Children's home run by Able Health Care Ltd

Inspection report for children’s home - monitoring visit: 2529815 1

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Able Health Care Limited

Monitoring visit 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 annex.

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Information about this children’s home

The manager was registered by Ofsted in August 2019.

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Information about this children’s home

Ofsted is aware of the challenges that COVID-19 (coronavirus) is currently posing to those we visit. During this visit, the inspectors took into consideration the impact of any measure being taken to slow the spread of COVID-19. This has included the effect that these have had on staffing arrangements.

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This monitoring visit

This monitoring inspection was undertaken with some remote inspection activity due to the challenges that COVID-19 is currently posing to Ofsted inspecting services.

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This monitoring visit

The purpose of this visit was to monitor and investigate concerns raised to Ofsted. This monitoring visit identified several shortfalls. The children’s home was judged requires improvement at the full inspection on 19 and 20 November 2019. At this visit, a further four requirements have been raised. There are no immediate safety concerns. The children are steadily making progress and using their time productively despite the challenges of COVID-19.

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This monitoring visit

The manager and staff have been challenged by a placement breakdown following which, eventually, a child was moved. The manager found this decision difficult to make. There were several serious incidents leading to the breakdown, during which other children felt frightened and witnessed damage to the home. This culminated in the police being called to the home and another child being influenced and becoming involved in anti-social behaviour. The manager has reflected on this Inspection report for children’s home - monitoring visit: 2529815 2 admission and raised concerns about the lack of information provided to her by the placing local authority.

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This monitoring visit

The house and garden require maintenance and the kitchen would benefit from refurbishment. The kitchen is dark and dated. The cooker has a door missing and the seal around the sink has deteriorated. The stair carpet is stained and ill-fitting. A broken windowsill and damage to the landing walls and ground floor door surrounds have not been properly repaired. The garden is untidy. The fence has several gaps and holes, and the garden furniture has been damaged. Some of these shortfalls were identified in November 2019.

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This monitoring visit

Some children smoke cigarettes and one child has resumed smoking since living at the home. A social worker has expressed concerns about this. Although the staff said that they discourage the children from smoking, the staff smoke regularly. This fails to provide healthy role models for children and encourages a culture in which smoking is accepted. There are no clear guidelines about how the staff should manage and discourage the children from smoking. One child’s risk assessment states that the staff are not to be with children when the children are smoking, but some staff were not aware of this.

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This monitoring visit

The staff fail to provide consistent and meaningful sanctions for children following negative behaviours. There have been several serious incidents in which the staff have been unable to control situations effectively. These situations have been managed using a variety of responses that do not help the children to learn from their actions. The staff aim to focus on positive reinforcement, and there are some instances in which sweet foods have been given as rewards. The wording has been amended to include: The staff no longer use food as a reward since this was identified by the external visitor in May 2020. However, using food as a reward is contrary to the behaviour management policy.

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This monitoring visit

The external monitoring visits are of good quality and highlight the issues and areas for improvement. However, the managerial monitoring lacks rigour and depth. Some incident records have no sign off or managerial comment.

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This monitoring visit

There are staff who have not had regular supervision despite being newly employed at the home. One new member of staff has had two supervisions in five months. This fails to support new staff in their roles.

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This monitoring visit

The manager has failed to ensure that all staff have thorough recruitment checks prior to starting employment. This was evident in one staff member’s file. The dates on the application form do not match the dates of previous employment. The dates do not consistently match the references, and the references sought came from the same employer.

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This monitoring visit

The manager has reported several allegations to Ofsted and the designated officer. There have been some conflict and confusion about the management and oversight of the associated investigations. During this time, the manager failed to notify Ofsted Inspection report for children’s home - monitoring visit: 2529815 3 about an allegation made by a child, although the police and the child’s social worker were made aware of this. Consequently, Ofsted did not have a full picture of significant events at the home and how they were managed.

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This monitoring visit

Overall, following a difficult and turbulent time, the home is settled. The children spoken with during the inspection are happy and stable. They acknowledged the recent difficulties and appreciate the calm period. Children are happy with bedrooms which are nicely furnished, clean and personalised. The children have good relationships with the staff and value the support that they receive.

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This monitoring visit

The six requirements that were raised at the last full inspection have not been fully reviewed at this visit and will be evaluated at the next inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 20/11/2019 Full Requires improvement to be good Inspection report for children’s home - monitoring visit: 2529815 4

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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 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(1)(a)(b)(c)(2)(a)(i)(ii)(iii)(iv)) 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— 06/01/2020 Inspection report for children’s home - monitoring visit: 2529815 5 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;

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Requirement Due date

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)) 06/01/2020

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Requirement Due date

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

The requirements are that— 06/01/2020 Inspection report for children’s home - monitoring visit: 2529815 6 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)) The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development;

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(a)(b)) 28/08/2020

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home; and

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Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home.

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Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (Regulation 35(1)(a)(b)(2)) 28/08/2020

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

there is an allegation of abuse against the home or a person working there. (Regulation 40(4)(a)(b)(c)(d)(i)(ii)(e)) 28/08/2020 Inspection report for children’s home - monitoring visit: 2529815 7

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000.

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Children’s home details

Registered provider: Able Health Care Limited

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Children’s home details

Registered provider address: 45 Wolsey Road, Northwood, Middlesex HA6 2ER

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Inspectors

Deirdra Keating, social care inspector Miss Angela Weston, social care inspector Inspection report for children’s home - monitoring visit: 2529815 8 to 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

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

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