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

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.

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because:

 Some young people’s transitions out of the home are not always managed effectively and means relationships with staff become compromised.

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because:

 Staff do not always record the action they have taken when young people go missing.  Restraint practice reflected in records does not always take into account the age, health needs, understanding of the young person and if the method of restraint used was appropriate in the specific circumstances.

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because:

 Records relating to restraint are insufficiently detailed.  Some systems relating to medication are weak.  Not all staff are suitably vetted prior to starting employment.  Aspects of management oversight and monitoring are inadequate.  Young people’s files are not stored appropriately.  Staff training has some shortfalls.

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The children’s home strengths

 Young people make progress in some important areas of their life.  Some core staff develop strong, supportive relationships with young people.  Young people recognise their own progress and put this success down to the staff and manager.

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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 protection of children standard, with particular reference to missing, the registered person must ensure that staff: (2)(a)(vi) take effective action whenever there is a serious concern about a child’s welfare. 02/02/2017

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Requirement Due date

In order to meet the care planning standard, with particular reference to admissions and discharges, the registered person must ensure that children:

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Requirement Due date

(1)(b) have a positive experience of arriving at or moving on from the home. 02/02/2017

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23 (1)) 02/02/2017

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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 a description of the measure and its duration. (Regulation 35 (3)(a)(iv)) 02/02/2017

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Requirement Due date

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. (Regulation 45 (1)) 02/02/2017

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Requirement Due date

The registered person must ensure that the system referred to in paragraph (2) provides for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (5)) 02/02/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

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Recommendations

 Ensure that restraint records also include interventions that restrict a child’s liberty of movement. Restrictions such as these, and all other restrictions of liberty of movement, should be recorded as restraint. (‘Guide to the children’s homes regulations including the quality standards’, page 47, paragraph 9.42)  Ensure that the recruitment 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)  Ensure that staff understand the importance of careful, objective and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)  Ensure that children are able to take up issues or make a complaint with support and without any fear that this will result in any adverse consequences. Regulation 39 sets out the requirements on the registered

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Recommendations

person to have a complaints procedure. Children must be aware of this procedure and be reminded of it as necessary. (‘Guide to the children’s homes regulations including the quality standards’, page 22 , paragraph 4.13,)  Ensure that approaches to restraint recognise that children are continuing to develop, both physically and emotionally. Any use of restraint should be suitable for the needs of the individual child. The context in which restraint is used should also recognise that, as a result of past experiences, children will have a unique understanding of their circumstances which will affect their response to restraint by adults responsible for their care. (‘Guide to the children’s homes regulations including the quality standards’, page 48, paragraph 9.54)  The registered person should ensure that staff can access appropriate facilities and resources to support their training needs, and should

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Recommendations

understand the key role they play in the training and development of staff in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.11)

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Information about this children’s home

The home may only provide care and accommodation for up to two children with emotional and/or behavioural difficulties. A private provider operates the home.

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Recent inspection history

Inspection date Inspection type Inspection judgement 23/03/2016 Interim Improved effectiveness 01/10/2015 Full Good 24/02/2015 Full Good 21/07/2014 Interim Sustained effectiveness

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Requires improvement

One young person has recently moved from the home. Managers took steps to communicate with the placing authority. The transition period was challenging and meant short notice changes left staff struggling to cope. Some breakdown in communication between staff and the placing authority hindered partnership work being more co-ordinated, especially at times of crisis. As a result, the young person’s relationship with staff, her feelings of safety and her experience of living in the home all became compromised.

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Requires improvement

Despite this, while living in the home, young people develop strong relationships with some ‘core’ staff. This makes sure that young people generally receive individualised care. This helps them to make progress in some key aspects of their life. For example, their attendance at school improves in relation to their starting points. This helps them to achieve more academically. One young person’s teacher confirmed this, stating, ‘She is achieving well.’ Overall, young people’s confidence and emotional well-being also improve and they actively engage in therapeutic support. A young person’s social worker reflected, ‘She has made progress.’

