Children's home run by Bramley Care Limited

Inspection report children's home: SC013553 1 SC013553 Registered provider: Bramley Care 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 is one of four operated by the same private provider. It is registered to provide care and accommodation for up to nine young people who have emotional and/or behavioural difficulties.

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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: 15 February 2017

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requires improvement to be good

Overall judgement at last inspection: Sustained effectiveness

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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

 Leaders and managers do not monitor the services provided adequately so that Inspection report children's home: SC013553 2 any shortfalls can be identified and remedied quickly.  Medication administration records are not accurate.  The monthly independent person visits have not taken place for four months.  Records do not show which member of staff completed them.

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Key findings from this inspection

 The progress and experiences of children are good. Young people like living here and talk about how much they have benefited.  Relationships between young people and staff are warm and supportive.  Staff know how to protect young people and act when necessary. Staff help young people to keep themselves safer.  Activities provide young people with a lot of different experiences which support them to develop their self-esteem and interests.

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Inspection date Inspection type Inspection judgement

15/02/2017 Interim Sustained effectiveness 16/11/2016 Full Good 16/02/2016 Interim Sustained effectiveness 30/09/2015 Full Outstanding Inspection report children's home: SC013553 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 leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the home that— helps children aspire to fulfil their potential and promotes their welfare (2) in particular, the standard in paragraph (1) requires the registered person to— (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(2)(h))

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Requirement Due date

This relates to having satisfactory systems in place which ensure that issues regarding staff practice and any gaps in records can be identified and rectified in a timely manner. 30/09/17

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received in the children‘s home. In particular the registered person must ensure that— (c) a record is kept of the administration of medicine to each child. (Regulation 23(c))

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Requirement Due date

Staff must particularly ensure that there are: accurate records of when a child refuses their medication; at all times accurate totals of each medication prescribed for a child and clear records as to who has administered each medication; immediate reports of any errors so the manager can take appropriate action. 30/09/17

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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))

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Requirement Due date

In particular the registered person must ensure that they have adequate plans in place to recruit a new independent person, if the need arises, without delay. 30/09/17

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Requirement Due date

The registered person must maintain records (―case records‖) for each child which— (c) are signed and dated by the author of each entry. 30/09/17 Inspection report children's home: SC013553 4 (Regulation 36 (1)(c))

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Requirement Due date

In particular the registered person must ensure that each author‘s signature is written in a way which is legible. 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) Schedule 1 (14(b) & Schedule 1(17)(b))

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Requirement Due date

In particular the provider must ensure that the statement includes detail of how they assess staff competence to restrain young people, and provide and detail on how to obtain information on the success of any therapies used. 30/09/17

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Requirement Due date

The care planning standard is that children— (a) receive effectively planned care in or through the children‘s home; and (b) have a positive experience of arriving at or moving on from the home. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— ( f) that staff help each child to access and contribute to the records kept by the registered person in relation to the child. (Regulation 14 (1)(a)(b)(2)(f))

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Requirement Due date

In particular, children should comment on and sign their restraint records. 30/09/17

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Recommendations

 The registered person should have a system in place so that all serious events are notified within 24 hours, to the appropriate people. The system should cover the action staff should be followed if the event arises at the weekend or on a public holiday. Notification must include details of the action taken by the home‘s staff in response to the event. (‗Guide to the children‘s homes regulations including the quality standards‘, page 63, paragraph 14.13)

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Recommendations

 As set out in regulations 31–33, the registered person is responsible for maintaining good employment practice. (‗Guide to the children‘s homes regulations including the quality standards‘, page 61, paragraph 13.1) In particular, any discussions regarding staff practice should be recorded in supervision. The registered person should also ensure that recruitment records demonstrate they follow the good practice guidelines outlined in ‗Working together to safeguard children 2015‘, and other related guidance. Inspection report children's home: SC013553 5

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improvement to be good

The overall experiences and progress require improvement to be good because the leadership and management of the home is judged inadequate. Leaders and managers do not adequately monitor and review staff practice or records. They miss opportunities to ensure that young people‘s safety and well-being are successfully protected and promoted. Leaders and managers have taken action to improve the monitoring and review of practice, but, as yet, there is no evidence of sustained improvement. Young people make progress and they can identify in themselves the changes and benefits of living here. They said the changes are due to the strong boundaries staff provide and the warm relationships they develop with staff. Some young people have reduced their aggressive behaviours, while others are now able to talk about their feelings and can better manage their behaviour. Young people choose to accept a place at the home and engage in the programmes

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improvement to be good

available. Before moving in, young people stay for a week, and there is a joint decision between professionals and young people about this being the right place. This allows young people to feel involved in decisions made about their care and to move in well and settle quickly. Young people are fully involved in decisions about changes in the home and have well established opportunities to put forward their views. They know their care plans and goals and read, sign and comment on the monthly reports staff write about their progress. Young people said these reports are accurate; when the reports are not accurate, they feel able to talk about their concerns. Staff support for education results in improvements to young people‘s learning and achievements. Young people attend school and are helped to complete their homework each day. They have their own study areas in their bedrooms. Staff help young people to

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improvement to be good

identify and achieve their career aspirations. Staff encourage young people to research the qualifications they will need. This helps young people to engage in their current educational programme. Young people‘s health needs are well understood and met. Staff monitor that young people attend any regular check-ups and each young person engages in weekly therapy sessions, which they find helpful and supportive. Young people take regular physical activity, eat healthily and are supported to manage any particular health need they have. Monitoring systems are ineffective in identifying errors in the recording and administration of medication. Medication administration records are incomplete. Some records do not confirm the number of tablets held at any given time, and in one record staff confirmed there was an incorrect date of administration. Records are monitored, but checks did not identify errors and no action was taken to improve medication administration recording.

