Children's home run by Altum Residential Care Ltd

Inspection report children’s home: SC489660 1 SC489660 Registered provider: Altum Residential Care Ltd

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Full inspection Inspected under the social care common inspection framework

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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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Information about this children’s home

The current statement of purpose notes, ‘The service is residential and designed for children and young people aged 11–17 who may have complex psychological needs and present with associated behaviours such as self-harm. The service is designed for children and young people who may be at risk or have been victims of child sexual exploitation and self-harm issues.’

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Information about this children’s home

The home is registered for up to three children and young people.

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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 are not protected and their welfare is not promoted or safeguarded, and the care and experiences of children are poor, and they are not making progress.

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inadequate

Date of last inspection: 7 February 2018

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inadequate

Overall judgement at last inspection: inadequate Inspection report children’s home: SC489660 2

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Enforcement action since last inspection

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

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Enforcement action since last inspection

A notice of proposal to cancel the registration of the home was issued to the provider on 28 February 2018. On 30 March 2018, the provider made written representations to Ofsted against the proposals to cancel its registration. After carefully considering the provider’s representations, Ofsted informed the provider that a decision had been taken to not uphold the representations. Ofsted is proceeding with the cancellation of the registration under section 14 of the Care Standards Act 2000 (the Act). The provider has appealed against this decision.

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Inspection date Inspection type Inspection judgement

07/02/2018 Full Inadequate 14/06/2017 Full Good Inspection report children’s home: SC489660 3

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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 education standard is that children make measurable progress towards achieving their educational potential and are helped to do so. (Regulation 8(1)) 28/09/2018

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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 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)(b)) In particular, ensure that if the manager is involved in physical intervention that there is independent oversight and sign-off. 31/08/2018

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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; and that staff are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12(1)(2)(a)(i)(vi)(b)) 31/08/2018

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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 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 work as a team where appropriate; ensure that staff have the experience, qualifications and skills to meet the needs of each child, and ensure that the home’s workforce provides continuity of care to each child. (Regulation 13(1)(2)(a)(c)(e)) 31/08/2018 Inspection report children’s home: SC489660 4 The registered person must ensure that children can access all appropriate areas of the children’s home’s premises; and any limitation placed on a child’s privacy or access to any area of the

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Requirement Due date

home’s premises is intended to safeguard each child accommodated in the home; is necessary and proportionate; is kept under review and, if necessary, revised; and allows children as much freedom as is possible when balanced against the need to protect them and keep them safe. (Regulation 21(b)(c)(i)(ii)(iii)(iv)) 31/08/2018

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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)) 31/08/2018

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision. (Regulation 33(4)(b)) 31/08/2018

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39(3)) 31/08/2018

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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)(c)) 31/08/2018

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Requirement Due date

* These requirements are subject to a compliance notice. Inspection report children’s home: SC489660 5

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Overall experiences and progress of children and young people: inadequate

The current standards of care and support provided in this home mean that children’s safety, emotional well-being and education needs are not being adequately met. Furthermore, it is difficult to identify the progress that children make from their individual starting points. Educational outcomes for children are poor. The current arrangements to support children to take part in meaningful education are limited and this affects their educational progress. This, and the lack of identified suitable education provision for children, affects children’s education opportunities and has the potential to impact on their later life chances.

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Overall experiences and progress of children and young people: inadequate

The placing authorities’ individual care plans identify the current contact arrangements for family members. However, children report that they are not supported to maintain positive and safe links with their family or friends.

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Overall experiences and progress of children and young people: inadequate

Within the home’s statement of purpose, it states that ‘At Altum we provide tailored care programmes, therapeutic environments and highly dedicated staff members to empower individuals to progress towards a better life and prepare them for independent living, with an independent support package for all our young people.’ Records do not demonstrate that care programmes are tailored to meet the individual needs of children. There was no evidence provided to demonstrate that there were independent support packages in place. Neither the manager nor staff understood the therapeutic approach and one child said about the support in place for them, ‘This support hasn’t helped me with anything.’

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Overall experiences and progress of children and young people: inadequate

Children’s privacy is limited as children are not allowed to speak to professionals in confidence. Furthermore, children’s freedom and access in their home are restricted. This is because the games room and kitchen are locked during periods of the day and night.

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Overall experiences and progress of children and young people: inadequate

Children know how to complain. The setting’s complaints policy is easy to understand. However, records are inaccurate and incomplete as allegations are recorded as complaints. This was discussed with the responsible individual, who accepted this error.

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Overall experiences and progress of children and young people: inadequate

The requirement made at the last inspection to improve the quality of activities provided for children has now been addressed and children are now accessing a range of activities they enjoy. This was confirmed by a social worker who said ‘they [staff] are proactive in accessing services and engaging [name of child] in community activities.’

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

Managers and staff are unable to identify, manage or minimise risks to children. Poor- quality risk assessments prevent the staff from having a clear understanding of children’s needs and vulnerabilities, including the consideration of their previous known risks. Inspection report children’s home: SC489660 6 These assessments do not provide staff with clear strategies to enable them to keep children safe. This fails to ensure that risks are managed consistently by staff and appropriate support is in place to help keep children safe.

