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

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.

p.2

The children’s home provision requires improvement because:

 Young people are not always supervised by staff in line with their assessed needs. This places their safety and welfare at risk. Preventable incidents have occurred.  Some safeguarding concerns are poorly recorded. For example, the concerns raised by a parent regarding the use of restraint are undocumented and lack effective reporting and response. This compromises the safety and well-being of young people.  Physical restraint records lack detail, making it difficult to review its impact and effectiveness. Young people rarely give their comments following restraint. This limits opportunities to hear young people’s views and to ensure that the use of restraint meets their needs.  Staff do not receive formal medication training and there is no written medication procedure or policy. Shortfalls in the administration of medication have resulted in staff administering incorrect medication to one young

p.3

The children’s home provision requires improvement because:

person.  Areas of the home that are awaiting renovation look tired and do not provide a high quality environment for young people. There are high levels of damage and wear and tear, and maintenance and redecoration do not keep pace with need.  Quality of care monitoring reports are not submitted to HMCI as required by regulation. This restricts the regulator’s ability to monitor the home in between inspections.  Staff supervision meetings are not occurring to stated timescales. Written records do not always clearly document the content of discussions and the outcomes of supervision. This impedes staff’s professional development.

p.3

The children’s home strengths

 A full permanent staff team knows young people well. This supports the development of trusted relationships between young people and the adults who care for them. Young people take their concerns to staff and receive help and support.  All young people attend education, and local authority social workers speak highly of the educational support that young people receive. The availability of in-house educational provision means that young people do not experience delays in accessing education. This maximises their educational progress.  Transition planning is thoughtful and meets young people’s individual needs. Young people contribute to the development of their transition plans. The care and thought put into transition planning supports young people’s journey into and on from the home.  Sanction use within the home has a strong emphasis on restorative justice. A successful rewards scheme helps young people to make progress towards

p.4

The children’s home strengths

their identified goals. Young people understand the goals that they are working towards and choose their rewards.  Staff work hard to motivate young people and to engage them in activities that they enjoy and benefit from. Young people speak positively about the opportunities that they have to take part in events and activities.

p.4

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.

p.5

Requirement Due date

The protection of children standard 12. In order to meet the protection of children standard, the registered manager must: (2)(vi) take effective action whenever there is a serious concern about a child’s welfare. 26/09/2016

p.5

Requirement Due date

The protection of children standard 12. In order to meet the protection of children standard, the registered manager must: (2)(b) ensure that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. 26/09/2016

p.5

Requirement Due date

13. In order to meet the leadership and management standard, the registered manager must: (2)(c) ensure that staff have the experience, qualifications and skills to meet the needs of each child, particularly in respect of administering medication, managing children’s behaviour and meeting children’s specialist needs. 26/09/2016

p.5

Requirement Due date

Ensure that records are kept of an allegation of abuse or neglect, and the action taken in response. (Regulation 34(2)(d)) 26/09/2016

p.5

Requirement Due date

Ensure that the registered person supplies 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)) 26/09/2016

p.5

Recommendations

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

p.6

Recommendations

 Ensure that each child’s day-to-day health and well-being needs are met, in particular that information and guidance from specialist reports is incorporated into care provided. (‘Guide to the children’s homes regulations including the quality standards’, page 33, paragraph 7.3)

p.6

Recommendations

 Ensure that staff continually and actively assess the risks to each child and the arrangements in place to protect them, in particular that risk assessments identify known risks and clearly guide safe care. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)

p.6

Recommendations

 Ensure that the home meets the needs of children, in particular that maintenance and decoration are undertaken in a timely fashion. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)

p.6

Recommendations

 Ensure that all staff receive supervision of their practice, which allows them to reflect upon their practice and the needs of children in the home. In particular that supervision is to timescale and includes records of the content and outcomes of supervision. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2)

p.6

Recommendations

 Ensure that the records of restraint kept enable the registered person and staff to review the use of control and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure that it meets the needs of each child. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

p.6

Recommendations

 Ensure that any child who has been restrained has the opportunity to express their feelings about their experience of the restraint, in particular that children feel supported to engage in conversation about restraint, with the support of an advocate if required. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.60) 

p.6

Information about this children’s home

The home is privately owned. It is registered to provide care and accommodation for five young people with emotional and behavioural difficulties.

