Children's home run by Elysium Healthcare Ltd

Inspection report children‟s home: 1270501 1 Registered provider: Elysium Healthcare Limited

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

The home is owned by a private organisation.

p.1

Information about this children’s home

The home provides care for up to five young people aged between 11 and 17 years who have emotional and behavioural difficulties.

p.1

Information about this children’s home

The manager has been registered with Ofsted since 23 March 2018.

p.1

Information about this children’s home

Inspection dates: 20 to 21 November 2018

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

requires improvement to be good

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

p.1

requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

p.1

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.

p.1

requires improvement to be good

Date of last inspection: this is the first inspection following registration

p.1

requires improvement to be good

Overall judgement at last inspection: not applicable

p.1

requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: 1270501 2

p.1

Recent inspection history

This is the home‟s first inspection following registration.

p.2

Inspection date Inspection type Inspection judgement

Inspection report children‟s home: 1270501 3

p.3

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.

p.3

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)) 31/12/2018

p.3

Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

p.3

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

p.3

Requirement Due date

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 are familiar with, and act in accordance with, the home‟s child protection policies.

p.3

Requirement Due date

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)(vi)(b)) 31/12/2018

p.3

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—

p.3

Requirement Due date

helps children aspire to fulfil their potential; and promotes their welfare.

p.3

Requirement Due date

In particular, the standard requires the registered person to—

p.3

Requirement Due date

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)(f)(h))

p.3

Requirement Due date

This is with reference to ensuring that there is regular 31/12/2018 Inspection report children‟s home: 1270501 4 managerial review of children‟s files, including risk assessments and behaviour support plans. The care planning standard is that children—

p.3

Requirement Due date

receive effectively planned care in or through the children‟s home. In particular, the standard in paragraph (1) requires the registered person to ensure—

p.4

Requirement Due date

that arrangements are in place to— manage and review the placement of each child in the home; and ensure that each child‟s relevant plans are followed. (Regulation 14 (1)(a)(2)(b)(ii)(c)) 31/12/2018

p.4

Requirement Due date

The registered person must ensure that all employees— receive practice-related supervision. (Regulation 33(4)(b)) 31/12/2018

p.4

Requirement Due date

within 48 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)—

p.4

Requirement Due date

has spoken to the user about the measure; and

p.4

Requirement Due date

has signed the record to confirm it is accurate; and

p.4

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 (3)(b)(i)(ii)(c)) 31/12/2018

p.4

Recommendations

 The regulation 45 six-monthly report should be sent to Ofsted and the placing local authority of all children in the home who are looked-after children. („Guide to the children‟s home regulations including the quality standards‟, page 65, paragraph 15.3) Inspection report children‟s home: 1270501 5

p.4

improvement to be good

The home has been through an unsettled period since its registration in March 2018. Staff have experienced difficulties in managing young people‟s unpredictable and aggressive behaviour. Consequently, four young people‟s placements ended earlier than planned, as the staff were unable to meet their needs. Despite staff acting to keep these young people safe, the risks remained too high. As a result, staff were unable to successfully devise strategies to manage the difficult behaviours and the ongoing risks.

p.5

improvement to be good

The home‟s admission procedures failed to fully consider the impact of new admissions on the existing group of young people. This resulted in a deterioration in young people‟s behaviours. There was an increase in missing-from-home incidents and criminal activity in the community. This had an impact on the overall experiences and progress of the young people. The manager has devised a new impact risk assessment for future referrals, but to date this has not been tested for effectiveness.

p.5

improvement to be good

One young person living at the home has an identified education setting and is progressing well. However, educational outcomes for the remaining young people are poor. The current arrangements to support young people to take part in meaningful education are limited and this affects their educational progress, which in turn has the potential to have an impact on their later life chances. While the home has taken some action through speaking with the head of the virtual school and arranging meetings to address the concerns, the daily routine of the home is disorganised and does not actively encourage educational attendance.

