Children's Home run by Horizon Care and Education Group Limited in Leicestershire

Inspection report children’s home: 1251076 1 Registered provider: Horizon Care And Education Group 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

This privately run home is registered to provide care and accommodation for up to three children with learning disabilities.

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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: This is the first inspection of the home following re- registration with Ofsted. Re-registration was required to reflect a change in the limited company arrangements of the organisation directly operating the home.

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Enforcement action since last inspection

None Inspection report children’s home: 1251076 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

 Care planning is poor. Leaders and managers are unable to demonstrate rigorous and up-to-date risk assessments, or regularly reviewed plans relating young people’s care.

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Key findings from this inspection

 A low stimulation and demand-free environment means that one young person misses out on constructive, structured interaction with staff.

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Key findings from this inspection

 One young person has not been allowed to leave the home for several weeks or access the home’s garden for several months. It is unclear on whose authorisation these decisions have been made. Placement planning documentation does not clearly explain the reasoning and there is no regular review of the effectiveness of this practice.

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Key findings from this inspection

 The provider has not sought permission from children’s placing authorities for the use of monitoring devices within the home. In addition, the reason for their use is not clear as it is not written in children’s plans. Also, there is no policy in place to ensure that their use is appropriate.

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Key findings from this inspection

 Staff have not had the opportunity to benefit from safeguarding training in relation to the needs of children who have disabilities. This means that staff may not have up-to-date safe care knowledge about the children they care for.

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Key findings from this inspection

 On the majority of occasions, children’s health needs are met through attendance at appointments with health workers. However, where, for example, an appointment has been cancelled or a statutory health assessment is overdue, staff are not always rigorous in ensuring that new appointments are made.

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Key findings from this inspection

 From their starting points when they first move in to the home, young people make very positive progress with their behaviour, social communication and personal hygiene. There is a significant decrease in risk-taking behaviour.

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Key findings from this inspection

 There have been very few significant incidents or use of physical intervention.

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Key findings from this inspection

 Staff have taken time to get to know young people. They have a calm and sensitive approach to their interactions with young people. Young people respond positively to this approach.

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Key findings from this inspection

 The home is led by experienced managers who are committed to achieving positive outcomes for young people.

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Key findings from this inspection

 Staff provide good emotional and practical support to young people so that they can maintain relationships with their families. Inspection report children’s home: 1251076 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

The care planning standard is that children receive effectively planned care in or through the children’s home. (Regulation 14 (1) (a))

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Requirement Due date

This particularly relates to having regularly reviewed plans in relation to children’s day-to-day activities. 12/06/2017

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Requirement Due date

The registered person must ensure that children can access all appropriate areas of the children’s home’s premises; and any limitation placed on a child’s access to any area of the home’s premises is intended to safeguard each child accommodated in the home; is necessary and proportionate; is kept under review and, if necessary, revised; and allows children as much freedom as is possible when balanced against the need to protect them and keep them safe. (Regulation 21 (b) and 21 (c) (i–iv)) 12/06/2017

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children, and the child’s placing authority consents in writing to the monitoring or surveillance. (Regulation 24 (1) (a–b)) 12/06/2017

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Recommendations

 Children with disabilities may have physical or emotional difficulties which mean that participation in leisure or cultural activities in the community is difficult to achieve. The registered person, in conjunction with any relevant person (such as a parent or school) should assess what would be safe, achievable and reasonable for each child, in line with their relevant plans, and ensure appropriate opportunities are available for each child to have fun, form friendships and enjoy life, relative to their stage of development and individual needs. (‘Guide to the children’s homes regulations including the quality standards’, page 32, paragraph 6.10) Inspection report children’s home: 1251076 4  Staff need the knowledge and skills to recognise and be alert for any signs that might indicate a child is in any way at risk of harm. The registered person should ensure that skills in safeguarding are gained, refreshed and recorded in the

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Recommendations

home’s workforce plan. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.12) This specifically relates to training about safeguarding children who have disabilities.

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Recommendations

 The registered person should ensure that all incidents of control, discipline and restraint are subject to systems of regular scrutiny to ensure that their use is fair and the above principles as set out in 9.35 are respected. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.36)

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Recommendations

 Staff should have sufficient understanding of relevant health services, including the functions of the designated nurse for looked-after children in their area. They should support children to navigate these services, advocating on their behalf where necessary and appropriate. (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.8)

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improvement to be good

A judgement of requires improvement has been given because shortfalls in planning and decision making have an impact on the quality of care provided. Not all young people have the opportunity to reach their potential, their access around the home is restricted so they cannot go outside to get fresh air, and they lack stimulation on a day-to-day basis. However, this inspection also identified some instances of considerate and positive care practice.

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improvement to be good

Managers and staff promote an atmosphere of low stimulation, calm and quiet. This can help young people who may be hypersensitive to noise or easily startled to feel relaxed and comfortable. This approach has helped reduce significant incidents and the use of physical intervention is very low. For some young people, this is a remarkable change in relation to their starting points. However, for one young person, the approach of low stimulation has meant that he has very little structured and constructive interaction with staff on a day-to-day basis. The young person has access to various toys, books and magazines, which he enjoys, but there is no plan in place to ensure that he has a purpose and goal to each day. This means that his experiences are currently poor as he risks isolation and is missing out on opportunities to develop and build relationships. Lack of access to activities means that he does not have a range of opportunities to

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improvement to be good

learn, take part in physical exercise or have fun. He does not have the opportunity to participate actively in life.

