Children's home run by Thoughts of Others Limited

Inspection report children‘s home: SC038066 1 SC038066 Registered provider: Thoughts of Others Ltd

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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 home is registered to provide care and accommodation for up to three children who have emotional and/or behavioural difficulties. It is operated by a private company. The company also operates a school nearby. The organisation provides therapeutic services.

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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 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

Overall judgement at last inspection: sustained effectiveness

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Enforcement action since last inspection

None. Inspection report children‘s home: SC038066 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 registered person has not taken effective action to improve the service in respect of record-keeping, staff appraisal, continuity of care and acting on feedback from children‘s experiences.  There is no registered manager for the home.  Staff fail to implement safeguarding procedures.  Arrangements for administration of medication are poor.  Staff training and professional supervision are weak and do not enable staff to have the necessary knowledge, skills and qualification to perform their work well.  Staff disregard or do not take action on children‘s complaints.  Leaders and managers do not use internal and external monitoring effectively to understand the strengths and weaknesses of the home  The recruitment of staff does not ensure that only suitable people get to work with children.  The registered person has not ensured that the statement of purpose sets out clearly what care the home will provide.

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Key findings from this inspection

 Managers fail to follow up recommendations made by the independent visitor.  The manager‘s quality of care review fails to drive improvement.

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Key findings from this inspection

 Children make good educational progress.  Parents are positive about the level of progress that their child is making.  Children have prompt access to the organisation‘s psychologist service, and creative therapy and assessment.  Children‘s health needs are met.  Good partnership working helps to ensure that children get access to guidance on staying safe.  Children are given encouragement and support to keep in contact with their family. Inspection report children‘s home: SC038066 3

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Inspection date Inspection type Inspection judgement

06/03/2017 Interim Sustained effectiveness 20/12/2016 Full Requires improvement 21/03/2016 Interim Sustained effectiveness 04/01/2016 Full Good Inspection report children‘s home: SC038066 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.

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Requirement Due date

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. To understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person and to take effective action 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; and that the effectiveness of the home‘s child protection policies is monitored regularly. (Regulation 12 (2)(a)(i)(v)(vi)(vii)(e)) 20/09/2017

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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.

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Requirement Due date

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 delivers the outcomes, set out in the home‘s statement of purpose; ensure that staff have the experience, qualifications and skills to meet the needs of each child. To ensure that the home‘s workforce provides continuity of care to each child and demonstrates 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) and (2)(a)(c)(e)(g)(ii)(h)) 20/09/2017

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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. The registered person must ensure that the home is at all times 20/09/2017 Inspection report children‘s home: SC038066 5 conducted in a manner which is consistent with its statement of purpose. (Regulation 16(1) and (5)) The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children‘s home. (Regulation 23(1)) 20/09/2017

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children‘s safety. (Regulation 32(1)) 20/09/2017

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Requirement Due date

The registered person must ensure that all employees have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(c)) 20/09/2017

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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 all elements of (3)(a)(i–viii) and 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‖)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within 5 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(3)(a)(i–viii)(b)(c)) 20/09/2017

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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; are kept up to date; and are signed and dated by the author of each entry. In particular, ensure local authority care planning documents, copies of any legal orders and a record relating to the protection or safety of the child. The registered person must ensure that case records must be kept securely in the children‘s home during the period when the child to whom the case records relate is accommodated there. (Regulation 36 (1)(a, b, c)) and (2)(c)) 20/09/2017

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (3)) 20/09/2017

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Requirement Due date

The registered person must establish and maintain a system for monitoring, reviewing and evaluating the feedback and opinions of children about the children‘s home, its facilities and the quality of care they receive in it. The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(2)(b)(5)) 31/10/2017

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Recommendations

Inspection report children‘s home: SC038066 6  Ensure that the recruitment, supervision and performance management of staff safeguards children and minimises potential risks to them. (‗Guide to the children‘s homes regulations including the quality standards‘, page 61, paragraph 13.1)  Ensure that staff receive good quality supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. In particular, that it includes any safeguarding or performance issues. (‗Guide to the children‘s homes regulations including the quality standards‘, page 61, paragraph 13.2)  Ensure that the children‘s home is a nurturing and supportive environment that meets the needs of the children, they will, in most cases, be homely, domestic environments. Children‘s homes must comply with relevant health and safety

