Children's Home run by Acorn Homes (UK) Ltd in Kent

Inspection report children’s home: 1250521 1 Registered provider: Acorn Homes (UK) 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 children’s home is one of a number operated by a private provider for up to four young people who have emotional and behavioural difficulties The provider also has a school which some young people attend and a health and well-being team that offers services to children at this home.

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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: This is the first inspection after registration on 11 May 2017

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requires improvement to be good

Overall judgement at last inspection: Not applicable

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Enforcement action since last inspection:

None Inspection report children’s home: 1250521 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

 There have been a number of unplanned changes for young people who live here in the three months since the home opened.  Continuity of care for young people has been difficult because of a high staff turnover since the home opened in May 2017.  The monitoring and reviewing systems have not consistently identified any gaps or errors in recording and shortfalls in practice.  Risk assessments are not always updated quickly when there is a change of circumstances or new information.  Records relating to safeguarding concerns and staff supervision could not be checked as these were not accessible.  Complaints management is not fully documented; this is especially so in relation to an ongoing complaint, where reviews of concerns do not clearly distinguish whether they relate to an already known issue or a new concern.

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Key findings from this inspection

 The leaders and manager have identified many of the concerns and now have plans to rectify the shortfalls and develop a stable staff team.  Staff have helped young people to be positive about their education and look forward to their new school year.  Staff support young people’s contact with important people well.  Staff help prevent young people from going missing and act appropriately if they do.  Staff build good relations with social workers and other professionals.

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Recent inspection history

Not applicable. Inspection report children’s home: 1250521 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 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)) The registered person must particularly ensure that staff accurately record how each medication is administered. 30/10/17

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year taking into account the requirement in regulation 12(2)(c) (the protection of children standard). (2) When conducting the review, the registered person must consult, and take into account the views of, each relevant person. (Regulations 46(1) (2). In particular the registered person must ensure that the location risk assessment is updated if any new risks are identified and record the outcome of their consultations with the local authority and police. 30/10/17

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Requirement Due date

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. (Regulation 31 (1)). In particular the registered person must ensure there is a stable workforce to support and care for young people. 30/10/17

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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— (1)(a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) lead and manage the home in a way that is consistent 30/10/17 Inspection report children’s home: 1250521 4 with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; (b) ensure that staff work as a team where appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (d) ensure that the home has sufficient staff to provide care for each child; (e) ensure that the home’s workforce provides continuity of care to each child; (f) understand the impact that the quality of care provided in the home is having on the progress and experiences of

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Requirement Due date

each child and use this understanding to inform the development of the quality of care provided in the home; (g) demonstrate that practice in the home is informed and improved by taking into account and acting on— (i) research and developments in relation to the ways in which the needs of children are best met; and (ii) feedback on the experiences of children, including complaints received; and (h) 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)(d)(e)(f)(g)(i)(ii)(h)) 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)) In particular the registered person must ensure that when a person makes multiple complaints records clearly identify whether this is part of a previous complaint which the provider has responded to or a new complaint which

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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. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. (Regulation 12 (2(i)(a)) In particular the registered person must ensure that records of the actions taken in response to safeguarding concerns are clearly documented and easily available to relevant senior staff. 30/10/17 Inspection report children’s home: 1250521 5

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Recommendations

 The registered person should have a workforce plan which can fulfil the workforce-related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should detail the process and timescales for supervision of practice (see regulation 33 (4) (b)) and keep appropriate records for staff in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8) In particular, the provider should ensure that any timescales they place on completing regular staff supervisions are met.

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Recommendations

 Children must be consulted regularly on their views about the home’s care, to inform and support continued improvement in the quality of care provided. Due consideration should be given to the child’s cognitive ability in the development and implementation of any consultation processes. Children should be able to see the results of their views being listened to and acted upon. (‘Guide to the children’s homes regulations including the quality standards’, page 22, paragraph 4.11) In particular, the registered person should ensure that any actions identified at a children’s meeting are reviewed with children at the next meeting.

