Children's Home run by Abbey Green Therapeutic Children’s Services Ltd in Nottinghamshire

Inspection report for children's home: 2700720 1 Registered provider: Abbey Green Therapeutic Children’s Services Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is run by an independent provider. It provides care for up to three children who may have social and emotional difficulties.

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Information about this children’s home

The home has a suitably experienced registered manager who has managed the home since it was first registered on 3 November 2022.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: not applicable

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requires improvement to be good

Enforcement action since last inspection: none Inspection report for children's home: 2700720 2

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Recent inspection history

Not previously inspected Inspection report for children's home: 2700720 3

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improvement to be good

This is the home’s first inspection. While children have made progress from their starting points, some aspects of the care provided need to improve.

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improvement to be good

Children are cared for by committed staff. They support children to attend school. Children generally have good morning routines and make progress academically. One child attends a school which is a considerable distance from the home. Despite this, staff remain committed to supporting the child’s school placement and are positively maintaining this important routine. Information provided by education professionals is positive.

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improvement to be good

Staff support children to remain physically fit and healthy. For example, staff regularly play football with one child in the garden. Another child was supported to adopt a healthier lifestyle, to choose healthier foods and to join a gym.

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improvement to be good

Staff ensure that children attend regular health appointments, to ensure they remain healthy. The manager supports children to access psychological therapy. Additionally, psychotherapists join team meetings and have regular communication with children.

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improvement to be good

The home is generally clean and tidy. However, the downstairs area is not personalised for children. After children have gone to bed, staff lock all the downstairs rooms. If children want a snack or a drink at night-time, they need to ask staff, instead of being able to get these for themselves. The locking of communal areas has become routine and this has an impact on all the children. This practice is not in response to a specific child’s safety needs. Consequently, this practice restricts children from accessing all areas of their home without a good reason.

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improvement to be good

Children’s bedrooms do have some personal touches. Bedrooms are spacious and tidy. However, in one child’s room there was a rug rolled up in the corner that had a noticeable stain on it, which appeared to be blood. This rug had been stained since February 2023 and yet it had not been removed or suitably cleaned.

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improvement to be good

Children have raised their concerns about being restrained by staff. There have been incidents when children have been harmed while being restrained by staff. Although records of incidents and restraints are descriptive, they lack sufficient management oversight. For example, when children have been injured during a restraint and it has been deemed as accidental, the manager has not carried out a learning review to assess how practice can be adapted or improved to avoid injury in the future. Similarly, when staff have been injured during behavioural incidents, there has been Inspection report for children's home: 2700720 4 no meaningful review by the manager to determine what could be done differently in the future to keep staff safe.

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improvement to be good

Behaviour-management strategies employed by staff are therapeutically informed. For example, staff may hug or hold a child who is experiencing strong emotions. However, the recording of these incidents suggests that, at times, holds are actually a form of restraint, albeit a low-level restraint. Records compiled by staff have referred to situations where a child has ‘demanded to be let go’ or described a child as ‘trying to break free’. Also, the contextual information also suggests the use of low-level holds as opposed to a hug. Consequently, low-level holds are not always recorded. Furthermore, the effectiveness of behaviour-management techniques should be subject to regular review.

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improvement to be good

During one incident when a ‘deep pressure cuddle’ was used, the child banged heads with a member of staff. However, there is no evidence that the child was asked about their injury, as would be good practice, and expected after a low-level restraint.

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improvement to be good

Since moving into the home, one child has not had the opportunity to spend unsupervised time with their friends. The manager’s view is that the child has not been allowed to do this because of their behaviour, and the child must ‘earn trust’ before spending unsupervised time with friends. This view is shared by other professionals. However, no progress has been made in this area since December 2022. It remains unclear what steps the manager has taken to advocate on behalf of the child to move this situation forward. This is having a negative impact on the child because they want more independence and privacy and to be allowed time with friends.

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improvement to be good

Consequences are used in the home to manage children’s behaviour. However, they focus on removing items or privileges from children. The manager is not regularly reviewing these consequences to ensure that they are time limited and proportionate. Therefore, some are becoming ineffective and risk having an adverse effect. It is not always clear how staff plan to incentivise children to manage their behaviour and to help children make progress. Furthermore, it is not always clear that staff know what goals children want to work towards.

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good

The manager is committed to the children. He aims to bring stability to the home and, as a result, he hopes that the children’s risk-taking behaviours will reduce. The manager says that he ‘won’t give up on children’. This is a positive commitment to the children, recognising that their progress is not always linear. He has a plan to help the home get on track to become good.

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good

For one child who recently left the home, there is a plan to provide ongoing outreach support. The manager and staff have remained in regular contact with this child and have supported them to move into their new accommodation. Inspection report for children's home: 2700720 5 There is a lack of management evaluation regarding how effective the current behaviour management processes are. This relates to the routine locking of doors in the home, effectiveness of consequences used by staff and the quality of restraint practice and/or recording. Without purposeful evaluation and robust oversight, there is a risk that behavioural incidents for children may not reduce.