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Recommendations

legislations (alarms, food hygiene etc.); however, in doing so, homes should seek as far as possible to maintain a domestic rather than ‗institutional‘ impression. This is with specific reference to personalising children‘s space, providing enough comfortable furniture for staff and children and addressing the number of locks on internal doors in children‘s areas. (‗Guide to the children‘s homes regulations including the quality standards‘, page 15, paragraph 3.9)  Take account of government guidance about assessing the location of a children‘s home, so that the manager of the home will benefit from a clear understanding of the benefits and disadvantages of living in a specific location. This will help establish whether the area is suitable for a home, ensuring that children feel safe and are able to benefit from good quality services. (‗Children‘s homes regulations amendments 2014, Advice for children‘s homes providers on new duties under

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Recommendations

amendments to regulations that came into effect in January and April 2014‘, page 5, paragraphs 1–1.30.)

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improvement to be good

Two of the three girls living at the home have a formal deprivation of liberty order that has been issued by the court. One child is a ward of court. The manager keeps under review the intensity of staff supervision. As staff supervision reduces, children benefit from more staff guidance that focuses on helping children to take on appropriate levels of responsibility.

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improvement to be good

Despite high staffing levels, staff are respectful about their movements around the house and engage positively with children. This is done sensitively and not in an oppressive way.

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improvement to be good

All three children have different needs and staff plan well to ensure that children‘s individualised needs are met. One child is nearing independence and is working towards Inspection report children‘s home: SC038066 7 a move back to her home area. Staff have supported her and her family to help to make this move as successful as possible. Another child has recently moved in and needs extra support at this early stage of her placement.

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improvement to be good

Staff are positive about the importance of education and its value to children‘s futures. All children regularly attend school. Children take pride in moving into and up through the organisation‘s school and into the sixth form. For example, one parent told the inspectors, ‗She is doing fantastic in education. She loves going to school. She is doing fantastically, she is real proud.‘ As a result, children are motivated to learn and achieve beyond expectations.

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improvement to be good

Children have a say about what happens in their daily lives. This includes being able to participate in regular planning and review meetings and benefit from direct working sessions in line with their local authority plans. However, staff can often disregard or take no action on concerns and complaints raised by children. As a result, children do not get a response to their raised concerns and the manager is not aware about the complaints that children make about their care.

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improvement to be good

Children have good health and keep appointments with their doctors, dentists and opticians. Staff encourage a good diet and there has been significant weight loss for some children. Active leisure pursuits support children‘s physical and emotional health. Children who need additional psychological or psychiatric help benefit from the registered person‘s advance planning with local psychiatric services. The organisation‘s therapists provide prompt assessments and ensure that referrals to appropriate secondary health services are made to avoid delay. Therapists help the staff to understand children‘s needs better. However, poorly maintained records for the administration of medication mean that the manager is not always assured that staff have administered children‘s medication in accordance with their prescribing doctor.

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improvement to be good

Staff try hard to make sure that the house is friendly and homely. However, the physical appearance of the property is not welcoming. The doorbell does not work and cigarette butts fill an empty flowerpot at the front door. Most of the internal doors on the ground floor have locks fitted. The bedrooms and sitting areas for some children lack personalisation. There is no comfortable seating in one child‘s lounge area for staff to sit down on while they work. The child needs three staff with her and they sit on beanbags or the floor, or stand.

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improvement to be good

Staff support children who live far from home to stay in touch with parents and friends. Staff drive long distances to help with home visits, including overnight stays. Parents and placing authorities appreciate this partnership working. One parent told the inspectors, ‗The staff team has always been really supportive. They are really good at keeping our relationship alive.‘

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improvement to be good

Staff have a good record of moving children successfully on to independence or moving children that reach adulthood to the organisation‘s care home for young adults. One social worker told the inspectors that she was pleased with the ability of the staff to care for one child, so much so that she wanted to, ‗sing their praises, she was in such a Inspection report children‘s home: SC038066 8 difficult situation, but she‘s responding really well‘.

