Children's Home run by Kingston upon Hull City Council in Kingston upon Hull

Inadequate

There are serious and/or widespread failures that mean that children and young people are not protected or their welfare is not promoted or safeguarded, and their care and experiences are poor and they are not making progress.

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The children's home provision is inadequate because:

 The manager has accepted inappropriate placements on the direction of senior managers. This has undermined the registered manager’s role and accountability to make autonomous placement decisions.  Young people’s vulnerability, emotional distress and risk have also increased due to poor decision-making and placement matching.  Inconsistent relationships between the home and external professionals do not promote good partnership relationships in all instances.  Some young people’s care plans change due to moves at short notice from one home to another. This practice takes place without consultation with young people, their parents or professional stakeholders.  There is little consideration of young people’s wishes and feelings and potential risk factors prior to some admissions. A young person was placed in the bed of another young person who was temporarily away from the home.  Weak impact risk assessments fail to evaluate the known risks to young

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The children's home provision is inadequate because:

people and those that they pose to themselves and others. This does not promote young people’s safety and welfare.  Poor risk management and vigilance from staff have exposed some young people to bullying, inappropriate behaviour and actual physical harm to their safety and welfare.  Behaviour in the home is not consistently well managed and monitored. This is compounded by staff sickness and shortages, which does not ensure the safety of young people and others within the home.  The premises are in a poor condition and state of repair. They do not provide young people with a message that they are valued.  Ineffective leadership and management practices have not recognised or addressed all aspects of weakness, or significantly enhanced young people’s experiences and progress. This has led to some unsafe situations for specific young people and staff.  The independent visitor’s reports continue to be insufficiently robust, and

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The children's home provision is inadequate because:

lack rigour, challenge and integrity. The findings have not promoted young people’s safety, welfare or rights, or helped the provider to improve outcomes for young people.

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The children's home strengths

 A consistent, experienced, caring and flexible core staff team has developed some positive relationships with the young people.  Young people have been engaged in a range of opportunities in areas, such as education, health and leisure, which help them to prosper and provide some enrichment to their lives.  Young people benefit from good contact arrangements that are effectively supported and facilitated by the staff team.

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Statutory requirements

This section sets out the actions that 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 within the given timescales.

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Requirement Due date

*5: Engaging with the wider system to ensure children's needs are met In meeting the quality standards, with particular reference to the registered manager consistently challenging his managers and local authority when they instruct him to make inappropriate placements, and to promote good working together practices with all stakeholders, and to seek to resolve issues of concern with regards to admissions and placement discharges, the registered person must ensure that staff (a) seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans; (c) if the registered person considers, or staff consider, a placing authority’s or a relevant person’s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans; and

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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. 16/09/2016

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Requirement Due date

*6: The quality and purpose of care standard In order to meet the quality and purpose of care standard, with particular reference to ensuring that the home is furnished, decorated and well maintained, in order to provide high-quality accommodation (2) the registered person is required to (b) ensure that staff (vii) provide to children living in the home the physical necessities 16/09/2016 they need in order to live there comfortably.

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Requirement Due date

7: The children's views, wishes and feelings standard In order to meet the children’s views, wishes and feelings standard, with particular reference to promoting their wishes and feelings about placement choices, and evidencing individual work completed with young people in response to issues that may impact on their well-being and continuing to influence young people to engage in their care plans, the registered person must (2)(a) ensure that staff (i) ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare; and (iii) help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child. 9/09/2016

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Requirement Due date

11: The positive relationships standard In order to meet the positive relationships standard, the registered person must ensure (a) that staff (i) meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans; (iii) encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding; (vi) help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful; (viii) strive to gain each child’s respect and trust; (ix) understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children; (xi) de-escalate confrontations with or between children, or potentially violent behaviour by children; and

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Requirement Due date

(xii) understand and communicate to children that bullying is 16/09/2016 unacceptable.

