Children's home run by Andover And District Mencap in Test Valley

Inadequate

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

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The children’s home’s provision is inadequate because:

 Poor leadership and management oversight of the service have failed to make sufficient progress in response to the repeated requirement to address fire safety shortfalls.  Staff have not received all of the necessary training they need to meet the children’s needs and to keep them safe.  Managers have not worked in partnership with external safeguarding agencies, and neither have they notified Ofsted of significant events.  The staff’s safeguarding guidance does not sufficiently steer them on the actions that they must take to protect the children.  Managers’ weak monitoring systems fail to identify weaknesses in staff practice. As a consequence, examples of poor practice do not improve.

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The children’s home’s strengths

 Children enjoy a variety of activities and they are encouraged to complete independent tasks which develop their skills.  The registered manager and staff communicate well with schools and children’s parents to obtain information to inform care planning and reviews.  For children with complex medical needs, the staff work closely with the community nurse to ensure that they have received the appropriate training and guidance.  Care plans have been redesigned to ensure that they are personalised and detailed, informing the staff on how to care for the children in the way the children prefer.

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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 positive relationship standard, the registered person must ensure that staff: (2)(a)(i) meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans; (iii) encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding; (v) 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. 16/04/2017

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Requirement Due date

In order to meet the protection of children standard, the registered person must ensure that staff: (2)(a)(i) 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; (iii) have the skills to identify and act upon signs that a child is at risk of harm; (vii) are familiar with, and act in accordance with, the home’s child protection policies; (e) that the effectiveness of the home’s child protection policies is monitored regularly. 16/04/2017

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Requirement Due date

*13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, the registered person must: (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; (c) ensure that staff have the experience, qualifications and 31/03/2017 skills to meet the needs of 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. The registered person must 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 (1)(b)) 16/04/2017

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Requirement Due date

*After consultation with the fire and rescue authority, the registered person must take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home. (Regulation 25 (1)(a)) 31/03/2017

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Requirement Due date

A responsible individual must have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated. (Regulation 27 (7)(b)) 16/04/2017

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Requirement Due date

For the purposes of paragraph (3)(b), an individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained the level 3 diploma for residential childcare (England) (‘the level 3 diploma’); or a qualification which the registered person considers to be equivalent to the level 3 diploma. (Regulation 32 (4)(a)(b)) 16/04/2017

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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: (ii) details of the child’s behaviour leading to the use of the measure; (v) details of any methods used or steps taken to avoid the need to use the measure; (vii) the effectiveness and any consequences of the use of the measure. (Regulation 35 (3)(a)(ii)(v)(vii)) 16/04/2017

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if: (c) there is an allegation of abuse against the home or a person working there; (e) there is any other incident relating to a child which the 16/04/2017 registered person considers to be serious. (Regulation 40 (4)(c)(e)) The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once every six months. In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating: (a) the quality of care provided for children; (b) the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and (c) any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

(Regulation 45 (1)(2)(a)(b)(c)) 16/04/2017

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Requirement Due date

* These requirements are subject to 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:  When considering new placements, the registered manager should fully consider the impact that the placement will have on children and young people. In particular, the registered manager should evidence their judgement of compatibility between the young people. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.4)

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Recommendations

 The registered person must ensure that there is a workforce plan in place which contains the information required by guidance. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.8)

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Recommendations

 The registered persons must ensure that there are clear arrangements in place to maintain effective management when the manager is absent, off duty or on leave. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.20)

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Recommendations

 The registered persons must ensure that supervision and performance management of staff safeguards children and minimises potential risks to them. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1)

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Recommendations

 The registered persons must further develop and consolidate the assessment of the suitability of the location of the home (‘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

The home provides short-break residential care for a maximum of four children and young people with learning difficulties and/or associated physical disabilities. It is a four-bed unit owned and managed by a local branch of a charitable organisation. No children or young people were staying at the service at the time of this inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 13/07/2016 Interim Declined in effectiveness 17/12/2015 Interim Sustained effectiveness 23/07/2015 Full Good 11/03/2015 Interim Sustained effectiveness

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Inadequate

The failure of leaders and managers to respond to a repeated requirement about fire safety places the safety and well-being of the children at risk. Short breaks are being provided in premises with inadequate fire protection.

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Inadequate

An overall lapse in many areas of staff training and guidance compromises the safety and the quality of the care that some children receive. Examples include the inappropriate use of a behavioural sanction which the child did not understand. For another child, medication errors placed their safety and health at risk of harm.

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Inadequate

Despite improvements to the quality and content of children’s care plans, individual communication plans are weak. They do not provide sufficient information on how staff can best encourage and promote a child’s ability to communicate. For example, when they are happy, sad, uncomfortable or in pain. This shortfall undermines other positive aspects when staff routinely encourage children to give their views and opinions about activities, meal choices and the things they would like to do during their stays.

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Inadequate

A previous recommendation, to ensure that the staff evidence their decision- making on the compatibility of the children placed together, is incomplete. The current process does not demonstrate staff’s consideration of how the children’s risks or behaviours may have an adverse impact upon others. As a result, there are no strategies to reduce the likelihood of these behaviours or risks affecting the other children.

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Inadequate

Parents of the children using the service are very positive about their children’s stays. They say that their children look forward to coming here. Each parent spoken with felt that their child had a good relationship with staff members, who know them well.

