Children's Home run by New Start in Knowsley

Unique reference number SC471289 Inspector Sue Winson Type of inspection Full Provision subtype Children's home

p.1

Registered person New Start Registered person address Job Bank 4 Tunnel Road LIVERPOOL L7 6QD

p.1

Responsible individual Allen Raymond Baynes Registered manager POST VACANT Date of last inspection N/A 2 of 12 Inspection date 04/07/2014

p.1

Previous inspection N/A Enforcement action since last inspection none

p.2

Overall effectiveness inadequate

Outcomes for children and young people inadequate Quality of care inadequate Keeping children and young people safe inadequate Leadership and management inadequate

p.2

Overall effectiveness

The home does not provide consistency of care, designed to meet the needs of young people and safeguard their welfare. Individual plans are not effective in providing guidance for staff to ensure young people understand what is expected of them so they are supported to maintain progress and meet the aims of placements. There is not a stable staff team, and staff are not equipped with the skills and experience needed to care for young people admitted in line with the home’s statement of purpose. Due to deficiencies in planning and recording, there is little evidence of positive outcomes for young people.

p.2

Overall effectiveness

Not all allegations or concerns for young people’s safety have been responded to appropriately. Communication with relevant people, including social workers, the police missing from care co-ordinator or the Local Authority Designated Officer (LADO), has been ineffective and does not adequately protect young people.

p.2

Overall effectiveness

Young people speak positively about the home and their relationships with staff, who they say care for them and are concerned about them. Whilst they don’t like some of the rules, they regard them as fair. Positively, they have been able to talk to staff when they feel they are bullied or intimidated by other young people. They want to remain in the home, and at times a positive and relaxed atmosphere is evident, despite the areas of concern and number of actions and recommendations 3 of 12 made as a result of this inspection.

p.2

Overall effectiveness

Oversight and monitoring of the home is ineffective in identifying areas of concern that have arisen from this inspection. As a result, leaders and managers have not taken adequate action to remedy deficits, and have not compiled development plans with the aim of improving services to young people.

p.3

Overall effectiveness

The breaches of regulations and failures to meet national minimum standards impact negatively on the welfare and safety of young people, and means that the home cannot demonstrate they are safe. 4 of 12

p.3

Information about this children’s home

This service provides care and accommodation for up to four young people who may have emotional and/or behavioural difficulties and/or learning disabilities and/or mental disorders. The home is owned by a private company. At the time of the inspection 2 young people were resident.

p.4

Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

p.4

Reg. Requirement Due date

4 (2001) ensure the registered person keeps under review, and where appropriate, revise the Statement of Purpose and children's guide (Regulation 5(a)) 31/07/2014

p.4

Reg. Requirement Due date

(2001) ensure that the children's home is conducted so as to promote and make proper provision for the care, education, supervision, support and, where appropriate, treatment, of children accommodated there (Regulation 11 (1)(b)) 31/07/2014

p.4

Reg. Requirement Due date

12B (2001) notify, in writing, the local authority for the area in which the children’s home is located without delay of the admission of a child into, and the discharge of a child from the children’s home (Regulation 12B (a) and (b)) 31/07/2014

p.4

Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children’s home a written record is made in a volume kept for the purpose (Regulation 17B (3)) 31/07/2014

p.4

Reg. Requirement Due date

(2001) make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the 31/07/2014 5 of 12 children’s home (Regulation 21 (1))

p.4

Reg. Requirement Due date

(2001) ensure that all persons employed by the registered person receive appropriate training, supervision and appraisal (Regulation 27 (4)(a)) 31/07/2014

p.5

Reg. Requirement Due date

(2001) maintain in respect of each child who is accommodated in a children’s home a record in permanent form which includes the information, documents and records specified in Schedule 3 relating to that child; is kept up to date; and signed and dated by the author of each written entry (Regulation 28 (1)) 31/07/2014

p.5

Reg. Requirement Due date

(2001) ensure that the requirements of any Order, and any regulations made under it except for article 23 (duties of employees), are complied with in respect of the home (Regulation 32 (1A) 31/07/2014

p.5

Reg. Requirement Due date

(2001) the independent person shall produce a written report about a visit and provide a copy of the report to HMCI (Regulation 33 (9)) 31/07/2014

p.5

Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at least once every 3 months; and improving the quality of care provided in the children’s home. (Regulation 34 (1)) 31/07/2014

p.5

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.5

Recommendations

 ensure that the views, wishes and feelings of children and those significant to them are taken into account in monitoring staff and in developing the home (NMS 1.7)  ensure that the home meets children’s emotional and behavioural needs, as s out in their care plan. Children’s privacy and confidentiality are appropriately protected (NMS 3.7)  ensure that the home’s location and design promotes children’s health, safety and wellbeing and avoids factors such as excessive isolation and areas that present significant risks to children (NMS 10.2)  ensure that the children’s home only provides admission to children whose assessed needs they can reasonably expect to meet.] (NMS 11.2)  ensure that the home contributes to the development of each child’s care plan including the pathway plan for “eligible” care leavers and works collaboratively with the young person’s social worker or personal adviser in implementing the

p.5

Outcomes for children and young people inadequate

Young people have not sustained settled placements where they have made consistent progress. Their risk taking behaviours have continued or increased, necessitating their unplanned moves from the home, for their safety. This disruption impacts on their ability to form meaningful attachments. The present residents have been in the home for short periods. Where possible the staff do visit them prior to admissions, to give them information about the home so they have some knowledge of the home they are moving into.

