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.

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Information about this children’s home

The registered manager left on 11 January 2019. A new manager started in post on 2 July 2019. He has started an application to register.

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Information about this children’s home

Inspection dates: 24 to 25 September 2019

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: inadequate

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requires improvement to be good

Enforcement action since last inspection: A restriction of accommodation notice was issued as a result of the full inspection in June 2019. The notice came into effect on 11 June 2019 and ended on 2 September 2019. As a result of the full inspection, four compliance notices were issued. A monitoring visit on 16 July 2019 found one Inspection report children’s home: SC446152 2 compliance notice met. The three unmet notices were re-issued along with two new compliance notices. A monitoring visit on the 28 August found three of the compliance notices to be met. The remaining two notices were re-issued and found to be met at this full inspection.

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Inspection date Inspection type Inspection judgement

05/06/2019 Full Inadequate 07/11/2018 Full Good 12/07/2017 Full Good 20/12/2016 Interim Sustained effectiveness 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 positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults. 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; 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; that each child is encouraged to build and maintain positive relationships with others. (Regulation 11(1)(a)(b)(c)(2)(a)(i)(ix)(b)) 22/11/2019

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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. In particular, the standard in paragraph requires the registered person to— ensure that— staff have the skills to identify and act upon signs that a child is at risk of harm; staff understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12(1)(2)(a)(iii)(v)) This is in relation to raising staff awareness to the signs that a child may be at risk of criminal exploitation or radicalisation. 22/11/2019

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Requirement Due date

The registered person must ensure that all employees have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(c)) 22/11/2019

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Requirement Due date

The registered person must maintain in the home the records in schedule 4. (Regulation 37(2)(a)) 22/11/2019

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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 22/11/2019 Inspection report children’s home: SC446152 4 of the children’s home at least once in each calendar year taking into account the requirement in regulation 12(2)(c) (the protection of children standard). 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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Recommendations

 The Statement of Purpose is of particular importance to this Standard (regulation 6(2)(a) and (b)(i)). Homes are required to develop and keep under review a "Statement of Purpose" (regulation 16 and schedule 1). The home’s Statement of Purpose should be child-focused, indicating how the home provides individualised care to meet the Quality Standards for the children in their care. (‘Guide to the children’s homes regulations including the quality standards’, p 14, paragraph 3.5)  The registered person must ensure the necessary support is given to children to enable them to access their education or training. (‘Guide to the children’s homes regulations including the quality standards’, page 28, paragraph 5.13)  Supervision of staff practice should ensure that individual adults in the home are engaged in the safeguarding culture of the home so they understand what they would need to do if they found other staff misusing or abusing their position to

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Recommendations

the detriment of the safety of a child. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.14) This relates to staff supervision including greater detail in the practice of safeguarding.  Records of restraint must be kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure it meets the needs of each child. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)  The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the

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Recommendations

needs of the children assigned to their care. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2)  Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective, and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to children. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4) Inspection report children’s home: SC446152 5  There is no expectation that the registered person will review the home against every part of the Quality Standards every six months – registered persons should use their professional judgement to decide which factors to focus on. The review

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Recommendations

should enable the registered person to identify areas of strength and possible weakness in the home’s care, which will be captured in the written report. The report should clearly identify any actions required for the next 6 months of delivery within the home and how those actions will be addressed. The whole review process and the resulting report should be used as a tool for continuous improvement in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.4)

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improvement to be good

There have been improvements to the overall experiences of the two children who have continued to live at this home since the last inspection. For example, children are now well supported by staff to ensure that their health needs are met. Arrangements for the treatment of a child’s skin condition have been reviewed in consultation with a general practitioner. Clear guidance for staff and the child about the self-administration of prescribed cream means that there have been visible improvements to the health of the child’s skin.

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improvement to be good

Staff help children to attend school. Good planning and encouragement from staff have helped one child to settle into secondary school well. Another child has been supported by staff and teachers to achieve an increase in the hours that he spends at school. However, staff are not always diligent in ensuring that children have the equipment they need for school. For example, one child has attended school without his planner and stationery. This means that he is not adequately prepared for his school day.

