Children's Home run by Total Care Matters Limited in North Northamptonshire

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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The children's home provision requires improvement because:

 The young person currently living in the home has experienced some inconsistency in her care due to the use of agency staff and staff from other homes within the company. This has been caused by staff leaving the home and the resulting vacancies. Although the remaining staff work hard to minimise the impact of this on the young person, it has made it difficult for her to make and sustain trusting relationships with those caring for her.  In order to assist the young person to successfully reintegrate into a full- time package of education, she requires increased structure in her day.  Some staff have not completed all of their mandatory training or training that would assist them to fully understand the complex needs of the young person currently living in the home.  Consent from the placing authority for the use of bedroom door alarms has not been obtained. Neither is this practice outlined in the home’s statement

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The children's home provision requires improvement because:

of purpose.  Incomplete recording of various documents, including physical intervention records, missing from care records and the home’s admissions and discharge register, impairs the manager’s ability to effectively monitor the day-to-day running of the home and the circumstances of each child or young person placed.  In order to improve responses to missing from care incidents, staff would benefit from ready access to individual missing from care protocols for every young person living in the home. While this has not had an impact on the young person living in the home currently, it has the potential to do so in the future as new staff start work or additional young people move into the home.

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The children's home strengths

 Despite the above shortfalls, the young person currently living in the home feels safe and she says that she is happy living in the home.  Incidents of challenging behaviour and the young person going missing have reduced.

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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

In order to meet the education standard the registered person must:

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Requirement Due date

(2)(a)(v) promote opportunities for each child to learn informally, with specific reference to providing structured educational activities during the school day in preparation for a return to structured school education. 09/01/2017

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard the registered person must:

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Requirement Due date

(2)(c) ensure that staff have the experience, qualifications and skills to meet the needs of each child. 09/01/2017

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard the registered person must:

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Requirement Due date

(2)(e) ensure that the home's workforce provides continuity of care to each child. 09/01/2017

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Requirement Due date

The registered person must compile in relation to the children's home a statement of purpose ('the statement of purpose') which covers the matters listed in schedule 1, with specific reference to including a full description of the home's approach to the monitoring and surveillance of children. (Regulation 16 (1)) 09/01/2017

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Requirement Due date

With particular reference to the use of bedroom door alarms, the registered person may only use devices for the monitoring or surveillance of children if the monitoring and surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned and the placing authority consents in writing to the 09/01/2017 monitoring or surveillance. (Regulation 24 (1)(a)(b)) The registered person must ensure that within 24 hours of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes a description of the measure, and 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, must have spoken to the user about the measure and signed the record to confirm it is accurate (Regulation 35 (a)(iv) and (b)(i)) 09/01/2017

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4, with particular reference to the admissions and discharge register including the child's address immediately before being accommodated in the home, their address on leaving the home and details of the child's placing authority (Regulation 37 (2)(a)) 09/01/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  The registered person should record the administration of controlled drugs in accordance with best practice. ('Guide to the children's homes regulations including the quality standards', page 35, paragraph 7.17)

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Recommendations

 The registered person must specify the procedures to be followed and the roles and responsibilities of staff when a child is missing from care or away from the home without permission and how staff should support the child on return home ('Guide to the children's homes regulations including the quality standards', page 45, paragraph 9.28)

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Recommendations

 Staff should be familiar with the home's policies on record keeping and understand the importance of careful, objective and clear recording, with particular reference to ensuring that all records include sufficient detail and are kept up to date. ('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 privately run children’s home provides care for up to three children and young people with emotional and/or behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement N/A No previous inspections

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Requires improvement

This is the home’s first inspection since it was registered on 8 June 2016. In July 2016, the current resident moved in. Following a detailed pre-placement assessment it was established that, in order to meet her specific and complex needs, no other admissions should be made. To date, this has remained the case.

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Requires improvement

The manager and staff have worked hard in partnership with the local authority to increase educational engagement and identify an appropriate school for the young person. In the intervening period, however, her days lack clear structure. Although the young person has established good early morning and bedtime routines, there is little evidence that she is engaged in constructive or structured activities in preparation for a staged return to education.

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Requires improvement

Staff encourage healthy lifestyle choices and ensure that the young person attends all core health appointments. Although there has been some delay, a referral to the child and adolescent mental health team (CAMHS) has now been made to help address the young person’s unmet emotional and psychological needs. Staff appropriately administer medication and it is safely stored. However, staff are not recording the administration of controlled drugs in accordance with best practice guidelines.

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Requires improvement

Bedroom door alarms, fitted to alert staff when young people leave their bedrooms at night, are in use. However, there is no risk assessment to establish whether this is proportionate and necessary to safeguard the current young person’s welfare. Neither is there evidence of written consent from the placing authority for the use of such alarms. Additionally, the home’s statement of purpose does not outline the fact that this monitoring approach is used.

