Children's home run by Smoothstone Care & Education Limited

Inspection report for children’s home: 1278966 1 Registered provider: Smooth Stone Care & Education Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home provides care for up to six children aged between 11 and 18 years. The children may have multiple and complex needs such as learning difficulties or associated mental health conditions. The home extends its leaving age to 20 years when this will assist children in their transition to independence.

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Information about this children’s home

The manager is registered with Ofsted and suitably qualified.

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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

Date of last inspection: 8 February 2022

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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 for children’s home: 1278966 2

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Inspection date Inspection type Inspection judgement

08/02/2022 Full Good 06/11/2019 Full Good 07/01/2019 Full Good Inspection report for children’s home: 1278966 3

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improvement to be good

Since the home was last inspected, there have been considerable changes in the staff team and high staff turnover. Consequently, children have not always had the opportunity to have meaningful goodbyes when staff have left. Furthermore, children have experienced some disrupted relationships. Staffing issues are now resolved and a full staff team is in place.

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improvement to be good

Staff spend quality time with children. As a result of this, key working has become a strength of the home. Children are starting to develop positive, mutually respectful relationships with staff and have been able to explore their personal issues more effectively.

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improvement to be good

Timely and careful transition planning takes place for older children as they prepare to leave the home. Staff hold regular transition meetings with relevant agencies, making sure to include family members whenever this is appropriate. Because children are provided with good information about their next steps, any stress or anxiety is minimised.

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improvement to be good

Children receive structured care, with consistent boundaries and clear expectations from the staff. Children benefit from established routines that are thoroughly embedded in their daily lives. This helps them to be settled and make progress.

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improvement to be good

Children make progress in education from their starting points. Some children have experienced long periods out of education. They are now attending school and making good progress. One child has been out of education for over two years and is now attending full time.

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improvement to be good

Children enjoy a range of in-house and on-site activities. However, activities away from the home for some children have been limited. This is because staff have not made plans to support children to manage their anxieties around leaving the home so that they can try new activities. This does not support children to have varied opportunities to help improve their confidence and enhance their social engagement. Children’s voices could be better captured.

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improvement to be good

Staff have a good understanding of children’s safety needs. However, risk assessments are not comprehensive. They do not provide staff with clear guidance on how to manage children’s identified risks and how to keep children safe. For example, one child’s risk assessment identifies that the child is epileptic, and staff must carry emergency medication with them for the child. However, the assessment fails to record that staff are not trained to administer this medication, and this can Inspection report for children’s home: 1278966 4 only be administered by trained medical personnel. Another child’s plans lacked detail of how their intimate personal care needs should be met. This leaves vulnerable children open to harm and abuse.

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improvement to be good

Children are supported to personalise their bedrooms. Other areas of the home are starting to look tired, and some maintenance issues have not been addressed in a timely manner. For example, screws were sticking out of a wall where a sign had previously been secured, some carpets are stained, and damaged walls remain untreated where TVs have been pulled down. This does not promote a homely environment.

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improvement to be good

Children spend time using electronic devices. Electronics contracts are in place and staff do support children when accessing the internet. However, effective reviewing systems are not in place to monitor mobile phone use. This leaves children vulnerable. The manager reintroduced these checks during the Ofsted visit.

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improvement to be good

Several medication errors have occurred, including one child not being administered a controlled drug. Other errors have occurred within administration records of medication. Not all errors have been investigated or concluded. Medication procedures have been reviewed by leaders because of this and some action has been taken to ensure medication systems are safe.

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improvement to be good

There have been no incidents of children going missing from care. This reflects that children want to be with staff. Staff are knowledgeable about how best to respond if a child does go missing. However, missing protocols in place are not fit for purpose. They do not include photos of the children or relevant information about the children who goes missing, and steps that staff should take to keep children safe are not properly outlined.

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improvement to be good

There are times when staff restrain children to keep them and others safe. A great deal of work has been carried out to reduce the use of physical intervention, which has been successful. However, physical intervention records do not include all required information, despite these being signed off by the manager. This has the potential to place children at increased risk.

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improvement to be good

Complaints are thoroughly investigated. There has been one anonymous complaint made to the home. Leaders have robustly investigated this in line with the home’s policies and procedures.

