Children's Home run by N H Care Limited in Birmingham

Inspection report children’s home: SC467264 1 SC467264 Registered provider: N H Care Limited 6038073

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is registered to provide care for four young people up to the age of 18. The home may provide care and accommodation for young people who have emotional and/or behavioural difficulties. The home is privately owned.

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Information about this children’s home

Inspection dates: 20 to 21 September 2017

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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: 12 January 2017

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requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

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requires improvement to be good

Enforcement action since last inspection: None

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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 home has not had a registered manager for over 26 weeks.  Some members of staff are not safely recruited. Inspection report children’s home: SC467264 2  Some areas of the home require improvement.  Staff do not follow the organisation’s policy for the recording of controlled drugs.  The manager has not updated the statement of purpose to reflect staffing changes.  The manager does not have a workforce development plan.  Not all staff have the necessary knowledge of fire safety, food hygiene, equality and diversity and self-harm.

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Key findings from this inspection

 Young people make good progress from their starting points.  Staff support young people to maintain family contact.  Staff help young people to enjoy a wide range of leisure pursuits and activities.  Young people are encouraged and supported to develop their independence skills.  Staff have good relationships with placing authorities and other professionals.  Staff feel supported through regular supervision.

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Inspection date Inspection type Inspection judgement

12/01/2017 Interim Sustained effectiveness 02/06/2016 Full Requires improvement 02/02/2016 Interim Sustained effectiveness 05/08/2015 Full Good Inspection report children’s home: SC467264 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 is that children receive care from staff who use their understanding of the children’s home’s overall aims 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 the premises used for the purposes of the home are designed and furnished so as to enable each child to participate in the daily life of the home. (Regulation 6(1)(2)(c)(ii)) 17/11/2017

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Requirement Due date

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

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Requirement Due date

This is with particular reference to ensuring that the staff structure and staff details are kept up to date. 17/11/2017

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines into the home. (Regulation 23(1)) 17/11/2017

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Requirement Due date

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)) 30/11/2017

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Requirement Due date

The registered person may only employ an individual to work at the children’s home if full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32(3)(d)) 17/11/2017

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Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development. (Regulation 33 (4)(a))

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Requirement Due date

This is in relation to training to raise awareness of fire safety, food hygiene, equality and diversity, and self-harm. 17/11/2017 Inspection report children’s home: SC467264 4

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Recommendations

 Ensure that children are provided with appropriate furniture, such as a lockable cabinet or drawers, to securely store personal items, including any personal information. (‘Guide to the children’s homes regulations, including the quality standards’, page 16, paragraph 3.19)  Ensure that there is a workforce plan in place, which can fulfil the requirements of Regulation 16 Schedule 1. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)

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improvement to be good

Young people get a good education. One member of staff told the inspector, ‘Education has to be a priority for the young people. It will unlock their futures. We are always in contact with schools, we do homework, we attend award ceremonies, we do daily contact with schools, we use praise with the kids to support them doing well.’

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improvement to be good

Three of the young people attend school on a full-time basis. All three young people are making academic progress and have excellent school attendance. Staff keep in regular contact with schools, which helps support young people to feel settled and able to achieve academic success. If issues do arise in the school, staff work well with young people and teachers so that any interruption to young people’s education is minimal. For example, a teacher told the inspector, ‘If we have an issue, the staff are always available to meet. We have had several meetings which is good. They come to PEPs and there are no issues with homework. His latest report says he is exceeding his progress in all subjects. He feels stable where he is and has the support from the home. He is obviously getting the right amount of support from them as he just gets achievement points.’

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improvement to be good

One young person had not attended school for two years prior to living at the home. While awaiting for a school placement, daily tutoring has helped him to manage his fears to the point where he is now ready for school. The tutor shared with the inspector, ‘When I met him he wouldn’t do anything. It took me three weeks to get him to do anything. We got him a laptop – it stayed in the box for six weeks. He now works independently and his work is tremendous. He can communicate and explain what he does and does not want. The progress is unbelievable.’

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improvement to be good

Young people are in good physical health and attend routine appointments with dentists and opticians. When young people need support from specialised services, such as child and adolescent mental health services, this is put in place. One young person has made significant improvements to his emotional health through support from a staff team that is nurturing and skilful in working with young people who have autistic spectrum Inspection report children’s home: SC467264 5 disorders. In professional feedback to the home, a consultant psychiatrist commented, ‘I am pleased that the care and support to this young person has kept him out of psychiatric hospital.’

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improvement to be good

Young people who are prescribed medication understand the reasons why they need to take their medication regularly. However, for one young person there is no guidance for staff about the circumstances in which to administer medication prescribed to be taken ‘as needed’. Furthermore, the arrangements for receiving controlled medication into the home is not in line with the organisation’s medication policy. The failure to adhere to policy increases the likelihood of medication errors.

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improvement to be good

Staff promote an active lifestyle. This encouragement means that young people take part in a range a leisure pursuits including swimming, walking, going to the gym and going to the park. One young person has been pro-active in taking responsibility for his own health and through a combination of exercise and healthy eating has lost over a stone in weight. Staff encourage young people to take part in music and singing lessons, cricket, football, mending pneumatics, biking and trampolining. This helps young people to be healthy, build their confidence and to develop new friendships.

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improvement to be good

Managers and staff support contact and are sensitive to the wishes and feelings of young people regarding contact with their friends and family. For one young person, the manager worked with the local authority to reverse a decision to reduce contact.

