Children's home run by Acorn Homes (UK) Ltd in Thanet

Inspection report children’s home: SC478616 1 SC478616 Registered provider: Acorn Homes (UK) Ltd 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 operated by a private company which has a small number of similar homes in the area. It is registered to accommodate up to three young people who may have emotional and/or behavioural difficulties. The company also has a school which young people may attend.

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Information about this children’s home

Inspection dates: 21 to 22 November 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 requires improvement to be 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

Overall judgement at last inspection: good Inspection report children’s home: SC478616 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

 Poor assessment practice has led to the admission of incompatible young people; this has had a negative impact on their experience and progress.  The significant emotional impact of negative experiences resulting from the quality of relationships between young people has not been recognised and addressed in a timely manner, and managers have not been proactive in escalating concerns or taking appropriate action to address this.  The physical condition and cleanliness of the premises are not conducive to meeting the needs of young people and a lack of consideration for matters of health and safety places young people at risk of harm.  Not all incidents of bullying and intimidation are recognised by staff and managers as such. Incidents are addressed, but are not managed in line with the bullying policy to ensure that appropriate support is provided for the young people involved in such incidents.

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Key findings from this inspection

 Staffing levels are insufficient and fail to deliver the supervision and support outlined in young people’s placement plans: this places young people at risk.  Monitoring of the management and administration of medication is ineffective. It has failed to pick up that one young person’s health needs are not being met; this has placed the young person at risk of significant harm.  The ineffective monitoring by leaders and managers has resulted in a failure to recognise and address a significant decline in the quality of service provision.

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Key findings from this inspection

 Despite shortfalls in the overall quality of care provided, some young people continue to make good progress in some aspects of their lives.  Young people report trusting relationships with staff who they believe are able to protect and care for them.  There is good support given to young people who are preparing for adult life.  Staff and managers benefit from a comprehensive induction and training programme that is designed specifically to meet the needs of young people.  Young people benefit from the support provided by health and well-being professionals in the development of effective behaviour management plans.  Staff and managers have developed good relationships with parents and family Inspection report children’s home: SC478616 3 members, and ensure their positive involvement in young people’s lives.

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Inspection date Inspection type Inspection judgement

23/03/2017 Interim Sustained effectiveness 11/05/2016 Full Good 09/03/2016 Interim Sustained effectiveness 17/11/2015 Full Good Inspection report children’s home: SC478616 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

(1)The health and well-being standard is that – (a) the health and well-being needs of children are met; (b) children receive advice, services and support in relation to their health and well-being. (Regulation 10(1)(a)(b))

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Requirement Due date

This is with specific reference to ensuring that prescribed medication is available to each child and that staff and managers are proactive in ensuring that prescription medication is obtained in a timely way, and that such supplies are replenished accordingly. 01/02/2018

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Requirement Due date

(1) The positive relationships standard is that children are helped to develop, and benefit from relationships based on – (a) respect and trust (b) an understanding about acceptable behaviour; and (c) positive responses to other children and adults.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to ensure – (a) that staff (xiii) have the skills to recognise incidents or indications of bullying and how to deal with them. (Regulation 11(1)(a)(b)(c) (2)(a)(xiii) 01/02/2018

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Requirement Due date

(1) 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

(2) In particular, the standard in paragraph (1) requires the registered person to ensure – 01/02/2018 Inspection report children’s home: SC478616 5 (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; (iii) have the skills to identify and act upon signs that a child may be at risk of harm; (iv) manage relationships between children to prevent them harming each other; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is serious concern about a child’s welfare; (b) that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm; (d) that the premises used for the purpose of the home are

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Requirement Due date

designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12(1)(2)(a)(i)(iii)(iv)(v)(vi)(b)(d))

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Requirement Due date

In particular, this relates to the living conditions within and maintenance of the home to ensure that children are protected from avoidable health and safety hazards derived from standards of hygiene, cleanliness and disrepair.

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Requirement Due date

13. The leadership and management standard

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Requirement Due date

(1) The leaderships and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that – (a) helps children to aspire to their full potential; and (b) promotes their welfare.

