Children's home run by Hillcrest Children‟s Services (2) Limited in Stratford-on-Avon

Inspection report children’s home: SC398392 1 SC398392 Registered provider: Hillcrest Children’s Services (2) Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

A large private provider of children’s services operates this home. The home provides care and accommodation for up to two children who have emotional and/or behavioural difficulties.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

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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requires improvement to be good

Date of last inspection: 23 February 2017

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requires improvement to be good

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC398392 2

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Key findings from this inspection

This children’s home requires improvement to be good because

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Key findings from this inspection

 The staffing arrangements do not allow for the consistent and effective care of young people.  The service, including the property itself, is not suitable to support the most challenging young people.  The vast majority of young people stay for short periods and leave in unfavourable circumstances.  Young people make inconsistent progress in their education.  Young people’s behavioural difficulties have a disproportionately negative impact on the day-to-day running of the home.  Young people do not always feel safe in the home.

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Key findings from this inspection

 Through regular and meaningful consultation, most young people establish good relationships with staff.  Staff undertake some imaginative work with young people.  Staff apply a therapeutic approach to the care of young people, which involves their families as much as possible.  Young people sustain and improve their relationships with their families.  Young people receive good support with their interests and hobbies.

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Inspection date Inspection type Inspection judgement

23/02/2017 Interim Sustained effectiveness 27/07/2016 Full Good 03/03/2016 Interim Improved effectiveness 11/08/2015 Full Requires improvement Inspection report children’s home: SC398392 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet 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

13. The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, the registered provider must:

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Requirement Due date

(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. 26/06/2017

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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:

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Requirement Due date

(2)(e) ensure that the home’s workforce provides continuity of care to each child. 26/06/2017

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Requirement Due date

In order to meet the care planning standard, the registered provider must ensure:

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Requirement Due date

(1)(a) That children receive effectively planned care in or through the children’s home. This is with regard to maintaining and sharing placement plans and the planning, implementing, and recording of key worker sessions. 26/06/2017

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Requirement Due date

Ensure that all staff have the appropriate experience, qualification and skills for the work that the individual is to perform. This is with particular regard to agency staff and their records. (Regulation 32(3)(b)) 26/06/2017

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Requirement Due date

Ensure that the quality of care review provides for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(5)) 26/06/2017

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Requirement Due date

Affix a certificate of registration in a conspicuous place in the establishment. (Care Standards Act 2000, section 28, paragraph 1) 26/06/2017 Inspection report children’s home: SC398392 4

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Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. This is with regard to correcting the internal and external damage. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)  Ensure that no more than half the staff on duty at any one time, by day or night at the home are from an external agency. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.17)  Ensure that staff keep and encourage children to keep appropriate memorabilia of the time spent living at the home and help them record significant life events. (‘Guide to the children’s homes regulations including the quality standards’, page 63, paragraph 14.5)

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improvement to be good

Young people do not experience consistently good outcomes. Although they usually arrive for the right reasons, they nearly always leave sooner than planned. Many young people have been unable to cope in other homes within the company and move here because it is smaller and less accessible. However, these features pose their own challenges, which contribute to the brevity of young people’s residencies. Consequently, the company is reviewing the viability of the service. Staff ensure that young people transfer to new settings as smoothly as possible but they do not always take memorabilia with them. This means that young people do not have reminders of this important period in their lives.

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improvement to be good

Most young people establish meaningful relationships with staff to the extent that several ex-residents keep in touch. The core staff are positive and consistent role models. They ensure that young people lead healthy lifestyles and receive good support in dealing with their emotional difficulties. Some young people learn to articulate their feelings, which is important progress. One told his social worker that he loved the home and did not want to leave.

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improvement to be good

The property itself is small. This creates a cosy atmosphere, which some young people appreciate. On the other hand, it compromises privacy and relaxation. Negative incidents have resulted in damage, for example, to doors and woodwork and to outbuildings, which the maintenance team has not completely rectified. This detracts from the appearance of the property inside and out. Staff and one young person worked together to creatively adapt one of the workshops into a personal den. In here, the young person pursues his mechanical hobbies, which facilitates his independence.

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improvement to be good

All of the recent young people have attended the organisation’s school. Staff have close Inspection report children’s home: SC398392 5 working relationships with teachers and use these to adapt young people’s programmes of education. Some young people have required several changes in their education plans but their progress has been limited. The behavioural difficulties of several young people have obstructed their educational efforts. Some of the young people benefit from tutoring at home. However, this short-term solution does not comprehensively meet either the home’s statement of purpose or the requirements of the placing authorities and is a feature of the current review of the service.

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improvement to be good

Young people have immediate access to woodland for exploring and adventurous play. Some join community groups, such as the scouts, and they regularly contribute ideas to the activity programme. Staff organise trips and celebrations of events such as Easter and Christmas. Staff discuss issues of race and religion with young people to help them understand current events. The rural location of the property does not allow young people to have independent access to transport links or community activities. This barrier is part of the current review of the service. However, staff often achieve improvements in young people’s relationships with their families, even over substantial distances. The placing authorities acknowledge their success in this important area.

