Children's Home run by Individual Specialist Care Limited in Sandwell

inspection

Ofsted judged the home inadequate in September 2016. Inspectors identified significant shortfalls in the management and referral of allegations of abuse. These placed young people at risk of serious harm. In addition, Ofsted issued a compliance notice relating to failures to recruit staff using recruitment procedures designed to promote young people’s safety, specifically the assessment of risk. This notice was subject to a monitoring visit on 19 October 2016 and deemed met.

p.2

Inadequate

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

p.2

The children’s home provision is inadequate because:

 The registered person has failed to address a number of requirements raised at the last inspection. This questions the capacity of the managers to implement necessary and required improvements to promote young people’s welfare and safety.  The use of physical restraint to manage young people’s behaviour is not proportionate or necessary. Measures of control used in the home are not authorised and staff do not record accurately the use of these physical restraints.  Managers do not consistently refer allegations of abuse or harm to other agencies as required. This places young people at serious risk of harm.  Managers do not consistently seek or scrutinise employment references for agency staff. This means that they are unable to assess fully the suitability of these staff to work with young people.  Staff do not provide young people with stimulating activities or encourage them to pursue their hobbies and interests. This shortfall curtails young

p.3

The children’s home provision is inadequate because:

people’s social development.  Staff do not have the necessary skills or experience to meet young people’s needs. They do not receive regular practice-related formal supervision to monitor and review their practice.  Monitoring systems fail to identify the service’s shortfalls.

p.3

The children’s home strengths

 Young people’s health needs improve as a result of the staff team’s effective partnership working with external health services, such as the mental health team and primary care services.  Staff promote young people’s learning through productive partnership working with specialist learning services.

p.3

Statutory Requirements

This section sets out the actions which must be taken so that the registered person(s) meets the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children's homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

p.4

Requirement Due date

7. The children’s views, wishes and feelings standard In order to meet the children’s views, wishes and feelings standard the registered person must ensure that staff: (2)(a)(iv) regularly consult children, and seek their feedback, about the quality of the home’s care. 31/03/2017

p.4

Requirement Due date

9. The enjoyment and achievement standard In order to meet the enjoyment and achievement standard the registered person must ensure that staff help each child to: (2)(a)(i) develop the child’s interests and hobbies; (ii) participate in activities that the child enjoys and which meet and expand the child’s interests and preferences. 31/03/2017

p.4

Requirement Due date

13. The leadership and management standard In order to meet the leadership and management standard the registered person enables, inspires and leads a culture in relation to the children’s home that: (1)(a) helps children aspire to fulfil their potential; and (b) promotes their welfare. 31/03/2017

p.4

Requirement Due date

13. The leadership and management standard In order to meet the leadership and management standard the registered person must: (2)(b) ensure that staff work as a team where appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; and (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 31/03/2017

p.4

Requirement Due date

Restraint in relation to a child must be necessary and 31/03/2017 proportionate. (Regulation 20 (2))

p.4

Requirement Due date

The registered person may only employ an individual to work at the children’s home if the individual satisfies the requirements in paragraph (3).The requirements are that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (2)(a)(3)(d)) 31/03/2017

p.5

Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development and receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(a)(b)) 31/03/2017

p.5

Requirement Due date

The registered person must implement a policy which sets out the procedure to be followed in the event of an allegation of abuse or neglect. (Regulation 34 (1)(b)) 31/03/2017

p.5

Requirement Due date

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 which includes all required information. (Regulation 35 (3)(i–viii) 31/03/2017

p.5

Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is an allegation of abuse against the home or a person working there. (Regulation 40 (4)(c)) 31/03/2017

p.5

Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating: the quality of care provided for children; the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. (Regulation 45 (2)(a)(b)(c)) 31/03/2017

p.5

Information about this children’s home

The home provides care and accommodation for up to three children and young people who have learning disabilities. A private provider owns and operates the home.