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improvement to be good

Since their starting points when they moved to the home, young people, who have highly complex needs, have made progress. Where historically they have been involved in frequent incidents of aggression and have needed high levels of staff presence or Inspection report children’s home: 1251076 5 physical intervention to help manage their behaviour, young people are now calmer and more settled. They begin to make small, but significant steps. For example, one young person who struggles to leave his bedroom has spent increasing amounts of time in the home’s sensory room. The young person’s social worker said, ‘The staff are invested in my young person. They worked really hard in the beginning to get to know him and understand him. They spend a lot of time trying to understand his behaviour and the way he interacts. They use this information to make all interactions they have with him positive interactions so they can build on them.’

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improvement to be good

Staff work very closely with the child and adolescent mental health services (CAMHS) to ensure that they can meet young people’s emotional health needs. A nurse from the CAMHS team visits the home regularly to provide advice and support to staff. In general, young people’s health is good. On the majority of occasions, young people attend health appointments. However, staff do not always advocate strongly enough on behalf of young people to ensure that health providers provide important healthcare, such as statutory health assessments or weight management advice. There are some examples of healthcare practice that create a positive impact; for example, leaders and managers have worked very closely with health providers to decrease the amount of prescribed medication that young people take. This improves young people’s well-being as a result. Young people’s self-care is improving, such as enjoying a regular bath. Young people eat

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improvement to be good

healthily and benefit from well-balanced and delicious home-cooked meals.

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improvement to be good

Young people receive education based on their individual needs. Attendance is variable, dependent on young people’s starting points and their behaviours. One young person attends school regularly and is making positive progress. For others, due to their complex needs, formal education is not currently realistic and staff are working with stakeholders to consider alternatives.

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improvement to be good

Young people see and spend time with their families frequently. Staff fully support and facilitate this, including inviting family members to visit the home on a regular basis. This promotes a sense of belonging for young people and enables staff to form positive working relationships with wider family members.

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improvement to be good

One young person has not been able to access the home’s garden for several months, despite wanting to do so. Plans held at the home do not clearly demonstrate the reason for this restriction. Although there are concerns for the young person’s safety, weak planning and a lack of effective review of risks mean that the restrictions may not be necessary or proportionate. There is also no evidence that the plans are regularly reviewed. In addition, due to the potential of his extreme behaviour when out in the community, he has not been able to leave the home and take part in any external activities for several weeks. Plans and risk assessments are unclear about when this situation will be reviewed. It is also unclear on whose authority these decisions have been taken. Specific, measurable and realistic goals that this young person can understand and work towards achieving have not been set. Inspection report children’s home: 1251076 6

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improvement to be good

There are some examples of positive behaviour management and incidents of challenging behaviour within the home are few. Staff use de-escalation techniques and strategies to support young people when their behaviour starts to escalate or they display potentially risky behaviours. Overall, risk assessments relating to young people do not consistently reflect their current needs and do not reflect the way in which staff should manage these risks. Regular and formal monitoring, reviewing and updating of risk assessments is needed, to ensure that all staff follow the most recent assessments and plans.

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improvement to be good

The majority of the staff team members are appropriately qualified. New staff will be enrolled onto a qualification course imminently. Staff take part in comprehensive online training during their probationary period. They have basic training, such as safeguarding and first aid, which helps enable them to meet young people’s needs. They have not received training that specifically considers safeguarding children who have disabilities. This means that staff may not have up-to-date knowledge to help them keep young people safe.

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improvement to be good

Recruitment practices help protect young people from the risk of harm. The registered provider ensures that all staff, including agency staff, have had all of the required recruitment checks. This means that managers can be assured that all staff are suitable to work with vulnerable young people.

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

Leaders and managers have not consistently ensured that care plans and risk assessments are well thought through or regularly reviewed. This has a negative impact on the ability of young people to have enriching life experiences. Improvements are also required to the management’s monitoring systems to ensure that any restrictions on young people’s movement are necessary and proportionate. However, the registered manager is very experienced and well qualified. He has the skills to deliver the necessary improvements quickly.

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

Management monitoring systems are generally suitable and the management team demonstrates a good knowledge of young people’s history and recent progress. The registered manager uses recommendations made by the independent visitor to help improve the functioning of the home. However, monitoring systems have not identified the shortfalls found at this inspection. This calls into question the quality of the monitoring systems. It also hinders staff members’ ability to develop and improve services.

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

The manager, supported by a deputy manager, is building a skilled and committed staff team. Staff feel well supported by the manager. They told the inspector that they enjoy their work and work well as a team. The staff team presents as committed and caring.

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

Leaders and managers have positive professional relationships with a range of stakeholders. It became apparent during the inspection that not all of the stakeholders involved with one young person were are aware of how he is being cared for or the Inspection report children’s home: 1251076 7 current restrictions on his liberty. There is no clear agreement in place to demonstrate that important people involved in the young person’s life consent to care plans or risk assessments.

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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: 1251076 8

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Children’s home details

Registered provider: Horizon Care And Education Group Limited

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Children’s home details

Registered provider address: Venture House, Unit 12, Prospect Business Park, Longford Road, Cannock WS11 0LG

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Children’s home details

Responsible individual: Ann-Cheri Callow

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Inspector

Catherine Honey, social care inspector Inspection report children’s home: 1251076 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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Inspector

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Inspector

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Inspector

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