Children's home run by Heartwood Residential Services Ltd in Barnet

Inspection report for children's home: SC423959 1 SC423959 Registered provider: Heartwood Residential Services Ltd

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Inspected under the social care common inspection framework

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Information about this children’s home

This privately run home provides care for up to five children with social and emotional difficulties.

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Information about this children’s home

The home registered with Ofsted on 1 March 2011 and the manager registered in December 2024.

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Information about this children’s home

There was one child living at the home at the time of this inspection.

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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/or 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: requires improvement to be good

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inadequate

Enforcement action since last inspection: none Inspection report for children's home: SC423959 2

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Inspection date Inspection type Inspection judgement

01/07/2024 Full Requires improvement to be good 22/11/2023 Full Requires improvement to be good 06/03/2023 Full Good 12/08/2021 Full Good Inspection report for children's home: SC423959 3

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Overall experiences and progress of children and young people: inadequate

Serious and widespread concerns regarding the leadership and management of the home, and the provider’s ability to implement effective risk management for children have led to an inadequate judgement.

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Overall experiences and progress of children and young people: inadequate

Leaders and managers have failed to effectively assess before children move into the home whether staff have the skills to meet their needs. This has been a contributing factor in children having unsuccessful outcomes and having to leave the home prematurely, causing disruption and instability. Leaders and managers have not prioritised the needs of children and have failed to acknowledge or accept the impact that their decision-making has had on the children’s overall experiences and progress.

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Overall experiences and progress of children and young people: inadequate

Records are disorganised and do not show that children receive effectively planned care. Children’s care plans do not always include necessary information about the child, and not all the required local authority records are in place. Additionally, leaders and managers do not ensure that children have personalised care plans. As a result, children’s needs have not been met and practice in the home fails to be child centred and individualised.

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Overall experiences and progress of children and young people: inadequate

The home environment is not suitable for children. At the time of this inspection, the home was in disrepair and unsafe in places due to significant damage caused by the child living there. There are plans in place to repair the damage in the home and some repair work has been undertaken to begin to make the home safe.

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Overall experiences and progress of children and young people: inadequate

The child living in the home is subject to high levels of supervision and restriction in response to their assessed risks. This includes two-to-one staffing in the community and regular bedroom searches. While intended to safeguard the child, these measures have not been regularly implemented in a way that is sensitive to the child’s needs. They have also not been reviewed effectively to ensure they are having any impact. For example, the child has been able to leave the care and supervision of staff on several occasions and has been at risk of harm at these times.

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Overall experiences and progress of children and young people: inadequate

Staff have frequently restrained the child, and have not completed records of these incidents. There is no management oversight to determine if the use of restraint was necessary and proportionate. This also reduces the possibility of managers understanding when any injuries may have been sustained by the child. It also prevents leaders and managers from carrying out a rigorous review of the incident and challenging practice as needed. Despite the frequent use of restraint, staff do not physically stop the child from leaving the home, in line with their plan to keep them safe.

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Overall experiences and progress of children and young people: inadequate

Some strategies used by staff make the home feel institutional. For example, staff lock the kitchen and lounge doors at certain times to manage children’s behaviours. On occasion, when children have wanted access at these times, staff have denied them this Inspection report for children's home: SC423959 4 and sent them back to their rooms. In addition, staff have not carried out direct work with children to support them or find other strategies to manage behaviour. Consequently, this impacts on the family-home ethos that the home is seeking to achieve and is outlined in its statement of purpose.

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Overall experiences and progress of children and young people: inadequate

Children are not given opportunities to share their views, wishes and feelings about their care. Children are not involved in their care planning, risk assessments or children’s meetings, to ensure that they are effectively involved in the decision-making processes that impact their lives. This hinders children’s ability to influence things that affect them and hinders staff in understanding children’s needs from their perspective.

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Overall experiences and progress of children and young people: inadequate

Children’s complaints are not managed effectively. One child’s complaint about staff making inappropriate comments about their family was not addressed and investigated. Furthermore, leaders and managers failed to report the allegation made by the child against the member of staff to Ofsted as required. This means children do not feel heard and are not reassured their concerns are being addressed. An external professional said that the child had been left feeling confused and upset. This had an adverse effect on their emotional well-being and trust in some of the staff responsible for their care and protection.

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

Safeguarding practice is inadequate. Staff, leaders and managers failed to report and act on a serious safeguarding concern for a child who is subject to high levels of supervision and restriction. The child was able to leave the care and supervision of staff for two days. Staff did not report this to other agencies as required, which limits external oversight of the home. Additionally, they failed to implement appropriate safeguards and sufficient risk management strategies to keep children safe. Due to the home’s poor recording and management oversight, it is unclear if there have been further safeguarding incidents involving children.

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

Leaders and managers do not ensure that there are up-to-date risk assessments and protocols in place to guide staff in keeping children safe. For example, following a search of a child’s room, the police found a makeshift weapon. However, leaders and managers failed to update the child’s risk assessment or consider this when assessing if new children moving into the home would be safe.

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

When incidents occur, there are missed opportunities to learn from these and improve staff practice. They do not accurately identify all known risks for each child. Staff do not have access to up-to-date information about children’s known and emerging risks and vulnerabilities. The failure to provide staff with specific strategies relating to these vulnerabilities places children at risk of significant harm.

