Children's home run by Livability

Inspection report children‟s home: SC371073 1 SC371073 Registered provider: Livability

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is registered for up to 16 children. The home provides care for children who may have physical disabilities and associated complex learning and care needs. The home is operated by a private organisation with charitable status. The manager has been in post since March 2017.

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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, their welfare is not promoted, the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Overall judgement at last inspection: requires improvement to be good

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inadequate

Enforcement action since last inspection: none Inspection report children‟s home: SC371073 2

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Inspection date Inspection type Inspection judgement

14/08/2018 Full Requires improvement to be good 27/02/2018 Interim Sustained effectiveness 11/12/2017 Full Good 15/03/2017 Interim Improved effectiveness Inspection report children‟s home: SC371073 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

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— (a) understand the children‟s home‟s 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 potential. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) understand and apply the home‟s statement of purpose; (b) ensure that staff— (i) understand and apply the home‟s statement of purpose; (ii) protect and promote each child‟s welfare; (iii) treat each child with dignity and respect; (iv) provide personalised care that meets each child‟s needs, as recorded in the child‟s relevant plans, taking account of the child‟s background; (ix) make decisions about the day-to-day arrangements for each child, in accordance with the child‟s relevant plans, which give the child an appropriate degree of freedom and choice;

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Requirement Due date

(3) The conditions are— (b) that the care meets the child‟s needs; (c) that the care is delivered by a person who— (i) has the experience, knowledge and skills to deliver that care; and (ii) is under the supervision of a person who is appropriately skilled and qualified to supervise that care; and (d) that the registered person keeps the child‟s general medical practitioner informed, as necessary, about the progress of the care throughout its duration. (Regulation 6 (1)(a)(b)(2)(a)(b)(i)(ii)(iii)(iv)(ix)(3)(b)(c)(i)(ii)(d)) 30/6/2019

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Requirement Due date

9: The enjoyment and achievement standard

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Requirement Due date

(1) The enjoyment and achievement standard is that children 30/6/2019 Inspection report children‟s home: SC371073 4 take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff help each child to— (i) develop the child‟s interests and hobbies; (ii) participate in activities that the child enjoys and which meet and expand the child‟s interests and preferences; and (iii) make a positive contribution to the home and the wider community; and (b) that each child has access to a range of activities that enable the child to pursue the child‟s interests and hobbies . (Regulation 9 (1)(2)(a)(i)(ii)(iii)(b))

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Requirement Due date

(1) The health and well-being standard is that— (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. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff help each child to— (i) achieve the health and well-being outcomes that are recorded in the child‟s relevant plans; (iv) understand and develop skills to promote the child‟s well- being. (Regulation 10 (1)(a)(b)(2)(a)(i)(iv)) 30/6/2019

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Requirement Due date

(1) The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— (a) mutual respect and trust; (b) an understanding about acceptable behaviour; and (c) positive responses to other children and adults. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) meet each child‟s behavioural and emotional needs, as set out in the child‟s relevant plans; (viii) strive to gain each child‟s respect and trust; (ix) understand how children‟s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children. 30/6/2019 Inspection report children‟s home: SC371073 5 (Regulation 11 (1)(a)(b)(c)(2)(a)(i)(viii)(ix))

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Requirement Due date

(1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) 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; (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; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is a serious concern about a child‟s welfare; and (vii) are familiar with, and act in accordance with, the home‟s child protection policies; (b) that the home‟s day-to-day care is arranged and delivered

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Requirement Due date

so as to keep each child safe and to protect each child effectively from harm; (e) that the effectiveness of the home‟s child protection policies is monitored regularly. (Regulation 12 (1)(2)(a)(i)(ii)(iii)(v)(vi)(vii)(b)(e)) 30/6/2019

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home‟s statement of purpose; (b) ensure that staff work as a team where appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (d) ensure that the home has sufficient staff to provide care for each child; 30/6/2019 Inspection report children‟s home: SC371073 6 (e) ensure that the home‟s workforce provides continuity of care to each child; (f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each

