Children's home run by Aurora Care and Education Opco Limited

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.

p.2

because:

 This is the home’s first inspection under its new registration and ownership. Leaders and managers are implementing an extensive development plan. Changes made to improve the quality of care and experiences for children and young people have started and need time to come to fruition and embed.  Leaders and managers are working hard to implement change. However, this impacts on their ability to monitor all aspects of the quality of care effectively.  Staffing has not yet reached a consistently stable level. Managers rely on using temporary staff from an agency and staff working overtime to ensure that there are sufficient staff to meet the needs of children and young people.  The arrangements for the recruitment of staff, staff induction, training and supervision require more rigour.  It is not yet evident that staff are showing the ability to help children and young people to progress and achieve their full potential.

p.3

because:

 Some children and young people have specialist beds that restrict them when they are in them. Records are not kept to determine the use of these beds. As a result, leaders and managers cannot effectively monitor their use.

p.3

The children’s home strengths

 Leaders and managers have a robust development plan to improve the home. They are working hard to make the necessary changes and improvements for children and young people.  Staff have warm and nurturing relationships with children and young people, which show care and empathy. There are a good range of alternative communication methods used to engage children and young children, to help them to express their views and make choices.  Children and young people have good access to a multi-disciplinary healthcare team to support their specialist needs. The team includes nurses, general practitioners, an occupational therapist and psychologists. 

p.3

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.

p.4

Requirement Due date

6: The quality and purpose of care standard In order to meet the quality and purpose of care standard, the registered person must (2) ensure that staff: (iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; (vi) help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult; (vii) provide to children living in the home the physical necessities they need in order to live there comfortably; (c) ensure that the premises used for the purposes of the home are designed and furnished so as to— (i) meet the needs of each child. In particular, they must ensure that care plans detail the needs of children and young people, that staff support them to make progress and that the quality of the environment in some of the houses improves to ensure that it meets the needs of children and

p.4

Requirement Due date

13: The leadership and management standard In order to meet the leadership and management standard, the registered person (1)(a) must ensure that they inspire and lead a culture that helps children to aspire to fulfil their potential. 2 The registered person must (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; 31/03/2017 (d) ensure that the home has sufficient staff to provide care to each child; (e) ensure that the home’s workforce provides continuity of care to each child; (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; (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. In particular, they must ensure that leaders’ and managers’

p.4

Requirement Due date

monitoring and oversight in the home focus on the quality of care and progress of children and young people, that the shortfalls in staffing improve and that the registered manager has the support and resources to carry out her role effectively.

p.5

Requirement Due date

23: Medicines Ensure that medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. (Regulation 23(2)(b)) 31/03/2017

p.5

Requirement Due date

25: Fire precautions Ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire. (Regulation 25(1)(d)) In particular, improve the recording of fire drills to include further details about the effectiveness of the drill and ensure that when children and young people move to different homes a fire practice is conducted at the earliest opportunity. 31/03/2017

p.5

Requirement Due date

32: Fitness of workers The registered person must ensure that any individual employed to work at the home has the appropriate experience, qualification and skills for the work that the individual is to perform; 31/03/2017 full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32(b)(d)) In particular, ensure that leaders and managers ensure that agency staff have the suitable skills and experience required to meet the needs of children and young people. Improve the rigour in recruitment processes, ensuring that it is clear that gaps in employment are always explored and references are verified.

p.5

Requirement Due date

33: Employment of staff (1) The registered person must ensure: (a) that each employee completes an appropriate induction; and undertakes appropriate continuing professional development; and (4) that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(a)(b)) This requirement refers to all staff, including agency staff. In addition, it refers to staff receiving the specialist training required to meet the needs of children and young people, such as autism and intimate care. 31/03/2017

p.6

Requirement Due date

35: Behaviour management policies and records 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: the name of the child; details of the child's behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (‘the user’), and of any other person present when the measure was used; and the effectiveness and any consequences of the use of the 31/03/2017 measure. (Regulation 35(3)(i)(ii)(iv)(v)(vii)) In particular, they must ensure that staff record the use of any restrictive equipment, such as specialist beds, which children and young people use.

p.6

Information about this children’s home

A private company owns this home, which was newly registered following the purchase from the previous provider. The home is registered for a total of 48 children and young people and can care for children and young people who have a learning and/or physical disability. The home operates as a residential special school. As some children live there all year, it is registered as a children’s home.

p.8

Recent inspection history

Inspection date Inspection type Inspection judgement N/A

p.8

Requires improvement

Leaders and managers cannot yet evidence that all children and young people are making progress. The care given to children was observed to be warm and nurturing. However, staff do not demonstrate enough purpose in helping children and young people to overcome challenges and to increase their independence. Placement plans that inform staff about the needs of children and young people require improvement. The plans do not provide sufficient detail about the full needs of children and young people and the care that they require from staff, even though staff review the plans regularly. Placement plans do not always correlate with information in behaviour support plans and health plans. As a result, information in records about children’s and young people’s needs is fragmented. The quality of the environment requires improvement. Leaders and managers recognise this and have a good plan in place to make the required improvements.