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good

When there is drift in children being able to achieve their goals, the manager is not yet advocating effectively on behalf of children to ensure there is no delay and drift in their plans. It is not always clear what goals children are working towards or how staff are supporting children to meet their goals.

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good

On occasion, safeguarding policies and procedures have not been followed. There have been two serious incidents that Ofsted has not been notified of. This prevents the regulator from having oversight of incidents in the home, to be assured that children are always being kept safe.

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good

The manager has not yet carried out an evaluative review of why children assault staff. Staff morale can be harmed due to being assaulted and there is a potential for staff burnout. The manager recognises that staff are at risk and, as a result, he has signposted staff to therapeutic support services.

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good

The staff are supported by the manager through regular professional supervision. The manager has increased staffing ratios to support one child with their behaviour and to help protect staff from harm. Staff are positive about the leadership in the home. Feedback from external professionals is also positive. Inspection report for children's home: 2700720 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 quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

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

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Requirement Due date

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

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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;

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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;

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Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child;

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Requirement Due date

enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b)(iv)(ix)(c)(i)(ii))

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Requirement Due date

This is specifically in relation to ensuring that children have access to communal areas of the home. If, in exceptional circumstances, this is not deemed safe, then the reasons should be child-specific, regularly reviewed and clearly recorded.

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Requirement Due date

The registered person should ensure that damaged items in the home are repaired or replaced. Additionally, they should ensure that stains are cleaned in a timely way. 15 June 2023

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due date

develop positive relationships with them; 15 June 2023 Inspection report for children's home: 2700720 7 engage with them;

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

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Requirement Due date

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

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Requirement Due date

ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare;

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Requirement Due date

help each child to express views, wishes and feelings;

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Requirement Due date

help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child;

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Requirement Due date

regularly consult children, and seek their feedback, about the quality of the home’s care;

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Requirement Due date

help each child to understand how the child’s privacy will be respected and the circumstances when it may have to be limited;

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Requirement Due date

help each child to prepare for any review of the child’s relevant plans and to make the child’s views, wishes and feelings known for the purposes of that review. (Regulation 7 (a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(v)(vi))

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Requirement Due date

Specifically, the registered person should ensure regular consultation with children and, when appropriate, advocate on their behalf. They should ensure that children’s wishes and feelings inform how their care is planned.

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Requirement Due date

Children should be given the opportunity to have privacy in the community, where possible. If this not deemed safe or appropriate, then the rationale for this needs to be clearly recorded.

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Requirement Due date

The registered person should regularly review consequences, their proportionality and effectiveness. Inspection report for children's home: 2700720 8 The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and promotes their welfare.

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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

demonstrate that practice in the home is informed and improved by taking into account and acting on— feedback on the experiences of children, including complaints received;

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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)(f)(g)(ii)(h))

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Requirement Due date

The registered person should ensure that monitoring systems are in place. These systems need to review effectively the quality of care and safety of children.

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Requirement Due date

The registered person should consider carrying out an evaluative review of why staff may be assaulted by children. They should implement new strategies to try and keep children and staff safer.

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Requirement Due date

The registered person should have measurable systems in place which can identify when children are making progress.

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Requirement Due date

When the registered person is not at work, management arrangements should still follow the necessary reporting processes to protect children. 15 June 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; and 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. 15 June 2023 Inspection report for children's home: 2700720 9 The registered person must ensure that—

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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

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. (Regulation 35 (a)(b)(2)(3)(a)(vii)(vii)(b)(i)(ii))

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Requirement Due date

The registered person should carry out an evaluative review of restraint practice.

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Requirement Due date

The registered person should support children to reflect on what makes them feel unsafe or anxious.

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Requirement Due date

When children are injured while being restrained, the registered manager should carry out a learning review to prevent this from happening again.

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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;

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Requirement Due date

a child protection enquiry involving a child —

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Requirement Due date

is instigated; or 15 June 2023 Inspection report for children's home: 2700720 10 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.

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Requirement Due date

A notification made under this regulation—

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Requirement Due date

the other persons, bodies or organisations (if any) who or which have been notified; and any actions taken by the registered person as a result of the matter;

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Requirement Due date

must be made or confirmed in writing. (Regulation 40 (a)(b)(c)(d)(i)(ii)(e)(5)(a)(i)(ii)(iii)(b))

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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: 2700720 11

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Children’s home details

Registered provider: Abbey Green Therapeutic Children’s Services Ltd

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Children’s home details

Registered provider address: 51 Abbey Green Road, Leek ST13 8SA

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Inspector

Andi Lilley-Tams, Social Care Inspector Inspection report for children's home: 2700720 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.

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Inspector

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Inspector

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Inspector

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