Children's home in Hillingdon

inspection

A compliance notice was served on 14 March 2016 in relation to inadequacies in the staff vetting process. A monitoring visit conducted on 28 April 2016 found compliance had not been achieved.

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inspection

The responsible individual was therefore interviewed under the police and criminal evidence arrangements on 19 May 2016. The responsible individual stated that he had not personally received the notice. A further interview under these arrangements, conducted on 2 June 2016 established that the notice had been properly served and that the notice had therefore not been met. A final warning letter was served on 10 June 2016.

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protected, their welfare is not promoted and safeguarded and their care

and experiences are poor; they are not making progress.

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The children's home provision is inadequate because:

 There is a continued and recurrent failure to ensure that staff who work in the home are suitable to be working there.  Serious deficiencies within the physical environment place young people at risk of harm and potential injury.  Assessments of prospective new young people fail to fully consider their needs, as well as the impact of their admission upon the current young people. Neither do these assessments demonstrate whether the staff team is equipped to meet the identified specific needs of new young people’s.  Some young people have needs described in their referral information that are contrary to the home’s admissions criteria.  Young people are not engaged in purposeful or educational activities. They do not make progress.  Relationships between staff and young people and young people’s relationships with each other are volatile.  Poorly maintained behaviour management records fail to demonstrate

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The children's home provision is inadequate because:

whether the strategies used by staff are effective or sufficiently monitored.  Staff do not receive adequate training or guidance in relation to young people’s known individual needs. Consequently, staff are not knowledgeable or confident in supporting all of the needs of the young people.  Staff are not supported to manage risk effectively because of inadequate risk reduction strategies.  Monitoring systems fail to identify shortfalls and Ofsted is not informed of all issues that require notification.  Significant safeguarding information is not always shared with the relevant external agencies, such as the designated officer.  Examples of poor record keeping compromise the quality and accuracy of young people’s care plans.  Supervision arrangements for the current manager are ineffective.

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The children's home strengths

 Young people make positive relationships with some staff. These particular staff engage established young people in regular house meetings and actively seek their views.

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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 within the given timescales.

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Requirement Due date

In order to meet the protection of children standard, with particular reference to ensuring that children are only admitted whose needs can be met and that staff are provided with clear strategies to manage risk, the registered provider must:

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Requirement Due date

(i) assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; (ii) help each child to understand how to keep safe; (iii) have the skills to identify and act upon signs that a child is at risk of harm; (iv) manage relationships between children to prevent them from harming each other; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is a serious concern about a child’s welfare; and (vii) are familiar with, and act in accordance with, the home’s child protection policies; (b) that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm; (c) that the premises used for the purposes of the home are

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Requirement Due date

located so that children are effectively safeguarded; and (e) that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12.(1) (2) (i) (ii) (iii) (iv) (vi) and (b)) 5 August 2016 12: The Protection of Children Standard

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Requirement Due date

In order to meet the protection of children standard, with particular reference to ensuring that the environment is safe for children to live in, the registered provider must ensure:

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Requirement Due date

(d) that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (d)) 22 July 2016

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Requirement Due date

In order to meet the education standard, with particular reference to ensuring that children have and are engaging in education, training or employment on a daily basis, the registered provider must ensure that:

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Requirement Due date

(1) children make measurable progress towards achieving their educational potential and are helped to do so. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) help each child to achieve the child’s education and training targets, as recorded in the child’s relevant plans; (ii) support each child’s learning and development, including helping the child to develop independent study skills and, where appropriate, helping the child to complete independent study; (iii) understand the barriers to learning that each child may face, and take appropriate action to help the child to overcome any such barriers; (iv) help each child to understand the importance and value of education, learning, training and employment; (v) promote opportunities for each child to learn informally; (vi) maintain regular contact with each child’s education and training provider, including engaging with the provider

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Requirement Due date

and the placing authority to support the child’s education and training and to maximise the child’s achievement; (vii) raise any need for further assessment or specialist provision in relation to a child with the child’s education or training provider and the child’s placing authority; (viii) help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the 5 August 2016 period of exclusion or non-attendance and to return to school as soon as possible; (ix) help each child who is above compulsory school age to participate in further education, training or employment and to prepare for future care, education or employment; (x) help each child to attend education or training in accordance with the expectations in the child’s relevant plans; and (b) that each child has access to appropriate equipment, facilities and resources to support the child’s learning.

