Children's home run by Altum Residential Care Ltd

Inspection report children’s home: SC489660 1 SC489660 Registered provider: Altum Residential Care Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home provides care and accommodation for up to three young people who have emotional and/or behavioural difficulties. The home is owned by a private organisation.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected and their welfare is not promoted or safeguarded and the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Overall judgement at last inspection: Good

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Enforcement action since last inspection:

An unannounced visit took place on 9 October 2017. This was because of concerns that were raised with Ofsted by the police and the local child sexual exploitation team. During the visit, a number of significant shortfalls were identified. The registered manager and staff had failed to take effective action in response to safeguarding concerns. Furthermore, the registered manager and staff had failed to identify, minimise and manage all known risks to the young people. The lack of Inspection report children’s home: SC489660 2 robust safeguarding practice compromised young people’s welfare and safety, resulting in eight requirements being raised and two compliance notices being issued.

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Enforcement action since last inspection:

On 19 October 2017, Ofsted carried out a further unannounced visit to the home. The purpose of the monitoring visit was to assess the progress made by the registered manager in meeting the steps required in the compliance notice, Regulation 12, the protection of children. The monitoring visit identified that the registered manager had taken sufficient steps to meet the notice.

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Enforcement action since last inspection:

On 13 November 2017, Ofsted carried out a further unannounced visit to the home. The purpose of the monitoring visit was to assess the progress made by the registered manager in meeting the steps required in the compliance notice, Regulation 8, the education standard. The monitoring visit identified that the registered manager had taken steps to address the notice.

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Key findings from this inspection

This children’s home is inadequate because:

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Key findings from this inspection

 The management team does not run the home in line with the home’s statement of purpose.  The registered person has failed to ensure that suitable management arrangements are in place.  Poor leadership and management mean that young people receive inconsistent care from staff who are inexperienced, unqualified, and unsupported to meet young people’s individual needs.  Inadequate care and poor risk-management planning place young people at risk of harm, especially those who are deemed to be at risk of missing from home.  Staff have not been able to manage relationships effectively between young people to prevent them from harming each other.  Safer recruitment procedures have not been adhered to and fail to safeguard the young people and minimise any potential risks to them.  Young people’s health needs are not fully understood or managed.  Young people’s educational outcomes do not improve during their time at this

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Key findings from this inspection

home.  Management review and evaluation of the home’s records are not good enough. This hinders improvements in the ways that staff understand and respond to young people’s needs and behaviour. Inspection report children’s home: SC489660 3 The children’s home’s strengths:

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Key findings from this inspection

 Staff support young people to develop skills and knowledge that they need for adulthood.

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Inspection date Inspection type Inspection judgement

14/06/2017 Full Good Inspection report children’s home: SC489660 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

5: Engaging with the wider system to ensure children’s need are met. (1) In meeting the quality standards, the registered person must, and must ensure that staff— (a) seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plan; (b) seek to secure the input and services required to meet the child’s needs; (c) if the registered person considers, or staff consider, a placing authority’s or a relevant person’s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans. 04/05/2018

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Requirement Due date

8: The education standard (1) The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so. (2)(a) In particular, the standard in paragraph (1) requires the registered person to ensure that staff— (viii) help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible. 04/05/2018

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Requirement Due date

9: The enjoyment and achievement standard (1) The enjoyment and achievement standard is that children take part and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interest and skills. (2) In particular, the standard in paragraph (1) requires the 04/05/2018 Inspection report children’s home: SC489660 5 registered person to ensure that a staff help each child to— (i) develop the child’s interests and hobbies; (ii) participate in activities that the child enjoys and which meet and expand the child’s interest and preferences; and (iii) make a positive contribution to the home and the wider community.

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Requirement Due date

10: The health and well-being standard (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; (c) and children are helped to lead healthy lifestyles. 04/05/2018

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Requirement Due date

11:The positive relationships standard (1) The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— (a) mutual respect and trust; (b) an understanding about acceptable behaviour and positive responses to other children and adults. (2)(a) In particular, this standard requires the registered person to ensure that staff— (ii) help each child to develop socially aware behaviour; (iii) encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding; (iv) help each child to develop and practise skills to resolve conflicts positively and without harm to anyone. 04/05/2018

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Requirement Due date

12: The protection of children standard (1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2)(a) In particular, the standard in paragraph (1) requires the registered person to ensure 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; (iv) manage relationships between children to prevent them from harming each other; 04/05/2018 Inspection report children’s home: SC489660 6 (ii) help each child to understand how to keep safe; (iv) manage relationships between children to prevent them from harming each other; (b) ensure 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.