p.6

Recent inspection history

Inspection date Inspection type Inspection judgement 21/09/2016 Full Inadequate 24/02/2016 Interim Sustained effectiveness 16/06/2015 Full Good 03/02/2015 Full Adequate

p.6

Inadequate

Ofsted last inspected the home in September 2016 and judged the service inadequate. Inspectors identified significant shortfalls at that time in providing for and promoting young people’s welfare and safety, and in relation to the leadership and management of the home.

p.7

Inadequate

Since September 2016, the registered person has failed to take sufficient action to remedy the identified shortfalls. As a result, Ofsted has again judged the home inadequate. This is because continuing failures to protect young people from harm and to provide effective leadership and management means that young people’s overall experience of the service is poor. As a result, Ofsted has issued a notice restricting accommodation under section 22B of the Care Standards Act 2000.

p.7

Inadequate

Staff practice remains inconsistent and there is a lack of teamwork. For example, young people say that staff often disregard support plans designed to provide them with clear and unambiguous boundaries. One young person said, ‘When some staff are on shift I can do things that I can’t do when other staff are on shift. It changes all the time so I don’t really know what I can do.’ Furthermore, staff still do not record one-to-one sessions with young people. Staff do not seek young people’s views about the quality of care or pursue their opinions on their plans for the future. One young person said, ‘I don’t know where I’m going to go and no one has asked me what I really want.’ More positively, care planning processes have improved since the last inspection. Internal support plans are up to date and include reference to statutory documentation and information relating to young people’s individual needs. These records are available on young people’s case files.

p.7

Inadequate

Staff do not encourage or support young people to develop their hobbies or interests. Activity plans are weak, lack structure and do not reflect young people’s preferences or requested leisure pursuits, such as swimming. Staff are unaware of available community activities or specialist local resources that may support young people to learn new social or practical skills. Young people say that their weekly activities often consist of ‘going for a drive’ or ‘doing the shopping’. This means that young people do not benefit from necessary social stimulation to help them to develop their interaction skills.

p.7

Inadequate

Staff liaise effectively with specialist learning services to provide young people with suitable education placements. They provide young people with practical support, such as transporting young people to college and to enable young people to participate in lessons. Staff address young people’s health needs through partnership working with external health services, such as the mental health team and primary care services. This collaborative partnership helps to ensure that young people receive the emotional support that they need.

p.7

Inadequate

The registered manager has taken sufficient action to improve the internal environment of the home. Bedrooms, communal rooms and corridor areas now benefit from having been decorated and new fixtures and fittings installed. This greatly enhances the aesthetics of the home and provides young people with a comfortable home.

p.8

Inadequate

Young people remain at risk of significant harm. This is because the registered manager has failed to take appropriate action to make sure that the use of physical restraint is always proportionate and necessary.

p.8

Inadequate

At the last inspection, staff used ‘weighted blankets’, which some young people use as comforters, as a method of restraint. Staff had deployed this technique without suitable risk assessment, agreed protocol or any discussions with or agreement from placement authorities. This unacceptable practice has ceased since the last inspection. However, the staff describe replacing this form of intervention with the use of ‘physical pressure’. For one young person, this means that during physical restraints staff ask the young person if they require ‘pressure’. Staff told the inspector that this technique was to satisfy the young person’s need for sensory stimulation, a need often associated as a feature of autism. The use of this form of restraint is unacceptable without consultation with, or assessment by, occupational therapists and other health professionals. The registered manager has failed to follow this process. She has not discussed the use of this measure of control with

p.8

Inadequate

the placing authority or provided staff with training in this technique. These shortfalls place young people at risk of significant harm.

