Children's home run by Altum Residential Care Ltd

Inspection report for children’s home - monitoring visit: 1241656 1

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Altum Residential Care Ltd

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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This monitoring visit

This monitoring visit was arranged in response to the home’s interim manager leaving his post, and the admission, at short notice, of two new children. The visit also monitors the home’s progress in meeting the requirements and recommendations made at the interim inspection in December 2017.

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This monitoring visit

In the months following the full inspection in May 2017 there was a decline in the functioning of the home. The registered manager resigned in August 2017 and a new manager was appointed in October 2017. This appointment led to a period of improved functioning. This new manager was quickly promoted to become the organisation’s responsible individual. At the time of the interim inspection in December 2017, another new manager had been appointed.

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This monitoring visit

Since the interim inspection in December 2017 the functioning of the home has declined significantly. Instability in the leadership and management arrangements over several months has had an impact on the registered person’s ability to maintain or progress any developments or improvements at the home. The manager appointed in December 2017 has left. The home has not had a registered manager since 31 August 2017. Changes in management arrangements have led to significant shortfalls in staff supervision and training. Care planning for children is poor and has an impact upon their experiences and progress. Another new manager has been appointed and was on the second day of his induction on the day of this monitoring visit. He is currently preparing to apply for registration with Ofsted. Inspection report for children’s home - monitoring visit: 1241656 2 Two new children were admitted to the home in January 2018. The care planning

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This monitoring visit

for these children is extremely poor. One child has no placing authority documentation at all. The registered provider has not ensured that staff have sufficient guidance about the child’s needs prior to, or following, their admission. Staff have not devised any care planning documents for either child. For example, there is no care plan, risk assessment, behaviour management plan, healthcare plan or education plan. Staff are providing care and accommodation for these children without the necessary written guidance to help them understand how to keep the children safe, and how to help them make progress. One child smokes in their bedroom. The inspection found that there is no assessment in place to consider the risks. This places children and staff at risk of harm.

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This monitoring visit

Another example of poorly planned care relates to one child’s education provision. This child is not currently in education, but regularly attends horse-riding sessions. This experience brings the child a lot of joy and she looks forward to it. This experience has developed into voluntary work at the stables, which is referred to at the home as ‘work experience’. A session of ‘work experience’ was taken away from the child as a sanction following an incident of this child going missing while out with staff. This decision was poorly thought through and was an inappropriate sanction.

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This monitoring visit

Safeguarding processes used in the home are weak. Staff are not familiar with, or confident in, the use of safeguarding processes should they witness poor practice by another staff member. In addition, the responsible individual, when conducting an investigation into an allegation made by a child, did not fully consider all available information. He was not professionally curious or rigorous enough in his approach. Omissions in his own understanding of the incident meant that he provided potentially inaccurate information to the designated officer for safeguarding.

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This monitoring visit

At the interim inspection, a requirement was made to ensure that staff receive appropriate support to enable them to manage their own feelings and responses to children’s behaviours and emotions. This requirement was made following an incident of poor staff conduct towards children. Although the responsible individual provided Ofsted with a plan detailing how members of staff would be supported and their performance managed, this has not been followed through. Consequently, children are being cared for by staff who have not had the opportunity to consider their actions and learn from them, and whose performance has not been monitored to ensure that they are suitable to work with children

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This monitoring visit

Incidents of physical intervention are poorly recorded and lack sufficient detail. Since the last inspection, there have been two records made of physical intervention. One record lacks a clear description of the type of holds used. The previous interim manager was involved in both of these incidents of physical intervention. He had not had the same physical intervention training as the rest of the staff. This had been a recommendation at the last inspection. When staff are trained in different methods of physical intervention, this increases the risk of Inspection report for children’s home - monitoring visit: 1241656 3 errors and does not promote consistent or transparent practice. If mistakes were made, witnesses may not be able to recognise them. In addition, the previous manager signed off both records, even though he was involved in the intervention. This is not best practice. There has been no managerial oversight of these records

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This monitoring visit

by the responsible individual or anyone unconnected with the incident. This demonstrates unsafe physical intervention practice, poor recording practice and a lack of suitable management oversight.

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This monitoring visit

Although the majority of staff have had recent medication training, staff did not seek any medical advice when a child missed two doses of a prescribed medication recently. This lack of action had the potential to have a significant impact on the child’s health.

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This monitoring visit

Leadership and management are weak. The required review of the quality care report is several months overdue. This means that as the regulator, Ofsted is limited in its ability to monitor the functioning of the home. This was a requirement at the previous inspection and is repeated at this inspection. In addition, the home’s location risk assessment has not been updated. This means that the registered provider has not consulted with relevant people about the appropriateness of the location of the home, and any risks associated with the area. This requirement is repeated.