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Requirement Due date

13: The leadership and management standard (1) The leadership and management standard is that the registered person must enable, inspire and lead a culture in relation to the children's home that— (a) helps children aspire to fulfil their potential (b) promotes their welfare. (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; (d) ensure that the home has sufficient staff to provide care for each child; ensure that the home’s workforce provides continuity of care to 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 this understanding to inform the development of

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Requirement Due date

the quality of care provided in the home; (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 04/05/2018

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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. The registered person must keep the statement of purpose under review and, where appropriate, revise it and notify HMCI of any revision and send HMCI a copy of the revised statement within 28 days of the revision. The registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (1)(3)(a)(b)(5)) 04/05/2018

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. The registered person may only employ a person to work at the 04/05/2018 Inspection report children’s home: SC489660 7 children’s home if the individual satisfies the requirements in paragraph (3). The requirements are that full and satisfactory information is available in relation to the individual in respect of each matter in schedule 2. In particular, that proof of identity including a recent photograph is obtained, and, if a person has previously worked in a position involving work with children or vulnerable adults, verification so far as reasonably practicable of the reason why the employment or position ended. (Regulation 32 (1)(2)(a)(3)(d))

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b)) 04/05/2018

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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— the name of the child; details of the child’s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (‘the user’), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person and any medical treatment administered, as a result of the measure; 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

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Requirement Due date

the measure and has signed the record to confirm it is accurate; and within 5 days 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)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)) 04/05/2018 Inspection report children’s home: SC489660 8 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; are kept up to date and are signed and dated by the author of each entry. (Regulation 36(1)(a)) 04/05/2018

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home. The registered person must maintain in the home the records in Schedule 4 and ensure that the records are kept up to date. (Regulation 37 (1)(2)(a)(b)) In particular, the records include a copy of the staff duty roster of persons working at the home, and a record of the actual rotas worked, and a record of any persons who work at any time at the home. 04/05/2018

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Requirement Due date

The registered person must establish a procedure for considering complaints made by or on behalf of children. This procedure must provide that no person who is subject of a complaint takes part in its consideration or investigation, and the registered person must ensure a record of any complaints, the action taken in response, and the outcome of any investigation. (Regulation 39 (1)(2)(3)) 04/05/2018

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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. (Regulation 45 (1)) 04/05/2018

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Recommendations

 Staff should support young people to be aware of and manage their own safety both inside and outside the home to the extent that any good parent or carer would. Staff should help young people to understand how to protect themselves, feel protected, and be protected from significant harm. (‘Guide to the children’s home regulations including the quality standards’, page 43, paragraph 9.9) This is with particular regard to ensuring that the staff conduct meaningful direct work with young people which enables them to understand how to keep themselves safe from the risks associated with their identified behaviour.  The registered person should ensure that staff can access appropriate facilities and resources to support their training needs, and should understand the key role they play in training and the development of staff. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.11)

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Recommendations

This is with particular regard to ensuring that the staff are provided with training opportunities on supporting young people who put themselves at risk of child sexual exploitation due to missing-from-home behaviour. Inspection report children’s home: SC489660 9  No more than half of the staff at any one time, by day or night at the home, should be from an external agency. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.17)

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Overall experiences and progress of children and young people: inadequate

Young people live in a home that is not managed or led effectively. The home does not meet the aims and objectives of the statement of purpose, because staff members do not have sufficient skills, experience and qualifications to create a safe environment. This means that young people’s care, progress and safety have been compromised.

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Overall experiences and progress of children and young people: inadequate

Poor structures, boundaries and routines further hinder young people’s ability to engage in any meaningful education, training or employment opportunities. Records viewed, for example the daily logbook, and discussions with young people confirm that staff do not provide young people with any structured routines or activities during the day. Young people spend an increasing amount of time with each other outside of the home. When young people return to the home, evidence is that they engage in harmful and damaging behaviours, such as violence and aggression towards staff and the home.

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Overall experiences and progress of children and young people: inadequate

Although the previous manager commissioned one-to-one tutoring for one hour per day for each young person, engagement is varied. While one young person does engage occasionally, the other young person does not. Despite one young person requesting to return to an education setting, this has yet to be arranged. This means that one young person has not had access to a suitable education provision since November 2017 when they arrived at the home. This impacts on young people’s opportunities to reach their full educational potential and subsequent later-life chances.

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Overall experiences and progress of children and young people: inadequate

Young people do not benefit from improved health outcomes. The young people living at the home smoke cigarettes and misuse alcohol and illegal substances with increasing frequency. This, combined with their complex medical needs and their reluctance to cooperate with their health treatment plans, increases their vulnerability and affects their health and well-being.