p.7

Recent inspection history

Inspection date Inspection type Inspection judgement

p.7

Recent inspection history

08/02/2016 Interim Declined in effectiveness

p.7

Recent inspection history

17/02/2015 Interim Improved effectiveness

p.7

Requires improvement

The home provides placements for young people with emotional and behavioural difficulties. Challenging behaviour is prevalent. Some professionals raise concerns about the ability of staff to manage young people’s behaviour. A local authority social worker said, ‘His supervisor tends to give in to him. It would appear as if the easy option is to go with what he wants to do.’ Observations of staff’s engagement with young people during this inspection were positive. Impact assessments do not fully consider the impact of new young people on the group dynamics within the home. The combined needs and behaviours of young people have a mixed impact upon the well-being and happiness of others. Through Ofsted surveys, some young people raised concerns about admissions and behaviour within the home. While one young person said that they were ‘happy’, another, no longer at the home, described the home as ‘horrible’.

p.8

Requires improvement

Individual transition planning for young people moving into and on from the home is thoughtful. Plans include young people’s wishes and feelings and guide transition at an appropriate pace. A local authority social worker said, ‘Before he moved in, two members of staff came to meet with him. He was able to ask questions. When we arrived the welcome was really good. They worked hard to make him feel comfortable.’ Where young people have specialist needs, staff training does not always address these. Young people with eating disorders and who self-harm are admitted to the home, despite staff training failing to address these issues. Although some senior managers have undertaken specialised training, this knowledge is not actively disseminated to the staff providing day-to-day care. Consequently, some young people’s specialist needs are not fully understood. Young people develop trusted relationships with staff, particularly their key

p.8

Requires improvement

workers. During the inspection, the inspector observed young people seeking, and being provided with, advice and support from staff. One young person said, ‘The staff are alright. If I was worried I would speak to any of the adults.’ Many of the young people placed at this home have attachment difficulties, so their development of positive relationships with staff is significant. A comprehensive young people’s guide inducts young people into daily life in the home. Young people know how to complain. Their complaints are taken seriously, investigated and resolved. The young people’s guide provides information regarding advocacy but no young people are receiving support from advocacy services. Staff support young people’s education well. There is daily communication with schools, and staff support young people during the school day where required. A local authority social worker said: ‘They are supporting his education well. They

p.8

Requires improvement

have a very good education set-up and he is doing very well and likes being at school. The staff are supportive of his progress and the link between home and school is proactive.’ Staff quickly initiate new young people without a school placement into suitable education. This maximises their educational outcomes. Young people have access to specialist therapeutic support from a qualified therapist. This service is in-house, so young people do not experience delays in receiving the therapeutic support that they need, and this support continues for as long as young people require. Young people work towards goals targeted to their individual needs. They understand their goals and choose their rewards. Young people are motivated to meet their targets. This system effectively supports behaviour change. Staff work hard to motivate young people and engage them in activities that they benefit from and enjoy. They undertake watersports, gym and boxing, go on

p.9

Requires improvement

holidays and day-trips and undertake voluntary work. Young people take part in their local community and develop a sense of belonging.

p.9

Requires improvement

Young people’s individual risk assessments contain gaps. For example, one young person has recognised internet-use risks which are not documented. This fails to take into account known pre-placement information. The opportunity to provide this young person with the level of protection they need has been missed. Neither is this practice in line with the home’s internet policy which requires internet safety to be included in all risk assessments. Risk assessments identify the levels of staff supervision and monitoring required to keep young people safe but this is not always implemented in practice. Incidents compromising the safety and welfare of young people have occurred due to ineffective staff supervision. The medication policy is not fit for purpose and there is no medication training for staff. New staff learn informally about medication procedures with no management check of their competence or understanding. Poor procedures have resulted in a

