Children's Home run by Birtenshaw in Bolton

Unique reference number SC470797 Inspector Paul Scott Type of inspection Full Provision subtype Children's home

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Registered person Birtenshaw Registered person address Birtenshaw, Darwen Road Bromley Cross BOLTON BL7 9AB Responsible individual David Gerald Reid Registered manager Yvonne Georgina Nelson Date of last inspection N/A 2 of 11 Inspection date 08/07/2014

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Previous inspection N/A Enforcement action since last inspection There has been no enforcement action since the home opened in October 2013.

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Overall effectiveness good

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

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Overall effectiveness

This is relatively new service that has significantly impacted on young people's lives. Parents and professionals comment very positively about the service and recognise the positive impact the home has made on their young people, sometimes in a relatively short period of time. One parent said, '(Name) is a happy boy. He is more confident and his speech has improved a lot. I cannot fault the home or staff because they provide excellent family care that has benefitted us and our child.'

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Overall effectiveness

Young people are safe and their welfare is paramount. They are well protected by robust safeguarding procedures that are integral to staffs day-to-day practice. This means young people's known and emerging risks and vulnerabilities are managed effectively and their personal safety is maintained at all times.

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Overall effectiveness

Relationships between young people and staff are very strong. Staff utilise these effectively to help young people manage their challenging and complex behaviour. Care planning and care practice is highly individualised and responsive to young people's needs. Staff are familiar with these needs and provide young people with consistently good support that enables them to grow and explore their potential. This has contributed to young people thriving and making excellent progress in 3 of 11 many aspects of their lives including behaviour, communication, social awareness and mobility.

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Overall effectiveness

Managers and staff are highly motivated and place the needs of young people at the centre of the work they do. Staffing levels are high and ensure young people's known and emerging needs can be consistently met at all times. Staff have high aspirations for young people. They work exceptionally hard to overcome the inequalities associated with their disabilities and show a genuine commitment to continuous improvement and development.

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Overall effectiveness

A number of shortfalls were identified during this inspection. These relate to how incidents of restraint are recorded and failure to notify Ofsted of significant events. Neither of these breaches of Regulations has impacted directly on young people's welfare. 4 of 11

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Information about this children’s home

This is one of a number of children's homes operated by a charitable organisation. The home is registered to provide care and accommodation for up to three children and young people with physical disabilities and/or learning disabilities.

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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.

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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 which shall include all information set out in that regulation (Regulation 17B (3)(a-i)(4)(a-b)) 07/08/2014

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Reg. Requirement Due date

(2001) if, in relation to a children’s home, any of the events listed in column 1 of the table in schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table. (Regulation 30 (1)) 07/08/2014 5 of 11

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Outcomes for children and young people outstanding

Young people are happy and settled at this home. They enjoy a genuine sense of belonging that derives from the positive attachments they have established with staff, who care for them dearly. Staff treat young people with dignity and respect. They are dedicated to helping young people overcome the challenges they face in their lives to enable them to achieve their potential. This means young people get the right support they need and are successfully making progress in achieving their personal goals and aspirations. For example, young people have been supported to reduce the use of their wheelchair and develop alternative forms of mobility. Consequently, young people make very good progress because their opportunities are not limited by the inequalities associated with their disabilities.

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Outcomes for children and young people outstanding

Staff have an excellent understanding of young people's individual mannerisms and communication style. They creatively use their knowledge to enable young people to contribute positively to their day-to-day lives. This ensures that they exercise genuine choice about the meals they eat, the activities they want to undertake and the staff who they spend time with, for example.

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Outcomes for children and young people outstanding

Young people benefit from the well-organised and consistent management of their complex health needs. Staff know young people well and are well trained to deal with their specific health issues and challenging behaviour. Their needs are appropriately prioritised by staff, are well understood and proactively addressed. As a result, young people maintain good health and well-being.

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Outcomes for children and young people outstanding

School attendance is consistently high with all young people routinely attending the organisation’s special school. Young people clearly enjoy their time in school and are making good progress in their learning and development. Staff reinforce young people's progress through the use of positive praise when they return home from school at the end of the school day. This further promotes the value of education which is seen as an essential component of any young person's placement.

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Outcomes for children and young people outstanding

Staff have very strong links with young people's parents and families and ensure they continue to play a significant role in their child's life, where appropriate. Young people benefit from regular contact with parents, siblings and other family members, arranged and supported by the home. Staff make every effort to ensure contact is a positive and rewarding experience for everyone involved. For example, for parents who are unfamiliar with the area staff collated information about interesting activities that they could do when visiting their child.