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Requirement Due date

*12: The protection of children standard In order to meet the protection of children standard, specifically in relation to effectively promoting and monitoring children’s safety and welfare, and ensuring that all risk assessments are robust in clarity and detail, the registered person must ensure 2)(a) that staff (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; and (ii) help each child to understand how to keep safe. 16/09/2016

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Requirement Due date

*13: The leadership and management standard (1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that (a) helps children aspire to fulfil their potential, and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to (a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; (d) ensure that the home has sufficient staff to provide care for each child; (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; and (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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Requirement Due date

*14: The care planning standard The care planning standard is that children 16/09/2016 (a) receive effectively planned care in or through the children’s home; and (b) have a positive experience of arriving at or moving on from the home. In order to meet the care planning standard, specifically in relation to making appropriate placements with the registered person’s agreement, (2) in particular, the standard in paragraph (1) requires the registered person to ensure (b) that arrangements are in place to (iii) plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority; (c) that each child’s relevant plans are followed.

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it, and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision (Regulation 16(3)(b)). Specifically they must review to ensure an accurate account of service delivery to children. 9/09/2016

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any other incident relating to a child which the registered person considers to be serious (Regulation 40(4)(e)). This is specifically in relation to the registered manager reviewing his safeguarding thresholds with respect to serious incidents in the home. 16/09/2016

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Requirement Due date

*The independent person must produce a report about a visit (‘the independent person's report’) which sets out, in particular, the independent person's opinion as to whether children are effectively safeguarded, and the conduct of the home promotes children's well-being. (Regulation 44(4)(a)(b)(5)). In particular, the independent visitor must provide an accurate, rigorous and challenging report about care practices in the home and recommend any actions, and the registered person must consider whether to take those actions. 16/09/2016

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Requirement Due date

In order to complete a quality of care review, the registered person must maintain a system for monitoring, reviewing and 30/09/2016 evaluating the quality of care provided for children; 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. The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(5))

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Requirement Due date

* These requirements are subject to statutory requirement notice.

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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

 As part of the policies for protection of children, the registered person should include information about whistle-blowing, with clear procedures for how a staff member should report to an appropriate authority any concern they have about a child in the home being either at risk of, or already experiencing, significant harm. The policy should reflect the principles set out in the Francis review ‘Freedom to speak up.’ (‘Guide to the children's homes regulations including the quality standards’, page 43, paragraph 9.15)  Staff should be familiar with the home's policies on record-keeping and understand the importance of careful, objective, and clear recording. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the children's homes regulations including the quality standards’, page 62, paragraph 14.4)

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Information about this children's home

The home is owned and run by a local authority. It is registered to look after a maximum of six children who may have emotional and/or behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

4/03/2016 Interim Sustained effectiveness

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Recent inspection history

9/02/2015 Interim Improved effectiveness

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Inadequate

Weak care planning, caused by poor leadership and management decisions in the making of unsafe, inappropriate placements with poor risk management plans, has negatively impacted on young people’s overall experiences and group dynamics. Some young people’s care plans have changed at short notice. This is due to management directives that result in young people’s swift moves from one children’s home to another. In one example, the registered manager was directed by senior management to discharge, at short notice, a young person who has lived at the home for over eight months despite having informed the young person the week previously that they would be staying at the home until they reached 18. The reason provided for the move was to accommodate a younger person of a different gender, whose placement had broken down, and there were no other suitable placements available. No prior consultation with the discharged young person took

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Inadequate

place, and their wishes and feelings were ignored. This negatively impacted on their sense of belonging and value. This practice has caused much distress to the young person, and there has been an increase in their risky activities and poor engagement at their new home. The young person made an initial complaint which they later withdrew. Discussions with a parent and the independent reviewing officers for both young people did not take place prior to the moves. This impeded parents and relevant professionals challenging such decisions through the proper channels. Impact risk assessments are not robust. This has led to new admissions where there has been no consideration to young people’s history of violence and aggression. Additionally, new risks that come to light post admission are not effectively reviewed and added to young people’s ongoing risk management plans. Consequently, young people have been the subject of allegations, bullying and actual physical and emotional

