Children's Home, Residential special school run by Hesley Services Limited in Doncaster

Assurance visit report: SC035687 1 SC035687

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Information about this children’s home

This is a residential special school that is owned and managed by a private company. It is registered as a children’s home and offers care and accommodation for up to 37 children with learning disabilities and/or learning difficulties, together with complex needs, including behaviour that may challenge. The home consists of 16 separate houses.

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Information about this children’s home

The manager registered with Ofsted in June 2018.

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Information about this children’s home

Previous inspection date: 12 November 2019

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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. 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. Assurance visit report: SC035687 2

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Findings from the visit

We identified the following serious and widespread concerns in relation to the care or protection of children at this assurance visit:

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Findings from the visit

 safeguarding arrangements are not effective and do not protect children from exposure to emotional and/or physical harm, including during restraints  leaders and managers at all levels in the organisation fail to ensure that children receive high-quality care and protection  staff do not have sufficient knowledge of children’s unique and individual needs, including their communication needs  leaders and managers have not ensured that all staff are trained to meet the multiple complex needs of children  leaders and managers have not ensured that staff have current training in physical intervention  managers do not support staff with regular high-quality supervision or debrief staff appropriately when incidents take place  where safeguarding incidents occur, leaders and managers do not develop any learning or take sufficient action to prevent further incidents  the leadership and management of the service is weak. Monitoring of the

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Findings from the visit

service is not sufficient, which results in harmful, poor-quality care for children.

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The care of children

There are serious and widespread concerns in multiple areas of practice relating to the care that children receive. This places children at serious risk of harm. Some children have suffered actual physical harm, either through alleged deliberate acts or through neglect of care. Children’s care planning documents include information about known triggers for children’s levels of anxiety and distress, and details about how staff should support them. However, staff do not consistently follow this guidance. This leads to serious incidents where some children sustain avoidable injuries and suffer significant, prolonged periods of avoidable distress.

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The care of children

Staff do not always treat children with dignity and respect. This includes a failure to protect children’s privacy and dignity where intimate support is needed, for example while bathing.

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The care of children

Not all staff have completed training to enable them to be able to communicate with children, understand their needs, seek their wishes and feelings, and understand how to help the children to express themselves. This leaves children unsupported and at risk of harm.

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The care of children

Children’s personal information, such as a child’s name and first language, is not known by all staff. This means that the individual needs of children and their unique Assurance visit report: SC035687 3 characteristics are not able to be understood, respected, or responded to by those who are caring for them.

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The care of children

Not all staff have the appropriate level of training and understanding of children’s medication needs, the administration of medication or checks needed. This exposes children to a potential risk of harm. Staff do not always follow medication protocols where they are in place. This exposes children to further potential risk of harm.

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The safety of children

Not all children are safe in this home. When children have multiple and complex needs, the lack of staff training and understanding of such needs results in inappropriate interventions for some children. This results in the children suffering unnecessary harm.

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The safety of children

Not all staff are trained to help children through a behavioural crisis and avoid a physical intervention. Staff do not always follow the behavioural plans that guide staff about how to manage the presenting behaviour in a way that is supportive to the child. This increases the anxiety felt by the child and increases the potential risk of harm.

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The safety of children

When physical interventions take place, there are significant gaps in the records. This includes whether medical assessment or treatment was required or undertaken when children have sustained injuries. These serious shortfalls mean that there are no assurances that children receive appropriate care and attention when they are hurt or held. There is a lack of debrief for both children and staff. These serious shortfalls mean that some children are exposed to avoidable physical interventions. Children are also at risk of harm from staff who do not have sufficient understanding and skills to undertake a physical intervention.

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The safety of children

Serious allegations have been made from within the service that staff have acted to deliberately harm children. While managers appropriately report incidents where children have suffered harm and take action in relation to individual staff members, inappropriate practice continues.

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The safety of children

Staff do not always support children to wear protective items provided by support services, such as head gear, which helps them to avoid injury. This exposes children to a potential risk of harm. Staff have been provided with protective equipment to help them to safely manage behaviour, but this is not worn consistently. This compromises the safety of staff and children.

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The safety of children

These shortfalls demonstrate that there is a systemic inability to safeguard and protect children.

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Leaders and managers

The leadership of this home is not effective. There are insufficient safeguarding measures in place to ensure the safety and well-being of children. The leaders and Assurance visit report: SC035687 4 managers have failed to satisfactorily address safeguarding concerns. As a result, children have suffered harm and been exposed to ongoing risk.

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Leaders and managers

The level of injuries that children sustain, as recorded in restraint and incident records, together with the insufficiency of staff training and lack of management oversight, poses a serious risk to children. When safeguarding incidents occur that involve the inappropriate behaviour of staff, while managers take appropriate action, it does not result in any learning of action to prevent further incidents happening.

