Children's home run by Altum Residential Care Ltd

Inspection report children‟s home: 1241656 1 Registered provider: Altum Residential Care Ltd Interim inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is registered to provide care and accommodation for up to three children who have emotional and/or behavioural difficulties. It is owned by a private company.

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and young people since the most recent full inspection

This home was judged good at the last full inspection. At this interim inspection, Ofsted judges that it has sustained effectiveness.

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and young people since the most recent full inspection

Since the last inspection, there have been significant changes in the home. Over the summer period there was a deterioration in the home‟s functioning. This was a difficult time for some young people. In addition, there were significant changes within the leadership and management structure. The registered manager left the home in August 2017, and a new manager came into post in September 2017.

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and young people since the most recent full inspection

Turnover of staff during the summer period led to a reliance on agency members of staff, although regular, consistent agency staff have been used as much as possible. A recruitment drive has resulted in the employment of several new, permanent members of staff who are due to start at the home in January 2018. This will help to ensure that there is better continuity of care for young people.

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and young people since the most recent full inspection

The new manager has made a positive impact on the home. He is realistic about the Inspection report children‟s home: 1241656 2 home‟s current functioning, and he has identified areas for improvement and development. He has devised an action plan to ensure that changes are made in a timely way. The impact of these changes is beginning to be felt.

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and young people since the most recent full inspection

The new manager has been promoted within the organisation and is now performing the role of head of care and responsible individual. This left the manager‟s post vacant. However, a new manager has just been appointed and he started two days prior to the inspection. He is preparing his application for registration. The responsible individual will retain oversight of the home during the new manager‟s induction.

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and young people since the most recent full inspection

On the whole, outcomes for young people remain positive. One young person has remained in placement since the last inspection, and two new young people have been admitted. Young people have made progress in relation to their mental health and there has been a decrease in their self-injurious behaviour. Staff have worked effectively with partner agencies. For one young person, this has led to a positive review of care arrangements. A decision was made to reduce the level of supervision and allocated staffing, in recognition of the progress the young person has made. Young people demonstrate their trusting relationships with staff. They are able to talk to staff about significant, historic issues that have affected them, and they talk about their feelings and their wishes for the future. Young people rarely go missing from the home. Although young people can present as loud and disruptive, there has been very little need for the

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and young people since the most recent full inspection

use of physical intervention to help manage young people‟s behaviour.

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and young people since the most recent full inspection

Not all young people are receiving the education they are entitled to. This has a negative impact on their chances in later life. The responsible individual has appropriately escalated his concerns to the local authority and has advocated on behalf of a young person, resulting in a slight improvement. However, education provision remains insufficient and the provider appropriately continues to escalate their concerns. Despite careful placement matching, one young person has struggled to settle in placement, and the provider has considered whether the home can safely continue to meet their needs. The impact on other young people living in the home, including their feelings, is also considered. In consultation with the placing authority, one young person‟s placement will end imminently. Although this is unplanned, it reflects a carefully balanced decision made in the best interests of all young people.

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and young people since the most recent full inspection

At the last inspection, two requirements and four recommendations were made. The two requirements and three of the recommendations are met.

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and young people since the most recent full inspection

 The statement of purpose now more accurately reflects the services offered by the home. There has only been one complaint since the last inspection.  An appropriate record is made of any complaint, the action taken in response and the outcome of any investigation, leading to greater transparency.  The home‟s workforce development plan has been updated and all staff either hold the level 3 qualification for residential care, or have been enrolled on to the course, as required by regulation. This means that young people will be cared for by appropriately qualified staff. Inspection report children‟s home: 1241656 3  At the last inspection, all the staff were female and there was no clear plan in place to show how young people would have contact with appropriate male role models. The manager of the home is male and some new members of staff, due to start work at the home in January 2018, are male. This will create a better

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and young people since the most recent full inspection

gender balance within the staff team.  Safer recruitment practices are in place and improved, helping to ensure that only appropriate adults have contact with young people.

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and young people since the most recent full inspection

One recommendation remains unmet and is repeated. The responsible individual, who has been monitoring physical intervention records, has not been trained in the physical intervention method used by the staff in the home. This may impact on his ability to safely monitor incidents. In practice, there have been few incidents of physical intervention. The responsible individual has plans to provide training for staff in a different system of behaviour management and physical intervention in the new year. In the meantime, it is important he has a better understanding of the current methods used.

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and young people since the most recent full inspection

The responsible individual has identified the following areas for the home‟s improvement, and has taken positive action.

