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

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 This service is good because young people make clear progress.  Staff establish good relationships with each young person.  Young people learn to feel secure and use this to try a wide range of new things. Previous risks cease to be a key part of their lives.  The level of risk to each young person falls. Consequently, young people increasingly lead lifestyles that are typical of others of their age.  There is effective integration of care, therapy, and education.  Staff establish meaningful relationships with young people’s families, which contributes to adults taking a consistent approach towards each young person.  Young people regularly attend school. Formal education becomes part of their lives, and they develop ambitions.  Young people gain in self-confidence and feel optimistic about the future.  Young people learn to expect decision-makers to hear their views and act on them.  There is insufficient leadership in several areas, including the evaluation of

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The children's home provision is good because:

patterns and trends, the monitoring of physical interventions, and the staffing arrangements. Improvements are already underway in several areas and the impact of these shortfalls on the young people is slight.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meet(s) 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

13: The leadership and management standard

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Requirement Due date

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

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Requirement Due date

(2)(a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes set out in the home’s statement of purpose. This is with regard to ensuring that staff maintain the property appropriately. 28/02/2017

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it. They must also notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16(3)(a)(b)) 28/02/2017

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Requirement Due date

The registered person must ensure that restraint in relation to a child is necessary and proportionate. (Regulation 20(2)(2)) 28/02/2017

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Requirement Due date

The registered person must ensure that, 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’), has spoken to the user about the measure. (Regulation 35(3)(b)(i)) 28/02/2017

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Requirement Due date

The registered person must ensure that the independent person produces a report about a visit (‘the independent person’s report’) which sets out, in particular, the independent person’s opinion as to whether (a) children are effectively safeguarded; and (b) the conduct of the home promotes children’s well-being. This is with regard to recording these conclusions clearly. (Regulation 44(4)) 28/02/2017

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Requirement Due date

The registered person must complete a quality of care review by establishing and maintaining a system for monitoring, reviewing and evaluating the quality of care provided for children. This is with regard to evaluating patterns and trends, such as those affecting staff. (Regulation 45(2)(a)) 28/02/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Detail in the workforce plan the necessary management and staffing structure (including any staff commissioned to provide health and education), the experience and qualifications of staff currently working within the staffing structure and any further training required for those staff, to enable the delivery of the home’s statement of purpose. The plan should be updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home's manager. ('Guide to the children's homes regulations including the quality standards', page 53, paragraph 10.8)

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Recommendations

 Review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home's location and strategies for managing these. Providers should refer to the non-statutory advice about the location assessment process, ‘Children's homes regulation amendments 2014: Advice for children's homes providers on new duties under regulations that came into effect in January and April 2014’. This is with regard to identifying social issues in the area, such as other children's homes, and coming to a clear conclusion about the ongoing suitability of the home's location. ('Guide to the children's homes regulations including the quality standards', page 64, paragraph 15.1)

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Information about this children's home

Ofsted has registered this home for two young people who have emotional and/or behavioural difficulties, or learning disabilities. A small, private care company operates the service. The home is located close to city amenities.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

17/02/2016 Interim Declined in effectiveness

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Recent inspection history

26/03/2015 Interim Improved effectiveness

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Good

Young people feel happy in their home and their outcomes are good. They recognise the positive effects. One young person told the inspector, ‘The staff listen to you and want to help you. Nothing could be better here.’ External professionals echo this sentiment. The social worker for one of the young people said, ‘It’s very good. I wouldn’t hesitate to use [the home] again.’

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Good

Young people usually arrive at the home at a time when they have highly complicated and well-established difficulties and they require very high staffing levels to keep them safe. Both the current young women are making progress. One said, ‘The therapy really helped me. I don’t make as many mistakes now.’ This sense of success and security has opened up mainstream opportunities to the young people and helped them to benefit from the therapeutic support. Greater self-confidence led one young person to sing in a choir recently. Her social worker noted her ‘massively improved’ communication with other people in the year since her admission. The other resident recently enjoyed a conversation with her member of parliament. This sort of achievement is indicative of their marked improvements in social, educational and recreational matters.

