Children's home run by Altum Residential Care Ltd

Inspection report for children‘s home – monitoring visit: SC489660 1 SC489660

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Altum Residential Care Limited

Monitoring visit 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 children and young people who have emotional and/or behavioural difficulties.

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Information about this children’s home

The home is owned by a private organisation.

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Information about this children’s home

The home has not had a registered manager in post since 16 October 2017.

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This monitoring visit

At the full inspection on 7 and 8 February 2018, Ofsted judged this home to be inadequate. Ofsted held an urgent internal case review. The outcome of this review was that Ofsted issued an emergency suspension notice.

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This monitoring visit

An emergency suspension notice was issued to the provider on 9 February 2018. The period of this notice ended on the 8 May 2018. During this time, two separate monitoring visits were carried out on the 14 March 2018 and 18 April 2018 respectively. During these visits, it was confirmed that no children or young people were living at the home.

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This monitoring visit

Ofsted issued a further notice to the provider on the 28 February 2018. This notice was a notice of proposal to cancel the registration of the home and the provider. On 30 March 2018, the provider made written representations to Ofsted against the proposals to cancel their registration. After carefully considering the provider‘s representations, Ofsted informed the provider that a decision had been taken to not uphold the representations. Ofsted intends to proceed with the cancellation of the registration under section 14 of the Care Standards Act 2000 (the Act). Inspection report for children‘s home – monitoring visit: SC489660 2 This monitoring visit was undertaken to monitor the safeguarding arrangements for the children living in this home. This visit was necessary because the provider had informed Ofsted that they had admitted three children into the home at different points from 20 May 2018.

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This monitoring visit

At this monitoring visit, two children were living in the home and had been in the placement for less than 11 days.

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This monitoring visit

It was evident during this monitoring visit that the staff have begun to introduce routines for the two children in placement. Staff have encouraged the children to engage in basic education at the home, and have provided an opportunity for them to take part in activities. Links with the virtual head and the looked after children‘s nurse have been made. A plan for them to visit the home was in place. However, the children do not yet have school placements and the effectiveness of these arrangements could not be evaluated because the proposed work has not yet commenced. One other child had been admitted and discharged. It is reported that, during their stay at the home, there were no significant incidents and the child had returned to live with their family. Each of the three children had been admitted to the home on an emergency basis.

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This monitoring visit

The responsible individual and the proposed manager were present throughout this visit. They provided information which on further exploration was found to be factually inaccurate and contradictory. In particular, initial information about the staff team was incorrect; some staff training records were inaccurate; and the supervision arrangements for staff were not all in line with the home‘s policies and procedures. Furthermore, the provider had failed to obtain any legal documents for the placement of all children and had not provided a copy of the manager‘s review of the service to HCMI, as required by regulation. The above shortfalls demonstrate that the leadership and management arrangements continue to be unsatisfactory.

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This monitoring visit

At the last monitoring visit, the inspector was informed that there was a new online recording system in place to prompt and support the management and staff team. During that visit, the staff reported that they felt confident about using the recording system. During this monitoring visit, it is too early to evidence any positive impact from the online recording system on the quality of care for children or improvement to management systems.

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This monitoring visit

Staffing arrangements in the home continue to be inconsistent. During the last monitoring visit, it was reported by the manager that there was a full staff team in place. However, four members of staff have since left the organisation. This includes the deputy manager and a long-standing, experienced member of staff. Although attempts are being made to replace these staff, some of the staff recruited are inexperienced and have limited childcare experience and qualifications.

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This monitoring visit

Arrangements to support staff continue to be insufficient, as staff are not supervised in line with the standards set out in the home‘s statement of purpose. Despite the provider‘s plans to improve the supervision arrangements for staff, these plans have Inspection report for children‘s home – monitoring visit: SC489660 3 proved to be ineffective. Although the proposed manager stated that all staff were now being supervised sufficiently, this was found not to be accurate. The proposed manager stated the reason for supervision not taking place for one individual was that the individual was ‗away‘. However, following further scrutiny by the inspector it was established that these periods ‗away‘ were only for short periods of time, and therefore did not account for some significant gaps. This means that inexperienced and unqualified new staff are not being sufficiently supported to undertake their role. Furthermore, this affects the proposed manager‘s ability to assess the staff‘s

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This monitoring visit

performance during their early stages of employment, to ensure that they deliver a good level of safe care to children. This shortfall was discussed with the responsible individual, who said he was not aware that supervisions had not taken place.

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This monitoring visit

Despite the provider‘s plans to improve the management oversight of significant incidents with the introduction of their new online recording system, there is limited evidence to suggest that this process has been effective in improving this area of practice. The inspectors found shortfalls in the proposed manager‘s review and oversight of the effectiveness of the sanctions imposed in the home. The review of the online recording system showed that the proposed manager had only reviewed one of the five sanctions imposed. The proposed manager said that the online system had not triggered a notification to prompt her to review or evaluate these sanctions. However, at the previous monitoring visit, it was reported that the new system would automatically generate a notification of any significant events or incidents to the home‘s manager and senior management team. The functionality of the new system to alert managers to important information was a key component in

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This monitoring visit

the provider‘s action plan to address previous failures. This subsequent failure demonstrates either that the system is not effective in supporting the proposed manager to meet the Children‘s Homes (England) Regulations 2015, or that the proposed manager‘s oversight and/or use of the system is ineffectual.

