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

Inspection report for children‘s home - monitoring visit: SC464249 1 SC464249

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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

The home provides care and accommodation for up to two children who have experienced trauma during their childhood. The organisation currently chooses to operate this home for girls only. The statement of purpose identifies that a prerequisite of a child‘s admission is that the placing authority will seek to obtain a legal order to deprive children of their liberty while they live at the home. A private company operates this home. It operates three other children‘s homes in the local area.

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Information about this children’s home

The registered manager is currently absent from the home due to a period of maternity leave. The acting manager has not been in day-to-day control of the home since 31 March 2018. The responsible individual is yet to notify Ofsted of the management arrangements for the home.

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This monitoring visit

This children‘s home was judged inadequate at the last three full inspections. At the last full inspection, in March 2018, 15 requirements and six recommendations were raised. Seven of these requirements and four of the recommendations had been raised at the previous full inspection in November 2017. These repeated regulatory breaches indicate a failure by leaders and managers to implement and sustain the necessary changes to improve standards within the home.

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This monitoring visit

At the time of this monitoring visit, all of the requirements remain within the timescale for completion. Consequently, this visit has focused on the level of progress being made by managers to meet the requirements.

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This monitoring visit

Managers told inspectors that they have developed an action plan to address the requirements. However, progress to meet the requirements remains slow. Inspection report for children‘s home - monitoring visit: SC464249 2 The registered manager is still on maternity leave. Despite there being an acting manager in post since September 2017, the organisation has not ensured that the acting manager has submitted an application to Ofsted to be registered. As a result, the home has been without a registered manager in day-to-day charge for over seven months. Staff told the inspectors that the acting manager has not been in day-to-day charge of the home since 31 March 2018. This has left staff with limited direct contact with a manager to enable them to receive daily support and guidance. The lack of managerial oversight has resulted in insufficient attention being given to staff practice. For example, only one member of staff has received practice-related

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This monitoring visit

One child has made an allegation against a member of staff since the last inspection. Staff on duty were unable to provide the inspectors with evidence that the allegation had been referred to the appropriate designated officer for the local authority. Similarly, staff were unsure if the allegation had been notified to Ofsted.

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This monitoring visit

Inspectors identified the following additional regulatory breaches at this monitoring visit:  There is no evidence of management oversight of physical restraint records within the home since 9 April 2018. This is in addition to the shortfalls already noted at previous inspections about physical restraint recording. This demonstrates a lack of review and reflection regarding the use of physical restraint in the home.  Leaders and managers have not updated the statement of purpose. Consequently, the statement of purpose does not provide accurate information about the facilities at the home or the staffing structure.  Staffing rotas fail to show which members of staff are working at the home on any given day. This lack of clarity compromises the safety and well-being of children.  Leaders and managers have failed to monitor the consistency of staffing at the home. This lack of oversight means there are times when there are

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This monitoring visit

insufficient staff on duty to operate the staffing ratio required to meet the assessed needs of individual children.  Staff on duty are not clear which members of staff make up the home‘s core staff team. This continued uncertainty in the home‘s staffing model means that staff do not have the opportunity to have a shared understanding of how to successfully work together to achieve positive outcomes for children in their care. Inspection report for children‘s home - monitoring visit: SC464249 3

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Recent inspection history

Inspection date Inspection type Inspection judgement 07/03/2018 Full Inadequate 22/11/2017 Full Inadequate 08/08/2017 Full Inadequate 29/03/2017 Full Requires improvement Inspection report for children‘s home - monitoring visit: SC464249 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

In meeting the quality standards, the registered person must, and must ensure that staff seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children‘s home is to provide care and accommodation. (Regulation 5 (d)) 04/05/2018

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children‘s home‘s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children‘s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to understand and apply the home‘s statement of purpose and ensure that staff provide personalised care that meets each child‘s needs, as recorded in the child‘s relevant plans, taking account of the child‘s background. (Regulation 6 (1)(a)(b) and (2)(a)(iv))

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Requirement Due date

In particular, ensure that staff have ease of access to up-to- date and accurate information about children and that they deliver individual plans. 04/05/2018

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children‘s home‘s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children‘s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that the premises used for the 04/05/2018 Inspection report for children‘s home - monitoring visit: SC464249 5 purpose of the home are designed and furnished so as to meet the needs of each child. (Regulation 6 (1)(2)(c)(i))

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Requirement Due date

In particular, ensure that the home is maintained to a good standard of repair. 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—

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Requirement Due date

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 to reduce the risk of any harm to the child;

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Requirement Due date

and that the effectiveness of the home‘s child protection policies is monitored regularly. (Regulation 12 (1) and (2)(a)(i)(e))

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Requirement Due date

This relates specifically to assessment of risk from self-harm, risk during restraint, and the manager‘s monitoring and review of the effectiveness of risk assessment after any significant incident. 04/05/2018

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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 take effective action whenever there is serious concern about a child‘s welfare. (Regulation 12 (1)(2)(a)(vi))

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Requirement Due date

This relates to staff taking timely and effective action when a child makes an allegation against a member of staff. 04/05/2018

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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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

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;

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Requirement Due date

to ensure that staff have the experience, qualifications and 04/05/2018 Inspection report for children‘s home - monitoring visit: SC464249 6 skills to meet the needs of each child;

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Requirement Due date

to ensure that the home‘s workforce provides continuity of care to each child;

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Requirement Due date

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;

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Requirement Due date

and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) and (2)(a)(c)(e)(f)(h)) 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.