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Requirement Due date

child and use this understanding to inform the development of the quality of care provided in the home; (g) demonstrate that practice in the home is informed and improved by taking into account and acting on— (i) research and developments in relation to the ways in which the needs of children are best met; and (ii) feedback on the experiences of children, including complaints received; and (h) 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)(b)(c)(d)(e)(f)(g)(i)(ii)(h))

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Requirement Due date

(1) The registered person must recruit staff using recruitment procedures that are designed to ensure children‟s safety. (2) The registered person may only— (a) employ an individual to work at the children‟s home; or (b) if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3). (3) The requirements are that— (a) the individual is of integrity and good character; (b) the individual has the appropriate experience, qualification and skills for the work that the individual is to perform. (4) For the purposes of paragraph (3)(b), an individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained— (a) the Level 3 Diploma for Residential Childcare (England) (“the

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Requirement Due date

Level 3 Diploma”); or (b) a qualification which the registered person considers to be equivalent to the Level 3 Diploma. (5) The relevant date is— (a) in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home; or (b) in the case of an individual who was working in a care role in a home on 1st April 2014, 1st April 2016. (Regulation 32 (1)(2)(a)(b)(3)(a)(b)(4)(a)(b)(5)(a)(b)) 30/6/2019 Inspection report children‟s home: SC371073 7 33: Employment of staff

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Requirement Due date

(1) The registered person must— (a) ensure that each employee completes an appropriate induction. (4) The registered person must ensure that all employees— (a) undertake appropriate continuing professional development; (b) receive practice-related supervision by a person with appropriate experience; and (c) have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (1)(a)(4)(a)(b)(c)) 30/6/2019

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Requirement Due date

34: Policies for the protection of children

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Requirement Due date

(1) The registered person must prepare and implement a policy which— (a) is intended to safeguard children accommodated in the children‟s home from abuse or neglect; and (b) sets out the procedure to be followed in the event of an allegation of abuse or neglect. (2) The procedure to be followed in the event of an allegation of abuse or neglect must, in particular— (a) provide for liaison and co-operation with any local authority which are, or may be, making a child protection enquiry in relation to a child accommodated in the home; (b) provide for the prompt referral of an allegation about current or ongoing abuse or neglect in relation to a child to the placing authority and, if different, the local authority in whose area the home is located; (c) provide for the prompt referral of an allegation about past abuse or neglect in relation to a child to the placing authority and, if different, the local authority in whose area the alleged

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Requirement Due date

abuse or neglect occurred; (d) provide for records to be kept of an allegation of abuse or neglect, and the action taken in response; (e) describe the measures which may be necessary to protect children following an allegation of abuse or neglect; and (f) describe how and to whom staff are to report, without delay, any concern about abuse or neglect of a child. (Regulation 34 (1)(a)(b)(2)(a)(b)(c)(d)(e)(f)) 30/6/2019

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Overall experiences and progress of children and young people: inadequate

Children are at serious risk of harm. Services have seriously declined since the last Inspection report children‟s home: SC371073 8 inspection, when the service required improvement to be good. Many of the current weaknesses have been known to leaders and managers. However, their attempts to reduce the risk and improve services for children have not been effective in addressing the serious concerns. Leaders and managers assess the current level of risk to children as „really high‟. Due to the seriousness of the risks, Ofsted suspended the registration of the children‟s home with immediate effect.

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Overall experiences and progress of children and young people: inadequate

The quality of children‟s experiences is inadequate. Significant staffing shortages mean that children‟s opportunities and activities are vastly reduced. Children currently spend most of their leisure time inside the children‟s home building and grounds. There are too few staff appropriately trained to take children out into the local community, and specialist play equipment, such as the sensory room, is not often used.

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Overall experiences and progress of children and young people: inadequate

Children are not receiving care from a consistent, well-trained staff team that knows them well and understands their needs. Leaders and managers recognise this critical weakness. Nevertheless, they cannot assure themselves or the regulator that children‟s complex healthcare needs are being met.

