Children's Home run by PCT Care Services Limited in Norfolk

Inspection report children‟s home: SC471856 1 SC471856 Registered provider: PCT Care Services 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 children‟s home provides care and accommodation for up to six children who have emotional and/or behavioural difficulties and learning disabilities. The home is owned by a private company.

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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 Good

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Requires improvement to be good

The effectiveness of leaders and managers Inadequate

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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: 31 October 2016

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Requires improvement to be good

Overall judgement at last inspection: Requires improvement

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Enforcement action since last inspection

On 13 March 2017, an inspector carried out a compliance visit to the home. This found that the risk assessments were not being used effectively to identify and reduce risks to the children. A compliance notice relating to the effectiveness of risk assessments was issued on 17 March 2017. To evaluate the progress that the home had made in meeting the compliance notice, a monitoring visit was undertaken by an inspector on 5 March 2017. At this visit, the inspector found that the compliance notice had not been met. A further compliance notice was issued on 18 April 2017 and a compliance visit undertaken Inspection report children‟s home: SC471856 2 by an inspector on 3 May 2017. At this, visit the inspector found that the compliance notice had been met.

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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 home does not have a manager. There have been several changes of manager and, for the last 30 months, no manager has been registered.  There has not been a review of the quality of care for seven months, and one has not yet been started. The previous review lacked evaluation and did not include the views of the children and staff.  There has been a high turnover of staff, resulting in an inexperienced staff team that has a low level of qualification.  The administration of the medication records for one child is missing. The risk assessment does not consider transportation of medicines when the children are on contact visits.  The acting manager requires more in-depth safeguarding training.  Only four of the staff have had internet safety training, and no staff have had training on radicalisation. This is despite these being areas from which the children in the home could potentially be at risk.

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Key findings from this inspection

 The staff are not receiving regular supervision.  Annual appraisals of staff performance have not been taking place.  Records of physical intervention do not contain all of the required information.

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Key findings from this inspection

 The children are making progress at the home.  The children are attending education more often and improving their grades.  The staff are helping to ensure that the children‟s health needs are met.  The staff are helping the children to prepare for independence.  The staff help the children to express their views and influence their plans.  The children have reduced their risk-taking activities, including being missing from care and placing themselves at risk of sexual exploitation.  There are good relationships with the placing social workers.  The staff support the children to have rewarding contact with their families. Inspection report children‟s home: SC471856 3

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Inspection date Inspection type Inspection judgement

31/10/2016 Full Requires improvement 23/08/2016 Full Inadequate 08/06/2016 Full Inadequate Inspection report children‟s home: SC471856 4

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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 protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff 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. (Regulation 12(1) and (2)(a)(i)) In particular, ensure that there is a risk assessment relating to a child transporting their own medication between the home and their contact visits and monitoring the child‟s use of „as required‟ medication. 21/07/2017

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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 the effectiveness of any consequences of the use of the measure. Further, that within 48 hours of the use of the measure, that the registered person, or a person who is authorised by the registered person to do so, has spoken to the user about the measure; and has signed the record to confirm it is accurate. (Regulation 35(3)(a)(vii)(b)(i)(ii)) 21/07/2017

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Requirement Due date

The registered provider must appoint a person to manage the children‟s home. (Regulation 27(1))* 18/08/2017

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13(1)(a)(b) and (2)(c)) In particular, ensure that there is a suitably qualified and experienced staff team. 31/08/2017 Inspection report children‟s home: SC471856 5 The registered person must ensure that all employees undertake appropriate continuing professional development; receive practice-related supervision by a person with appropriate experience; and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(a)(b) and (c)) 21/07/2017

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Requirement Due date

The registered person must ensure that an independent person visits the children‟s home at least once each month. (Regulation 44(1)) 21/07/2017

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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 6 months. In order to complete a quality of care review, the registered person must establish and maintain a system for monitoring, reviewing and evaluating the quality of care provided for children, the feedback and opinions of children about the children‟s home, its facilities, and the quality of care they receive in it and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. This must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(1)(2)(a)(b) and (c) (5)) 31/07/2017

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Requirement Due date

The registered person must maintain records (“case records”) for each child which include the information and documents listed in Schedule 3 in relation to each child. (Regulation 36(1)(a)) In particular, records of any medicines kept for the child in the home, including details of the administration of any medicine to the child. 21/07/2017

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Requirement Due date

* These requirements are subject of a compliance notice.

