Children's Home run by Nurture Me Psychological Services Limited in Staffordshire

Inspection report for children's home: 1270298 1 Registered provider: Nurture Me Psychological Services 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 by a small company. It is registered with Ofsted to care for up to four children with learning disabilities and/or social and emotional difficulties.

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Information about this children’s home

There has been no registered manager in post since 18 July 2023, and the responsible individual resigned on 6 December 2023.

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Information about this children’s home

A new manager was appointed on 16 October 2023. The director, who currently provides therapy to the children at this home, plans to take on the role of the responsible individual.

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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, and 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: outstanding

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inadequate

Enforcement action since last inspection: none Inspection report for children's home: 1270298 2

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Inspection date Inspection type Inspection judgement

14/03/2023 Full Outstanding 20/07/2021 Full Outstanding 18/02/2020 Interim Sustained effectiveness 16/07/2019 Full Good Inspection report for children's home: 1270298 3

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inadequate

Since the previous inspection, two children have continued to live at this home and one child has moved out of the home. Another child moved into this home the day before this inspection. At the time of the inspection, three children lived at this home.

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inadequate

The quality of care provided to children is inadequate. There are serious and widespread failures in the safeguarding arrangements for children and the leadership and management of the home. During this inspection, Ofsted issued a notice to suspend the registration of the home due to the serious safeguarding concerns found.

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inadequate

Managers’ and staff’s approach to children’s care is chaotic. This has impacted on the stability of the service and the care and support provided to children. Children are not helped to understand their care arrangements, and managers have changed the children’s care plans without a clear rationale. Staff are also unaware of changes to the care plans for children, including the managers’ decision to change the staffing compliment that had previously been agreed with the placing authorities. This leads to confusion and unsafe care practices.

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inadequate

Children are not consulted about their care or any changes to their care plans. This does not support children to feel safe and secure and gain an appropriate sense of permanence and belonging. The unstructured changes to care planning arrangements have also impacted on children’s positive relationships with staff.

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inadequate

Children have not received the care and supervision necessary to support their safety and well-being. Staff report that they do not receive guidance that helps them to meet the needs of children. Managers have not reviewed children’s care plans, risk assessments or daily logs. Not all incidents such as allegations or where staff have intervened to keep children safe including restraints have been recorded, and those that have been recorded do not provide a clear picture of what has taken place. Managers have not reviewed the records of incidents to identify learning and inform any changes required to the safe care of children. As a result, staff do not have adequate guidance on how to provide consistent care to children to meet their needs.

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inadequate

Children understand how to make a complaint. However, children’s concerns and allegations against staff are not responded to. Managers have not always recorded, reported or investigated concerns and allegations. Children are not listened to, and action has not been taken to establish if they have come to harm.

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inadequate

The majority of recordings made by managers and staff are of poor quality and they lack accountability. Records are unclear and fail to provide an account of what Inspection report for children's home: 1270298 4 has occurred, the action taken and if all professionals were notified. At the time of the inspection, the manager and director had difficulty locating records stored electronically. This means records completed by managers and staff do not accurately reflect the child’s lived experiences and do not safeguard children should a serious incident occur in the home.

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inadequate

Children make varied progress in their educational outcomes. One child is participating full time in their education. Another child has been excluded from their educational placement and does not attend full-time education. Staff do not put in place clear routines if children do not attend school. This does not support children to return to school in a planned and supportive way.

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inadequate

Children are supported with a wide range of activities. One child has made progress in attending a youth club.

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inadequate

Staff support children to spend time with their families. This has helped children to keep in contact with people who are important to them.

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

Children have come to harm while living at this home due to inadequate safeguarding practices. One child has been able to access a laptop and has used it unsupervised. Staff confirmed that the child had access to adult websites and was exposed to adult chat rooms where there is evidence of inappropriate sexualised conversations and photographic materials from adults. This is a criminal offence. When staff observed the content on the laptop, they deleted all the information and failed to follow safeguarding practices and notify the police, the child’s placing authority and Ofsted.

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

Leaders, managers and staff do not appropriately respond to safeguarding incidents that occur or implement effective strategies to safeguard children. This unsafe practice does not protect children from harm.