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Good

The organisation places great emphasis on meeting young people’s therapeutic needs. Staff understand individual young people’s behaviour well and liaise closely with their therapists. Staff use a range of resources to help young people to learn and apply new and constructive strategies. One young person has lived here for about three years and is particularly adept at describing her own progress. She now needs much less confirmation from staff that she is succeeding. This means that she can make everyday decisions about activities much more safely and effectively. She has a new-found pride in her appearance, for example her ability to match colours, and she enjoys coordinating her clothes.

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Good

Staff foster and sustain good relationships with young people’s families. This is a vital contribution to young people’s progress. Parents appreciate the communication and efforts of staff. Young people are aware of this and it helps them to feel more settled. Young people gradually increase the amount of time they spend with their families and feel more optimistic about the future.

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Good

Both young people are confident about their prospects. Their experiences in the home have given them hope for the future, whereas they were previously disillusioned. One made a stark comparison. She said, ‘[Before I came here] I was likely to go into a mental hospital and now I’m looking forward to my own flat.’ She has a realistic ambition to work with animals, and the other young person expects to return home. Staff work hard to develop young people’s independence skills. The staff adapt the programmes according to young people’s progress and setbacks. One young person now travels to school independently and happily cooks for large groups. The manager is considering ways to expand their opportunities further.

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Good

The company has its own school through which the young people are progressing. Staff ensure that young people attend school regularly. Young people miss very few lessons and successfully take examinations. They have learned to treat school and school events positively. They have recently enjoyed the Christmas celebrations and one young person is on the school council.

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Good

The young people enjoy being with staff. They plan and enjoy a wide range of social and recreational activities together, such as badminton, trampolining and ice- skating. Both young people enjoyed summer holidays earlier this year. One has just returned from a day shopping in York after saving her money for several weeks. The location of the house means that young people have easy access to city amenities.

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Good

An independent advocate meets the young people every six weeks. He provides each young person with an additional means of expressing concerns. Very few complaints arise. The advocate said that young people speak highly of the staff. Staff consult young people well and act on their views. Recently, they contributed to the new colour scheme in the house. One young person pointed out that, because of these choices, staff purchased a new, differently coloured suite for the lounge. Overall, the property is pleasantly decorated and comfortable. Each young person has their own lounge, which they have decorated for Christmas. However, pen marks on all the light-coloured dining chairs spoil the dining room. This is superficial, but the lack of prompt remedy gives young people a poor model to follow.

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Good

Staff pay particularly close attention to the safety of young people. Consequently, there are very few serious incidents and young people have very few harmful experiences here. They do not go missing, there is minimal contact with the police, and previous risks from child sexual exploitation and misuse of drugs have all but disappeared. As a result, young people feel safe. They have a secure platform on which to learn new ways of living, and their parents comment on their greater self- care. Staff understand each young person’s risks well. The manager is considering ways of tracking changes in risk levels more accurately, for use in care planning decisions. Staff apply a very close supervisory regime to young people, which is sometimes restrictive. For example, new young people may have three staff members with them at all times. This raises questions about whether or not staff are illegally depriving them of their liberty. The company is currently reviewing in detail the

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Good

restrictions that it places on young people to ensure that staff act within the law, have appropriate training and respect young people’s rights. External professionals consider that the ethos and practices are reasonable. The current young people have progressed to a point at which there are relatively few restrictions. Staff manage the violent and self-harming behaviours of young people with a range of strategies including physical intervention. The pattern of such incidents reflects young people’s positive progress in managing their feelings. There is a clear downward trend. Young people take pride in this progress. One said, ‘I don’t need [restraints] now. I needed them [before] because of my risks.’ Young people say that staff do not deliberately hurt them during these holds. However, staff and the manager do not adequately justify each physical intervention, and the records have other deficits. This means that accurate monitoring is not possible. Restraints

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Good

have occurred in sensitive locations, such as bedrooms, and staff occasionally hold young people on the floor or on their beds face down. This is potentially highly sensitive for young people. The records do not show that the discussions between the manager and staff occur within the required timescales or that the manager has sufficiently considered the regulatory issues. However, following recent inspections of the company’s other homes, during which inspectors identified similar shortfalls, the directors have acted to improve the procedures. They have reminded staff about the need to avoid restraining young people whenever possible. In addition, newly improved paperwork is ready to use, the manager has more time to review restraints and a new safeguarding manager will monitor such incidents.