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Requires improvement

Some young people are not fully aware of how complaints against more senior staff are managed in the home’s complaints procedure. This hinders young people being confident a complaint involving an allegation will be managed impartially.

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Requires improvement

Staff support young people to develop some of the practical skills they need as they approach adulthood. They also help them to stay in touch with people who are important to them, if it is safe to do so. This is especially important to young people who may live a considerable distance from where they were born.

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Requires improvement

The management, understanding and assessment of risk is variable. Young people rarely go missing, due in part to high staff ratios. This is a significant improvement for some young people. This helps them to be safer and reduces risks in other areas, including the risk of exploitation. However, on one occasion, when a young person was reported missing, the staff team’s recorded account to help secure her safe return was sparse. During the period the young person was missing, the staff assigned to support her were reassigned to other homes owned by the provider. This hindered staff the opportunity to undertake ongoing work with other agencies to secure her safe return.

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Requires improvement

Incidents when young people hurt themselves reduce and staff understand the risks young people face in this regard. Young people’s behaviour generally improves. One social worker commented that a young person was previously, ‘Out of control’ but that staff had, ‘Really pulled her round… They managed her behaviour really well.’

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Requires improvement

Staff and the manager do not always provide adequate details about a physical intervention in their records. For example, sometimes the description of the hold used and the duration of the restraint are not clearly recorded. Consequently, accurate monitoring is not always possible. Restraints have on occasion, resulted in young people being held on the floor. This is potentially highly sensitive for young people. The record does not always show that a discussion between the manager and staff took place within the required timescales and that the manager has considered any potential regulatory issues. This compromises the manager in reviewing effectively staff practice so that issues or trends of concerns can be reviewed, including ensuring any restraint takes into account the age, health needs, understanding of the young person and if the method of restraint used was appropriate in the specific circumstances.

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Requires improvement

On occasion, staff will restrict young people’s liberty of movement. For example, by preventing young people from leaving the home because staff are concerned for their safety. Although the staff actions are aimed at safeguarding young people, managers do not record this restriction of movement.

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Inadequate

An experienced registered manager is in post. She was registered in April 2015 and is currently completing the level 5 diploma in leadership and management for residential childcare.

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Inadequate

Some staff are suitably qualified and hold the level 3 diploma in residential childcare or a suitable equivalent. Others are working towards this and they are currently within the required timescales for completion. There are some shortfalls in staff training records that indicate that not all staff are trained in first aid, the care of medicines and ligature training.

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Inadequate

The registered manager does not have effective monitoring and review systems in place. Consequently, she is unable to assess whether the service is fully delivering the aims and objectives outlined in the statement of purpose. Formal ‘quality of care reviews’ are not completed in the required timescales. They lack detail and do not ascertain or consider the opinions of young people, their parents, placing authorities and staff. This limits the registered manager’s ability to identify the home’s weaknesses. It also limits her understanding of the impact that the quality of care provided in the home is having on the progress and experiences of young people.

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Inadequate

The arrangements for handling, recording, and storing medication are inadequate. Medicines belonging to a young person who has moved from the home are still in the medication cabinet. Prescription labels do not always match how the medication is being used. It is therefore unclear whether some medication should be used ‘as and when required’ or more regularly. In addition, some staff are unaware of the purpose of some medication or the impact if young people refuse to take it. This places young people at potential risk.

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Inadequate

Young people records are not always stored securely. This does not safeguard young people’s confidential information. Managers have an established system for the safe recruitment of staff. However, on occasion, this rigorous system is not fully applied and means new staff are at risk of starting without all checks completed.

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Inadequate

The staff and manager develop positive relationships with a number of agencies. These includes education and mental health services. These relationships help to ensure that communication is effective so that young people make progress educationally and emotionally. One young person spoke very positively about the quality of her care. She highlighted that she now feels she has people supporting her and is now able to see a good future in front of her. She puts this progress down to the staff and manager at the home.

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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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