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improvement to be good

Staff focus on the needs of each young person, although young people’s challenging behaviours have diverted efforts away from more constructive topics. The planning and recording of discussions with young people are insufficiently robust to address important topics effectively. Staff feel disappointed that their efforts have not been wholly successful. They regularly engage young people in conversations about issues and plans. For example, staff helped one young person understand the negative impact of his racist comments. However, at other times, young people are resistive.

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improvement to be good

By moving into this home, young people often resolve some of their previous difficulties. For example, the lower number of other young people suits most of them, the frequency of self-harming falls, and there is a low rate of young people going missing. Young people are not at risk of radicalisation or exploitation. From the point of view of the police, the home operates well and staff communicate very effectively. However, young people do not always feel safe or learn to stay safe. Recently, for example, young people have felt concerned about the damage to property and violence towards staff. This is unsettling for them and the perpetrators.

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improvement to be good

Some difficulties have arisen because placing authorities have not provided full information about a young person. In such cases, the manager challenges local authorities. However, the additional information sometimes arrives too late to prevent placements breaking down.

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improvement to be good

Staff consult widely with other professionals and engage directly with young people about their challenging behaviour. Members of staff have a clear understanding of each young person’s behaviour and written risk assessments define the strategies. However, this has not prevented placements deteriorating to the point that the organisation has Inspection report children’s home: SC398392 6 given notice to the placing authority that the young person needs to leave the home. This is an effective step when a young person needs another type of placement but is another disruption to their lives. The strategy to address negative behaviour starts to become ineffective once a young person needs the help of two staff. At this point, there are insufficient core staff and bank staff, so agency staff are used. This reduces the competency of the team and the continuity of care provided to young people.

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improvement to be good

Recently, young people have needed two staff each. The property itself is not suitable for up to five adults and two young people, especially if staff need to hold young people to keep them safe. Staff try to avoid using restraint but it has been justified on many occasions recently to avoid serious injuries to staff and young people. Young people have not been able to live comfortably together. The substantial use of agency staff has compromised the adherence to consistent boundaries. This has made staff and young people anxious and one senior member of staff has left. Nevertheless, young people have made very few complaints or allegations. When they arise, the manager addresses all such issues appropriately, including issues arising from recruitment checks. This means that young people receive care from safe adults.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager started here in 2015. She has an appropriate qualification and has substantial managerial experience. Young people say that she is ‘good’. However, her administration of the service has deteriorated. Contributory factors include staff turnover, sickness, and unprecedented increases in levels of challenging behaviour. These have required her to redirect her time into providing direct support to staff. A key problem is insufficient core staff in the company to deal with the occasional but inevitable increases in demands from young people. At such times, agency staff cannot provide the level of competency and knowledge required to maintain the service at a good level. The previous inspection in February identified this shortfall. The lack of progress in this issue is one reason why the organisation is currently reviewing the future of the service.

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The effectiveness of leaders and managers: requires improvement to be good

The continuity of care has been inadequate at times, although since the departure of one young person, it has reverted to a good standard. On some shifts, no core staff were available. The departure of two core staff since the last inspection exacerbated the position. Senior staff do ensure that a sufficient number of staff are on duty but not that all such staff are familiar with each young person or the administration of the service. This means that occasionally young people have very weak or no relationship with their carers. This does not promote their welfare. It also means that the coordination of the service, including its administration, has suffered. For example, direct work or key working with individual young people is not sufficiently well organised. The manager has amended young people’s placement plans but not made them available to staff or young people, and staff are not up to date with the minutes of meetings. This reduces the

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The effectiveness of leaders and managers: requires improvement to be good

effectiveness of the service. In addition, the registered manager has failed to display the home’s certificate of registration in a conspicuous place.

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The effectiveness of leaders and managers: requires improvement to be good

Staff continue to benefit from regular personal support and a comprehensive programme Inspection report children’s home: SC398392 7 of training. All core staff are either qualified or on track to qualify within the required timescale. The records for agency staff do not always show that their training in behaviour management is sufficient or, if it is not, why the manager has allowed the individual to be on duty. The recruitment of agency staff through one agency reduces this risk because the agency should only provide individuals who meet specific criteria. However, the records, including those online, do not allow verification.

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The effectiveness of leaders and managers: requires improvement to be good

Monitoring by the manager and the independent person is satisfactory in most regards. The independent person provides useful assessments and recommendations every month. The manager has a good understanding of her service and its current shortfalls. She communicates this well to her organisation and other professionals, as appropriate. However, she does not gain the views of other people, such as social workers and parents. Systems to capture such views in order to improve the service have lapsed.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC398392 8

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Children’s home details

Registered provider: Hillcrest Children’s Services (2) Limited

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Children’s home details

Registered provider address: Hillcrest Children’s Services (2) Limited, Turnpike Gate House, Alcester Health, Alcester, Warwickshire B49 5JG

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Inspectors

David Morgan, social care inspector Inspection report children’s home: SC398392 9 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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