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Outcomes for children and young people outstanding

A small number of young people do not have regular contact with their family. In these circumstances staff work closely with advocacy services and seek the involvement of an independent visitor. This ensures that young people are not 6 of 11 isolated when living away from home.

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Outcomes for children and young people outstanding

The daily life of the home provides opportunities for young people to develop social and independence skills, relative to their age and ability. With the support of staff, young people are assisted to participate in basic tasks such as cleaning their teeth, collecting laundry, tidying the home and helping with the shopping. This provides them with good foundations on which to develop skills that will help them grow in confidence and become more independent.

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Quality of care outstanding

Young people live in a highly supportive environment where staff focus on their unique and individual needs. Staff are attentive, calm and patient and demonstrate a genuine commitment towards the young people in their care. Young people and staff share warm, reciprocal relationships with each other. These are the foundations to helping young people feel safe and well cared for in a mostly settled environment. A social worker wrote 'It is lovely to see how settled (name) is at school and in the home. It is great to see his sense of humour come out in such a short time and how he obviously feels reassured and relaxed with staff.'

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Quality of care outstanding

Staff make every effort to overcome the barriers to communication and ensure young people can express themselves and make informed choices about their care and the daily running of the home. Young people's families are routinely involved, consulted and informed about all aspects of their child's care. Their knowledge and opinions are respected and they say their views are fully taken into account when planning their child's care. This ensures young people's needs and wishes are fully understood and that they and their families are able to make a positive contribution to making decisions about their lives.

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Quality of care outstanding

Admissions are well planned and sensitively managed. Staff work closely with young people and their families to help alleviate anxieties and concerns associated with living away from home. Young people's compatibility with each other is carefully considered. This ensures young people are well matched and has provided them with good opportunities to form positive relationships with their peers.

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Quality of care outstanding

Care planning and care practice is highly individualised and child-centred. Care plans are comprehensive, up-to-date and information is effectively used by staff to ensure young people's individual needs are known and consistently met. Staff recognise young people as individuals from different backgrounds with their own set of interests, needs and circumstances. They work exceptionally hard to ensure young people are well supported and that their progress is not limited by their disabilities. They work closely with young people's families, social workers and relevant agencies to promote consistency and continuity of care. As a result, young people's holistic needs are met because they receive an excellent service that is individually tailored to their specific and unique needs. 7 of 11 Young people benefit from rigorous assessment of their health needs and detailed planning to ensure those needs are appropriately met. Staff are consistent in their

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Quality of care outstanding

efforts to support young people with routine health care matters and actively encourage them to learn self-care skills that enhance their levels of independence. Young people's health is well monitored and staff engage fully with a range of healthcare professionals to ensure young people's routine, specialist and emerging health needs are met on a day-to-day basis.

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Quality of care outstanding

Staff promote young people's education by ensuring the daily routine supports their participation in school. They work closely with education staff to make sure young people get the right support they need to fulfil their education potential. This includes transporting young people to and from school, sharing information on a daily basis, attending meetings and celebrating young people's achievements.

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Quality of care outstanding

Young people are regularly involved in a wide range of activities that provide them with fun, exercise and stimulation. Staff encourage young people to pursue their individual interests and talents such as colouring, using the computer and spending time in the small sensory room. Every opportunity is taken to encourage young people to engage in activities outside of the home such as visiting a youth club, dining out, visiting the park, going for walks or trips to the seaside, for example. This inclusive approach has enabled young people to grow in confidence, improve their social skills and become more socially adept.

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Quality of care outstanding

The design and location of the home is suitable in meeting young people's needs. This includes young people with physical disabilities as the home has had a number of adaptations that cater for their needs, including those relating to mobility. The home is neutrally decorated in response to the need to create a non-stimulating environment for young people with autism. Young people are encouraged to personalise their bedrooms with photographs from home and personal possessions where appropriate. The home has recently added two small ground floor extensions. This is to enhance resources and compensate for the restrictions brought about by having only one communal area in which young people can spend time together. The large garden is currently being landscaped and when complete it will provide an excellent outdoor space for young people to relax and play in, weather permitting.

