Children's home in Tewkesbury

Inadequate

There are serious and widespread failures that mean children and young people are not protected, their welfare is not promoted or safeguarded and their care and experiences are poor.

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The children's home provision is inadequate because:

 Managers and staff fail to keep the young person safe or promote his welfare.  Leadership and management oversight is poor.  Managers have not resolved concerns relating to fire safety.  The young person does not get the support that he needs to achieve his educational potential.  Staff do not always give the young person clear boundaries.  Staff are not always clear about when physical restraint can be used.  Some complaints are poorly recorded.  Managers have failed to make sure that the home’s safeguarding policies contain all of the required information.  Some records are not up to date and others are poorly written.

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The children's home strengths

 The young person has made some progress from when he first arrived at the home. For example, he is more confident. He has also developed his independence skills. This is due to the support that he receives from staff.

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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 ensure that:

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Requirement Due date

(1) children make measurable progress towards achieving their educational potential and are helped to do so. 28/02/2017

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Requirement Due date

In order to meet the positive relationships standard, with particular reference to behaviour, the registered person must ensure that:

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Requirement Due date

(1)(b) children are helped to develop, and to benefit from, relationships based on an understanding about acceptable behaviour; and

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Requirement Due date

(2)(a)(v) staff communicate to each child expectations about the child's behaviour and ensure that the child understands those expectations in accordance with the child's age and understanding. 28/02/2017

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Requirement Due date

In order to meet the protection of children standard, with particular reference to safeguarding, the registered person must ensure that:

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Requirement Due date

(2)(a)(i) staff assess whether each child is at risk of harm, taking into account information in the child's relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child;

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Requirement Due date

(iii) staff have the skills to identify and act upon signs that a child is at risk of harm; 28/02/2017 (v) staff understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

(vi) staff take effective action whenever there is a serious concern about a child's welfare; and

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Requirement Due date

(b) 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. 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

(1)(a) enable, inspire and lead a culture in relation to the children's home that helps children aspire to fulfil their potential;

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Requirement Due date

(b) enable, inspire and lead a culture in relation to the children's home that promotes children’s welfare; *

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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;

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Requirement Due date

(f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; and

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Requirement Due date

(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 28/02/2017

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Requirement Due date

The registered person must ensure that restraint in relation to a child is only permitted for the purpose of preventing injury to any person (including the child) or serious damage to the property of any person (including the child). (Regulation 20 (1)(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)) 28/02/2017

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Requirement Due date

The registered person must ensure that the requirements of the Regulatory Reform (Fire Safety) Order and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home. (Regulation 25 (2)(b)) 28/02/2017

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Requirement Due date

The registered person must prepare and implement a policy which 28/02/2017 is intended to safeguard children accommodated in the children's home from abuse or neglect. (Regulation 34 (1)(a)) The registered person must ensure that 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. (Regulation 35 (3)(a)) 28/02/2017

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which are kept up to date. (Regulation 36 (1)(b)) 28/02/2017

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (3)) 28/02/2017

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Requirement Due date

* This requirement is subject to a statutory requirement notice.

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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 case records are signed and dated by the author of each entry. ('Guide to the children's homes regulations including the quality standards', page 62, paragraph 14.3)

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Recommendations

 Ensure that staff understand the importance of careful, objective and clear recording. Information about the child must always be recorded in a way that will be helpful to the child. ('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

The service is operated by a private company and is registered to provide care and accommodation for up to two young people who have emotional and/or behavioural difficulties and learning disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement 07/09/2016 Full Inadequate 11/03/2016 Interim Sustained effectiveness 14/07/2015 Full Good

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Inadequate

Ofsted judged that the home was inadequate at the last inspection. Since the last inspection, there has been little progress to develop the service. Management oversight continues to be ineffective and significant shortfalls have not been resolved. These have directly affected the safety and well-being of the young person, the quality of the care that he receives and his experiences of living at the home.

