Children's Home run by Reflexion Care Group Limited in Shropshire

Inspection report children’s home: SC396721 1 SC396721 Registered provider: Reflexion Care Group Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately operated children’s home is registered to provide care and accommodation for one young person who has emotional and/or behavioural difficulties and/or learning disabilities.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Overall judgement at last inspection: Sustained effectiveness

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good

Enforcement action since last inspection: None Inspection report children’s home: SC396721 2

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Key findings from this inspection

 Effective safeguarding arrangements and multi-agency partnership work mean that the young person is stable and safe.  Good educational outcomes for the young person stem from close work between the staff and teaching staff.  A high priority is given to the young person’s involvement in his care. Staff respect his wishes and feelings.  The home is welcoming and tailored to the young person’s needs.  Staff help the young person to learn life skills.  The young person has the help he needs to maintain family relationships and to make sense of his developing identity.  Responsive, positive behaviour management keeps the young person focused on making good progress.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 Opinions of parents, placing authorities, staff and other professionals should be included by the manager in the six-monthly report for the review of the quality of care.  Monitoring of staff practice in reviewing physical restraints and supervision by the manager occasionally lacks detail.  Promote safe opportunities for the young person to have independent community involvement and friendships.

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Inspection date Inspection type Inspection judgement

01/03/2017 Interim Sustained effectiveness 07/12/2016 Full Good 23/03/2016 Interim Sustained effectiveness 19/10/2015 Full Outstanding Inspection report children’s home: SC396721 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The 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. In particular, the standard in paragraph (1) requires the registered person: to ensure that the home’s workforce provides continuity of care to each child; demonstrate that practice in the home is informed and improved by taking into account and acting on feedback on the experiences of children, including complaints received; 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)(e)(g)(h)) 30/04/2018

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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 that they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. The system must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(2)(b)(c)(5)) 30/04/2017

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Recommendations

 Ensure that, in a restraint situation, staff use their professional judgement, supported by their knowledge of each child’s risk assessment, an understanding of the needs of the child (as set out in their relevant plans) and an understanding of the risks the child faces. Professional judgements may need to be taken quickly, and staff training and supervision of practice should support this. (‘Guide to the children’s homes regulations including the quality standards’, page 48, paragraph 9.53) This is in respect of clarity in risk assessment planning about the threshold for necessary and proportionate restraint and managerial review of serious floor or prolonged restraints. Inspection report children’s home: SC396721 4  Ensure that supervision of staff practice ensures that individual adults in the home are engaged in the safeguarding (and therapeutic) culture of the home. (‘Guide to the children’s homes regulations including the quality standards’, page 43,

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Recommendations

paragraph 9.14) This relates to ensuring consistent standards of staff response in respect of children’s plans and the home’s approach through practice-related supervision.  Identify and provide appropriate opportunities for children to develop themselves in accordance with their wishes and feelings and as part of the home’s plan for their care. Each child’s talents and interests should be understood and nurtured, with children selecting activities based on their personal preferences and abilities, so far as is reasonable. Staff should also support children to try activities that are new for them, where appropriate, such as other clubs, volunteering and leisure activities that will promote their independence. (‘Guide to the children’s homes regulations including the quality standards’, page 31, paragraph 6.4)

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Overall experiences and progress of children and young people: good

Staff provide a safe, stable and secure home base for the young person. The young person’s experience continues to be very constructive since he moved into the home in 2015. This is helped by having a multi-agency group of professionals who meet regularly to consider the young person’s early childhood trauma risks and violent behaviour. Staff benefit from advice from the organisation’s psychologist to inform their daily care of the young person. However, direct therapy has not taken place for some months. A forensic risk assessment commissioned by the placing authority has not provided the required clarity to inform the planning for the next stage in the young person’s life, including the value of therapy for the young person. Staff make sure that the young person’s family is always made welcome. The young person’s parent told the inspector, ‘Most of the carers are alright and make us feel welcome.’

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Overall experiences and progress of children and young people: good

The staff give a high priority to the young person’s involvement in his care. For example, regular key-working sessions help to ensure that the young person has the opportunity to talk through important issues in his life. This includes talking about his identity, personal safety, behavioural incidents and personal responsibility. Close, supportive relationships with the young person’s school help to promote good school attendance. This includes staff assisting the young person in school for part of the day. In preparation for a Duke of Edinburgh Bronze award, the young person regularly completes hikes with staff, helping the young person to recognise that hard work helps achieve personal goals. Better communication between staff and the young person is assisted though good links with the specialist learning disability team. Recent changes to medication mean that the young person sleeps better at night and feels more rested to enjoy the day.