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improvement to be good

The children are making progress at this home. An example is that one child is preparing for independence. Her recent pathway plan review reports that she has:

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improvement to be good

 begun to improve her grades at college  developed a sense of self and an understanding of her past experiences  reduced the frequency of being missing from care  become independent in booking her own health appointments  learned to manage her emotions much more effectively  begun to do more things with her family. Inspection report children‟s home: SC471856 6 The plan states that the child has begun to distance herself from staff, but this is seen as part of her disengagement in preparation for leaving the home. The responsible individual has found an apprenticeship-based nursing course for the child for when she finishes college, as this is what she has wanted to do for some time. Although the child does remain resistant in some health-related areas, the staff do encourage her to seek appropriate specialist advice and support. The placing social worker for another child has recently completed a survey which was

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improvement to be good

very positive about the work that staff have done to allow the child to „have the most positive time [at the home] as possible.‟ He commented that the child is relaxed and at ease with workers in the home and, as a result, the child is now able to have much calmer and focused conversations with a number of people. This child has increased his time in education since being at the home and the staff have worked effectively with him and his parents to promote contact. This progress has led to realistic plans for the child‟s return home. The staff have provided both of these children with individualised care to help them make progress. Despite initial resistance, both children have agreed to take part in work with specialist drug misuse workers. One child left the home during the inspection. This was part of a planned move to be nearer to her home authority. The staff took her and all the other children out for a

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improvement to be good

farewell meal to mark her leaving and chose a leaving present which had particular significance to her. The staff supported her with the move, including taking her a considerable distance to her new placement. They have also agreed to support one child‟s contact even though it will take place in his home authority, which is a significant distance from the home. The staff listen to the children‟s views and help them to express these views. Staff spent time with one child before his looked after child review to help him prepare for the review, and supported him to think about his wishes for more free time and a move home. Both of these were agreed at the review. The staff have regular key-working sessions with the children. They use these sessions as opportunities to discuss things that are important to the children. Although the children do make progress in relation to their health, there are some shortfalls in how the staff manage this. For example, the records of one child‟s „as

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improvement to be good

required‟ medication when she is at her family home on a regular basis could not be found, and it is not clear if they have been recorded. This not only removes a safeguard for the child, but does not allow clear monitoring of the frequency of which she is using this medication. Her risk assessment for medication does not assess the risk of her transporting the medication when she goes to and returns from contact. Indications from other records are that she is developing independence in her management of her own health, but this has not been clearly assessed in order to ensure that she remains safe and that risks are appropriate and manageable.

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How well children and young people are helped and protected: good

The children do become safer while they are living at the home. For some of the children, this has been a significant reduction in the times that they are missing from Inspection report children‟s home: SC471856 7 care; for others, it is a reduction in self-harming behaviour and risks of sexual exploitation. Some of the children are resistant to reducing their use of illegal substances, but there is some progress in this area, and the staff have very clear zero tolerance, with strategies such as supervised spending and room searches to respond to any concerns. There are individual missing-from-care protocols in place for each child, which set out for the staff the actions that they should take if the child goes missing. The staff follow these protocols, and this helps to protect the children from the risks of being missing. Managers make referrals to the local authority designated safeguarding officers if there

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How well children and young people are helped and protected: good

are any allegations or concerns about the staff. The deputy who is covering the manager‟s post has only completed a basic safeguarding course, which is unlikely to provide him with all of the information he needs to deal with the wide range of potential safeguarding matters. Further, only four members of staff have completed training on internet safety (and one of these is on maternity leave) and no staff have had any training on radicalisation. The children‟s risk assessments identify internet safety as a risk for some of them and, due to the children‟s backgrounds, are vulnerable to potential radicalisation. Managers are aware of these gaps, and there are plans to address them, but as yet they have not come to fruition. It is important that the managers and the staff have the training and knowledge to keep the children safe in all areas of their lives. It was a requirement of the previous inspection that the records of sanctions and

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How well children and young people are helped and protected: good

physical intervention include an assessment of the effectiveness of the measure. Further, that within 48 hours of the use of physical intervention, the registered person, or a person who is authorised by them, has spoken to the staff involved in the measure. The independent visitor‟s reports from April 2017 identified that this was still not happening. Since that time, the deputy manager has been reviewing the records of sanctions and has ensured that the home meets the regulations. There have not been any further incidents of physical intervention since this was identified by the independent visitor and, consequently, the most recent records still do not include all of the information required. Not having effective discussions about the use or physical intervention following its use can limit the opportunities to improve practice and reduce the duration and frequency of these incidents. It is positive that the use of physical intervention has reduced.

