Children's home run by Horizon Care Limited in Cannock Chase

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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because:

 Some compatibility risk assessments are not completed with full and accurate information. This has impacted on the staff’s ability to maintain young people’s safety and resulted in further placement moves for young people.  Medication records are not robust and do not contain all required information. On occasions, medication is unaccounted for.  Some of the records that the home is required to maintain provide inaccurate and incomplete information. This hinders the formal processes needed to monitor young people’s progress and to address how their individual needs are met. This is with particular regard to placement plans and risk assessments.  All staff, including agency workers, who are working on shift with young people need to be fully aware of all the current risks assessments and any changes and updates that have taken place.  The home environment, specifically young people’s bedrooms, is of a poor

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because:

standard. This does not reflect the nurturing care that staff are trying to promote.Managers do not have accurate information about the training and development needs of the staff team. These circumstances bring into question the ability of staff to consistently meet the needs of young people living in the home.  Measures of control, discipline and restraint are not consistently evaluated for effectiveness. Neither do they provide sufficient detail of the measure used, nor include the young person’s view. They are not, therefore, compliant with the children’s home’s regulations 2015.  On occasions, managers have failed to ensure that there is appropriate monitoring in the home to adequately review the quality of care and identify areas for improvements.

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The children's home strengths

 Young people said that they have good, trusting and respectful relationships with staff and are able to talk to them if they are worried or concerned.  Young people like living in the home and enjoy the support that they receive from caring and enthusiastic staff. They are able to pursue interests and activities that build their self-esteem and confidence.  The home has made very good links with a variety of professionals. These professionals speak highly of the home and the progress that some young people have made.

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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

13: The leadership and management standard In order to meet the leadership and management standard, the registered person must (2)(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 16/09/2016

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Requirement Due date

14: The care planning standard In order to meet the care planning standard, the registered persons must ensure that children (1)(a) receive effectively planned care in or through the children's home. In particular, compatibility risk assessments need to consider all current and historical information to ensure that care planning is effective. 16/09/2016

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Requirement Due date

23: Medicines The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. In particular, the registered person must ensure that a record is kept of the administration of medicine to each child. (Regulation 23(1)(2)(c)) 16/09/2016

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Requirement Due date

35: Behaviour management policies and records The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out (1)(a) how appropriate behaviour is to be promoted in the children's home; and (b) the measures of control, discipline and restraint which may be 16/09/2016 used in relation to children in the home. (2) The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (3) The registered person must ensure that (a) 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 (i) the name of the child; (ii) details of the child's behaviour leading to the use of the measure; (iii) the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the need

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Requirement Due date

to use the measure; (vi) the name of the person who used the measure (’the user’), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; (b) within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’) (i) has spoken to the user about the measure; and (ii) has signed the record to confirm it is accurate; and (c) within five days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (1)(a)(b)(2)(3)(a)(b)(c)

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Ensure that records are kept detailing all individual incidents when children go missing from the home and actions taken by staff. In particular, support should be provided to young people on their return home. (‘Guide to the children’s homes regulations including the quality standards’, page 45, para 9.31)  Ensure that a record of supervision is kept for staff that provides evidence that supervision is being delivered in line with regulation. (‘Guide to the children’s homes regulations including the quality standards’, page 61, para 13.3)  Ensure that staff continually and actively assess the risks to each child and the arrangements in place to protect them. When there are safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any

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Recommendations

assessed risks on a day-to-day basis. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph, 9.5)  Ensure that staff provide appropriate boundaries in relation to the children’s behaviour. Homes must also meet children’s basic day-to-day needs and physical necessities. Staff should seek to meet the child’s basic needs in the way that a good parent would, recognising that many children in residential care have experienced environments where these needs have not been consistently met. Doing so is an important aspect of demonstrating that the staff care for the child and value them as an individual, This is with particular regards to improving the conditions of young people’s bedrooms (‘Guide to the children’s homes regulations including the quality standards’, page 15, para 3.7)

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Information about this children's home

The private children’s home provides care and accommodation for up to three young people with 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

04/02/2016 Interim Improved effectiveness

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Recent inspection history

14/01/2015 Interim Improved effectiveness

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Requires improvement

Young people say that they have good relationships with staff and feel cared for. Young people’s comments include, ‘They were always there for support and never gave up on me’, and, ‘They are kind and friendly’. This has led to young people forming trusting relationships with staff who care for them. Consistently robust compatibility risk assessments are not completed prior to young people moving into the home. This has placed the young person and others already living at the home at an increased level of risk. Assessments are completed without a full and accurate account of young people’s histories. This has led to young people moving into the home without a full assessment of their needs, specifically in regards to concerns about bullying younger peers, criminal behaviours and child sexual exploitation. As a result, other young people living in the home have been victimised, and placements have ended within a relatively