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Requirement Due date

(Regulation 8(1) (2) (a) I (ii) (iii) (iv) (v) (ix) (x) and (b))

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Requirement Due date

In order to meet the care planning standard, with particular reference to ensuring that decisions about admissions are based on thorough pre-admission assessments, the registered provider must ensure that:

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Requirement Due date

children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14 2 (a)) 22 July 2016

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Requirement Due date

5: Engaging with the wider system to ensure children’s needs are met

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Requirement Due date

In order to meet the quality standard engaging with the wider system, with particular reference to the manager and staff gaining a clear understanding about the roles of other agencies and professionals and the protocols that govern their work, the registered person must ensure that staff—

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Requirement Due date

(d) seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate, having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5 (5) (d)) 5 August 2016

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Requirement Due date

The registered person must 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 which includes: the name of the child; details of the child’s behaviour 5 August 2016 leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (‘the user’), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised

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Requirement Due date

person’) has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within five days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. This is with specific reference to records of consequences and the following points in the regulation. (Regulation 35 (3) (a) (vii) (b) (i) (ii) (b) (c))

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. The registered person may only employ an individual to work at the children’s home; or if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3). The requirements are that:  the individual is of integrity and good character;  the individual has the appropriate experience, qualification and skills for the work that the individual is to perform;  the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and  full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule

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Requirement Due date

2. With specific reference to the following points in the regulation. (Regulation 32 (1) (2) (3) (a) (d)) 22 July 2016

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Requirement Due date

The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once every six months. In order to complete a quality of care review, the registered person must establish and maintain a system for monitoring, reviewing and evaluating:

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Requirement Due date

 the quality of care provided for children; 5 August 2016  the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and  any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review (‘the quality of care review report’). The registered person must supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed; and make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home. The system referred to in paragraph

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Requirement Due date

(2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff.

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Requirement Due date

(Regulation 45 (1) (2) (a) (b) (c) (3) (4) (a) (b) and (5))

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Requirement Due date

The independent person must provide a copy of the independent person’s report to HMCI. (Regulation 44 (7) (a)) 5 August 2016

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Requirement Due date

The registered person must without delay notify HMCI of all significant events in the home as defined in the corresponding regulation. (Regulation 40 (4)) 22 July 2016

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Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in Schedule 1. Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (1) and (5)) 22 July 2016

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Requirement Due date

The registered person must ensure that all employees: undertake appropriate continuing professional development; receive practice-related supervision by a person with appropriate experience. With specific reference to staff training in areas of need young people have and the supervision of the manager. (Regulation 33 (1) (4) (a) (b)) 5 August 2016

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4; with specific reference to the home’s register. 5 August 2016 (Regulation 37 Schedule 4 12 (d))

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. With specific reference also to ensuring that children’s case records are accurately maintained. (Regulation 36 (1) (a) (b) (c)) 5 August 2016

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Recommendations

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

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Recommendations

 It is good practice for a note of the content and/or outcomes of the manager's supervision sessions to be kept and to ensure that both the person giving the supervision and staff member have a copy of the record. (‘Guide to the children's homes regulations including the quality standards’, 13.4, page 60)

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Information about this children's home

This privately owned home is registered to provide care and accommodation for up to five children who may have emotional and behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

13 October 2015 full Requires improvement

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Recent inspection history

3 March 2016 interim Declined effectiveness

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Recent inspection history

28 April 2016 Monitoring visit Compliance notice not met

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Inadequate

Relationships between staff and young people are volatile, as are relationships between the young people. Staff struggle to manage violent incidents successfully. This adversely impacts their ability to build helpful and trusting relationships. There were some positive and affectionate interactions noted between a young person and staff but the chaotic environment makes it difficult for staff and young people to interact in a positive way routinely on a daily basis. Young people’s complex needs relating to their past experiences of abuse and/or trauma are not fully recognised because staff have not received sufficient training in caring for young people with such complex needs. As a consequence, staff are unable to confidently support young people to develop more trusting and heathy attachments. Some young people who have left the home have said they wanted to stay in the home while others currently living there have mixed views about their experience. For

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Inadequate

example, one young person was refusing to return to the home because relationships with staff had broken down.

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Inadequate

Young people have friendships in the community and friends and family members are made welcome when they visit the home. However, there have been occasions when young people have smuggled friends into the home overnight. This presents potential risks to other young people and staff.

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Inadequate

None of the young people living in the home have significant needs relating to their physical health. They are registered with routine health services such as GPs and their physical health needs are met. The complexity of their emotional and psychological needs means that they require specialised professional input. Staff support young people to attend appointments with the children and adolescent mental health team. The organisation has recently employed a therapist and young people have developed relationships with her. It is too early to assess the impact she is having on young people’s emotional and psychological well-being but this is a positive development.

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Inadequate

None of the three young people living in the home are taking part in education, training or employment. Staff are unsuccessful in getting young people out of bed until late morning or early afternoon. Young people’s lack of engagement in sufficient, purposeful activities during the day is adversely affecting their future prospects. They have little ambition for their future. They are not learning and developing the tolerance and skills needed to succeed in life. They are not experiencing the benefits that achievement could bring to their self-esteem and confidence. When progress is made, such as applying for and gaining their own employment, this has not then been followed through by young people. It is easier for them to revert to their usual pattern of staying in bed.

