Children's home run by Kids

Inspection report children‘s home: 1272379 1 Registered provider: Kids Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This short-break children‘s home is operated by a national charity. It is registered to provide care and accommodation for up to five children. The children may have learning disabilities and/or physical disabilities and sensory impairment. A condition is in place that requires the home to reduce the number of children by the number of people aged 18 and over for which it also provides care and accommodation. The manager has been registered with Ofsted since December 2017 and holds the level 5 qualification.

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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/or widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and/or the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Date of last inspection: not applicable (first inspection)

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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: 1272379 2

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Inspection date Inspection type Inspection judgement

Not applicable. Inspection report children‘s home: 1272379 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 quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children‘s home‘s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children‘s needs 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—

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Requirement Due date

provide personalised care that meets each child‘s needs, as recorded in the child‘s relevant plans, taking account of the child‘s background. (Regulation 6 (1)(a)(b)(2)(b)) 21/03/2019

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Requirement Due date

The health and well-being standard is that—

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the health and well-being needs of children are met. (Regulation 10 (1)(a)) 21/03/2019

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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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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

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; 21/03/2019 Inspection report children‘s home: 1272379 4 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;

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Requirement Due date

that the premises used for the purposes of the home are located so that children are effectively safeguarded; 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)(v)(b)(c)(d)) 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

helps children aspire to fulfil their potential;

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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

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

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ensure that the home‘s workforce provides continuity of care to each child; and

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(c)(e)(h)) 21/03/2019

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Requirement Due date

The care planning standard is that children—

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receive effectively planned care in or through the children‘s home. (Regulation 14 (1)(a)) 21/03/2019

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Requirement Due date

The placement plan must set out, in particular—

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how, on a day-to-day basis, the child will be cared for, and the child‘s welfare safeguarded and promoted by the home;

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Requirement Due date

the arrangements made for the child‘s care, education and health; and

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Requirement Due date

any arrangements made for contact with the child‘s parents, relatives and friends. 21/03/2019 Inspection report children‘s home: 1272379 5 (Regulation 18 (5)(a)(b)(c)) Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (2)) 21/03/2019

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Requirement Due date

the privacy of children is appropriately protected. (Regulation 21 (a)) 21/03/2019

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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. In particular the registered person must ensure that—

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Requirement Due date

medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them;

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

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a record is kept of the administration of medicine to each child. (Regulation 23 (1)(2)(a)(b)(c)) 21/03/2019

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if—

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children;

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Requirement Due date

the child‘s placing authority consents in writing to the monitoring or surveillance; and

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Requirement Due date

the monitoring or surveillance is no more intrusive than necessary, having regard to the child‘s need for privacy. (Regulation 24 (1)(a)(b)(d)) 21/03/2019

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Requirement Due date

If the Regulatory Reform (Fire Safety) Order 2005(a) applies to the home—

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Requirement Due date

the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home. (Regulation 25 (2)(b)) 21/03/2019

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Requirement Due date

If the registered provider appoints a person to manage the home, the registered provider must, without delay, give HMCI notice of— 21/03/2019 Inspection report children‘s home: 1272379 6 the name of the person so appointed; and

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Requirement Due date

the date on which the appointment takes effect. (Regulation 27 (1)(2)(a)(b)) The registered person must maintain records (―case records‖) for each child which—

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include the information and documents listed in Schedule 3 in relation to each child;

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are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 21/03/2019

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Requirement Due date

The registered person must ensure that the following items, which may be kept in electronic form, are kept in an accessible manner—

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records of the use of measures of control, discipline or restraint (see Regulation 35); and

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records of complaints (see Regulation 39). (Regulation 38 (h)(l)) 21/03/2019

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Requirement Due date

Subject to paragraph (6), the registered person must establish a procedure for considering complaints made by or on behalf of children.

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (1)(3)) 21/03/2019

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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. (Regulation 45 (2)(a)(b)(c)) 21/03/2019

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children‘s home at least once in each calendar year taking into account the requirement in Regulation 12 (2)(c) (the 21/03/2019 Inspection report children‘s home: 1272379 7 protection of children standard).

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Requirement Due date

When conducting the review, the registered person must consult, and take into account the views of, each relevant person. (Regulation 46 (1)(2))

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Overall experiences and progress of children and young people: inadequate

Children accessing the service are not adequately assessed. A lack of planning with placing authorities has meant that expectations are not clear when children move in. Current funding arrangements are not sufficient to meet the children‘s highly complex needs. As a result, the quality of care provided has been compromised.

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Overall experiences and progress of children and young people: inadequate

Care planning is poor. Children have not received the level of personalised care described in the home‘s statement of purpose. Case files are disorganised, key information is missing and files contain old records. Care plans do not identify children‘s individual needs or targets. Guidance for staff is either contradictory or out of date. The ability of the staff to look after children and to help them progress is limited.

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Overall experiences and progress of children and young people: inadequate

Records of children‘s overnight stays evidence that not all decisions made by staff and managers are in their best interest. Children are routinely put to bed early to accommodate staff rotas and children who are not able to eat orally are regularly taken to restaurants as an activity.

