Children's Home run by Action for Children in Surrey

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:

 There have been delays in notifying professionals of potential safeguarding information. Policies and procedures have not been followed, nor has information been shared appropriately.  Information and records were difficult to locate relating to safeguarding concerns. Outcomes of investigations have not always been obtained or recorded. Recording systems in operation require improvement to enable effective oversight.  Information relating to a new admission was not detailed, and care planning does not give staff sufficient guidance on how to support fully a young person who has transitioned into the home.  Impact risk assessments are not completed. This does not enable a robust evaluation to determine if they are able to meet the young people’s needs and assess if they are able to keep all young people safe.  Documentation when restraint has taken place is poor and does not detail all the necessary information. In addition, young people and staff are not

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because:

consistently offered debriefs following an incident.  Training requirements, as outlined in the home’s statement of purpose, are not being met.  Internal monitoring and review systems have not identified the issues raised in this inspection. There needs to be consideration of whether the manager’s review systems are effective in identifying weaknesses.

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because:

 Significant events have not been notified to Ofsted as required. This was a requirement at the last inspection and has yet to be implemented in practice.

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The children’s home’s strengths

 The manager is enthusiastic and child-centred in her approach. It was evident that young people’s needs are fully taken into account in her decision making. . Young people’s demeanour indicates that they are happy in each of the homes, and that they feel safe and are well cared for.  The manager and staff team have begun to make progress in identifying and reflecting on the practice in the home and are positive about making further changes.  Inter-agency working ensures that there is a universal approach in meeting the specific needs of young people.  Young people have made progress since arrival at the home and for some this has been significant.  The staff teams in each of the houses were observed to have a nurturing relationship with the young people. They were attentive and patient in their interactions with them.  Young people are involved in everyday decisions, and this is an area the home has continued to improve.

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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 In order to meet the quality and purpose of care standard, the registered person must ensure that staff: (2)(b)(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. In particular, care plans for new young people are detailed to enable staff to support children. 28/10/2016

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Requirement Due date

12: The protection of children standard In order to meet the protection of children standard, the registered person must ensure: (2)(a) that staff: (vii) are familiar with, and act in accordance with, the home’s procedure under Regulation 36 (1) (policies for the protection of children) (d) the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. In particular, that fire risk assessments are followed in respect of propping open fire doors. (Regulation 12 (2)(a)(vii)(d)) 28/10/2016

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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)(a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers outcomes, set out in the home’s statement of purpose. In particular, staff refresh and undertake training as detailed (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (2)(a)(h)) 28/10/2016

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Requirement Due date

14: The care planning standard In order to meet the care planning standard, the registered person is required to: 28/10/2016 (2)(a) ensure that children are admitted to each of the homes only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. This specifically relates to carrying out impact risk assessments to determine suitability. (Regulation 14 (2)(a)) 35: Behaviour management policies and records 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 (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 (3)(a)(c)) 28/10/2016

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Requirement Due date

40: Notification of serious events The registered person must notify HMCI and each other relevant person without delay if a child protection enquiry is instigated or concludes and there is any other incident relating to a child which the registered person considers to be serious, or there is an allegation of abuse against the home or person working there. (Regulation 40 (4)(c)(d)(e)) 28/10/2016

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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 external agency staff’s qualifications and skills are taken into account before they commence work and are documented on agency profiles. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.16)  Ensure that staff record the relevant information with regard to health needs of a child. This specifically relates to ensuring that necessary paperwork is completed following any seizure activity. (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.12)  Ensure that the manager adheres to actions set in internal investigations to enable staff to be familiar with and act in accordance with the protection of children policies. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.21)

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Recommendations

 Ensure that staff are familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear recording. (‘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

This home is run by a charitable organisation and is registered to provide care and accommodation for up to 19 children: 15 children with learning disabilities and up to four places for children with a physical disability.

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Recent inspection history

Inspection date Inspection type Inspection judgement 08/03/2016 Interim Improved effectiveness 18/11/2015 Full Good 22/12/2014 Interim Sustained effectiveness 28/08/2014 Full Good

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Requires improvement

Weaknesses were found during the inspection in how well children are helped and protected, and therefore in the effectiveness of the leadership in the home. These have an impact on this judgement. Although the judgement is ‘requires improvement’, there are a number of positive areas seen, and young people do have fun and develop. The staff in each of the houses were observed to have developed nurturing relationship with the young people. They were attentive and patient during their interactions and young people benefit from the quality of the relationships they have with the caring members of staff working with them. Positive role-modelling by staff has helped young people to improve their social skills and to understand acceptable behaviours. Comments from a professional included, ‘In my observation, the care staff are dedicated and committed to ensuring that all the young people receive the best possible care.’

