Children's home run by Lioncare Ltd Operating as The Lioncare Group in Epping Forest

Inadequate

There are serious and/or widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded.

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The children’s home provision is inadequate because:

 The management of allegations made against staff is poor and not in accordance with the procedures laid out in the home’s statement of purpose.

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The children’s home provision is inadequate because:

 Children who make allegations against staff are not consistently given the support and care needed to ensure their safety and emotional well-being.

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The children’s home provision is inadequate because:

 Physical restraint is not always used as a last resort and has been used to ensure children’s compliance with staff instructions.

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The children’s home provision is inadequate because:

 The physical environment is poorly maintained. There are hazards which compromise the safety of children living in the home.

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The children’s home provision is inadequate because:

 Systems for monitoring the quality of care are weak. This prevents shortfalls in standards being identified and remedial action being taken.

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The children’s home provision is inadequate because:

 The recording and administration of prescribed medication is poor. Effective action has not been taken in response to recent medication errors.

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The children’s home provision is inadequate because:

 Managerial lines of accountability are blurred. The registered manager has limited input into some processes linked to her day-to-day responsibilities.

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The children’s home provision is inadequate because:

 Practice is not robust in relation to the safer recruitment of staff.

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The children’s home provision is inadequate because:

 Managers do not have a thorough understanding of the ‘Statutory guidance on children who run away or go missing from home or care’.

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The children’s home strengths

 The therapeutic model, outlined in the home’s statement of purpose, is understood by staff, and implemented in practice. This ensures that consistent routines and boundaries are maintained and provides children with a sense of stability.  Children engage well in daily group meetings, which are used to promote positive relationships and resolve conflicts. Over time, most children develop increased emotional resilience.  Children have access to a range of therapists and counsellors who can provide support tailored to meet the child’s individual needs.  Transition plans for children moving on from the home are comprehensive and designed to minimise any anxieties the child may feel.  The home has a robust local area assessment. This ensures that staff are familiar with the risks children may face when out in the local community. This knowledge is used to minimise the risk of children coming to harm when away from the home.

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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 specific reference to assessing whether children are at risk of harm, the management of allegations made against staff and subsequent response to children and maintenance of the premises, the registered person must ensure that:

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Requirement Due date

(2)(a)(i) staff 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 (2)(a)(vi) staff take effective action whenever there is a serious concern about a child’s welfare (2)(a)(vii) staff are familiar with and act in accordance with, the home’s child protection policies (2)(b) 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 (2)(d) 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. 09/09/2016

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, with particular reference to monitoring the quality of care and disseminating information obtained through monitoring systems, the registered person must:

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Requirement Due date

(2)(f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home (2)(h) use monitoring and review systems to make continuous 09/09/2016 improvements in the quality of care provided in the home.

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Requirement Due date

Restraint in relation to a child must be necessary and proportionate (Regulation 20 (2)). 09/09/2016

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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. A record is kept of the administration of medicine to each child(Regulation 23 (1) and (2)(c)). 09/09/2016

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Requirement Due date

The registered person may only employ an individual to work at the children’s home if full and satisfactory information is available in relation to the individual in respect of each of the matters in schedule 2. Specifically, ensure satisfactory disclosure and barring service checks have been completed before an individual undertakes direct work with children (Regulation 32 (2)(a) and (3)(d)). 09/09/2016

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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

 Ensure the home complies with relevant health and safety legislations (food hygiene). In particular, ensure fridges and freezers used for storing food are kept clean and free from mould (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9).

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Recommendations

 Ensure the home has regard to the relevant aspects of the ‘Statutory guidance on children who run away or go missing from home or care’. Specifically, ensure managers and staff are familiar with the guidance relating to independent return home interviews (‘Guide to the children’s homes regulations including the quality standards’, page 45, paragraph 9.25).

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Recommendations

 Record that a child has talked about their feelings no longer than five days after an incident of restraint, and ensure that children are offered the opportunity to access advocacy support to help them with this (‘Guide to the children’s homes regulations including the quality standards’, page 50, paragraph 9.6).

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Recommendations

 Ensure that everyone working at the home understands their roles and responsibilities, and that there are clear lines of accountability. Specifically, ensure the registered manager is actively engaged in recruitment procedures and admission processes (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.20).