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Requirement Due date

(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 with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (e) ensure that the home has sufficient staff to provide care for each child; (f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use the understanding to inform the development of 01/02/2018 Inspection report children’s home: SC478616 6 the quality of care provided in the home; (h) use the 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

In order to meet the care planning standard, the registered person is required to –

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Requirement Due date

(2)(a) ensure that children are admitted into the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14(2)(a))

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Requirement Due date

This is with specific reference to ensuring that the home makes a comprehensive assessment of the potential impact that the young person is likely to have on the existing children individually and as a group. The ability of staff to balance the needs of each child while managing the needs of the group effectively should form part of the assessment and inform the decision-making about the viability of the placement. 01/02/2018

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Recommendations

 Children’s homes should work closely with the placing authority to understand the child’s relationship history and then the impact that the child’s arrival may have on the group living in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 38, paragraph 8.3)  Staff should understand what they must do to prevent bullying of children by other children or adults. Staff should be able to recognise and address different types of abuse such as peer abuse, cyber-bullying and bullying in day-to-day relationships in the home. Registered persons must ensure that procedures for dealing with allegations of bullying are in place and staff have the skills required to intervene, protect and address bullying behaviours effectively (see regulation 34(3) on the policy for the prevention of bullying). (‘Guide to the children’s homes regulations including the quality standards’,

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Recommendations

page 39, paragraph 8.16)  Staff should continually assess the risks to each child and the arrangements in place to protect them. Where there are safeguarding concerns for a child, their placement plan, agreed between the home and the placing authority, must include details of the steps the home will take to manage any assessed risks on a day-to-day basis (‘Guide to the children’s homes regulations including the Inspection report children’s home: SC478616 7 quality standards’, page 42, paragraph 9.5). In particular, risk assessments and positive handling plans should be updated and communicated to all staff, to ensure that they are familiar with changes to risks assessments and take appropriate actions to safeguard the child.  Sufficient staff means a home having enough suitably trained staff (including in a management role) on duty to meet the assessed needs of all children in the home, and that those staff are able to respond to emergency placements

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Recommendations

where accepted (‘Guide to the children’s homes regulations including the quality standards’, page 51, paragraph 10.1). In particular, this relates to ensuring that there are sufficient staff on duty to meet the needs of children as outlined in their placement plan, and to ensuring that children’s welfare is safeguarded at all times.  Contingency plans should be prepared in the event of a shortfall in staffing levels. If it is likely that there might only be one member of staff on duty at any time the manager should make a formal assessment of the implications for children’s care, including any likely risks. This assessment should be recorded and available for inspection by Ofsted and placing authorities. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.18)  Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear reporting. (‘Guide to

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Recommendations

the children’s homes regulations, including the quality standards’, page 62, paragraph 14.4)  Any individual appointed to carry out visits to the home as an independent person must make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the children’s home. (‘Guide to the children’s homes regulations, including the quality standards’, page 65, paragraph 15.5)

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improvement to be good

Compatibility assessments are not always undertaken prior to a young person coming to the home. Assessments carried out by the manager have failed to consider the young person’s needs against those of existing young people. Areas of potential risk are not adequately planned for, and do not provide accurate consideration of the skills and experience of the staff and their capacity to care effectively for each individual young person and the young people as a group.

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improvement to be good

Incompatibility issues have impacted adversely upon young people and some unhelpful alliances have formed. This has resulted in harmful experiences for the young people involved. Young people have been affected by inappropriate sexualised behaviour and Inspection report children’s home: SC478616 8 intimidation and bullying, as well as the considerable damage that has been done to the premises. These issues have not been addressed effectively by leaders and managers.

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improvement to be good

Young people are encouraged to personalise their bedrooms in order to enhance their sense of ownership and belonging. However, staff have failed to provide support and guidance for young people in relation to taking pride in their bedrooms and their belongings and consequently young people’s personal spaces have declined to a standard which is very concerning. This lack of attention and care on the part of staff and managers adversely affects the self-esteem of the young people.

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improvement to be good

Some areas of young people’s health needs are not well supported by staff. For example, staff and managers were not proactive in ensuring that one young person’s medication supply was managed effectively, resulting in the young person not being given his prescribed medication for three days. This resulted in an avoidable decline in the young person’s behaviour and the need for physical restraint in order to protect the young person. Managers and staff did not demonstrate an understanding of the negative emotional impact of this shortfall upon the young person.