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Leaders and managers

In addition to the harm to children, staff regularly sustain injuries during restraints, some of which are serious. Staff debriefs do not always take place and are not always recorded as required. The recordings of debriefs, if they do take place, are vague and sparse. The manager places the responsibility on staff to seek a more in- depth debrief when they have sustained injuries. The management oversight of such incidents is not sufficient to ensure that restraint is appropriate or conducted safely. This lack of scrutiny and oversight places children and staff at risk.

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Leaders and managers

A staffing list was provided that included multiple inaccuracies. A significant number of staff were on shift who were not included on the list of current staff. This demonstrates that leaders and managers do not have sufficient oversight of the day- to-day running of the home.

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Leaders and managers

Following this visit, a notice of suspension has been served. Five requirements are issued to address areas of serious and widespread concern. The previous visit, which was a monitoring visit carried out on 2 March 2021, resulted in two compliance notices being issued under regulations 13 and 33, a requirement under regulation 9 and a recommendation. These remain in place.

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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, the 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 enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills.

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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— 18 April 2021 Assurance visit report: SC035687 5 develop the child’s interests and hobbies;

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Requirement Due date

participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and

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Requirement Due date

make a positive contribution to the home and the wider community; and

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Requirement Due date

that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1) (2)(a)(i)(ii)(iii)(b))

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Requirement Due date

This requirement, which was issued as a result of the monitoring visit carried out 2 March 2021, was not considered during this visit.

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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

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

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and are familiar with, and act in accordance with, the home’s child protection policies;

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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; and 19 March 2021 Assurance visit report: SC035687 6 that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (1) (2)(a)(i)(iii)(v)(vi)(b)(d)(e))

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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— helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— 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; ensure that staff work as a team where appropriate;

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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’s workforce provides continuity of care to each child;

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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;

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Requirement Due date

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

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Requirement Due date

research and developments in relation to the ways in which the needs of children are best met; and

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Requirement Due date

feedback on the experiences of children, including complaints received; 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)(a)(b)(c)(e)(f)(g)(i)(ii)(h))

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Requirement Due date

This requirement, which was issued as a result of the monitoring visit carried out 2 March 2021, was not considered during this visit. 18 April 2021 Assurance visit report: SC035687 7 The registered person must compile in relation to the children’s home a statement ("the statement of purpose") which covers the matters listed in Schedule 1.

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Requirement Due date

Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (1) (5)) 19 March 2021

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Requirement Due date

An individual may only carry on a children’s home if the individual satisfies the requirements in paragraph (5).

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Requirement Due date

have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated. (Regulation 26 (1) (7)(b))

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Requirement Due date

This specifically relates to the responsible individual’s capacity and skills to supervise the management of the home effectively. 19 March 2021

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Requirement Due date

A person may only manage a children’s home if—

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Requirement Due date

the person is of integrity and good character;

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Requirement Due date

having regard to the size of the home, its statement of purpose, and the number and needs (including any needs arising from any disability) of the children—

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Requirement Due date

the person has the appropriate experience, qualification and skills to manage the home effectively and lead the care of children. (Regulation 28 (1)(a)(b)(i))

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Requirement Due date

This specifically relates to the registered manager’s capacity and skills to manage the home effectively. 19 March 2021

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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

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform. (Regulation 32 (1) (3)(b)) 19 March 2021 Assurance visit report: SC035687 8 This specifically relates to staff being sufficiently skilled and qualified to support children with communication needs.

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Requirement Due date

ensure that each employee completes an appropriate induction.

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Requirement Due date

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. (Regulation 33 (1)(a) (4)(a)(b))

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Requirement Due date

This requirement, which was issued as a result of the monitoring visit carried out 2 March 2021, was not considered during this visit. 18 April 2021

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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—

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so ("the authorised person")—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(viii)(b)(i)(ii)(c)) 19 March 2021

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Requirement Due date

*These requirements are subject to a compliance notice. Assurance visit report: SC035687 9

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Recommendations

 The registered person should work with the placing authority to ensure that each child’s transition is planned to prepare them practically and emotionally for leaving. (‘Guide to the children’s homes regulation including the quality standards’, page 57, paragraph 11.9)

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Children’s home details

Registered provider: Hesley Services Limited

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Children’s home details

Registered provider address: Hesley Hall Coach House, Hesley, Doncaster, South Yorkshire DN11 9HH

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Inspectors

Paula Kelly, Social Care Inspector Jacqueline Tate, Social Care Inspector Jamie Richardson, Social Care Inspector Assurance visit report: SC035687 10 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

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Inspectors

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