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How well children and young people are helped and protected: good

The children are able to take age-appropriate risks. One child‟s social worker had commented in a survey that the child is encouraged to be age-appropriate, but in an environment which is safe. When the child has tested the level of trust that he has been given and put himself at risk, the level of independence has been reviewed. The staff feel that behaviour management and the use of sanctions is more effective under the current management arrangements. There is more clarity and consistency over what behaviours are acceptable and how staff will respond to unacceptable behaviour. While incidents of challenging behaviour still occur, the staff are dealing with them more successfully. The staff are using a more restorative approach to behaviour management. For example, in response to concerns that a child had been using cannabis in the home, the child took part in a key-work session and designed a poster on risks of

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How well children and young people are helped and protected: good

drug use. Positive behaviour is recognised and rewarded. This has included rewards for the children for helping around the house and, for one child, a reward for taking part in role play as part of staff training. Inspection report children‟s home: SC471856 8

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The effectiveness of leaders and managers: inadequate

There is not currently a manager at the home, and there has not been a registered manager for 30 months. A manager did submit an application to register, but they left the home at the end of August 2016 before the application had been processed. Since that time, the then responsible individual covered the manager‟s post and was due to apply to register as manager, but left the organisation. Another manager was appointed and has since left before submitting an application for registration to Ofsted. The deputy manager is covering this post with support from the current responsible individual, the manager of another home owned by the organisation and, recently, from an external consultant. The continued lack of a permanent and registered manager is a serious concern to Ofsted, as the children and the staff in the home have experienced changes and inconsistencies in management. In addition, a number of the shortfalls identified in

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The effectiveness of leaders and managers: inadequate

this report relate to a lack of effective management over time. Supervision agreements for staff state that they will receive monthly supervision. This frequency is not being met. One member of staff had five supervisions over the last eight months, and another has had only two. Also, the staff are not having their performance reviewed annually. This does not allow managers to have a good oversight of staff practice and does not allow the staff to develop and improve. This is particularly significant given that there has been 10 new staff start and nine leave since the last inspection on 31 October 2016. Many of the new staff are inexperienced in children‟s residential care and, of the whole staff group, only two have an appropriate qualification, although others are enrolled on this. The responsible individual is currently trying to recruit experienced staff, but the staff team as it stands is not sufficiently experienced or

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The effectiveness of leaders and managers: inadequate

qualified and this has the potential to limit the quality of care provided to the children. Since the last inspection, the people carrying out the independent visits to the home have changed. One such provider did not complete the visits as required, so two months have been missed. The current provider is visiting monthly and providing good-quality reports to help identify the strengths and shortfalls in the home. There has not been a review of the quality of care in the home for seven months; although one is planned, it has not yet begun. The previous report lacked evaluation and did not include the views of the staff or the children. Consequently, the report was not sufficiently effective in identifying ways to improve the quality of care. Both the responsible individual and deputy manager have a sound understanding of the children at the home, their needs and plans. This includes their individual needs relating

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The effectiveness of leaders and managers: inadequate

to equality and diversity. They want the children to do well and make progress. Managers use monthly reports for the children to identify their progress, but some information is lacking, and this has not been identified. For example, the records lack information on one child‟s medication as described above. There is some recent effective monitoring of practice in the home which has led to some improvements. The monthly report for one child for April 2017 was very short and contained little information other than the child was spending much of their time on contact. This was identified by the deputy manager, who spoke to staff about it at a team meeting; as a result, the report for May 2017 is much more detailed and shows a significantly increased level of contact with the child‟s step-parent. Records of sanctions and incidents are also being effectively Inspection report children‟s home: SC471856 9

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The effectiveness of leaders and managers: inadequate

reviewed. Managers are aware of many of the shortfalls in the home, but have to date been unable to address them. This is partly as a result of the changing management arrangements. The relationships that the managers and staff have with current placing social workers are good. There is effective communication and the social workers are consulted about the home‟s plans for the children. This helps to ensure that professionals are working together for the children. When the managers feel that placing authorities are not acting in children‟s best interests they will challenge this and, when appropriate, help children to get advocates.

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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 who 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: SC471856 10

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Children’s home details

Registered provider: PCT Care Services Limited

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Children’s home details

Registered provider address: Old Hall Farm, Silfield Road, Silfield, Wymondham, Norfolk NR18 9NH

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Inspector

Clive Lucas, social care inspector Inspection report children‟s home: SC471856 11 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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