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Information about this children’s home

The home can accommodate up to seven children. The service accommodates children who have emotional and behavioural difficulties and provides a therapeutic care approach towards meeting their needs. The home is part of an organisation which has five residential homes and a school.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

30/03/2016 Interim Sustained effectiveness

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Recent inspection history

26/02/2015 Interim Improved effectiveness

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Inadequate

Significant weaknesses in practice in relation to the management of allegations made against staff, the administration and recording of medicines, and the quality of the physical environment, undermine the safety and welfare of children in this home.

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Inadequate

An inappropriate response was given to a child who made an allegation against a member of staff. Comments made by staff and managers suggested that the child was not believed. Furthermore, her right to confidentiality was compromised by the matter being discussed in a group meeting.

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Inadequate

The recording and administration of prescribed medication are weak. In recent months, one child received a double dose of medication. The child did not come to harm as a result. Leaders and managers have not learned from this error. Medication records are disorganised and fail to record consistently and accurately when a child is administered prescribed medication. One member of staff was observed handling prescribed medication without wearing hygienic gloves. This poor practice is partly attributable to the fact that staff receive no formal medication training. It is addressed in the staff induction programme, but there is no process for assessing the competency of staff to practise safe handling of medication.

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Inadequate

The message that children are valued in the home is undermined by the poor physical state of the premises. The children’s play room, in the basement of the house, is an unwelcoming environment for a child. There is no furniture in the room, the standard of decoration is poor and the lights do not work. In other areas of the home, damage caused by distressed children, such as holes in the wall and a broken tumble dryer, have not been repaired for many weeks. In one child’s bedroom, where a sink has been removed, the walls and floor have not been made good. The standard of cleanliness is poor. The inside of a fridge was observed to be dirty and black mould was seen on the rubber seals of the freezer. The physical neglect of the home is not commensurate with the therapeutic ethos that strives to give children the message that they are valued.

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Inadequate

Managers and staff focus on building positive relationships with children by taking a genuine interest in their development, encouraging them to do well and celebrating their achievements. One young person was observed taking pride in his art work when praised by a member of staff. The home generally provides a stable environment for children, through consistent implementation of the therapeutic practice model outlined in the home’s statement of purpose. Established routines, such as the children’s daily group meeting, ensure that children are familiar with the boundaries in place and what actions will be taken to promote good peer relationships and resolve conflicts. Challenges presented by one particular child, who has now left the home, resulted in some children feeling unsettled and apprehensive when their peer demonstrated aggressive behaviour, but most say things have now improved.

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Inadequate

The daily group meeting provides children with the opportunity to make their views known on how they are being cared for and supported to build good peer relationships. The deputy manager who facilitated the meeting during this inspection was skilled in communicating with the children, and ensured that all had the opportunity to express their views. He demonstrated a nurturing approach, making sure all children knew which staff would be supporting them to settle at bedtime. This commitment to ensuring that children’s views are taken into account is not consistently applied to all areas of practice. Children are not offered the support of an advocate to discuss their feelings after being physically restrained. This is particularly relevant due to the high number of physical restraints since the previous full inspection.

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Inadequate

Staff ensure that all children regularly attend appointments relating to their physical and emotional well-being. The registered manager is tenacious when it comes to making sure medical records are transferred when a new child is admitted to the home. A healthy, balanced diet is provided, and a good range of child-centred activities provide opportunities to take regular exercise. The organisation has access to a number of therapists, and this results in children receiving specialist counselling, tailored to meet their individual needs.

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Inadequate

All children attend education, either in the local community or at the organisation’s school. Staff help children to prepare for the school day and make sure reliable transport arrangements are in place. One child has made notable academic progress since coming to live at the home. The registered manager has taken appropriate action in relation to one member of staff, who failed to offer appropriate support to a child who became distressed and challenging when arriving at school.

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Inadequate

Over time, most children become more emotionally resilient and better equipped to manage their anxieties and anger. For one child, this has resulted in improved relationships with family members, to the point where he is ready to return to the care of his parent. Inevitably, not all children progress at a similar pace, and one child’s level of aggression and antisocial behaviour escalated to the point where managers concluded police involvement was necessary. Managers and staff demonstrated high levels of commitment to the child. A well-planned transition to another of the organisation’s homes has resolved this situation. The home has established child-focused procedures for admitting new arrivals to the home. Since the previous full inspection many of the new admissions have been emergency placements. Increasingly, placing authorities are unable to commit to making medium- to long-term placements and this sometimes makes it

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Inadequate

difficult for the organisation to meet its stated aim of providing stable care placements for between two and six years.

