Children's Home run by 3 Dimensions Care Limited in Somerset

Inspection report children’s home: SC060758 1 SC060758 Registered provider: 3 Dimensions Care Limited Interim inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is one of a small group of services which are operated by a private company. The home provides care and accommodation for up to five children and young people who may have emotional and behavioural difficulties, and/or learning disabilities. The home has an independent special school on-site.

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Information about this children’s home

The manager was registered by Ofsted on 1 December 2017.

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Information about this children’s home

Enforcement action since last inspection: none

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and young people since the most recent full inspection

This home was judged good at the last full inspection. At the interim inspection, Ofsted judges that it has declined in effectiveness.

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and young people since the most recent full inspection

This interim inspection was carried out in response to increasing concerns about behaviour management in the home. The inspection found persistent weaknesses in this area. There are also major shortfalls in recording, management monitoring and in the quality of the environment. In addition, some serious incidents have not been notified to Ofsted.

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and young people since the most recent full inspection

Since the full inspection, there have been some serious incidents, mainly involving one young person. The staff managed the incidents well, but the young person’s behaviour Inspection report children’s home: SC060758 2 began to have an impact on the other children in the home. The registered person worked with the local authority to find a more suitable placement for the young person concerned, but this took some time to come to fruition. Since this young person moved on in December 2018, the situation has been calmer and the children remaining in the home have been safe.

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and young people since the most recent full inspection

Poor recording remains a concern. For example, placement plans and behaviour management plans still do not provide clear, specific, achievable strategies to help staff manage the children’s behaviours. Staff have access to good-quality verbal information at team meetings and handovers to inform their daily care of the children, but this is not enough to ensure consistently good, accountable care.

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and young people since the most recent full inspection

Staff spend time with the children and help them with their individual needs. However, there have been some instances when staff have not demonstrated professional curiosity in investigating the reasons for children’s behaviour. For example, there were frequent, repeated conversations with one child about his difficulty in getting out of bed in the morning. There was no evidence that the cause of his difficulty has been adequately explored. This was unproductive and not in keeping with the home’s stated therapeutic parenting ethos.

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and young people since the most recent full inspection

The staff do not always record children’s individual behaviour management interventions appropriately. Simple childhood activities such as swimming, going to a youth club and playing hide-and-seek are recorded as ‘rewards’, when they should be part of the child’s usual routine. For example, for apologising for his behaviour, one child received a ‘reward’ of ‘time with carer’. Time with his carer is a right, not a privilege. The responsible individual explained that activities are not withheld for poor behaviour and that this is a recording issue, not a shortfall in the staff’s practice.

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and young people since the most recent full inspection

Physical intervention is sometimes used to avoid injury to children or adults. The large majority of restraints have involved just one child, who has been restrained on 21 occasions since June 2018. All restraints appear to have been appropriate and carried out in line with the home’s chosen method of intervention. However, records are not always completed in sufficient detail. There is no evidence that the registered manager has identified, or acted on, these weaknesses in recording.

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and young people since the most recent full inspection

There was one instance when a child complained of having been hurt during a restraint, and he was offered medical assistance. However, the staff did not complete a body map, so there was an incomplete record of the incident. There are other examples where the antecedents to the restraint are not sufficiently well explained to give the reader a picture of the sequence of events.

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and young people since the most recent full inspection

There are some positive aspects to the home’s behaviour management. Staff enforce appropriate boundaries to keep children safe. When the strategies used have not resulted in the desired outcome, the manager has, in many cases, identified these incidents and has debriefed the staff concerned. Generally, debriefs are well recorded, although on one occasion the manager debriefed staff about a restraint in which he himself had participated. This lacked objectivity. In the past 10 years, there have been Inspection report children’s home: SC060758 3 six requirements and five recommendations made about restraint policy and recording, so there has been insufficient improvement.

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and young people since the most recent full inspection

The registered manager correctly identified two medication errors. In October 2018, a child missed two doses of penicillin from the same course. Missing doses of this medicine is not directly harmful but can reduce the overall effectiveness of the treatment. There is no evidence of any management investigation or advice to staff in response to these errors.

