Children's home run by Thoughts of Others Limited in Birmingham

Inadequate

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

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The children’s home provision is inadequate because:

 Staff do not record accurately the use of physical restraint. This means that young people may be subjected to unnecessary or disproportionate use of this measure of control or the methods of restraint used.  Young people do not receive personalised care and support. Care plans and risk assessments are generic to all young people. Managers and staff do not ensure that support plans reflect young people’s individual needs, risks or vulnerabilities.  Managers fail to ensure that they implement recruitment procedures designed to promote young people’s safety and welfare.  Monitoring systems are weak and ineffective. The registered manager does not review the quality of care provide by the home and does not seek young people’s feedback on the care that they receive.  Managers do not adequately support staff. Staff do not receive regular practice-related supervision. This means that their practice and performance

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The children’s home provision is inadequate because:

is not monitored or scrutinised.  The registered manager does not refer allegations of abuse or harm to other agencies as required. This compromises young people’s safety and welfare.  Staff do not ensure that young people’s case files include all necessary information or ensure that they keep these records up to date. This means that young people do not have an accurate record of their placement.

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The children’s home strengths

 Young people make progress in education and re-engage in formal learning.

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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

6. The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard, the registered person must ensure that staff— (2)(b)

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Requirement Due date

(iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

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Requirement Due date

(vi) help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult. 03/10/2016

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Requirement Due date

7. The children’s views, wishes and feelings standard

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Requirement Due date

In order to meet the children’s views, wishes and feelings standard, the registered person must ensure that staff— (2)(a)

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Requirement Due date

(iv) regularly consult children, and seek their feedback, about the quality of the home’s care. 03/10/2016

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Requirement Due date

In order to meet the protection of children standard, the registered person must ensure that staff— (2)(a)

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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. 03/10/2016

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Requirement Due date

13. The leadership and management standard 03/10/2016 In order to meet the leadership and management standard, the registered person must—

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Requirement Due date

(2)(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;

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Requirement Due date

(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

Restraint in relation to a child must be necessary and proportionate. (Regulation 20(2)) 03/10/2016

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Requirement Due date

Subject to paragraph (5), the registered person must ensure that children are provided at all reasonable times with access to the following facilities, which they may use without reference to persons working in the home: a telephone on which to make and receive telephone calls in private. (Regulation 22(3)(a)) 03/10/2016

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. (Regulation 32(1)) 03/10/2016

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b))* 16/09/2016

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out the measures of control, discipline and restraint which may be used in relation to children in the home. This is with specific reference to the use of ‘floor holds’. (Regulation 35(1)(b)) 03/10/2016

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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 details of the child’s behaviour leading to the use of the measure; details of any methods used or steps taken to avoid the need to use the measure; 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. (Regulation 35(3)(a)(ii)(v)(vii)(viii)) 03/10/2016

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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. (Regulation 03/10/2016 36(1)(a)(b)(c))

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is an allegation of abuse against the home or a person working there. (Regulation 40(4)(c) 03/10/2016

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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. (Regulation 45(1)) 16/09/2016

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Requirement Due date

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. (Regulation 45(4)(a)) 16/09/2016

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Requirement Due date

* These requirements are subject to a 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 recommendation(s):

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Recommendations

 The design of the home should provide staff that sleep in the home overnight with appropriate accommodation and facilities to do so. (‘Guide to the children’s homes regulations including the quality standards’, page 17, paragraph 3.26)

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Information about this children’s home

The home provides care and accommodation for up to six young people with emotional and/or behavioural difficulties. The home is owned and operated by a private company.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

25/02/2016 Interim Declined in effectiveness

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Inadequate

There are significant shortfalls in providing for and promoting young people’s welfare and safety. There is a high level of restraints that are disproportionate to the behaviour presented by young people. The registered manager has failed to ensure that young people are safe in the home or protected from harm. This area of practice and the leadership and management of the home are inadequate. These failures are detrimental to young people’s progress and their day-to-day and overall experiences of living in the home.

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Inadequate

Young people do not receive care that reflects their individual needs, specific vulnerabilities or known risks. Internal care plans, support plans and ‘daily outcome charts’ are weak and generic. For example, young people have identical ‘targets’ for achievement, regardless of their skills, abilities or support needs. The internal care plans for some young people are indistinguishable from the plans of other young people, although their identified needs and risks are noticeably different. There is a lack of one-to-one sessions with young people. This means that staff do not capture young people’s views, opinions or feedback about the quality of care provided by the service. Failures by managers and staff to ensure that they devise and deliver personalised care packages limits young people’s progress. This is because the care that young people receive is not necessarily reflective of their individual needs. Daily outcome targets for young people are all identical,

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Inadequate

irrespective of young people’s needs or abilities.

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Inadequate

Managers and staff do not ensure that young people’s case files include all required information, as there is no challenge to the local authority to provide the documentation. For example, minutes of statutory review meetings and agreed contact arrangements are not available for all young people. Managers and staff do not regularly review or update young people’s case files and staff do not consistently sign and date each entry that they make. This means that case files do not provide young people with an accurate record of their placement.

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Inadequate

Relationships between young people and staff are mixed. Young people say that they like spending time with ‘some staff’ but feel others ‘just want to boss you around’. One young person said, ‘I get on well with (name of staff). He gets me and understands me but some of the others are just here for the money. You can just tell.’

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Inadequate

Young people appreciate the emotional and practical support they receive to maintain contact with their families. One young person said, ‘I get to see my family and that really means a lot. I thought that I wouldn’t see them for ages but the staff make sure I do.’ Nevertheless, young people are unable to have contact with their families without asking staff. This is because they do not have free access to a telephone, despite no court orders or written agreements with placing authorities restricting contact being in place.