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Inadequate

Children do benefit from a number of aspects of the service. They have fun, develop skills and interact socially. The children access a wide range of activities both on- and off-site. They have the opportunity to go out to places such as the shop, a beach and a farm. Children have enjoyed wider and enriching social experiences. Staff work closely with parents and the children’s educational establishments to identify common goals so that everyone can support the children to achieve. This consistent approach helps children to develop new skills and to regulate their emotions better. Children with complex medical needs receive competent care and support. The community nurse provides necessary specialist training and practice oversight. Judgement grade

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Inadequate

Leaders and managers have neglected their responsibility to keep the children, staff and visitors safe from the risks of fire. A previously repeated requirement, with regard to consulting the fire service and the provision of fire doors, remains unmet. Three fire doors have been installed, but the majority of the children’s bedrooms, the staff sleep-in room and the lounge are still without adequate protection. A review of staff’s training profiles fails to demonstrate that staff have undertaken training in fire safety. In the event of a fire, everyone in the property is at risk of significant harm.

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Inadequate

Insufficient safeguarding policies, combined with a lack of safeguarding training for staff, fails to provide suitable protection for the children. Children’s risk assessments do not contain all of the relevant information; nor do they provide guidance on all of the necessary preventative strategies to keep them safe. Policies and guidance do not refer to significant risk factors, such as child sexual exploitation, radicalisation, online safety or self-harm. Neither is there guidance on providing personal care to children safely. Consequently, staff are not provided with the knowledge or skills they need to identify risks or to devise plans and take appropriate safeguarding action.

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Inadequate

Children’s risk assessments do not mention significant risk factors, such as child sexual exploitation or online safety. Children do use the internet. However, staff are not informed about how a child may be at risk when using it or how preventative strategies should be implemented to keep the child safe. The registered manager has consulted a variety of external sources to inform the service’s location risk assessment. However, the assessment does not consider all risk factors associated with the location of the home and immediate neighbourhood, nor does it provide detailed strategies to reduce the risks the location may pose.

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Inadequate

Safeguarding procedures are not being followed. Managers have investigated allegations against staff prior to notifying the local authority designated officer (LADO). In one case, there was a delay of five days before the manager notified the LADO. This failure hinders the relevant authorities’ responses, such as those of the LADO or the police, therefore compromising any investigation and its outcomes.

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Inadequate

Medication administration is not always safe. In one example, staff have been administering a higher dose of a child’s medication than prescribed. Staff have not obtained evidence of the prescription being changed by the child’s doctor, nor have they advised the child’s social worker.

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Inadequate

The use of sanctions and physical interventions by staff is rare because de- escalation techniques are frequently successful. However, the two incidents which have occurred, one resulting in a sanction, the other in a physical restraint, demonstrate practice shortfalls. The sanction was not restorative in nature and was implemented for a child who does not have the capacity to understand its purpose. The record of the physical restraint lacks sufficient detail about the events leading up to it, and does not say that staff followed the prescribed strategies to try to de- escalate the situation and avoid its use. This lack of detail compromises the manager’s ability to evaluate the staff’s practice, to ensure that the correct strategies were used and that physical intervention was implemented only as a last resort.

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Inadequate

Serious managerial failures in the oversight of this service have led to significant failings. Safeguarding issues, fire risks and poor care practice examples have not been identified or addressed. The inaction of leaders raises concerns about their knowledge and ability to fulfil their roles and responsibilities.

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Inadequate

A requirement to consult with the local fire department and to take steps to reduce the risks of fire has been repeated over three previous inspections. Safeguarding incidents have not been appropriately reported.

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Inadequate

Some incidents occurred during the registered manager’s absence. Staff do not have the necessary knowledge and understanding of policies, procedures and regulations to ensure that routine systems function smoothly when she is away. Examples include safeguarding concerns not being reported to the LADO or children’s services appropriately and no notifications made to Ofsted. As a result, external professionals cannot evaluate practice and ensure that all appropriate actions have taken place to protect the children.

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Inadequate

Ineffective monitoring exacerbates these issues. Leaders and managers have poor oversight of the service and a limited understanding of its weaknesses. The manager has failed to evaluate all aspects of the service adequately and has been blind to its shortfalls. The incidents that occurred during her absence have not been sufficiently followed up. The service does not have a development plan and there are no systems to drive improvement. The areas identified for improvement within the reports completed by the independent visitor have not been addressed. Such failings question the competence of the provider.

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Inadequate

The organisation’s workforce training strategy does not cover the information required by guidance and provides a limited overview of the management structure and expectations for the staff. Staff supervision is sporadic and some staff do not receive supervision within the timescales prescribed in the service’s statement of purpose. There is limited discussion on the children’s progress and how the service can be developed. The quality of team meeting minutes has deteriorated, as there is limited focus on how the service and the experiences of the children can be improved.

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Inadequate

The registered manager has been in post since 1999. Despite her relevant qualifications as a registered nurse and having both level 4 and level 5 management qualifications, she fails to exercise sufficient leadership. When necessary, she has challenged the children’s placing authorities to ensure that families receive the support they require, but her own service is failing to deliver.

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Inadequate

Staff have not had the required training to ensure that they have the necessary up- to-date knowledge and skills to care for the children. Some staff have not completed the level 3 qualification, despite their length of time in post. The majority of the staff have not had training in autistic spectrum disorder or learning disabilities to aid their understanding of the children they support. Staff have not undertaken training that sufficiently informs them to be able to identify safeguarding concerns or how to manage risks factors such as online safety and child exploitation. Some of the staff have not completed initial or refresher training, as outlined in the service’s statement of purpose. The absence of sufficient training and support seriously restricts the staff’s ability to safeguard the children and promote their well-being.

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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 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 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, 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: 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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