Children's home run by Able Health Care Ltd

Inspection report children’s home: 2529815 1 Registered provider: Able Health 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

This privately owned children’s home provides care for up to four children. Three children can be accommodated in the main home and one child in the adjoining annexe. The home works closely with a consultant psychiatrist. The manager was registered at the same time as the home, in August 2019. This is the home’s first inspection since registration.

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Information about this children’s home

Inspection dates: 20 to 21 November 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: not applicable

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requires improvement to be good

Enforcement action since last inspection: not applicable Inspection report children’s home: 2529815 2

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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 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. (Regulation 12(1)(2)(b)) 06/01/2020

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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—

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Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12(1)(2)(d)) 06/01/2020

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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 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

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child; 06/01/2020 Inspection report children’s home: 2529815 3 ensure that the home’s workforce provides continuity of care to each child; 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)(c)(d)(e)(h)) The registered person must ensure that—

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Requirement Due date

any limitation placed on a child’s privacy or access to any area of the home’s premises—

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Requirement Due date

is kept under review and, if necessary, revised; and

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Requirement Due date

allows children as much freedom as is possible when balanced against the need to protect them and keep them safe. (Regulation 21(c)(ii)(iii)(iv)) The registered person may only use devices for the monitoring or surveillance of children if—

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Requirement Due date

the child’s placing authority consents in writing to the monitoring or surveillance. (Regulation 24(1)(b)) 06/01/2020

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home; or

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Requirement Due date

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,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32(1)(2)(a)(b)(3)(d)) 06/01/2020 Inspection report children’s home: 2529815 4

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improvement to be good

The behaviour of some of the children sometimes causes the other children to feel uneasy. The staff have been unable to manage certain incidents effectively and the police have been called to the home to assist. Subsequently, children have been arrested following assaults on staff.

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improvement to be good

The children expressed concerns about the damage to televisions, which are out of use. The condition of the garden has been highlighted by the independent visitor, but the manager has not rectified the issues in a timely way. A fence is broken and there were items left outside the front of the home after the building renovation. These shortfalls have an impact on how the children feel about their home and pose safety risks.

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improvement to be good

The staff support the children to attend education. Since coming to live at the home, the children’s educational attendance has improved. The staff advocate on behalf of children who are out of school, to find them educational provision. Children are encouraged to attend activities. One child enjoys horse riding and another child attends a local youth club.

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improvement to be good

Children’s health has improved since coming to live at the home. A child who experienced anxiety about visiting the dentist now receives dental care. The staff work with the children to improve their diet and to help them to make healthy choices.

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improvement to be good

A consultant child psychiatrist and art therapist work closely with the home. The children have a period of assessment when they arrive, and art therapy is available. The staff benefit from group consultation with these professionals to support the staff to reflect on the children’s behaviours.

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improvement to be good

There was no clear record to capture a restraint incident and this had not been picked up by the manager. The current training fails to provide the staff with the steps and knowledge to manage restraint effectively. This leaves the staff and the children vulnerable. Despite a restraint taking place and featuring in other records and discussions with social workers, this restraint was not recorded. The child’s view was not sought or recorded following the restraint. This does not enable learning from these incidents. Lack of clear records coupled with poor management oversight mean that children are not adequately protected.

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improvement to be good

The statement of purpose pledges that children will have an individual plan to manage smoking, in discussion with their social worker. There was no relevant plan for a child who smokes and keeps lighters in his bedroom. This child’s social worker said that she had not been involved in discussions about the smoking arrangements for this child. This Inspection report children’s home: 2529815 5 could pose a potential risk to this child and the other children.

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improvement to be good

Door alarms are used on all the children’s bedrooms. Discussions with social workers had not taken place prior to activating these alarms and written agreements with social workers were not in place. One child’s social worker was not aware of the door alarm being used. Consent for another child was sought during the inspection. A lack of consultation on and planning for these restrictive interventions does not allow for regular monitoring and review of these arrangements.

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improvement to be good

Missing-from-home episodes are reducing for a child who has been a victim of criminal exploitation. The staff check this child’s whereabouts when he is in the community and encourage him to stay in contact during free time. Multi-agency working with the local police and the youth offending services is helping to reduce the vulnerability of this child.

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improvement to be good

Staff have put effective measures in place to reduce the risks to a child who self-harms with positive outcomes.

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

The registered manager is qualified to level 5 in leadership and management in children’s residential care.

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

Since opening the home, the manager has had difficulty recruiting enough permanent staff and two of the staff have been dismissed. The manager talked about difficulties covering shifts and long working hours. Agency staff cover waking nights and some daytime shifts. This fails to provide continuity of care for children. During the inspection, the manager raised that a child said that he was unsure how to tell if the adults at the home were meant to be there when he woke up in the night. This was because he had not met them before. The staff said that they now show children a photograph of new staff before they arrive. However, this does not succeed in enabling the children to feel secure and comfortable about the staff.

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

The arrangements for ensuring that agency staff are appropriately checked prior to employment are not effective. This could lead to unsuitable adults working at the home.

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

Staff do not always have the experience and skills to manage the children’s complex behaviours. One staff member was left alone with a child who has a history of violent assaults on the staff. The police were called to assist, as there were no other staff available. Failure to deploy appropriately experienced staff could potentially lead to children being criminalised and makes the staff vulnerable.

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

The systems for monitoring the quality of care do not demonstrate learning from incidents. There is no development plan available and, therefore, no clear plan to improve the home and address the shortfalls.

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

There are some experienced staff who show enthusiasm for their role. Some of the staff have gained experience and training prior to coming to work at the home. The staff said Inspection report children’s home: 2529815 6 that they feel supported by their manager and that they feel positive about the future of the home.

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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: 2529815 7

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Children’s home details

Registered provider: Able Health Care Limited

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Inspector

Angela Weston: social care inspector Inspection report children’s home: 2529815 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

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Inspector

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Inspector

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