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Overall experiences and progress of children and young people: inadequate

Children‟s health is at risk of harm because the nursing team is severely depleted, and medication is not managed safely. Medication errors are still happening. Prior to this inspection, a child required urgent medical attention after being given medication that was not prescribed to him. Following this inspection, nursing care was due to be provided solely by agency staff. Several agency nurses employed to work in the home do not have paediatric experience. Leaders and managers advised the inspectors that there is a very high risk that the service will not be able to meet the specialist care needs of the children.

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

Children are not protected from harm. Managers in charge of the home do not have child protection training and have insufficient knowledge in regard to recognising and managing child protection concerns. Leaders and managers said that there is a high risk of safeguarding incidents not being reported.

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

Child protection concerns are not always managed well. During the inspection, leaders and managers found several safeguarding concerns that had not been reported to Ofsted as required. Leaders and managers do not know what action has been taken in response to these safeguarding concerns, as child protection records are disorganised and do not clarify the action or confirm the outcome. A quality review undertaken in April 2019 also identified that body-map records were not being monitored appropriately by managers.

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

Children‟s medical equipment is not being checked as required, and risk assessments relating to the use of oxygen and first aid are out of date. Leaders and managers recognise that there is insufficient oversight of health and safety matters. Nevertheless, these are serious safeguarding concerns, and plans in place to mitigate the risk are insufficient. Inspection report children‟s home: SC371073 9 Staff selection is inadequate. Leaders and managers do not ensure that staff recruited to work in the home have enough childcare experience. For example, out of 12 agency staff, only one has previous experience of working with children. Interview notes are poor quality and recruitment records do not confirm the reasons why managers decide to appoint.

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

Risk assessments and care plans lack vital information. For example, they do not specifically confirm how staff are to use medical equipment safely and ensure that children‟s complex healthcare needs are met. Staff were unable to tell the inspectors how to use suction techniques correctly. This places children at significant risk of harm.

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The effectiveness of leaders and managers: inadequate

Leadership and management are inadequate. The registered manager has been absent from the home since December 2018. Since that time, the home has been managed by several interim managers who do not have current childcare expertise nor a good understanding of the children‟s home regulations. Shortfalls are widespread and serious.

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The effectiveness of leaders and managers: inadequate

Staffing arrangements are unsafe, as the home is insufficiently staffed; there are currently 11 staff vacancies. Half of the members of the permanent workforce are in their probationary period and the remainder of the rota is covered by temporary staff, many of whom do not have the expertise and knowledge required to care appropriately for children.

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The effectiveness of leaders and managers: inadequate

Relationships between staff and children are severely compromised because many of the staff are new or working in the home temporarily. One child‟s care plan states that they must be cared for by staff members who know the child well; this is not happening. Another child told the inspector he found it „strange‟ having lots of different adults working in the home.

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The effectiveness of leaders and managers: inadequate

Staff training is inadequate. Most children require personal care and invasive medical treatment. Leaders and managers cannot confirm that staff are well trained and assessed as competent to manage these needs safely. Leaders and managers said that there is a significant shortfall in training compliance for the staff currently working in the home. A quality review completed in April 2019 also identifies that fewer than half of the staff team members have level 1 behaviour management training and only one member of staff has level 2. In addition, fire safety training is insufficient as new staff do not know the fire evacuation procedures.

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The effectiveness of leaders and managers: inadequate

Staff are not well prepared to care for the children. Temporary staff do not have access to the online recording system to review children‟s records and to document the care they give to children. Too few staff have read children‟s files. This is unsafe practice and places children at risk.

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Information about this inspection

Inspection report children‟s home: SC371073 10 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: SC371073 11

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider address: 6 Mitre Passage, London SE10 0ER

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Inspector(s)

Wendy Anderson, social care inspector Paula Lahey, social care regulatory inspection manager Inspection report children‟s home: SC371073 12 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)

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

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