Children's Home run by Ivory Cottage Limited in Worcestershire

Assurance inspection report for children’s home: 2633744 1 Registered provider: Ivory Cottage Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

This home is operated by a private company. It provides care for up to three children who may have experienced childhood instability resulting in trauma and associated complex behaviours.

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Information about this children’s home

The registered manager post is currently vacant.

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Information about this children’s home

Date of last inspection: 22 November 2022

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Information about this children’s home

Judgement at last inspection: requires improvement to be good

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Information about this children’s home

Enforcement action since last inspection: none

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Information about this inspection

At this inspection, the inspector evaluated:

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Information about this inspection

 the care of children  the safety of children  the effectiveness of leaders and managers. Inspectors have looked closely at the experiences and progress of children, using the social care common inspection framework. This assurance 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’. Assurance inspection report for children’s home: 2633744 2

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Findings from the inspection

We identified the following serious and widespread concerns in relation to the care or protection of children at this assurance inspection:

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Findings from the inspection

 Leaders and managers have failed to keep the children safe.

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Findings from the inspection

 Ofsted has not been notified of serious events as required by regulation.

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Findings from the inspection

 There has been ineffective monitoring and reviewing of the service, which has impacted on the quality of care that children have received.

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Findings from the inspection

 Children are not helped to keep themselves safe when risks are identified.

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Findings from the inspection

 Children’s records are not kept up to date.

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The care of children

Managers have not adequately planned for the arrival of new children in the home. For example, one child moved into the home without the manager fully considering the child’s needs, risks or behaviours. In addition, significant information provided by the local authority had been omitted from the provider’s impact risk assessment. As a result, the child did not receive care in line with their needs and was placed at risk of significant harm.

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The care of children

Children’s plans do not contain up-to-date information relating to their specific and individual care needs. For example, the plans do not provide suitable information in relation to children’s behavioural needs. This means staff are not provided with guidance to ensure that they provide care that meets children’s needs. This impacts on the quality of care provided to children.

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The care of children

Since the last inspection, the home has been redecorated. The soft furnishings create a warm and homely feel. Children’s rooms are personalised to their taste and are kept clean and tidy.

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The safety of children

Children’s risk assessments are poor. For one child, who presents with risks of child sexual exploitation, managers have not ensured that staff have fully explored this risk, or that risk management strategies are in place to help reduce the potential harm to the child. Consequently, the child’s vulnerability and exposure to risk have increased.

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The safety of children

Managers’ oversight of safeguarding arrangements to protect children is ineffective. Managers do not monitor, review and evaluate significant incidents such as missing from care episodes. During the inspection, managers were unable to demonstrate Assurance inspection report for children’s home: 2633744 3 records about the incidents and subsequent records to demonstrate appropriate risk management. This lack of action places children at risk of harm.

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The safety of children

Managers have failed to demonstrate that they respond to allegations appropriately. For example, during the inspection, the director was unable to provide the inspector with a clear overview of an allegation made by a child towards a member of staff. The director informed the inspector that this had been investigated. However, they were unable to evidence this due to the information being held in a locked cabinet, which, at the time of the inspection, the director was unable to gain access to. This did not satisfy the inspector that the appropriate action was taken to ensure the safety and welfare of the child.

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The safety of children

Leaders and managers have failed to notify Ofsted of significant incidents involving children. For example, on one occasion, a child was reported missing from the home and significant concerns were identified around a sexual assault. On another occasion, Ofsted was not notified when a child made an allegation against a member of staff. As a result, Ofsted is unable to carry out its monitoring function to ensure that appropriate action is taken by the provider to safeguard children.

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The effectiveness of leaders and managers

There has been no registered manager since January 2023. Furthermore, the home’s operational manager and deputy have left the home. The director has made the decision to manage the home on an interim basis until a registered manager has been appointed. However, this only took effect as of 20 March 2023. The director’s skills and ability in undertaking this role are still to be determined, and it is expected that the director should apply to be registered with Ofsted in the absence of a suitable alternative manager.