p.5

improvement to be good

Despite identified shortfalls, positive interactions between staff and the young people currently living at the home were observed during the inspection. The young people described staff as, „kind‟, „good at listening‟ and „helpful‟.

p.5

improvement to be good

Young people are supported well to maintain and improve relationships with their families and significant people in their lives. Staff understand that good and well- supported contact arrangements with parents and family members can form the basis for the development of positive relationships that will be helpful to young people in the future.

p.5

improvement to be good

The practice in relation to helping and protecting young people needs to improve. This inspection has found failings. While there is nothing to show that these have led to young people suffering harm, if left unchecked then they have the potential to do so. Despite the shortfalls identified at this inspection, the young people living in the home reported that they feel safe. Inspection report children‟s home: 1270501 6 For a period, there was a significant increase in serious incidents of aggression and assault, both in the community and in the home. Staff requested police assistance on several occasions to help manage young people‟s aggressive and challenging behaviours. Consequently, some young people have been subject to criminal justice procedures because of their behaviour.

p.5

improvement to be good

In some instances, the staff‟s attentive approach means that their de-escalation and distraction techniques are successful. This means that young people learn to manage their emotions more constructively. Despite this, in other examples staff have struggled to support some young people during periods of crisis and this has resulted in the need for physical restraint. The manager‟s oversight of physical intervention is of variable quality. For example, incidents are not always reviewed within the required timescales and the details of actions taken as part of the review are not always clear.

p.6

improvement to be good

Some young people spend a good deal of time away from the home unsupervised, often in their home towns. They increasingly return home late and are reported to the police as missing. While staff usually maintain phone contact with young people, they often do not know who young people are with, or where they are.

p.6

improvement to be good

Young people do go missing from the home. However, staff have a robust protocol in place. This includes doing as any good parent would and searching for young people. Staff are proactive in working with young people to reduce the number of episodes of going missing.

p.6

improvement to be good

Young people‟s health and well-being are promoted in the home, and their individual health needs are being addressed. Staff spend time talking to young people about their health and general well-being and provide support to attend all appointments, such as appointments with dentists and opticians. Medication, where used, is safely stored and carefully administered. Detailed records of medication are routinely checked for accuracy. This ensures that any errors are quickly identified and promptly resolved.

p.6

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

The manager is experienced in residential care and appropriately qualified for the role. She understands the strengths and areas for improvement identified at this inspection.

p.6

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

Staff feel valued and supported by the manager. However, some staff have not received regular supervision in recent months. The lack of regular supervision does not enable staff to reflect on their practice and identify any further training that they need to support their continued professional development.

p.6

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

The monitoring of incidents by managers lacks rigour and evaluation. Staff do not always complete behaviour management records, including records relating to physical interventions, to an acceptable standard. Managers have failed to note that these documents do not always specify that debriefing has taken place. To date, these weaknesses have not had an impact on the safety and welfare of young people, but they Inspection report children‟s home: 1270501 7 have the potential to do so if not rectified.

p.6

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

The registered manager has not been proactive in identifying gaps in required documentation and care plans. One young person‟s records did not provide an updated placement plan detailing the young person‟s identified needs and the necessary guidance for staff to meet these. This included actions set out in a recent child looked after review meeting.

p.7

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

The registered manager fully acknowledges all shortfalls raised at this inspection. She recognises how they have an impact on the day-to-day running of the home and the outcomes for young people. She shows capacity and enthusiasm to make all the required improvements, including more robust systems to ensure that young people‟s care planning, safety and well-being are prioritised.

p.7

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.

p.7

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: 1270501 8

p.7

Children’s home details

Registered provider: Elysium Healthcare Ltd

p.8

Children’s home details

Registered provider address: Unit 2, Imperial Place, Maxwell Road, Borehamwood, Hertfordshire WD6 1JN

p.8

Inspectors

Elaine Allison, social care inspector Marina Tully, social care inspector Inspection report children‟s home: 1270501 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 looked after children, safeguarding and child protection.

p.8

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.9

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.9

Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

p.9