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Inadequate

There is a useful space attached to the home that young people could use for study. There used to be a computer in this room for young people and they used it for their studies. The computer has now been removed. The room presents as being rarely used and no longer looks or feels inviting. The manager spoke of his plans to put the computer back into the room and get young people in there using it.

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Inadequate

Young people’s views are sought about a range of matters. Positively, they attend a weekly meeting and put their views and wishes across to the staff. Some of these are met. For example, the manager addressed an issue that young people raised about staff spending too much time in the office. Young people sometimes struggle to understand why staff cannot meet inappropriate requests, despite staff trying to help them to understand. Young people use the complaints procedure if unhappy about something and the manager investigates and writes to the young person with his decision. A young person’s views about the decision are recorded. However, when a young person expressed concerns about personal safety, this was not given due weight and therefore was not adequately addressed.

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Inadequate

Young people are developing the practical skills that they will need to live independently. They are learning, or already have learned, to budget, cook and do their own washing. Their emotional readiness to live independently is less well developed. They are not developing their social skills or learning to deal, in an appropriate way, with the frustrations that life brings to them. Disruption, aggression and violence are the ways in which they try to get things done. They do not develop a realistic view about what their future holds and what they need to do to improve their life chances.

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Inadequate

Young people coming to live in the home are welcomed sensitively. A social worker described how the staff and young people encouraged their young person to go into the building when they did not want to get out of the car. However, admissions of young people are underpinned by inadequate assessments of risk that do not fully explore all known information. There is insufficient consideration given either to the needs and protection of all the young people or to the staff team’s knowledge and skills to manage an individual’s specific behavioural or other needs. For example, referral information identified that one young person has significant attachment difficulties and another young person had a diagnosis of attention deficit disorder. Staff have not had any training in caring for young people with these specific needs and were not confident about dealing with these issues. There have been a number of young people who have left the home in an

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Inadequate

unplanned way and have not had positive endings to their placement there. Some have left because their behaviour became too difficult for the staff to manage effectively and safely and others have left because their local authority made a decision to move them.

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Inadequate

Young people are not safe living in this home. There is inadequate attention paid to the health and safety of the environment. During the inspection, maintenance workers were undertaking repairs to door handles. The inspectors’ tour of the premises identified there were risks of electric shock, fire spreading and/or smoke inhalation from:  Exposed live wiring to a wall light above the sink in the bathroom.  An outside light hanging on its wire.  A broken fan placed face down on the floor that was still plugged into a live extension lead in a young person’s bedroom which had not been occupied for over a week.  Young people regularly smoking in their rooms.  Incidents of young people setting fires in the home.  The condition of an intumescent strip on one of the young people’s bedroom doors compromised its effectiveness to protect from fire and smoke.  The kitchen fire door was wedged open on both days of the inspection.

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Inadequate

Additional risks were posed from:  A failure to lock the cupboard in the kitchen which contains a range of cleaning fluids that young people could easily access.

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Inadequate

 Unwrapped chicken in the bedroom that had not been occupied for over a week that presented a risk of infestation.

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Inadequate

 Two of the young people’s bedroom door frames were broken, presenting security issues.

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Inadequate

 Cooked and uncooked meats were stored in the fridge on top of each other.

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Inadequate

There was no evidence to demonstrate that any of the above issues had been identified or risk assessed within a planned maintenance programme. The approach to risk management tends to be reactive even when risks are known about and therefore predictable. Risk assessments in relation to young people and their behaviour are updated following incidents. However, information for staff about strategies they can use to minimise risks tends to be generic and does not specify what action staff need to take. For example, there are statements about monitoring a young person or monitoring ‘hot spots’ (for bullying) but there is no guidance about what type of monitoring is required and where the ‘hot spots’ are. On one risk assessment, staff were advised to refer to a behaviour management plan for strategies to use when bullying occurs. This information was not in the young person’s behaviour management plan. Another example recognises a young

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Inadequate

person is at risk of sexual exploitation but there is no clear guidance for staff to implement to manage or reduce these risks. The home’s inadequate approach to risk assessment and management means that incidents are occurring that could have been avoided. Young people are placed at unnecessary risk. Staff struggle to support young people to manage their behaviour more effectively. Behaviour management is inconsistent, especially across the day and night staff teams; this confuses young people. When physical interventions are used, they are used for permitted reasons. Staff do not often use these techniques. Police say they are frequently called to help staff deal with aggressive and dangerous incidents and say that on occasions they are called to incidents that staff should have been able to manage without the police involvement. A full record of sanctions made since the last inspection could not be found. From

