Children's home run by Thoughts of Others Limited in Birmingham

Inspection report for children’s home - monitoring visit: SC049714 1 SC049714

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Thoughts of Others Limited

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This private children’s home is registered to provide care and accommodation for two children who have emotional and/or behavioural difficulties. They may stay past the age of 18 when this is part of a plan to move on. The organisation operates a nearby school and can provide therapeutic services. The organisation operates this setting as a home for girls.

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This monitoring visit

This children’s home was judged inadequate at the full inspection on 6 and 7 September 2017. Following the inspection, Ofsted raised 10 requirements and issued two compliance notices. These were in respect of:  failure to put in place safe arrangements for the administration of children’s medication  failure to use monitoring and review systems to make continuous improvements in the quality of care. A monitoring visit was conducted on 31 October 2017. This visit found that the registered person had not met the compliance notices and previous requirements. Following the inspection, Ofsted issued a further compliance notice. This was in respect of:  failure to take action, or put systems in place, to keep children safe. A second full inspection judged the home inadequate on 19 and 20 December 2017. This visit found that the registered person had not met the three compliance notices and six of the previous requirements. Ofsted judged the home to be inadequate

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This monitoring visit

because of the persistent regulatory failure and a new weakness in respect of:  failure to take action, or put systems in place, to monitor and review the quality Inspection report for children’s home - monitoring visit: SC049714 2 of care provided for children. In order to evaluate the progress that the managers and staff have made in addressing these concerns, a monitoring visit was undertaken on 15 February 2018. This visit found that the registered person has not taken any action to meet the previous regulatory failures. Although the compliance notices were re-issued in December, the notices were returned to Ofsted undelivered. Management oversight of the home continues to be ineffective. Despite the registered manager’s child-centred approach, he has not been able to exert sufficient influence to make the required changes to meet regulatory shortfalls. However, the provider has not taken effective or sufficiently timely action to meet

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This monitoring visit

the regulatory shortfalls. Internal monitoring of quality standards and safeguarding practice remains ineffective. Managers still do not routinely monitor or review the quality of care provided to children. There is no formal review undertaken every six months, as required by regulation. Lessons are not learned after children raise safeguarding allegations, including when children raise concerns over physical restraint. Allegations of verbal abuse made by staff are not investigated or notified to Ofsted. The registered person has not reviewed a member of staff’s practice against the safeguarding policy. Basic information about restraint, allegations and missing from care episodes gathered before Christmas 2017 by managers has still not been analysed to identify patterns and trends of incidents. This demonstrates a lack of professional curiosity about children’s experience or any strategic intention to inform

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This monitoring visit

the development of the quality of care provided in the home. A systematic lack of organised monitoring, review and transparent reporting hinders improvement and confidence in their independent ability. The registered person has not submitted a report to Ofsted for over a year about the quality of care at the home or how they wish to improve it. There has been no formal consultation with staff, parents or placing authorities. Consultation with children has started but has not been analysed as part of a quality review process. This ongoing weakness means that the organisation still has no transparent self-evaluation process that leads to improvement. Staff still do not have the skills or training to meet the significant needs of the children who they care for. This extends to a lack of knowledge in mental health, attachment, online safety and how to keep children safe who might self-harm. Staff still do not have sufficient management support because they do not receive regular,

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This monitoring visit

good-quality supervision or routine annual appraisals. Staff do not have any debriefing after significant behavioural incidents such as restraint. As a result, children are not assured of safe care by an appropriately reflective, experienced or qualified staff team. At the last inspection, the registered provider had undertaken a monthly analysis of staff working at the home. This identified some short-term actions to stabilise the core staff team. This has now been implemented. However, managers have not continued this analysis or drawn conclusions from fresh data collected between 12 December 2017 and 26 January 2018. They are not sure that these actions have Inspection report for children’s home - monitoring visit: SC049714 3 been effective or had a positive impact on the consistency of staff working with children. Staff fail to safely record their administration of children’s medication. The medication policy does not help them. It still does not advise staff how to manage

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This monitoring visit

the storage and administration of home remedies, ‘as and when required’ (PRN) medication, how staff competency will be assessed or how medication is safely audited. Consequently, medication records continue to be chaotic. Some staff do not make a daily record of their administration of medication. If they forget to sign on the day, they add their signature to make it look as though they did. The weaknesses in the safe administration of medication leave children’s health at potential risk because the records are unreliable. The management of physical restraint within the home remains unacceptably poor. Staff restrain children only to prevent self-harm. However, physical restraints that have taken place have resulted in children being restrained in ways that include high levels of risk to the child. Records do not give a complete picture of these events. For example, face down on the ground and face down on beds. There is no record