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Inadequate

The young person’s school attendance has increased since living at the home. However, staff do not work in partnership with his teachers to monitor how often he refuses to attend certain lessons on his timetable by choosing instead to remain in the home. In addition, staff do not monitor the number of times that he is sent home from school or is excluded. This absence of oversight and management compromises the young person’s educational potential.

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Inadequate

Staff do not always make it clear to the young person what their expectations are about his behaviour. For example, when the young person displays aggressive or challenging behaviour, staff do not ensure that boundaries are consistently implemented. For instance, staff are sometimes inconsistent about how ‘free time’ is managed. Specifically, on one occasion, staff did not allow the young person to go and meet his ‘friends’ (due to potential risk). The young person chose to go anyway. Staff did not follow this up effectively. In addition, staff sometimes allow the young person to take his phone into school with him. This is against the wishes of school staff. Furthermore, staff do not give clear messages to the young person about his smoking habits. This includes the staff keeping some of the young person’s spare tobacco in the office for him in case he runs out. Staff are also unsure how to deal with parcels that arrive for the young person that contain

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Inadequate

tobacco. This does not encourage the young person to stop smoking. As a result of these shortfalls, the young person’s relationships with staff are not based on an understanding about what behaviour is acceptable. This lack of understanding detracts from the quality of these relationships and places the young person at risk.

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Inadequate

Despite these issues, the young person has made progress in some areas since moving to the home. He is more able to express his views appropriately. This is helping him to form meaningful relationships with staff. His social worker told the inspector that, ‘He responds to staff and has some relationships with them.’ He is also starting to undertake some basic household tasks. This includes vacuuming and cleaning up. Building up these life skills is helping him to prepare for adulthood. This is particularly significant given the young person’s starting point and has been made possible because of the support that staff provide. Staff help the young person to stay in touch with his family, who live a considerable distance away. They do this by arranging visits and ensuring that he travels there safely. This helps him to see the people who are most important to him.

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Inadequate

Managers and staff do not keep the young person safe. They do not always respond appropriately to serious incidents. For example, managers do not make sure that staff always follow the young person when he goes missing or leaves the home. In addition, managers have failed to assess the young person’s safety when he is away from the home. The staff have not done enough to enquire about the people who the young person is spending time with and to assess what risk these people may pose. This places the young person at risk of harm, including potential exploitation, and fails to promote his welfare.

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Inadequate

The young person has had access to dangerous and illegal items, which he stored in his bedroom. These include shotgun cartridges taken from a local farm and drug paraphernalia, the origins of which are unclear. Management oversight of these incidents has been poor. For example, action has not been taken in a timely way to remove these items or to challenge these concerns with the young person. As a result, managers have not adequately protected the young person, staff or visitors to the home.

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Inadequate

On several occasions, the young person has displayed unsafe behaviour while travelling in the car. This behaviour includes an incident when he attempted to get out of a moving car. The response by staff was ineffective. For example, they later drove again with the young person, despite him being unsettled. Subsequently, managers have not made suitable arrangements to reduce these concerns. Consequently, staff are placing the young person at continued significant risk of harming himself. The driver of the vehicle, and other road users, are also placed in danger should the young person try to get out of the car while it is moving, or should his behaviour cause the car to change speed/direction unexpectedly.

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Inadequate

Managers have not made sure that staff have the knowledge and skills that they require to meet the young person’s needs. Training is insufficient, especially in safeguarding and e-safety. As a result, staff are not identifying when the young person may be at risk of harm, particularly when he is using his mobile phone to communicate with potentially unsafe people. Safeguards designed to minimise concerns are not always followed because staff do not always understand their safeguarding responsibilities. For example, staff do not always check the young person’s mobile phone as required by his risk assessments.