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Inadequate

Managers and staff work effectively with professionals, parents and carers to ensure that agreed arrangements for children’s contact with family takes place. Staff help children prepare for contact and respond sensitively to any anxieties the child may have about seeing family members. Over time, this ensures that contact becomes a more positive experience for all concerned.

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Inadequate

Children are not supported when raising concerns about staff who work with them. In a recent case, where a child made an allegation against a member of staff, managers did not follow the home’s own procedures. The allegation was not reported to the designated person in the local authority and no internal investigation was undertaken. The child’s truthfulness was challenged and the matter was later discussed in front of other children and the member of staff against whom the allegation had been made. The child subsequently retracted the allegation. The designated officer expressed concern to inspectors about this poor practice.

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Inadequate

There is an inconsistent approach to the management of risk associated with individual children. Most children have individual risk assessments which identify their vulnerabilities and define the strategies staff should follow to keep them safe. However, risk assessments relating to a child who had lived at the home for a month were still being completed at the time of this inspection. An impact assessment had been undertaken prior to her admission, which identified that she demonstrated ‘sexualised behaviour’. Since admission, a risk assessment to address the child’s interaction with adults has not been completed, despite this issue being identified as ‘high risk’. Consequently, staff have no advice or guidance on how they should interact with the child to ensure her safety and minimise risks of allegations against them.

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Inadequate

Each child has an individualised behaviour management strategy. Staff promote positive behaviour through open discussion with children about the impact of their negative behaviour on others. Incentives are also used to promote good behaviour and sanctions are imposed when necessary. The effectiveness of sanctions is kept under review, and children confirmed that sanctions were fair, although not popular.

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Inadequate

The use of physical restraint to manage challenging behaviours is common. There have been 121 incidents since the previous full inspection. On occasions, physical restraint has been used before alternative de-escalation techniques have been attempted. Although the registered manager, and some staff, had recognised this was happening, they had taken no steps to address the issue, and practice had not improved as a result. Restraint is also used to ensure that children comply with staff instructions when there is no immediate risk of injury or damage to property. One child was restrained when trying to leave the play room where he had been taken because he: ‘had been angry and had hurt adults earlier that day’.

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Inadequate

Recording of physical restraint incidents is not consistently good. In some cases, there is inaccurate recording of how long the child was held. In other cases, the registered manager’s comments are brief and do not clarify why the restraint was judged to be appropriate. Some recording gives a brief description of why the child did not speak about the incident after the restraint, such as: ‘he was not able to speak to adults about the incident’, but lacks detail. The restraint reports often do not record whether further attempts were made to discuss the matter with the child at a later date or that the child was offered advocacy support to do so.

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Inadequate

Children spoken to during to the inspection said that they feel safe in the home, although some mentioned that a young person, who has since left, had made them feel unsafe, due to his difficult behaviour. This had sometimes amounted to bullying and one child felt that staff action to address this had not made it stop. Children said that bullying is no longer an issue in the home. Children were able to name staff that they would speak to if they had any worries. However, the response to the child making an allegation against staff, referred to earlier in this section of the report, indicates that children are not consistently given the message that they will be believed if they do share their concerns with staff.

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Inadequate

Staff and relevant agencies provide a coordinated response to children who go missing. Staff follow the home’s procedures and take into account children’s risk assessments when taking action. They follow children if they leave the home without permission and promptly report them as missing to the appropriate authorities if their whereabouts becomes unknown. The response to children when they return from a missing episode is not as robust. There have been four missing episodes since the previous inspection, involving two children, both from different placing authorities. Independent return home interviews were not arranged by either of their placing authorities. Discussions with the registered manager and deputy manager during the inspection indicated that they were not familiar with the 'Statutory guidance on children who run away or go missing from home or care', and had therefore not addressed this issue with the children’s social workers.

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Inadequate

Staff who spoke to inspectors had a good understanding of the potential for children to become sexually exploited and gave detailed descriptions of the signs that might alert them to this. The home’s locality assessment provides detailed analysis of the potential for children to become exploited in the community. Staff also have a good understanding of the risks children face when accessing the internet. Measures are in place to educate children about these risks and prevent access to inappropriate web and social media sites.