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Requirement Due date

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. (Regulation 13 (1)(a)(b)(2)(e)) 11/06/2018

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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. In particular the registered person must ensure that medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed. (Regulation 23 (1)(2)(b)) 04/05/2018

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Requirement Due date

The registered person may only employ an individual to work at the children‘s home if the individual satisfies the requirements in paragraph (3). In particular that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (2)(a)(3)(d) 04/05/2018

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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; and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(b)(c)) 04/05/2018

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Requirement Due date

The registered person must prepare and implement a policy (‗the behaviour management policy‘) which sets out the measures of control, discipline and restraint which may be used in relation to children in the home. The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (Regulation 35 (1)(b)(2)) 04/05/2018 Inspection report for children‘s home - monitoring visit: SC464249 7 In particular, improve guidance about restrictions of liberty and movement and managerial review of the effectiveness of measures of control. The registered person must maintain records (―case records‖) for each child which are kept up to date and are signed and dated by the author of the entry. (Regulation 36 (1)(b)(c)) 04/05/2018

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Requirement Due date

The registered person must ensure that the following items, which may be kept in electronic form, are kept in an accessible manner: records of the use of measures of control, discipline or restraint. (Regulation 38 (h)) 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. This review must meet all elements of this regulation: consultation, action planning, reporting and sharing the report of the review with placing authorities. (Regulation 45 (1)(2)(b)(3)(4)(5)) 04/05/2018

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Requirement Due date

The registered person must give notice in writing to HMCI, as soon as is reasonably practicable to do so, if any of the following events take place or are expected by the registered person to take place a person other than the registered person carries on or manages the children‘s home. (Regulation 49 (a)) 04/05/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is an allegation of abuse against the home or a person working there. (Regulation 40 (4)) 04/05/2018

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)(b)) 11/06/2018

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Requirement Due date

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—

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Requirement Due date

details of the child‘s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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Requirement Due date

a description of the measure and its duration; 11/06/2018 Inspection report for children‘s home - monitoring visit: SC464249 8 details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the name of the person who used the measure (―the user‖), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result 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‖)—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

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)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii) and (c)(iv)) 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; ensure that the records are kept up to date; and retain the records for at least 15 years from the date of the last entry. (Regulation 37 (1)(2)(a)(b)(c)) 11/06/2018

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Recommendations

 Ensure that staff understand that a deprivation of liberty may occur when a child is both under continuous supervision and control and is not free to leave the home. A children‘s home cannot routinely deprive a child of their liberty without a court order, such as a section 25 order to place a child in a licensed secure children‘s home. In the case of young people aged over 16 who lack mental capacity, a deprivation of liberty may be authorised by the Court of Protection following an application under the Mental Capacity Act 2005. (‗Guide to the children‘s homes regulations including the quality standards‘, Inspection report for children‘s home - monitoring visit: SC464249 9 page 50, paragraph 9.63)  Continually and actively assess the risks to each child and the arrangements that are in place to protect them. This is with respect to inclusion in risk documentation of all risks, such as actions in the event of self-harm, or for

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Recommendations

occasions where staff restrict children‘s movement. (‗Guide to the children‘s homes regulations including the quality standards‘, page 42, and paragraph 9.5)  Ensure that the home complies with relevant health and safety legislations (alarms, food hygiene etc.); however in doing so, homes should seek as far as possible to maintain a domestic rather than ‗institutional‘ impression. (‗Guide to the children‘s homes regulations including the quality standards‘, page 15, paragraph 3.9) In particular, ensure that the kitchen, new extension and partition meet the local authority health and safety and planning standards; provide a garden area that takes account of children‘s need for active play and for fresh air; and ensure that principles of food hygiene are implemented throughout the home.  The design of the home should provide staff that sleep in the home overnight with appropriate accommodation and facilities to do so. (‗Guide to the

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Recommendations

children‘s homes regulations including the quality standards‘, page 17, paragraph 3.26)  Children should be encouraged by staff to see the home‘s records as ‗living documents‘ supporting them to view and contribute to the record in a way that reflects their voice on a regular basis. (‗Guide to the children‘s homes regulations including the quality standards‘, page 58, paragraph 11.19)  The children‘s guide should help children understand how to contact the Office of the Children‘s Commissioner. (‗Guide to the children‘s homes regulations including the quality standards‘, page 24, paragraph 4.22)

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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. Inspection report for children‘s home - monitoring visit: SC464249 10

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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: 73–75 Station Road, Erdington, Birmingham B23 6UG

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Inspectors

Tracey Coglan Greig, social care inspector Alison Cooper, social care inspector Inspection report for children‘s home - monitoring visit: SC464249 11 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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Inspectors

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Inspectors

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Inspectors

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