p.9

Requires improvement

recent incident of staff administering inaccurate medication to one young person.’ All staff undertake de-escalation and restraint training prior to working with young people. Only approved techniques are used. Recent changes to the forms used to record restraints have not yet led to improvements in the quality of recording. This makes it difficult to review the use and effectiveness of restraints. There is little evidence of young people engaging in discussions and exploring their feelings after restraint, and no provision of advocacy for young people to support this process. Not all safeguarding concerns are appropriately addressed. For example, a concern raised by a parent in respect of restraint use remains unrecorded, unreported and unaddressed. This does not demonstrate effective safeguarding. Staff safeguarding training is up-to-date and includes child exploitation and radicalisation. All young people have clear plans detailing what to do if they go missing, and staff

p.10

Requires improvement

utilise this guidance where there are incidents. Young people are rarely missing from the home, as a proactive and knowledgeable staff response to young people going missing maximises young people’s safety. Young people receive support to manage their feelings and behaviour, via one-to- one time with staff and the daily therapeutic young people’s meetings. Staff explore and address relationship difficulties between young people. One young person said, ‘Sometimes bad things happen and young people are bullying. I tell staff and they talk to them. It makes things better.’ Young people are confident of staff support for the concerns that they raise. Sanction use in the home is thoughtful, with a creative, restorative approach. A local authority social worker said, ‘He is learning to reflect after incidents. He still has flashpoints but I have seen a significant improvement in his behaviour and presentation.’ Careful sanction use helps young people to reflect upon and modify

p.10

Requires improvement

their behaviour. For example, one young person who damaged the home worked alongside maintenance staff to repair the damage caused. Staff recruitment is safe and thorough: this protects young people. Health and safety checks and fire drills are up to date, providing a safe home environment for young people and staff.

p.10

Requires improvement

A manager, registered with Ofsted for one year, leads this home. He has 21 years of residential childcare experience and is qualified with an MA in child and adolescent mental health. He is in the process of completing his level 5 diploma in leadership and management for residential childcare. The registered manager demonstrates awareness of the strengths and weaknesses of the home. However, some known concerns are not addressed. For example, shortfalls in the completion of staff supervision to timescale remain, despite this being a required action in previous quality of care monitoring. Quality of care monitoring is thorough and produced at appropriate intervals, but is not submitted to HMCI within required timescales and this limits the oversight undertaken. Scrupulous external monitoring supplements internal monitoring. This is valued by the registered manager and provides additional quality assurance to

p.11

Requires improvement

the home. Some staff supervision records lack detail and do not clearly document the content of discussions. Supervision does not always occur in line with the homes statement of purpose. Failure to provide timely, well-recorded supervision does not promote staff development or individually recognise and support the emotional impact of their work. The home is staffed with a full, permanent staff team. All staff undertake the level 3 diploma in residential childcare and complete this within required timescales. Training has a focus upon therapeutic care, ensuring that all staff understand the therapeutic ethos of the home. Young people’s care plans are comprehensive, although some fail to include care strategies from pre-placement reports. For example, the home failed to incorporate specialist occupational therapy recommendations into one young person’s care plan. Specialist knowledge and individualised strategies therefore remain unused,

p.11

Requires improvement

missing opportunities to support young people’s progress with specialist care techniques. The home works proactively with placing authorities. A local authority social worker said, ‘I get weekly reports from the home and any incidents are well reported. I have a good working relationship with the manager and staff team.’ Positive partnership working benefits young people. Maintenance and decoration does not keep pace with the high levels of wear and tear and damage experienced in the home. One placing social worker said, ‘In my observation, the home could do with improvement in the physical environment, it can look a bit shabby.’ Maintenance is under way, and decor and furnishing of some rooms is now of a high standard. However, areas of the home that are awaiting renovation look tired and do not provide a high quality environment for young people.

p.11

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’.

p.13

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

p.13

What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

p.13

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

p.14

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 .

p.14

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,

p.15

Information about this inspection

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

p.15

Information about this inspection

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

p.15

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

p.15