Children's Home run by Aspris Children’s Services Limited in Cornwall

Inspection report for children‟s home - monitoring visit: 1263270 1

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The Priory Group

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This children‟s home is part of a large national organisation. This home is currently registered to care for up to five children.

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This monitoring visit

This monitoring visit was undertaken in response to an increase in notifications about serious incidents. Inspectors identified serious and widespread weaknesses at this visit and a failure by leaders and managers to keep children safe; enforcement action is being taken.

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This monitoring visit

Since it was registered in August 2017, this home has had recurring changes in manager and continues to perform poorly. Weaknesses and poor performance are repeatedly identified at successive inspections and stem from inadequate leadership and management. Since May 2018, this home has been issued with six compliance notices, and regulatory breaches found at this monitoring visit have been identified at previous inspections. There is a distinct and ongoing failure by senior leaders to make and sustain the improvements necessary to provide children with good experiences and care.

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This monitoring visit

Leadership across all levels is inadequate. Scrutiny by leaders and managers into what happens in this home is weak. They do not have adequate control of the home because they do not understand accurately how it is performing.

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This monitoring visit

Leaders and managers do not fulfil their responsibilities to safeguard children effectively. Child protection concerns are not always dealt with in accordance with safeguarding policies, and internal investigations are not adequately completed to enable leaders to fully understand what happened. Medical attention is not always obtained promptly for children who are injured, and neither the manager nor responsible individual know whether all the windows and glass doors throughout the Inspection report for children‟s home - monitoring visit: 1263270 2 property are protected with safety glass. This is of significant concern because a child repeatedly uses these items to self-harm.

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This monitoring visit

Leaders and managers do not monitor incidents effectively. Staff do not receive good-quality debrief discussions, and leaders and managers have failed to ask important questions about what happened and why. During this visit, staff members described to inspectors incidents when they had physically intervened and restrained a child. The holds used are not recorded in any incident record and are not documented as permitted techniques in the child‟s support plan. Leaders and managers had failed to obtain this information from staff themselves.

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This monitoring visit

Leaders and managers fail to fulfil health and safety requirements adequately. Accidents and injuries sustained by children and staff are not always recorded, and neither is the administration of homely remedies that staff are using to treat a child‟s injuries. Leaders and managers have failed to identify this shortfall, despite weaknesses in the management of medication being subject to two previous compliance notices. Managers are unaware of whether serious injuries staff have sustained in the workplace are reportable under the „reporting of injuries, diseases and dangerous occurrences‟ regulations.

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This monitoring visit

Staff are still not provided with appropriate training and support to enable them to meet children‟s complex needs effectively. Lack of sufficient training for staff has been a repeated weakness. New staff and the manager said that the quality of induction they received was poor and failed to equip them with the skills to undertake their role effectively. For example, not all staff have been provided with training in using augmented communication techniques or supporting children who have autism spectrum disorder. Despite starting work in September 2018 and being expected to oversee practices in the home, the manager has not yet received training in restraint or the safe administration of medication. Inspectors identified serious weaknesses in both areas, confirming poor oversight by the provider.

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This monitoring visit

The provider demonstrates insufficient learning from previous poor decisions. A decision by the organisation resulted in a change to a child‟s school placement without first informing and obtaining consent from the placing authority. Insufficient action was taken by leaders, managers and staff in the children‟s home to challenge this decision and arrange a more carefully thought-out plan. This poor decision- making led to an increase in incidents of the child self-harming and harming others that continued for several weeks before the plan was halted. Despite these poor outcomes, another attempt was made the week of this inspection to change the child‟s school placement again without sufficient notice and involvement of carers and the placing authority. On this occasion, leaders and managers from the children‟s home did prevent the move from taking place, but this is an example of ineffective partnership working across the wider organisation.

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This monitoring visit

The environmental restrictions placed on one child mean that they are unable to participate in the day-to-day activities of the home such as preparing meals and Inspection report for children‟s home - monitoring visit: 1263270 3 snacks. Food is locked away in the adjoining home in an attempt to reduce the trigger for incidents. This reactive approach has been necessary at times, but staff do not have plans in place to reduce this level of restriction and help the child to make progress in this area.