p.7

Outcomes for children and young people inadequate

Their physical health needs are largely met, and they have access to a range of local services where necessary. Prompt action is taken in contacting emergency services to safeguard their health when needed. Their emotional and psychological needs are not consistently met. This is due to delays in accessing specialist services, a lack of clarity in care planning and a lack of consistency in the support provided.

p.7

Outcomes for children and young people inadequate

Not all young people are engaging in education, either in the home, or externally at alternative provision. Young people over sixteen are not in education, employment or training. Where they do engage, they have opportunities to follow their interests and skills, both in education and in their leisure time. Assessing their attainment is not possible due to the short period in placement of current residents.

p.7

Outcomes for children and young people inadequate

Young people’s meetings are not held regularly. Whilst staff consult with young people informally, there are few examples of direct work, or key working sessions, that demonstrate how staff ascertain young people’s wishes and views about the care they receive and how they can influence this. However, young people do say they have choices, and that staff respond positively to reasonable requests.

p.7

Outcomes for children and young people inadequate

Not all young people have pathway plans, or care plans which set out their individual needs or how the home are working to promote the development of their life skills in an effective manner. Young people can, and do, choose their meals, take part in cooking and are learning new skills. There are some examples of young people being encouraged to manage their free time in a structured way to build their understanding of keeping themselves safe.

p.7

Outcomes for children and young people inadequate

Young people benefit from appropriate contact with their families, and staff are active in promoting and facilitating contact. This means young people are able to maintain and build upon relationships that are important to them.

p.7

Quality of care inadequate

8 of 12 Positive outcomes for young people are not consistently being achieved in the home. Due to lack of effective planning and recording deficits there are very few examples of how staff are working with them on the aims of their placements.

p.8

Quality of care inadequate

The homes assessment prior to admission of their ability to meet the identified needs of young people, is not evident. It is also unclear how far the needs of those already resident are taken into account when the compatibility of new placements is being considered. Staff describe the dynamics between very different personalities as complex and, at times, unmanageable. They report that boundaries have not been clear to them or to the young people. This is compounded by a lack of clear leadership and management, specifically in regard to guidance and communication. This results in a lack of consistency of care for the young people. In addition those staff working in the home do not all have experience or skills in working with the complex needs of the young people placed.

p.8

Quality of care inadequate

Care plans are not all up to date and do not contain clear aims and objectives or specify how they will be achieved. There is no evidence of regular monitoring and review of the plans and it is difficult to assess progress to establish whether the actions or strategies to support young people are making a positive difference.

p.8

Quality of care inadequate

Young people are routinely registered with local doctors, dentists and opticians and healthy living is promoted as part of daily life. Positively, a local health representative meets with the home monthly and maintains regular weekly contact to monitor the ongoing health needs of resident young people. They also give information and advice about local services and assist in referring young people to relevant health specialists. For example, young people know about sexual health services that are available to them and how to access them if needed. Additionally, the local drugs team are to provide staff training to develop staff knowledge in this area. However, there have been delays in meeting the psychological needs of the young people, specifically in accessing Children and Adolescent Mental Health (CAHM’s) teams.

p.8

Quality of care inadequate

The arrangements for the safe management and administration of medication are not sufficiently robust. There is a lack of stringent recording and checking of medicines brought into the home, and given to young people. Risk assessments do not include the arrangements for young people to ensure they are safely keeping and taking their own medication. Overall this fails to adequately protect young people.

p.8

Quality of care inadequate

Whilst staff promote engagement in education, not all young people choose to attend schools or access college courses. Some limited progress has been made in attendance by encouraging young people to include areas of interest in education time, for example engaging in animal care. Background information about young people’s education, including Personal Education Plans, is not consistently secured by the home in order to inform their education on site. Overall the lack of success in engaging young people in purposeful education, employment or training impacts on their future life chances. Similarly whilst a range of activities are promoted not all young people choose to engage. 9 of 12 The home is located in a rural setting, and provides sufficient space for the young people. The house is well furnished and there is space for young people to meet with visitors privately.

p.8

Keeping children and young people safe inadequate

Young people say that they are safe and that staff talk with them about personal safety. They have spoken to staff when bullied or intimidated by other young people, and have made complaints and allegations. Young people are given information on how to make a complaint and have done so. However, the management response to their behaviours and allegations means they are not consistently safe either in the home or outside. Their welfare is therefore not adequately safeguarded.

