Children's home run by Total Care Matters Limited

Inspection report for children’s home: 2669259 1 Registered provider: Total Care Matters Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned by a private provider. It is registered to provide care for up to four children who may have social and emotional needs.

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Information about this children’s home

The manager is suitably qualified and experienced and is registered with Ofsted.

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Information about this children’s home

There is one child currently living in the home, and they were in the home during the inspection.

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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

Date of last inspection: 13 September 2022

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report for children’s home: 2669259 2

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Inspection date Inspection type Inspection judgement

13/09/2022 Full Good Inspection report for children’s home: 2669259 3

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improvement to be good

Since the last inspection, one child has moved out in an unplanned manner and one child with highly complex needs has moved into the home. Leaders and managers have decided that they can no longer keep the child safe and have asked the relevant local authority to find a new home for the child.

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improvement to be good

The child’s progress and experiences in the home have been variable. Initially, the child was settled and was given opportunities to attend mainstream education. The child developed friendship groups in the local area and was making some progress. They had started to build trusting relationships with some staff. More recently, the child’s progress has seriously declined, and they are now subject to a court order that is placing extensive restrictions on their day-to-day lived experiences.

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improvement to be good

Education was not a positive experience for the child, and alternative education arrangements were sought. There has been a significant delay in accessing appropriate education, and at present, this is limited in duration. This is causing a barrier to the child’s learning, and this education is not being accessed currently. Staff are being flexible in trying to provide some alternative education in the home through creative writing, arts and crafts and developing the child’s independence skills.

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improvement to be good

The child was being supported to maintain contact and relationships with people who were important to them. They were having time away from the home to spend with friends and family. However, several risk factors affected this, and a greater level of staff supervision was required. This has led to a reduction in the friendship groups and limited interactions being available to the child. Some relationships with staff have been damaged following incidents, and these have not yet been repaired. This has led to some changes in the staff team.

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improvement to be good

The child’s health needs are being met, and they have accessed specialist support when needed. The child has a specific self-injurious behaviour support plan. This plan does not contain all information and risk factors, which prevents staff from understanding how best to support the child and keep them safe from potential harm. On one occasion, medical attention was not sought in response to self- injurious behaviour, which could have resulted in harm to the child.

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improvement to be good

The child’s plans are individual to them but need to be updated to reflect the recent changes for the child. The current restrictions in place mean the child cannot leave the home, and they are required to stay indoors. This is closely monitored by the manager, staff and external professionals to ensure that the impact on the child’s emotional health and well-being is minimal. Inspection report for children’s home: 2669259 4 The child is provided with a comfortable home that is well furnished and nicely decorated. The child’s room has been decorated to reflect their individual taste. At present, this room is inaccessible to the child as it is awaiting some repairs. An alternative bedroom has been provided as a temporary measure.

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improvement to be good

There are significant concerns in relation to missing-from-care incidents and how these have been managed. Staff do not always take a proactive response in trying to locate the child and return them to the home, leaving this to external agencies. On one occasion, despite knowing a child’s whereabouts, staff did not take steps to try and locate the child. This was a missed opportunity for staff to locate the child and return them to the home. This has led to external agencies raising concerns about the home’s response to missing-from-care episodes and in preventing these.

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improvement to be good

On at least two other occasions, the child has left the home without staff being aware. On one of these occasions, they were alerted to this by a local farmer who had seen the child in the village. Staff had been unaware that the child had left the home. This is despite a 2:1 staffing ratio being in place to provide the level of supervision the child needs to keep them safe.

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improvement to be good

On another occasion, a child returned from a missing-from-care episode that had lasted several days. On their return, the child informed staff that they would go missing again and were seen to be preparing to leave the home. The child was also overheard on the phone planning to be collected. Despite this, staff did not take extra precautions to prevent another missing-from-care episode. Subsequently, the child walked out of the home and went missing.

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improvement to be good

Staff do not always have the necessary skills and knowledge to manage and de-escalate incidents. On one occasion, staff used CCTV to monitor a child while in the garden rather than being outside supervising the child. On another occasion, staff failed to manage and de-escalate an incident where a child took a can of drink to their bedroom. Staff had not communicated effectively, and this led to an incident requiring police involvement and the child being searched. This caused the child distress.

