managers, and new arrangements are in place for the deputy manager to support the registered manager in providing staff supervision. Other systems in place, such as group supervisions and process meetings have been more consistent and have ensured that staff are supported to undertake their role.

p.11

leaders and managers

The requirement also identified the need for monitoring systems to promote continuous improvement in the quality of care. There has been progress made, and the registered manager regularly monitors significant events. Children’s care plans are regularly reviewed and updated, in response to their changing circumstances. The children’s progress towards meeting their targets is monitored and taken into account when their care plans are reviewed. Staff engage in care review days, providing them with the opportunity to reflect on the success of the strategies and interventions used to support children’s development. Children have many opportunities to discuss their needs with staff, but formal key-work sessions, referred to as care-coordinator sessions in the home, are not yet undertaken with the regularity described in the home’s statement of purpose.

p.11

leaders and managers

Established systems for monitoring the quality of care ensure that the registered manager generally identifies any weaknesses. These are reflected in the quality of care reports provided by the service. The responsible individual reports that the organisation is focused on making these reports more evaluative and analytical of the impact that the quality of care has on the children. An external independent person undertakes monthly visits to the home and provides detailed reports on the functioning of the home. Consultation with children and external stakeholders further enhances the effectiveness of monitoring procedures in the home.

p.11

leaders and managers

Leaders and managers can describe the process that they go through when considering the appropriateness of admitting a new child to the home. However, no record is kept of the decision-making process, and leaders and managers cannot evidence how they have assessed the likely impact of new children joining the group. Organisational documents prompt leaders and managers to consider whether a new admission is likely to disrupt the functioning of others in the group, but this form is not always completed prior to a child being admitted. Since the last full inspection, one child who was admitted significantly disrupted the group, and had a negative impact on young people’s day-to-day experiences in the home. Records do not show that the potential for this to happen was given detailed consideration.

p.11

leaders and managers

The registered manager is a good role model and inspires staff to practise in accordance with the therapeutic model described in the home’s statement of purpose. Staff feel well supported, and say that this helped them to manage during a disruptive period when there were staff shortages and the behaviour of one child was extremely challenging. They work collaboratively as a team, and are focused on meeting the needs of the children.

p.12

leaders and managers

A rigorous staff induction programme ensures that new staff are well prepared for the role. Essential training, in areas relating to child protection and behaviour management, is delivered during the induction period. Staff training records are not always kept up to date. As a result, it is not always possible to identify when staff have completed mandatory refresher courses. In addition, the staff training record is not an accurate reflection of the courses available to staff, because some of these have been discontinued.

p.12

leaders and managers

Leaders and managers recognise the importance of maintaining effective communication with placing authorities. A social work team manager commented, ‘We are always given the information we need when an issue arises.’ This approach promotes good partnership working and ensures that professionals work together for the benefit of the children.

p.12

leaders and managers

Some areas of the home have recently been renovated and redecorated. Further work still needs to be undertaken to ensure that the home provides a comfortable, well-maintained environment. The need for this work is recorded in organisational development plans, which are reviewed regularly to ensure that progress is maintained.

p.12

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.13

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 children looked after 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.13

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.13

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 that 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 whom 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.14

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.14

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.15

Information about this inspection

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

p.15

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.15

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.15