Children's home run by Milton Keynes City Council

Inspection report for children’s home: SC052599 1 SC052599 Registered provider: Milton Keynes Council Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is owned and managed by a local authority. It provides care for up to 10 children aged between five and 19 years. According to the home’s statement of purpose, the home provides residential short breaks and day care for children with learning disabilities.

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Information about this children’s home

At the time of the inspection, the home was providing short breaks and an emergency placement in another area of the building (the annex). Inspectors considered the progress and experiences of children using the short-breaks service and the annex.

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Information about this children’s home

The manager has been registered with Ofsted since 1 August 2021.

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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 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

Date of last inspection: 10 January 2022

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report for children’s home: SC052599 2

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Inspection date Inspection type Inspection judgement

10/01/2022 Full Good 22/01/2020 Full Good 30/01/2019 Full Good 31/08/2017 Full Good Inspection report for children’s home: SC052599 3

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inadequate

The home is judged inadequate overall because of the care and support provided to a child living in the annex. He has a poor experience of care, and his welfare is not being promoted. The environment is unsafe and unwelcoming, and there are no clear plans in place for education, activities or healthy meals. The health and medication plans do not follow the same detailed format as for the children using the short-breaks service. The child has a very limited diet of highly processed food, which risks being detrimental to his health. Staff were not trained in the use of emergency medication until after the child had moved in; this presented a risk of harm.

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inadequate

Children visiting for short breaks are well cared for. Detailed plans enable staff to support children’s individual needs. When additional specialist training is needed, this is provided. Staff are assessed to ensure that they are competent to deliver care in relation to meeting the needs of children who need specialist support to eat. Staff use sign language and picture symbols to accommodate different communication needs.

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inadequate

Children visiting for short breaks do so in a way that meets their needs, and overnight stays are well planned. Strong links with external professionals mean that care and support are consistent. One parent said that work between the home and their child’s school has led to a huge improvement in areas of self-care.

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inadequate

Families of children who visit for short breaks talk positively about a staff team that knows their children well and provides personalised care and support. Staff demonstrate their knowledge about each child’s personality by tailoring activities to meet their sensory needs. One parent said that the team is very creative and gave an example of how an activity was adapted to enable their child to get the sensory feedback from kicking leaves by replicating this with ripped pieces of paper.

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inadequate

The relationships between staff and children in the short-breaks service are warm and nurturing. Children have fun and enjoy new experiences. A social worker for four of the children said, ‘The children all love it there, and the families get so much from their breaks.’

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inadequate

The child living in the annex does not have the same positive experiences. A small team of familiar staff gives some consistency. However, the engagement and commitment to provide the child with the same quality of care as that provided elsewhere in the home are not evident.

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inadequate

Furnishings in the annex are very sparse. Damage inside the annex includes broken and boarded-up windows, a missing internal door and broken electrical sockets. The external door needs repair and the garden is not safe, due to a broken shed and Inspection report for children’s home: SC052599 4 fence panel. All appliances have been removed from the kitchen, and one bathroom has had the toilet removed because it is broken and not safe to use.

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inadequate

Some of the decor and furnishings in the rest of the home look tired and worn. Plans are in place to redecorate bedrooms and to have two bathrooms and a kitchen renovated. This is intended to make the home brighter and the access easier for personal care tasks.

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

The home is inadequate because the safety and welfare of the child living in the annex are not being promoted. The annex does not provide a safe environment. Sharp edges on broken windows and door frames, and a broken fence panel, mean that staff must be extra vigilant to protect children from injury.

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

Staff in the annex are trained in a different behaviour model to the staff in the short-breaks area of the home. This means that joint working and effective management oversight are not consistent. Records of restraint in the annex are poor and do not contain sufficient information to evidence that physical interventions are carried out safely and only when necessary. Following an incident, managers did not speak to the child and staff about ways to minimise the risk of a repeat incident.

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

Management oversight and review of risks in the annex are not effective in maintaining a safe environment. Maintenance and repairs have not been carried out promptly to make the place safe and suitable for a child to live in.

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

Children on short breaks very rarely need to be physically restrained. When a child’s behaviour means that they or someone else are in danger, and they do need staff to physically intervene, this is done safely and effectively. The manager reviews incidents and explores ways to minimise the risk. Additional staffing has been sourced for one child who needs two-to-one support to be cared for safely.

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

A recent fire safety audit highlighted areas for action and consideration, including the need to review monitoring equipment and to repair some of the fire doors. The manager acted quickly to put plans in place to address some of the immediate concerns, to ensure that preventable risks are managed in the event of a fire.

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

There are not always enough staff on duty to carry out personal emergency evacuation plans in the event of a fire. During the inspection, the manager took immediate action to review these plans and to ensure that sufficient staff were on duty.

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

For children on short breaks, staff understand their needs and vulnerabilities. Children’s care and safety plans are kept under review and staff adapt their care practice in response to children’s needs and presenting behaviours.

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

The registered manager ensures that staff working in the short-breaks service are recruited using safer recruitment practice. The same scrutiny has not been given to Inspection report for children’s home: SC052599 5 the recruitment of agency staff in the annex. These members of staff are supplied by an external agency and the manager was unable to obtain full and satisfactory checks to ensure they are suitable to provide good care for the child living in the annex.