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and young people since the most recent full inspection

These incidents were also not notified to Ofsted. In addition, some other serious incidents involving staff conduct were not notified. Notifications are variable and some of those that have been made lack sufficient detail to enable the regulator to make an informed decision about the management of the incident.

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and young people since the most recent full inspection

The response to previous inspection requirements and recommendations is also variable. There were three requirements at the last full inspection.

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and young people since the most recent full inspection

One requirement concerned the weaknesses in leadership and management. In the past 10 years, six requirements and two recommendations have been made on this subject. This inspection found that management monitoring remains inconsistent and unreliable. The requirement has been repeated.

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and young people since the most recent full inspection

The remaining two requirements from the last inspection, regarding staff completing their level 3 awards and the quality and frequency of staff supervision, have both been met. All staff have now achieved their level 3 awards in the care of children and young people. They are happy with their training and report being well supervised and supported in their work.

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and young people since the most recent full inspection

There were two recommendations at the last full inspection.

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and young people since the most recent full inspection

The first recommendation concerned the quality of the home’s environment. The registered person has worked hard to ensure that the kitchens and bathrooms have been refurbished to a high standard. The gardens are beautifully maintained and provide an attractive and relaxing space for the children. The main office now provides comfortable seating areas for children, so that they can come in and chat with the staff.

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and young people since the most recent full inspection

The overall quality of the home is still adversely affected by persistent institutional features, such as the style of the internal doors. Recommendations made at four previous inspections have resulted in some improvement, but this is insufficient to provide a consistently attractive and homely environment throughout the home. This recommendation has now been incorporated into the requirement under the quality of care standard.

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and young people since the most recent full inspection

The second recommendation concerned record keeping. As described above, this remains a major weakness which has the potential to affect the children’s quality of care. This recommendation has been incorporated into the requirements made at this inspection, to set a timescale for action and ensure that improvements are made. Inspection report children’s home: SC060758 4

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Inspection date Inspection type Inspection judgement

19/06/2018 Full Good 03/10/2017 Full Good 21/12/2016 Interim Sustained effectiveness 23/08/2016 Full Good

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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

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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 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 ensure that staff protect and promote each child’s welfare; provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; and ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. (Regulation 6 (1)(2)(b)(ii)(iv)(c)(i))

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Requirement Due date

 ensuring that work continues to reduce the institutional appearance of some areas of the home;  ensuring that children’s placement plans and behaviour management plans are updated every time there is a change and that they contain specific and achievable strategies, so that the staff have clear information to inform their daily care of the children; and 15/04/2019 Inspection report children’s home: SC060758 5  ensuring that normal day-to-day care practices are not designated as ‘rewards’.

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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 fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to 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 research and developments in relation to the ways in which the needs of children are best met; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(f)(g)(i) and (h))

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Requirement Due date

This is with particular reference to ensuring that management monitoring identifies areas for staff development, including weaknesses in recording. Also, ensure that staff work as a team to implement the principles of therapeutic parenting consistently. 31/03/2019

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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.

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Requirement Due date

This is with particular reference to ensuring that prescribed medicines are given to each child in accordance with the doctor’s instructions. (Regulation 23 (1)) 31/03/2019

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Requirement Due date

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 the name of the child; details of the child’s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use 31/03/2019 Inspection report children’s home: SC060758 6 the measure; the name of the person who used the measure and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and 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

In particular, ensure that restraint records are recorded in sufficient detail to provide a full narrative about the incident. In addition, if a child reports discomfort or injury, ensure that a body map is completed as part of the safeguarding process. (Regulation 35 (3)(a)(i)-(viii))

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)) 31/03/2019

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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

This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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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 Inspection report children’s home: SC060758 7 it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’.

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Children’s home details

Registered provider: 3 Dimensions Care Limited

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Children’s home details

Registered manager: Hendrik Van Schalkwyk

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Inspector(s)

Heather Chaplin, social care inspector Inspection report children’s home: SC060758 8 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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