Children's Home run by N H Care Limited in Birmingham

Inspection report children’s home: SC467264 1 SC467264 Registered provider: NH Care Limited

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Full inspection 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 for up to four young people aged eight to 17, who have social and emotional needs.

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Information about this children’s home

The manager has been registered since June 2017. The manager is undertaking a level 5 diploma in leadership and management, with an expected completion date of December 2018.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 7 February 2018

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requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: SC467264 2

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Inspection date Inspection type Inspection judgement

07/02/2018 Interim Sustained effectiveness 20/09/2017 Full Requires improvement to be good 12/01/2017 Interim Sustained effectiveness 02/06/2016 Full Requires improvement Inspection report children’s home: SC467264 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 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. (Regulation 12(1)(2)(a)(i)) 12/10/2018

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Requirement Due date

The protection of children standard is that the registered person must ensure that staff understand their roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12(2)(a)(v)) 12/10/2018

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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 premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12(1)(2)(d)) 12/10/2018

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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. This is with particular reference to ensuring that staff details are current. (Regulation 16(1)) 14/09/2018

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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 home. (Regulation 23(1)) 12/10/2018

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home. This is with particular reference to ensuring that fire-resisting doors are only held open with an appropriate automatic door hold-open release device. (Regulation 25(1)(a)) 14/09/2018

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Requirement Due date

The registered person may only employ an individual to work at the children’s home if full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32(3)(d)) 12/10/2018 Inspection report children’s home: SC467264 4 The registered person must ensure that any individual who works in the home in a care role has achieved the appropriate qualification by the relevant date. The relevant date is, in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home. (Regulation 32(5)(a)) 02/01/2019

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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)) 12/10/2018

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Requirement Due date

The registered person must maintain records (‘case records’) for each child that include the information and documents listed in Schedule 3. (Regulation 36(a)) 12/10/2018

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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 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(1)(2)(a)(b)(3)(5)) 12/10/2018

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Recommendations

 ‘Managing medicines in care homes’ (March 2014) is a guideline that applies across both health and social care (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.17). This is with particular reference to using the guide to support the safe receipt, storage, administration and disposal of medicines.  Ensure that there is a workforce plan in place, which can fulfil the requirements of Regulation 16, Schedule 1. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)  All staff must have their performance and fitness to carry out their role formally appraised at least once annually. This appraisal should take into account, where reasonable and practical, the views of other professionals who have worked with the staff member over the year and children in the home’s care. As part of the performance management process, poor performance should be addressed by a

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Recommendations

timely plan to bring about improvement. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.5) Inspection report children’s home: SC467264 5

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improvement to be good

Since the last inspection, one young person has moved into the home. Planned introductions to the home helped the young person to feel welcomed and reassured. The young person told the inspector, ‘They came to visit, and I came for dinner and an overnight stay. I got to meet everyone. It helped me feel OK.’

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improvement to be good

Staff give careful attention to young people’s education. As a result, young people are making good academic progress.

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improvement to be good

Young people enjoy good health. They eat a varied diet and take part in a range of activities which promote good physical health. Staff support young people to access specialist health services as set out in their care plans. One young person’s confidence has increased as a direct result of staff supporting his wish for therapeutic meetings to be undertaken at the home.

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improvement to be good

Young people are supported to keep in touch with family and friends. For one young person, these visits now take place in the community as a direct result of staff advocating on his behalf.

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improvement to be good

The physical conditions of the home require attention. For example, staff do not ensure that kitchen cupboards are kept clean. A shower in a young person’s bathroom is broken and staff do not ensure that supplies including toilet roll, soap and handtowels are routinely available in bathrooms. This detracts from young people living in a safe and homely environment.

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improvement to be good

Since the last inspection, there have been three allegations about staff conduct. The registered manager has taken appropriate action and notified the relevant agencies. This ensures that the safety of young people is increased through external oversight of the conduct of the home. During the inspection, a further allegation about a member of staff conduct was made to the inspector. Ofsted made a referral to the designated officer.

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improvement to be good

Managers have failed to update young people’s risk assessments and to provide staff with enough guidance on how to manage and reduce risks effectively. For example, one young person’s risk assessment has not been updated to include how risks arising from the use of technology should be managed. Furthermore, managers do not make sure that the risks posed to young people are clear to new staff before they start work with Inspection report children’s home: SC467264 6 young people. This leaves staff ill-informed about how to ensure the safety of young people in their care.

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improvement to be good

Since the last inspection, there have been two medication errors. In response, the registered manager has put in place more diligent arrangements to ensure the safe administration of medication. However, the system does not promptly identify poor recording by staff. This heightens the risk of further medication errors.

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improvement to be good

The registered manager ensures that regular safety checks on gas appliances and electrical and fire safety systems are completed. Regular fire drills ensure that there are clear arrangements for the safe evacuation of young people in case of a fire. However, during the inspection, a chair and a piece of carpet were used to prop open fire doors. This compromises the fire safety arrangements.

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The effectiveness of leaders and managers: requires improvement to be good

Staff spoke positively about their work and appreciate the support of the registered manager. One member of staff told the inspector, ‘He is a brilliant manager. A listening ear.’

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has developed positive relationships with parents and professionals. This benefits the care of young people. One parent told the inspector, ‘I have a lot of faith in [manager’s name] He has done right by [name of child].’

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has high aspirations for young people and works hard to ensure that they receive individualised care. However, weak management oversight of records means that some young people’s files do not hold essential care planning documents from the placing authority. For example, two young people’s files do not hold copies of their personal education plan. In addition, the registered manager was unaware that staff do not always record in the designated record consequences given to young people. Shortfalls in keeping records compromise the registered manager’s ability to ensure that young people’s care meets their needs and promotes their welfare.

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The effectiveness of leaders and managers: requires improvement to be good

Staff have access to a range of training to help them to understand the needs of young people. The manager has devised a workforce development plan. However, the plan is not clear about the ongoing training and development needs of staff or the frequency of staff supervision. Two members of staff have not obtained their level 3 qualification in residential childcare within the necessary timescale. In addition, staff do not receive regular supervision or prompt annual appraisal. The lack of attention to the support and professional growth of the workforce results in staff not having enough opportunities to explore their practice or their ongoing development.

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The effectiveness of leaders and managers: requires improvement to be good

Managers have failed to ensure that staff who work at the home are safe to work with young people. Two members of staff started their employment without gaps in their employment histories being checked. In addition, agency staff begin in post without adequate management scrutiny of their suitability to work with young people. This Inspection report children’s home: SC467264 7 means that it is unclear whether the vetting of agency staff is sufficient to ensure the safety of young people. A lack of diligence in safe recruitment leaves young people at risk of being exposed to care from unsuitable adults.

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The effectiveness of leaders and managers: requires improvement to be good

An independent person visits the home regularly and the registered manager responds promptly to the visitor’s recommendations. The manager has undertaken a review of the quality of care. However, the benefit of this for service development is compromised as the review has not considered the views of children, parents or other key stakeholders.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has not reviewed the statement of purpose to reflect changes to staffing. This has resulted in up-to-date information about the service not being available to those who may need it.

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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: SC467264 8

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Children’s home details

Registered provider address: 3 Shetland Close, Birmingham, Warwickshire B16 0RF

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Inspector

Alison Cooper, social care inspector Inspection report children’s home: SC467264 9 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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Inspector

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Inspector

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Inspector

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