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Requires improvement

Young people have made progress since arrival at the home, and for some this has been significant. Staff report proudly on achievements and describe how young people continue to develop skills and grow in confidence. Some of the examples of progress include developing independence in self-care skills and in social interaction. The team also recognises that during transitions young people’s anxiety may be displayed in the form of negative behaviour. For two young people, negative behaviours increased prior to moving on, and the staff worked with the young people and the necessary professionals to try to alleviate anxiety and promote a positive ending.

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Requires improvement

Young people are involved in everyday decisions, and this is an area the home has strived to improve. Staff ensure that all young people are given opportunities to express their views and choices fully in everyday decisions, such as activities. Due to the evolving relationships between the young people and staff, staff are able to recognise when young people are upset and to advocate on their behalf if the need arises.

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Requires improvement

The staff team works with local health services to ensure that young people’s individual support needs are met. Young people with specific health needs, such as epilepsy, have protocols in place. However, training in relation to these health needs has not been kept up to date. This has been reported on under the leadership judgement. Epilepsy monitoring forms are not always completed following a seizure, and although this information is contained in daily logs it is not easy to extrapolate this information. Medication procedures are monitored and any known errors have been addressed and appropriate action has been taken. There is good management oversight of medication systems. Individual placement plans are in place for the young people. These are in place from the time that they arrive. The manager has been working with the staff team on the development of these care plans to incorporate clear aims and outcomes for

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Requires improvement

the young people. This is beginning to be seen in practice. The documentation for young people who have been in placement for a length of time is informative and supports staff in relation to individual vulnerabilities and gives clear direction for staff. However, information relating to a new admission was not detailed and care planning did not reflect information found on the young person’s file from other professionals. This means staff are not clear enough on how to support fully a young person that has transitioned into the home.

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Requires improvement

Having complex needs does not prevent these young people from enjoying a range of activities, and staff seek out opportunities for young people to do things that they enjoy. Young people make good use of the opportunities on site, and were seen to be enjoying the outside play area in particular. Young people are encouraged to build positive peer relationships during these times. It is evident that young people have fun and develop as a result. Young people are encouraged and supported to develop everyday skills to help them into their adult lives. This is dependent on each young person’s starting points. This enables young people’s self-confidence and self-esteem to be developed further.

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Requires improvement

Young people’s demeanour indicates that they are happy, and that they feel safe and are well cared for. They are at ease with staff, they interact confidently and have fun. Staff have a good understanding of safeguarding procedures and appropriate actions to take in response to any incidents concerning the protection of the young people. Following an internal investigation, actions were taken including requiring all staff to complete additional training in whistle- blowing. Although processes have been discussed within team meetings, this training has yet to be completed within the timescales set by the management team.

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Requires improvement

Young people who live in the houses are not currently assessed as displaying high risk in the areas of self-harm or going missing. A number of young people display self-injurious behaviours due to their disabilities and sensory needs. Staff seek appropriate support and advice from external professionals. This has resulted in young people managing their anxieties and behaviours, causing the intensity and number of injuries to be reduced. Incidents of young people putting themselves at risk of harm, through behaviours such as going missing, are very infrequent. There has only been one incident where a young person went off-site unsupervised. Action was taken and information shared with the staff team. Managers are aware of risks in relation to child sexual exploitation and policies and procedures are available to staff to enable them to act and report on concerns.

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Requires improvement

Staff are vigilant in how they support young people and respond to gestures, expressions and behaviours. The staff fully understand and effectively manage the complex behaviours of the young people daily. The positive relationships formed enable the young people to begin to learn the importance of appropriate guidance and boundaries. Early intervention is encouraged, to understand how young people are feeling before situations escalate, but physical restraint is used in exceptional circumstances. These incidents are confined to a small group of young people. Prescribed PRN (when required) is used, in agreement with the necessary professionals, to manage mood and behaviour. However, documentation of when this has taken place is poor and does not detail all the necessary information. In addition, young people and staff are not consistently offered debriefs following an incident. The management team has recognised that this is an area they need to

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Requires improvement

improve. However, this has yet to be seen in practice. Trends and patterns following incidents are evaluated to enable any changes to practice to be identified. However, due to the lack of information, this may not be as effective as intended.

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Requires improvement

Staff have been using restorative ways of working with young people to increase a sense of personal responsibility. For example, staff explain to a young person why behaviours, such as hitting others, aren’t acceptable, and work with the young person involved to find alternative ways of managing a situation. Sanctions are not used and staff respond instead with appropriate boundaries about what is safe and acceptable. Because of young people’s disabilities, they generally choose not to have much interaction with each other and mainly interact with staff. Young people are encouraged to treat each other with respect through appropriate role-modelling and reinforcement of boundaries.