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and young people since the most recent full inspection

 Recording systems in the home do not always provide a clear audit trail. For example, incident records cannot be clearly cross-referenced with post-incident follow-up work undertaken with young people. In recognition of this, a new electronic recording system is due to be implemented imminently, which will provide a much better recording system and will aid the manager‟s monitoring of the quality of care.  Improvements have been made in helping staff understand their responsibilities when a young person goes missing from care. This means that, in the event of a young person going missing, staff have a clear flowchart to follow. A specialist in the field of child sexual exploitation is also due to attend the next staff meeting, to share information on local systems and best practice.  The responsible individual identified that the training staff receive about how to best manage young people‟s behaviour is below the standard he requires. Staff

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and young people since the most recent full inspection

will receive training in a different system of behaviour management imminently.

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and young people since the most recent full inspection

These improvements, among others, demonstrate that the provider has identified areas for development and has a realistic plan in place to help improve the functioning of the home, for the benefit of young people.

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and young people since the most recent full inspection

Despite improvements made, some shortfalls were identified during this inspection. An incident recently occurred that fell below the standards required for residential care. Young people experienced a member of staff using inappropriate language towards them. The responsible individual took appropriate action during the inspection to manage the issue, and followed safeguarding procedures. The responsible individual believes that training for staff in the new system of behaviour management and in whistleblowing will address this shortfall. Inspection report children‟s home: 1241656 4 A fire door was observed to be propped open during the inspection. This means that, in the event of a fire, fire safety systems may be less effective as the door would not be able to help protect against the spread of smoke and flames. Other fire safety systems, such as daily or weekly health and safety checks, are regularly carried out.

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and young people since the most recent full inspection

The home‟s location risk assessment does not include consultation with relevant people in the community about the appropriateness of the home‟s location.

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and young people since the most recent full inspection

Although the responsible individual has been carrying out his own monitoring of the quality of care, the quality of care review report has not been sent to Ofsted as required by regulation. This has limited the regulator‟s ability to monitor the functioning of the home.

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and young people since the most recent full inspection

When considering new referrals to the home, an impact risk assessment is used to help the manager determine whether a new young person would be an appropriate match with other young people living in the home. The process does not currently reflect a comparison between the needs of the new young person and the needs of young people currently residing at the home, and the potential impact that a new placement might have. This is a recording issue rather than a practice issue. These areas are considered, but a record has not been made. Having a record of decision-making aids reflection and consideration of any ways in which the system for referral can be improved if a placement breaks down, as has happened recently.

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and young people since the most recent full inspection

Despite the shortfalls identified, young people predominantly receive a good quality of care. Young people say that they have access to lots of activities. Some members of staff were described as „amazing‟ and „the best‟, demonstrating positive relationships between young people and the majority of the staff team.

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Inspection date Inspection type Inspection judgement

03/05/2017 Full Good Inspection report children‟s home: 1241656 5

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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 positive relationships standard is that children are helped to develop, and to benefit from, relationships based on mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same.

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Requirement Due date

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

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Requirement Due date

In particular, that fire safety systems are not compromised by the propping open of fire doors. 20/12/2017

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Requirement Due date

The registered person must complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months and supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed.

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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. When conducting the review, the registered person must consult, and take into account the views of, each relevant person.

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Requirement Due date

(Regulation 46 (2)) 10/01/2018 Inspection report children‟s home: 1241656 6

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Recommendations

 The registered person is responsible for ensuring that all their staff have been adequately trained in the principles of restraint and any restraint techniques appropriate to the needs of the children the home is set up to care for as defined in the home‟s statement of purpose and behaviour management policy. This specifically applies to ensuring that all staff and the manager are trained in the same method of restraint and physical intervention. („Guide to the children‟s homes regulations, including the quality standards‟, page 49, paragraph 9.57)

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Recommendations

 The registered person should only accept placements where they have fully considered the impact that the placement will have on the existing group of children. This relates to ensuring that there is a record of this assessment of impact. („Guide to the children‟s homes regulations, including the quality standards‟, page 56, paragraph 11.4)

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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 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

This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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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‟.

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Children’s home details

Registered provider: Altum Residential Care Ltd

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Children’s home details

Registered provider address: Altum Residential Care Ltd, 550 Valley Road, Nottingham NG5 1JJ Inspection report children‟s home: 1241656 7 Responsible individual: Matthew Spooner

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Inspector

Catherine Honey, social care inspector Inspection report children‟s home: 1241656 8 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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