Children's home run by Nisa Care Home Limited

Inspection report children’s home: 2519919 1 Registered provider: Nisa Care Home Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned by a private company. It is registered to provide care for up to three children aged between eight and 18 years with learning difficulties.

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Information about this children’s home

The registered manager holds qualifications in children’s care, learning and development at level 3 and leadership and management at level 5.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: 2519919 2

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Inspection date Inspection type Inspection judgement

25/05/2021 Full Good Inspection report children’s home: 2519919 3

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improvement to be good

Two children live in the home. Children’s learning opportunities are inconsistent. One child attends school daily and is making good progress. The other child is not enrolled to attend a school and his education, health and care plan is not up to date. The registered manager has not formally escalated concerns about delays in supporting the child to access education. This practice does not maximise the child’s opportunity to reach their learning potential.

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improvement to be good

Staff register children with local health services and support them to access these when needed. Delays in receiving children’s most recent healthcare plans mean that staff do not have up-to-date information to support meeting children’s assessed health needs.

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improvement to be good

The registered manager ensures that staff receive training on administering medication. This means that medication is administered to children in line with the prescriber’s directions. The registered manager has not ensured that there is a central recording log for controlled drugs. Some medication stored in the home is required to be stored at a specific temperature. There is no system in place to monitor the temperature of the room where medication is kept. This has the potential for children to be administered medication that is spoiled.

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improvement to be good

One child has had an unplanned move from the home. The registered manager and staff recognised that this could be upsetting for the child. Therefore, at short notice, they arranged a party and the child was given gifts. This practice ensured that the child had a positive experience of moving from the home.

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improvement to be good

Children form positive relationships with some staff who look after them. This creates opportunities for children to speak about things that worry them. However, the registered manager has not put any arrangements in place to allow children to speak with people who are independent of the home.

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improvement to be good

The registered manager and staff ensure that there is a structured daily routine. The repetition of the routine helps children to understand their plans and self-regulate their emotions.

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improvement to be good

Staff take an interest in the activities that children enjoy. This means that children are supported to access activities that support their physical and emotional development. One child, who has limited vocabulary, now uses more words to express their wishes, which are often associated with activities they enjoy taking part in.

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improvement to be good

Promoting children’s independence is a particular strength. Staff encourage children to develop self-care skills, such as tying their shoelaces and bathing themselves. Inspection report children’s home: 2519919 4 Children help staff to cook evening meals and carry out household chores, such as washing up and setting the table. Developing these skills helps children to grow in confidence and promotes their self-esteem.

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improvement to be good

Staff ensure that children’s cultural needs are supported. One child is supported to attend their place of worship and celebrate religious festivities.

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improvement to be good

The registered manager does not ensure that children’s plans help staff to recognise and respond to some behaviours or risks. For example, one child’s plan does not guide staff on how to respond if a child ties an item around their neck. Although this behaviour is rare, staff do not have access to a ligature cutter and have not completed training in self-harm and ligatures. This does not help to keep children safe.

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improvement to be good

Staff use physical interventions to prevent children causing harm to others. However, records of these interventions have insufficient descriptions of the holds used. Furthermore, after a physical intervention, children are not spoken to by someone who was not involved. This limits children’s opportunities to raise concerns about their experiences.

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improvement to be good

Safer recruitment systems are not consistently used. For example, the registered manager does not always seek clear education and employment dates. This has the potential for gaps in employment to not be found and explored. On two occasions, the registered manager has not requested sufficient references. This practice does not help to identify potential practice issues that need consideration before working with children.

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improvement to be good

Staff have a good understanding of children’s vulnerabilities, and measures are in place to keep children safe. Staff discuss stranger danger with children and help them to think about who they should seek support from in an emergency. This helps children to develop skills in keeping themselves safe.

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improvement to be good

There have been no incidents of children going missing from care, bullying or exploitation. Staff have high expectations of children’s behaviours. Behaviours are managed through rewards and consequences. Sometimes, consequences do not relate to the behaviours displayed by children and are therefore not helpful in addressing the behaviour.

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good

The registered manager’s monitoring systems are not effective as they do not support the registered manager to find shortfalls in practice. This contributes to a delay in improvement being made. During the inspection, the registered manager Inspection report children’s home: 2519919 5 found it difficult to access some documents. For example, previous rotas worked by staff could not be accessed on the electronic recording system.

