Children's Home run by Bristol City Council in Bristol

Inspection report for children’s home - monitoring visit: SC034184 1 SC034184

p.1

Bristol City Council

Monitoring visit Inspected under the social care common inspection framework

p.1

Information about this children’s home

This local authority home is registered to provide care for up to five children and young people aged up to 18 years with social and emotional difficulties. At the time of this monitoring visit, two children were living in the home.

p.1

Information about this children’s home

The registered manager has been registered with Ofsted since July 2020.

p.1

This monitoring visit

Ofsted last visited this children’s home on 23 July 2019, when a full inspection was carried out. This monitoring visit was carried out because of a high number of notifications involving the police being called to the home and concerns about the matching of children.

p.1

This monitoring visit

This monitoring inspection included a visit to the home to speak with children and staff and to check the environment. In response to the current COVID-19 (coronavirus) lockdown restrictions, a review of the records and discussions with professionals took place remotely.

p.1

This monitoring visit

Since April 2020, six children have moved out of the home and four children have moved in. Poor decisions made by leaders and managers about the matching of children who live in the home and weak planning have negatively affected the quality of care provided to children and the progress they make.

p.1

This monitoring visit

For example, one child returned to secure care after living at this home for just over two months. Another child moved into the home from hospital requiring specialist mental healthcare. This type of care falls outside the home’s usual remit. Agency nursing care was required, alongside the use of restrictive practices in the home that negatively affected the other children. Inspection report for children’s home - monitoring visit: SC034184 2 Children’s differing needs and the inability of the team to care effectively for all the children have resulted in poor outcomes for some children. For example, one child, who has lived in this home for 18 months, described witnessing staff’s responses to other children’s behaviours causing her distress, disruptions at night affecting her sleep, items being locked away, and worries about completing her college work. More recently, this child has had to spend temporary periods in a hotel because staff

p.1

This monitoring visit

have been unable to manage the complex behaviours of another child, who was in acute distress.

p.2

This monitoring visit

The team acknowledges that they have been unable to meet the needs of a child who moved into the home in November 2020. The manager escalated his concerns to senior managers about this child’s needs being ‘beyond the capability’ of staff in December 2020. While senior managers held critical case discussions to support the home the situation continued until this monitoring visit. The home’s statement of purpose does not describe the expertise and training staff need to have in order to care for children with complex needs and significant self-harming behaviours.

p.2

This monitoring visit

Managers and staff have not provided one child with good routines and consistency of care to ensure that the child’s personal care and health needs are met in accordance with their statutory health assessment and care plan. Concerns have been identified about the child’s diet and weight. However, staff have not ensured that the child has received required check-ups with the dentist and optician, or had a review of their additional health needs in relation to their diet and personal care.

p.2

This monitoring visit

During the COVID-19 pandemic, staff have supported children to keep in touch with their families and those who matter to them. For example, one child’s family visit the home at weekends and help staff to cook his favourite meals. Staff are flexible and use a range of methods to keep families up to date about their children’s needs.

p.2

This monitoring visit

Leaders and managers have failed to ensure that agency staff have the necessary checks in place to work with children. Basic details, such as dates of birth and qualifications, are not recorded. Information is not checked, including the verification of references, qualifications, training and previous employment history. This means that children’s safety and welfare are not prioritised.

p.2

This monitoring visit

Staff speak positively about the support and guidance they receive from the registered manager. Staff told the inspector that the manager is very dedicated and always available. A social worker told the inspector that ‘the staff are great and really try their best’. Another social worker shared that ‘I was really impressed with the attitude and commitment from the managers and individual care staff’.

p.2

This monitoring visit

The registered manager is very organised and passionate about providing good- quality care to children. He ensures that staff keep detailed records about incidents relating to children. Physical intervention records show that staff and children are spoken to after the use of restraint within timescales, to check their welfare. However, the recording form does not include information about any injury to a child Inspection report for children’s home - monitoring visit: SC034184 3 during restraint or medical treatment offered. These details need to be recorded to ensure manager oversight and that the child’s well-being is promoted.