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Inadequate

A shortfall was identified in the home’s practice around the recruitment of staff. One member of staff was allowed to begin working in the home before the completion of the disclosure and barring service check after a risk assessment had been undertaken. Issues later arose in relation to the check. The member of staff stated that matters relating to this were discussed during the interview process. However, no record had been kept of the interview. This meant leaders and managers were unable to challenge the staff member over whether full information had been disclosed.

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Inadequate

The physical environment is poorly maintained. A number of hazards were observed which put the safety of children at risk. In the playroom, electrical wiring could be seen through a hole high up on one wall and electric light fittings could be seen in a hole in the ceiling. There was no handle on the door to the room and the floor covering was dirty. In the children’s lounge, a large radiator had come away from the wall brackets and was on the floor propped up against a wall. This was removed during the inspection. All instruction notices above the fire extinguishers had been removed. The registered manager advised that action was being taken to replace these notices.

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Inadequate

The manager of the home was registered with Ofsted in January 2016. She has previously been a deputy manager with the organisation and has several years’ experience working with vulnerable children and young people. She is currently studying for the level 5 diploma in leadership and management for residential childcare. Since the previous full inspection in September 2015, there have been a number of staff changes. Ten staff have left the home and nine staff have started work. The majority of staff are qualified to level 3 diploma standard, and those who are not are studying for these qualifications.

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Inadequate

Systems to monitor the quality of care being delivered are not consistently effective. Quality of care monitoring reports are compiled by the organisation’s service manager. However, she does not have day-to-day responsibility for managing the home. The registered manager had not seen the most recent quality of care report and therefore was not aware of any shortfalls identified or what recommendations had been made. This is indicative of weak communication channels between leaders and managers.

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Inadequate

The standard of monitoring undertaken by the registered manager is poor. For example, some monitoring of significant incidents, such as physical restraint, identifies areas where practice could improve. Other records lack detail and do not explain why the registered manager felt action taken by staff to manage behaviour was appropriate or inappropriate. Monitoring has not picked up on many of the shortfalls identified at this inspection. A major shortfall was the failure to recognise that the organisation’s policy relating to the management of allegations was not being followed.

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Inadequate

Reports provided by the independent visitor indicate an appropriate level of scrutiny and challenge. However, the recommendations made are not always responded to effectively. In a recent report, the independent visitor highlighted the lack of training for staff on the administration of medicines. However, no action was taken as a result of the recommendation made about this. This compromises the staff team’s ability to give medication safely to children.

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Inadequate

The manager is not consistently involved in leadership and management processes directly linked to the responsibilities she holds as the registered manager. For example, she does not always play a full role in the recruitment of staff. Neither she, nor the deputy manager, had input into an impact assessment prior to a new child being admitted. This task was undertaken by the service manager. The registered manager and the deputy manager were not aware that impact assessments are undertaken before a child is admitted to the home. This has a detrimental impact on the quality of care being delivered as there is potential for the registered manager not to be fully aware of the care needs of children or the professional development needs of staff to meet those needs.

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Inadequate

External professionals contacted during the inspection gave a mixed picture of how effectively managers and staff communicate and work with them. One social worker said managers and staff are: ‘quick to respond’ and expressed appreciation that staff always alert her to the child’s mood before she visits. Another social worker said she: ‘had no confidence’ in the home. Similarly, the local authority designated officer stated that normally the organisation could be relied upon to consult over any matters relating to allegations and the practice of staff, but was ‘appalled’ at the response to a child making an allegation recently.

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Inadequate

Management oversight of children’s care plans is good. This ensures that care plans are relevant to the needs of children and progress is monitored. Recent planning for one child’s transition to another of the organisation’s homes was particularly strong and the social worker described this as: ‘well thought out and well managed’. Action has been taken to address both of the requirements made at the interim inspection in March 2016. New arrangements have been put in place for the supervision of staff and the frequency of this now reflects the home’s statement of purpose. This improvement needs to become embedded in practice and the registered manager is taking steps to ensure that supervision notes are written up in a timely manner. Staff feel well supported and engage positively in a range of structured meetings to support them to implement the therapeutic practice model.

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Inadequate

The organisation provides a range of training courses for staff. This ensures that they have the opportunity to develop their practice in line with the therapeutic model and develop the knowledge and skills to work with vulnerable children. Staff do not consistently work to the ethos of the model, potentially limiting the progress that children make.

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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 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, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after 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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