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improvement to be good

Young people’s views about the general quality of care that they receive are sought in a variety of ways; however, their expressed wishes and feelings are not always acted upon in a timely manner. Concerns raised by young people about relationships and the dynamics in the home have not led to improvements being made.

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improvement to be good

Young people generally reported positive relationships with staff. They are able to seek out staff members they feel able to talk to when they have a problem and there are some strong and helpful relationships between young people and staff. One young person said that staff understand him, and take time to support him in specific family- related activities which are important to him. Another young person described staff and managers as supportive and understanding; he said that he feels cared for and important, and that staff have helped him to learn how to express himself more positively.

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improvement to be good

Staff have good working relationships with education providers, and have developed their skills and knowledge regarding how to support young people in their education attendance and achievements. This has resulted in some improvements in young people’s self-motivation and aspirations. One young person has successfully achieved formal qualifications and most young people have improved their attendance, and are achieving at a higher level than before. Young people who are not so self-motivated have tailored programmes of education to support them to get into a routine. However, sometimes staff do not enforce these schedules and this inconsistency is confusing for young people, and does not help them to develop a good study and work ethic.

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improvement to be good

Staff have good working relationships with the organisation’s health and well-being professionals, and benefit from the guidance they provide in regard to supporting young people’s emotional and mental health needs. Effective multi-agency working is shown to be essential in helping staff consider and prepare for young people’s more unpredictable behaviours, such as self-harm. Inspection report children’s home: SC478616 9 Young people have made some progress in the development of their social skills. One young person has made significant progress in decreasing his aggressive behaviours, and is better able to recognise and regulate these. Another young person has become more confident in social situations, and mixes more confidently with the other young people.

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improvement to be good

Staff support young people well to develop or maintain relationships with their families or other significant people in their lives. Staff demonstrate an understanding that good and well-supported contact with parents and other significant people can form the basis for the development of positive relationships that will be helpful to the young people in the future.

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improvement to be good

As a result of complex relationship difficulties and dynamics between young people living in the home, there have been some instances of bullying and intimidation. Although staff address instances of unkindness between young people, they do not always recognise incidents of bullying. This does not provide the support which young people need to develop healthy and safe relationships with each other.

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improvement to be good

Some young people said that they are not happy with some aspects of living in the home and one young person said that he does not always feel safe. He attributes this to the behaviour of one young person and the impact which this has had on upon himself and others. He feels that staff are no longer able to spend as much time with him and his peers, as they are involved in managing the behaviours of that particular young person. Insufficient staffing has resulted in young people being inadequately supervised. Staffing ratios do not reflect those outlined within young people’s placement plans. This has resulted in ineffective supervision and monitoring of the relationships between young people. It has also contributed to the decline in the physical conditions and cleanliness within the home, and has resulted in an environment which is not conducive to safeguarding young people. Staff are not always adequately informed about how to keep the young people safe.

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improvement to be good

Some young people’s risk assessments are not updated to include all of their known risks and behaviours. A lack of clear guidance means that staff are not sufficiently informed about how to intervene to protect young people. However, staff and managers do record consequences and physical interventions appropriately.

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improvement to be good

The physical condition of the premises is concerning and, while steps have been taken to ensure that damage caused by young people is repaired, there has been no monitoring by managers of the quality of the repairs. No action has been taken to ensure that, after repairs have been completed, any broken furniture has been replaced, or that areas used by young people have been cleaned. Maintenance materials have not been stored in a safe manner and managers have not taken steps to ensure that the home is physically conducive to meeting the needs and ensuring the safety of young people. The Inspection report children’s home: SC478616 10 environment does not promote a sense of feeling valued for young people. Leaders have not questioned the high use of maintenance services effectively, and have failed to recognise this as an indicator of shortfalls or difficulties within the service.

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improvement to be good

Fire safety within the home is compromised. Door frames are damaged and fire seals are missing. There are no fire safety notices. This is because a young person regularly removes them, yet the staff fail to ensure their quick replacement. There are no safety locks or retainers on one young person’s upstairs bedroom window and repairs to electrical sockets are inadequate. A broken shower and broken taps in the young people’s bathroom have not been replaced.