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This monitoring visit

Staff are not receiving sufficient managerial direction and support to enable them to fulfil their roles well. The majority of staff have not received one-to-one supervision since November 2017. New members of staff, who are in their probationary period, have not been receiving sufficient support. In January, the majority of staff completed mandatory training in safeguarding (including sexual exploitation), physical intervention, medication administration and first aid. However, the majority of staff have not received specific training for working with children who have emotional and/or behavioural difficulties. For example, there has been limited training about working with children who have experienced trauma, have mental health difficulties or display self-injurious behaviour. As a consequence, the registered provider is not providing care that is consistent with its statement of purpose.

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This monitoring visit

Important records are not kept up to date. For example, the home’s admission and discharge log did not detail where two previous residents had moved to or provide any information about the two new residents. There is a risk of important information being lost. In addition, there was no evidence of the local authority in which the home is based being informed of the discharge or admission arrangements, as required by regulation. This lack of information-sharing means that the local authority is unaware of children looked after in the area and cannot therefore adequately plan local resources.

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This monitoring visit

There is poor maintenance around the home. One child’s bedroom carpet is heavily stained and a sofa in the lounge has no legs and is stained. The tap lever in the children’s bathroom is broken, the door to the downstairs toilet is stiff and requires Inspection report for children’s home - monitoring visit: 1241656 4 a great deal of force to open or close it. Poor maintenance does not make children feel valued or encourage them to develop respect for their environment. In addition, a fire door is not closing properly, making it ineffective in the event of a fire.

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This monitoring visit

Two new recommendations are made a result of this monitoring visit. None of the children living in the home are currently in education. Although some staff make an effort to encourage and plan activities with the children, they are rarely taken up.

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This monitoring visit

Additionally, when previous residents contact the home or write to members of staff, there is no log kept of this contact. This is important as, although the children no longer live at the home, staff are maintaining contact with children. This may be relevant in terms of life-story work, information-sharing or relevant in the event of an allegation or incident.

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Recent inspection history

Inspection date Inspection type Inspection judgement 06/12/2017 Interim Sustained effectiveness 03/05/2017 Full Good Inspection report for children’s home - monitoring visit: 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 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 and use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. (Regulation 6 (a)(b))

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Requirement Due date

This relates to ensuring that consequences for poor behaviour do not have a negative impact on a child’s well- being. 25/03/2018

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Requirement Due date

The health and well-being standard is that— the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being and children are helped to lead healthy lifestyles.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (2)(c))

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Requirement Due date

In particular, ensure that medical advice is sought in the event of a child refusing to take prescribed medication. 25/03/2018

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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 are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12 (1)(2)(a)(vii)) 25/03/2018

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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 25/03/2018 Inspection report for children’s home - monitoring visit: 1241656 6 registered person to ensure— 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. (Regulation 12 (2)(d)) *The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that promotes their welfare. (Regulation 13 (1)(b))

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Requirement Due date

This specifically relates to ensuring that there are sufficiently robust and effective monitoring and recording systems in place to allow the registered person to identify shortfalls in practice and make suitable improvements in the quality of care. 25/03/2018

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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. (Regulation 14 (1)(a))

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Requirement Due date

This specifically relates to ensuring that up to date and meaningful care planning systems are in place that are accessible to staff. 25/03/2018

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Requirement Due date

The registered person must co-operate with the child’s placing authority in agreeing and signing the child’s placement plan. (Regulation 17 (2)) 25/03/2018

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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. (Regulation 25 (2)(b))

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Requirement Due date

In particular, that fire safety systems are not compromised by the ill-fitting fire doors. 13/02/2018

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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— a description of the measure; the effectiveness and any consequences of the use of the measure.

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Requirement Due date

Within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; 25/03/2018 Inspection report for children’s home - monitoring visit: 1241656 7 and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(iv)(vii)(b)(i)(ii)(c)) 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. (Regulation 36 (1)) 25/03/2018

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Requirement Due date

The registered person must— maintain in the home the records in Schedule 4. (Regulation 37 (2)(a))

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Requirement Due date

This specifically relates to the register of children admitted to and discharged from the home. 25/03/2018

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Requirement Due date

The registered person must notify, without delay, the local authority for the area in which the children’s home is located of every admission of a child into the home and every discharge of a child from the home. (Regulation 41 (1)) 25/03/2018

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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. (Regulation 45 (1)(4)(a)) 25/03/2018

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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. (Regulation 46 (2)) 25/03/2018

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendations

 Where children placed in a home are not participating in education because they have been excluded or are not on a school roll for some other reason, the registered person and staff must work closely with the placing authority so that the child is supported and enabled to resume full-time education as soon as possible. In the interim, the child should be supported to sustain or regain their confidence in education and be engaged in suitable structured activities. (‘Guide to the children’s homes regulations including the quality standards’, page 28, paragraph 5.15) Inspection report for children’s home - monitoring visit: 1241656 8  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

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Recommendations

policy. This specifically applies to ensuring 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)  Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective, and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4) This relates to maintaining a log if a child who has left the children’s home maintains contact.

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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: 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

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Inspector

Catherine Honey, social care inspector Inspection report for children’s home - monitoring visit: 1241656 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 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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