Children's home run by Thoughts of Others Limited

Inspection report for children‟s home – monitoring visit: SC038066 1 SC038066

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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

A private company owns this home. It is registered to provide care and accommodation for up to three young people. The home provides care for young people who have social and/or emotional needs. The manager became registered with Ofsted in December 2017.

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This monitoring visit

This home was judged requires improvement to be good at the last full inspection. At the interim inspection on 20 February 2018, Ofsted judged that the home had sustained effectiveness. Six of the 10 requirements made at the full inspection and three of the four recommendations made had not been met. One new requirement and one new recommendation were made at the interim inspection.

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This monitoring visit

To evaluate the progress that the managers and staff have made in addressing the requirements and recommendations, a monitoring visit was conducted on 21 May 2018. During the monitoring visit, managers told inspectors that little progress had been made in meeting the seven requirements and three recommendations.

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This monitoring visit

 Young people‟s risk assessments have been reviewed and individualised missing-from-care risk assessments have been developed. However, risk assessments are not correct and do not cover all potential risks. For example, one young person has recently started having free time in the community. However, her missing-from-care risk assessment has not been updated to reflect this development. Managers confirmed that another young person‟s risk assessment is inaccurate as it details that she should be moved to „her‟ lounge when she becomes challenging. However, the young person does not have a lounge of her own. A lack of attention to ensuring that clear, up-to- date risk assessments are in place means that staff do not have access to Inspection report for children‟s home – monitoring visit: SC038066 2 essential information to help them safely manage the risks posed to young people.  Staff have not completed training in mental health, missing from care,

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This monitoring visit

keeping safe online and attachment theory. Gaps in staff knowledge mean that they are not sufficiently informed about how to meet young people‟s needs and how to promote the safety and welfare of young people in their care.  There has been no change to the staffing model used by the organisation. This means that the registered manager continues to work on shift and a high number of different staff work with young people. Consequently, young people do not always know who will be caring for them and staff do not always have an up-to-date understanding of young people‟s needs and how to meet these. In addition, there has been no progress made with managers using staffing data to understand how the organisation‟s staffing model impacts on the needs and progress of young people.  Progress in safe recruitment has not been made. For example, the organisation has failed to obtain a reference from an employee‟s last

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This monitoring visit

permanent employer. Furthermore, managers do not ensure that when staff have previously worked with children or vulnerable adults, the reasons for the employment ending are validated. This means that there is the potential for young people to be exposed to unsuitable adults.  Young people‟s behaviour management plans have been reviewed. However, they do not include essential information to help staff understand and reduce behaviours of concern. For example, plans do not identify key behaviours such as skin picking and swallowing items. Triggers for one young person‟s self-harming behaviour are not clear. There is no information in one young person‟s plan about why staff are required to stay in her bedroom during the night. In addition, behaviour management plans are still not signed by staff. New guidance has been issued to staff about restricting young people‟s liberty. However, there is no evidence that the staff have read and

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This monitoring visit

understood this new guidance.  One young person‟s record does not hold all the necessary statutory care planning documents. For example, the young person‟s record did not have the local authority care plan, placement plan, statutory health assessment or education, health and care plan. This means that staff do not have access to essential information to ensure that they are meeting young people‟s needs in accordance with the placing authority‟s plans.  There have been no notifiable events since the last inspection. However, managers confirmed that they had not notified Ofsted of an allegation of verbal abuse towards a child by a member of staff found at the last inspection.  The registered manager has completed a review of the quality of care. However, the review does not include the views of young people, staff, families or professionals. This means that the manager‟s conclusions about Inspection report for children‟s home – monitoring visit: SC038066 3

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This monitoring visit

the home‟s strengths and limitations are ill informed, as key stakeholders have not had the opportunity to influence the review or plans for the development of the home.  Not all staff receive supervision as set out in organisational policy. When supervision does happen, there is little evidence that staff and managers reflect on practice. This means that staff miss valuable opportunities to discuss how they can develop their practice to meet young people‟s needs.  The location risk assessment for the home has been updated and includes data about local crime statistics. However, there is a lack of analysis of this information to help inform staff about the potential risks associated with the local community.  The registered manager has not developed a workforce plan. Consequently, the plans for staff to receive required training are not clear. Four new concerns were identified at this visit:  Managers give insufficient attention to the physical conditions of the home.

