Children's home run by NH Care Limited in Birmingham

Inspection report children’s home: SC477796 1 SC477796 Registered provider: N H Care Limited 6038073

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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 seven young people. The home provides care and accommodation for young people who have learning disabilities. The home is privately owned.

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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

Date of last inspection: 1 February 2017

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requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

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Enforcement action since last inspection:

None Inspection report children’s home: SC477796 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

 The home has not had a registered manager for over 26 weeks.  The physical condition of the home requires improvement.  Young people’s case records do not include copies of the placing authority’s plans.  Staff do not ensure that risk assessments are clear about the actions needed to reduce risk.  Managers have not ensured that the home’s statement of purpose is kept up to date.  Managers do not ensure that the home operates in accordance with the statement of purpose.  Staff supervision is infrequent  Managers do not give sufficient attention to the safe recruitment of agency staff.  Not all staff members have achieved the necessary qualifications in residential childcare within the required timeframe.  Managers have not ensured that staff are competent in the administration of medication.

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Key findings from this inspection

 Young people benefit from consistent care.  Staff ensure that there is good communication between the home and schools to help young people to attend and enjoy school.  Staff make sure that young people have access to a range of health services.  Young people have many leisure opportunities to enable them to pursue their hobbies and interests.  Staff support young people to develop age-appropriate independence skills.  Managers and staff work well with family members and other professionals to the benefit of young people.  Staff support young people to have contact with families in line with their care plans. Inspection report children’s home: SC477796 3

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Inspection date Inspection type Inspection judgement

01/02/2017 Interim Sustained effectiveness 27/06/2016 Full Good 17/02/2016 Interim Sustained effectiveness 18/08/2015 Full Good Inspection report children’s home: SC477796 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 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 understand their roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12(1)(2)(a)(v))

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Requirement Due date

This is with specific reference to ensuring young people’s risk assessments are clear about the action staff must take to manage risk. 19/03/18

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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 the premises used for the purpose of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12(1)(2)(d)) 30/04/2018

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Requirement Due date

The care planning standard is that children are admitted to 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)) 09/02/2018

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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)) This is with particular reference to ensuring the staff structure and staff details are current. 19/03/2018

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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)) 19/03/2018

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Requirement Due date

The registered person must ensure that any individual who works in the home in a care role has achieved the appropriate 30/04/2018 Inspection report children’s home: SC477796 5 qualification by the relevant date. The relevant date is, in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home. (Regulation 32(5)(a)) The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b)) 30/03/2018

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Requirement Due date

The registered person must maintain records (‘case records’) for each child that include the information and documents listed in Schedule 3. The records must be kept up to date, signed, and dated by the author of each entry. (Regulation 36(a)(b)(c)) 30/03/2018

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Recommendations

 The registered person must ensure that staff have the relevant skills and knowledge to be able to respond to the health needs of children. (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.12) This is with specific reference to ensuring staff are competent in administering medication.

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improvement to be good

Young people benefit from living in a warm and welcoming atmosphere, where an enthusiastic, stable and dedicated staff team helps them to enjoy their home and to make progress. For example, one young person’s confidence has grown and they are now more open to accepting guidance from adults. Staff know the young people well and are creative in getting the young people doing new and exciting things. A social worker told the inspector, ‘They understand individual needs. [Young person] is doing things he would never have got to do in his family. They help them take controlled risks and give him opportunities.’

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improvement to be good

However, since the last inspection, there have been some changes to the young people living at the home. On one occasion, insufficient enquiry with the placing authority meant that a young person’s primary need was not clearly understood. Consequently, on admission the staff were unable to manage the young person’s emotional and behavioural needs. Poor matching compromised the experiences of the young people already living at the home through exposure to behaviours including bullying, inappropriate language and aggression to staff. One young person shared with the inspector, ‘I felt a bit uncomfortable as he caused lots of trouble. It’s better now living with just these young people.’ Inspection report children’s home: SC477796 6 All of the young people attend school on a full-time basis. Young people are encouraged to develop and maintain daily routines, which supports them in maintaining good attendance. Staff routinely attend parents’ evenings and school events. Daily

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improvement to be good

communication between the staff and teachers helps to reduce young people’s worries about school. A teacher told the inspector, ‘They drop and pick him up so we communicate on drop-off and collection. If there are any issues through the day, we will phone and we will pull together a plan.’

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improvement to be good

Staff are attentive to young people’s health needs. Staff help young people to attend routine appointments with local healthcare services, such as the doctor, dentist and optician. When a young person has a specific health need, the staff make sure that the right health services are accessed. For example, one young person attends an epilepsy clinic. The young person’s epilepsy nurse has ensured that the staff have an epilepsy protocol to follow in case the young person has a seizure.

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improvement to be good

Young people are encouraged to lead an active lifestyle and staff promote young people’s involvement in activities and hobbies. Young people enjoy opportunities to be involved in leisure activities, such as sensory play, going to the cinema, bowling, going shopping and doing arts and crafts at home. Each evening young people have the opportunity to go for a walk. Young people have benefited from holidays away from the home and the chance to attend occasions, such as a red-carpet event in London and a film premiere in Edinburgh.