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improvement to be good

The staff team has remained consistent, and relationships between staff and children are developing. However, children told the inspector that on occasions they are unhappy living with each other. Staff have had training to help them understand the individual needs of children, which they said they found insightful. However, staff are not always proactive in applying their learning and ensuring that children have the individual attention they need. This means that children have had disagreements with each other as a result of competing for the attention of key staff.

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improvement to be good

Children are helped to develop their skills for adulthood. Children keep their bedrooms clean and enjoy helping staff to plan and cook daily meals. One child was complimentary about the support he has from staff to help him eat healthily.

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improvement to be good

Children regularly take part in leisure activities outside of the home, including trips to cafés and the cinema and have had the opportunity to try out new experiences, for example sea cadets and army cadets. Both children have enjoyed a summer holiday to Cornwall. Inspection report children’s home: SC446152 6 The home is clean, tidy and well maintained. Children are proud of their bedrooms, which staff have helped them personalise to their own taste.

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improvement to be good

Managers have ensured that children’s risk assessments are up to date and include clear risk reduction strategies. However, not all staff are familiar with the contents of these risk assessments. For example, one member of staff was unaware that one child is at risk of going missing from care. A lack of awareness by staff about the risks posed to children and the action to take to reduce and respond to risk leaves children vulnerable to harm.

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improvement to be good

Staff have access to training to help them to understand their general responsibility to safeguard children. However, in practice, staff lack insight in key areas of safeguarding. For example, one member of staff was unaware of the role of the local authority designated officer. Staff were unable to talk about the indicators that a child may be at risk of criminal exploitation or radicalisation. Limitations in the understanding of staff may mean that safeguarding issues go undetected.

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improvement to be good

Positive behaviour is encouraged through praise, and consequences are rare. There has been a reduction in incidents involving children displaying challenging behaviour since the last inspection. When staff have used physical intervention, this has been appropriate to prevent the risk of harm to a person. The manager is mostly diligent in his oversight of the records of measures of control. However, on one occasion a debrief with staff did not explore the reasons for the child’s behaviour. This was a missed opportunity to reflect on the triggers to the incident and review practice.

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improvement to be good

Children said they feel safe at the home. Direct work with children in areas such as internet safety, stranger danger and child sexual exploitation raises children’s awareness to these risks and how to keep themselves safe from harm.

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improvement to be good

Managers have worked hard to ensure that the vetting of staff meets regulatory requirements and promotes the safety of children.

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improvement to be good

There has been one allegation against staff since the last monitoring inspection. This is well recorded and was shared appropriately with relevant agencies.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager left the home in January 2019. An experienced manager from within the organisation managed the home on an interim basis while recruitment to the permanent post was undertaken. Difficulties in identifying a suitable manager meant that the manager post remained vacant until the current manager took up post in July 2019. The manager started his application to register on commencement of his employment. Inspection report children’s home: SC446152 7 Staff said they are well supported by the manager through supervision and regular team meetings. However, supervision records do not show that staff have the opportunity to reflect on their work, including safeguarding practice. In addition, staff who have been in post for over a year have not had the benefit of an appraisal. These are missed opportunities for staff to explore their knowledge, practice and areas for development.

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The effectiveness of leaders and managers: requires improvement to be good

The manager regularly updates key people about children’s progress. He has developed good relationships with other professionals who are positive about the impact he is having in developing the quality of care for children. However, he has not consulted with relevant partners when reviewing the suitability of the location of the home. This means that information about the risks posed to children in the local community is not current.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has now established and implemented a system for the ongoing monitoring of the operation of the home. However, the quality of care report does not effectively evaluate the overall strengths and development areas of the service and the action plan is weak. This may hinder the manager in further developing the home in a planned and timely way.

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The effectiveness of leaders and managers: requires improvement to be good

Despite clear guidance from the manager, staff are still not ensuring that children’s daily records are kept up to date in accordance with organisational policy. This limits children’s understanding of their journeys when they access their records.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has reviewed the statement of purpose. However, this lacks attention to detail. For example, the statement of purpose repeatedly mentions the name of another home.

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The effectiveness of leaders and managers: requires improvement to be good

Managers have not ensured that staff records, including rotas, include full and accurate information. Consequently, a requirement from the full inspection of June 2019 has been re-made.

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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 8

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Children’s home details

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

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Inspector

Alison Cooper, social care inspector Inspection report children’s home: SC446152 9 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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