p.2

This monitoring visit

During this monitoring visit, leaders and managers made a decision to move one child to prevent further negative impact on her progress. The responsible individual has confirmed that the second child will continue to live in the home alone until another home is found to meet his needs. A compliance notice has been issued in relation to regulation 6: the quality and purpose of care standard. Ofsted will monitor action to address this notice and will review the care provided at this home.

p.3

Recent inspection history

Inspection date Inspection type Inspection judgement 23/07/2019 Full Good 19/03/2019 Interim Declined in effectiveness 07/08/2018 Full Good 28/02/2017 Interim Sustained effectiveness Inspection report for children’s home - monitoring visit: SC034184 4

p.3

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.

p.4

Requirement Due date

*The quality and purpose of care standard is that children receive care from staff who—

p.4

Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

p.4

Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

p.4

Requirement Due date

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

p.4

Requirement Due date

understand and apply the home’s statement of purpose;

p.4

Requirement Due date

understand and apply the home’s statement of purpose;

p.4

Requirement Due date

protect and promote each child’s welfare;

p.4

Requirement Due date

treat each child with dignity and respect;

p.4

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;

p.4

Requirement Due date

help each child to understand and manage the impact of any experience of abuse or neglect;

p.4

Requirement Due date

help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult;

p.4

Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably;

p.4

Requirement Due date

provide to children personal items that are appropriate for 1 March 2021 Inspection report for children’s home - monitoring visit: SC034184 5 their age and understanding; and

p.4

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;

p.5

Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to—

p.5

Requirement Due date

enable each child to participate in the daily life of the home; and

p.5

Requirement Due date

ensure that any care that is arranged or provided for a child that—

p.5

Requirement Due date

relates to the child’s development (within the meaning of section 17(11) of the Children Act 1989) or health; and

p.5

Requirement Due date

is not arranged or provided as part of the health service continued under section 1(1) of the National Health Service Act 2006(a),

p.5

Requirement Due date

satisfies the conditions in paragraph (3).

p.5

Requirement Due date

that the care is approved, and kept under review throughout its duration, by the placing authority;

p.5

Requirement Due date

that the care is delivered by a person who—

p.5

Requirement Due date

has the experience, knowledge and skills to deliver that care; and

p.5

Requirement Due date

is under the supervision of a person who is appropriately skilled and qualified to supervise that care; and

p.5

Requirement Due date

that the registered person keeps the child’s general medical practitioner informed, as necessary, about the progress of the care throughout its duration. (Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(ix)(c)(i)(ii) (3)(a)(b)(c)(i)(ii)(d)) Inspection report for children’s home - monitoring visit: SC034184 6 The provider is required to take urgent action to ensure that staff have the training and skills needed to meet each child’s needs. In addition, the provider is required to review the statement of purpose to ensure that each child moving into the home can be supported to meet their full potential and that staff can meet each child’s individual needs according to their plans.

p.5

Requirement Due date

The health and well-being standard is that—

p.6

Requirement Due date

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

p.6

Requirement Due date

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

p.6

Requirement Due date

children are helped to lead healthy lifestyles.

p.6

Requirement Due date

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

p.6

Requirement Due date

achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

p.6

Requirement Due date

take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs; and

p.6

Requirement Due date

that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (1)(a)(b)(c) (2)(a)(i)(iii)(c))

p.6

Requirement Due date

This particularly refers to seeking the appropriate advice and treatment for children in relation to dental and optician checks, weight, diet (including any supplements), sleeping patterns and any necessary follow-up appointments recommended. 1 March 2021

p.6

Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

p.6

Requirement Due date

an understanding about acceptable behaviour; and 1 March 2021 Inspection report for children’s home - monitoring visit: SC034184 7 positive responses to other children and adults.