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This monitoring visit

For example, detailed cleaning is absent. Kitchen cupboards are soiled. Walls and skirting boards in a young person‟s bathroom and a downstairs toilet are dirty. Young people‟s bedrooms are extremely unkempt. Electrical equipment in one young person‟s bedroom is not safety checked. Out-of-date food was found in a fridge. An area to the rear of the garden, accessible to young people from the road, has hazards including food waste, waste bins containing stagnant water and a broken glazed window unit. Old furniture stored in the area presents a potential fire hazard. These various shortfalls mean that young people live in an environment that presents risks to their health and safety.  Managers have been unable to sustain improvement to the standard of physical intervention records. For example, records do not hold enough detail about the circumstances leading to a young person being held on the floor.  The home‟s statement of purpose has not been updated to reflect changes

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This monitoring visit

made to the staff team and the home‟s behaviour management policy. This means that up-to-date information about the service provided by the home is not available.  Rota planning is weak. Rotas are planned independently of the registered manager and do not ensure that there are always enough staff on duty to meet the young people‟s assessed staffing needs. Insufficient staffing results in young people being unable to access community-based activities. In addition, on one occasion the lack of staff meant that young people were taken on an activity without the required number of staff to meet their needs. Inadequate staffing levels compromise young people‟s experiences and safety. Inspection report for children‟s home – monitoring visit: SC038066 4

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Recent inspection history

Inspection date Inspection type Inspection judgement 20/02/2018 Interim Sustained effectiveness 19/07/2017 Full Requires improvement to be good 06/03/2017 Interim Sustained effectiveness 20/12/2016 Full Requires improvement Inspection report for children‟s home – monitoring visit: SC038066 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 protection of children standard is that the registered person must ensure that the premises used for the purpose 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)) 09/07/2018

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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 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. To understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person and to take effective action whenever there is a serious concern about a child‟s welfare and 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(2)(a)(i)(v)(vi)(vii)(e)) 09/07/2018

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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 lead and manage the home in a way that is consistent with the approach and ethos delivers the outcomes, set out in the home‟s statement of purpose; 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 demonstrates that practice in the home is informed and improved by taking into account and acting on feedback on the experiences of children, including complaints received and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 09/07/2018 Inspection report for children‟s home – monitoring visit: SC038066 6 (Regulation 13(1)(a)(b)(2)(a)(c)(e)(g)(ii)(h)) The leadership and management standard is that the registered person enables, inspires and leads a culture in

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Requirement Due date

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 (2) requires the registered person to ensure that the home has sufficient staff to provide care for each child. (Regulation 13(2)(d)) 09/07/2018

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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)) 09/07/2018

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children‟s safety. (Regulation 32(1)) 09/07/2018

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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. (Regulation 33(4)(b)) 09/07/2018

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out how appropriate behaviour is to be promoted in the children‟s home and the measures of control, discipline and restraint which may be used in relation to children in the home. (Regulation 35(1)(a)(b)) 09/07/2018

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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

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Requirement Due date

person”) has spoken to the user about the measure; and has signed the record to confirm it is accurate. (Regulation 35(3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)) 09/07/2018

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Requirement Due date

The registered person must maintain records (“case records”) for each child which include the information and 09/07/2018 Inspection report for children‟s home – monitoring visit: SC038066 7 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. In particular, ensure local authority care planning documents, copies of any legal orders and a record relating to the protection or safety of the child. The registered person must ensure case records must be kept securely in the children‟s home during the period when the child to whom the case records relate is accommodated there. (Regulation 36(1)(a)(b)(c)(2)(c)) 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)(c)) 09/07/2018

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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 registered person must 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. 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)(4)(a)(5)) 09/07/2018

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Recommendations

 Take account of government guidance about assessing the location of a children‟s home, so that the manager of the home will benefit from a clear understanding of the benefits and disadvantages of living in a specific location. This will help establish whether the area is suitable for a home, ensuring that children feel safe and are able to benefit from good-quality services. („Children‟s homes regulations amendments 2014, Advice for children‟s homes providers on new duties under amendments to regulations that came into effect in January and April 2014‟, page 5, paragraphs 1–1.30)  The registered person should have a workforce plan which can fulfil the workforce-related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should detail the necessary management and staffing structure (including any staff commissioned to provide health and education), the experience and qualifications of staff currently working within the staffing

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Recommendations

structure and any further training required for those staff, to enable delivery of the home‟s Statement of Purpose. („Guide to the children‟s homes regulations including the quality standards‟, page 53, paragraph 10.8) Inspection report for children‟s home – monitoring visit: SC038066 8

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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: SC038066 9

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Children’s home details

Registered provider: Thoughts of Others Ltd

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Children’s home details

Registered provider address: Thoughts of Others, 73–75 Station Road, Erdington, Birmingham B23 6UG

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Inspectors

Alison Cooper, social care inspector Mrs Coglan Greig, social care inspector Inspection report for children‟s home – monitoring visit: SC038066 10 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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Inspectors

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Inspectors

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Inspectors

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