Children's home run by Thoughts of Others Limited in Birmingham

Inspection report for children’s home - monitoring visit: SC464249 1 SC464249 Thoughts of Others Limited Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This home provides care and accommodation for up to two children who have emotional and/or behavioural difficulties. A private provider operates this home. The organisation operates a school nearby and can provide therapeutic services.

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This monitoring visit

This home was judged inadequate at a full inspection on 8 August 2017. Ofsted found significant shortfalls and raised 11 requirements. These included priority requirements with earlier dates for action. These were:

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This monitoring visit

 Fire safety and an unsafe environment.  Staff members’ lack of understanding of the application and recording of restraint, deprivation and the restriction of children’s liberty of movement.  Poor risk management in planning, advising staff and recording how to help children if they self-harm or run away.  The absence of external scrutiny of the home by an independent monthly visitor.

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This monitoring visit

In order to evaluate the progress that the home has made to improve, a monitoring visit was undertaken on 3 October 2017. Inspectors found that insufficient action had been taken against all four priority requirements.

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This monitoring visit

The organisation’s safeguarding officer is now the acting manager. She told the inspectors that the registered manager, after going on maternity leave earlier than planned at the end of August, was absent. The acting manager had taken up her post in mid-September. The responsible individual did not notify Ofsted of this earlier than anticipated absence and the change to managerial arrangements.

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This monitoring visit

An external consultant carried out a full fire safety risk assessment after the last inspection. This triggered some improvements being made to fire safety. However, Inspection report for children’s home – monitoring visit: SC464249 2 the registered person has not completed all required actions recommended by the external consultant. After the external assessment, the responsible individual undertook a second fire risk assessment. This new version describes a different house. It documents that a specific fire safety door-closing device was fitted to five upstairs door. However, this device was found to be fitted to just one door. The assessment described rooms that do not exist at this home. The fire risk assessment written by the responsible individual advised staff to evacuate from the front or rear doors. This advice was given despite the fact that staff did not have the key to open the lock and escape from the back yard. During the inspection, the registered person

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This monitoring visit

arranged for the removal of the lock on the gate and added a bolt to allow for safe evacuation. The registered person has arranged for staff to be trained in fire safety in the near future.

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This monitoring visit

The registered person has now appointed an independent monthly visitor. There were two visits in August and September. However, neither the registered person nor the independent visitor has sent the report to Ofsted. The acting manager said that she had withheld one report in order to take up issues with the visitor.

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This monitoring visit

Once, a copy of a recent independent visitor report was shown to the inspectors. This included a child’s statement that the waking night staff were all asleep when she took some keys and left the house.

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This monitoring visit

Children are at risk when being missing from the home, because staff do not follow the organisation’s policies to notify the police. The registered person has taken no action to improve this. Risk assessments are still inaccurate regarding deprivations or restrictions of liberty of movement, because the registered person has not made any changes to these documents since the last inspection. Children’s behaviour, risk and care plans still do not tell staff how to respond to self-harm incidents or what to do when children go missing from care. Consequently, when a child did go missing, staff did not notify the police immediately. Records of this incident are inadequate. There is no record of the contact with the placing authority or that anyone spoke to the child afterwards.

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This monitoring visit

Policy, procedure and records about behaviour management are still not fit for purpose. Arrangements still do not ensure that staff fully understand their responsibilities in relation to restraint and the deprivation of liberty. One plan, for example, incorrectly advises staff to restrain a child if they strip off or masturbate. Managers and staff are still not clear about how staff should record any restrictions of movement and limitations of access to certain rooms in the house, or the circumstances when they may restrict a child’s liberty. Children’s care, risk and behaviour management plans do not make this clear and have not been updated since the last inspection.

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This monitoring visit

Records of behavioural incidents, including restraints and restrictions, are still inadequate, because they still do not give a complete picture of what happened or the date of the incident. Staff have recorded eight ‘restrictions’, but without any understanding of what constitutes a restriction and without the detail required by Inspection report for children’s home – monitoring visit: SC464249 3 law. None of these appeared to inspectors to be unnecessarily restrictive. Despite this, there has been no review by any manager of these eight apparent restrictions of children’s liberty.

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This monitoring visit

The registered person has still not monitored or analysed the regular pattern of allegations by one child about restraint. Instead, staff see this as a behavioural issue. However, staff have not updated the child’s behavioural plan. These allegations have been referred to the local authority safeguarding team. However, there has not been any follow up with staff in supervision after the allegations. The registered person does not demonstrate any professional curiosity to improve children’s safety or their experience.

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This monitoring visit

The registered person has taken action to make safe an area of the yard that was previously easily accessible and full of harmful items.

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This monitoring visit

Children’s confidential records are once again in an unlocked cabinet and accessible to visiting maintenance staff. Children’s records are still inaccurate and out of date, and the acting manager presented to inspectors a newly created document that was an overwritten ‘cut and paste’ document of another child, containing their name and confidential information. There are still no curtains in one child’s lounge. The acting manager acknowledged that the organisation has not done enough to meet the requirements, and that this was due to a change in the management.

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This monitoring visit

Children have a mixed experience at the home. One child told inspectors about alleged abusive and unprofessional behaviour by staff. Ofsted shared these matters with the acting manager, and referred them to the local designated officer and the placing authority. Another child is doing well and is happier. Both children are in school for the first time in a long while.

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This monitoring visit

This inspection has raised new concerns. The house is not clean. There was a strong smell of faeces in the kitchen. Staff have no system for hygienically disposing of soiled items, and have no easily accessible hand towels. This means that staff and children are at risk of infection and sickness when cleaning up and then cooking.