p.9

Keeping children and young people safe inadequate

Positive behaviour management is not always evident, as on several occasions it has been necessary to call the police to assist in managing situations safely. Behaviour management plans are not clear or comprehensive and do not to provide staff with clear guidance, for continuity of care. The use of physical restraint is difficult to assess due to poor recording in the home. For example, the information in restraint records is not always the same as in the incident reports of the same event. Some records contain different handwriting so there is no clarity about who has completed reports. There is no evidence of follow up work with young people following restraint. On one of the inspection days, neither member of staff on duty had been trained in positive behaviour management and safe handling techniques. This places both young people and members of staff at an unacceptable level of risk in the event of

p.9

Keeping children and young people safe inadequate

an incident occurring. There is no evidence of manager’s monitoring resulting in improved behaviour management.

p.9

Keeping children and young people safe inadequate

Risk assessments, although in place, lack detail and significant information is missing. They are not regularly monitored and reviewed to assess the impact of measures taken to reduce the risks nor have they been updated with information gained after significant incidents involving high risk behaviours. Risk management plans have not been completed for the two young people resident. The lack of rigour and oversight fails to adequately safeguard young people.

p.9

Keeping children and young people safe inadequate

The incidents of young people missing from care have not been significantly reduced This means that they remain at high risk due to their individual vulnerabilities. The local missing from care police co-ordinator reports that she has not received regular incident reports and updates about the young people at this home or about new placements, despite being in regular contact. The local police team convened a strategy meeting recently due to concerns about the young people resident, including the staff’s lack of knowledge about individual residents and their care plans and vulnerabilities.

p.9

Keeping children and young people safe inadequate

Not all allegations have been handled appropriately. The necessary people have not 10 of 12 always been informed or consulted when allegations have been made by young people. This has included failure to inform social workers, LADO’s and HMCI. As a result no actions have been taken to protect young people pending investigations. In addition young people are not consistently supported following their allegations. The current arrangements and practice fails to sufficiently safeguarded young people.

p.9

Keeping children and young people safe inadequate

Fire evacuations have not taken place shortly after young people have been admitted, therefore they have not all had the opportunity to practice leaving the building safely Where young people did not respond to fire practice alarms, no further action has been taken to raise their awareness of the dangers consequently they are at a heightened risk in the event of a fire.

p.10

Keeping children and young people safe inadequate

The arrangements for the recruitment of permanent staff follows appropriate procedures and the required vetting and references take place. The home contains information about agency staff working there.

p.10

Keeping children and young people safe inadequate

The area outside of the main garden is full of debris and recently resulted in young people putting themselves at risk after they climbed over the dividing fence. The clearing of the area, in order to make it safe, has begun.

p.10

Leadership and management inadequate

This is the first inspection following registration of the home. Several staff have left since that time. There is no registered manager in post after the previous post holder recently resigned. The current leaders and managers have been active in recruiting a manager and new staff, and have sent out appointment letters subject to the receipt of references and checks. The area manager has a high presence in the home in the meantime.

p.10

Leadership and management inadequate

Due to a number of permanent staff leaving there has been a reliance on agency staff to support the remaining permanent team. The home recently changed agencies and there has continued to be a lack of continuity and consistency of care for the young people. The permanent and current agency staff do not have extensive experience and skills to meet the needs of the young people resident. Deficits in staff training include lack of awareness and knowledge in specific areas necessary to meet the complex needs of young people in the home such as risks associated with exploitation.

p.10

Leadership and management inadequate

The management of the home is ineffective. Leaders and managers do not have a good understanding of the strengths and weaknesses of the home, nor is there a development plan in place to remedy the deficits that have been identified only recently by the RI and area manager. This demonstrates a lack of proper oversight of the service and fails to ensure the safety, welfare and positive progress of young people. 11 of 12 There are records of regular visits under Regulation 33, however these have not identified the concerns and deficits, which were found during this inspection. No reports have been sent to Ofsted as required. Monitoring and auditing reports compiled by the manager have not identified areas needing improvement, or included actions to enhance the quality of care.

p.10

Leadership and management inadequate

The home’s statement of purpose is now out of date. Records are not clear, well organised or contain all the necessary information. Some reports contain names and personal information about more than one young person. Many are unsigned and undated. This fails to provide an accurate record of the young people’s experience at the home and does not adequately contribute to an understanding of the young people’s life.

p.11

Leadership and management inadequate

The home is adequately resourced and the service is reported to be financially viable. Although not fully occupied at present, this home is financially supported by sister services owned by the company. Website: www.ofsted.gov.uk

p.11

Leadership and management inadequate

This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

p.12

Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

p.12

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.12

Judgement Description

Adequate A service that only meets minimum requirements.

p.12

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.12

Information about this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

p.12

Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

p.12