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Overall experiences and progress of children and young people: inadequate

Staff and managers have made no attempt to help children understand their environment by using signs and systems designed for disabled children. Children‘s individual communication methods are either not recorded or are incorrect. An example of this was found in a child‘s evacuation plan. Guidance states that she should be given verbal instruction in the event of the alarm sounding. However, interim managers spoken to said that this would be ineffective as she uses a bespoke type of Makaton.

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Overall experiences and progress of children and young people: inadequate

The current internal layout of the premises does not fully meet the needs of the children. Rooms are very disjointed and not clearly defined. The building lacks a homely feel. There is a real absence of pictures, photographs, toys and games. Staff were also using equipment that is indicative of institutionalised practice, for example medication and linen trolleys.

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

Staff and managers have failed to identify, to manage and to mitigate risks to children. Risk assessments lack detail and do not consider all hazards to children. The staff have also failed to keep the home safe. Interim managers spoken to during the inspection said that a box of large kitchen knives had been found in a toy box in a toy area. They Inspection report children‘s home: 1272379 8 also described having to take remedial action and to put locks on cupboards where harmful and dangerous substances were kept.

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

Interim managers also raised concerns about the inappropriate use of a safe space bed for a child. Staff were using this under instruction from the registered manager without the appropriate consent or guidance in place. These managers felt strongly that the child was being placed at risk of significant harm when sleeping in it, particularly in the event of an emergency and staff needing to attend to her. Due to the level of concerns identified for the child‘s immediate safety and the safety of other children who had used it, the organisation decided to stop using the bed upon its discovery.

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

Staff and managers lack understanding about when the use of physical restraint is permitted. Records viewed showed that staff used wheelchairs for children that did not require them while out in the community as well as holding children by the wrists.

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

There are widespread failures in the handling and administration of children‘s medicines. Forms for booking medication in and out of the home do not correlate to other records. Administration records are unclear, contain errors and are missing key information. Staff routinely change instructions without explanation.

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

Prior to inspection, inspectors were made aware of one error reported to the registered manager when a child had received the incorrect amount of prescribed food supplement. The registered manager failed to address this concern and to take the necessary action to prevent a reoccurrence.

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

Children‘s health plans are not sufficient to meet their individual complex needs. A recent incident resulted in a child being taken to hospital in the home‘s vehicle with the paramedic on board as the ambulance could not transport the child‘s specific wheelchair.

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

Video surveillance was routinely being used by staff to monitor children during the night. This was described by interim managers as being done for staff‘s convenience rather than for genuine safeguarding reasons. It was also being carried out without the necessary written consent from the placing authority and outside of the home‘s statement of purpose and function.

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

Children are not protected from harm. Health and safety records show that routine checks on the fire alarm system are not being carried out. A recent incident of the fire authority being called to the home highlighted some concerns about the evacuation plan given the level of the children‘s vulnerabilities.

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The effectiveness of leaders and managers: inadequate

This is the first inspection of the home since registering with Ofsted in January 2018.

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The effectiveness of leaders and managers: inadequate

Since opening, there has been a high turnover of staff. Parents and commissioners have raised concerns about the impact of this, which includes short breaks being cancelled at short notice and children being looked after by different agency staff. This has resulted Inspection report children‘s home: 1272379 9 in a lack of consistency for children and low morale among the staff team. As a result, senior managers took the decision to close the home in October 2018 to address concerns.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to recognise verbal expressions of dissatisfaction as complaints. A recent complaint from a parent was not managed in accordance with the home‘s policy. Therefore, there was no audit trail of what action, if any, had been taken to address the concerns. As a result, the responsible individual was now dealing with the matter with the aim of getting a resolution.

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The effectiveness of leaders and managers: inadequate

The registered manager is not currently in day-to-day charge of the home. Interim managers were brought in to work on the identified shortfalls. Senior managers failed to notify Ofsted of these arrangements. However, during the inspection, they were very open and transparent about what they had found and were methodically working their way through a programme of improvements. This has included recruiting to the high number of vacancies and implementing a programme of training and development.

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The effectiveness of leaders and managers: inadequate

The registered manager does not have a system to monitor training to ensure that the staff have the relevant skills, knowledge, qualifications and experience to meet children‘s individual needs, including delegated health tasks. Individual staff training records show that training is either out of date or linked to a previous workplace.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to implement a system to monitor, review and evaluate the quality of care provided. A recent review report completed by the registered manager and sent to Ofsted lacks any analysis and a clear action plan. This has contributed to the widespread failings that have been identified.

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The effectiveness of leaders and managers: inadequate

The home‘s location risk assessment is out of date and has not been reviewed.

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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: 1272379 10

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Children’s home details

Registered provider address: 7–9 Elliotts Place, London N1 8HX

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Children’s home details

Responsible individual: Caroline Stevens

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Inspectors

Amanda Harvey: social care inspector Joe Davys: social care inspector Inspection report children‘s home: 1272379 11 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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Inspectors

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Inspectors

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Inspectors

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