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

The managers’ and staff’s administration of medication is unsafe and dangerous. This has exposed a child to significant harm and potential addiction to a medication. One child has been given a controlled medication against the appropriate advice and guidance from a qualified medical professional. The child was exposed to this medication for a significant period.

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

Staff have failed to supervise children adequately. One child has had the opportunity to access the company’s credit card and make purchases that have been delivered to the home. Despite new clothing and footwear being delivered to the home, managers and staff lacked professional curiosity and failed to explore this further. This left the child at risk.

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

Physical intervention practices are poor. There is insufficient guidance and training for staff to ensure that they use physical intervention safely and to protect children. Inspection report for children's home: 1270298 5 Staff were unclear about the agreed method of physical intervention that is used in the home. This does not demonstrate that the training provided to staff is effective.

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

When staff have used physical intervention, they have failed to record sufficient information, and it is not clear if the methods used have been safe or proportionate. Leaders and managers have failed to evaluate the effectiveness of the measures used and did not identify that the holds used by staff are not included in the policy or training provided. This is because the manager has not received training in the organisation’s approved use of restraint. This fails to safeguard all involved.

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The effectiveness of leaders and managers: inadequate

There is no management oversight of staff practice and the quality of care provided to children. The registered manager and responsible individual have left the organisation. The home is currently being overseen by the director, who plans to take on the role of the responsible individual. However, they only notified Ofsted of this change during the inspection. The newly appointed manager has been in post five weeks. The current management arrangements do not provide assurances that the failures identified in this inspection will be acted on and rectified.

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The effectiveness of leaders and managers: inadequate

The home’s six-monthly quality of care report contains duplicate information from historical quality of care reports submitted to Ofsted. This does not provide Ofsted with assurance that leaders and managers understand the purpose of this key document and maintain effective monitoring and review systems

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The effectiveness of leaders and managers: inadequate

The independent person visit reports do not provide an accurate assessment of the care provided to the children. In part, this is because the independent person does not routinely consult with children, professionals or their families. In addition, the independent person does not provide the children’s placing authority and the director with the findings of the visits. This has hindered the leaders’ and managers’ understanding of the home’s strengths and areas for development and prevented other agencies from acting to protect children.

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The effectiveness of leaders and managers: inadequate

There is not enough staff to safely care for the children in line with their plans. In addition, several staff have resigned. A further reduction in staffing will not ensure that there are sufficient staff to safely care for children.

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The effectiveness of leaders and managers: inadequate

Staff do not have the training, knowledge or skills to meet the needs of the children. There have been significant shortfalls in staff’s practice that have exposed children to harm. As a result, children have been exposed to harm.

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The effectiveness of leaders and managers: inadequate

Leaders and managers fail to challenge poor staff practice, and such practices have become normalised. Staff do not receive supervision sessions in accordance with the organisation’s internal policy. In addition, some staff report that they do not receive support that promotes their continuous professional development.

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The effectiveness of leaders and managers: inadequate

Staff gave inspectors mixed feedback on the quality of the leadership and management in the home. Some staff told inspectors that since the new manager Inspection report for children's home: 1270298 6 started things have begun to improve. However, some staff shared that they do not have confidence that the management of the home will act on their concerns about children’s safety.

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The effectiveness of leaders and managers: inadequate

Ofsted does not receive notifications when a serious incident happens. This prevents the regulator from having oversight of serious incidents in the home, in line with regulation. Inspection report for children's home: 1270298 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, The 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 effec- tively from harm; and

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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

In particular, the registered persons must ensure that: 29 February 2024 Inspection report for children's home: 1270298 8  there is clear and up-to-date guidance in place that is based on children’s current presentations, which informs staff on how to keep children safe

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Requirement Due date

 leaders, managers and staff have undertaken training to identify and act on signs that a child is at risk

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Requirement Due date

 leaders, m leaders, managers and staff understand their roles and responsibilities and act on concerns and allegations of abuse shared by 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

helps children aspire to fulfil their potential; and

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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 has sufficient staff to provide care for 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; and

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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)(c)(d)(e)(f)(h))