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This monitoring visit

This visit has raised ongoing serious concerns about care and practice at the home and about the registered person’s capacity to improve in the absence of effective management. Ofsted will return to carry out another full inspection within 16 weeks of the last full inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 08/08/2017 Full Inadequate 29/03/2017 Full Requires improvement 01/11/2016 Full Requires improvement 23/03/2016 Interim Improved effectiveness Inspection report for children’s home – monitoring visit: SC464249 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 quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to understand and apply the home’s statement of purpose, and ensure that staff provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background. (Regulation 6(1)(a)(b), (2)(a)(iv))

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Requirement Due date

In particular, ensure that staff have ease of access to up-to-date and accurate information about children and that they deliver individual plans. 09/10/2017

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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; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action whenever there is a serious concern about a child’s welfare that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health; and that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12(1), (2)(a)(i)(v)(vi)(d)(e)) 01/11/2017

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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. 09/10/2017 Inspection report for children’s home – monitoring visit: SC464249 5 In particular, the standard in paragraph (1) requires the registered person: to lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; to 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; to understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care

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Requirement Due date

provided in the home and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b), (2)(a)(c)(e)(f)(h))

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Requirement Due date

The care planning standard is that children receive effectively planned care in or through the children’s home; and have a positive experience of moving on from the home.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that arrangements are in place to plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority, and that each child’s relevant plans are followed. (Regulation 14(1)(a)(b), (2)(b)(iii)(c))

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Requirement Due date

In particular, improve stability in children’s placements by reviewing and learning lessons about early endings. 09/10/2017

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Requirement Due date

The registered person must ensure that restraint in relation to a child is only permitted for the purpose of preventing injury to any person (including the child) or serious damage to the property of any person (including the child). Restraint in relation to a child must be necessary and proportionate. These Regulations do not prevent a child from being deprived of liberty where that deprivation is authorised in accordance with a court order. (Regulation 20(1)(a)(b), (2),(3)) 01/11/2017

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Requirement Due date

The registered person must ensure that the requirements of that Order (Regulatory Reform (Fire Safety) Order 2005(a)) and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home. (Regulation 25(2)(b)) 01/11/2017

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out the measures of control, discipline and restraint which may be used in relation to 09/10/2017 Inspection report for children’s home – monitoring visit: SC464249 6 children in the home. The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (Regulation 35(1)(b), (2))

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Requirement Due date

In particular, improve guidance about restrictions of liberty and movement and managerial review of effectiveness of measures of control.

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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 this regulation. (Regulation 35(3)(a)) 09/10/2017

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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. (Regulation 36(1)(a)(b)(c)) 09/10/2017

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Requirement Due date

The registered person must ensure that an independent person visits the children’s home at least once a month and must provide a report. The independent person must provide a copy of the independent person’s report to HMCI and the placing authorities of children. (Regulation 44(1), (7)(a)(c)) 01/11/2017

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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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Requirement Due date

The registered person must, if the person who is in day-to-day charge of the children’s home proposes to be absent from the home for a continuous period of 28 days or more, the registered person must give notice in writing to HMCI of the proposed absence. If the absence arises as a result of an emergency or is unforeseen, the registered person must give notice of the absence— within one week of the beginning of the absence; and specifying the matters in paragraph (2)(b). If the notice required under paragraph (2) or (3) has not been given as required, it must be given without delay. Regulation 48(1), (3)(a)(b), (4)) 09/10/2017 Inspection report for children’s home – monitoring visit: SC464249 7

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Recommendations

 Ensure that restraint records also include interventions that restrict a child’s liberty of movement. Restrictions such as these, and all other restrictions of liberty of movement, should be recorded as restraint. (‘Guide to the children’s homes regulations including the quality standards’, page 47, paragraph 9.42)  Ensure that staff understand the importance of careful, and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)  Ensure that staff understand that a deprivation of liberty may occur when a child is both under continuous supervision and control and is not free to leave the home. A children’s home cannot routinely deprive a child of their liberty without a court order, such as a section 25 order to place a child in a licensed secure children’s home. In the case of young people aged over 16 who lack mental capacity, a deprivation of liberty may be authorised by the Court of

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Recommendations

Protection following an application under the Mental Capacity Act 2005. (‘Guide to the children’s homes regulations including the quality standards’, page 50, paragraph 9.63)  Continually and actively assess the risks to each child and the arrangements that are in place to protect them. This is with respect to inclusion in risk documentation of all risks, such as actions in the event of self-harm, or for occasions where staff restrict children’s movement. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)  Ensure the children’s home is a nurturing and supportive environment that meets the needs of its children and is a homely, domestic environment. Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene, etc.); however in doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression.

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Recommendations

(‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9) In particular, ensure that the kitchen, new extension and partition meet the local authority health and safety and planning standards. Provide a garden area that takes account of children’s need for active play and for fresh air.  The design of the home should provide staff that sleep in the home overnight with appropriate accommodation and facilities to do so. (‘Guide to the children’s homes regulations including the quality standards’, page 17, paragraph 3.26) Inspection report for children’s home – monitoring visit: SC464249 8

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000.

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Children’s home details

Registered provider: Thoughts of Others Ltd

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Children’s home details

Registered provider address: 99 College Road, Sutton Coldfield, West Midlands B73 5DL

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Inspectors

Christy Wannop, social care inspector Alison Cooper, social care inspector Inspection report for children’s home – monitoring visit: SC464249 9 to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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