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improvement to be good

Activities are well organised and provide a range of opportunities to extend young people‘s Inspection report children's home: SC013553 6 learning, skills and interests. One young person summed up activities as ‗fun‘. The programme provides opportunities for experiences which young people may have missed in the past, such as fishing in streams and playing musical instruments. Staff encourage empathy for others by supporting young people to contribute to the community. Examples include knitting blankets for dogs‘ homes. Young people‘s independence is promoted and supported effectively. Independence plans are developed with young people and take account of the constraints and risks they pose to themselves and others. Planned independence programmes help staff to assess how well a young person can keep themselves safe in the community and how well they develop life skills such as washing and cooking. Young people enjoy helping staff with everyday tasks

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improvement to be good

and will offer to help cook meals on a regular basis.

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

Staff follow good safeguarding practice. Staff know what to do if a young person is at risk and take appropriate action to protect the young person and help them to keep themselves safe. However, poor recording systems do not always provide a comprehensive chronology which fully demonstrates all actions taken. As a result, staff are not able to monitor effectively any drift in how a referral is managed. Behaviour management strategies are effective; these enable young people to learn how to develop coping mechanisms which help them to improve their behaviour. Young people are polite and helpful. Restraints are minimal, and sanctions imposed where necessary. Records of restraint are appropriate; the detail provides a full view of what occurred and how managers checked that they are satisfied with what occurred. Managers‘ review the details of any sanctions imposed, but the young person does not always sign and comment on

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

each record. Support for managing conflict works well. Young people have confidence that staff deal with any concerns they have. A restorative approach supports young people to empathise with others and develop more positive relationships. Young people say bullying is rare, but when it happens staff deal with it well and help to build better relationships between young people. Staff facilitate group discussions between young people to talk about the impact of incidents such as going missing on the others. This helps young people reflect and think about what they could do differently. There has been an increase in the number of times in which young people go missing, but this still remains rare. Staff work appropriately with relevant agencies to find young people, talk to the young person to understand why they went missing and find solutions which reduce this behaviour. Records of when children go missing give a picture of the actions

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

taken to prevent its reoccurrence and manage the incident itself. The standards of recruitment practice is variable. While the recruitment practice for care staff is thorough, the recruitment of the independent visitor lacks similar rigour. The file contained no evidence of how the person‘s qualifications were verified, no application form which demonstrated their ability to meet the requirements of the position, and no record of any interview held. Inspection report children's home: SC013553 7 Health and safety checks are regularly undertaken. However, managerial oversight of checks is not robust. Records of portable appliance tests did not clearly state when each piece of equipment was tested. Managers had met the requirement from the last inspection to take account of the Fire Safety Officer‘s report from June 2017. Records relating to the actions taken, and changes made, in respect of the report were not readily available, and it

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

took managers some time to clarify the actions taken. Amendments to the fire safety plan were made during the inspection.

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The effectiveness of leaders and managers: inadequate

Leaders and managers do not identify and rectify shortfalls in an effective and timely manner. Monitoring systems are weak. The provider has identified these concerns and acted to improve them. Additional support for the manager has been arranged, but as yet there is insufficient evidence of sustained improvement. The home has been without a registered manager since late last year. One manager left before registration was completed, and the current manager failed to submit her application within the expected 28 days. No independent person has visited the home since February 2017. The responsible individual and office manager have completed monthly visits. However, an independent visitor has been appointed and started in July 2017. Managers are taking action to ensure that they are not in this position in the future and have the capacity to find a new independent person more quickly in the future. The statement of purpose does not contain all the necessary detail. For example, the name

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The effectiveness of leaders and managers: inadequate

of the provider is missing; the role of the responsible individual is not clarified and does not contain details of how staff competence to restrain young people is monitored; and there is no information about the successes of any therapies in use. Notifications are not sent to Ofsted without delay and do not always contain all the information required. The forms used do not cover all required areas. Managers have created a culture of high aspirations for young people, which includes supporting them to develop tolerance and understanding of others. Staff clearly want the best for the young people and meet the aims set out in the home‘s statement of purpose. Sufficient numbers of adequately trained staff who know young people well support them throughout the day and night. Staff have regular supervision, appraisal and training. Supervisions cover a good range of issues, including any concerns about staff practice.

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The effectiveness of leaders and managers: inadequate

However, supervision records do not always accurately reflect the issues discussed or demonstrate how managers deal with any shortfalls in staff practice. Staff are positive about managers, feel able to discuss any concerns with them and are confident managers take their concerns seriously. For example, previously all staff went to work at the provider‘s school during the day. One person now returns to the home to complete administration tasks. Staff maintain children‘s records well. The records provide good detail of a young person‘s progress, and staff update the records appropriately. Staff initial rather than sign documents. These initials are not legible, and it is not always easy to determine who has Inspection report children's home: SC013553 8 completed the record.

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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. Whenever 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 and 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: SC013553 9

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Children’s home details

Registered provider: Bramley Care Limited

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Children’s home details

Registered provider address: Bramley Care Limited, Nicholas House, Riverfront, Enfield, Essex EN1 3FG

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Inspectors

Ruth Coler, social care inspector Paul Taylor, social care inspector Inspection report children's home: SC013553 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 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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