Children's Home run by Grace Care Limited in Nottingham

Inspection report for children's home: SC436818 1 SC436818 Registered provider: Grace Care Limited Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This home is owned by a private provider and is registered to provide care for up to three children with learning disabilities.

p.1

Information about this children’s home

The manager is registered with Ofsted and is suitably qualified and experienced. They are currently absent from the home and were not present for this inspection.

p.1

Information about this children’s home

The inspectors spent time with the children during this inspection.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

inadequate

How well children and young people are helped and protected inadequate

p.1

inadequate

The effectiveness of leaders and managers inadequate

p.1

inadequate

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

p.1

inadequate

Date of last inspection: 17 January 2023

p.1

inadequate

Overall judgement at last inspection: inadequate

p.1

Enforcement action since last inspection:

A compliance notice was set under regulation 13, the leadership and management standard, at the last full inspection, on 17 January 2023. This was reviewed during a monitoring visit on 3 March 2023 and the actions had been met. Inspection report for children's home: SC436818 2

p.1

Inspection date Inspection type Inspection judgement

17/01/2023 Full Inadequate 05/01/2022 Full Good 03/04/2019 Full Good 09/05/2018 Full Good Inspection report for children's home: SC436818 3

p.2

inadequate

Children receive unsafe and inconsistent care. Care planning is poor. Children’s plans do not accurately reflect their needs and are not regularly reviewed or updated. Some elements of care, such as monitoring children through surveillance, are not risk assessed or included in care plans. There is no evidence that plans are routinely shared with staff. This prevents staff from having a clear understanding of the children’s needs and has led to inconsistent care being provided. Children’s care is variable because staff do not work to an agreed plan. Children’s care plans are not routinely shared with their social workers.

p.3

inadequate

Children’s communication needs are not met. Staff do not use consistent means of communicating with each child. It is difficult for children to communicate in the home because resources they need are not accessible to them. For example, picture cards are kept in locked cupboards, and children are dependent on staff for providing this resource. Staff do not consistently use children’s communication devices, which further limits children’s ability to communicate their needs.

p.3

inadequate

Staff do not understand children’s health needs. They do not know why children take certain prescribed medications. One child has not taken medication since this was prescribed and staff have taken no action in response to this. Children’s health is not routinely monitored, and staff do not share information with medical professionals.

p.3

inadequate

Children’s dignity is not consistently respected. Staff use video and listening surveillance devices to observe children when they are in their bedrooms and overnight. The use of these monitors has not been risk assessed or agreed with external professionals. This practice prevents children from having privacy in line with their age and understanding. When undertaking personal care such as bathing, doors are not always closed, which allows anyone in the vicinity to be able to see the child.

p.3

inadequate

Children have access to activities in the home and community, such as swimming and attending a local gym. However, activities can be variable, depending on which staff are on duty. For example, one child was observed to be in their bedroom for most of the day with little engagement from staff, but the following day they were taken out into the community and spent some positive, meaningful time with staff.

p.3

inadequate

Children have limited communal space in the home and cannot freely access this space. The sensory room and dining room are both used as staff bedrooms. The staff’s fold-up bed is stored in the dining room and this impacts on the children’s homely environment. Children can no longer access the sensory room, which for one child is part of their care plan. All the downstairs doors are locked, without a clear rationale for this. Children are reliant on staff allowing them into rooms, including the kitchen, and they cannot freely access drinks and food. Inspection report for children's home: SC436818 4 Leaders were unable to provide inspectors with a children’s guide. The recommendation made at the previous inspection in relation to this has therefore been restated.

p.3

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

Children’s risk assessments are of poor quality, not regularly reviewed and not reflective of the children’s needs. Risks are not known and understood by staff. For example, self-harm is used as a generic term and strategies for management of self- injurious behaviour are vague. This places children at risk of harm as staff do not know how to manage risk.

p.4

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

Staff do not consistently follow agreed supervision levels for children. Children have been left unsupervised or without sufficient staff to manage their needs. On one occasion, contrary to a child’s risk assessment, a child was left unsupervised. They were able to access the staff office and remove their electronic device [I-pad] without staff knowing. This placed the child at risk of harm.

p.4

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

Incidents involving children are not consistently recorded or shared by staff with the manager or external professionals. This prevents oversight of staff practice and learning from incidents. Children are not routinely spoken to following incidents and this prevents them from expressing their views.

p.4

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

Some hazards were identified in the physical environment. For example, fire exits are key-locked, and staff do not consistently follow the risk assessment in place to mitigate risk. This places children, staff and visitors at risk of harm and potentially unable to evacuate the home in the event of a fire. The fire risk assessment is inaccurate and describes a fire exit that does not exist. This inaccuracy has not been challenged by the management team.

p.4

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

Children were observed to be playing with broken play equipment which posed a risk of physical injury to them. Staff do not consistently use protective equipment when completing personal care. Some doors have been left unlocked, such as the room where cleaning materials are stored and the staff office. This places children at risk of harm.

p.4

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

There have been allegations of bullying and poor staff practice in the staff team. Despite management instruction, staff continue to use their personal mobile phones when working with the children. This has the potential to place children at risk of harm when they are not being appropriately supervised by staff.

p.4

The effectiveness of leaders and managers: inadequate

Leadership and management of the home are weak and ineffective. Both the responsible individual and the registered manager have been absent for over a month. The responsible individual for another home has now assumed responsibility for day-to-day management and is being supported by the director. Inspection report for children's home: SC436818 5 The management team has not had effective oversight of the home. Systems and processes in place have not identified the shortfalls in the care of children. Concerns that have been raised about staff practice have not been adequately addressed and have continued. This has not provided children with safe and consistent care.