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Good

The regular application of routine health and safety procedures keeps staff and young people safe. The home is located in a densely populated area, and the manager has completed a report about the ongoing suitability of its position. However, the conclusions are not clear, and there is no consideration of certain social issues, such as the location of other children’s homes.

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Requires improvement

Leadership and management require improvement to be good. The manager has worked for the company for many years. Ofsted registered him for this home in September 2016. He is on track to complete the required qualification within the statutory timescale. The company has recently removed managers from the rota. This means that the new manager has additional time in which to undertake administerial tasks and to develop his skills. Both he and the deputy manager work solely at this home. Parents and external professionals feel that there is excellent communication with them. The manager displays a clear focus on each young person’s needs, which he understands well. He ensures that young people’s records describe these needs thoroughly and show their progress.

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Requires improvement

The manager has addressed the issues arising from the previous inspection. This includes providing a telephone for young people. This means that young people who do not have their own phone can ring specified individuals without asking for staff’s permission. This reduces their isolation from their families and helps to defuse the tensions that naturally arise from time to time. The manager challenges other professionals when necessary. For example, one young person has not received a plan for her transition into adult services from her local authority. The manager has taken up this unsettling situation with personnel in her local authority.

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Requires improvement

The written statement about the purpose of the home is satisfactory. It describes the main purpose as being to provide crisis intervention. The manager has amended the document slightly and further work is underway. He is required to send an up-to-date version to Ofsted. Part of the current revision involves the directors reviewing the focus of the service. Ofsted registered the home for children and young people who have learning disabilities as well as those who have emotional and/or behavioural difficulties. The statement of purpose does not describe the needs of young people who have learning disabilities, and this is no longer relevant in practice.

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Requires improvement

The staff team displays a high degree of care for the young people and understands their needs. A core group of staff undertake most shifts in the home. Young people have good relationships with staff, and they and their social workers express no concerns about unfamiliar carers. One young person said, ‘I’ve known the main ones since I moved in [three years ago].’ Staff from within the company’s team of carers complete the additional shifts, as necessary. This system has the advantage of allowing centralised control over the use of staff and their training. It also has disadvantages, such as the dispersed responsibility for their formal supervision and lack of clarity about the core team. The directors have acknowledged this and recently introduced new procedures in which the manager plays a clearer role. It is too early to assess the impact of this change.

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Requires improvement

The new supervision procedure goes some way towards clarifying which staff are accountable to the manager. However, the workforce plan does not explain the structural arrangements sufficiently clearly. This makes it difficult to confirm that the rate of completion of training and qualifications is satisfactory. Based on the manager’s figure of 16 as the size of the core team, four staff, or 25%, remain in post since the last full inspection. The manager does not explain this substantial change in his monitoring report. This reduces the likelihood of his understanding or resolving the problem. Six staff members are qualified and the remainder are on track to complete the qualification within the required timescale. This, too, is a low ratio. New staff benefit from five days’ training before they work in the home, which gives them a thorough grounding. A new training officer oversees the training programme and ensures its timely implementation.

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Requires improvement

New independent individuals monitor the service, as does the manager. Both processes are in their developmental stages. For example, the independent visitors are insufficiently clear in their reports about whether the welfare and safeguarding of young people are satisfactory. The manager does not evaluate key trends, such as staffing issues, sufficiently well. These are relatively minor shortfalls by newly appointed personnel. The manager and directors have made various improvements to the service since the last inspection, as indicated above, and have others planned.

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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 the ‘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 0300 123 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

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

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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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