Children's home run by Aurora Care and Education Opco Limited

Inspection report children’s home: 1243958 1 Registered provider: Aurora Care and Education Opco Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The children’s home provides care for up to 48 young people irrespective of gender who have learning and physical 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: 8 November 2016

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requires improvement to be good

Overall judgement at last inspection: requires improvement

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: 1243958 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 previous registered manager did not manage the home effectively.

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Key findings from this inspection

 The previous registered manager failed to monitor and review the development of the home and the young people’s progress effectively. They failed to take responsibility for a significant number of management tasks.

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Key findings from this inspection

 Since the last inspection, there have been many staff changes. The number of agency and bank staff means that positive and trusting relationships between young people and staff have not been achieved for all young people.

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Key findings from this inspection

 The Head of Care in the role of acting manager, and a number of staff failed to follow safeguarding procedures in respect of reporting a serious injury sustained by a young person.

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Key findings from this inspection

 A number of medication errors have taken place as a result of inconsistent staffing.

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Key findings from this inspection

 In one of the houses, young people are living in accommodation that is institutional and requires refurbishment.

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Key findings from this inspection

 The Director of Operation who is overseeing the vacant principal role, and acting manager demonstrate exceptionally strong leadership and management, skills and knowledge. They have, in a very short period of time, produced a number of systems and procedures to address the shortfalls identified.

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Key findings from this inspection

 A number of the homes have undergone extensive refurbishment and young people are now living in warm, homely and safe environments.

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Key findings from this inspection

 The core staff team is committed, enthusiastic and motivated by the changes that the current management team is implementing.

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Inspection date Inspection type Inspection judgement

08/11/2016 Full Requires improvement Inspection report children’s home: 1243958 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 quality and purpose of care standard The quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. In particular, the standard in paragraph (1) requires the registered person to ensure that staff protect and promote each child’s welfare; treat each child with dignity and respect; provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; provide to children living in the home the physical necessities they need in order to live there comfortably and ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. (Regulation 6 (1)(a)(b)(2)(b)(ii)(iii)(iv)(vii)(c)(i))

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Requirement Due date

The health and well-being standard The health and well-being standard is that the health and well- being needs of children are met. 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. (Regulation 10 (1)(a)(2)(a)(i)) 18/10/2017

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Requirement Due date

The protection of children standard 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; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action 18/10/2017 Inspection report children’s home: 1243958 4 whenever there is a serious concern about a child’s welfare; and are familiar with, and act in accordance with, the home’s child protection policies; that the premises used for the purposes of the home are located so that children are effectively safeguarded; that the premises used for the purposes of the

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Requirement Due date

home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (1)(2)(a)(i)(iii)(v)(vi)(c)(d)) The leadership and management standard 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 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; ensure that staff work as a team where appropriate; ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home’s workforce provides continuity of care to each child; understand the impact that the quality of care provided in

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Requirement Due date

the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; demonstrate that practice in the home is informed and improved by taking into account and acting on feedback on the experiences of children, including complaints received; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home (Regulation 13 (1)(a)(b)(2)(a)(b)(c)(e)(f)(g)(ii)(h)) 18/10/2017

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Requirement Due date

Medicines The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. In particular, the registered person must ensure that a record is kept of the administration of medicine to each child. (Regulation 23 (1)(2)(c)) 18/10/2017

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Requirement Due date

Fire precautions After consultation with the fire and rescue authority, the registered person must take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home. In particular, the registered person must ensure risk assessments are completed and remain up to date. (Regulation 25 (1)(a)) 18/10/2017 Inspection report children’s home: 1243958 5 Appointment of manager The registered provider must appoint a person to manage the children’s home if there is no registered manager in respect of the home. (Regulation 27 (1)(a)) 18/10/2017

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Requirement Due date

Staffing of children’s homes The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. In particular, the registered person must ensure that there is a reduction in the use of agency and bank staff. (Regulation 31 (1)) 18/10/2017

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improvement to be good

Most of the young people benefit from living in homes that have undergone extensive refurbishment. They have very well decorated rooms that are personalised and reflect their identities while supporting their complex behavioural and physical needs. Unfortunately, a small number of young people continue to have bedrooms that look and feel institutional. There are clear plans in place for the continuing refurbishment of all of the homes.

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improvement to be good

A number of members of the core staff team have an understanding of the needs of the young people. Where trusting relationships have developed, challenging behaviours are addressed with a minimal use of physical intervention. However, since the last inspection, there has been a high turnover of staff, and recruitment has not been successful. This has resulted in an over-reliance on agency and bank staff. The impact of this is that a lot of young people have experienced a high volume of different care givers, a lack of consistency and have not been able to form positive relationships.

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improvement to be good

The quality of care and placement plans and recording is variable. It is evident that when staff know the young people well they follow the plans and the recording of progress is clear. There is evidence that some staff are skilled in capturing the views and wishes of young people with complex communication needs. In one particular home, the house manager and his deputy lead dynamically and creatively and young people are making progress. This is not the case for all young people. Weak oversight by the previous registered manager has resulted in little evidence of inclusion, consultation and the progress of most young people since they have lived in the home. Inspection report children’s home: 1243958 6 All of the young people benefit from living next to their school. A high staffing ratio means that all young people are supported at school and their attendance is 100%. Most young people participate in activities when not in school. Unfortunately, poorly kept

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improvement to be good

records do not demonstrate that all young people have personalised activities that meet their individual needs.

