Children's home run by Horizon Care Limited in Cannock Chase

Inspection report for children’s home – monitoring visit: SC374939 1 SC374939

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Horizon Care Limited

Inspected under the social care common inspection framework

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Information about this children’s home

This home provides care and accommodation for up to three young people who have emotional and/or behavioural difficulties. The home is owned by a private organisation.

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This monitoring visit

During the full inspection visit to the home on 23 and 24 May 2017, Michelle Edge, social care regulatory inspector, found that safeguarding practice at this home was not sufficiently robust and that the arrangements for safeguarding young people were inadequate. A large number of failings were identified, including a lack of effective action by managers and staff in response to serious safeguarding concerns, leaving young people at risk of harm, and young people’s needs not being met across aspects of their welfare, including health and education. The practice of recording and administering medication was unsafe. There was also a lack of required education and health documents to inform practice. Furthermore, behaviour management practices in relation to restraint were unsafe, and the registered manager and staff had failed to identify, minimise and manage all known risks to young people. These practices failed to protect young people from the risk of harm.

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This monitoring visit

The children’s home was judged inadequate.

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This monitoring visit

As a result, 12 requirements were made, four of which are subject to compliance notices, and were issued on 26 May 2017. On 1 June 2017, a further monitoring visit found that there continued to be failings in the safeguarding and protection of young people. As a result, it was Ofsted’s view that it was unsafe to admit any other young people to the home. A restriction of accommodation notice was issued on 2 June 2017 for a 12-week period. Inspection report for children’s home – monitoring visit: SC374939 2 Further monitoring visits took place on 8 and 16 June 2017 to monitor the notices. Both visits identified gradual improvements in the home, including the provider taking action to recruit a suitably trained and experienced manager.

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This monitoring visit

A further unannounced monitoring inspection was undertaken on 27 June 2017 to monitor the four compliance notices issued under section 22A of the Care Standards Act 2000 and adherence to the restriction of accommodation in place.

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This monitoring visit

This inspection found that no young people had moved into the home since 2 June 2017. Therefore, the restriction of accommodation notice had not been breached.

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This monitoring visit

The manager has taken appropriate action to ensure that all staff understand their roles and responsibilities in relation to keeping young people safe. Clear guidance and improved communication ensure that staff are able to identify when young people are at risk of harm. Furthermore, when concerns arise, staff take appropriate action to safeguard young people. For example, staff acted promptly when they had concerns about a young person’s welfare when he was out in the community. They looked for the young person and liaised with family members to locate the young person quickly. They ensured that when the young person returned, he did not require any medical attention and immediately contacted the placing authority to arrange an independent return home visit. In addition, when the placing authority failed to fulfil their duties and failed to arrange an independent visit, the manager escalated her concerns in a timely manner and arranged for an independent person

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This monitoring visit

to spend time with the young person. Being alert to potential risk and taking appropriate action protects young people from harm.

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This monitoring visit

Positive steps are in place to strengthen the leadership and management arrangements. The new manager in place is driving improvements forward. She has resisted a ‘quick fix’ approach to improving the service and this means that while all areas are being addressed, progress is still required. Daily monitoring by the manager identifies shortfalls in staff’s recording skills. Through training and direct one-to-one support with staff, the manager plans to ensure that improvements continue. Quality assurance processes do not yet analyse the impact of changes on the quality of care provided, or assess staff performance. The manager accepted that the action plan is very much a work-in-progress and remains subject to change dependent upon outcomes for young people. The action plan is regularly reviewed and updated and is used as a measureable, outcome-led development plan. This will help managers to ensure that the home stays on track with improvements that

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This monitoring visit

When the manager has concerns about a young person’s progress, she acts. For example, she has arranged education and care planning meetings to review the concerns regarding the young person’s reluctance to attend education. She has devised plans for the home concerning expectations for young people within school hours and spent time with the young person to agree a way forward, including how staff can be supportive. She has also requested an update from the education Inspection report for children’s home – monitoring visit: SC374939 3 provider about the young person’s attainment levels and requested appropriate schoolwork, if the young person refuses to attend. Furthermore, she monitors whether or not relevant professionals have acted on the recommendations made at these meetings. This prevents any drift or delay and ensures that all professionals maintain their roles and responsibilities.

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This monitoring visit

Risks to young people’s safety have been minimised due to improved staff knowledge and understanding. Investigations into historic allegations have been concluded to the satisfaction of external protection professionals. Young people are afforded improved protection because staff have attended refresher training in behaviour management. The manager has continually reviewed records of incidents, sanctions and restraint and set actions arising from the monitoring. This includes improving poor records, and reflecting on ways to improve staff practice, such as defusing potential upset by ensuring that the young person is productively engaged in activities that meet his needs and interests.

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This monitoring visit

The manager, in conjunction with the young person’s key worker, has revised risk assessments, to ensure that the young person’s emerging needs are identified and set out in clear strategies to ensure that there is consistency in staff actions. Following e-safety training, staff have educated and helped the young person to agree a clear contract and support system that highlights the importance of safe social media activity. This means that the young person is learning how to recognise unsafe behaviour in order to protect himself from harm.

