Children's Home run by Assure Care Homes Ltd in Hampshire

Inspection report for children’s home: 2666995 1 Registered provider: Assure Care Homes Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

According to the provider’s statement of purpose, this children’s home provides care and accommodation for up to two children with social and emotional difficulties. It is owned by a private organisation.

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Information about this children’s home

The manager and the home have been registered with Ofsted since 18 November 2021 . This is the home’s first full inspection.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Overall judgement at last inspection: not applicable

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inadequate

Enforcement action since last inspection: none Inspection report for children’s home: 2666995 2

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inadequate

This service is judged inadequate due to serious and widespread failures to deliver safe care, the lack of effective leadership, and poor management oversight of care practice. The lack of attention and care with regard to supporting the child living in the home in key aspects, such as health and education, means that the child is not receiving the help that they need to make progress or stay safe.

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inadequate

On 24 February 2022, Ofsted carried out a monitoring visit to the home to assess the quality of care provided to children. This was in response to incidents that had been notified to Ofsted. At that visit, serious shortfalls were identified and, as a result, seven requirements were made. Three of the requirements were subject to compliance notices.

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inadequate

Following that visit, on 25 February 2022, Ofsted issued a notice restricting accommodation to the children’s home due to there being a risk of harm if further children moved into the home.

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inadequate

On 7 March 2022, Ofsted carried out a further monitoring visit to the home to ensure that the provider was complying with the notice restricting accommodation and to seek assurance that one compliance notice in relation to fire safety was met. This notice had not been met so a further compliance notice was served with regard to fire safety.

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inadequate

This full inspection included the review of three compliance notices, seven requirements and a notice restricting the provider’s accommodation. There is currently one child living in the home. Two of the compliance notices have been met and the provider is complying with the restriction notice.

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inadequate

Some staff have built a positive relationship with the child. One member of staff conducted a kitchen science experiment with the child, while others have had meaningful discussions with the child about how to keep safe and the importance of attending regular health appointments. However, the child often eats their meals in their bedroom and spends hours during the day, including in school hours, playing video games. The staff are struggling to establish trusting relationships with the child or to engage them in more meaningful activities.

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inadequate

The staff and managers have not been successful in finding a school or suitable education provision for the child. The registered manager has escalated this on several occasions to the child’s allocated social worker. Recently, a tutor has provided some educational support to the child, with limited success. However, the child’s education, health and care plan has not been reviewed or updated and relevant information in this document is not being used to inform the care provided to the Inspection report for children’s home: 2666995 3 child. For example, the staff were not aware of the child’s educational targets or previous school achievements.

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inadequate

The provider has not obtained the child’s most recent healthcare plan, including their immunisation record and last medication review. Most of the staff were also unaware of the child’s health needs, and therefore could not identify or demonstrate how they are meeting and addressing these needs.

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inadequate

Since the last monitoring visit, the child has been registered with a general practitioner and has attended a dental appointment. The staff have been proactive in rebooking an optician’s appointment for the child after a refusal to attend the initial appointment.

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inadequate

The registered manager and the staff have not kept the child’s care planning documents up to date. The inspector found conflicting and confusing information about how staff are expected to support the child. For example, the child’s risk assessment refers to the staff using a model of care practice that they are not trained to deliver. Arrangements for the child to see their family are not clear.

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inadequate

The staff team is newly appointed and they are getting to know each other’s strengths and weaknesses. They are a reflective team and have good ideas and suggestions as to how they can improve care practice. However, most of the staff are unqualified and inexperienced, and are new to children’s residential care. They lack the training, support and leadership required to enable them to keep children safe.

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

Internet safety measures are poor and this places the child at risk of harm. The staff do not complete internet safety training and lack information on current online trends and how to protect children online. For example, there are no parental controls or restrictions on the child’s devices and there are no monitoring systems in place that alert staff or managers to inappropriate access. The child has unlimited access during the day to video games that are inappropriate for his age and social media platforms that pose potential risks, without consistent supervision from the staff.

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

Managers have not responded appropriately to risks relating to suicide ideation and attempts to self-harm. There have been no referrals to the appropriate health agencies and the staff have not received training in how to support children at risk of self-harm. They have not been trained to cut ligatures, should this be necessary to protect children from serious harm. The registered manager did inform the child’s allocated social worker of their concerns about the child’s risks of self-harm; however, this was not met with an appropriate response or timely action. This has had a significant impact and delay in the child receiving clinical help and support.

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

The staff do not always respond appropriately, confidently or in accordance with risk management plans when the child displays behaviours that place them or others at Inspection report for children’s home: 2666995 4 significant risk of harm. In one example, staff failed to act when there was clear evidence of danger. The advice given to staff by the on-call manager did not direct them to take appropriate action. Because of this, a serious incident occurred that could have been prevented.