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

Not all staff have received training in physical intervention. On one occasion, a child described an incident when another child was causing damage in the home and was distressed. Staff were not able to physically intervene as there was only one staff member trained in physical intervention on the shift. The training matrix for the home confirmed this information. Furthermore, children’s safety is further compromised as there is no independent oversight of physical restraints when the manager has been directly involved in them. This fails to demonstrate that the interventions used have been carefully considered to ensure that they are appropriate and that they have only been used as a last resort to protect the children involved.

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

The provider has failed to ensure that accurate and complete records of all complaints or safeguarding incidents are maintained. The manager failed to provide a full and accurate account of one allegation to safeguarding agencies, such as the designated officer, and to the regulator as required. This prevents all agencies from having a clear understanding of how children are safeguarded. This practice hinders Ofsted’s ability to evaluate that effective action has been taken to minimise risks.

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

The safety and well-being of children have been compromised. On one occasion, a child who has a history of placing herself at risk and is unable to have unsupervised access to the internet took the home’s computer to her bedroom for approximately four hours. This was without the knowledge or intervention of the staff caring for her. Another child living in the home brought this to the attention of staff. Furthermore, children who are reported to be on 1:1 staffing at all times have left the home without the detection or knowledge of the manager and staff on shift.

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

The arrangements for administering and recording children’s medication require further attention by the management team to ensure that children’s medical needs are met. On one occasion, staff had failed to accurately record the number of tablets administered to a child. On another occasion, the medication administration record sheet for medication was left blank. The manager and staff were unclear from the records if medication had been administered or not.

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

The provider has failed to ensure that children are cared for by experienced, qualified and competent staff. On 24 July 2018, two new members of staff, who had not been trained in self-harm, took two children, who display high risk-taking behaviour, out for the day on an activity. No strategies had been devised or put in place to ensure that the safety and well-being of the children and staff had been carefully considered. Neither was there evidence that any action had been taken to minimise the potential risks.

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

Although there are some shortfalls in the recruitment and selection of staff, when brought to the attention of the director, he took immediate action to identify the strategies he would implement to rectify this.

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The effectiveness of leaders and managers: inadequate

Inspection report children’s home: SC489660 7 The experiences, progress and protection of children are inadequate, and leaders and managers do not know the strengths and weaknesses of the home. They have been ineffective in prioritising, challenging and making improvements.

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The effectiveness of leaders and managers: inadequate

The home has been without a registered manager since 16 October 2017. The provider appointed a manager on 5 February 2018. She has applied to Ofsted to become the registered manager.

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The effectiveness of leaders and managers: inadequate

During the inspection, it was evident from discussions with the manager and staff that the home is not run in line with the ethos and vision identified in the home’s statement of purpose. The manager and staff demonstrate a lack of understanding and knowledge about the newly implemented model of care, ‘The Altum Way’. This is despite the provider’s previous assurances that all staff had been trained and understood this model and that this had been embedded into practice.

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The effectiveness of leaders and managers: inadequate

The current statement of purpose states, ‘The service is residential and designed for children and young people aged 11–17 who may have complex psychological needs and present with associated behaviours such as self-harm. The service is designed for children and young people who may be at risk or have been victims of child sexual exploitation and self-harm issues.’ Despite this, the provider does not ensure that all the staff have the skills, knowledge or have completed relevant training to provide appropriate care and support to meet the individual needs of the children that are in their care.

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The effectiveness of leaders and managers: inadequate

The quality and effectiveness of staff support through supervision are debatable. ‘The Altum Way’, which incorporates reflective supervision, is not embedded in practice. Although some supervision records were shown to inspectors, staff stated that supervision was not taking place and therefore the value of supervision is questionable. Furthermore, staff do not receive regular and effective supervision

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The effectiveness of leaders and managers: inadequate

There continue to be inconsistencies with the staffing arrangements. Since the last monitoring visit, four staff members have left the organisation. This does not enable children to build positive relationships with a consistent staff team and has had a negative effect on their overall care and experiences. One child said, ‘There is new staff even since I have been here and a new team leader. They don’t tell you the same thing, they all have to run to the manager.’

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The effectiveness of leaders and managers: inadequate

Leaders and managers have not ensured that staff have regular opportunities to reflect on their professional development as a group. There has only been one team meeting since children moved into the home. The manager was unclear about the date of the meeting and provided a handwritten note to show that a team meeting had taken place. This was attended by three staff members. The record did not identify the date of the meeting. The notes were extremely limited and did not demonstrate that staff had been provided with an opportunity to discuss or reflect on the individual needs of the children or identify any strengths or improvements required in care practices. Inspection report children’s home: SC489660 8 The statement of purpose states that this is a therapeutic home that has access to an external therapy service. However, despite the responsible individual’s assurances that clinical input is provided to the manager and staff, during reflective supervision and

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The effectiveness of leaders and managers: inadequate

practice sessions to help inform the care planning process for children, this could not be validated during this inspection.

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The effectiveness of leaders and managers: inadequate

The manager was difficult to engage during the inspection, and she did not cooperate with inspectors in an honest and open manner. The manager failed to provide information that was factually accurate. On one occasion, information given was untruthful and was accepted by the manager to be an untruth. The responsible individual who was party to the discussion took action.

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The effectiveness of leaders and managers: inadequate

There is not a coherent flow of information within the child’s file that provides a detailed picture of the child’s life throughout their placement. This is a missed opportunity to clearly evidence and monitor the progress made by the children in this 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 and 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 9

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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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Inspectors

Janine Shortman-Thomas, social care inspector Elaine Allison, social care inspector Inspection report children’s home: SC489660 10 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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