Children's home run by F2L Investments Limited

Assurance inspection report for children’s home: 2748820 1 Registered provider: F2L Investments Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

This home is privately run and provides care for one child who may experience social and emotional difficulties.

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Information about this children’s home

The manager registered with Ofsted in April 2024.

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Information about this children’s home

At the time of the inspection, one child was living at the home.

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Inspection date: 17 March 2025

Enforcement action since last inspection: none

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Information about this inspection

At this inspection, the inspector evaluated:

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Information about this inspection

 the care of children  the safety of children  the effectiveness of leaders and managers. The inspector has 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: 2748820 2

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Findings from the inspection

Serious safeguarding failures have been identified.

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Findings from the inspection

Risk assessments are not updated following incidents and do not reflect the child’s current risks. For example, repeated physical interventions due to staff continuing to purchase and eat food separate to what the child was offered were not reflected in the risk assessments, and after a serious self-harm incident, the risk level remained incorrectly listed as ‘low’.

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Findings from the inspection

The practice of physical intervention is unsafe and poorly recorded. Records fail to capture crucial details, such as the number of staff involved, the identity of the staff members, or the duration of the restraint. The lack of management oversight of these interventions raises significant concerns about their necessity and appropriateness. The child’s account of being regularly restrained by three staff members to the point of struggling to breathe indicates that physical intervention is not being used appropriately. The poor quality of records makes it impossible to determine whether these interventions were justified, which further exacerbates the safeguarding concerns. There is no consideration of the impact of such practice on the child living here.

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Findings from the inspection

Allegation procedures have not been followed, leaving the child unprotected. The social worker confirmed they do not receive regular incident reports and must request the registered manager investigates any concerns raised. There were no notifications to Ofsted regarding allegations of harm, and essential safeguarding procedures, such as debriefs following physical interventions, body maps and records of harm, were not completed. This failure to follow basic safeguarding procedures further jeopardises the child’s safety and well-being.

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Findings from the inspection

Serious concerns were identified in the care provided to the child. Staff frequently engaged in exclusionary behaviour, such as ordering takeaway food for the staff team and not including the child, which fosters an unnecessary divide between staff and the child. Additionally, staff were heard telling the child that they needed them to ‘be good’, reinforcing a transactional approach to their behaviour and implying that their access to activities is contingent on compliance rather than their overall well-being. This approach seems to have been internalised by the child, as evidenced by their own comments about needing to ‘watch my behaviour’ before they were able to go out on activities.

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Findings from the inspection

Progress for the child is limited, with no clear plan to reduce their 3:1 staffing ratio, which remains excessively high. While physical interventions have decreased, this may be due to the child adapting out of fear, not meaningful progress. The child reported feeling isolated, lacks access to education and struggles to form friendships, expressing a desire to mix with peers their own age. The child has expressed feeling scared of being restrained, and described the practice as ‘brutal’, mentioning that they are often held by three staff members to the point where they Assurance inspection report for children’s home: 2748820 3 cannot breathe. The child’s concerns about being hurt during these interventions have been dismissed, further exacerbating their sense of fear and isolation.

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Findings from the inspection

Leadership and management in the home are ineffective and fail to ensure safe and effective care for the child. The manager lacks a clear understanding of her responsibilities and failed to take accountability for the home’s failings. The manager admitted to feeling constrained by external pressures and stated that she was not responsible for many decisions, such as incident reporting and staffing choices. This lack of accountability is dangerous and has contributed to the formation of a closed culture within the home, which impedes transparency and effective safe care.

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Findings from the inspection

The manager has allowed a practice to develop whereby staff record conversations with the child for the purpose of taking ‘minutes’, which raises concerns about inappropriate practices within the home. The manager will be leaving the home, submitting her voluntary cancellation form prior to this inspection. There is no clear plan of who will oversee the home when she leaves.

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Findings from the inspection

The staff team lacks the necessary experience and training to provide appropriate care for the child at the home. There is a significant need for further development and upskilling, particularly in areas such as record-keeping and understanding the needs of the child in their care. Without effective training, staff are unable to meet the emotional, psychological and developmental needs of the child, which further undermines the care provided.

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Findings from the inspection

The responsible individual (RI) is present in the home two days a week. Despite this, his oversight has not been robust. While the RI acknowledged the need for improvement, there was a lack of accountability for the failings within the home. The RI demonstrated a lack of understanding regarding Ofsted notifications and failed to take proper action when issues were raised. Monthly audits identified gaps in record- keeping, but there was limited evidence to show how these issues were addressed in a timely manner.

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Findings from the inspection

The RI was supportive of the assurance inspection and subsequent findings and showed support for the registered manager during the inspection.

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Findings from the inspection

As a result of this inspection, the regulator has issued three compliance notices and a restriction of accommodation notice, preventing any further children from living at the setting. Assurance inspection report for children’s home: 2748820 4

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Inspection date Inspection type Inspection judgement

30/07/2024 Full Good Assurance inspection report for children’s home: 2748820 5

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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

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)(v)(vi)(vii))

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Requirement Due date

This specifically relates to ensuring risk assessments are updated in line with the needs of the child and correct child protection processes are followed. 11 May 2025

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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

promotes their welfare. 11 May 2025 Assurance inspection report for children’s home: 2748820 6 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

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)(c)(g)(ii)(h))

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Requirement Due date

This specifically relates to ensuring that staff employed in the home are considered to have appropriate qualifications, experience and skills. It also relates to ensuring that there is appropriate monitoring and oversight of the home and that learning from incidents is embedded.

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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—

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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; 11 May 2025 Assurance inspection report for children’s home: 2748820 7 a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

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

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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

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Requirement Due date

This specifically relates to ensuring that all records of physical intervention are recorded with sufficient detail, that debriefs with the child and staff involved in physical interventions occur within the correct timescales and that there is clear management oversight on physical interventions.

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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

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

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Requirement Due date

that staff— 11 May 2025 Assurance inspection report for children’s home: 2748820 8 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

de-escalate confrontations with or between children, or potentially violent behaviour by children. (Regulation 11 (1)(a) (2)(a)(ix)(xi))

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Requirement Due date

This specifically relates to ensuring that staff understand the children in their care and how to respond to them appropriately.

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if—

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children;

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Requirement Due date

the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy. (Regulation 24 (1)(a)(d))

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Requirement Due date

This specifically relates to ensuring the child is not unnecessarily recorded in the home. 11 May 2025

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Requirement Due date

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

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Requirement Due date

there is no registered manager in respect of the home. (Regulation 27 (1)(a))

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Requirement Due date

This specifically relates to ensuring a suitable manager is appointed to replace the current registered manager once she leaves. 11 May 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

there is an allegation of abuse against the home or a person working there. (Regulation 40 (4)(c))

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Requirement Due date

This specifically relates to ensuring all allegations of abuse against a staff member are reported to Ofsted. 11 May 2025

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Requirement Due date

*These requirements are subject to a compliance notice. Assurance inspection report for children’s home: 2748820 9

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Children’s home details

Registered provider: F2L Investments Limited

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Children’s home details

Registered provider address: 1 Bosworth Way, Leicester Forest East, Leicester LE3 3QQ

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Inspector

Lauren Barwell, Social Care Regulatory Inspector Assurance inspection report for children’s home: 2748820 10 to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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