Children's Home run by Genesis CTE Limited in Gloucestershire

Inspection report children’s home: 1277861 1 Registered provider: Genesis CTE 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

This children’s home is registered to provide care and accommodation for up to five children. The provider states in its statement of purpose that the home works with young people who have sexually harmful behaviour, in a unique therapeutic environment.

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Information about this children’s home

Inspection dates: 31 July to 1 August 2018

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

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inadequate

Date of last inspection: This inspection is the home’s first inspection since registration.

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inadequate

Overall judgement at last inspection: not applicable

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inadequate

Enforcement action since last inspection: none Inspection report children’s home: 1277861 2

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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

20: Restraint and deprivation of liberty

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Requirement Due date

Ensure that restraint in relation to a child is only permitted for the purpose of preventing –

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Requirement Due date

(a) injury to any person (b) serious damage to the property of any person (including the child) (2) a restraint to a child must be necessary and proportionate. (Regulation 20 (1)(a)(b)(2))

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Requirement Due date

In particular, that ground hold restraints are not undertaken by staff who are not trained in this technique. Restraints must only be undertaken in line with individual behaviour management plans. The record of restraint must detail the duration of any restraint and medical assistance must be offered to a child following a restraint. 14/09/2018

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Requirement Due date

The health and well-being standard is that –

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Requirement Due date

(a) the health and well-being needs of children are met; (b) children receive advice, services and support in relation to their health and well-being. (Regulation 10(1)(a)(b))

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Requirement Due date

In particular, that each child has a healthcare plan that documents their healthcare needs and directs how these needs will be met. 14/09/2018

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Requirement Due date

4: The leadership and management standard 14/09/2018 Inspection report children’s home: 1277861 3 The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that –

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Requirement Due date

(a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (Regulation 13 (1)(a)(b)(2)(e))

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Requirement Due date

In particular, ensure that the staff have the skills, experience and qualifications to meet the needs of each child.

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Requirement Due date

6: The quality and purpose of care standard

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Requirement Due date

(1) The quality and purpose of care standard is that children receive care from staff who –

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Requirement Due date

(a) understand the children’s home overall aims and the outcomes it seeks to achieve for children; (b) use this understanding to deliver care that meets children’s needs and supports them to fulfil their full potential. (Regulation 6(1)(a)(b))

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Requirement Due date

In particular, ensure that the staff understand the home’s statement of purpose and help each child to develop resilience and skills that prepare the child to return home, to live in a new placement, or to live independently as an adult. 14/09/2018

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Requirement Due date

5: Engaging with the wider system to ensure children’s needs are met

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Requirement Due date

In meeting the quality standard, the registered person must ensure that staff –

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Requirement Due date

(a) seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans; (b) seek to secure the input and services required to meet each child’s needs; (c) if the registered person considers 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.

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Requirement Due date

(Regulation 5(a)(b)(c)) 14/09/2018 Inspection report children’s home: 1277861 4 12: The protection of children standard

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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

(i) assess whether any child is at risk of harm, taking into account information in the child’s relevant plans and, if necessary, making arrangements to reduce the risk of any harm to the child; (ii) help each child to understand how to keep safe; (iii) have the skills to identify and act upon signs that a child is at risk of harm. (Regulation 12 (1)(2)(a)(i)(ii)(iii))

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Requirement Due date

In particular, that staff intervene and take prompt action to ensure the safety of the young people in their care. 14/09/2018

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Requirement Due date

The care planning standard is that children receive well planned care from the home and have a positive experience of the admission and transition process.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that arrangements are in place to manage and review the placement of children in the home. (Regulation 14 (2)(b)(ii))

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Requirement Due date

This is in particular reference to the need to ensure that each child has a placement plan that contains clear aims and objectives that are regularly reviewed and document progress. 14/09/2018

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

In particular, ensure that full and satisfactory information is available in relation to the individual in respect of each of the Inspection report children’s home: 1277861 5 matters in Schedule 2.

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Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases be homely, domestic environments. Homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. In particular, that unnecessary institutional signs in the home are removed. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)

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Overall experiences and progress of children and young people: inadequate

This is the home’s first inspection under a new company registration. This home was taken over by a new company in June 2018. The young people, staff and manager remain the same as when the home was operated by a previous provider.

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Overall experiences and progress of children and young people: inadequate

Healthcare plans do not clearly document the healthcare needs of the young people and how staff are to meet identified needs. One child who has specific medical and health needs does not have a health care plan in place. As a result, it is difficult to ensure that their needs are met. In addition, it is not clear how staff monitor the trends and patterns associated to one health need; to gain a greater understanding of possible triggers.

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Overall experiences and progress of children and young people: inadequate

Medication prescribed to the young people is safely stored and medication records are well managed. Information regarding side-effects of medication are kept in the home. However, young people are at risk as not all the staff know how to access this information.

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Overall experiences and progress of children and young people: inadequate

Placement plans do not contain all the necessary information that staff require to safely care for the young people and support them effectively to make progress. The plans do not document measurable outcomes, so that the progress of the young people can be clearly understood and areas for further work identified. One member of staff was not able to accurately explain the key risks for each child.