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good

Shortfalls in management monitoring have meant that potentially serious issues are not identified quickly enough. Managers have appropriately focused on supporting staff and children through an unsettled period in the home. However, they have not been thorough enough in reviewing plans and assessments. Senior leaders have acknowledged the shortfalls, and already have plans in place to monitor the home carefully as it continues to develop. Inspection report for children’s home: 1278966 5 Managers have failed to review, analyse and evaluate records. For example, children’s personal evacuation plans in the event of a fire do not include all required information. In addition, managers have not realised that visual checks on children have not been recorded as they should have been at specified intervals. Also, managers have not identified some gaps in children’s daily diaries.

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good

Electronic recording systems have been implemented, with a desire for the home to be a paperless organisation. However, these systems are still in their infancy. As a result, managers struggled to evidence some electronic records, for example the completion of exit interviews when staff have left. This prevents lessons from being learned around staff retention.

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good

Local authority plans for the children are out of date. Despite the efforts of the manager to escalate concerns, children do not have up-to-date care plans on file. As a result, the manager has not been able to ensure that the local authority plans inform the children’s relevant plans. This is an impediment to good care planning.

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good

The manager has not received regular formal supervision. Additionally, the manager has not ensured that all staff have received regular, reflective supervision. This fails to support the monitoring and reviewing of staff performance. Management oversight of supervisions is not robust. However, staff say they feel supported. Staff told inspectors that the manager operates an ‘open-door’ policy, ensuring that staff can always access guidance and advice. One staff member said: ‘The manager is a hands-on manager. I could not ask for a more supportive management team, they really are the best.’

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good

The staff undertake bespoke training which is tailored to the specific needs of the children. Staff can readily describe how the training has positively influenced their practice. Some gaps within training records were identified. However, this training is scheduled and will further support individualised care to be provided.

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good

Despite these shortfalls, the manager and deputy have strengths. Their energy and motivation have meant that the home has continued to function and care for children with complex needs during a period of high staff turnover. There is a focus on staff retention and well-being. Managers have introduced mental health first aiders in the workplace, well-being hampers and shopping vouchers to support staff with the cost-of-living pressures. Managers have a clear understanding of the actions that are required to improve the home. Inspection report for children’s home: 1278966 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

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

help each child to understand how to keep safe;

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Requirement Due date

manage relationships between children to prevent them from harming each other;

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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

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. (Regulation 12 (1) (2)(a)(i)(ii)(iv)(v)(b)(d))

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Requirement Due date

This specifically relates to ensuring that risk assessments reflect the needs of children and include guidance on how staff should respond to risks. It also relates to ensuring that maintenance works are completed to keep children safe. 28 November Inspection report for children’s home: 1278966 7 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 have the experience, qualifications and skills to meet the needs of 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

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)(c)(f)(h))

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Requirement Due date

This specifically relates to managers embedding monitoring systems in the home to improve the quality of care provided. It also relates to managers ensuring that all staff receive regular supervision and have the required training to meet the needs of children. 12 December

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home;

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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

manage and review the placement of each child in the home. (Regulation 14 (1)(a) (2)(b)(ii))

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Requirement Due date

This specifically relates to managers ensuring that the children’s care plans are accurate and up to date. 12 December Inspection report for children’s home: 1278966 8 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

medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them;

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

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Requirement Due date

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

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Requirement Due date

This specifically relates to managers ensuring that medication is stored safely and administered in line with the prescriber’s instructions. It also relates to the manager ensuring that all medication errors are thoroughly investigated in a timely manner and lessons learned are identified. 12 December

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Requirement Due date

within 24 hours of the use of the 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

details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the name of the person who used the measure ("the user"), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and 12 December Inspection report for children’s home: 1278966 9 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 signed the record to confirm it is accurate. (Regulation 35 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii))(b)(ii))

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Requirement Due date

This specifically relates to the manager ensuring that records of physical intervention include all required information.

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Recommendations

 The registered person should ensure that children are consulted regularly on their views about the home’s care, to inform and support continued improvements in the quality of care provided. Due consideration should be given to the cognitive ability in the development and implementation of any consultation processes. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 22, paragraph 4.11)  The registered person should ensure that children are offered a wide range of activities, both inside and outside the home (where appropriate), and are encouraged to participate in those activities. Staff should support children to take part in clubs, volunteering and leisure activities. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 31, paragraph 6.5)

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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: 1278966 10

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Smooth Stone Care & Education Ltd

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Children’s home details

Registered provider address: Datum House Electra Way, Crewe, Cheshire CW1 6ZF

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Inspectors

Zoey Lee, Social Care Inspector Linda Mason, Social Care Inspector Inspection report for children’s home: 1278966 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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Inspectors

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Inspectors

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Inspectors

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