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

Complaints are very rare. When the manager does receive a complaint, it is taken seriously and dealt with promptly. Things that children want to improve are shared through a ‘wishes box’. The ‘wishes’ are reviewed in weekly team meetings and changes made, or feedback is given to the children on the progress towards acting on their wishes. One example during the inspection was a request by a child to go to a trampoline park. This was then booked for the child’s next visit to the short- breaks service.

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

Children’s access to the internet is carefully managed. Time on tablets and devices is minimal, due to children accessing other activities. When children do have internet access, it is monitored by staff. Additional parental controls ensure that content is age appropriate.

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

Children using the short-breaks service receive their medication from trained staff, who have specialist training and are assessed as competent by a qualified health professional.

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

In the annex, there was a discrepancy when a controlled dose of medication was not administered. This was not reported. This meant that reflection and learning on ways to avoid a repeat error did not take place.

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The effectiveness of leaders and managers: inadequate

A lack of oversight from leaders and managers of the annex has resulted in poor practice in an unsafe environment and inadequate standards of care for the child living there. The manager had limited oversight of records and care practice. This meant that there were gaps in reporting, including safeguarding, administration of medication and behaviour management that were not detected or addressed.

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The effectiveness of leaders and managers: inadequate

In the short-breaks service, the manager knows the children well and ensures that they receive the care and support required to meet their needs. Staff talk positively about the progress that children make, and they celebrate all achievements.

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The effectiveness of leaders and managers: inadequate

The manager provides good direction and support to the staff in the short-breaks service. She leads a dedicated and well-established team of staff, some of whom have been working in the home for over 20 years. One staff member said, ‘The manager and deputy manager work really hard and are a great management team. They are supportive, approachable and non-judgemental, and keep us motivated.’

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The effectiveness of leaders and managers: inadequate

A requirement made at the last inspection regarding the management reports on the quality of care that are required to be sent to the regulator has not been met and is therefore repeated. Additionally, since the last inspection, the registered provider Inspection report for children’s home: SC052599 6 has failed to inform Ofsted on two occasions when there has been a change to the responsible individual. Inspection report for children’s home: SC052599 7

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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

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

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Requirement Due date

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

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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)(iii)(vi)(b)(d))

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Requirement Due date

In particular, ensure that the home environment in the annex is safe and suitable. 5 April 2023

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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 5 April 2023 Inspection report for children’s home: SC052599 8 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

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding;

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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)(ii)(iv))

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Requirement Due date

In particular, a healthy diet should be provided to all children.

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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

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

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

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

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Requirement Due date

In particular, ensure that there is effective management oversight of the quality of care provided to all children using the service. 5 April 2023 Inspection report for children’s home: SC052599 9 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. (Regulation 23 (1) (2)(a)) 5 April 2023

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Requirement Due date

If the Regulatory Reform (Fire Safety) Order 2005(1) applies to the home—

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Requirement Due date

the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home. (Regulation 25 (2)(a)(b))

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Requirement Due date

In particular, ensure that children’s evacuation plans are effective in the event of a fire and that the actions from the fire safety audit are carried out in a timely way. 5 April 2023

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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

the individual is of integrity and good character;

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform;

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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 registered person may permit an individual to start work at the home despite the fact that the requirement in paragraph (3)(d) has not been met if—

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Requirement Due date

the registered person has taken all reasonable steps to obtain full information about each of the matters in Schedule 2 in respect of the individual, but the enquiries in relation to any of the matters in paragraphs 3 to 6 of Schedule 2 are incomplete; 5 April 2023 Inspection report for children’s home: SC052599 10 full and satisfactory information in respect of the individual has been obtained in relation to the matters in paragraphs 1 and 2 of Schedule 2;

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Requirement Due date

the registered person ensures that the individual is appropriately supervised while carrying out the individual’s duties, pending receipt of any outstanding information on the matters in paragraphs 3 to 6 of Schedule 2, which is then considered satisfactory by the registered person.

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Requirement Due date

The registered person must take reasonable steps to ensure that any individual who is working at the home and who does not fall within paragraph (2)(a) and (b) is appropriately supervised while carrying out the individual’s duties. (Regulation 32 (1) (3) (a)(b)(d) (7) (a)(b)(d) (8))

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Requirement Due date

In particular, when recruiting agency staff, the registered person must be satisfied that staff are suitably trained and experienced to meet the children’s needs.

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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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a description of the measure and its duration;

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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; 5 April 2023 Inspection report for children’s home: SC052599 11 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 (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 complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months.

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1) (2)(a)(b)(c) (5)) 5 April 2023

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Requirement Due date

The registered person must give notice in writing to HMCI, as soon as it is reasonably practicable to do so, if any of the following events take place or are expected by the registered person to take place—

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Requirement Due date

if the registered provider is an organisation—

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Requirement Due date

any change in the identity of the responsible individual. (Regulation 49 (e)(iii)) 5 April 2023 Inspection report for children’s home: SC052599 12

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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: SC052599 13

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Children’s home details

Registered provider address: Milton Keynes Council, Saxon Court, 502 Avebury Boulevard, Milton Keynes MK9 3HS

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Children’s home details

Responsible individual: Victoria Courtis

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Inspectors

Sara Stoker, Social Care Inspector Tony Waite, Social Care Inspector Inspection report for children’s home: SC052599 14 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 looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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