Children's Home run by Regional Therapeutic Homes Limited in West Northamptonshire

Assurance inspection report for children’s home: 2674029 1 Registered provider: Regional Therapeutic Homes Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

This children’s home is operated by a private company. The home provides care for up to four children who may have social and emotional difficulties.

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Information about this children’s home

Four children were living at the home at the time of the inspection.

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Information about this children’s home

The registered manager post has been vacant since February 2024.

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Information about this children’s home

Judgement at last inspection: outstanding

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Information about this children’s home

Enforcement action since last inspection: none

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Information about this inspection

At this inspection, the inspectors evaluated:

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Information about this inspection

 the care of children  the safety of children  the effectiveness of leaders and managers. Inspectors have looked closely at the experiences and progress of children, using the social care common inspection framework. This assurance 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’. Assurance inspection report for children’s home: 2674029 2

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Findings from the inspection

Ofsted completed an assurance inspection having received whistle-blowing concerns about the care and safety of children. Ofsted found serious and widespread concerns at this assurance inspection.

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Findings from the inspection

Ofsted issued a restriction of accommodation notice and two compliance notices under regulation 12 and regulation 13. Given the identified shortfalls and concerns for children’s safety, placing authorities have provided additional safety measures. The steps taken by the local authorities have assured Ofsted that children’s safety can be maintained for an interim period.

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Findings from the inspection

Children say that they do not enjoy living in the home, they are unhappy about their care and have very few meaningful relationships with staff. The acting manager is new to role, and the children don’t know her well. There is a lack of management oversight throughout all care practices for children.

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Findings from the inspection

Children’s bedrooms do not demonstrate that children are receiving therapeutic care as outlined in the home’s statement of purpose. For example, one child had binbags inside their wardrobe and no clothing was hanging up. Another child has taped cardboard over their window to prevent light coming in because they did not have a blind. It is recognised that some of the children’s bedroom furniture was broken and that this needed to be replaced. However, it is not trauma-informed practice to store a child’s clothing in bin bags, and the other child had not been taken shopping to purchase a blind in a timely manner. All children’s bedrooms were messy and are not calming environments to sleep in.

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Findings from the inspection

Senior leaders are not proactive in talking to children and seeking their views. Children’s wishes and feelings are not well sought, understood or acted on by staff. Staff expect the children to come to them with any concerns, as opposed to staff providing a platform for children to regularly raise their views.

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Findings from the inspection

Children have raised a concern over several months that they have struggled with the peer dynamics in the home. Some children have cited this as a reason for self- harming or going missing. These concerns have not been addressed in a timely way and the situation has been allowed to drift. Management oversight of peer-to-peer incidents in the home is poor. This is despite some children being physically and verbally hurt by peers in the home.

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Findings from the inspection

Staff are not proactive in ensuring that children’s educational needs are met. Staff are unable to motivate children to wake up in the morning. For example, two children did not wake up until the afternoon during the inspection. Children who do not attend school are not doing schoolwork or learning during the day. Despite this, staff took one child to the nail salon despite them having stayed in bed for most of the day. Assurance inspection report for children’s home: 2674029 3 Children’s health needs are not well met by staff. One child had no fingernail after pulling off an acrylic nail. The child said that they had not been offered medical care by staff. Another child had been tattooed illegally and staff could not motivate this child to attend a GP appointment to have these tattoos looked at.

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Findings from the inspection

Medication practice is not compliant with regulation. The recording of medication is not clear. There are blank entries on medication forms, with no management oversight as to what the blank entries relate to. It is not clear if children have refused medication or whether children have not been offered it. Some blank entries relate to the contraceptive pill. However, there has been no management review as to what impact this could have on a child.

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Findings from the inspection

Medication is not audited regularly. It was clear that one child had three tablets missing from their medication, although there was no follow-up as to where this medication had gone. Another child’s medication had run out and staff had not reordered it on time. This had a negative impact on the child.

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Findings from the inspection

Senior leaders are not ensuring that safeguarding processes are being followed. These processes are vital to safeguard children. On inspection, one child had multiple bruises over their arms and legs, and it was alleged that these injuries happened following the child being restrained by staff in the home. There was no record of this child’s injuries. There was no record of this child having been spoken to. The physical intervention records were not complete. The child had received no medical treatment, despite complaining of back ache and head pain. There was no advocacy for this child to have a child protection medical. There was no recorded management oversight of this incident.