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The effectiveness of leaders and managers

A responsible individual has been appointed. However, the director has not provided the required information to Ofsted to demonstrate that she has sufficient skills, knowledge and experience to fulfil the role.

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The effectiveness of leaders and managers

Managers’ monitoring is inadequate. They have not actively or regularly monitored the quality of care provided to the children. They have not ensured that children’s plans are up to date and reflective of their individual needs. This lack of oversight means that staff are not working with the most up-to-date information. This means that children receive an inconsistent quality of care from staff.

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The effectiveness of leaders and managers

Reporting and recording is poor. For example, some documents have not been reviewed or scrutinised for errors. Managers fail to oversee incidents and records comprehensively. This means that staff are not challenged when their approach falls short of good practice comprehensively.

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The effectiveness of leaders and managers

During this inspection, Ofsted identified significant shortfalls in the provider’s safeguarding practice due to ineffective leadership and management arrangements. As a result of the shortfalls identified, a notice of restriction of accommodation and a Assurance inspection report for children’s home: 2633744 4 compliance notice against regulation 13, the leadership and management standard have been raised. Assurance inspection report for children’s home: 2633744 5

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Inspection date Inspection type Inspection judgement

22/11/2022 Full Requires improvement to be good 15/02/2022 Full Requires improvement to be good 24/11/2021 Full Inadequate Assurance inspection report for children’s home: 2633744 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

have the skills to identify and act upon signs that a child is at risk of harm;

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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

take effective action whenever there is a serious concern about a child’s welfare;

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii))

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Requirement Due date

This specifically relates to staff understanding and implementing children’s risk assessments, the monitoring and supervision of children, and their role in keeping children safe. 28 May 2023 Assurance inspection report for children’s home: 2633744 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;

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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

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)(c)(f)(h))

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Requirement Due date

This specifically relates to the manager ensuring that they have monitoring and reviewing systems in place that identify shortfalls effectively. 28 May 2023

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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; and 28 May 2023 Assurance inspection report for children’s home: 2633744 8 that each child’s relevant plans are followed. (Regulation 14 (1)(a) (2)(b)(ii)(d))

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Requirement Due date

This specifically relates to children having up-to-date plans that are reflective of their needs.

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Requirement Due date

An individual may only carry on a children’s home if the individual satisfies the requirements in paragraph (5).

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Requirement Due date

the individual is of integrity and good character;

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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;

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Requirement Due date

the individual is mentally and physically fit to carry on the home; and (d) the individual is financially fit to carry on the home. (Regulation 26 (a)(b)(c)) 28 May 2023

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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

how appropriate behaviour is to be promoted in the children’s home;

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Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home.

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Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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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

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; 28 May 2023 Assurance inspection report for children’s home: 2633744 9 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

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Requirement Due date

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 spoken to the user about the measure; and

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Requirement Due date

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 (1)(a)(b) (2) (3)(a)(i)(ii)(iii)(iv) (v)(vi)(vii)(viii)(b)(i)(ii)(c))

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Requirement Due date

The registered person must maintain records ("case records") for each child which—

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Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

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Requirement Due date

are kept up to date. (Regulation 36 (1)(a)(b)) 28 May 2023

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation;

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Requirement Due date

an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious;

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Requirement Due date

there is an allegation of abuse against the home or a person working there; 28 May 2023 Assurance inspection report for children’s home: 2633744 10 a child protection enquiry involving a child—

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Requirement Due date

concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4) (a)(b)(c)(i)(ii))(e)

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendations

 The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 61, paragraph 13.2) Assurance inspection report for children’s home: 2633744 11

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Children’s home details

Registered provider address: Ivory Cottage Ltd, Skytax, 37th Floor, One Canada Square, Canary Wharf, London E14 5AA

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Inspector

Lydia Isaac, Social Care Inspector Assurance inspection report for children’s home: 2633744 12 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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