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Recommendations

 Registered persons must ensure that there are procedures in place for welcoming and introducing each child to the home, and that they are sensitive to the needs of the child at the time of arrival. A warm welcome and introduction to the home is an entitlement for all children, whether they are admitted in a planned way or in an emergency. When possible, other children and young people should be supported to contribute to the design of the welcome and introduction and, when appropriate, the welcome itself. The home has a key role in helping children to understand why they are living there and the plans for their future. (‘Guide to the children’s homes regulations including quality standards’, page 57, paragraph 11.7) Inspection report children’s home: 1250521 6

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improvement to be good

In the three months since the home opened, there have been significant changes to the staff team that works here, including changes to the senior management team. This has not provided sufficient continuity of care or satisfactory leadership and management. The level of change has severely affected young people’s opportunities to build relationships with staff. The provider has now taken action to address this.

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improvement to be good

Staff are now being supported by stronger, clearer leadership. Managers are undertaking a full review of the home to identify shortfalls and make the necessary improvements. Relationships during the inspection were positive, and staff reported that they considered that, with stronger guidance, they were building better relations with young people. However, further work is required to ensure that good practice is fully embedded and consolidated.

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improvement to be good

The quality of young people’s experiences and progress varies. Three young people moved in but left after very short periods because of their levels of concerning behaviours. Young people’s introductions to the home have not always been planned well. The timing and staff deployment has not ensured that staff focus on ensuring that all young people have sufficient attention so that a smooth transition is supported. However, the social worker for one young person who has lived here since the home was registered in May 2017 was very positive about the support the young person has received and the progress she has made. A second young person recently moved in. She said staff had helped her to do this well, giving them eight out of ten for their support so far.

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improvement to be good

Young people’s healthcare needs are identified and monitored. Plans to improve young people’s health, such as through gym membership, are also in place. Managers identified poor medication management and introduced changes to ensure safe practice occurs. Evidence of improved practice is not yet available, as young people generally enjoy good health and staff administer little medication.

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improvement to be good

Programmes of support for particular health needs are appropriate and have resulted in one young person’s self-injurious behaviour reducing. The organisation’s health and well- being team is expected to start an assessment of young people’s mental health needs within 28 days of a young person coming to live here. This did not occur for most young people who were admitted to the home. These are missed opportunities for staff to learn more about young people’s therapeutic needs and develop holistic care plans. Where these were in place, staff said that the content helped them to know the young person better.

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improvement to be good

Consultation with the young people is regular and meaningful. Frequent children’s meetings occur. Staff record any actions to be taken in the minutes, but these are not Inspection report children’s home: 1250521 7 reviewed at the next meeting. Young people therefore do not know how their views are taken into consideration. Knowing this would assist them in further building their trust in staff.

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improvement to be good

Young people’s education is prioritised and nurtured. Plans are made immediately to support young people to be in full-time education which meets their needs. Young people who have found engaging in education difficult now look forward to the start of the school year and have developed an enjoyment for learning. Staff encourage learning in the home, note young people’s achievements and engage them in developing healthy routines during term time which assist their school attendance. A new post of virtual head teacher for all of the provider’s homes has been created. The head teacher undertakes an educational needs assessment, which supports staff in knowing a young person’s educational needs and assists them to identify and support local authorities to make application to an appropriate school in the area.

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improvement to be good

Contact with family and friends is promoted and supported well. Staff help young people to maintain positive relationships; they chase up any questions about when contact will occur and have supported young people to put their views about contact forward.

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improvement to be good

Regardless of why a young person has left, staff work hard to make moves a positive experience. This was particularly noted by one social worker.

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improvement to be good

The quality of safeguarding practice could not be fully verified. A chronology of how staff have managed safeguarding concerns after referral was not available. The secure cabinet where files are stored could not be unlocked. Staff could not find a key to open it. The safeguarding policy is generic. The policy does not clearly detail how it relates to the young people who live here nor does it name people who hold particular safeguarding roles in the organisation. It does not contain sufficient clarity for staff about what to do in different circumstances. For example, it does not indicate which safeguarding agencies should receive the referral if a young person makes an allegation of historic abuse.

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improvement to be good

Staff proactively work to keep young people safe and to support young people to keep themselves safer. Senior staff on duty were not aware of all the actions taken about safeguarding concerns, which impedes their ability to make suitable decisions regarding a young person’s safety. The senior managers were acting to improve this and had plans to rectify this the day after inspection.