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good

The communal areas of the home are decorated and furnished to a reasonable standard. However, one sofa in the lounge is torn, and children’s bedroom walls are marked and damaged. One child’s wardrobes do not have doors on. This does not provide children with a space of their own that is nice to spend time in.

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good

The registered manager does not maintain an accurate record of when staff have received supervision. Some staff receive regular supervision. However, one new staff member only had one supervision session during a four-month period. Staff are not always supervised by a person who has been trained in supervising staff. This means that staff’s experiences of supervision are inconsistent, which does not create a supportive culture for all staff.

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good

Four members of staff hold relevant qualifications, and three members of staff are working towards completing their qualifications. Two members of staff plan to enrol on the course in the future. Staff have completed training courses that support them to fulfil their role. Staff are not trained in some areas which are specific to the individual needs of the children who live in the home. For example, staff are not trained in Makaton. This does not help one child to develop different ways of communicating.

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good

The registered manager and staff discuss incidents. These lack reflection. For example, following incidents, debriefs do not consider what worked well and what was not effective. This is a missed opportunity and does not promote a culture of learning from practice.

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good

There is a stable staff team. Three members of staff have joined the team and one staff member has left. This means that children receive care from staff who they know well.

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good

The registered manager plans monthly team meetings. These are well attended and provide an opportunity for staff to discuss children’s plans. This helps staff to provide consistent care to children who live in the home.

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good

The registered manager has a good understanding of the children’s childhood experiences and care plans. She communicates well with children. As a result, children seek affection from her. Inspection report children’s home: 2519919 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

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

if the registered person considers, or staff consider, a placing authority’s or a relevant person’s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans. (Regulation 5 (c))

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Requirement Due date

This specifically relates to the registered manager escalating concerns to external agencies when children’s plans are not reviewed and received within acceptable timescales. 7 July 2022

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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so.

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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

help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible. (Regulation 8 (1) (2)(a)(viii))

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Requirement Due date

In particular, the registered manager should be proactive in ensuring that all children have access to a formal education and any delays are challenged without delay. 7 July 2022

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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— 7 July 2022 Inspection report children’s home: 2519919 7 that staff—

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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. (Regulation 12 (1) (2)(a)(i))

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Requirement Due date

In particular, the registered manager should ensure that children’s risk assessments provide staff with guidance on how to identify, reduce and respond to children’s behaviours and risks.

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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

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(h))

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Requirement Due date

This relates to the registered manager ensuring that there is effective monitoring and review systems in place to review and improve the quality of care provided for children. 7 July 2022

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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.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

a record is kept of the administration of medicine to each child. (Regulation 23 (1) (2)(c))

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Requirement Due date

This relates to the registered manager ensuring that controlled medication administered is recorded in a separate logbook and staff monitor the temperature of the room where medication is kept. 7 July 2022

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. 7 July 2022 Inspection report children’s home: 2519919 8 The registered person may only—

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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, the registered manager should ensure that gaps in education and employment are understood and references are obtained when staff have delivered care in previous roles.

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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 relates to ensuring that all staff are supervised by the registered manager or delegated person on a regular basis and that a record of discussions is kept. 7 July 2022

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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 the measure and its duration;

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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 7 July 2022 Inspection report children’s home: 2519919 9 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)(iv)(b)(i)(ii)(c))

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Requirement Due date

This relates to ensuring that physical interventions recorded are completed fully and that reviews of the interventions take place within the required time frame. This also relates to ensuring that there is appropriate management oversight of sanctions.

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Recommendations

 The registered person should ensure that the home is a nurturing and supportive environment that meets the needs of the children. Children’s homes will, in most cases, be homely, domestic environments. In particular, the registered manager should ensure that children’s bedrooms are maintained and furnished to a reasonable standard and any damaged furniture is removed or replaced. (‘Guide to the Children’s Homes Regulations, including quality standards’, page 15, paragraph 3.9)  The registered person should ensure that there is a sufficient number of staff who are suitably trained staff on duty to meet the assessed needs of all children in the home. This specifically relates to the registered manager ensuring that staff are trained in Makaton and managing incidents of self-harm, including ligatures. (‘Guide to the Children’s Homes Regulations, including quality standards’, page 51, paragraph 10.1)

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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: 2519919 10

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Children’s home details

Registered provider: Nisa Care Home Limited

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Children’s home details

Registered provider address: 64 Francis Road, Stechford, Birmingham, Worcestershire B33 8SN

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Inspector

Helen Malanaphy, Social Care Inspector Inspection report children’s home: 2519919 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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