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improvement to be good

There have been several incidents where staff have not acted quickly or effectively. For example, one child was able to leave hospital while waiting for an assessment, and the staff required support from the police. During another incident, a child went into the office and removed a personal mobile phone belonging to a member of staff. The child used the phone to take photos without staff’s knowledge. These incidents expose the child to a risk of harm and demonstrate that oversight requires improvement.

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improvement to be good

The manager has not provided effective evaluation and oversight of these incidents and has not identified staff learning and development. Staff have not been supervising the child effectively or responding in a proactive way to missing-from- Inspection report for children’s home: 2669259 5 care incidents, and this has not yet been addressed. This means that risks have escalated and there has been an ineffective response to try and minimise risks and prevent incidents from occurring.

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improvement to be good

There have been several allegations made against staff. These have been reported and managed appropriately, although some guidance has been needed from external professionals. A recent concern about a member of staff has been responded to and relevant action has been taken.

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good

The manager’s oversight has been impeded due to recent staff absences. Senior leaders and managers have provided additional support and been a visible presence in the home, but not all relevant information has been shared with them. This has prevented senior managers from providing the right guidance. This has limited their awareness of some of the incidents and difficulties being experienced.

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good

The independent visitor to the home has provided detailed and useful insight, but the manager has failed to respond to some of the points and recommendations raised. This has limited the reflection and learning from events, and it has hindered improvements in staff practice and in the management of incidents and missing- from-care events.

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good

The manager’s quality assurance and monitoring systems have not identified shortfalls and the areas where improvements are needed. Evaluation of incidents has not identified themes and trends that may have led to alternative strategies being used to avoid recurrences. Staff have not been supported to reflect on and learn from incidents.

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good

There has been a high turnover of staff. This has impacted on the stability of the home and limits opportunities for the child to develop positive and consistent relationships with staff. This has now started to improve, and staff are working together to provide support to the child. Most of the staff are new and inexperienced, and only one staff member has the relevant qualification for residential childcare.

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good

Staff are provided with a wide range of training. This supports their development and the knowledge and skills to provide good and consistent care to children. However, staff have not been provided with training in relation to children going missing from care, which may have given them more knowledge and awareness and helped to develop their understanding, so they were better able to support the child.

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good

Staff are not having regular supervision, and this limits opportunities to reflect on and develop their practice. Relevant staff have not had an annual appraisal, and therefore, they have not been supported to identify goals and targets to assist with their professional development. New staff are not having regular supervision in line Inspection report for children’s home: 2669259 6 with company policy, and this has the potential to impact on their probation and induction processes.

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good

The manager has been working with a multi-disciplinary team, but there are currently some tensions within these relationships, and concerns have been raised about the care of the child and the home’s ability to keep the child safe. Information provided by external professionals differs from the written information in the home. This meant it was difficult to get a clear understanding of incidents and events that had occurred and the action that staff and the manager had taken in response. Inspection report for children’s home: 2669259 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 positive relationships standard is that children are helped to develop, and to benefit from, relationships based on —

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Requirement Due date

an understanding about acceptable behaviour; and

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Requirement Due date

positive responses to other children and adults.

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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

meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans;

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Requirement Due date

understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children;

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Requirement Due date

are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviours and emotions of children, and to help children to do the same. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ix)(x))

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Requirement Due date

In particular, this relates to ensuring that all relevant information is included in children’s plans and that staff are supported through supervision to respond in appropriate and positive ways to children when they display behaviour that may challenge. 1 April 2024

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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 — 1 April 2024 Inspection report for children’s home: 2669259 8 that staff —

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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

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

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. (Regulation 12 (1) (2)(a)(i)(v)(vi)(b))

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Requirement Due date

In particular, this relates to the manager and staff taking a proactive response to missing-from-care episodes by actively trying to locate and return the child to the home. This also relates to staff ensuring that they follow agreed supervision levels to minimise the risks of missing-from-care episodes.

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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

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)(c)(f)(h)) 1 April 2024 Inspection report for children’s home: 2669259 9 In particular, this relates to staff being sufficiently experienced and skilled to work effectively with the children in the home. It also relates to the manager using quality assurance and monitoring systems to evaluate incidents and events effectively to support learning and the development of the home.

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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: 2669259 10

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Children’s home details

Registered provider: Total Care Matters Limited

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Children’s home details

Registered provider address: 230 Bathley Street, The Meadows, Nottingham, Nottinghamshire NG2 2ER

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Inspector

Sarah Orriss, Social Care Regulatory Inspector Inspection report for children’s home: 2669259 11 regulates and inspects 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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