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This monitoring visit

Staff have taken appropriate action to support the young person with his religion and beliefs. They spent time with the leader of the religious setting and used this as an opportunity to update their knowledge base and ask direct questions about any further concerns that they may have or how best to support the young person. Following the piece of work, discussions with all staff took place to ensure that they all had a clear factual understanding of the faith and the strategies to support and guide the young person appropriately. This ensures that the young person has the right support and is able to talk openly about his faith with the adults who are caring for him.

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This monitoring visit

Staff are now fully aware of any identified risks to the young person’s health, because care plans include all the information necessary to ensure that the young person has access to the correct medication and treatment he may need. Records now include outcomes from appointments and clearly identify all actions that staff must take to meet the young person’s health needs. Medication records have significantly improved and all staff are clear about what they need to do to store, administer and record medication safely. In addition, daily audits are conducted by the manager to ensure that errors are immediately identified and acted on. This helps to ensure that all staff are following the correct procedure and the young Inspection report for children’s home – monitoring visit: SC374939 4 person has the appropriate support to meet his health needs.

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This monitoring visit

The young person has been involved in reshaping and redecorating the home. His bedroom is now clean and well presented and daily checks ensure that an acceptable standard of cleanliness is maintained. The lounge is now comfortable and relaxing and other areas of the home are in the process of improvement. The garden area has been cleaned and there have been discussions with staff about the company’s policies and procedures regarding smoking on the property. This ensures that the young person lives in a safe, comfortable home.

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This monitoring visit

The home has immediately addressed all of the critically unsafe issues and events that affected the immediate welfare and safety needs of the young person. The home is compliant with the four regulations that were subject to compliance notices. Other requirements made at the last inspection will be monitored during the next full inspection. The manager recognises that staff continue to need high levels of support and guidance to manage young people’s complex needs safely. A period of consolidation is required to allow for continued improvement. This will enable young people’s individual plans to be progressed. As a result, the restriction of accommodation notice remains in place. Managers are taking an in-depth approach to improvement, rather than a sticking plaster approach. This means that the changes are more likely to be sustained. However, this can only be seen over time, and under the leadership of a registered manager.

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Recent inspection history

Inspection date Inspection type Inspection judgement 24/05/2017 Full Inadequate 07/02/2017 Interim Sustained effectiveness 11/08/2016 Full Requires improvement 04/02/2016 Interim Improved effectiveness Inspection report for children’s home – monitoring visit: SC374939 5

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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

7: The children’s views, wishes and feelings standard

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. (Regulation 7(1)(c))

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Requirement Due date

In particular, ensure that feedback is provided on any issues or concerns raised by children within their group meetings. 25/06/2017

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Requirement Due date

The health and well-being standard is that the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well- being; and children are helped to lead healthy lifestyles. In particular, the standard in paragraph (1) requires the registered person to ensure that staff help each child to— achieve the health and well-being outcomes that are recorded in the child’s relevant plans; and that each child has access to such dental, medical, nursing, psychiatric and psychological advice, and other services as the child may require. (Regulation 10(1)(a)(b)(c)(2)(a)(i)(c))

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Requirement Due date

In particular, actively ensure that children receive dental treatment and assessment without delay. 25/06/2017

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Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘The statement of purpose’) which covers the matters listed in Schedule 1. (Regulation 16(1))

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Requirement Due date

In particular, include in the statement of purpose the number of children for whom it is intended that accommodation is to 25/06/2017 Inspection report for children’s home – monitoring visit: SC374939 6 be provided.

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b)) 25/06/2017

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Requirement Due date

35: Behaviour management policies and records

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Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it. 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)(i) the name of the child; (ii) details of the child’s behaviour leading to the use of the measure; (iii) the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the need to use the measure; (vi) the name of the person who used the measure (‘the user’), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

Also ensure that, within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’) (b)(i) has spoken to the user about the measure; and (ii) has signed the record to confirm it is accurate; and within five days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35(2)(3)(a)(i)(ii)(iii)(iv)(v)(vii)(viii)(b)(i)(ii)(c)(ii)) 25/06/2017

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Requirement Due date

The registered person must maintain in the home the records in schedule 4; and ensure that the records are kept up to date. 25/06/2017 Inspection report for children’s home – monitoring visit: SC374939 7 (Regulation 37(2)(a)(b))

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Requirement Due date

In particular, maintain accurate staff rosters.

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40(4)(a)(b)(c)(d)(i)(ii)(e)) 25/06/2017

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Requirement Due date

44: Independent person: visits and reports

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Requirement Due date

The independent person must produce a report about a visit (‘the independent person’s report’) which sets out, in particular, the independent person’s opinion as to whether children are effectively safeguarded; and the conduct of the home promotes children’s well-being. (Regulation 44(4)(a)(b)) 25/06/2017

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home – monitoring visit: SC374939 8

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Children’s home details

Registered provider: Horizon Care Limited

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Children’s home details

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

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Inspector

Michelle Edge, social care inspector Inspection report for children’s home – monitoring visit: SC374939 9 to 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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