Children's home run by Q Plus Limited

Inspection report children's home: 1269565 1 Registered provider: Full inspection Inspected under the social care common inspection framework

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Information about this children's home

This purpose-built home is designed to care for up to four children with autism spectrum disorder, learning disabilities and associated challenging behaviours.

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Information about this children's home

The post for a registered manager has been vacant since 27 May 2020, although there is a proposed manager in post whose application is currently in progress.

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Information about this children's home

Due to COVID-19 (coronavirus), at the request of the Secretary of State, we suspended all routine inspections of social care providers on 17 March 2020.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers requires improvement to be good

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good

The children's home provides effective services that meet the requirements for good.

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good

Date of last inspection: 5 December 2019

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good

Overall judgement at last inspection: sustained effectiveness

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good

Enforcement action since last inspection: none Inspection report children's home: 1269565 2

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Inspection date Inspection type Inspection judgement

05/12/2019 Interim Sustained effectiveness 22/08/2019 Full Good 11/02/2019 Interim Sustained effectiveness 14/11/2018 Full Requires improvement to be good Inspection report children's home: 1269565 3

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Overall experiences and progress of children and young people: good

Children receive high-quality and individualised care. All three children who live at the home have made progress from their starting points. Although progress is often simple, for these children it can be a great achievement. For example, children learning independence through staff encouraging and supporting them to do things for themselves, such as clearing up after meals, encouraging them to wash themselves and, for one child, walking straight without physical support.

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Overall experiences and progress of children and young people: good

The home has a highly motivated and committed staff team. The inspector observed that staff have positive relationships with the children and are highly skilled in their work. Three parents and two social workers all confirmed the positive practice observed in their feedback about the care and support children receive. For example, parents said that, ‘Staff have been very proactive and child centred’ and, ‘The home is full of love and enjoyment’.

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Overall experiences and progress of children and young people: good

Children’s views are sought via a mixture of methods, including pictorial exchange communication systems, verbal communication and being shown/led by children. This enables children to make choices and share their views, for example what activities they prefer, to plan their menus or give their views about physical restraints.

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Overall experiences and progress of children and young people: good

All children attend education and during the holidays they are supported to have both indoor and outdoor activities to promote their enjoyment, skills and independence. Water play, nail painting, cinema and a meal out are just a few activities observed during this inspection.

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Overall experiences and progress of children and young people: good

In general, children’s health needs are well known and well responded to. An example of this is the strong initiative shown in securing an agency psychiatric nurse on every shift to support a child’s mental health, and thus preventing a move to an alternative home/setting.

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Overall experiences and progress of children and young people: good

Arrangements for children who come to the home for a short break are not established. Clearer processes and records should document decision-making. There is not yet an impact risk assessment in place which helps staff to understand the impact any new children coming to the home may have on existing children who already live at the home.

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Overall experiences and progress of children and young people: good

Children receive well-planned transitions when leaving the home. One child is being helped to understand his transition through social stories, visits and by workers from his new home visiting him to learn and understand his needs prior to his move. The transition plan arranged was multi-agency and the social worker stated, ‘The transition team are working well together, this is fantastic’. Inspection report children's home: 1269565 4 Family time is supported well by staff and the importance of this for children is understood. Because children live close by, they are facilitated to visit their families, where agreed and safe to do so, on a regular basis. Staff generally walk with children, and one child is taken home every day to meet his specific needs.

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Overall experiences and progress of children and young people: good

The home environment is not the most suitable due to being within the school setting. However, there are positives to this as well, which include the use of resources such as the sensory rooms, wet play and cooking facilities.

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Overall experiences and progress of children and young people: good

The short-breaks room looks quite bleak. A loose ceiling panel was made safe during the inspection, once pointed out by the inspector. Despite staff stating that they decorate the short-breaks room when children arrive to stay overnight, more could be done to ensure the basics are in place, for example fresh paintwork, new blinds and other ideas to make the room brighter and more welcoming.

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How well children and young people are helped and protected: good

Risks for children are clearly identified and well assessed. This is reflected in behaviour support plans, risk assessments, personal evacuation plans and team around the child information. Records are simple and clear for staff and include known trigger points for arousal and strategies to manage behaviour. Simplified information in pictorial form is on file, which is accessible for children.

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How well children and young people are helped and protected: good

Children living at this home have highly complex needs. They are dependent on staff for all of their care needs and for guidance and maintenance of positive behaviour, which makes them extremely vulnerable. Their care is arranged via agreed education, health and care plans (EHC plans) which have multi-agency input. All children have personal emergency evacuation plans which guide staff about the processes to support children to evacuate the building in the event of a fire.

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How well children and young people are helped and protected: good

The home has a magnetic door entry system, which is essential given the children’s needs and vulnerability. All children have this restriction of liberty written into their EHC plans or they have a deprivation of liberty order via the courts. All children have a missing from care risk assessment despite the low probability of them going missing from the home. This ensures that staff know what to do in the event that a child does go missing from the home.

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How well children and young people are helped and protected: good

Staff know the children well and recognise the greatest risk the children face is from self-harm, peer harm and harm to others through dysregulation. These risks are managed well by a skilled staff team working well together, with relevant and helpful documented information which informs practice. Staff monitor children closely and manage signs of dysregulation. This helps them to pre-empt and avoid risk of harm via diversion and through high and appropriate staffing levels.

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How well children and young people are helped and protected: good

Staff meet and talk regularly about the care needs of children, through hand-over meetings, an online messaging group, team meetings and informal and formal meetings. This shared knowledge supports clear and consistent boundaries for Inspection report children's home: 1269565 5 children. Children test boundaries, but staff use known strategies to divert and manage risks. and these responses help children to feel safe and secure.