p.9

Requires improvement

They have made some progress in this area, renovating one of the houses to a good standard. However, the living accommodation for one young person in another house is unsuitable and requires urgent attention as it is failing to meet their needs. While there is a plan to rectify this, it has not been implemented swiftly enough. Staff are attentive to the needs of children and young people. They are caring and supportive in their manner. It is clear when staff know the children well that they have developed positive relationships with them. Children and young people choose different activities that they want to do. They use their local community regularly and enjoy what it has to offer them. There has been good progress in encouraging children and young people to make choices and express their views about certain aspects of their care and experiences. Staff listen to their views about activities, the food, the decor and how

p.9

Requires improvement

they wish to be cared for. Leaders and managers implement a 24-hour nursing provision to meet the health needs of children and young people. There is good access to healthcare services, and specialist clinics and regular general practitioner clinics are held at the home. Staff support children and young people to attend hospital appointments. Judgement grade

p.9

Requires improvement

Leaders’ and managers’ monitoring requires improvement to ensure that they identify all weaknesses in the quality of care that could put children and young people at risk. Some feedback from professionals and parents indicates some concerns about the care of children and young people in relation to sufficient staffing levels and experience and the healthcare provided. Leaders and managers have acted on these concerns effectively. Investigations into complaints are conducted and areas of learning identified. Medication errors, which include errors in administering medication as well as clerical errors, occur in the home. Leaders and managers identify this as a key area for improvement. As a result, medication audit processes have increased so that medication is checked regularly throughout the day and a full monthly audit is undertaken by the nursing team. A consultant pharmacist is supporting leaders and

p.10

Requires improvement

managers to review the medication policy and practices. Each house has appropriate medication storage facilities. Leaders and managers are transparent when an error occurs. They seek advice from external health professionals and notify the parents and professionals, including the designated officer in the local authority. Health practitioners have assessed children’s and young people’s needs, resulting in some children and young people having specialist beds. When children and young people use these beds, they are restricted in them and unable to leave the bed without assistance. Care plans do not provide staff with information and instruction about how to use these beds safely, thereby ensuring the welfare of the child. Staff do not keep records detailing when children and young people are restricted in the beds. As a result, leaders and managers are unable to monitor the use of this restrictive equipment or assess the impact to the child.

p.10

Requires improvement

Staff have an understanding of the child protection policy and report any concerns about the welfare of children and young people to leaders and managers. Leaders and managers deal with child protection concerns effectively, ensuring that children and young people are safe. They report concerns to the appropriate external professionals. The system for recording child protection concerns and complaints needs further attention in order to differentiate between the two. The outcomes of investigations, child protection referrals and complaints are not always explicit in the records. All children have a behaviour support plan and risk assessment, which are individual to them. Information in these documents does not always thread through to the placement plan. Staff offer support to children and young people, when they become anxious, and identify clear strategies for each young person. Staff restrain some children and young people. Staff are aware of leaders’ and managers’ aim to

p.10

Requires improvement

reduce restraint. There is some progress towards meeting this aim, as restraint is reducing over time.

p.11

Inadequate

There are significant weaknesses in the leaders’ and managers’ ability to monitor the quality of care, due to the complexities of the changes that they are attempting to reinforce and embed in the home. The responsible persons recruited the registered manager because of the credentials that she has built up in her previous roles as a registered manager and social care practitioner. The registered manager is suitably qualified for the role. There is a high number of complaints that the registered manager is investigating and responding to. This volume of work impacts on her capacity to reinforce the changes being made and monitor the care that children and young people receive effectively. The complaints procedure requires more rigour to enable managers to deal with complaints more efficiently. Leaders and managers are not using the advocate to ensure that the views of children and young people are considered in

p.11

Inadequate

complaints made on their behalf. Leaders’ and managers’ oversight into the progress that children and young people make in the home is weak. Some children and young people are not given enough opportunities to progress, as leaders and managers are not scrutinising or reviewing the daily care routines that the staff provide to children and young people. Staff offer the familiar structures and care, which meet the children’s needs, but they are failing to purposefully support children and young people to move on and to achieve their full potential. There has been a large turnover of staff, as leaders and managers make changes to the ethos and culture in the home. Leaders and managers have not yet achieved their aim to recruit the full complement of staff. As a result, vacancies are covered by staff from an external agency, and permanent staff work overtime. This arrangement negatively affects the consistency of care that some children and

p.11

Inadequate

young people receive. The recruitment processes require improvement. Leaders and managers are not obtaining enough information about the skills and experience of agency staff before the agency staff start caring for children and young people on a one-to-one basis. In addition, when references received from previous employers provide limited information, there is no process to seek further information about staff members’ previous employment and suitability to care for children and young people. Leaders and managers identify that the supervision of staff is not yet regular and of good quality. There are gaps in some staff members’ induction. Leaders and managers have a training programme in place for staff to complete, which includes safeguarding children and first aid. The nursing team also provides personalised training for staff who care for children and young people who have particular complex health conditions. Currently, specialist training in autism and intimate care

p.11

Inadequate

is not included in the training programme. However, these are essential skills that staff require. Fire drill records are not sufficiently detailed for leaders and managers to monitor the effectiveness of the drill. The record does not confirm which staff and children were involved in the drill or practice, nor does it include the time taken to evacuate or any concerns or review required of personal emergency evacuation plans. Children in one of the houses have not undertaken a fire drill or practice since moving into the home. Leaders and managers have a clear focus on what they want to achieve and recognise that they are still working on making improvements. Since this company took over, there has been a significant amount of change that is improving the quality of care and experiences that children and young people have in the home. The development plan is extensive and progress is being made. Leaders and

p.12

Inadequate

managers require more time to make the changes and to embed the new ethos and systems.

p.12

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.13

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

p.13

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.13

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

p.14

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.14

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.15

Information about this inspection

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

p.15

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.15

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.15