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Findings from the inspection

Some children are at risk in the community. They have been involved in episodes of going missing and have misused substances. There is a lack of professional curiosity from staff when children return home. For example, there is little evidence of children being asked how they are, who they have been with or whether they are okay. There is also a lack of management oversight, which means it is unclear whether incidents may be related or not. Although professionals’ meetings take place with the local authority, staff are not doing the necessary groundwork to prepare for these reviews. Risks posed to children are not well understood, reflected on or evaluated.

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Findings from the inspection

Some children hurt themselves. However, the nature of these injuries is not clear. There is a lack of follow-up in terms of staff asking children how they are or offering them care or nurture.

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Findings from the inspection

The practice of searching children’s bedrooms is poor. The rationale for room searches is not always recorded. Children are not routinely informed when room searches have happened. This led to a serious incident, where one child hurt another child after they had mistakenly presumed that the other child had taken something from their bedroom. This situation was preventable. Assurance inspection report for children’s home: 2674029 4 Senior leaders are not providing continuity of care for children. Several staff have left, and senior leaders are actively trying to recruit new staff. Presently, rotas are not secure. For example, most day shifts are covered by managers. On the week of the inspection, three staff were not securely sourced for the Sunday. The following week, nighttime staff had not been secured for two days. There is an over-reliance on agency workers. Children are not being given the security of knowing week by

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Findings from the inspection

week who they can rely on to look after them.

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Findings from the inspection

Senior leaders are not providing the necessary management oversight of children’s care and safety. Processes for learning from incidents are not in place. On one occasion, a staff member gave two children a pair of scissors and left them unsupervised. This was despite both children having risks relating to self-harm. The children cut their own hair, but no lessons learnt exercise was completed and the incident was not recorded on children’s files.

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Findings from the inspection

On another occasion, a child went missing undetected by staff. This was despite waking night staff being present. No learning review happened and Ofsted were not notified. Ofsted similarly has not been notified when children have been admitted to hospital following the deterioration of their mental health. One of these incidents included a serious ligature incident.

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Findings from the inspection

There has been no registered manager since February 2025. However, there is a responsible individual, senior manager, operations manager, acting manager and deputy manager. For such reasons, it is unclear why the management oversight is poor because there are multiple managers overseeing care for children.

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Findings from the inspection

There is some evidence that the acting manager has started to audit some of the children’s documents to identify gaps in information. This is positive. However, when gaps had been identified, there was no evidence of follow-up. Managers are routinely caring for children as a management team. However, this hinders their ability to provide adequate or effective leadership. Assurance inspection report for children’s home: 2674029 5

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Inspection date Inspection type Inspection judgement

11/07/2024 Full Outstanding 22/08/2023 Full Outstanding 26/10/2022 Full Good Assurance inspection report for children’s home: 2674029 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, 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

manage relationships between children to prevent them from harming each other;

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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. Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii) 23 March 2025

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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— 15 April 2025 Assurance inspection report for children’s home: 2674029 7 the name of the child;

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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 has signed the record to confirm it is accurate;

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Requirement Due date

and 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 (3)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c))

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Requirement Due date

The registered person should ensure that this regulation is complied with. Children’s well-being and safety should remain at the forefront of all restraint practice. The manager should ensure that staff only restrain children in a way that is consistent and safe. This needs to be considered when using staff that are not permanent.

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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 23 March 2025 Assurance inspection report for children’s home: 2674029 8 promotes their welfare.

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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 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;

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Requirement Due date

demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

feedback on the experiences of children, including complaints received; 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)(d)(e)(f)(g)(ii)(h))

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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

The registered person should ensure that medication practice is compliant with regulation. Children’s medications and health needs should be kept under review by the manager and staff. Children should be given medication when they need it. 15 April 2025

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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; 15 April 2025 Assurance inspection report for children’s home: 2674029 9 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

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

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Requirement Due date

understand and apply the home’s statement of purpose;

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Requirement Due date

understand and apply the home’s statement of purpose;

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

help each child to understand and manage the impact of any experience of abuse or neglect;

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Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably.

