Children's Home run by BTTLR Limited in West Northamptonshire

Inspection report for children’s home: 2556338 1 Registered provider: BTTLR Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is privately owned and provides care for one child who may be experiencing emotional, social and behavioural difficulties.

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Information about this children’s home

There has been no registered manager at the home since January 2022.

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

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inadequate

Overall judgement at last inspection: requires improvement to be good

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inadequate

Enforcement action since last inspection: none Inspection report for children’s home: 2556338 2

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Inspection date Inspection type Inspection judgement

Good Inspection report for children’s home: 2556338 3

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inadequate

Widespread failures in the protection of children and leadership mean that children have poor care experiences and do not make progress. The provider was judged requires improvement to be good at the last full inspection, with inadequate leadership. Several statutory requirements remain unmet, with additional requirements set at this inspection. There has been no evidence of improvement during the inspection period, contributing to this inadequate judgement.

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inadequate

There were no children living at the home at the time of the inspection. One child has recently left the home in an unplanned way, having only lived here for several days. She arrived from a hospital late at night while experiencing a mental health crisis, and sadly left in the same manner. The circumstances of her arrival and departure were not positive and likely added to the child’s trauma. The placing authority stated, ‘It is disappointing the placement ended so quickly, this should have been a long-term home for the child.’

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inadequate

One child who lived at the home was not able to build trusting and secure relationships with staff. This affected the quality of care that she received. During her time here, her physical and emotional health deteriorated to such dangerous levels that she was admitted to hospital and sectioned under the Mental Health Act. The attempts of staff to support the child were ineffective which impacted on the progress she was able to make. Given the circumstances of her departure, she was unable to have a positive goodbye. She celebrated her sixteenth birthday while living here, which the inspector was told was a success.

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inadequate

Arrangements for children to access and receive specialist help have not been effective. The acting manager, at times, has advocated for children and challenged professionals to find the right care for children. Crucial training that could have enabled staff to better meet children’s needs has not been provided. This has resulted in poor experiences for children and safeguarding incidents that could have been avoided.

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inadequate

One child has not been able to access and engage in education while they have lived at the home. Staff have not been able to overcome the barriers to accessing education, despite a placement being identified. Staff have not been able to motivate and encourage the child to get back into education. They have not been able to devise a daily routine of educational activities. This has prevented the child from succeeding at a critical point in her childhood education. Another child only lived here for five days which did not provide ample opportunity to establish an education package. Inspection report for children’s home: 2556338 4

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

Children’s risk assessments are poor quality and not reflective of children’s complex needs and trauma histories. Some risks are not known and comprehensively understood by staff. Information from placing authorities gathered pre-admission is not used effectively to inform decision-making and care planning. For example, self- harm is used as a generic term and strategies for the management of self-injurious behaviour are vague. Specific risks from overdoses, choking risks, and ingesting harmful substances are not covered adequately. This places children at risk of harm as staff do not know how to manage specific risks.

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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 several occasions, contrary to a child’s risk assessment, care plan and deprivation of liberty order, a child was left unsupervised and without the agreed adult ratios. This resulted in several safeguarding incidents where children attempted to hurt themselves and others. For example, during a home visit, one child took a suspected overdose of someone else’s prescribed medication during a period of time that she was without staff supervision, resulting in an emergency hospital admission. Staff have repeatedly called emergency services to manage children’s behaviours as they themselves were unable to cope. This poor safeguarding practice places children at risk of harm.

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

Incidents of physical intervention are not consistently recorded. Inadequacies in report writing mean that it is difficult for managers to properly evaluate the quality of care. Managers told the inspector that additional report-writing training has been given to staff, but with little positive impact. Incidents involving the managers are not evaluated by a senior manager or other independent person. This prevents oversight of staff practice and learning from incidents. Leaders cannot assure themselves that care practices are safe and that children are protected from harm. Children are not routinely spoken to following incidents and this prevents them from expressing their views.

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

Some hazards were identified within the physical environment. For example, a locked fire door had been implemented to prevent a child from accessing a kitchen area. This also prevented access to a rear fire escape, should this be needed in the event of an emergency. There is no fire risk assessment in place to mitigate this risk and staff are not advised on how to manage this risk. This unsafe practice places children, staff and visitors at risk of harm and potentially unable to evacuate the home in the event of a fire.

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

Medication errors and discrepancies identified by the inspector had not been identified by managers. This means that responses to medication errors are inadequate and could have significant implications for children with complex health needs. Staff do not always follow the home’s medication processes adequately, and some staff have not attended the required training. Records of medication administration and auditing are exceptionally poor. The disposal of medicines is not always done safely and is not clearly documented, which, again, prevents a clear Inspection report for children’s home: 2556338 5 evaluation of care practices in the home. The storage and administration of medication in the home is not safe. Controlled drugs that are prescribed to children are not recorded in line with good-practice recommendations.