p.4

The effectiveness of leaders and managers: inadequate

There is instability in the staff team and staff from another home and agency staff have been providing additional support to cover the shortfalls. This does not provide children with consistency and prevents them from developing secure relationships with staff. Staff do not work together as a team, and this has led to confusion when planning shifts as staff are not being given clear direction and guidance.

p.5

The effectiveness of leaders and managers: inadequate

Not all staff are sufficiently trained or experienced to manage the complex needs of the children. Some staff have not completed specific training relevant to children’s needs, which would provide them with greater knowledge and understanding. Some staff have not completed any form of safeguarding training, including safeguarding of children with disabilities. This prevents staff from understanding the signs of abuse and their responsibilities in reporting any concerns. Inspection report for children's home: SC436818 6

p.5

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.

p.6

Requirement Due date

*The quality and purpose of care standard is that children receive care from staff who—

p.6

Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

p.6

Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

p.6

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.6

Requirement Due date

understand and apply the home’s statement of purpose;

p.6

Requirement Due date

understand and apply the home’s statement of purpose;

p.6

Requirement Due date

protect and promote each child’s welfare;

p.6

Requirement Due date

treat each child with dignity and respect;

p.6

Requirement Due date

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

p.6

Requirement Due date

help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult;

p.6

Requirement Due date

provide to children living in the home the physical necessities they need in order to live their comfortably;

p.6

Requirement Due date

make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice; 30 May 2023 Inspection report for children's home: SC436818 7 ensure that the premises used for the purpose of the home are designed and furnished so as to-

p.6

Requirement Due date

enable each child to participate in the daily life of the home; and

p.7

Requirement Due date

that the registered person keeps the child’s general medical practitioner informed, as necessary, about the progress of the care throughout its duration. (Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(iii)(iv)(vi)(vii)(ix)(c)(i)(ii) (3)(b)(d))

p.7

Requirement Due date

In particular this relates to children’s care plans not accurately reflecting their care needs, not being agreed with placing local authorities and not being shared with other professionals and the staff team.

p.7

Requirement Due date

*The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

p.7

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

p.7

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;

p.7

Requirement Due date

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

p.7

Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

p.7

Requirement Due date

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

p.7

Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies; 30 May 2023 Inspection report for children's home: SC436818 8 that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm;

p.7

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; and

p.8

Requirement Due date

that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (1) (2)(a)(i)(iii)(v)(vi)(vii)(b)(d)(e))

p.8

Requirement Due date

In particular, this relates to risk assessments not being reflective of the children’s needs, that poor practice concerns raised are not addressed and staff not ensuring the physical environment is safe for the children.

p.8

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—

p.8

Requirement Due date

helps children aspire to fulfil their potential; and

p.8

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.8

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;

p.8

Requirement Due date

ensure that staff work as a team where appropriate;

p.8

Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

p.8

Requirement Due date

ensure that the home has sufficient staff to provide care for each child;

p.8

Requirement Due date

ensure that the home’s workforce provides continuity of care to each child;

p.8

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; 30 May 2023 Inspection report for children's home: SC436818 9 use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(a)(b)(c)(d)(e)(f)(h))

p.8

Requirement Due date

In particular, this relates to leaders not implementing systems and processes to monitor the home effectively, to address staffing concerns and ensure all staff receive suitable training.

p.9

Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if—

p.9

Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children;

p.9

Requirement Due date

the child’s placing authority consents in writing to the monitoring or surveillance;

p.9

Requirement Due date

so far as reasonably practicable in the light of the child’s age and understanding, the child is informed in advance of the intention to do the monitoring or surveillance; and

p.9

Requirement Due date

the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy. (Regulation 24 (1)(a)(b)(c)(d))

p.9

Requirement Due date

In particular, this relates to the use of video and listening devices to monitor children in the home. 30 May 2023

p.9

Requirement Due date

After consultation with the fire and rescue authority, the registered person must—

p.9

Requirement Due date

provide adequate means of escape from the home in the event of fire. (Regulation 25 (1)(b))

p.9

Requirement Due date

In particular, this relates to risk management and processes for locking all doors in the home, including the fire door. Also, to the fire risk assessment not accurately describing the fire exit door when considering risk. 30 May 2023

p.9

Requirement Due date

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

p.9

Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child; 30 May 2023 Inspection report for children's home: SC436818 10 are kept up to date;

p.9

Requirement Due date

are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c))

p.10

Requirement Due date

In particular, this relates to not keeping children’s files and plans up to date.

p.10

Requirement Due date

*These requirements are subject to a compliance notice.

p.10

Recommendation

 The registered person should ensure that care is provided which meets each child’s needs and promotes their welfare, taking into account the child’s disability, their assessed needs and any relevant plans. This specifically relates to ensuring that the children’s guide is produced in a way that is tailored to each child’s communication needs. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 14, paragraph 3.2)

p.10

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: SC436818 11

p.10

Children’s home details

Registered provider address: 77 Boundary Road, West Bridgford, Nottingham NG2 7DB

p.11

Children’s home details

Responsible individual: Beverley Russell

p.11

Inspectors

Sarah Orriss, Social Care Inspector Ellen Monk, Social Care Inspector Inspection report for children's home: SC436818 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 looked after children, safeguarding and child protection.

p.11

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.12

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.12

Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

p.12