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Requires improvement

Despite these shortfalls, the young person presents as happy. She reports having positive relationships with some staff and she says that she feels well cared for. Where other placements have broken down, this one has endured because of the commitment of the manager and her core staff team. The young person’s parent said, ‘My daughter appears to have settled where no other placement has succeeded.’ The young person’s social worker is of the view that this is the right placement for her and reports that she is making progress, particularly in relation to her previously very aggressive behaviour.

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Requires improvement

Some creative one-to-one work with the young person enables her to talk about her feelings as well as express them through art and poetry. Staff consult regularly with the young person about the day-to-day running of the home and they act upon her views. Staff are quick to praise her for any achievements. This helps her to feel valued and helps raise her self-esteem.

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Requires improvement

Staff maintain the home to a good standard. It provides a comfortable and homely environment. The young person’s bedroom is personalised and the communal areas of the home are decorated with art work and poetry created by her. This reminds the young person of her achievements.

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Requires improvement

Staff use physical interventions to prevent the young person from harming herself and others. Initially, incidents were high in numbers, but these have reduced month by month. When incidents do occur, or when sanctions are set, the recording of these needs to improve. Holds are not always accurately described. Some sanctions and one physical intervention were not recorded at all. Records are not always signed off by a manager, and debriefs with staff are sometimes absent. These recording shortfalls limit the manager’s ability to monitor and improve practice in this area.

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Requires improvement

Despite the above, the behaviours of the young person living in the home have improved. Behaviour management strategies such as praise and rewards have had a positive impact. Incidents of violent and aggressive behaviours have reduced and the young person is enjoying the rewards that she has worked hard to achieve.

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Requires improvement

The young person has a significant history of going missing from care. However, because of close supervision, incidents of her going missing have reduced. This is in spite of her individual missing from care protocol not being available or on file on the day of the inspection. By ensuring that staff have access to such documents at all times, risks in relation to going missing are likely to reduce further.

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Requires improvement

The young person says that she feels safe in this home and her risk management plans, which staff implement, help to keep her safe. The risk management plans are individualised and include details of how staff should help and protect the young person in all aspects of her day-to-day care as well as her specific vulnerabilities. For this young person, incidents of self-harm have continued. In addition to having the risk assessments to guide them, staff would benefit from additional training about different types of self-harm and how best to support the young person in relation to these. Judgement grade

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Requires improvement

The registered manager is suitably qualified and experienced. She is child-focused and prioritises the day-to-day needs of the young person living in the home. However, vacancies within the senior team have had an impact on her ability to give her full attention to managerial tasks. New appointments, very recently made, are likely to create capacity for her to delegate more and focus on her managerial role.

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Requires improvement

The regular use of agency staff and staff from other homes within the company, necessitated by staff leaving the home, has prevented the young person from receiving the level of consistent care which her complex needs demand. The young person is struggling to trust staff because some staff, with whom she had built relationships, have left. The manager is taking action to address this issue and is recruiting new staff. This is work in progress.

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Requires improvement

The staff team is relatively new and inexperienced. One member of staff holds the required qualification, while all others are either working towards it or are in their probationary period. Additionally, not all staff members have completed all of their mandatory training, such as fire safety and food hygiene, and not all staff have had the opportunity to participate in additional training specific to the needs of the current young person, such as attachment, trauma and self-harm. Improved opportunities and engagement in a wider range of training will help develop the skills, knowledge and understanding of staff members and ultimately help raise standards of care in the home.

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Requires improvement

Gaps in recording in case records make it difficult for the manager to monitor what is happening in the home on a day-to-day basis. For example, gaps identified in missing from care records, physical intervention records and risk assessments hinder managerial oversite of practice in the home.

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Requires improvement

Some records, required by the Children’s Homes Regulations 2015 do not hold all the required information. Specifically, the home’s admission book does not give the address of previous placements. Neither does it provide clarity about the local authority placing the young person. As a result, important information is not readily available to inform future decision making and planning.

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Requires improvement

Partnership working is well established. This helps to ensure consistency of care. A social worker described communication as ‘regular and prompt’ and a parent said, ‘The manager has been wonderful at keeping us updated and regularly consults with us.’

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Requires improvement

Data collected on a daily basis enables the manager to monitor patterns and trends in behaviours and this in turn informs the young person’s care plan. Monitoring and analysis systems are in the process of being developed further so that young people’s progress can be more effectively tracked and reported upon on a month- by-month basis. The manager is aware of the strengths and weaknesses in the home and she has an action plan to address shortfalls identified by herself and by the monthly external quality assurance visitor.

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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 looked after children 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

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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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