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

Agency staff working at the home do not undergo the required pre-employment checks before they work with children. Managers do not pay attention to the checks required by the regulations. For example, three agency workers have insufficient references, dated Disclosure and Barring Service checks, and no employment history gathered. This increases the risk of unsuitable people working at the home. Agency staff do not receive an appropriate induction before working with children in the home. Managers do not assure themselves that all staff have the necessary experience and skills to meet the children’s needs.

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The effectiveness of leaders and managers: inadequate

There has been no registered manager since January 2022. Leadership was judged inadequate at the last full inspection in 2022 and has remained inadequate. There were no children living in the home between July 2022 and November 2022. Interim management arrangements have not been effective. The home is still without a robust leadership team. The current manager and senior manager who have been in post less than a year have both resigned. All managers’ report a lack of trust among the leadership group, which prevents them from working as an effective team.

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The effectiveness of leaders and managers: inadequate

The management team has not had effective oversight of the home. Systems and processes in place have not identified the shortfalls in the care and protection of children. Concerns identified by the inspector have not been adequately addressed and have been allowed to continue. This has not provided children with safe and consistent care.

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The effectiveness of leaders and managers: inadequate

The home is not adequately staffed to meet the needs of the children being admitted. All the staff are new to their employment and remain in a probation period. Only one staff member has the relevant qualification required by regulations. Many of the staff lack the required residential childcare experience. Most staff have been recruited from overseas through the director’s sponsorship licence. The team is still developing. At times, they have been unable to cope with the demands of children’s complex health and care needs, often relying on managers or emergency services to resolve incidents.

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The effectiveness of leaders and managers: inadequate

Not all staff are sufficiently trained or experienced to manage the complex needs of the children. Children who have lived here during this inspection period have diagnosed eating disorders and emerging mental health conditions, resulting in frequent hospital admissions for emergency care and treatment. Staff have not completed specific training relevant to those children’s needs, which would have provided them with a greater knowledge and understanding. Some staff have not completed medication training. The catalogue of training available appears to be basic and most is covered online as self-directed learning. This prevents staff from developing as competent childcare professionals and from having a comprehensive understanding of complex care needs. Inspection report for children’s home: 2556338 6 The home’s statement of purpose is a misleading document. The provider states that children and staff benefit from the specialist care and services of a qualified

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The effectiveness of leaders and managers: inadequate

occupational therapy doctor. Neither child who has lived here in this inspection period has benefited from such a service. Staff and managers told the inspector that they had never met the doctor and were not able to evidence such a service.

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The effectiveness of leaders and managers: inadequate

Leaders have not taken sufficient action in relation to the previous statutory requirements. Those, along with additional requirements, have been reset. Any planned action and progress are now likely to be hindered by the resignation of the current manager and senior manager. The responsible individual is in day-to-day charge of the home. She advised the inspector that she is keen to recruit and appoint a new management team to improve the care of children.

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The effectiveness of leaders and managers: inadequate

The current leadership, management and staffing arrangements are not sufficiently robust or safe to manage children’s needs. Safeguarding practice is ineffective and has failed to prevent children from coming to harm. Inspection report for children’s home: 2556338 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

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

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; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

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

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Requirement Due date

This is with specific reference to staff understanding and following children’s risk assessments and care plans in 1 August 2023 Inspection report for children’s home: 2556338 8 relation to known safeguarding risks. It also relates to ineffective safeguarding practices when the child was being cared for away from the children’s home.

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential;

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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 work as a team where appropriate;

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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)(b)(c)(f)(h))

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Requirement Due date

This is with specific reference to leadership in the home. There has been no registered manager since January 2022. The current post holder has resigned. This impacts on stability for both children and staff. This also relates to ensuring an appropriate skill and experience mix throughout the staff team of adults who are qualified and experienced to work with children. It also relates to a lack of robust management monitoring and review systems which impacts on the quality of children’s care. 1 August 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; and 1 August 2023 Inspection report for children’s home: 2556338 9 have a positive experience of arriving at or moving on from the 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

that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14 (1)(a)(b) (2)(a))

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Requirement Due date

This specifically relates to leaders welcoming only children into the home who’s known and presenting risks and needs can be met. It also relates to the delivery of care being in line with the statement of purpose.

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Requirement Due date

Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (5)) 1 August 2023

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. 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)) 1 August 2023

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Requirement Due date

The registered provider must appoint a person to manage the children’s home if—

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Requirement Due date

there is no registered manager in respect of the home (Regulation 27 (1)(a)) 1 August 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 requirements are that— 1 August 2023 Inspection report for children’s home: 2556338 10 full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (3)(d))

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Requirement Due date

ensure that each employee completes an appropriate induction. (Regulation 33 (1)(a)) 1 August 2023

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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;

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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

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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 1 August 2023 Inspection report for children’s home: 2556338 11 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.

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Requirement Due date

(Regulation 35 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(iv))

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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: 2556338 12

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Children’s home details

Registered provider address: Enterprise Centre East Northants, Unit 3, Michael way, Warth Park, Raunds, Wellingborough, Northampton, NN9 6GR

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Children’s home details

Responsible individual: Shamiso Ringisai

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Inspector

Rachael Sprigg, Social Care Inspector Inspection report for children’s home: 2556338 13 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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