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improvement to be good

Staff work in partnership with the police and external agencies to help children make wiser and safer choices. For example, the police have carried out direct work with children about the risks of child sexual exploitation. This has helped children to understand the dangers. Children get to practice travel and personal safety skills with one of the company‘s therapists. This increases children‘s insight into how to make safe decisions, especially when out in the community. The work done by staff, police and therapists means that social workers and parents are confident that children are being kept safe. Despite all this good practice, supporting documents fail to match practice. For example, one child is at risk of going missing. However, there is no written plan to manage this risk, including how this information is shared with the police. Another child‘s risk assessments have not been updated to show the current reduction in staff

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improvement to be good

Staff do not receive training to help them understand children‘s behaviour that can include self-harming. However, in practice, children get a swift response. Children feel supported and cared for. One child told the inspectors, ‗They accept you for who you are. See you for being you. They do not judge you.‘

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improvement to be good

Safeguarding issues are rare. However, staff practice in respect of referring concerns, record-keeping and management review is weak. The manager is unable to access the organisation‘s safeguarding records independently. Junior staff hold designated safeguarding lead roles and although trained, they do not fully understand their roles and responsibilities, or the home‘s child protection policy. In one instance, staff delayed a referral of a child protection concern to the local authority safeguarding team. The referral lacked adequate information. Records of the incident are dispersed between different staff email accounts and a whole-organisation spreadsheet. The quality of the centralised recording is poor and does not show a conclusion. Following one safeguarding issue, the registered person failed to monitor the effectiveness of the child protection policy afterwards. This created a missed opportunity to learn lessons and to

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improvement to be good

The manager and staff have a good understanding of the triggers and the reasons for children‘s behaviour. As a result, the use of physical restraint has reduced dramatically from the time of the last inspection, both in frequency and in duration. The home is changing from one system of physical restraint to another. During this period of transition, some staff members‘ training has expired. However, these staff continue to restrain children. The manager has not picked this up when signing off records. A previous requirement to improve the quality of restraint records is still not met. Staff continue to leave gaps in their records of restraint and sanctions. Despite this, children feel the benefit of a calm approach. One child told inspectors, ‗Staff are outstanding. They give you boundaries that make sure you are safe. For example, if you are unsettled they will give you 30 minutes. You can calm down. Then you can go out or carrying on

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improvement to be good

Inspection report children‘s home: SC038066 9 with what you were doing and enjoy it.‘

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improvement to be good

Staff recruitment procedures are not thorough. For example, managers fail to secure the most appropriate references. Managers are not assessing risk when staff have criminal records. This includes missing details and dates of offences. Because of these shortfalls, it is not evident how the registered person has measured an applicant‘s suitability against the need to promote children‘s safety.

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improvement to be good

Despite these shortfalls, children do become increasingly safe at the service. This is not just through the restrictions allowed by formal deprivation of liberty orders, but because staff offer children good advice and support to develop their own calm and protective behaviour.

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The effectiveness of leaders and managers: inadequate

There has been no registered manager working full-time at the home since August 2016, when the current acting manager was appointed to the role. The previous registered manager resigned from this post in February 2017. The acting manager had not submitted a complete application until the point of the inspection.

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The effectiveness of leaders and managers: inadequate

The registered person took action to meet two of the five requirements made at the last interim inspection. Children‘s legal status is now clear and staff now know who makes decisions about children‘s care. The responsible individual updated the behaviour management policy in June 2017. However, he has not shared it with staff. Consequently, while the policy now makes it clear how the service implements restrictions or deprivations of liberty, staff do not benefit from this information.

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The effectiveness of leaders and managers: inadequate

The registered person has still not met a previous requirement to demonstrate that the staffing model ensures continuity of care for children. High staffing levels on shift require 35 additional staff from other homes to supplement the 24 core staff attached to the home. The registered person had made no analysis of the additional numbers until during the inspection, and has not analysed the effect on children of less familiar staff working at the home. Similarly, children‘s feedback on their care and their complaints do not help inform the development of the home or the report of the review of the quality of care.