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improvement to be good

With the support of staff, some young people are becoming increasingly more independent. They are encouraged to cook, tidy their rooms and engage with the wider community, for example going shopping and going on bus trips.

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improvement to be good

Young people with complex physical and personal needs are supported sensitively by staff. Most of the time, young people enjoy a well-balanced diet and they attend all necessary health appointments. A 24-hour nursing support service is available. However, during the course of the inspection, inspectors identified one young person who was not receiving sufficient support in accordance with her health and dietary needs. A new audit and recording system has been implemented but remains in its infancy.

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improvement to be good

Since the last inspection, the monitoring of young people’s behaviours, serious incidents and complaints has been poor. This means that there is little or no evidence of how staff’s practice and behaviour management are evaluated. A newly implemented recording system is very much in its infancy but early indicators are positive. Staff spoke positively and are enthusiastic about this new system and how it will help to improve the progress of young people.

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improvement to be good

Young people’s files have the required behaviour plans and risk assessments. Staff support young people when they become anxious and apply effective strategies. While there is a reduction in the use of restraint, records are not monitored effectively by leaders and managers. Restraint records do not consistently provide a clear picture of the incidents.

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improvement to be good

There remains a number of staff vacancies across the homes. Recruitment has not been overly successful. Young people continue to be cared for by a high volume of agency and bank staff. Records confirm that during some shifts the majority of staff have been agency staff. There is a direct correlation between the lack of permanent staff and the inconsistency of care that young people receive. For example, there have been five medication errors that are attributable to the ratio of agency and bank staff. In some instances, leaders and managers have failed to ensure that sufficient management cover is in place. They have identified a new system to reduce the number of medication errors that also increases the capacity for children to self-administer their medication and become more independent.

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improvement to be good

Some professionals and parents report concerns about the care that young people receive in relation to sufficient staffing levels. There is evidence that the current acting manager has been swift to respond to the most recent complaints and areas of learning Inspection report children’s home: 1243958 7 have been identified.

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improvement to be good

Serious incidents and accidents are recorded and staff spoken with demonstrate a good understanding of the home’s safeguarding procedures. While some records lack sufficient evaluation and analysis, mostly there is evidence of management oversight.

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improvement to be good

Inspectors did identify one serious incident of an unexplained injury to a young person where safeguarding procedures were not followed. As a result, a thorough investigation into the incident including communication with the designated officer did not take place. Further to this, a lack of management analysis of this incident meant that staff’s practice has failed to be scrutinised and there is insufficient evidence of learning.

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improvement to be good

During the inspection, deficits were found in the frequency of fire alarm testing in some houses and location building assessments. There was no evidence that actions had been completed on some older fire risk assessments dating back to October 2016. The inspectors identified a number of areas of concern during the inspection which were actioned immediately.

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

Since the last inspection, a catalogue of concerns including widespread weaknesses in management and leadership and the monitoring of the quality of care have been identified by the provider. As a result, the senior management team has very recently been changed. An acting manager with an impressive history of managing children’s services and the director of operations demonstrate an excellent level of knowledge are now in role.

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

Inspectors found that under the previous leadership, young people’s progress, the quality of care, how complaints are responded to and the practice of staff in respect of behaviour management were not routinely monitored. As a result, there are isolated incidents of poor practice, variations in the quality of recording and outcomes for some young people remain poor.

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

The acting manager is suitably experienced and qualified. Along with the director of operations have been actively seeking to address all of the shortfalls identified at the last full inspection. While some progress has been made, there has been insufficient time to assess the impact of the strategies and tools that have been introduced.

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

The acting manager has focused on stabilising the workforce. An internal review concluded that there has been a high turnover of staff due to changes to the rota and changes to the culture of the home. Mostly, staff are pleased with recent changes and welcome a new rota system. Supervision now takes place regularly and includes time to reflect and identify further learning opportunities. The introductions of iPads to record and collate information coupled with the ‘School Pod’ electronic recording system means that staff are more efficient with their time and management oversight has improved.

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

The training of staff requires improvement. There are gaps in some staff’s training, in Inspection report children’s home: 1243958 8 particular the safe administration of medication. However, a training programme is now in place to ensure that all staff receive relevant training.

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

The acting manager has a clear focus on what is necessary to improve the outcomes of the young people living in the home. Since his recruitment, he has been able to implement a number of changes. However, he recognises that there is more to do. The development plan is extensive and progress is being made. More time is required to make these changes and embed new systems.

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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 differences 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: 1243958 9

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Aurora Care and Education Opco Limited

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Children’s home details

Registered provider address: Carisbrooke Lodge, Westbury Park, Bristol, BS6 7JE

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Inspector(s)

Linda Bond: social care inspector Heather Chaplin: social care inspector Nicola Lownds: social care inspector Inspection report children’s home: 1243958 10 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 looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

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