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Requires improvement

short timeframe. This has impacted on the safety and welfare of both the young people in the home and the new young person who is awaiting another new placement. Young people are encouraged to adopt healthy lifestyles. Staff acknowledge young people’s right to make choices about their health, but seek to educate and influence individuals where there can be improvements, for example encouraging healthy eating and exercise. However, not all health records detail the work completed by staff to promote healthy lifestyles, including the encouragement of young people to attend all planned health appointments. This does not provide a detailed overview of young people’s health needs and the strategies, support and guidance in place to promote them. Young people are consulted about their day-to-day routines and arrangements. Staff are aware of young people’s needs, but this knowledge is not underpinned by up-to-date placement plan documents. For example, plans do not clearly reflect the

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Requires improvement

changes to young people’s contact plans or plans for working towards independence. Plans also do not reflect young people’s views or fully express their own aims and aspirations regarding what they want to gain from the placement. In the absence of this information, staff are unlikely to fully address and meet the needs of each young person. The registered manager and staff understand the importance of education. They support young people to return to their education provisions, when they had experienced previous disruptions. When young people experience difficulties in their education, staff liaise with teaching staff and arrange meetings, to look at any further support that the young person can access. In addition, when appropriate education placements have not been in place for young people, the registered manager has challenged the placing authorities and attended the fair access panel to ensure that the most appropriate education provision is in place for individual

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Requires improvement

young people. This ensures that their education needs are met. Some young people in the home live a long way from home. Staff promote and support contact with families and friends. When difficulties arise, staff hold discussions with placing authorities to look at improvements that can be made to contact plans. This has resulted in young people having longer contact days with their families, which has improved their relationships. However, when there have been changes to contact plans, these are not included in all young people’s records. For example, placement plans and contact plans contain different information about the frequency of agreed contact. This does not ensure that staff have up-to-date and accurate plans for each young person. Parts of the home’s environment are poor. During the inspection, some young people’s bedrooms were unclean, had clothes strewn across the floor, and dirty plates with the remnants of food left on them. Young people had written notes

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Requires improvement

with profanity on them and had stuck them on their bedroom doors. Staff had failed to address this with young people. The inspectors brought to staff’s attention the condition of young people’s bedrooms. While staff took immediate action to rectify the issues raised, the home’s daily routine had not enabled staff to notice these.

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Requires improvement

There have been some significant safeguarding issues for young people in the home, relating to child sexual exploitation. This resulted in two placement breakdowns since the last inspection. At this present time, a young person is staying in a holiday home, for a period of respite, with two-to-one staffing from the home, until an alternative placement is identified that can meet her needs and keep her safe. This action was taken to safeguard the young person and other young people in the home. This has resulted in a change in staff rotas and agency staff having to be used on a regular basis. This has impacted on all the young people living at the home. Risk assessments are in place for the young people. These include risks, strategies and triggers. However, not all staff, including agency workers, have signed the documents to indicate that they are fully aware of the current risks and recent changes to the documents. These include recent incidents involving child sexual

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Requires improvement

exploitation and bullying. One agency worker spoken to during the inspection stated, ‘I have not had the chance to look at any risk assessments and I’m not really aware of the changes.’ He was on shift, working directly with young people. Consequently, the registered manager cannot be assured that all staff are aware of the risks associated with behaviours or whether additional safeguards are required to reduce risks to young people or others. Young people do not always benefit from clear and consistent boundaries or effective behaviour management strategies. On occasions, responses to challenging behaviour do not provide a consistent, positive message to young people. Consequences can sometimes be disproportionate, confusing and punitive, with no clear overview of why this decision was agreed. For example, records indicate that two young people caused damage in the home. One young person received a fine of £12, while the other received a £15 fine. There was no clear

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Requires improvement

indication of why this measure was appropriate or how and when this would be repaid. Records do not show that the consequences given resulted in the young person learning from their actions. Managers do not have a consistent overview of the records or their appropriateness. This does not help staff to evaluate and identify the effectiveness of the measure used in helping young people to make changes to their behaviours. On occasions, physical intervention is used in the home. However, the records do not clearly identify the behaviours that lead to the intervention. In addition, there is no evidence that a full debrief takes place with the young people following the intervention, by an independent person. This is a missed opportunity to provide young people with time to reflect on the incident, discuss their views about what happened and gain an understanding of why the measures are necessary. Medication records are not completed in full. In some records, the date and time

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Requires improvement

that medication has been administered are not recorded. Records also indicate that medication was missing. In addition, there were discrepancies in the amounts given to young people and the amount left in stock. During the inspection, the registered manager identified that staff had taken medication for the young person on respite. However, there are no records to indicate what medication had been removed or how much. This does not demonstrate the safe handling, administration or recording of medication in the home. Staff in the home undertake room searches. Staff report that they are conducted due to young people smoking and having illegal substances in their bedrooms. However, not all room search documentation is completed. Rooms have been searched on occasions and staff have not followed the home’s own policies and procedures, by completing all required documentation. Since the last inspection, there has been a significant increase in the occasions