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Requirement Due date

In particular, the registered persons must ensure that: 29 February 2024 Inspection report for children's home: 1270298 9  there are rigorous and effective monitoring systems in place that provide oversight on all aspects of the care children receive and their safety and progress

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Requirement Due date

 leaders and managers have an accurate understanding of the strengths and weaknesses of the home and there is an action plan in place with clear timescales for improvement

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Requirement Due date

 that enough staff are employed to meet the needs of the number of children the home is registered for

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Requirement Due date

 that all staff have had the training and have the skills to meet the needs of children the home intends to accommodate, as outlined in the home’s statement of purpose

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Requirement Due date

 the appointed manager submits an application to register with Ofsted so that it can be determined if the manager has the experience, qualifications and skills as outlined in Regulation 28.

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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. (Regulation 23 (1))

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Requirement Due date

In particular, the registered persons must ensure that the arrangements for the handling, recording, safekeeping and safe administration of medicines are reviewed. Ensure that sufficient staff are trained in line with the organisation’s internal medication policy. 29 February 2024

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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

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Requirement Due date

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

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Requirement Due date

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— 29 February 2024 Inspection report for children's home: 1270298 10 details of the child’s behaviour leading to the use of the measure;

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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

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so ("the authorised person")—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (1)(a)(b) (3)(a)(i)(ii)(v)(b)(i)(ii)(c))

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Requirement Due date

In particular, the registered persons must ensure:

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Requirement Due date

 that the behaviour management policy and physical intervention practices in the home are reviewed

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Requirement Due date

 that all physical intervention incidents are recorded in line with regulation and reviewed by the manager to ensure that any physical intervention is used in accordance with regulation, the children’s behaviour management plan and the organisation’s internal behaviour management policy.

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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 29 February 2024 Inspection report for children's home: 1270298 11 concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

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

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Requirement Due date

This specifically relates to the requirement that the provider must ensure that a notification is submitted to Ofsted in line with the regulations.

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Requirement Due date

The independent person must produce a report about a visit ("the independent person’s report") which sets out, in particular, the independent person’s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children’s well-being. The independent person must provide a copy of the independent person’s report to—

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Requirement Due date

upon request, the local authority for the area in which the home is located;

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Requirement Due date

the placing authorities of children; and

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Requirement Due date

the registered provider and, if applicable, the registered manager. (Regulation 44 (4)(a)(b) (7)(b)(c)(d))

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Requirement Due date

In particular, the registered persons must ensure that a suitable independent visitor is appointed to carry out external monitoring visits of the home and they are submitted to the parties specified in this regulation. 29 February 2024

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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 29 February 2024 Inspection report for children's home: 1270298 12 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

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review ("the quality of care review report").

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Requirement Due date

supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed. (Regulation 45 (1) (2)(a)(b)(c) (3) (4)(a))

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Requirement Due date

This specifically relates to the requirement that the manager submits a six-monthly quality of care review, which accurately reflects the care provided in the home and shows their monitoring, reviewing and evaluating of the quality of care provided to children.

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Requirement Due date

An organisation may only carry on a home if—

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Requirement Due date

the organisation has notified HMCI of the name, address and position in the organisation of the responsible individual.

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Requirement Due date

satisfy the requirements in paragraph (5)(a) to (c); and

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Requirement Due date

have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated. (Regulation 26 (4)(ii) (7)(a)(b)) 29 February 2024

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 29 February 2024 Inspection report for children's home: 1270298 13 Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home.

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Requirement Due date

maintain in the home the records in Schedule 4; and

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1) (2)(a)(b)) 29 February 2024

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Recommendation

 The registered persons should ensure all records are recorded in a way that is non-stigmatising and can distinguish between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 61, paragraph 14.4)

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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: 1270298 14

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Children’s home details

Registered provider: Nurture Me Psychological Services Limited

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Children’s home details

Registered provider address: 58 High Street, Madeley, Telford, Shropshire TF7 5AT

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Inspectors

Sam Dulay-Kainth, Social Care Inspector Sophie Hills, Social Care Inspector Inspection report for children's home: 1270298 15 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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