Children's home run by Able Health Care Ltd

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

Previous inspection date: 20 November 2019

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Information about this children’s home

Previous inspection judgement: Requires improvement to be good

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Information about this visit

Due to COVID-19 (coronavirus), Ofsted suspended all routine inspections in March 2020. As part of a phased return to routine inspection, we are undertaking assurance visits to children’s social care services that are inspected under the social care common inspection framework (SCCIF).

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Information about this visit

At these visits, inspectors evaluate the extent to which:

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Information about this visit

 children are well cared for  children are safe  leaders and managers are exercising strong leadership.

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Information about this visit

This visit was carried out under the Care Standards Act 2000, following the published guidance for assurance visits.

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Information about this visit

Her Majesty’s Chief Inspector of Education, Children’s Services and Skills is leading Ofsted’s work into how England’s social care system has delivered child-centred practice and care within the context of the restrictions placed on society during the COVID-19 pandemic.

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Findings from the visit

We identified the following widespread concerns in relation to the care or protection of children at this assurance visit: Assurance visit report: 2529815 2  Children have been put at risk due to the staff not following the children’s contact plans and risk assessments.  Safety hazards in the home have not been attended to, despite being identified a significant time ago.  The staff have not provided effective support for children to use the internet safely.  Poor routines for children have had an impact on their sleep and their ability to manage attendance in education.  The manager has failed to identify and address shortfalls in practice, which means that risks to the children have not been addressed.

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The care of children

The home was judged requires improvement at the full inspection in November 2019. A monitoring visit was undertaken on 1 July 2020 to monitor and investigate concerns raised to Ofsted.

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The care of children

There are two children living at this home. One child moved out in August 2020 and experienced an unplanned ending. This followed an unsettled period during which this child caused significant damage to the home, which was frightening for the other children.

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The care of children

The home is more settled now, but the children do not have good daily routines. One child spends considerable time in his room playing computer games, this continues into the early hours of the morning. This behaviour goes unchallenged by the staff. A social worker raised concerns about this child’s sleeping patterns, but these have not been sufficiently addressed by staff. Although the deputy manager said that the games console controller should be removed at bedtime, the records do not reflect that the staff follow this plan. The staff’s failure to adhere to plans and provide clear boundaries and routines has an impact on children’s health and well- being.

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The care of children

One child has an education provision of six hours per week, having been out of education for some time prior to moving to the home. However, the child has very low engagement with education. One child has been to visit a potential education provider and is due to start attending.

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The care of children

The children regularly eat convenience foods, snacks and takeaways. Sometimes the children skip meals. Due to a lack of fresh, home-cooked meals, the children do not consume a healthy and varied diet.

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The care of children

Some damage to the home has been repaired. However, the cooker was damaged in April 2020 and the oven door has been missing since this time. Failure to repair damage poses a hazard to the children’s safety and prevents the children having full use of the kitchen facilities. Although COVID-19 restrictions made repairs difficult for Assurance visit report: 2529815 3 a period of time, the manager has failed to ensure that repairs were made post lockdown.

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The care of children

Staff bring their dogs to the home and children go on dog walks with the staff. The staff have set up an incentive scheme for a child who wants a pet rabbit, to help her work towards this. Children earn extra pocket money when they undertake chores around the home.

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The care of children

During the coronavirus pandemic, the home maintained contact with and input from the consultant child psychiatrist. This meant that staff accessed advice and guidance.

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The safety of children

Children’s risk assessments are overly long and contain historic and sometimes conflicting information. This means that they do not give staff the clarity that they need on the steps to take to manage or reduce risks.

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The safety of children

Sometimes, the staff do not follow the children’s risk assessments. In one instance, this led to a child going missing overnight. Failure to follow children’s risk assessments leaves children at risk of harm.

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The safety of children

During the coronavirus pandemic, the staff helped the children to stay in touch with their families. The children valued being able to keep in touch with people who are important to them. However, miscommunication between the staff and a child’s social worker meant that a child accessed unauthorised family contact outside of the child’s agreed plan. This left a vulnerable child in an unsafe situation.

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The safety of children

Arrangements to safeguard children using the internet are ineffective. The children access the internet into the early hours of the morning. A staff member has allowed the use of the internet overnight to placate a child. Lack of clear boundaries and effective monitoring of internet use puts children at risk of exploitation.

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The safety of children

The staff follow relevant procedures when children go missing. Missing from home episodes have reduced. One child who was running away regularly before coming to live at the home no longer goes missing.

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Leaders and managers

The manager was not at the home at the time of this assurance visit. The deputy manager was running the home in the manager’s absence. There has been insufficient progress with meeting the requirements set at the last inspection. Four requirements have not been met and additional requirements have been raised.

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Leaders and managers

The independent visitor has continued to provide external monitoring of the home during the coronavirus pandemic. Virtual visits have included video tours and online discussions with the children. Despite this external monitoring and the associated recommendations, the provider has failed to address the identified shortfalls. For Assurance visit report: 2529815 4 example, the first-floor toilet does not have a sink for children to wash their hands. This was raised at the full inspection in November 2019. There is extensive damage to the garden fencing. A dismantled shed and other debris remain in the garden and the kitchen windowsill is broken. These are longstanding shortfalls. This does not create a homely environment for the children.

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Leaders and managers

External professionals have reported poor communication and relationships with the home. This was evidenced during the visit. Failure to work effectively in partnership has a negative impact on children’s outcomes.

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Leaders and managers

The staff are not provided with clear guidance on how to manage children’s routines and meet their needs. Some records contain gaps in information and are not signed by staff. In addition, because of the manager’s failure to monitor records effectively, practice shortfalls and inconsistencies are not identified and addressed. These inconsistencies mean that children do not benefit from secure boundaries and staff responses.

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Leaders and managers

At times, the children have caused significant damage before the staff have intervened effectively. There have been numerous calls to the police to manage the children’s behaviour. Restraint is used infrequently. However, there is a lack of evident reflection on incidents to inform future practice.

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Leaders and managers

New staff have recently joined the home. Some staff have left the home. Despite the challenges of the coronavirus, the home has continued to offer staff training and supervision. The staff said that they feel supported.

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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. Assurance visit report: 2529815 5

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Requirement Due date

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans;

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5(a)(d)) 23/10/2020

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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—

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Requirement Due date

understand the barriers to learning that each child may face and take appropriate action to help the child to overcome any such barriers;

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Requirement Due date

promote opportunities for each child to learn informally;

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Requirement Due date

help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible. (Regulation 8(1)(2)(a)(iii)(v)(viii)) 23/10/2020

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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

that staff help each child to— 23/10/2020 Assurance visit report: 2529815 6 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))

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Requirement Due date

In particular, provide healthy and nutritious meals for the children, and healthy sleep routines. 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

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;

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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)(a)(i)(b)(d))* 23/10/2020

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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 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

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b)(2)(h))* 23/10/2020 Assurance visit report: 2529815 7

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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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Inspector

Angela Weston, Social Care Inspector Assurance visit report: 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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Inspector

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