p.8

Inadequate

Staff do not adhere consistently to physical restraint procedures or record these events appropriately. Records relating to the use of physical restraint and the issuing of sanctions remain of poor quality. Staff and supervising managers have failed to make sure that these documents include all necessary information. These failures compromise young people’s safety. This is because the registered manager is unable to evaluate these records to identify any pattern or trends, to review staff practice or to make sure that the measure of control used is necessary and proportionate. In addition, a number of physical restraint and sanction records are missing from the home. The registered manager told the inspector that she did not know where these records were. At the last inspection, managers and staff had failed to implement safeguarding policies designed to respond to allegations of abuse or harm. One young person

p.8

Inadequate

was subject to a specific protocol, as agreed with the designated officer for the local authority, to respond to the increasing frequency of allegations. Managers failed, as required, to implement that protocol or make sure that staff recorded all allegations. The registered manager has not remedied this failure and shortfalls remain. Since the last inspection, one young person has made six allegations of abuse. The registered manager has referred only two of these to the designated officer for the local authority. On these occasions, initial ‘fact finding’ investigations were instigated, although records of these investigations are incomplete and do not include the full scope of the investigation. Furthermore, the registered manager has not sent notifications of all of these allegations to Ofsted. These continued failures to protect young people or promote their welfare and safety means that they are at risk of harm.

p.9

Inadequate

Since the last inspection, the registered manager has completed risk assessments relating to the employment of staff with declared criminal convictions or cautions. She has made sure that relevant employment references are available for all permanent staff. However, the registered manager does not seek necessary or appropriate previous employment references for agency staff. For example, of the four agency staff employed on a regular basis since the last inspection, none of these agency staff files include two detailed references as required. This means it is not possible for the registered manager to verify that suitable staff support young people.

p.9

Inadequate

There have been no further incidents of bullying since the last inspection. Staff completed training in this area and staff are now aware of the signs of bullying and intimidation. The registered manager has implemented a ‘bullying log’ to track all incidents and to record how staff challenge this behaviour.

p.9

Inadequate

The acting manager registered with Ofsted in December 2016. She holds suitable qualifications for this role, including a level 4 diploma in the management of children’s residential care.

p.9

Inadequate

Ofsted raised 16 requirements at the last full inspection in September 2016. The registered manager has sufficiently addressed 10 of these requirements. For example, young people have free movement around the home and the registered manager has removed restrictive ‘electronic access fobs’. Complaints monitoring records are in place and staff now monitor and take action on health and safety concerns in a timely manner. Furthermore, all eligible staff have now completed required qualifications for their role or are working towards this qualification. However, a further six requirements remain outstanding. This questions the home’s capacity to improve and to provide good-quality care and support for young people.

p.9

Inadequate

The registered manager has introduced a case file monitoring tool. The purpose of this document is to assess internal documents and records to highlight any patterns or trends. This system is ineffectual in highlighting service shortfalls or prescribing actions required to address these. For example, the registered manager has failed to monitor physical restraint records to make sure that staff record all necessary information. As a result, poor practice in the home continues to have an adverse impact on young people’s overall experience and safety. Furthermore, the review of the quality of care provided by the home is insufficient and does not accurately reflect the service. For example, the recent review report does not refer to the failures of the service, does not identify any patterns or trends and does not include the views of young people or other agencies. These shortfalls hinder the home’s capacity to develop.

p.10

Inadequate

The majority of staff have not received formal supervision since the last inspection. Team meetings are infrequent and fail to address practice issues or provide staff with the necessary support to meet young people’s needs. Training programmes are basic and do not reflect young people’s needs or known risks, such as self- harm. In addition, staff have not refreshed their mandatory training in first aid, safeguarding and fire safety. Consequently, staff lack the necessary skills and experience to support young people’s development. Staff say that they do not feel supported in their role and some staff report feeling bullied. They say that they are anxious about their continuing employment and that they believe this anxiety impacts on young people and their behaviour. Staff report a lack of cohesion and unity in the team and with senior managers in the company. This means that the registered manager does not lead a culture in the home that supports young

p.10

Inadequate

people to aspire to fulfil their potential or one that continually promotes their welfare.

p.10

What the inspection judgements mean

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

p.11

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

p.11

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.

p.11

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 who it is trying to help, protect and look after. This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the Children’s

p.12

Information about this inspection

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

p.12

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,

p.13

Information about this inspection

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

p.13

Information about this inspection

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

p.13

Information about this inspection

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

p.13