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Overall experiences and progress of children and young people: inadequate

Young people do not benefit from positive relationships with each other and the staff. Staff have not been able to manage relationships between young people effectively, in order to prevent them from harming each other. There have been incidents of young people physically fighting with each other, resulting in them sustaining significant injuries. Despite this, poor management oversight of these incidents means that there are no effective strategies in place to prevent the re-occurrence of incidents. This means that appropriate action has not been taken to protect young people.

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Overall experiences and progress of children and young people: inadequate

Staff support one young person to maintain links with their family in their hometown, enabling the young person to maintain a sense of identity. The other young person, however, has said that they have not been helped by the staff team to maintain any links with their family or friends. This is because the management team has not Inspection report children’s home: SC489660 10 challenged the placing local authorities appropriately to ensure that suitable contact plans requested by the young people are in place. This shortfall not only isolates young people from those who are important to them, but it hinders them from building any positive relationships and links in the areas that they will return to.

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Overall experiences and progress of children and young people: inadequate

Staff support young people to develop independence skills in line with their age and understanding. This practice equips young people with skills that they will need as they move to adulthood.

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

Safeguarding practice in this home is not sufficiently robust and the arrangements for safeguarding young people are inadequate. Furthermore, the poor leadership and management structures, coupled with a fluctuating and inexperienced staff team, mean that young people continue to engage in risk-taking behaviour, which compromises their safety and well-being.

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

Care plans and risk assessments do not accurately reflect or address the current needs of young people. Furthermore, insufficient action has been taken to ensure that all risk assessments are reviewed and updated following significant incidents. The manager has also failed to ensure that all assessments satisfactorily detail how risk is to be reduced or managed or identify alternative support to educate young people about the significant risks they are placing themselves in and therefore to understand the serious implications of this behaviour.

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

Incidents of young people going missing from the home have increased and have resulted in the young people suffering from harm. The pattern of incidents of going missing and the inadequate response and lack of prevention strategies place the young people at a continued risk of harm. Between 22 November 2017 and 4 February 2018, young people were reported to the police as missing from the home on 28 occasions. Of these incidents, 14 occurred in January 2018. On 10, 23, 25, 26, 29 and 30 January 2018 and on 3 and 4 February 2018, young people left the home and on their return were under the influence of alcohol and drugs. Despite this happening frequently, the manager has failed to implement sufficient strategies to address and reduce this behaviour.

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

Poor resources in the home do not support staff to keep young people safe. Staff said that they are not always able to access financial resources to collect and return young people safely. For example, on one occasion the police contacted the home and asked the staff to collect the young people who had been reported as missing from care. The police had found the young people in Manchester town centre. The young people were under the influence of alcohol and with a group of adult males. Staff reported that they were unable to do this as there was only £1.50 in petty cash and they did not have business car insurance to allow them to use their own transport. This lack of adequate accessible resources for staff means that they are unable to ensure the speedy and safe return of the young people, and this places them at further risk of harm.

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

Young people are not supported to understand the risks associated with their behaviour so that they can become increasingly safe. Direct key-worker sessions do not take place Inspection report children’s home: SC489660 11 systematically to educate, support and guide young people on the risks that they are in when they are missing from home and misusing drugs and alcohol. Furthermore, despite this service being commissioned as a therapeutic environment with clinical input, the responsible individual reported that there have been changes to the clinical input available to young people. These changes mean that there have been disruptions and delays to the young people’s care. Consequently, young people have not been helped to understand how their emotional responses and behaviours link to past behaviours and place them at risk of harm. In addition, staff and young people do not discuss the additional concerns and risks associated with the young people’s diagnosed health

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

conditions, which increase their vulnerability. Although the management team reported that young people are encouraged to have these discussions with staff when they return to the home, there is no evidence that this takes place.

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

There are not clear and consistent boundaries or effective behaviour management strategies to support the young people in improving their behaviour. This means that young people continue to display violent, aggressive behaviour, which places themselves and others at risk of harm. Furthermore, there is a lack of effective monitoring of physical restraints and complaints made by young people. One young person had informed the inspector that restraints were used unnecessarily and another young person had made a complaint about the actions of an agency staff member. However, relevant paperwork had not been sufficiently completed and some records lack an accurate, factual reflection of the events. Consequently, limited recording and explanation do not assist in the analysis or evaluation of the interventions. Similarly, the lack of monitoring of the robustness of records has an impact on the assessment as to

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

whether staff practices and behaviour management strategies remain appropriate to safeguard young people.