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This monitoring visit

of conversations between the registered manager and staff about their restraint practice to demonstrate close monitoring. The registered provider has not used the organisation’s behavioural management trainer to review the appropriateness of face-down ground holds or restraints on beds, to help to identify alternative strategies. Children have raised concerns about how staff restrain them, but the registered person has still not undertaken any internal investigation or review of staff practice after advice from the local safeguarding authority. The registered provider has moved staff from this home to other homes after restraint concerns, and other staff have been transferred to this home after concerns elsewhere. No risk assessments cover their deployment. This weak safeguarding culture demonstrates a failure to ensure that questions about staff practice are resolved or that managers follow up on recommendations made by safeguarding professionals.

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This monitoring visit

There is now independent scrutiny from a peer within the company when the registered manager has been involved in physical intervention. Staff do now talk to children in a timely manner following a physical restraint. Plans to improve fire safety have not been delivered. The registered person has failed to implement the requirements of the fire service as stated in the home’s action plan to have one staff member fully trained on each shift. Arrangements had been put in place to train sufficient staff to keep children safe from the risk of fire but staff failed to attend. The registered manager told inspectors that he does not know whether current staff deployment on shift ensures fire safety. The reports of independent scrutiny of children’s well-being and safeguarding are now in place and sent into Ofsted. The current independent visitor’s reports contain inaccuracies. They do not report on the progress made against requirements or

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This monitoring visit

compliance notices. They do not draw conclusions about incidents and practice or scrutinise children’s safety. This leaves managers without independent insight into how they safeguard or promote children’s well-being. Inspection report for children’s home - monitoring visit: SC049714 4 Children’s records continue to be unreliable. Risk assessments and in-house care plans are out of date and confusing. Records, including of restraint, medication, safeguarding and self-harm incidents, lack essential information to help children to make sense of their experience, now or later in life. Staff do not use these records to inform their care or record significant events in children’s lives. This leaves staff without a clear understanding of how their work influences positive change in children’s lives. The registered manager is still working on shift. He does not have sufficient skilled, competent staff to release him to fulfil his regulatory responsibilities. Staff and

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This monitoring visit

children rely on him and the deputy. He acknowledges that he has not completed the compliance actions. He has also not had formal supervision from his line manager since the December 2017 inspection. The registered manager and the responsible individual have been unable to complete the most basic of tasks such as supervision of staff, review of safeguarding incidents and completion of a review of the quality of care for over 12 months. Leaders and managers are unable to take the decisive action necessary to secure children’s well-being.

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Recent inspection history

Inspection date Inspection type Inspection judgement 19/12/2017 Full Inadequate 06/09/2017 Full Inadequate 30/03/2017 Interim Declined in effectiveness 20/12/2016 Full Good Inspection report for children’s home - monitoring visit: SC049714 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 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 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; to ensure that staff have the experience, qualifications and skills to meet the needs of each child; to ensure that the home’s workforce provides continuity of care to each child; and to 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 the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(a)(c)(e)(f)) 31/03/2018

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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 use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(h))* 31/03/2018

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23 (1))* 31/03/2018

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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. In particular, the standard in paragraph (1) requires the registered person to ensure that staff: assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements 31/03/2018 Inspection report for children’s home - monitoring visit: SC049714 6 to reduce the risk of any harm to the child; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action whenever there is a serious concern about a child’s welfare; are familiar with, and act in accordance with, the home’s child protection policies; and that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (1)(2)(a)(i)(v)(vi)(vii)(e))* The registered person must ensure that all employees

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Requirement Due date

receive practice-related supervision by a person with appropriate experience and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(b)(c)) 31/03/2018

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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 all elements of this regulation. (Regulation 35 (3)(a)) 31/03/2018

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Requirement Due date

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)(b)(c)) 31/03/2018

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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 they receive in it. The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (2)(b)(5))* 31/03/2018

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Requirement Due date

The independent person must produce a report about a visit (the independent person’s report) which sets out, in particular, the independent person’s opinion as to whether children are effectively safeguarded and the conduct of the home promotes children’s well-being. (Regulation 44 (4)(a)(b)) 31/03/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 31/03/2018

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Requirement Due date

*These requirements are subject to a compliance notice. Inspection report for children’s home - monitoring visit: SC049714 7

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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: Thoughts of Others Limited

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Children’s home details

Registered provider address: Thoughts of Others, 99 College Road, Sutton Coldfield, West Midlands B73 5DL

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Inspector

Dawn Bennett, social care inspector Christy Wannop, social care inspector Inspection report for children’s home - monitoring visit: SC049714 8 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 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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