Children's Home run by Institute of Integrated Systemic Therapy in Norfolk

Inspection report children’s home: SC065792 1 SC065792 Registered provider: Institute of Integrated Systemic Therapy Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is run by a charitable organisation. It specialises in the treatment of up to eight children with severe social and emotional difficulties as a result of attachment difficulties that are usually rooted in early life trauma.

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Information about this children’s home

The manager registered with Ofsted in January 2020.

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Information about this children’s home

Due to COVID-19, at the request of the Secretary of State, we suspended all routine inspections of social care providers carried out under the social care common inspection framework (SCCIF) on 17 March 2020. We returned to routine SCCIF inspections on 12 April 2021.

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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 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: 14 October 2019

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good

Overall judgement at last inspection: outstanding

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good

Enforcement action since last inspection: none Inspection report children’s home: SC065792 2

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Inspection date Inspection type Inspection judgement

14/10/2019 Full Outstanding 09/01/2019 Full Outstanding 28/11/2017 Full Outstanding 31/01/2017 Interim Sustained effectiveness Inspection report children’s home: SC065792 3

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Overall experiences and progress of children and young people: good

Children are happy at this home and enjoy living here. They are looked after by staff who have a good understanding of their needs and are committed to helping them to progress.

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Overall experiences and progress of children and young people: good

Managers complete detailed assessments before children move to the home. This helps to ensure that children’s care is well planned and that managers are confident that they can meet children’s individual needs. Several children at the home have had multiple placement breakdowns before moving in. However, they have lived at this home for a significant time. Good planning has helped to provide children with a level of stability that they have not previously had.

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Overall experiences and progress of children and young people: good

Children make good progress in their education. One child had not attended school for a long period before moving to the home. He now attends school full time. The child’s last school report outlined the significant progress that he has made in his education since living at the home. Another child does not have a suitable full-time education provision in place. Staff have helped him to engage in regular home tuition. The manager has strongly advocated for him in relation to his education and has appropriately challenged professionals in relation to this.

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Overall experiences and progress of children and young people: good

Staff help children be healthy. One child has a long-term health condition. Staff support her well with this and the condition is now managed much more effectively.

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Overall experiences and progress of children and young people: good

Children are well engaged in the day-to-day life of the home. Regular community meetings provide a forum for children and staff to discuss a wide variety of topics in relation to children’s lives. Children participate well in these meetings and use them to think about any concerns that they have and discuss how these can be resolved.

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Overall experiences and progress of children and young people: good

Children participate in a wide range of activities. During the COVID-19 pandemic, managers purchased kayaks, which has helped to encourage children to continue to engage in outdoor activities. Children attend local clubs depending on their individual interests. One child is a highly talented writer and has attended a local creative writing club to help further develop her skills and interests in this area.

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

Staff have a good understanding of risks to children and work hard to help to reduce these. Children feel safe at the home. There has been one incident of a child being reported missing. In response to this, managers worked with the child and their social worker to review plans for the child to see friends in a safe way. She has since engaged well with this and there have been no further incidents of her going missing from care. Inspection report children’s home: SC065792 4 Concerns in relation to children’s safety are appropriately addressed. On two occasions, a child raised concerns that staff had hurt them during incidents of restraint. On each occasion, a referral was made to the designated officer and the allegations were appropriately investigated. This helped to ensure that concerns in relation to staff practice were thoroughly considered and that the child’s voice was clearly heard and acted on.

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

Children’s risk assessments contain strategies for staff to help children to manage their behaviour. However, some behaviours that children display are not included in their risk assessments. This means that there are no clear strategies outlined for staff to mitigate some risks to children. While staff demonstrate a good understanding of how to reduce risks, missing information in risk assessments has the potential to lead to inconsistent approaches.

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

Some children have been involved in frequent incidents of aggressive behaviour. This has led to a high number of restraints being used to keep children and staff safe. Most incidents of restraint are appropriate and there has been a good level of management oversight of them. However, for some incidents, it is unclear why restraints have gone on for the duration that they have. This brings into question the proportionality of these restraints. Managers have failed to identify this on review of incidents and therefore these concerns have not been addressed.

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

Staff help children to understand appropriate behaviour and give clear responses to unwanted behaviours. However, for one child, there is no clear plan of how staff are working with him in relation to appropriate relationships and boundaries.

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The effectiveness of leaders and managers: good

The manager is child focused and has high aspirations for children. She is accessible to children and staff and has built excellent relationships with them.

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The effectiveness of leaders and managers: good

Regular staff meetings and reflective sessions to consider children’s behaviours take place. These provide staff with opportunities to consider how they are supporting children and to identify areas for improvement to practice.

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The effectiveness of leaders and managers: good

Staff are highly trained, and this includes in topics relevant to individual children’s needs. The home’s therapeutic model provides staff with a good understanding of children’s backgrounds and the trauma that they have experienced. This supports staff to work with children in ways that help the children to better understand what has happened to them.

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The effectiveness of leaders and managers: good

Managers have built good working relationships with external professionals. All professionals spoken with say that communication is excellent and that staff and managers contribute effectively to multi-agency meetings. Managers appropriately challenge external professionals when needed to ensure that children have the support that they need. Inspection report children’s home: SC065792 5 Managers welcome external scrutiny and use it to help drive improvement. In recent months, they have commissioned a new independent person as they felt that the visits being undertaken could be more beneficial in terms of identifying areas in which they could improve care for children. Good use of external monitoring has helped managers to continue to develop practice.

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The effectiveness of leaders and managers: good

Safer recruitment checks are undertaken before staff begin working at the home. However, these do not include checks on reasons why staff have left previous roles working with children or vulnerable adults.

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The effectiveness of leaders and managers: good

Most staff have received regular supervision. However, in recent months, some staff have not had supervision with the frequency outlined in the home’s supervision policy. While other support is in place for staff, gaps in supervision sessions mean that they have not always had the individualised support that supervision provides. Inspection report children’s home: SC065792 6

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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 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 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. (Regulation 12 (1) (2)(b))

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Requirement Due date

In particular, ensure that children’s risk assessments reflect all known behaviours and risks and include strategies for staff to manage these. 17 January 2022

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Requirement Due date

Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (2)) 27 December 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

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

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))

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Requirement Due date

In particular, ensure that if a person has previously worked in 17 January 2022 Inspection report children’s home: SC065792 7 a position involving work with children or vulnerable adults, that verification is undertaken so far as reasonably practicable of the reason why the employment or position ended.

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Recommendations

 The registered person should ensure that staff understand and help children to understand what makes a healthy, nurturing relationship. Staff should be skilled to recognise the signs and provide support to children in danger of or involved in damaging relationships with others. (‘Guide to the children’s homes regulations, including the quality standards’, page 38, paragraph 8.10)  The registered person should have systems in place so that all staff receive supervision of their practice in accordance with the home’s supervision policy. (‘Guide to the children’s homes regulations, including the quality standards’, page 61, paragraph 13.2)

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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: SC065792 8

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Children’s home details

Registered provider: Institute of Integrated Systemic Therapy

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Children’s home details

Registered provider address: 210 Borough High Street, London SE1 1JX

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Inspector

Joe Cox, Social Care Inspector Inspection report children’s home: SC065792 9 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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