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improvement to be good

The staff’s poor recording of medication administration increases the likelihood of medication errors occurring, including the potential for a young person to receive the stated medication dose twice. Gaps were identified in medication administration records without an explanation of why the medication had not been given. Lack of managerial oversight has resulted in continued poor recording and management of medication.

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improvement to be good

Young people are consulted about their care planning and any restrictions placed upon them are carefully explained in order that they understand that staff are trying to keep them safe. Some young people’s risk management arrangements are effective in that they allow the young person to take reasonable risks in line with their needs, age and level of understanding.

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improvement to be good

Staff ensure that young people are aware of the dangers of social media, and ensure that access to the internet is carefully supervised. Young people demonstrated a good awareness of the dangers of sexual exploitation. They were able to explain why certain local areas were deemed to be dangerous, and knew to avoid areas that are frequented by known gang associates.

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improvement to be good

Staff have undertaken extensive training in safer care and safeguarding practices. Their training records are impressive and staff reported that they have access to a wide range of training opportunities within the organisation, including bespoke training designed to meet the specific needs of young people.

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improvement to be good

The organization ensures that recruitment of all staff involves rigorous checks and vetting, and that only those who demonstrate a robust suitability for working with children and young people are employed.

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The effectiveness of leaders and managers: inadequate

The registered manager is suitably qualified and experienced, and was registered by Ofsted in May 2014.

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The effectiveness of leaders and managers: inadequate

Managerial failures in the monitoring of the service have resulted in significant failings. Monitoring systems are ineffective and leaders and managers have poor oversight of the service, and a limited understanding of its weaknesses. Where shortfalls have been Inspection report children’s home: SC478616 11 identified, these have not been addressed effectively or in a timely way. The service does not have a development plan and there are no systems in place for driving improvement.

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The effectiveness of leaders and managers: inadequate

Senior managers have failed to recognise and act upon indicators of the decline in the quality of the service provided for young people and supervision of the registered manager is infrequent and ineffectual. This has resulted in a perceived lack of support on the part of the registered manager, and an inability to address shortfalls effectively.

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The effectiveness of leaders and managers: inadequate

While external monitoring visits to the home take place on a monthly basis, these have not identified the significant deterioration in the physical state of the home, nor the extent to which poor-quality compatibility assessments have impacted upon the experiences of the young people. Some recommendations made by the independent visitor have not been acted upon. Consistently poor monitoring of the administration and management of young people’s medication has been highlighted as a shortfall and this has not been addressed. The poor management of one young person’s medication resulted in an avoidable failure to provide the young person with his prescribed medication.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have not addressed the significant shortfall in staffing ratios, and have not ensured that sufficient staff are available to support young people in line with their placement plans. This has resulted in the poor supervision of young people, which has led to opportunities for bullying, intimidation and inappropriate behaviour between young people. Managers have failed to demonstrate an understanding of the impact of such behaviour upon young people, and have failed to take steps to address the staffing shortfalls.

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The effectiveness of leaders and managers: inadequate

The statement of purpose clearly describes the purpose of the service and the manner in which this is to be provided. However, leaders and managers have failed to ensure that the service is provided according to the ethos and values outlined.

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The effectiveness of leaders and managers: inadequate

Young people are aware of how to make a complaint. If they do so, the manager ensures that their complaints are taken seriously and fully investigated, and that the outcomes are discussed with the young people.

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The effectiveness of leaders and managers: inadequate

The last inspection resulted in two requirements. One requirement related to the maintenance of young people’s case records and the manager has ensured that these are up to date. However, at the time of this inspection, not all records were signed and dated by the author of each entry and information was not kept in an easily accessible manner. This results in staff being unable to access information and guidance on dealing with the risks to young people, and with their behaviour, in a timely manner.

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The effectiveness of leaders and managers: inadequate

A second requirement related to the supervision of staff members. Staff receive regular, practice-related supervision that is provided by a person who has the appropriate experience. Staff report that supervision is of a good quality, and is helpful to them because it provides them with an opportunity to reflect upon their practice and the effectiveness of this. Inspection report children’s home: SC478616 12

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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

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: SC478616 13

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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

Jacqueline Georghiou: social care inspector Inspection report children’s home: SC478616 14 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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