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Inadequate

the limited records available, it seemed that staff generally impose appropriate sanctions, such as paying towards damage caused. Records of sanctions do not detail the effectiveness of the sanction or show that any conversations have taken place with the person giving the sanction or the young person receiving the sanction. Sanctions are inadequately monitored, therefore it is not assured that the most effective consequence is used to support each young person to modify their behaviour. There are incidents of bullying but there is no central log kept. This made it difficult to assess the effectiveness of management and staff in dealing with these issues. When a young person goes absent without authority or missing from care, this is not always reported to all relevant people. A young person’s absence is reported to the police. However, on one recent occasion a young person who broke his court ordered curfew was not reported as missing to the youth offending worker as had

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Inadequate

been agreed. On another occasion, a parent complained that she had not been informed of her child’s absence. There have been occasions when young people have left the home at night without the knowledge of waking night staff. Young people have committed offences while missing and have placed themselves and members of the public at risk of harm. The management approach to staff vetting remains of concern. The manager has failed to ensure that missing information or information known about current staff has been fully considered to ensure their suitability to work with the young people. For newer members of staff, there has been a failure to fully explore and evaluate all known information about an applicant before they commence work in the home.

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Inadequate

The manager has developed links to the local designated officers for safeguarding children. He has referred issues of concern to them. He has not kept a record of all matters referred or discussed with them so there is no clear audit trail of how he has progressed matters. He also has not informed the designated officer of the outcome of a recent staff disciplinary matter, despite the officer making a request that he do so.

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Inadequate

There has been no manager registered for the home since August 2015. There is a permanent manager in the home and he has managed the home since the registered manager left. He is going through the registration process with Ofsted.

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Inadequate

The manager has not submitted a report under Regulation 45 to Ofsted to demonstrate that he is robustly carrying out his duty to monitor, develop and improve the quality of care in the home. There is an independent visitor who visits on a monthly basis but their last two reports have not been forwarded to Ofsted. The focus of each visit is on the previous month, sometime weeks after the end of the month. The reports do not provide an up-to-date view about recent practice in the home. The manager said that often he has addressed issues before they are raised as recommendations. Poor attention to monitoring has failed to identify the significant shortfalls found during this inspection that place young people at risk. There is no development plan for the home but it was stated that one is being created. Without a clear strategic approach to monitoring and development, the home is coasting along with little sense of purpose and significant shortfalls go

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Inadequate

unnoticed and improvements are not made.

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Inadequate

Notifications are not being made to Ofsted and this, along with the failure of the management monitoring, means that the regulator does not have clear, up-to-date information about what is happening in the home and is unable to ensure that young people are safe and its regulatory duties are discharged.

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Inadequate

The manager has challenged other professionals when he feels that young people’s needs are not being met, for example in relation to education. There was mixed feedback from professionals who work with the young people and the staff. Some felt that communication and information sharing is inconsistent, as is staff’s and the manager’s understanding about the roles and protocols that other professionals follow. More positive feedback was that staff or the manager always make themselves available for meetings.

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Inadequate

The home’s statement of purpose does not meet regulations. It does not detail how people working with young people or other interested parties can access the complaints procedure. It does not specify what the arrangements are for the professional supervision of the therapist or how her work is measured. In the statement of purpose, it is clearly stated that young people who have a significant history of violence towards staff will not be admitted to the home. Young people who have a significant ongoing history of violence towards staff and other figures of authority have been placed in the home. The staff working in the home are enthusiastic about their work and want to make a difference to the lives of the young people. Staff struggle to support young people to keep safe and to modify their behaviour because of inadequate consideration of the viability of placements, a failure to ensure clear strategies are

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Inadequate

available for staff to use, and a lack of adequate staff training in some key areas. Staff have been assaulted, young people assault each other and are regularly absent or missing from care. Some young people have been further criminalised. Additionally, there are tensions between the day and night staff and, as a consequence, the behaviour management strategies that are in place are inconsistently applied. The manager was aware of these tensions and said he was addressing these issues. The manager is not supported through formal supervision from a suitably qualified and experienced person. Records of supervision sessions that had taken place between him and the responsible individual were not available. The manager is not adequately supported in his role.

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Inadequate

Records maintained in the home are inadequate. Some records were missing, such as the sanctions book, some records were not dated or signed and some contained incorrect information. For example, an individual placement plan written by staff had incorrect information in it relating to a young person’s background and needs. The register of children held in the home does not detail in every case which local authority has responsibility for the child or the child’s address on leaving the home.

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Inadequate

The requirements from the previous inspection have not been met in full. Specifically, requirements in relation to: staff recruitment; making notifications; recording of sanctions; ensuring the accuracy of case and other records; the quality of the support to the manager. Requirements that have been met are improvements in the record keeping of complaints and maintaining up-to-date staff duty rotas.

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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 children 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 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 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

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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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