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Overall experiences and progress of children and young people: good

Inspection report children’s home: SC396721 5 The house is a good place to make a home. Personal touches are everywhere. The young person has full access to all shared rooms as he would in any ordinary family home. The young person told the inspector that the home was nice, but he would like it to be slightly bigger, have better television reception and he would like a pet. He said he had not asked the manager about this. He likes living by himself without other young people to disturb his things. He said he thought that living at the home had helped him. He told the inspector, ‘I’ve come a long way from what I was like.’ Staff are not always consistent in their approach to the young person. However, despite these challenges, the young person wrote his view to the manager, and said ‘There is nothing bad about this home.’ He described to the manager that the worst thing is ‘staff being annoying’. The young person’s social horizons do not extend beyond school, staff and family. The

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Overall experiences and progress of children and young people: good

registered manager has begun to help the young person develop his life skills by practising independent travel while he does his own food shopping. A social worker told the inspector of their hopes to reduce staff supervision to fit in with the next steps in the young person’s life. However, there is no formal plan in place outlining how staff should achieve this.

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

Effective systems protect and help the young person. All professionals connected with the home recognise the young person’s current and future risks. Multi-agency public protection arrangements have previously considered the young person’s risk. Violent behaviour has resulted in criminal proceedings and the involvement of youth offending services. Despite staff being injured on occasions, they have a desire to continue working with the young person, by putting his needs first. Close staff supervision helps to reduce the risks for the young person of exploitation or going missing from home. The young person’s internet access is closely supervised on the computer and staff carry out regular direct work with him in order to increase his awareness of risks. Staff involve the young person in all arrangements for staying safe. For example, safe use of a mobile phone, restricted to only texts and calls, is part of a

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

recent contract agreed with the young person. Staff encourage the young person to maintain a calm, rational thinking and peaceful response to frustrations. The organisation’s psychologist told the inspector, ‘I cannot praise the staff highly enough for their management of his behaviour.’ Imaginative use of a ‘Praise log’ keeps staff and the young person focused on even small steps and reparations, even when there are setbacks. Staff use their good relationship with the young person to help manage aggressive and harmful behaviour. The placing authority social worker recognised the impact of staff efforts by telling the inspector, ‘Staff work extremely hard under difficult circumstances. This is the most consistent behaviour from him in a long time. His aggression and violence is coming down. It is still high risk, but not every day.’ Physical restraint is infrequently used, but is significant when it does happen. Staff talk

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

to the young person first and then use distraction techniques. Restraint is used only as a Inspection report children’s home: SC396721 6 last resort. However, risk assessment guidance suggests that staff may use restraint as a first resort to prevent a young person leaving their care. While this does not happen in practice, it may confuse inexperienced staff. The manager’s review of restraints does not always sufficiently evaluate the length of restraints or if these have taken place on the floor. As a result, the manager may omit the young person’s experience of being held in this way. The manager’s debrief with staff and the young person is otherwise effective and focuses on reflection and repairing relationships. Effective safeguarding procedures and training guide the registered manager and staff in their responsibilities to keep the young person safe. The registered manager works with the placing authority when issues arise and implements a clear threshold to escalate

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The effectiveness of leaders and managers: good

The experienced and qualified registered manager has been in post since November 2012. She manages this home and another children’s home nearby. Staff and the young person are confident about her ability, support and management skills. Professionals described good working relationships with the manager and staff. For example, a headteacher said, ‘Liaison, communication and teamwork is fantastic. They always follow up any issues.’ A small staff team knows the young person well. The balanced staff team has a range of experience and qualifications that gives the young person a good balance of adult role models. Staff report receiving regular and supportive supervision by their line managers. The manager ensures that staff appraisal, induction and training programmes are tailored to the young person’s specific needs. However, supervision records do not always show that supervision has been tailored to individual staff needs or that it has

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The effectiveness of leaders and managers: good

addressed known practice issues. Opinions of parents, placing authorities and stakeholders do not formally contribute to systems for monitoring, review or improvement about the quality of care. Consequently, the previous requirement is not met. More positively, the registered manager did include the young person’s views in the most recent September 2017 report. External professionals have flagged with the manager specific issues about consistency and lack of skill in some staff’s therapeutic approach. Staff have not always delivered a skilled approach and have allowed the young person to watch DVDs that portray inappropriate sexual imagery and violence. The registered manager is aware that two professionals have reported staff’s inappropriate language and attitudes. The manager’s action in response to this is not evident in any formal or informal process for complaints, or in staff supervision. Consequently, the young person is not consistently receiving a

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The effectiveness of leaders and managers: good

therapeutic approach to meet his needs. Inspection report children’s home: SC396721 7

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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: SC396721 8

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Children’s home details

Registered provider: Reflexion Care Group Limited

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Children’s home details

Registered provider address: Reflexion Care Group Ltd, Black Birches, Hadnall, Shrewsbury, Shropshire SY4 3DH

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Inspector

Christy Wannop, social care inspector Inspection report children’s home: SC396721 9 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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