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This monitoring visit

At times, staff have been advised by senior staff to tell children that the police will be called if they do not comply with a particular request or stop difficult behaviour. At times, the police have been called and attended the home because the manager has felt that incidents were out of control. Ofsted has not been notified of all of these incidents despite the manager identifying them as serious.

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This monitoring visit

Too often, records are of poor quality and are not scrutinised effectively by leaders and managers. Too many restraint and/or incident records do not include the date or duration of the incident as required, and entries in children‟s daily log books are not always signed by the author.

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This monitoring visit

Ofsted is not satisfied that this home is led and managed effectively. Enforcement action is being taken and inspectors will continue to monitor the performance of the home.

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Recent inspection history

Inspection date Inspection type Inspection judgement 07/08/2018 Full Requires improvement to be good 09/05/2018 Full Inadequate 20/11/2017 Full Requires improvement to be good Inspection report for children‟s home - monitoring visit: 1263270 4

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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

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

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Requirement Due date

In meeting the quality standards, the registered person must, and must ensure that staff— seek to involve each child‟s placing authority effectively in the child‟s care, in accordance with the child‟s relevant plans; if the registered person considers, or staff consider, a relevant person‟s performance, in this instance this refers specifically to the school provider, or response to be inadequate in relation to their role, challenge the relevant person to seek to ensure that each child‟s needs are met in accordance with the child‟s relevant plans; and seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children‟s home is to provide care and accommodation. (Regulation 5 (a)(c)(d))

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Requirement Due date

 Ensure that the placing authority is always involved in decisions being made about a child‟s school placement, before these decisions are agreed on.  Ensure that sufficient challenge is taken swiftly when there are concerns that decisions being made about a child are not in their best interests.  Ensure that an effective relationship is maintained with each child‟s school. 28/01/2019

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Requirement Due date

6: The quality and purpose of care standard

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who— understand the children‟s home‟s overall aims and the outcomes it seeks to achieve for children, and use this understanding to deliver care that meets children‟s needs 28/01/2019 Inspection report for children‟s home - monitoring visit: 1263270 5 and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to— understand and apply the home‟s statement of purpose, and ensure that staff— understand and apply the home‟s statement of purpose; protect and promote each child‟s welfare; provide personalised care that meets each child‟s needs, as recorded in the child‟s relevant plan, taking account of the child‟s background; 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; provide to children living in the home the physical necessities they need in order to live there comfortably; make decisions about the day-to-day arrangements for each child, in accordance with the child‟s relevant plan, which give the child an appropriate degree of freedom and choice; ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each

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Requirement Due date

child and enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b)(2)(a)(b)(i, ii, iv, vi, vii)(c)(i, ii)) 10: The health and well-being standard

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Requirement Due date

The health and well-being standard is that— the health and well-being needs of children are met and that children receive advice, services and support in relation to their health and well-being.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure— that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (1)(a)(b)(2)(c))

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Requirement Due date

In particular:  Ensure that appropriate medical attention is provided swiftly when staff are concerned about injuries to a child. 28/01/2019

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual respect and trust; an understanding about acceptable 28/01/2019 Inspection report for children‟s home - monitoring visit: 1263270 6 behaviour; and positive responses to other children and adults.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff— meet each child‟s behavioural and emotional needs, as set out in the child‟s relevant plans; help each child to develop socially aware behaviour; encourage each child to take responsibility for the child‟s behaviour, in accordance with the child‟s age and understanding; communicate to each child expectations about the child‟s behaviour and ensure that the child understands those expectations in accordance with the child‟s age and understanding; de-escalate confrontations with or between children, or potentially violent behaviour by children. (Regulation 11 (1)(a)(b)(c)(2)(i, ii, iii, v, xi))

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Requirement Due date

In particular:  Ensure that staff have the skills to de-escalate and manage children‟s behaviour and avoid using the police or the threat of police to provide this support.  Ensure that staff do not use physical intervention techniques that they have not been trained to use or are not recorded in the child‟s behaviour plan. 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