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The effectiveness of leaders and managers: inadequate

In order to meet a compliance notice, managers were required to identify any gaps in staff training and produce a written plan, with timescales, to demonstrate how these gaps will be addressed. This review was undertaken by the responsible individual. However, not all gaps in staff training were identified during this process. This means that the staff do not have all the training that they need in order to meet the child’s needs. Therefore, this compliance notice has not been met.

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The effectiveness of leaders and managers: inadequate

Managers were also required to complete a written review of the matching and impact risk assessments for children and to review policies and procedures with regard to how they support children moving into the home. Managers have strengthened their admission procedures by creating a new assessment form. It is designed to capture the necessary information to ensure that managers can adequately assess, and therefore match, the needs of children moving into the home. Managers have also reviewed the home’s admission policy and have streamlined this process. There have been no children admitted to the home since the last inspection, so these improvements have yet to be tested in practice. The compliance notice with regard to care planning has been met.

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The effectiveness of leaders and managers: inadequate

The compliance notice in relation to fire safety has been met. The responsible individual has completed a written review to explore why fire safety checks were not completed and now has monitoring systems in place to ensure that checks are completed. The staff are carrying out regular fire drills with the child. All firefighting equipment checks are now up to date, including checks on fire doors and emergency lighting. This reduces the risk of harm to children and staff in the event of a fire.

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The effectiveness of leaders and managers: inadequate

The registered manager has recently decided to step down from the registered manager’s role and has informed Ofsted of their intention. Senior leaders have been proactive and are in the process of recruiting a replacement manager. There is currently no deputy manager working in the home. The responsible individual is covering additional management duties at another home operated by this organisation. This means that they have reduced capacity to provide the management oversight required in this home. This also means that there is currently insufficient management capacity to provide leadership, direction and oversight of the quality of care provided to children.

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The effectiveness of leaders and managers: inadequate

The registered manager’s approach to behaviour management and plans to reduce risk-taking behaviours for one child are ineffective. For example, the registered manager uses monetary incentives to encourage the child to comply with reasonable boundaries that are necessary to keep them safe. This creates an unrealistic situation where the child is only motivated to comply with boundaries when they are ‘paid’ to do so. Inspection report for children’s home: 2666995 5 Staff say that they are supported by the manager and new recruits say that they receive reflective supervision regularly. However, in practice, supervision is not carried out in line with the frequency and the quality specified in the home’s statement of purpose. This requirement has not been met from the previous inspection and is repeated.

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The effectiveness of leaders and managers: inadequate

The arrangements for signing out controlled medicines are unsafe. For example, medication is being separated from its original packaging and it is unclear what this medication is and who it is for. The registered manager has not taken advice from the relevant health professionals as to how these types of packaged medicines from the pharmacy can be safely handled. Inspection report for children’s home: 2666995 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 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

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

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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

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Requirement Due date

understand and develop skills to promote the child’s well- being. (Regulation 10 (1)(a)(b)(c)(2)(a)(i)(iii)(iv))

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Requirement Due date

In particular, the registered person should refer children to the necessary clinical agencies when needed. They should ensure they are in receipt of the children’s relevant medical histories.

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Requirement Due date

This requirement was made at the last inspection and is restated. 19 June 2022

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Requirement Due date

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

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Requirement Due date

mutual respect and trust; 19 June 2022 Inspection report for children’s home: 2666995 7 an understanding about acceptable behaviour; and

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Requirement Due date

positive responses to other children and adults.

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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

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

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Requirement Due date

strive to gain each child’s respect and trust;

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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; and

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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. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(viii)(ix)(x))

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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 19 June 2022 Inspection report for children’s home: 2666995 8 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)(a)(i)(iii)(v)(vi)(b))

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Requirement Due date

In particular, complete a written audit of each staff member’s skills and training in relation to risk assessment and management. This is to include senior leaders. Identify any gaps and produce a written plan, with timescales, to demonstrate how these gaps will be addressed.

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Requirement Due date

This requirement was made at the last inspection and is restated.

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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

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;

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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 has sufficient staff to provide care for 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 - 19 June 2022 Inspection report for children’s home: 2666995 9 research and developments in relation to the ways in which the needs of the children are best met; and

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Requirement Due date

feedback on the experiences of children and 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)(d)(e)(f)(g)(i)(ii))

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23 (1))

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Requirement Due date

In particular, the registered person must ensure that—

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Requirement Due date

There is a safe system in place in line with statutory guidance for the handling of regulated medicines 19 June 2022

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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 (4)(a)(b))

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Requirement Due date

This requirement was made at the last inspection and is restated. 19 June 2022

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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 for children’s home: 2666995 10

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Children’s home details

Registered provider: Assure Care Homes Ltd

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Children’s home details

Registered provider address: Unit 4, Northbrook Industrial Estate, Hollybrook Road, Shirley, Southampton, Hampshire SO16 6PB

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Inspector

Kelly Monniot, Social Care Inspector Inspection report for children’s home: 2666995 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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