Children's home run by A & T Home Limited in Mid Suffolk

Inspection report children’s home: 1183621 1 Registered provider: A&T Home 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

This home, which is run by a private organisation, provides care for up to four children. The home’s overall aim is to support children and their families to reunite.

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Information about this children’s home

There has been no registered manager in post since 6 July 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: 27 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: 1183621 2

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Inspection date Inspection type Inspection judgement

27/02/2018 Interim Sustained effectiveness 26/04/2017 Full Good 10/08/2016 Full Requires improvement 09/05/2016 Full Inadequate Inspection report children’s home: 1183621 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.

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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

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

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

manage relationships between children to prevent them from harming each other;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

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)(a)(i)(iii)(iv)(vi)(d)) 07/09/2018

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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;

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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. (Regulation 13 (1)(2)(a)) 31/08/2018

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Requirement Due date

The care planning standard is that children— 31/08/2018 Inspection report children’s home: 1183621 4 receive effectively planned care in or through the children’s home; and;

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Requirement Due date

have a positive experience of arriving at or moving on from the home. (Regulation 14 (1)(a)(b)) Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (1)(2)) 31/08/2018

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Requirement Due date

ensure that each employee completes an appropriate induction;

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development; and

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Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33 (1)(a)(4)(a)(b)) 31/08/2018

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Requirement Due date

The registered person must prepare and implement a policy for the prevention of bullying in the home, which must in particular set out the procedure for dealing with an allegation of bullying.

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Requirement Due date

The registered person must prepare and implement a policy (‘the missing child policy’) setting out—

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Requirement Due date

the procedures to be followed, and the roles and responsibilities of persons working at the home, in relation to a child who is, or has been, so absent.

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Requirement Due date

Before implementing or making an amendment which the registered person considers to be substantive to the missing child policy, the registered person must—

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Requirement Due date

consult, and take into account the views of, each relevant person; and

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Requirement Due date

have regard to any relevant local authority or police protocols on missing children. (Regulation 34 (3)(4)(b)(5)(a)(b)) 31/08/2018

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home and;

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Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home. 31/08/2018 Inspection report children’s home: 1183621 5 The registered person must ensure that

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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

a description of the measure and its duration;

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Requirement Due date

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.

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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 (1)(a)(b)(3)(a)(i)(ii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)) Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1)(2)(a)(b)) 31/08/2018 Inspection report children’s home: 1183621 6 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.

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

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’).

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Requirement Due date

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; and

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Requirement Due date

make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home.

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Requirement Due date

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)(c)(3)(4)(a)(b) and (5)) 31/08/2018

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Recommendations

 A child’s bedroom should not generally be entered without their permission, though it may be necessary to establish routines to allow for rooms to be cleaned regularly. Usually, rooms should only be searched if the child has been informed or asked for their permission. Immediate searching may be necessary where there are reasonable grounds for believing that there is a risk to the child’s or another person’s safety and well-being. (‘Guide to the children’s homes Inspection report children’s home: 1183621 7 regulations including the quality standards’, page 16, paragraph 3.20) In particular, record when children’s rooms have been searched.

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improvement to be good

The environment has significantly deteriorated. All areas of the home, including communal spaces and the children’s bedrooms, require deep cleaning, redecorating and refurbishing. The walls are bare and stained and have holes in them, furniture is broken and unsafe, potentially hazardous materials including bricks and lengths of wood are lying around the gardens, the fridge does not work properly, resulting in the loss of food, and there is mould growing on the bathroom wall. Overall, the environment does not present as a welcoming and homely environment. This does not give children an experience of living at a home that is cared for, and can have a detrimental effect on children’s welfare and safety.

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improvement to be good

Children do not have a positive experience of moving into the home. The children’s bedrooms are not painted or refurbished before a new child arrives. For example, one child’s bedroom has dark walls, while the other bedroom is covered in stains and dirty marks. Although children are provided the opportunity to redecorate on occasion there is a delay in this begin actioned.

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improvement to be good

There is a lack of up-to-date information in care plans, behaviour management plans and risk assessments. The lack of regular review of risk assessments and strategies results in a failure to ensure that risk management remains current and proactive.

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improvement to be good

A member of staff confirmed that searches of children’s bedrooms have been carried out. However, the manager could not evidence that the room searches had been recorded. Ofsted is therefore unable to establish if children were aware that their bedrooms had been searched, and the reason and outcome of the searches. This practice does not ensure that children have been consulted and their views listened to.