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Requires improvement

when young people have been missing from the home. Managers and staff informed inspectors of the efforts they have made to locate young people who have been missing from home, for example contacting young people, their family members and friends by telephone and, on several occasions, travelling long distances to attempt to locate young people, who were thought to be at risk of significant harm. However, the records do not reflect what action is taken when young people return home. Return home interviews are not routinely completed. This prevents young people from having an independent person to speak to following each missing episode. Young people are fully aware of the home’s complaints procedure. They have used this appropriately and have received both verbal and written confirmation about the progress and actions from their complaint. This demonstrates that young people are fully informed and updated in a timely way. For example, when two

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Requires improvement

young people were unhappy about the variety of foods available to them, which they did not feel met their cultural needs, the registered manager arranged for staff to take them shopping to consider their cultural needs. Following further discussions, the complaint was resolved. Young people said that they were ‘happy’ with the outcome and felt that staff had listened and supported them.

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Requires improvement

The registered manager is suitably qualified and has the necessary experience to manage the home. She is an enthusiastic and committed manager who is very child centred. As well as managing the home, she is a locality mentor for other managers in the organisation. In addition, she has been undertaking extra shifts with a young person who is staying in a holiday home out of the area for a period of respite. For example, on the day of the inspection she returned to the home from a sleep-in shift and after the inspection returned to the respite home to undertake another sleep-in shift. The manager acknowledged that this was directly affecting her ability to maintain a clear overview of practice issues in her home and monitor staff practices and records in the home. Staff duty rosters fail to accurately reflect the actual staff on duty and lack transparency. This prevents a clear audit trail of who is working in the setting, and

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Requires improvement

when and where they are working. In July 2016, there were two copies of the same rota, identifying different staff on duty on the same days. In addition, the staff who signed into the daily logbook and handover were different from those staff stated on the rota. While the staff team was working across both the home and the respite provision, there was no clear evidence indicating in which location staff were working. Thus, the home’s records provide conflicting information and it is therefore difficult to establish which staff are on duty. The lack of transparency of who is on duty potentially places young people at risk and compromises the continuity of care. Although staff report that they have supervision on a regular basis, records in the home do not evidence that supervision is recorded in line with the home’s own policies and procedures. Supervision records lack detail and do not demonstrate that they are reflective. Some records are a direct duplication of previous

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Requires improvement

supervision sessions, including the detail of the discussions that have taken place. Staff have not signed records of supervision to indicate that they are a true reflection of the session and that they are happy with their content. A lack of effective supervision does not provide staff with opportunities to reflect on their practice or to identify any further training that they may need. Furthermore, it does not ensure that they are promoting better outcomes for all young people. Staff members are either qualified to national vocational qualification (NVQ) level 3 or are undertaking this essential training. The home has implemented an ongoing staff development and training programme. Staff were complimentary about the range of training offered. However, records do not demonstrate that all staff have attended the company’s mandatory training or refresher courses. The training records indicate that some staff have not received any training in relation to child

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Requires improvement

sexual exploitation or refresher training in physical intervention, medication or food hygiene. Thus, staff on some occasions are not provided with the competencies to effectively fulfil their roles. When this was discussed with the registered manager, she reported that this is a recording issue. However, she was unable to provide any further evidence to demonstrate that the training has taken place. Although young people and staff acknowledged that key-working sessions take place, the records do not always provide an insight into the young people’s lives or their journeys through care. Therefore, there is limited information by which to measure young people’s progress or to identify the effectiveness of the support provided. In addition, this prevents a complete record of young people’s time at the home, although it has not affected their welfare. Team meetings are held on a regular basis and detailed records evidence the

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Requires improvement

discussions held. Staff report that the managers are supportive and are ‘passionate about their work and very committed to young people’, and ‘they are always available and will listen to any concerns and respond appropriately’. The staff team members work well together and share the same level of motivation, care and passion as the manager. A staff member said, ‘I love working at this home. Although I am an agency worker, I am treated as a part of the team and involved in everything. I feel like the manager has faith in me.’ The registered manager has continued to work in partnership with a wide range of external services. Collaborative relationships exist with placing social workers and independent reviewing officers, which help to support effective communication and coordination of services for the benefit of young people. Additionally, regular meetings held with community services, including safer neighbourhood teams,

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Requires improvement

have enabled the home to integrate better into the local community. The registered manager has considered the workforce development plan for the home. However, this still requires additional information, including details about staff induction, training, supervision and managing poor performance. The registered manager has already started to take action to address the shortfalls found at this inspection and is working with her senior support workers to compile a clear action plan to meet the requirements and recommendations.

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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

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Information about this inspection

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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