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This monitoring visit

In line with the home‘s statement of purpose, the provider has admitted children into the home on an emergency basis. However, the provider has failed to ensure that the correct statutory documents and information are obtained from the placing authorities prior to, or shortly after, children are placed in the home. For example, the provider failed to obtain any statutory children looked after documentation from the placing authorities. This means that the provider cannot be assured that they, and the staff team, have the skills, knowledge and experience to meet the needs of children consistently, and ensure their safety and well-being.

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This monitoring visit

The leadership and management arrangements of this home are not yet ensuring that the basic foundations are in place to make sure that this home is meeting the requirements of a good home. This is despite the provider identifying an action plan to address the shortfalls raised in the previous full inspection visit. As a result, the provider has yet to sufficiently address the requirements and recommendations made at the previous visit. Furthermore, as a result of shortfalls identified during this monitoring visit, a further two requirements have been issued. These relate to the arrangements for medication and the quality of care review. Inspection report for children‘s home – monitoring visit: SC489660 4 The arrangements for the safe administration of controlled medication are unsafe and do not comply with the National Institute for Health and Care Excellence and the subsequent guidance, ‗Managing medicine in care homes‘ March 2014. This is

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This monitoring visit

because the controlled medication is not stored correctly. When this was discussed with the responsible individual as an area of concern, he acknowledged that he had not addressed this matter. This is a further indication, that while senior managers are aware of shortfalls in practice, they have failed to take immediate action to address them.

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This monitoring visit

Management oversight is insufficient to secure the improvements that are required to ensure that children receive good care and support. The proposed manager has undertaken her quality of care review. However, she has failed to demonstrate how she intends to address the significant shortfalls that were raised in the previous inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 07/02/2018 Full Inadequate 14/06/2017 Full Good Inspection report for children‘s home – monitoring visit: SC489660 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

In meeting the quality standards, the registered person must, and must ensure that staff— seek to involve each child‘s placing authority effectively in the child‘s care, in accordance with the child‘s relevant plan; seek to secure the input and services required to meet the child‘s needs; and 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. (Regulation 5(a)(b)(c)) 29/06/2018

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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so. In particular, the standard in paragraph (1) requires the registered person to ensure that staff— 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. (Regulation 8(1)(2)(a)(viii)) 29/06/2018

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Requirement Due date

The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. In particular, the standard in paragraph (1) requires the registered person to ensure that staff help each child to— develop the child‘s interests and hobbies; participate in activities that the child enjoys and which meet 29/06/2018 Inspection report for children‘s home – monitoring visit: SC489660 6 and expand the child‘s interests and preferences; and make a positive contribution to the home and the wider community. (Regulation 9(1)(2)(a)(i)(ii)(iii))

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Requirement Due date

The health and well-being standard is that— the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being; and children are helped to lead healthy lifestyles. (Regulation 10(1)(a)(b)(c)) 29/06/2018

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual respect and trust; and an understanding about acceptable behaviour and positive responses to other children and adults. In particular, this standard requires the registered person to ensure that staff— help each child to develop socially aware behaviour; encourage each child to take responsibility for the child‘s behaviour, in accordance with the child‘s age and understanding; and help each child to develop and practise skills to resolve conflicts positively and without harm to anyone. (Regulation 11(1)(a)(b)(2)(a)(ii)(iii)(iv)) 29/06/2018

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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 to reduce the risk of any harm to the child; help each child to understand how to keep safe; and manage relationships between children to prevent them from harming each other; 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. (Regulation 12(1)(2)(a)(i)(ii)(iv)(b)) 29/06/2018

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Requirement Due date

The leadership and management standard is that the 29/06/2018 Inspection report for children‘s home – monitoring visit: SC489660 7 registered person must enable, inspire and lead a culture in relation to the children‘s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

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; ensure that staff have the experience, qualifications and skills to meet the needs of each child; 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; 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; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b)(2)(a)(c)(d)(e)(f)(h))

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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)) 29/06/2018

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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 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 that if a person has previously 29/06/2018 Inspection report for children‘s home – monitoring visit: SC489660 8 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)) 29/06/2018

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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

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Requirement Due date

user about 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)) 29/06/2018

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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)) 29/06/2018 Inspection report for children‘s home – monitoring visit: SC489660 9 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, 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. 29/06/2018

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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. (Regulation 23(1)) In particular, ensure that all the controlled medication is stored as required. 29/06/2018

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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. In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating the quality of care provided for children and identify any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review (―the quality of care review report‖). 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. (Regulation

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Recommendation

 Staff should support children to be aware of and manage their own safety both inside and outside the home to the extent that any good parent would. Staff should help children 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 in particular regard to ensuring that the staff conduct meaningful direct work with children, which enables them to understand how to keep themselves safe from the known risks associated with their identified behaviour. Inspection report for children‘s home – monitoring visit: SC489660 10

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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: SC489660 11

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Children’s home details

Registered provider: Altum Residential Care Limited

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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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Inspectors

Janine Shortman-Thomas, social care inspector Lynn O'Driscoll, social care inspector Inspection report for children‘s home – monitoring visit: SC489660 12 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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