Children's home run by N H Care Limited in Birmingham

Inspection report children’s home: SC446152 1 SC446152 Registered provider: Nh Care Limited

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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 to provide care and accommodation for three children who have learning disabilities and/or emotional and social difficulties. The home is privately owned. There are three children currently living in the home.

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Information about this children’s home

The registered manager left on 11 January 2019. An interim manager has been overseeing the day-to-day management of the home since February 2019. The organisation has not yet appointed a permanent manager.

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

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inadequate

Date of last inspection: 7 November 2018

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none. Inspection report children’s home: SC446152 2

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Inspection date Inspection type Inspection judgement

07/11/2018 Full Good 12/07/2017 Full Good 20/12/2016 Interim Sustained effectiveness 19/07/2016 Full Good Inspection report children’s home: SC446152 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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; ensure that the premises used for the purposes of the home are designed and furnished so as to enable each child to participate in the daily life of the home. (Regulation 6(1)(2)(b)(iv)(c)(ii))* 14/07/19

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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff maintain regular contact with each child’s education and training provider, including engaging with the provider and the placing authority to support the child’s education and training and to maximise the child’s achievement. (Regulation 8(1)(2)(vi)) 14/07/19

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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. (Regulation 10(1)(a)) 28/08/19

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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 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 and practise skills to resolve conflicts positively and without harm to anyone; strive to gain each child’s respect and trust; 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 28/08/19 Inspection report children’s home: SC446152 4 children; are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same; de-escalate confrontations with or between children, or potentially violent behaviour by children; that each child is encouraged to build and maintain positive

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Requirement Due date

relationships with others. Regulation 11(1)(a)(c)(2)(i)(iv)(viii)(xi)(x)(xi)(b)) 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 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; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; 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)(v)(b))* 14/07/19

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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 ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home’s workforce provides continuity of care to 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; use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(2)(a)(c)(e)(f)(h))* 14/07/19

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Requirement Due date

The care planning standard is that children receive effectively planned care in or through the children’s home; that staff help each child to access and contribute to the records kept by the registered person in relation to the child. (Regulation 14(1)(a)(f))* 14/07/19

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Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in Schedule 1. (Regulation 16(1)) 14/07/19

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. 28/08/19 Inspection report children’s home: SC446152 5 (Regulation 32(1)(3)) The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b)) 28/08/19

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Requirement Due date

The registered person must maintain in the home the records in schedule 4. (Regulation 37(2)(a)) 28/08/19

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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(3)) 28/08/19

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is an allegation of abuse against the home or a person working there. (Regulation 40(4)(c)) 28/08/19

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Requirement Due date

* These requirements are subject to a compliance notice.

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Overall experiences and progress of children and young people: inadequate

Staff fail to pay enough attention to children’s basic care. For example, inspectors found one child had been considered by the staff to be ready for school despite wearing a grubby shirt and a blazer and pair of trousers that had not been ironed. Staff showed no concern about the child’s appearance and were happy to let the child go to school in this poor state until an inspector intervened. Another child’s teacher told an inspector that he had attended school in a jumper that was too small for him and was seen to have dirty socks. This demonstrates a poor regard for children’s rights to have their dignity respected and is neglecting their right to be provided with good-quality, basic care.

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Overall experiences and progress of children and young people: inadequate

Internal care planning for children is poor. Some records written by staff are not legible, and the language in some records is not child-centred. For example, one record described a child as ‘acting like a baby’. Children’s records do not contain all the information from their placing authority. For example, one child’s record does not contain a copy of his personal education plan. Staff do not ensure that the home’s care plan captures children’s day-to-day care and is updated to reflect each child’s specific needs. One child is diagnosed with encopresis, oppositional defiance disorder and reactive attachment disorder. However, his care plan does not reflect how these conditions have an impact on his care. In addition, staff confirmed to inspectors that they have not received training to help them understand these conditions. Consequently, children do not receive care that meets their specific needs.

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Overall experiences and progress of children and young people: inadequate

Managers fail to create opportunities to ensure that children build positive and trusting relationships with their carers. Since the last inspection, four new staff have been moved to the home from within the organisation without being introduced to the children beforehand. Further, managers have failed to ensure that children receive care from a Inspection report children’s home: SC446152 6 stable team of carers. Staffing rosters show that since 1 April 2019, twenty different members of staff have worked in the home in addition to the core staff team. This means that children are not receiving the stable and secure care that they need.

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Overall experiences and progress of children and young people: inadequate

Some incidents of bullying include instances when children have been physically hurt by each other. Strategies to manage this and to help children repair relationships are weak. This leaves children without the essential skills to resolve difficulties positively.

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Overall experiences and progress of children and young people: inadequate

Staff no longer communicate with one child in their preferred methods of communication, which includes the use of Makaton, symbols and social stories. Staff report that this has ‘dropped off’. In addition, managers have not ensured that all staff have received training to help them to be able to communicate with the child in his preferred way. This significantly compromises the child’s ability to be fully included in day-to-day conversations and in decisions that may influence his care.