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The effectiveness of leaders and managers: inadequate

A previous requirement to ensure that all staff have an annual appraisal is not met. Annual appraisals are overdue for more than half the staff who should have had their performance reviewed. Arrangements are not yet good enough to ensure that all staff are trained or competent to meet the needs of the children currently living at the home. Less than 25% of the core staff team have the relevant qualification at level 3 in working with children. Staff do not have awareness training around the risks of self-harming. Not all staff are trained in administering medication. Restraint training for some staff is out of date. Staff have a long probationary period of two years. The manager has planned some additional training and staff said that they gained knowledge through staff meetings at which some children‘s progress is discussed. Inspection report children‘s home: SC038066 10 Staff supervision lacks an effective safeguarding focus. It happens, but is not practice

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The effectiveness of leaders and managers: inadequate

related in respect of safeguarding or performance issues. Arrangements for the management of safeguarding by junior staff confuse roles and hierarchies of accountability. The manager does not supervise the home‘s designated safeguarding officer, and so there is no opportunity for professional conversations about safeguarding matters.

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The effectiveness of leaders and managers: inadequate

The quality of record-keeping was a previous requirement and is still an area that requires improvement. Staff do not always have the benefit of a child‘s local authority plan, or a copy of the deprivation of liberty order, to help them implement appropriate care. Absent or unreliable records mean that some of the most important information about children‘s life in the home is completely missing. For example, there is no record of a child protection incident for one child, who has no account to look back on in later life. Other documents appear to be overwritten from standardised ‗pro forma‘ records. For example, one details a previous risk of allegations against staff, when the social worker confirmed there had not been any. Another said that a child was attending school, when she was not. Records omit staff signatures or dates. Another record was signed with an incorrect date. Computerised and printed records of staff supervision

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The effectiveness of leaders and managers: inadequate

show contradictory dates, so it is not clear which is accurate. They also describe staff as working at a different home. This casts doubt on the reliability of records in general. Not all records are kept securely. Some are left out in public areas and can be viewed by unsupervised maintenance staff.

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The effectiveness of leaders and managers: inadequate

The manager and the responsible individual do not review significant safeguarding events. The manager, despite not being registered, appears to have been solely responsible for the most recent review of the quality of care without the responsible individual‘s input. A number of recommendations from the independent visitor ‗roll over‘ from one monthly visit to the next. For example, a recommendation to improve the home‘s location assessment to include risks from local gangs has still not been completed.

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The effectiveness of leaders and managers: inadequate

A copy of the statement of purpose has not been sent to Ofsted. The copy held at the home omits information about the qualifications and professional supervision of the therapists working with children. It says that the home will provide a classroom with IT facilities. However, there are no facilities. It does not specify that the service requires each child‘s local authority to seek a deprivation of liberty order as a prerequisite of admission. There is no evidence of the monthly qualitative monitoring reports about therapeutic intervention detailed in the statement of purpose. Children, their parents and placing authorities do not have good-quality information about the service.

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The effectiveness of leaders and managers: inadequate

The registered person has submitted an application to increase the number of children living at the home. However, he has not yet provided sufficient information to establish that he has the local authority‘s planning permission to allow this.

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The effectiveness of leaders and managers: inadequate

Despite these weaknesses, the acting manager and staff are very involved in the lives of the children. The acting manager leads the home to ensure that children‘s daily physical and emotional needs are promoted. He knows the children‘s histories in detail. Children Inspection report children‘s home: SC038066 11 seek him out for advice and support. This might be for emotional support or talking about having their nails painted. Staff respect the manager and are very appreciative of his support. He is ‗hands on‘ and works the majority of his hours on shift. The responsible individual told inspectors that in future, no managers would be required to make up numbers on shift routinely.

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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: SC038066 12

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Children’s home details

Registered provider: Thoughts of Others Ltd

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Inspectors

Christy Wannop, social care inspector Dawn Bennett, social care inspector Inspection report children‘s home: SC038066 13 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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