Children's Home, Residential special school run by Kisimul Group Limited in Lincolnshire

Inspection report for children’s home: SC034241 1 SC034241 Registered provider: Kisimul Group 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 owned and cares for up to 22 children with severe learning disabilities.

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Information about this children’s home

Care is provided to children in 2 homes that are located on the same site.

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Information about this children’s home

At the time of this inspection, 14 children were living at the homes. Their views were considered during the inspection.

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Information about this children’s home

The registered manager has been in post since November 2025.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and the care and experiences of children and young people are poor, and they are not making progress.

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report for children’s home: SC034241 2

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Inspection date Inspection type Inspection judgement

06/05/2025 Full Good 16/04/2024 Full Requires improvement to be good 21/08/2023 Full Requires improvement to be good 03/05/2023 Full Inadequate Inspection report for children’s home: SC034241 3

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Summary of findings

Since the last inspection, children’s experiences have been variable. Children have not always been safe and there have been instances when children have been harmed due to ineffective teamwork and staff not following procedures. Leaders and managers have not had sufficient oversight of the home and were unaware of the issues that the inspectors raised during the inspection. The care to children is provided in 2 separate buildings, and staff in each have been working in isolation, meaning that inconsistent practice has developed, which has impacted on children’s overall experiences.

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Overall experiences and progress of children and young people: inadequate

Since the last inspection, 15 children have moved into the home and 3 have moved out. For one of the children, it was assessed that the home was unable to meet their needs. There was a coordinated and planned move out of the home that took account of the child’s specific needs.

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Overall experiences and progress of children and young people: inadequate

Over the last year, the home has been decorated so that it is more homely and welcoming. Personalised touches have been added to the children’s bedrooms. However, one child’s bedroom had a strong smell of urine and another child’s bathroom had mould in it. Senior leaders were able to outline action taken to replace the flooring, although they were not aware of the mould. This was addressed once the inspectors had brought this to their attention.

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Overall experiences and progress of children and young people: inadequate

Staff are not provided with the most up-to-date documents detailing the needs of the children. Care plans are of a variable standard and while some plans were complete, others lacked essential information and specific detail outlining how staff need to respond to children. As a result, staff are not equipped with the necessary knowledge to meet children’s individual needs.

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Overall experiences and progress of children and young people: inadequate

One child lives in an area of the home that has been specifically adapted to meet their complex needs. Professionals involved with the child meet on a regular basis to monitor the child’s progress and to identify if any changes are needed to meet their evolving needs.

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Overall experiences and progress of children and young people: inadequate

Staff spend time working directly with children to understand and capture their views, wishes and feelings. Staff are expected to undertake individual sessions with children to support their overall development and help them work towards their identified targets. Not all children benefit from the same standard of direct work as practice varies across the homes.

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Overall experiences and progress of children and young people: inadequate

Children enjoy seeing their families on a regular basis. Staff ensure that they liaise with the children’s parents, so that the time they all spend together is meaningful and enjoyable for all. Inspection report for children’s home: SC034241 4 Children are cared for by staff who show a clear commitment to working with children who have complex needs. Staff take time to build trusting relationships, enabling them to recognise each child’s unique communication style. This approach has led to children making progress towards their individual targets.

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

There have been 2 occasions when a child has been harmed due to staff giving them food that they are allergic to. Both occasions resulted in a medical emergency, and the child had to be taken to hospital. Despite the manager identifying the need for staff competence in this area to be assessed, the manager failed to review all the work that staff had completed. As a result, the manager was unable to assure himself that staff understand the health needs of the child and how to keep them safe. This continues to place the child at significant risk of harm.

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

A child ran from their bedroom to the dining room and took hold of a glass jar, which they then smashed and put glass in their mouth. This occurred due to lack of staff supervision and vigilance. The manager has not been proactive in identifying risks in the home. Staff sought support from health agencies after the incident, however, staff at the home failed to provide adequate care, and as a result the child was placed at risk of significant harm.

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

On one occasion, staff did not correctly follow the home’s safeguarding policies and seek medical advice when a child injured themselves. Senior managers had to prompt staff to seek health advice. Delays in seeking medical oversight have the potential to place the child at increased risk of harm.

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

At times, children become upset and unable to manage their emotions. On occasion, this has resulted in staff having to physically intervene. Restraint records do not include all the required information, which makes it difficult to evidence that interventions were used as a last resort and carried out in a safe and proportionate way. Managers have not reviewed all incidents in a timely manner. This prevents lessons from being learned and changes being made to practice, to promote the welfare of the children.

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

Safer recruitment checks are of a varying standard. When one member of staff was recruited, a reference could not be obtained. A risk assessment was completed by the manager, however, this failed to provide sufficient detail to reflect the concern and how the identified risks would be managed. Leaders could not evidence that all necessary safeguards had been applied and that the member of staff was safe to start in their role.