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Overall experiences and progress of children and young people: inadequate

Limited effort is given to helping children become part of their local community. This means that children are not helped to make new friends outside of the home or to pursue hobbies and interests.

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Overall experiences and progress of children and young people: inadequate

Staff fail to seek medical advice. For example, staff told the inspector that they believe one child to be lactose intolerant. Despite this, staff have failed to consult the child’s general practitioner to seek advice on how to safely manage this condition. Another child self-administers her prescribed cream to treat a skin condition. Staff are aware that she frequently scratches and picks dry skin that causes scarring. However, staff do not consider that further medical advice might be needed.

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Overall experiences and progress of children and young people: inadequate

Parts of the house are visually worn and dirty. For example, windows are stained, the inside of the oven is greasy and skirting boards are dirty. The carpet to the upstairs landing has an unpleasant smell. There is no blind or hand towel to the upstairs bathroom. A desk in one child’s bedroom is broken. Children’s personal possessions are poorly stored in an outside shed and an internal store cupboard. There are insufficient chairs and table mats for mealtimes to enable children and staff to eat together. This demonstrates a lack of action by managers to ensure that children live in a clean and homely environment that is free from avoidable hazards and is comfortable for children.

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Overall experiences and progress of children and young people: inadequate

Despite the shortfalls, children have made some progress. One child has joined Girl Guides and has made friends, and another child has developed his independence skills to include cooking his own breakfast and all children regularly attend school.

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

Leaders and managers have failed to ensure that staff who work at the home are safely recruited. Not all references are verified, and references are not always sought from the last employer. Managers cannot evidence that they have satisfied themselves about the reasons given for gaps in staff employment chronologies. This could result in unsuitable adults being employed to work with children. Inspection report children’s home: SC446152 7 Staff do not ensure that food is stored safely and that they properly supervise the children’s access to it. Inspectors found that the fridge contained open and unlabelled sauces and pickles, and one item of food was found to be out of date. In addition, chicken and fish from the previous day had been left in the oven overnight. One child attempted to eat the fish. He was only prevented from doing so by intervention from an inspector. A lack of attention to the safe storage of food poses a significant risk to

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

Staff do not ensure that children’s risk assessments take account of all known risks. For example, one child who is at risk of going missing from care does not have a missing from care protocol in place. This leaves staff without essential information about the action to take if he was to go missing from the home. When staff identify risks, the management strategies put in place are weak. For example, children’s risk assessments do not provide sufficient guidance to help the staff manage or reduce the risk of bullying occurring in the home. This has resulted in two children suffering physical harm.

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

One child’s risk assessment identifies a risk of sexualised behaviour. Information relating to this risk is poorly recorded. In addition, managers have still not evaluated the impact on children’s care when staff work alone with children. The failure to take appropriate steps to identify, manage and reduce risk means that children are at risk of potential harm.

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

Staff do not have the skills to meet children’s specific needs. For example, one child requires help with their personal care. However, staff have not received training to enable them to deliver safe care and to protect the child’s dignity.

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

Children have made four complaints since the last inspection. Managers were unable to find full records for two of these complaints. Consequently, managers were unable to reassure the regulator that these two complaints have been investigated or whether there were any concerns about the care provided to children.

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The effectiveness of leaders and managers: inadequate

Significant weaknesses in managerial oversight in recent months have resulted in a systemic failure in how the staff safeguard children and meet their care needs.

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The effectiveness of leaders and managers: inadequate

Two requirements from the last inspection, concerning the monitoring of the home and staffing records, have not been met. Managers have failed to establish clear systems for the ongoing monitoring of the operation of the home. Although managers have ensured that staff rotas are kept in the home, these records still do not include full and accurate information.

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The effectiveness of leaders and managers: inadequate

Managers cannot demonstrate that staff have access to regular supervision. Staff told inspectors that they feel unsupported and when they have supervision their views are not used to improve the care given to children. Inspection report children’s home: SC446152 8 Managers do not ensure that the regulator is notified of all significant events. Inspectors identified two occasions when a child had raised a concern about the conduct of a member of staff and Ofsted was not informed. This reduces the extent to which external oversight can support the safety and well-being of children.

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The effectiveness of leaders and managers: inadequate

Managers have failed to keep the statement of purpose up to date so that it gives stakeholders accurate information about the service.

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The effectiveness of leaders and managers: inadequate

As a result of this inspection, Ofsted has issued a restriction of accommodation order and four compliance notices. In response, the organisation has placed a new manager and two senior care staff from within the organisation to make rapid improvements and to address concerns raised in this report.

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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: SC446152 9

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Children’s home details

Registered provider address: 3 Shetland Close, Birmingham, Warwickshire B16 0RF

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Inspectors

Alison Cooper, social care inspector Debbie Bond, social care inspector Inspection report children’s home: SC446152 10 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 children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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