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Overall experiences and progress of children and young people: inadequate

Trends and patterns in young people’s behaviours are not identified and do not inform their placement plans and risk assessments. One young person has an identified behavioural issue that puts themselves and others at risk. There are no clearly documented strategies for staff to follow in order to manage this behaviour and support the young person to change their behaviour. Inspection report children’s home: 1277861 6 Up-to-date pathway plans that detail how two of the young people are to be prepared for when they leave the home are not in place. The young people who are leaving the home in the near future do not yet know where they are going and how this move will be achieved. This delay is causing them distress and anxiety. Staff have insufficiently challenged the placing authorities about this delay.

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Overall experiences and progress of children and young people: inadequate

It is not clear what independent living skills young people are learning or have learned, in order to prepare them for adult life. There are no documented plans of how staff will withdraw the high level of support the young people receive as they progress, so that they are prepared for reduced support when they leave the home as an adult.

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Overall experiences and progress of children and young people: inadequate

The young people take part in a weekly community meeting, where they are able to voice any concerns or ideas. Requests from young people are not recorded as followed up by the staff. It is not clear if requests are acted on by the staff, or if not, why not.

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Overall experiences and progress of children and young people: inadequate

The house is well furnished and decorated. Pictures of the young people and staff are on display in the home. This helps to give it a homely appearance. Any damage is quickly repaired. The young people said that they like their bedrooms, which they are able to personalise. Some institutional fire safety signs, and signs indicating where the first aid box can be found, are prominently displayed, detracting from the otherwise homely environment.

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

The staff are undertaking ground hold restraints with one young person when they are not trained to do so and it is not the policy of the home to use ground holds. The behaviours leading up to the restraint do not justify restraining a young person. Managers could not evidence that one of the members of staff involved in one of the incidents had received basic restraint training.

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

Records of restraint do not detail how long some holds were used for. Medical attention was not provided to a child who said that they were hurt by the staff following the incidents of restraint. The young person said to staff following one of the restraints: ‘What happened was not OK.’

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

Leaders and managers do not always take robust safeguarding action to ensure that the young people are safe. One young person reported to the registered manager that they were always hurt in incidents of restraint with one particular member of staff. This allegation was not followed up, the issue not reported and was not discussed in supervision with the member of staff. Management monitoring of these incidents fails to address the seriousness of the incidents.

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

Leaders and managers do not ensure that the staff are professionally curious and vigilant when working with the young people in their care. The staff lack documented guidance and strategies so they can safely manage the young people’s high-risk behaviour. Staff do not always promptly intervene to keep young people safe. Inspection report children’s home: 1277861 7 Staff recruitment records do not contain evidence that criminal record checks for all the staff have been completed, and any issues arising from the checks investigated. This safeguarding failure leaves young people at risk, as managers cannot be sure that all of the staff working in the home are suitable to be working with the young people in their care.

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

The staff use a financial reward system to encourage the young people to develop positive behaviours, such as tidying their rooms or getting up for school. A member of staff commented that these are ineffective, as one young person is not motivated by earning money. In addition, the system is not effective in encouraging positive behaviour. It can be disheartening for a young person to lose their whole day’s reward for one mistake.

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

Since the provider took over the home, the young people’s progress with their behaviour is mixed. One young person is making progress and is due to return home to their parents. Other young people are reaching adulthood and are due to leave the home. These young people continue to display concerning and risk-taking behaviours.

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The effectiveness of leaders and managers: inadequate

Insufficient action has been taken by leaders and managers to address practice shortfalls and improve systems that they inherited from the organisation that previously operated the home. The manager is working to update the systems, practice and policies and procedures. This work is not yet embedded and is in its infancy. Most systems and paperwork inherited from the previous organisation continue to be used by the staff.

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The effectiveness of leaders and managers: inadequate

The home’s statement of purpose states that the home provides a ‘unique therapeutic environment’. The staff receive basic training in playfulness, acceptance, care and empathy (PACE) methods of care, but are not trained or qualified to deliver the intensive therapeutic input that the young people require to support them with their identified high-risk and very complex care needs. The young people receive 45 minutes of therapy from a qualified psychologist each week, but strategies from these sessions are not documented and are not used effectively to inform care plans.

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The effectiveness of leaders and managers: inadequate

Leaders and managers do not ensure that all the staff are trained in all of the skills that are essential to provide safe and expert care for the young people. For example, not all staff are trained in restraint, yet are involved in restraining the young people.

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The effectiveness of leaders and managers: inadequate

Supervision of the staff does not always challenge their practice and ensure that there is learning and reflection from any incidents. Staff development plans do not contain comprehensive details of actions that the staff need to take to ensure that their skill levels and practice are sufficient to meet the care needs of the young people.

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The effectiveness of leaders and managers: inadequate

The home’s development plan fails to identify the strengths and areas for development in the home and how these will be addressed. Inspection report children’s home: 1277861 8 Managers undertake newly implemented systems of governance and quality monitoring. The manager has a daily meeting with senior leaders to discuss any issues or concerns. These quality monitoring systems are not yet embedded and are not yet comprehensively addressing the significant shortfalls identified at this inspection.

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The effectiveness of leaders and managers: inadequate

A consistent staff team works at the home, providing continuity of care for the young people. Relationships between most of the staff and young people are positive. Staff report that they are happy working at the home and report that the staff team is happier following a change in senior management and ownership of the 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: 1277861 9

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Children’s home details

Registered provider address: 2 & 3 The Hawthorths, Hawthorn Lane, Staunton, Gloucestershire GL19 3NY

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Inspector

Tina Maddison, social care inspector Inspection report children’s home: 1277861 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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Inspector

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Inspector

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