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How well children and young people are helped and protected: good

Recording of restraint practice has been improved considerably and is a strength. However, in the absence of both the interim and deputy manager, the required debrief of staff and children has not always happened and management oversight is missing. Where recorded correctly, the impact of staff debrief is obvious in its reading. It has encouraged a reflective element to practice and has helped staff to recognise helpful responses in complex circumstances. Changes to ongoing practice have been made as a result. Particularly good practice was seen in photographs of non-verbal children completing feedback on their feelings about being physically restrained.

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How well children and young people are helped and protected: good

Safeguarding arrangements have been strengthened through training from the designated officer. The local authority reports a more open culture of consulting/reporting and challenging poor practice. Staff spoken with were aware of the safeguarding lead for the home and the role of the designated officer, should they have any child protection or safeguarding concerns to report.

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good

There has not been a registered manager at this home since May 2020. The interim manager, who was appointed in May 2020, then had a period of extended absence from December 2020 to June 2021. During this absence, the provider recruited a consultant into the deputy manager role to run and support the service. In June 2021, the proposed manager returned to their post and they have subsequently applied to register. Their application is in process.

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good

The responsible individual’s skills and knowledge of children’s residential care and regulation have been questioned by recent reports of safeguarding incidents at the school where he is also the headteacher. This has led to his re-interview by Ofsted to ensure his skills and knowledge are sufficient, to ensure oversight of the home’s compliance with the children’s homes regulations.

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good

The consultant deputy manager has worked hard to ensure processes are in place to maintain compliance during the interim manager’s absence. These processes have improved systems and supported children’s positive outcomes at the home. Staff feedback in respect of the deputy manager and the changes she has implemented has been overwhelmingly positive.

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good

The proposed manager acknowledges there have been many changes, including new staff recruitment, which have led to him stating he is not aware of current operational processes. There has been some delay in organising support for his return to work. However, a new mentor/supervisor is being sourced to support his understanding in this transition. The proposed manager describes reluctance in the transfer of responsibility, although he acknowledges some of this has been due to Inspection report children's home: 1269565 6 both managers unavailability due to sickness, self-isolation, covering shifts and holiday leave.

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good

Overall, staff say they feel supported and are offered supervision and training which helps them to work more effectively with the children. However, there is some evidence of a staff split with two different lines of management. For example, staff describe receiving conflicting messages when given guidance. There is no impact on children at this stage. However, there is emerging impact on staff morale, with some staff saying they are considering their positions and feeling unsettled.

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good

The proposed manager is employed to run the home, although currently it is the deputy manager who is carrying this responsibility. Senior leaders and managers are responsible for ensuring clear and confirmed lines of communication and accountability. What is clear is that the lack of clarity remains for staff and this is having an impact on morale.

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good

The home’s statement of purpose has been updated; however, it is a very long and confusing document. The statement of purpose also quotes incorrect regulation and does not have the most up-to-date staffing structure and information.

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good

Some information requested by the inspector was not provided despite a reminder of the clear legal requirement upon providers to do so. This information, once forthcoming, may have an impact on the judgements reached and given during feedback. Inspection report children's home: 1269565 7

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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

A responsible individual must— 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 (7)(b))

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Requirement Due date

Specifically, the responsible individual who oversees the management of the home must understand the duties and responsibilities of their role under the Children's Homes (England) Regulations 2015 including the quality standards. 1 October 2021

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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

(b)the measures of control, discipline and restraint which may be used in relation to children in the home. (Regulation 35 (1) (b))

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Requirement Due date

This refers specifically to ensuring that the policy for the use of control and restraint is updated. 1 October 2021

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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

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

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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;

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Requirement Due date

ensure that staff work as a team where appropriate; (Regulation 13 (1) (2)(a)(b)) 1 October 2021 Inspection report children's home: 1269565 8 Specifically, in relation to ensuring that there is consistency in management decision-making and clear lines of communication and accountability.

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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

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. (Regulation 13 (1) (2)(c))

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Requirement Due date

Specifically, in relation to ensuring that the proposed manager has access to a supervisor/mentor who can support his and the home's development. 1 October 2021

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Requirement Due date

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

keep the statement of purpose under review and, where appropriate, revise it; and

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Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision.

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Requirement Due date

If a home has a website, the registered person must ensure that a copy of the statement of purpose is published on that website unless the registered person considers that such publication would prejudice the welfare of children in the home. (Regulation 16 (1) (3)(a)(b) (4)) 1 October 2021

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who— understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. In particular, the standard in paragraph (1) requires the registered person to— 1 October 2021 Inspection report children's home: 1269565 9 ensure that the premises used for the purposes of the home are designed and furnished so as to— meet the needs of each child. (Regulation 6 (1) (a)(b) (2)(c)(i)

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Requirement Due date

Specifically, in relation to ensuring that the short-breaks room is decorated and personalised to meet individual children’s needs.

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Recommendations

 The registered person should ensure that records of restraint are kept up to date and these records should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure it meets the needs of each child. Specifically, in relation to ensuring there is management oversight of restraint records and practice and a process is in place to ensure this oversight continues when managers are absent. ('The Guide to the Children's Homes Regulations including the quality standards', page 49 paragraph 9.59)

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Recommendations

 The registered person should ensure they only accept placements for children where they are satisfied that the home can respond effectively to the child's assessed needs as recorded in the child's relevant plans and where they have fully considered the impact that the placement will have on the existing group of children. Specifically, in relation to ensuring children coming to the home for a short break are matched with the existing children at the home. ('The Guide to the Children's Homes Regulations including the quality standards', page 56 paragraph 11.4)

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, 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: 1269565 10

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Inspector

Christine Kennet, Social Care Inspector Inspection report children's home: 1269565 11 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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Inspector

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Inspector

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