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Requires improvement

The home has made effective links with the designated officer and the safeguarding team in the local authority. However, during the inspection information was shared by the management team in relation to an allegation. This had not been formally referred on to the designated officer in the local authority for advice. In addition, another allegation, although it had been shared with the adult social worker, had not been communicated with the designated officer in the local authority. There was an assumption that other professionals had shared this information. However this had not taken place. The management team has not followed the safeguarding policy to ensure that young people are protected and the appropriate advice sought. They investigated these matters internally, but information and records were difficult to locate. During the inspection, it was difficult to gain information relating to safeguarding concerns, and outcomes of

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Requires improvement

investigations have not always been obtained or recorded. Recording systems in operation require improvement to enable effective oversight.

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Requires improvement

The management team reports that they discuss all admissions prior to placement to determine if they can meet young people’s needs, and there is liaison with professionals to anticipate known vulnerabilities when young people are new to the home. However, impact risk assessments are not completed. This does not enable a robust evaluation to determine if they are able to meet the young people’s needs and assess if they are able to keep all young people safe. In discussions with staff, they were not aware of behaviours that may be exhibited by a recent admission. It is not evident if particular vulnerabilities have been taken into account and shared when these decisions have been made.

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Requires improvement

The physical environment was observed to be safe. There is generally a sound level of health and safety awareness across the site. The home is appropriately secure, taking into account the needs of the young people. Routine testing of the equipment and detailed risk assessments are regularly undertaken to ensure that a safe environment is maintained. However, it was observed that sliding fire doors in two houses are being propped open to allow easy access. Although signs are displayed, these doors are not being kept shut. Staff should be reminded, or an alternative solution should be sought.

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Requires improvement

Since the last inspection, the manager has been successfully registered with Ofsted. The manager has been in post since March 2016 and has recently completed a level 5 qualification in leadership and management for residential childcare. She is enthusiastic and child-centred in her approach. It was evident that young people’s needs are prioritised. The management team has undergone a period of change in the last year and there have been a high number of care staff leaving and new staff joining the organisation. The managers have worked hard to build confidence within the staff team and are continuing to identify and develop practice and processes. They have introduced a new role of operations manager to support the registered manager in day-to-day tasks. The manager and staff team have begun to make progress in identifying and reflecting on the practice in the home and are positive about making further changes. The home is still on a

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Requires improvement

journey, and some areas that the manager has recognised as needing improvement have yet to be embedded in practice.

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Requires improvement

The managers have been actively recruiting to vacant positions and have been more creative in their approach. They are looking at how to retain staff and to ensure that staff are aware of the job role before they apply. Staff will cover shifts among themselves, or the home will at times use agency staff. Information relating to agency workers’ skills and qualifications are not documented on the agency profiles and it is not clear if they have been fully taken into account prior to offering shifts. In particular, training has not been explored to ensure that they can fully support the young people living in each of the houses.

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Requires improvement

Staff report that they are receiving regular supervision that provides the opportunity to reflect on their practice and gives them emotional support when required. Training opportunities are provided to staff to develop their skills in supporting the young people. However, there has been a gap in training being refreshed. This has resulted in training requirements, as outlined in the home’s statement of purpose, not being met. This relates to training in epilepsy and areas such as first aid and safeguarding. Some training has been booked but there is not a rolling plan in operation to ensure that staff are booked onto refresher courses before their training expires. The process of booking can take a number of weeks, as this needs to be agreed by senior managers in the organisation.

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Requires improvement

There are regular quality assurance monitoring visits from an independent visitor who reviews the conduct of the home. The manager reports that these visits provide challenge and are effective at identifying strengths and weaknesses. The manager undertakes internal monitoring, with a focus on young people achieving good outcomes. She is clear on the progress that young people have made and continues to develop the systems for evidencing this. However, the internal monitoring has not identified the issues raised in this inspection. There needs to be consideration if the manager’s review systems are to be effective in identifying weaknesses.

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Requires improvement

The team works with professionals within health services, education and social care departments. The manager has also developed links with the British Institute of Learning Disabilities to enable staff to gain advice on specific behaviours. This inter-agency working ensures that there is a universal approach in meeting the specific needs of young people. The children’s home has received some complaints since the last inspection. These complaints have been fully investigated and practice has changed as a result. The manager now contacts parents and social workers quarterly to enable more effective communication. She is extending this to schools as a result of feedback.

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Requires improvement

Significant events have not been notified to Ofsted as required. There have been child protection enquiries instigated and serious incidents that have not been shared. This does not enable transparency and sharing of information to ensure that appropriate actions have been taken. This was a requirement at the last inspection and has yet to be implemented in practice.

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Requires improvement

Records are not always accurate, as they have incomplete and imprecise information. For example, detail within body maps was very limited, information did not demonstrate who was contacted in some cases and dates in records were inconsistent.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against ‘Inspection of children’s homes: framework for inspection’.

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What the inspection judgements mean

An outstanding children’s home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children’s home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children’s home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children’s home is not yet delivering good protection, help and care for children and young people. A children’s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

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

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children’s home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the Children’s

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Information about this inspection

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

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Information about this inspection

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

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Information about this inspection

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

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Information about this inspection

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Information about this inspection

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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