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improvement to be good

Some aspects of the physical condition of the home require improvement. For example, the kitchen door slams closed, the downstairs toilet does not flush easily, the carpet to the stairs is not safely fitted, the carpet to one young person’s bedroom is marked, there are no mirrors in young people’s bathrooms and a shower rail is broken. Young people are able to personalise their own bedrooms but do not have access to lockable storage to keep personal items safe. The various shortfalls detract from young people having a homely environment in which to live.

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

High staffing ratios means that staff are able to spend quality time with young people, and positive relationships continue to develop. Young people say they feel safe and that they enjoy living in the home. One young person told the inspector, ‘I love school and get to go on lots of activities. I get on with the other young people. I am not worried about anything. I like my room. I feel safe.’

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

Expectations and boundaries are clear and consistently reinforced by staff. This gives a sense of security for young people and encourages socially acceptable behaviour. Sanctions are rarely used, and staff focus on developing young people’s strengths though a weekly reward programme and through giving praise. Established routines give young people structure.

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

Young people are encouraged to be independent. For example, young people help with laundry, cooking, laying the table, washing up, drying and sweeping. This gives young Inspection report children’s home: SC467264 6 people a sense of responsibility, and helps to boost their self-confidence.

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

Young people benefit from discussions with staff about the advantages and risks of using the internet. Young people are aware of how to keep themselves safe online. One young person told the inspector, ‘I know what the dangers of the internet are; I do not talk to strangers online, I do not meet anyone, I do not bully, and I do not give personal information. I also do not give security codes or passcodes and where I live.’

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

Focused risk assessments and behaviour management plans contain straightforward guidance, which means that staff know what support young people require to meet their needs and to be safe. Young people do not go missing and staff are clear about what to do should a young person’s whereabouts become unknown. Training in behaviour management and physical intervention means that staff are equipped to manage challenging behaviours.

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

Since the last inspection, there have been a number of physical interventions. Post- incident, the manager evaluates the record to ensure that the restraint was necessary and to help improve practice. For example, in one instance through the process of review the manager identified and shared with the team that a physical intervention may not have been necessary if staff had intervened earlier. This process of reflective review supports the team’s learning about individual behaviour management strategies that have seen a reduction in the need for physical intervention.

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

Staff are confident about reporting safeguarding concerns and have had training to support them to meet their safeguarding obligations. Staff receive training that helps them to understand the risks of child sexual exploitation, radicalisation and how to stay safe online. However, not all staff have completed training in the areas of fire safety, food hygiene, equality and diversity and self-harm. This means that some staff do not have all of the necessary knowledge needed to ensure that young people are safe.

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

Fire, gas and electrical equipment is subject to routine checks to ensure that it is in good working order.

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The effectiveness of leaders and managers: inadequate

The home has been without a registered manager since April 2016. This long period of absence of a registered manager has had an impact on the effectiveness of leaders and managers’ judgement.

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The effectiveness of leaders and managers: inadequate

A new manager started in January 2017 and made an application to Ofsted to be registered in June 2017, which is in progress. He is working towards achieving a level 5 diploma in leadership and management, with an anticipated completion date of December 2017.

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The effectiveness of leaders and managers: inadequate

In addition to the manager, the home has a deputy manager, three full-time team leaders, four full-time residential care workers and two night staff. Of these, four of the staff hold the level 3 diploma in residential childcare. The remaining staff are enrolled on Inspection report children’s home: SC467264 7 the award and are due to complete within required timescales.

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The effectiveness of leaders and managers: inadequate

Since the last inspection, there have been some changes to staffing. Three new team leaders have taken up post. Three residential care workers have left and three have joined. The manager has managed this change sensitively with minimal impact on young people, and the team is becoming more secure. A clinical psychologist told the inspector, ‘They are getting much better at consistency with staff. The last few months they have been really good at allocating people. The kids know who their key-workers are. Roles are clear and identifiable to everyone; this is a strength for sure. It feels much more stable and they have been working as a team.’

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The effectiveness of leaders and managers: inadequate

However, managers have failed to ensure the appropriate vetting of new staff. One agency member of staff commenced their duties without references, identification and evidence of qualifications. The reasons for gaps in employment are unknown for a number of staff. A lack of diligence in vetting means that there is the potential for contact between unsuitable adults and young people.

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The effectiveness of leaders and managers: inadequate

Staff say they feel supported and benefit from regular supervision and access to development opportunities. Monthly support from an independent clinical psychologist provides staff with a space to talk and to develop safe behavioural and self-care strategies. Frequent, well-attended team meetings keep staff up to date. One member of staff told the inspector,

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The effectiveness of leaders and managers: inadequate

‘I think my managers are brilliant. You can ring them any time and any day and they will support you in any need you have. If you need a supervision, have a question they will go through it with you straight away. They are good managers – that’s why I enjoy working here. They have made me grow a lot.’

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The effectiveness of leaders and managers: inadequate

However, the manager does not have a workforce development plan. This leaves him without informed knowledge about individual and team training, and development needs.

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The effectiveness of leaders and managers: inadequate

The manager has undertaken a review of the quality of care. He is clear and enthusiastic about plans to continue to develop the service. A social worker told the inspector, ‘A committed manager and a stable management team has certainly helped to make improvements to the home.’ However, the statement of purpose does not reflect changes to the team structure or staffing, which means up-to-date information about the service is not available to those who may need it.

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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 Inspection report children’s home: SC467264 8 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: SC467264 9

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Children’s home details

Registered provider: N H Care Limited 6038073

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Children’s home details

Registered provider address: 3 Shetland Close, Birmingham B16 0RF

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Inspector

Alison Cooper, social care inspector Inspection report children’s home: SC467264 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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Inspector

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Inspector

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Inspector

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