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Inadequate

Staff and managers do not always make sure that the home’s day-to-day care practice gives the young person the protection that he needs. Confidential files and other sensitive items have been left accessible to the young person. On one occasion, this resulted in the young person having access to individual staff supervision notes. On another occasion, he was able to photograph a bank card belonging to a member of staff. Other incidents involve him gaining access to the office. Since then, managers have made some improvements to make their office more secure. However, these improvements were not completed swiftly enough. In addition, staff do not regularly record important health and safety checks. For example, checks of window restrictors are not always evident. Consequently, it is impossible to know whether staff have carried these checks out. On one occasion, the young person was able to leave the home during the night after breaking a

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Inadequate

window restrictor. He suffered significant injuries during the incident that followed.

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Inadequate

Staff do not always understand the acceptable parameters governing the use of physical restraint. On one occasion, a senior member of staff discussed using restraint to remove the young person’s mobile phone. Records relating to this lack clarity. Although there is no evidence that this restraint did take place, there was the potential that it could. As a result, there is a risk that staff could use restraint in a way that is neither necessary nor proportionate. Furthermore, on one occasion, staff did not appropriately record a physical restraint. This reduces the oversight that managers have. It also reduces the support offered to the staff involved and the young person.

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Inadequate

Management oversight and leadership continues to be poor. Because of this, staff and managers are still providing an inadequate service to the young person who they support. Managers do not consistently enable, inspire or lead in a way that helps the young person to fulfil his potential. They do not always prioritise his safety or promote his welfare.

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Inadequate

The registered manager has been in post since November 2014. He is suitably experienced and qualified. However, he has been away from the home for significant periods this year. Senior managers did not make sure that adequate interim arrangements were in place during this absence. This has reduced day-to- day oversight and the quality of care that the young person receives.

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Inadequate

Monitoring and review systems are not always effective and do not help managers to understand the impact that the quality of care provided at the home is having on the young person’s progress and experience. In addition, managers have failed to resolve some of the regulatory shortfalls identified at the previous inspection. These include shortfalls relating to safeguarding and fire safety.

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Inadequate

Following the previous inspection, managers commissioned an independent fire safety assessment to help them tackle the shortfalls in this area. This assessment set out a number of recommendations. The response from managers was slow. They tackled some of the shortfalls. However, there was a significant delay. They did not meet other recommendations. These include aspects of training for staff and the position of some fire extinguishers. This lack of management response to correct shortfalls, both within a reasonable timeframe and make sure that they have all been completed, has the potential to put the young person, staff and visitors at risk from fire.

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Inadequate

On one occasion, the record of a complaint was poor. Specifically, senior managers did not thoroughly record the action taken in response to the young person’s concerns or the outcome of the investigation. These deficits hinder the oversight that managers have and limit the learning that can be achieved.

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Inadequate

Managers have not made sure that the home’s safeguarding polices are kept up to date or contain key details. This failure specifically relates to how staff use photographs. On one occasion, staff took photographs of the young person’s injuries after a significant incident. Staff did not assess the appropriateness of this or make sure that other safeguards were in place. For example, they did not seek the views of other professionals, managers or the young person.

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Inadequate

The quality of some records is variable. For example, staff do not ensure that the young person’s profile in the ‘missing persons and absent without authority log’ is kept up to date. Other records are missing the author’s signature and date to validate the entry. These include a record of an investigation into a complaint. These shortfalls reduce the quality of the records available to managers and their ability to be held accountable for practice. They also affect how helpful the records will be to young people who may wish to view them in the future.

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Inadequate

Records show that managers supervise staff regularly and discuss some key issues. Staff talk positively about these sessions , which allow them time to reflect on their practice . Some staff have achieved the level 3 diploma in residential childcare or a suitable equivalent. Others are working towards this. Managers have plans in place to make sure that all staff complete this within the required timescales. This helps staff to feel supported.

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Inadequate

Managers and staff are developing good relationships with some newly involved professionals, for example, the youth offending service and a newly allocated social worker. This joint working is helping the staff and the manager to begin to share key information that is enabling the young person’s needs to be better identified.

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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 that 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, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children 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: http://eepurl.com/iTrDn .

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Information about this inspection

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

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