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Inadequate

harm, which have impacted on their outcomes. An emergency placement did not take into account the young person’s wishes and feelings in relation to the location of the home being a mile and a half away from an area of potential risk due to allegations of a sexual nature. The boundaries continue to be an area of challenge for some young people, whose harmful and threatening behaviours have de-stabilised the home environment, when serious incidents have occurred. Opportunities to discuss such negative behaviours and other significant concerns with young people, either individually or in young people’s meeting forums, have not been used to their full potential. This does not reinforce the unacceptable nature of their behaviour, teach them to take responsibility for their actions or help them to learn the value of respect for themselves and others. Some young people however are responding well to staff guidance, which helps them build trusting and amicable relationships. This enables

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Inadequate

them to confide in staff, to speak to them about their concerns and to exercise their right to complain. Young people’s access to primary, specialist healthcare services promotes their health and well-being and raises their awareness about relevant issues, such as smoking, substance misuse and sexual health matters. Similarly, their differing educational attendance and progression is reinforced through good links with the virtual school and education providers. Contact arrangements are facilitated well and supported by the staff team, which helps young people to stay in touch with their culture, identity and family ties. Positive relationships between staff, parents and carers also support young people’s return home when this is the plan. A number of young people are making positive progress to develop skills that will help them to be self-sufficient when they make the transition into independence.

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Inadequate

Young people’s safety and welfare have been significantly compromised by inconsistent and poor safeguarding practices in the home. Young people say that they do not feel safe all of the time. Contributing factors include weak impact risk assessments. These fail to assess and evaluate the impact that placing particular young people at the home is likely to have on them and others well-being and safety. Consequently, a disclosure from a young person relating to inappropriate sexual activity has raised serious concerns about the safety and wellbeing of a vulnerable young person in the home. Another young person’s tendency to present with violent and aggressive behaviour has been scored low, contrary to the information provided about them, and has resulted in aggressive and violent incidents. Existing risk assessments have not been robustly updated following significant events, and provide insufficient guidance for staff and others to follow. This has contributed to poor risk

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Inadequate

management and has exposed some young people to serious bullying, inappropriate behaviour and actual harm to their safety and welfare. Furthermore, there is no evidence to show how young people are helped to develop self- protection skills when this need has been identified following safety and welfare concerns. It is therefore unclear whether the staff interventions are keeping those young people safe. Negative and challenging behaviours presented by young people are not consistently well managed. This is compounded by staff sickness and shortages that negatively impact on the safe monitoring of the young people’s activities around the home. Since the last inspection, there have been a number of serious incidents that have warranted police contact and intervention. On other occasions, police resources have been used to assist staff to manage young people’s challenging behaviours. Included have been incidents in which the police have

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Inadequate

been contacted for their assistance to speak to young people about their behaviours, following play fighting between young people or bullying behaviour. On one known occasion, this has resulted in young people spending the night in a police cell. These examples indicate that staff use the police reactively to help them to manage young people’s everyday behaviour, which has the potential to criminalise them. This approach does not concur with the statement of purpose, which indicates that staff have training in a specific behaviour management technique that helps them to identify triggers and effectively manage such behaviours. In spite of the behavioural challenges that may warrant physical interventions, the number of restraints have significantly reduced since the last inspection. Sanctions are also used to counter negative behaviours. However, these have not always been monitored by the registered manager. This does not show that he satisfies

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Inadequate

himself that the behaviour management measures used by the staff are safe, necessary and fair. In addition, they do not indicate that he has responded to the gaps and missing comments from young people in some entries. This means the manager does not have the necessary level of oversight and that young people at the home may be exposed to potentially unsafe staff practice. A decline in young people going missing from the home reduces the risk of harm to them. In the event that young people absent themselves, staff follow clear missing-from-home protocols and go out searching for them, conduct safe and well visits and chase known contacts to ensure their safe return. No young people are believed to be at risk of child sexual exploitation or involved in substance and alcohol misuse. Those young people who self-harm have not partaken in this behaviour since their admission to the home.