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improvement to be good

Staff enable young people to become more independent. As part of daily routines, young people help to keep their bedrooms clean and tidy, participate in doing laundry tasks and are encouraged to make their own snacks and drinks. Young people approaching adulthood undertake a detailed independence programme to prepare them with the practical and emotional skills necessary for adulthood. For one young person, this work has included exploring relationships.

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improvement to be good

Staff try hard to ensure that young people stay in contact with family and friends, in keeping with their care plans. Relationships between staff and parents are productive and regular communication keeps parents informed. A parent told the inspector, ‘They are fantastic and I am happy overall. I like the flexibility they have, they keep me informed and their flexibility has kept him in community.’

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improvement to be good

Managers have not given sufficient attention to the physical conditions of the home. For example, the decoration in the young people’s bathroom is poor: wall tiles are cracked, there is no shade fitted to the ceiling light, a wall mirror is missing and a radiator is rusty. In one young person’s bedroom, the curtains do not cover the window and a set of drawers is broken. A windowpane is broken in the dining room and there are not enough dining chairs to allow young people and staff to eat together at the dining table. The patio in the garden is slippy in areas. Curtains are missing from the lounge. These numerous shortfalls in the physical conditions of the house detract from young people living in an environment that is safe and homely.

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

Inspection report children’s home: SC477796 7

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improvement to be good

Young people say that they feel safe. One young person told the inspector, ‘I am safe here. I feel really safe, safer than I’ve ever been.’ Young people are comfortable and relaxed in the home and enjoy strong and trusting relationships with staff. Managers ensure that young people have consistency of care by having a stable staff team and familiar agency and bank staff. However, managers have not given sufficient attention to safe recruitment. Agency members of staff have been able to start their duties without managers having checked their references, identification, qualifications and gaps in employment history. This lack of attention to vetting means that there is the potential for young people to have contact with unsuitable adults.

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improvement to be good

Staff speak confidently about how to protect young people from the risk of harm. Access to a range of safeguarding training helps to improve staff knowledge about how to keep young people safe. No young people are at risk of child sexual exploitation or radicalisation. Specific training opportunities in these areas help to equip staff to identify signs and symptoms. When young people have been missing from care, appropriate action has been taken to ensure their safe return home.

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improvement to be good

Young people have individualised risk assessments, and in practice staff show an understanding of the risks to young people and the day-to-day risk management arrangements. However, reviews of risk assessments are not always thorough. For example, one young person’s missing from care risk assessment fails to give an accurate account of the agreed staffing levels in and outside of the home. Another young person’s risk assessment fails to show what action staff must take if he attempts to run into the road. Furthermore, young people’s case records do not hold all of the required statutory records. This means that staff do not have information about the full range of young people’s needs.

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improvement to be good

Young people receive a copy of the children’s guide, which helps them to understand what happens in the home and how they can complain. Weekly young people’s meetings, regular one-to-one conversations with staff and questionnaires about the quality of care all help to give young people the opportunity to influence their care. Young people routinely influence the decisions over meal and activity choices.

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improvement to be good

The manager has completed a review of the arrangements for the safe receipt, storage and administration of medication and has made some changes to enhance practice. For example, medication received into the home is now recorded in a receipt register. However, managers have not followed organisational protocols, which require staff to have their competency in the safe handling of medicines to be assessed. This means that staff development needs in relation to administering medication safely are not understood.

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improvement to be good

The manager has quickly recognised that there are gaps in fire safety arrangements. A specialist company has been asked to undertake a fire safety audit. The manager intends to use this specialist advice to improve fire safety. Inspection report children’s home: SC477796 8

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The effectiveness of leaders and managers: inadequate

The home has been without a registered manager since June 2017. Following interim management arrangements, an experienced manager started employment in September 2017. She has recently submitted an application to Ofsted for registration. This long period of absence of a registered manager has had an impact on the judgement grade of the effectiveness of leaders and managers.

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The effectiveness of leaders and managers: inadequate

The manager has the support of an appropriately skilled and qualified management team, including a deputy manager and three full-time team leaders. In addition, there are seven full-time residential care workers and five night staff. Of these, eleven staff hold the level 3 diploma in residential childcare. Two staff are enrolled on the award and are due to complete their qualification within required timescales. For the remaining two staff, their progress is slow. Consequently, they have failed to complete their training within the timeframe required by regulation.

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The effectiveness of leaders and managers: inadequate

Staff are positive about the recent changes in management. One member of staff told the inspector, ‘The new manager has made a massive and positive difference to the team. She is really experienced and she knows what she’s doing, which is what we all needed. Everyone is on board with what needs to change and is up for it.’ Staff report that they feel supported and this helps them to fulfil the requirements of their roles. However, since the registered manager left the post, not all staff have had regular, good-quality supervision. This means that staff have not had the benefit of dedicated time to discuss and plan how to develop their practice.

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The effectiveness of leaders and managers: inadequate

The manager is child-focused and energetic in her vision for the home. She has reviewed the independent visitor reports and the quality of care review, and has a clear understanding of the strengths and development needs of the home, which she has documented in an improvement plan. Previous inspection requirements are addressed. However, the statement of purpose does not reflect changes to the management team structure or staffing. This means that up-to-date information about the service is not available to those who 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 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 Inspection report children’s home: SC477796 9 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: SC477796 10

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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: SC477796 11 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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