Children's home run by South West Mental Health Ltd in Somerset

Inspection report children’s home: 1185768 1 Registered provider: South West Mental Health Ltd

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately operated children’s home is currently registered to provide care and accommodation for up to three children and young people.

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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: 11 February 2019

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inadequate

Overall judgement at last inspection: sustained effectiveness

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inadequate

Enforcement action since last inspection: none Inspection report children’s home: 1185768 2

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Inspection date Inspection type Inspection judgement

11/02/2019 Interim Sustained effectiveness 31/07/2018 Full Requires improvement to be good 17/01/2018 Interim Sustained effectiveness 19/07/2017 Full Good Inspection report children’s home: 1185768 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

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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

understand and apply the home’s statement of purpose;

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Requirement Due date

understand and apply the home’s statement of purpose;

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

treat each child with dignity and respect;

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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;

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Requirement Due date

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

enable each child to participate in the daily life of the home. 02/08/2019 Inspection report children’s home: 1185768 4 (Regulation 6 (1)(a)(b)(2)(a)(b)(i)(ii)(iii)(iv)(vi)(ix)(3(b)(c)(i)(ii))

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being; and

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Requirement Due date

children are helped to lead healthy lifestyles.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

achieve the health and well-being outcomes that are recorded in the child’s relevant plans. (Regulation 10 (i)(a)(b)(c)(2)(a)(i)) 27/09/2019

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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—

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Requirement Due date

an understanding about acceptable behaviour.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans;

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Requirement Due date

help each child to develop socially aware behaviour;

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Requirement Due date

encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding;

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Requirement Due date

help each child to develop and practise skills to resolve conflicts positively and without harm to anyone; 27/09/2019 Inspection report children’s home: 1185768 5 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;

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Requirement Due date

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;

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Requirement Due date

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;

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Requirement Due date

de-escalate confrontations with or between children, or potentially violent behaviour by children. (Regulation 11 (1)(a)(b)(2)(a)(i)(ii)(iii)(iv)(v)(ix)(x)(xi))

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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—

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Requirement Due date

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

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

manage relationships between children to prevent them from harming each other;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

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)(ii)(iii)(iv)(v)(vi)(b)) 27/09/2019 Inspection report children’s home: 1185768 6 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—

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Requirement Due date

helps children aspire to fulfil their potential; and

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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

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;

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Requirement Due date

ensure that staff work as a team where appropriate;

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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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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;

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demonstrate that practice in the home is informed and improved by taking into account and acting on—

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research and developments in relation to the ways in which the needs of children are best met; 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)(a)(b)(c)(f)(g)(i)(h)) 27/09/2019

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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

In particular the registered person must ensure that—

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Requirement Due date

a record is kept of the administration of medicine to each child. (Regulation 23 (2)(c)) 27/09/2019 Inspection report children’s home: 1185768 7 Statement of purpose

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Requirement Due date

keep the statement of purpose under review and, where appropriate, revise it; and

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Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)) 27/09/2019

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which ─

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Requirement Due date

are signed and dated by the author of each entry. (Regulation 36 (1)(b)(c)) 27/09/2019

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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

Young people’s outcomes do not improve while living in this children’s home. Attendance at school or alternative education is poor. There is a lack of meaningful therapeutic care to support young people’s mental health needs.

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Overall experiences and progress of children and young people: inadequate

Young people do not always get the help that they need because the staff team are not given important and up-to-date information about how to provide care to each young person. Within therapists’ files, there is a lack of detail about therapeutic interventions, as well as an unacceptable use of derogatory language when referring to a young person.

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Overall experiences and progress of children and young people: inadequate

Leaders and managers fail to ensure that children and young people’s care plans are followed. Responses to serious incidents are not always carefully considered and, on occasions, the staff team’s responses fail to fully support the needs of the children and young people. Inspection report children’s home: 1185768 8 Leaders and managers have not made improvements to the therapeutic services they provide. Young people choose not to engage with these services and leaders and managers have not to provided young people with suitable alternatives.

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Overall experiences and progress of children and young people: inadequate

Leaders and managers fail to ensure that there are enough qualified and experienced staff to support the complex mental health needs of the children and young people. Some staff struggle to support the children and young people when they are upset. As a result, staff have been seriously injured, and a social worker reported that staff ‘fear’ one young person.

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Overall experiences and progress of children and young people: inadequate

Not all staff demonstrate that they have good-quality and positive relationships with the children and young people. Although there are some examples of children and young people having positive time with staff, this is inconsistent. The role modelling of good parenting by the registered manager is not having the desired effect to improve the care and outcomes for children and young people.

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Overall experiences and progress of children and young people: inadequate

Despite the weaknesses of the provision, some children and young people make satisfactory progress, for example in improved management of self-injurious behaviours, enjoying trips out and helping as volunteers.

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

Leaders and managers do not give sufficient consideration to providing safe, properly planned care. On five occasions a young person was cared for by the responsible individual in a holiday cottage. This provision was not set out in the young person’s care plan and it was not agreed or directed by the local authority. Furthermore, no records were kept of this period.

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

Management oversight of serious incidents is weak. Records do not always provide sufficient detail, and they are not always signed and dated. There is insufficient evidence of learning by staff following serious incidents in order to prevent re-occurrence and to help young people to develop new strategies.

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

Arrangements for the safe keeping and auditing of medication are inadequate. Several medication errors have occurred. Missing signatures and miscounts feature across medication records, and on one occasion a young person was admitted to hospital after ingesting anti-psychotic medication that a member of staff failed to keep secure.

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The effectiveness of leaders and managers: inadequate

The home is not achieving its aims and objectives as set out in the statement of purpose. This is because leadership and management of the home are ineffective. As a result, widespread failings feature across record-keeping and practice. These include leaders and managers failing to provide staff with regular supervision and specific training that equips staff with the skills to support children and young people with Inspection report children’s home: 1185768 9 complex mental health needs.

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The effectiveness of leaders and managers: inadequate

Children and young people do not always receive consistent care. This is due to staff absence, staff supporting another of the company’s children’s homes and vacancies. A recent recruitment drive, while successful, has resulted in an over-reliance on staff who lack experience of working with children and young people who have complex mental health needs.

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The effectiveness of leaders and managers: inadequate

An induction programme is provided to staff, which includes training in safeguarding and mental health needs. However, not all staff have been able to effectively implement the learning from this programme. As a result, children and young people have not received care that is safe, and their therapeutic needs have not been met.

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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: 1185768 10

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Children’s home details

Registered provider: South West Mental Health Ltd

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Children’s home details

Registered provider address: H & H Accountants Ltd, Old Bank Buildings, East Street, Ilminster, Somerset TA19 0AJ

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Inspector

Linda Bond, social care inspector Inspection report children’s home: 1185768 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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