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

Leaders and managers have failed to follow children’s safety plans or take into account information about children’s past traumatic experiences when determining staffing for the home. This led to a child becoming extremely distressed and absconding from the home. Leaders and managers’ lack of understanding of past traumatic events and their Inspection report for children's home: SC423959 5 ongoing impact on the child had detrimental consequences for the child’s emotional well- being.

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

Staff struggle to manage incidents and de-escalate negative behaviours. As a result, the police are often required to support staff in the home. Staff keep records of incidents, however, there is rarely management oversight of these incidents and records do not identify the outcomes and actions taken. This prevents staff from helping children to reflect and learn new ways to manage behaviours positively and safely when they are upset or frustrated.

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

Staff lack a full understanding of children’s individual complex needs. Staff’s ability to meet these is limited due to their lack of experience and insufficient training. In addition, staffing levels are not always in line with children’s court-ordered plans. This means children cannot be assured they always have safe levels of support. As a result, children are not receiving the individualised care and support needed to keep them safe.

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The effectiveness of leaders and managers: inadequate

Leaders and managers’ oversight of staff practice and risk management is inadequate. This has led to numerous shortfalls that leaders had failed to identify.

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The effectiveness of leaders and managers: inadequate

Leaders and managers do not adequately challenge staff’s poor practices. Staff take little responsibility for their actions and children are not safeguarded. In addition, the lack of reflection and challenge limits learning from poor staff performance. This contributes to poor development of strategies to safeguard children.

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The effectiveness of leaders and managers: inadequate

Monitoring and reviewing systems are ineffective. This leads to shortfalls in children’s records and documents and in day-to-day practice. The poor oversight of incidents means that individualised care plans and risk assessments for children are not effectively reviewed, updated and monitored. This has an impact on the quality and consistency of care provided to children.

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The effectiveness of leaders and managers: inadequate

Staff turnover is high and there is a high level of agency staff working in the home. This has reduced the opportunities for children to develop positive relationships with consistent adults. Agency staff have often worked at night when safeguarding incidents have occurred that have not been safely managed. Leaders and managers have not noticed this pattern and so have not adjusted staffing to better support children with consistent adults to care for them. In addition, agency staff do not have the appropriate experience, skills and training to manage the complex needs of children. This compounds the difficulties children experience in their care.

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The effectiveness of leaders and managers: inadequate

Following this inspection, three compliance notices were issued, under regulations 12, 13 and 35 to address serious shortfalls relating to children’s safety and widespread issues relating to the leadership and management of the home. A further six requirements were issued to address the other shortfalls found. Leaders and managers have provided Ofsted with an immediate action plan setting out the action they are taking to protect children and improve the quality of care that they receive. Inspection report for children's home: SC423959 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

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12 (1) (2)(a)(i)(ii)(v)) 30 August 2025

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Requirement Due date

*The registered person must ensure that—

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Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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Requirement Due date

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; 30 August 2025 Inspection report for children's home: SC423959 7 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 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(iv))

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Requirement Due date

In particular, leaders and managers must ensure that when behaviour management measures are used, they are recorded accurately and evaluated to review their effectiveness. Leaders and managers must ensure that children are spoken to about the incident and that their views are taken into account.

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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; 30 August 2025 Inspection report for children's home: SC423959 8 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)(h))

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Requirement Due date

The registered person must ensure that —

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Requirement Due date

children can access all appropriate areas of the children’s home’s premises. (Regulation 21 (b)(c)(i)(ii)(iii)(iv))

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Requirement Due date

In particular, this relates to staff unnecessarily locking doors to exclude children from communal areas. 30 August 2025

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The care planning standard is that children —

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receive effectively planned care in or through the children’s home.

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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 children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose;.

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Requirement Due date

that each child’s relevant plans are followed. (Regulation 14 (1)(a) (2)(a)(c))

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Requirement Due date

In particular, the registered person must ensure that a thorough assessment takes place before children move into the home, to consider if their needs can be met and how any known risks will be managed. This should take due consideration of other children already in the home.

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Requirement Due date

The registered person must ensure that all relevant plans are adhered to by staff and taken into account by leaders and the manager. 30 August 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; 30 August 2025 Inspection report for children's home: SC423959 9 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 — is instigated; or

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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. 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

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Requirement Due date

any actions taken by the registered person as a result of the matter. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii)(e) (5)(a)(i)(ii)(iii))

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Requirement Due date

In particular, leaders and managers must ensure that they inform the regulator of serious incidents, allegations and the actions taken.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform. (Regulation 32 (1) (3)(b))

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Requirement Due date

In particular, leaders and managers must ensure that agency staff have the adequate qualifications, skills and experience to care for children with complex needs. 30 August 2025

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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

are signed and dated by the author of each entry. 30 August 2025 Inspection report for children's home: SC423959 10 (Regulation 36 1(b)(c))

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Requirement Due date

Subject to paragraph (6), the registered person must establish a procedure for considering complaints made by or on behalf of children.

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (1) (3)) 30 August 2025

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Requirement Due date

*These requirements are subject to a compliance notice.

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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: SC423959 11

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Children’s home details

Registered provider: Heartwood Residential Services Ltd

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Children’s home details

Registered provider address: 416 Green Lane, Ilford, Essex IG3 9TH

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Inspectors

Sadia Akhtar, Social Care Inspector Salena Bryant, Social Care Inspector Inspection report for children's home: SC423959 12 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

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

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