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Requirement Due date

(Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(v)(vi)(vii))

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Requirement Due date

The registered person should ensure that children are cared for in accordance with the statement of purpose. Childrens bedrooms should be welcoming spaces, that are clean, tidy and free from hazards.

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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;

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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—

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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; 15 April 2025 Assurance inspection report for children’s home: 2674029 10 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

(Regulation 7 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv))

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Requirement Due date

The registered person should ensure that children are valued and cherished. Staff should ensure that children have a platform to routinely share their views on a day-day basis. When children are unhappy, their views should be taken seriously and responded to effectively.

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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

help each child to achieve the child’s education and training targets, as recorded in the child’s relevant plans;

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Requirement Due date

support each child’s learning and development, including helping the child to develop independent study skills and, where appropriate, helping the child to complete independent study;

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Requirement Due date

understand the barriers to learning that each child may face and take appropriate action to help the child to overcome any such barriers;

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Requirement Due date

help each child to understand the importance and value of education, learning, training and employment;

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Requirement Due date

promote opportunities for each child to learn informally;

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Requirement Due date

maintain regular contact with each child’s education and training provider, including engaging with the provider and the placing authority to support the child’s education and training and to maximise the child’s achievement. (Regulation 8 (2)(a)(i)(ii)(iii)(iv)(v)(vi))

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Requirement Due date

The registered person should ensure that children have good routines that support children’s progress and educational 15 April 2025 Assurance inspection report for children’s home: 2674029 11 routines. Staff should nurture and incentivise children to make progress and enjoy learning.

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being; and

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Requirement Due date

children are helped to lead healthy lifestyles. (Regulation 10 (1)(a)(b)(c))

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Requirement Due date

The registered person should ensure that children’s health and well-being needs are sought and prioritised by staff. Staff should ensure that children attend medical appointments and have good sleep routines. 15 April 2025

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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

help each child to develop socially aware behaviour;

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Requirement Due date

encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding;

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Requirement Due date

help each child to develop and practise skills to resolve conflicts positively and without harm to anyone;

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Requirement Due date

communicate to each child expectations about the child’s behaviour and ensure that the child understands those expectations in accordance with the child’s age and understanding; 15 April 2025 Assurance inspection report for children’s home: 2674029 12 help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful;

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Requirement Due date

help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship;

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Requirement Due date

strive to gain each child’s respect and trust;

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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 behaviour and emotions of children, and to help children to do the same;

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Requirement Due date

de-escalate confrontations with or between children, or potentially violent behaviour by children;

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Requirement Due date

understand and communicate to children that bullying is unacceptable; and

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Requirement Due date

have the skills to recognise incidents or indications of bullying and how to deal with them; and

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Requirement Due date

that each child is encouraged to build and maintain positive relationships with others

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Requirement Due date

(Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(viiii)(x)(xi)(xii)(xiii)(b))

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Requirement Due date

The registered person should ensure that children are supported to build meaningful relationships with other children in the home. Conflict between children should be responded to effectively and in a meaningful way.

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Requirement Due date

The registered person should ensure that children receive well-planned care from staff who they can trust and depend on. When staff arrive and leave, care practice should be child-centred, and children’s views should be thoughtfully considered. Assurance inspection report for children’s home: 2674029 13 A responsible individual must—

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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 (7)(b))

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Requirement Due date

The responsible individual should ensure that they have the skill set and capacity to oversee the quality of care in the home. The responsible individual should take action to ensure that lessons are learned following serious incidents. 15 April 2025

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Requirement Due date

The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 31 (1)) 15 April 2025

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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; 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

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 15 April 2025 Assurance inspection report for children’s home: 2674029 14 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 (1)(a)(b) (2)(a)(d)(e)(f)(g)(ii)(h))

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Requirement Due date

*These requirements are subject to a compliance notice. Assurance inspection report for children’s home: 2674029 15

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Children’s home details

Registered provider: Regional Therapeutic Homes Limited

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Children’s home details

Registered provider address: 66c Askew Road, London W12 9BJ

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Inspectors

Andi Lilley-Tams, Social Care Regulatory Inspection Manager Laura Copus, Social Care Inspector Assurance inspection report for children’s home: 2674029 16 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 children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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Inspectors

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