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Inadequate

The registered manager has held this position since March 2010. He has relevant childcare experience and social work and management qualifications. Poor leadership and management decisions in the making of some placements with little or no registered manager autonomy have significantly undermined the overall experiences and safety of young people living in the home. This has resulted in some poor, inappropriate and unsafe placement matching and transitions into and from the home that have not been in young people’s best interests. Any challenge from the registered manager of his seniors has been ineffective in changing the culture relating to admissions. Care planning irregularities have been identified as a regulatory breach at the previous two inspections of the home. The home’s statement of purpose currently does not accurately account for the services that young people can expect to receive. Current practice with respect to

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Inadequate

admissions and discharges, restorative practices, children’s rights, sufficient staffing levels and the protection of children and young people are all at odds with the desired outcomes that the home sets out to achieve. Feedback from staff regarding further senior management instructions to make inappropriate placements confirmed that lessons have not been learned to prevent similar incidents. Internal and external monitoring systems are inadequate. They do not enhance the home’s performance or young people’s lives. The independent visitor reports do not provide an accurate, rigorous, reliable or challenging account of safeguarding and childcare practices in the home. No recommendations for improvement have been made, since March 2016, to stimulate improvement and enhance the quality of care. The independent visitor does not provide a suitable opinion on the safety and welfare of young people, and information reported has been misleading and

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Inadequate

unreliable. For example, the June 2016 report made no mention of the young person, who was discharged from the home three days prior to the visit, having been ‘swapped’ with another young person to solve a placement breakdown issue. It is not clear how the independent visitor thought the young person was still living at the home, given their recent discharge. The registered manager, senior care officers and care staff were all present to advise the independent visitor of this fact. This raises serious concerns about the transparency and integrity of information sharing between the registered manager, staff and the independent visitor. Insufficient details in the report have also failed to alert Ofsted about the inadequate operation of the home. The registered manager has not notified Ofsted about all serious incidents. This does not enable Ofsted to review and act on any safeguarding matters. Oversight

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Inadequate

of risk and behaviour management strategies has been ineffective in highlighting that young people are not always cared for within consistently safe, fair and reasonable boundaries, due to gaps in information and practice. Planned individual work with young people to support their individual needs, risks and behaviours does not stand up to scrutiny, due to its omission in evidence. The registered manager and local authority have not meticulously investigated the serious incident that occurred in May 2016, and deficiencies in regulation 44 reports have gone by unchallenged. The registered manager’s monitoring under regulation 45 is maintained as a requirement from the previous inspection, to ensure that consultations with parents, the placing authority and staff are threaded into the report. These shortfalls do not instil confidence in raising standards and ensuring the consistent safety and security of young people.

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Inadequate

Overall, the young people’s home environment is in an inadequate condition and state of repair. It does not provide young people with a warm and homely environment. Typical comments from professionals include, ‘The home is a bit bare. It’s not the homeliest of homes.’ Another described the home as ‘stark’ and that the local authority should invest in a homely environment. Damage caused by some young people has not been adequately monitored to ensure that health and safety hazards are identified and removed proactively by staff. This does not represent a home environment that promotes value in young people. No investigation into the malodour in parts of the home has taken place for some time. On the ground floor, exposed small holes in the walls show where damaged pictures have not been replaced. A hole in the ceiling in the playroom and circular dents on the playroom wall, caused by pool cues, have not been made good.

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Inadequate

Missing curtains and ill-fitting net curtains in the lounge do not look good, nor do they promote young people’s privacy. The prompt replacement of damaged furniture has not happened. Bathrooms used by young people are uninviting. They are not conducive to relaxing bath and shower times. Improvement of the condition of the premises is an unmet requirement from previous inspections. Experienced staff show care and commitment towards the young people. Positive role modelling and support towards the young people help some of them to engage in their plans and activities. However, unresolved staff sickness and shortages have not assured consistency in their care or the safety of young people. A number of professionals confirm good working relationships with the home, and they said that they feel well informed about young people’s progress. A social worker said, ‘Staff do work on the positives’ and, ‘We have a good professional

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Inadequate

relationship.’ A parent said that they did not ‘have a bad word to say about the staff.’ However, not all professionals and parents have been included in some of the placement decisions, which does not promote strong working-together practices.

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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 that 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 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

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Information about this inspection

Homes (England) Regulations 2015 and the ‘Guide to the children's homes regulations including the quality standards’. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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

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Information about this inspection

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

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Information about this inspection

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

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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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