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Inadequate

Young people make good progress in education, taking account of their starting points. Staff work with the organisation’s own school and teaching staff to address any barriers to learning that young people face. One young person said, ‘School is good. It’s better than I thought it would be.’ Young people’s school attendance is good and they are proud of their achievements.

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Inadequate

Staff work in partnership with health professionals and specialist health services, such as mental health practitioners, to address young people’s emotional and psychological needs. Young people are encouraged to take responsibility for their physical health, eat a healthy diet and take regular exercise. These actions support their sense of well-being and promote a healthy lifestyle.

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Inadequate

Staff do not ensure that they support young people to gain the emotional or practical skills they need to move towards adulthood. Although some young people assist staff with food shopping, cooking meals and keeping the home tidy, staff do not sufficiently record young people’s participation in these activities. This means that staff do not adequately assess young people’s independent living skills to prepare them for their transition to adulthood.

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Inadequate

Staff do not adequately protect young people from harm. Failures to ensure that incidents of physical restraint are appropriately recorded mean that the use of this measure of control is potentially disproportionate and unnecessary.

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Inadequate

Records of restraint are incomplete and lack detail. Staff do not consistently include a description of young people’s behaviours, explain the steps taken to defuse the incident, clarify the method of restraint used or why these methods are necessary, or record the effectiveness of the restraint. For example, since the last inspection in February 2016, the majority of physical restraints involve the use of a ‘floor hold’. This involves staff holding young people on the ground. Staff do not record the reasons for the use of this restraint hold and therefore the purpose or need for its use is unclear and potentially unjustified. On one occasion, a young person suffered an injury during a restraint. There is no explanation recorded as to how this injury occurred, or any reference to any medical treatment given. Furthermore, the available physical restraint policy does not include reference to the use of ‘floor holds’. This means that young people, their families and placing

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Inadequate

authorities are unaware of this possibility.

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Inadequate

Young people’s risk assessments are generic and do not take account of all of their known behaviours. For example, all young people’s risk assessments reference the possibility that they may ‘spit’ at staff. This behaviour is specific to only one young person. Furthermore, staff do not record the strategies in place to reduce risk- taking behaviours identified in internal care plans, such as self-harm, substance misuse and inappropriately touching others, in risk-assessment documents. This lack of personalised care hinders young people’s development.

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Inadequate

Incidents of young people going missing from the home are rare. This is due to high levels of staff supervision. If young people do go missing, managers and staff liaise with local police, social workers and young people’s families. In these circumstances, staff also consider the potential risks of sexual exploitation and work with specialist agencies in relation to this risk.

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Inadequate

Managers and staff complete regular safeguarding and child protection training. This training includes referral processes for managing allegations of harm against a professional. Despite this training, the registered manager has failed to notify Ofsted, as required under regulation, of one allegation of abuse.

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Inadequate

Staff are not recruited using procedures designed to protect young people from harm. For example, when staff declare convictions, the potential impact of these on young people’s safety and welfare is not considered. Risk assessments are not in place to indicate that managers, including the registered manager, have explored the possible risks to young people, or established strategies to reduce these risks. This means that staff are not suitably verified as safe to work with young people.

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Inadequate

The manager registered with Ofsted in 2012. He has held his current post since the home opened in March 2015. He has experience of working in and managing services for young people. The registered manager is working towards gaining his level 5 diploma in leadership and management for residential childcare. He is required to complete this qualification by April 2017.

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Inadequate

The registered manager has failed to take sufficient action to address six of the nine requirements raised at the last inspection. For example, young people’s case files are not up to date, staff do not seek young people’s views regarding the quality of care provided by the service, and records of physical restraint are incomplete. These continuing shortfalls mean that the service cannot demonstrate a capacity for improvement. This is detrimental to young people’s development.

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Inadequate

The statement of purpose details the aims and objectives of the home. The registered manager does not ensure that the home delivers care in line with the outcomes for young people as defined in this document. This is because young people do not receive personalised care and the registered manager does not prioritise their individual needs. For example, the registered manager has not taken sufficient steps to ensure that young people’s care plans and risk assessments reflect their individual needs or vulnerabilities.

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Inadequate

The registered manager does not effectively monitor the home. Failures to ensure that internal records and reports, including case files, care plans, risk assessments and physical restraint records, are regularly checked hinders young people’s progress. This is because the registered manager is reluctant to recognise these practice shortfalls or take sufficient action to address these. The registered manager does not review the quality of care provided by the service and there is no suitable system in place to identify the strength and weakness of the home. Since the home opened in March 2015, the registered manager has not provided Ofsted with a quality of care review report.

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Inadequate

Staff do not receive regular or practice-related supervision. Ofsted raised this requirement following the inspections in August 2015 and February 2016. The registered manager has failed to address this shortfall. This means that staff do not receive adequate support. The registered manager does not monitor staff practice and their performance is not scrutinised. The lack of supervision means that any staff capability issues are unknown. This compromises young people’s safety and is detrimental to their progress and development.

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Inadequate

Staff do have adequate ‘sleep-in’ facilities. When staff spend the night in the home as part of their designated shift pattern, they are expected to either share a bedroom with another member of staff or move a ‘put up’ bed into a lounge area. This is unacceptable and leaves staff without adequate privacy.

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Inadequate

The registered manager liaises with external agencies, including the placing authorities and health professionals, to ensure that young people are able to access the additional support they may need. Feedback from other professionals is generally positive, although some practitioners comment on the ‘poor quality of case records and documents’. One social worker said, ‘Some months, the report I receive is identical to the one I received the month before.’

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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 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

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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