p.6

Requirement Due date

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

p.7

Requirement Due date

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

p.7

Requirement Due date

help each child to develop socially aware behaviour;

p.7

Requirement Due date

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

p.7

Requirement Due date

help each child to develop and practise skills to resolve conflicts positively and without harm to anyone;

p.7

Requirement Due date

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;

p.7

Requirement Due date

help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful;

p.7

Requirement Due date

help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship;

p.7

Requirement Due date

strive to gain each child’s respect and trust;

p.7

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;

p.7

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;

p.7

Requirement Due date

de-escalate confrontations with or between children, or Inspection report for children’s home - monitoring visit: SC034184 8 potentially violent behaviour by children;

p.7

Requirement Due date

understand and communicate to children that bullying is unacceptable; and

p.8

Requirement Due date

have the skills to recognise incidents or indications of bullying and how to deal with them; and

p.8

Requirement Due date

that each child is encouraged to build and maintain positive relationships with others. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(ix)(x)(xi)(xii)(xiii)(b))

p.8

Requirement Due date

This relates to ensuring that staff take appropriate action to support children to reduce aggressive and distressing behaviours and to develop positive relationships, and to reassure them.

p.8

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—

p.8

Requirement Due date

helps children aspire to fulfil their potential; and

p.8

Requirement Due date

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

p.8

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;

p.8

Requirement Due date

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

p.8

Requirement Due date

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;

p.8

Requirement Due date

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

p.8

Requirement Due date

research and developments in relation to the ways in which the needs of children are best met; and 1 March 2021 Inspection report for children’s home - monitoring visit: SC034184 9 feedback on the experiences of children, including complaints received; and

p.8

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)(c)(f)(g)(i)(ii)(h))

p.9

Requirement Due date

This specifically relates to staff having the skills, training and support to be able to meet the complex needs of children displaying harmful behaviours.

p.9

Requirement Due date

The care planning standard is that children—

p.9

Requirement Due date

receive effectively planned care in or through the children’s home; and

p.9

Requirement Due date

have a positive experience of arriving at or moving on from the home.

p.9

Requirement Due date

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

p.9

Requirement Due date

that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose;

p.9

Requirement Due date

ensure the effective induction of each child into the home;

p.9

Requirement Due date

manage and review the placement of each child in the home; and

p.9

Requirement Due date

plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority;

p.9

Requirement Due date

that each child’s relevant plans are followed;

p.9

Requirement Due date

that, subject to regulation 22 (contact and access to communications), contact between each child and the child’s parents, relatives and friends, is promoted in accordance with the child’s relevant plans;

p.9

Requirement Due date

that the child’s placing authority is contacted, and a review of that child’s relevant plans is requested, if— 1 March 2021 Inspection report for children’s home - monitoring visit: SC034184 10 the registered person considers that the child is at risk of harm or has concerns that the care provided for the child is inadequate to meet the child’s needs;

p.9

Requirement Due date

the child is, or has been, persistently absent from the home without permission; or

p.10

Requirement Due date

the child requests a review of the child’s relevant plans. (Regulation 14 (1)(a)(b) (2)(a)(b)(i)(ii)(iii)(c)(d)(e)(i)(ii)(iii))

p.10

Requirement Due date

This particularly refers to the approach of leaders in responding to children with complex needs at time of crisis to deliver good-quality care. This includes ensuring appropriate matching of children to the staff’s skill set and to the needs of other children.

p.10

Requirement Due date

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

p.10

Requirement Due date

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

p.10

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,

p.10

Requirement Due date

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

p.10

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))

p.10

Requirement Due date

This relates to managers ensuring that robust safer recruitment checks are in place for all agency workers who are caring for children. 1 March 2021

p.10

Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— 1 March 2021 Inspection report for children’s home - monitoring visit: SC034184 11 a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure. (Regulation 35 (3)(a)(viii))

p.10

Requirement Due date

This specifically relates to staff recording whether children sustain any injury or are offered medical treatment during incidents of physical restraint.

p.11

Requirement Due date

*These requirements are subject to a compliance notice.

p.11

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.

p.11

Information about this inspection

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

p.11

Children’s home details

Registered provider: Bristol City Council

p.11

Children’s home details

Registered provider address: Bristol City Council, Director of Legal Services, City Hall, College Green, Bristol BS1 5TR

p.11

Inspector

Anna Gravelle, Social Care Inspector Inspection report for children’s home - monitoring visit: SC034184 12 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.

p.11

Inspector

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.12

Inspector

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.12

Inspector

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

p.12