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

There has been a recent change to strengthen the medication training for staff. As part of the process, staff competency in administering medication is now assessed. However, the manager was unable to clearly demonstrate that there is always a member of staff on shift who can administer medication safely. This leaves children at risk of harm. Inspection report for children’s home: SC034241 5 The location risk assessment has been updated since the last inspection. However, the details in this document are not up to date and do not reflect the site that the children’s home is on. This prevents staff from having a clear understanding of the risks relevant to this home and how these are mitigated.

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The effectiveness of leaders and managers: inadequate

The manager does not have effective oversight of the home. Senior leaders have also failed to provide robust oversight of the service and the manager’s practice. Consequently, serious shortfalls found at this inspection had not been identified. Monitoring and review systems are weak and ineffective, and do not provide meaningful scrutiny of practice.

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The effectiveness of leaders and managers: inadequate

There have been occasions when staff have failed to work as a team. When staff have asked for support, colleagues have not always been responsive, leaving both staff and children vulnerable to harm. In addition, staff have not always communicated with each other regarding which child they are supporting. On one occasion, a child was locked in the gym area following a fire drill. Staff only realised that the child was unaccounted for when they returned to the home and identified the child was missing. Poor coordination between staff resulted in this avoidable incident, when the child was emotionally harmed.

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The effectiveness of leaders and managers: inadequate

Staff do not receive supervision in line with the organisation’s policy. The quality and frequency of supervision is inconsistent, and some staff do not benefit from purposeful or reflective discussions about their practice. This is a missed opportunity for managers to monitor staff performance, ensure children’s needs are being met and provide the guidance and support staff require to carry out their roles effectively.

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The effectiveness of leaders and managers: inadequate

Team meetings take place monthly. However, the minutes recorded capture only basic information. There is no evidence that the team is engaging in reflective discussions, identifying what is working well or considering lessons learned and next steps. As a result, staff have limited opportunities to develop their practice, improve consistency of care and strengthen outcomes for children.

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The effectiveness of leaders and managers: inadequate

Feedback from staff about the manager is mixed. Some staff spoke positively about the support they receive and feel able to raise issues with the manager. However, other staff report feeling unsupported and indicated that the manager is not consistently responsive when concerns or requests for assistance are raised.

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The effectiveness of leaders and managers: inadequate

Following this inspection, a compliance notice was issued relating to the leadership and management standard. A restriction of accommodation notice was also issued. Inspection report for children’s home: SC034241 6

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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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 work as a team where appropriate;

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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

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)(b)(c)(f)(g)(ii)(h))

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Requirement Due date

In particular, the manager must ensure that staff always work as a team and are aware of their responsibilities. The manager 10 August 2026 Inspection report for children’s home: SC034241 7 must assure himself that staff have the knowledge and skills to confidently care for children.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

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

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Requirement Due date

assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(v)(vi)(vii)(b))

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Requirement Due date

In particular, the manager must ensure that staff are equipped with the appropriate skills and knowledge to meet the needs of all the children living in the home. 10 August 2026

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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 10 August 2026 Inspection report for children’s home: SC034241 8 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)(b)(i)(ii)(c))

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Requirement Due date

In particular, the manager must ensure that when a child or member of staff is involved in a physical intervention, they receive a purposeful debrief within the set timescales.

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development;

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(a)(b)(c))

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Requirement Due date

In particular, the manager must ensure that staff are provided with supervision in line with the organisation’s policy and that in supervision staff have the opportunity to reflect on their practice. 10 August 2026

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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

employ an individual to work at the children’s home; or

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Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (2)(a)(b) (3)(d)) 10 August 2026 Inspection report for children’s home: SC034241 9 In particular, the manager must ensure that all necessary checks are completed. If a risk assessment is needed regarding a newly recruited member of staff, then it must specifically outline the risks and what will be put in place to mitigate those risks.

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year taking into account the requirement in regulation 12(2)(c) (the protection of children standard).

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Requirement Due date

When conducting the review, the registered person must consult, and take into account the views of, each relevant person. (Regulation 46 (1) (2))

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Requirement Due date

In particular, this refers to the manager updating the location risk assessment, ensuring they consult relevant professionals and capture all known risks and how these are going to be mitigated. 10 August 2026

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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: SC034241 10

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Kisimul Group Limited

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Children’s home details

Registered provider address: The Old Vicarage, High Street, Swinderby, Lincoln LN6 9LU

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Inspectors

Lizette Watts, Social Care Inspector Linda Mason, Social Care Inspector Thirza Smith, Social Care Inspector Inspection report for children’s home: SC034241 11 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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