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

Safer recruitment procedures are not always followed. The management team has failed to ensure that all staff references have been verified. The registered person was unable to provide evidence that they had secured proof of identity for one member of staff, including a recent photograph. Consequently, the management team is unable to demonstrate that all the staff have the skills, qualifications and experience, and are safe and suitable, to work with vulnerable young people.

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The effectiveness of leaders and managers: inadequate

Evidence gathered during this inspection and the external monitoring by the independent visitor confirm that young people do not consistently receive positive experiences or make any significant progress at this home. Furthermore, the provider has been unable to maintain and sustain any of the required changes that have been raised during previous inspection visits and monitoring visits. This means that the five requirements raised at the last monitoring visit, which focused on the leadership and management arrangements, behaviour management and risk management arrangements for young people, have not been addressed.

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The effectiveness of leaders and managers: inadequate

The provider has been unable to recruit a suitable, qualified and experienced manager to the post for any length of time. Since the registered manager left the post on 16 October Inspection report children’s home: SC489660 12 2017, there have been three different managers and, on 4 December 2017, a new responsible individual was introduced. This has created a period of uncertainty and change, which staff and young people have found difficult to manage. This has also prevented any positive changes from taking place in this home.

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The effectiveness of leaders and managers: inadequate

The lack of a consistent manager in the home means that staff are left unsupported and ill-equipped to meet the complex needs of young people in the home. Poor management arrangements mean that staff do not receive a consistent message about what is expected from them. Staff do not receive supervision, clear support, guidance, training and direction, as there is no one to lead and manage them. Consequently, despite the best efforts of the staff team, it is unable to provide good enough safe care to young people in this home.

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The effectiveness of leaders and managers: inadequate

The home does not meet the aims and objectives of the statement of purpose, because staff members do not have sufficient skills, experience and qualifications to create a safe environment. This was confirmed by a member of staff who said that they had not received any training in supporting young people who go missing from home, or may be at risk of child sexual exploitation. The responsible individual acknowledged that the home does not comply with the statement of purpose and that young people continue to place themselves at increased levels of risk because of their escalating behaviour. In addition to this, the senior leadership team does not ensure that the statement of purpose is kept up to date or shared with the relevant agencies as required.

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The effectiveness of leaders and managers: inadequate

Constant changes to the staffing arrangements in the home prevent young people from building and sustaining positive relationships with the staff. When the inspector asked a young person who would be caring for them that evening, they said:

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The effectiveness of leaders and managers: inadequate

‘I have no idea, probably an agency worker. All the staff have left. There is always new staff coming and going. You never know who is going to be here. The staff go on about building relationships with us, but what’s the point building up relationships with staff because they don’t stick around. They just go.’

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The effectiveness of leaders and managers: inadequate

Staff rosters in the home confirmed that a very high number of care staff and three interim managers had worked at the home from 27 November to 28 January 2018. Furthermore, the high levels of staff vacancies have affected the team’s ability to provide young people with continuity of care. This is compounded by the use of employees from agency staff. As a result, young people’s care, progress and safety have been compromised.

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The effectiveness of leaders and managers: inadequate

Placing local authorities and safeguarding agencies, for example the police, spoken to during the inspection raised concerns with regard to the safeguarding practices within the home. One police officer highlighted their concerns about the staff’s ability to keep young people safe when they leave the home and go missing. Several professionals spoken to said that young people in this home have an increased level of vulnerability in terms of their particular health needs and the behaviours they engage in. They confirmed that the staff are unskilled and unable to manage young people’s behaviour at this home. Inspection report children’s home: SC489660 13 Information in young people’s records is confusing and contradictory. Some young people’s files do not contain the required statutory documentation in order for the manager and the staff to be assured that they are supporting the young people as their needs require. For example, some young people’s case records provide different

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The effectiveness of leaders and managers: inadequate

information with regard to their health management plans, such as on their medical diagnosis and their medication regimes. This not only prevents the staff from having a clear understanding of young people’s presenting needs, but it also means that young people’s health needs are not managed well.

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The effectiveness of leaders and managers: inadequate

The management team has failed to ensure that it uses the monitoring and review systems, such as the regulation 44 reports, to make continuous improvements in the quality of care provided at the home. Consequently, areas for improvement have not been addressed and decisive action has not been taken to resolve issues. This demonstrates that the manager has failed to take effective action to resolve issues and to make improvements to the quality of care provided at the home.

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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, 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: SC489660 14

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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

Janine Shortman-Thomas, social care inspector Inspection report children’s home: SC489660 15 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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