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improvement to be good

Children enjoy trusting and meaningful relationships with the staff. The staff know the children well and how to engage with them. Children’s educational needs forms an important part of their time living at the home. This is supported through the addition of an educational support worker who participates in reviews and multi-agency meetings. One child spoke of their excitement about starting secondary school for the first time, which will support them into adult life.

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improvement to be good

Inspection report children’s home: 1183621 8 At the time of the inspection files reviewed showed that risk assessments, behaviour management plans and healthcare plans lacked information to ensure the children’s safety. One file contained information about another children. During the inspection on two occasions, children were fighting and staff had to resort to using restraint, despite not being trained in its use. There is no clear guidance in care plans for staff to follow on how to support the children’s complex needs and manage such incidents safely. During the inspection, discussions with staff demonstrated that they know how to meet the children’s needs. However, the lack of recorded information in plans means that there is potential for confusion and inconsistency in the approach to safeguarding children effectively.

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improvement to be good

When new residents arrive who have a history of instability and challenging behaviour, leaders and managers do not suitably consider each child’s presenting needs, whether the staff team has the skills to manage these, and the likely impact of new placements on the children already resident at the home. At times, there are not enough staff on shift to enable the staff to take effective action to prevent children from harming each other. This practice is not effective in ensuring the safety and well-being of all children.

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improvement to be good

The home has a ‘no restraint’ policy. However, challenging behaviour presented by some children has meant that staff have had to physically intervene and use inappropriate restraint techniques that they are not trained to use. The records do not accurately reflect incidents. This does not promote children’s and staff’s safety and well-being.

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improvement to be good

Errors in records of significant incidents such as bullying, episodes of going missing from home and restraint records evidence that further training in behaviour management, restraint and recording is required. Records need updating to include all of the relevant information. For example, restraint records were not completed, missing-from-care records were missing information, incidents of bullying have not been documented and the records have not been monitored by the manager. Consequently, strategies and behaviour management plans are not adapted and changed to ensure that the children are suitably supported.

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improvement to be good

Sanctions and consequences are inconsistent and ineffective in helping children to reflect on and modify their behaviour. The removal of electrical items such as children’s games consoles has been imposed as a sanction. There is no evidence to suggest that such strategies are effective, and no record of the duration of the sanctions. Not all sanctions are recorded on the correct records or monitored by the management team. This means that the manager is not able to ensure that sanctions are proportionate, fair and relevant to the situation.

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improvement to be good

The missing-from-home protocol and logs are in need of updating as there are no clear procedures or format for the staff team to follow in the event that a child goes missing. The manager has not ensured that debriefing sessions with children and staff have taken place to provide opportunities to explore each incident and see if lessons can be learned. Furthermore, there are insufficient arrangements for ensuring that return home interviews take place. This is a missed opportunity to gather information and to help the Inspection report children’s home: 1183621 9 children to make safer choices in the future.

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improvement to be good

The home’s register of children is not up to date. The visitors’ book is often not signed in full. This lack of accurate recording does not demonstrate that robust procedures are consistently followed.

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

The interim manager is currently in the process of submitting her application to register with Ofsted.

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

Three of the four requirements raised at the last inspection have not been met. These relate to the environment, behaviour management procedures and staff supervision. One recommendation out of four raised at the last inspection has not been met. The system to log and record bullying has not been implemented. These requirements and recommendation have been repeated at this inspection.

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

All of the staff spoken to say that they do not feel well supported or listened to by the managers and the leadership team. As part of the home’s ethos, monthly clinical supervision is available. However, some staff have not had the therapeutic supervision for over six months. Therefore, the care practice in the home is not consistent with the therapeutic approach and ethos that are set out in the home’s statement of purpose. Induction for some staff is not evidenced, and training is not up to date. This does not enable the staff to review and develop their childcare practice.

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

Some of the staff said that the monthly team meetings are not productive because the questions that they ask are not responded to, and as a result some have given up asking. The meetings do not provide the staff with sufficient opportunities to receive feedback or to reflect on their practice and identify new strategies for supporting children.

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

Leaders and managers have failed to undertake a quality of care review. The service is not monitored effectively and potential shortfalls are not fully identified. An independent person visits the home and produces monthly monitoring reports. The information contained in the reports gives a good overview of the home, the staff and the children who live there. However, when shortfalls in service provision are identified, managers do not take prompt action to address the shortfalls raised.

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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 Inspection report children’s home: 1183621 10 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: 1183621 11

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Children’s home details

Registered provider address: L B Group, Unit 7, Hydra, Orion Avenue, Great Blakenham, Ipswich, Suffolk IP6 0LW

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Inspector

Cathy Russell: social care inspector Inspection report children’s home: 1183621 12 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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Inspector

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Inspector

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Inspector

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