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improvement to be good

Risk assessments cover many aspects of a young person’s needs well and include appropriate plans to reduce or eliminate risks. Nonetheless, staff do not always identify new risks or quickly update risk assessments when circumstances change. This means staff do not have appropriate up-to-date guidance to manage young people’s changing behaviours. Inspection report children’s home: 1250521 8 Staff act appropriately to prevent young people from going missing and act quickly to find them. Risk assessments identify all the known locations that a young person may go to. Changes to levels of risk are not consistently updated so that staff have clear guidance about any changes to the circumstances in which they would report a young person as missing. Managers continue to improve how they prevent and manage young people going missing. For example, staff take a tracking device with them when they look for a young person. The device enables managers to identify and monitor where

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improvement to be good

young people are running to. They use trends to target their searches and to advise the police where to look. Managers are also able to track staff movements to better ensure their safety.

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improvement to be good

The locality risk assessment does not sufficiently address all issues regarding the area where the home is situated. The assessment has not been reviewed when concerns have arisen, such as a young person going to a nearby bridge over a busy dual carriageway. The document does not specify any known areas of concern or refer to the results of any consultations the provider completed with agencies such as the police or local authority planning officers. It does not address how to keep young people safe from farm equipment stored near the home.

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improvement to be good

Recruitment, and health and safety, are well managed. Repairs to the premises are quickly undertaken when necessary, especially when these relate to fire safety. Regular fire evacuations occur. Recruitment practice is carefully documented and shows how employment decisions are reached, especially when additional information is required.

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

The leadership and management of this home has been weak and has completely changed in the last month. The registered manager resigned on the first day of this inspection and both deputies have changed. This has impacted on young people’s continuity of care and their ability to develop relationships with a stable workforce. Monitoring and reviewing systems have not effectively ensured that all records and practice provide evidence that legislation and guidance are followed and access to appropriate records is poorly organised.

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

Staff said that they have found it difficult to manage some young people’s behaviour, the constant change of personnel has made it challenging to work together effectively and sufficient guidance from senior staff has been lacking. The provider identified that the home was not working well and has implemented a full review of its services here. An action plan to improve any deficits noted was implemented on 18 August 2017.

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

There has been significant instability in the staff team. Sufficient numbers of staff are on duty, but staff members’ abilities to fully meet young people’s needs has been severely impeded by a high turnover of staff in a short space of time. Only two members of staff remain from the team that opened the home. In order to support a positive team culture, staff from the provider’s other homes have moved to work here permanently. This is to enable young people to be cared for by a balance of experienced staff and Inspection report children’s home: 1250521 9 staff new to residential care.

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

Staff report that recent changes have provided greater guidance and support to them which has in turn helped them to better support young people and more effectively manage any difficult behaviours. As a result, there is a calmer atmosphere in the home.

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

Staff supervision has occurred, but its regularity is not in line with the organisation’s expectations. The quality of supervision could not be assessed, as the supervision files could not be accessed. Staff said supervision had recently improved and helped them to progress and learn. Managers were working some shifts to provide staff with learning opportunities. Monthly team meetings cover a wide range of topics, including young people’s progress and more practical issues such as cleaning responsibilities.

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

The provider is managing a number of complaints about the home which relate to its impact on the local community. There is a plan in place to address their neighbours’ concerns, which was agreed with those concerned. However, when the plan proves ineffective, clear action is not taken to agree any necessary changes. A record of all complaints made and how each one has been managed is not maintained. For example, there is no clear record of whether any further concerns from the local community are new or relate to a previous complaint that the provider has responded to. Staff were not fully aware of how these concerns are being progressed, nor did they know how they should respond to any concerns raised with them. They had not always recorded these conversations.

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

Staff training covers both general care and the specific needs that young people have, such as through training in handling self-harm.

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

Social workers report good relations with staff. One social worker said that staff provide them with regular updates on the young person they support and inform them of any concerns that occur.

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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 Inspection report children’s home: 1250521 10 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: 1250521 11

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Children’s home details

Registered provider: Acorn Homes (UK) Ltd

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Children’s home details

Registered provider address: 424 Margate Road, Ramsgate CT12 6SJ

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Inspector

Ruth Coler, social care inspector Inspection report children’s home: 1250521 12 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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