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— have the skills to identify and act upon the signs that a child is at risk of harm; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action whenever there is a serious concern about a child‟s welfare; and are familiar with, and act in accordance with, the home‟s child protection policies; 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)(iii, v, vi, vii)(d)) 28/01/2019 Inspection report for children‟s home - monitoring visit: 1263270 7 In particular:  Ensure that staff maintain detailed and up-to-date records about injuries children receive.  Assess the premises effectively to ensure that all

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Requirement Due date

windows and glass doors contain appropriate safety measures.  Ensure that staff do not investigate child protection concerns, including undertaking physical checks of children, without following child protection policies.  Ensure that managers review incidents effectively when restraint and physical intervention have been used in order to accurately identify if children have been placed at risk of harm. Take action to safeguard children.  Ensure that internal investigations are rigorously undertaken to ensure that leaders and managers accurately understand what has happened. 13: The leadership and management standard

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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 their full potential; and promotes their welfare.

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Requirement Due date

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 statement of purpose; ensure that staff have the experience, qualifications and skills to meet the needs of each child; 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; demonstrate that practice in the home is informed and improved by taking into account and acting on feedback on the experiences of children, including complaints received; 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)(a)(c)(f)(g)(ii)(h))

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Requirement Due date

In particular:  Ensure that staff are provided with ongoing support and training to meet the needs of children, specifically 28/01/2019 Inspection report for children‟s home - monitoring visit: 1263270 8 training in supporting children who have autism spectrum disorder and in the use of augmented communication, restraint and medication administration.  Ensure that leaders and managers monitor and review practices in the home effectively, including the quality of records kept about children, to ensure that children are kept safe and to identify and act on any trends, patterns or concerns. Managers should seek to learn lessons from serious incidents. 23: Medicines

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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.

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Requirement Due date

In particular, the registered person must ensure that— a record is kept of the administration of medicine to each child. (Regulation 23 (1)(c))

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Requirement Due date

In particular:  Ensure that when staff are providing first aid and ongoing treatment to injuries that a record is maintained of the treatment given and products administered. 28/01/2019

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Requirement Due date

The registered person must ensure that each employee completes an appropriate induction.

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Requirement Due date

The registered person must ensure that all employees— undertake appropriate continuing professional development; and receive practice-related supervision by a person with appropriate experience. (Regulation 33(1)(a)(4(a)(b))

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Requirement Due date

In particular:  Ensure that all staff complete a thorough and appropriate induction that skills them effectively to work in the home and meet children‟s needs. 28/01/2019

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Requirement Due date

35: Behaviour management policies and records

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Requirement Due date

The registered person must ensure that— 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 points i to vii as described in this 28/01/2019 Inspection report for children‟s home - monitoring visit: 1263270 9 regulation.

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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— has spoken to the user about the measure and has signed the record to confirm it is accurate. (Regulation 35 (3)(a)(i, ii, iii, iv, v, vi, vii, viii)(b)(i)(ii))

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Requirement Due date

In particular:  Ensure that leaders and managers undertake thorough and effective debrief discussions with staff to understand what happened and why.  Ensure that all incidents where staff use physical intervention and restraint with children are recorded. 36: Children‟s case records

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Requirement Due date

The registered person must maintain records (“case records”) for each child which— include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c))

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Requirement Due date

In particular:  Ensure that accident and injury records are completed and provide a detailed account of what happened and treatment received.  Ensure that each entry written in a daily log book can be clearly read and is signed and dated by each author. 28/01/2019

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; and when there is a serious incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(b)(e)) 28/01/2019

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Requirement Due date

* These requirements are subject to a compliance notice.

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Information about this inspection

Inspection report for children‟s home - monitoring visit: 1263270 10 The purpose of this visit was to monitor the action taken and the progress made by the children‟s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000.

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Children’s home details

Registered provider address: Priory Education Services Limited, 80 Hammersmith Road, London, Middlesex W14 8UD

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Inspector(s)

Paula Lahey, regulatory inspection manager Tracey Ledder, social care inspector Inspection report for children‟s home - monitoring visit: 1263270 11 to 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(s)

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Inspector(s)

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Inspector(s)

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