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Keeping children and young people safe good

Young people are protected by a range of effective safeguarding measures such as detailed risk assessments and procedures to follow in the event of any allegation, suspicion of abuse or unsafe practice. Staff are trained in safeguarding and clear about their roles and responsibilities in promoting young people's welfare and keeping them safe. They have a good understanding of young people's needs and take positive steps to manage their known risks and vulnerabilities, including those associated with their complex needs and disabilities. As a result, young people are 8 of 11 safe and well supported to minimise any risk to them.

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Keeping children and young people safe good

The home has effective procedures for monitoring young people. High staffing ratios ensure young people are given the supervision and support they need to keep themselves safe. Consequently, young people are effectively protected from bullying and discrimination and there are no issues of them going missing from home. One parent said, '(Name) is always safe because staff look out for him. He is happy and very well cared for and I have no concerns at all.'

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Keeping children and young people safe good

There is a very positive and calm approach to behaviour management. This means young people's complex and often challenging behaviour is sensitively and effectively managed. Staff have developed an understanding of the times and factors that contribute to young people becoming anxious, upset or frustrated. They use well thought-out and effective behaviour management strategies and challenging behaviour is sensitively and effectively managed through good use of positive relationships and early intervention.

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Keeping children and young people safe good

Staff are trained in the use of restraint and have on a number of occasions utilised these skills when all other strategies have failed. When physical intervention has been required it has been low level and to keep young people safe from harming themselves or others. A basic record of these interventions and other behaviours is maintained on young people's individual behaviour star charts, which are a useful tool for monitoring and evaluating behaviour. However, this is not a record designed for the purpose of recording restraint and the detail contained within these documents is insufficient to make a proper analysis of the incident. These records would not stand up to scrutiny and may leave staff vulnerable to challenge or complaint at a later date.

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Keeping children and young people safe good

A number of new staff have been recruited to the organisation and deployed to the home since opening. All staff are rigorously assessed, checked and vetted to ensure they have the right skills and competencies and do not pose a risk to young people.

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Keeping children and young people safe good

Young people live in a physically safe environment. They are well protected by a range of health and safety procedures, risk assessments and checks. Young people have individual evacuation plans that take into account their unique needs associated with their disability, including issues of mobility. Staff and young people are regularly involved in fire drills to ensure they all know how to safely evacuate the building in the event of a fire.

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Leadership and management good

The home’s Registered Manager holds level 4 qualifications relevant to working with children and young people and in leadership and management and has been in post since the home opened in October 2013. The manager has a wealth of experience of working with young people with complex needs and drives a strong, child-focused 9 of 11 approach across all aspects of care practice. She is well supported by a staff team who demonstrate a dedicated commitment to the young people in their care. Staff have high aspirations for young people and their efforts are rewarded in the progress all young people make as a result of consistently good support.

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Leadership and management good

Young people benefit from high staffing levels that ensure their individual and unique needs can be met on a daily basis. Staff receive regular supervision and are provided with frequent opportunities to review their performance through systems of appraisal that focus on professional development and improving practice. All staff are expected to undertake mandatory training. There are ample opportunities for staff to further develop their skills and knowledge through needs led training such as epilepsy, autism and administering rescue medication, for example. As a result, staff demonstrate a clear understanding of their roles and responsibilities and have the right skills and support to meet young people's known and emerging needs, including those associated with their disabilities.

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Leadership and management good

There is a good balance of experience and skills within the staff team. New staff are well inducted and supported throughout their probationary period. All staff spoke positively about how they are supported in their daily practice and through regular formal supervision. The home is well organised in ensuring staff have the opportunity to gain the right qualifications for their role with all staff having, working towards or being registered for a level three qualification.

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Leadership and management good

The home meets the aims and objectives of its Statement of Purpose, which is sufficiently detailed and regularly updated. Additional information in the form of the children's guide, which is available pictorial format, provides young people with key information about the home. This ensures young people and stakeholders are clear about the services and support provided by the home.

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Leadership and management good

There are plans to increase the number of young people for whom the home can provide care and accommodation. These plans are broadly outlined in the home’s development plan which is clearly focused on sustained improvement and development of the organisation and the home. The manager has a clear understanding of the future direction of the home and places the needs of young people at the heart of service development.

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Leadership and management good

The operation of the home is appropriately monitored. External monitoring processes complement internal management systems and ensure the conduct and performance of the home is suitably evaluated and the home’s strengths and weaknesses are known. When shortfalls are identified they are appropriately addressed. This ensures young people's care is of a consistently high standard.

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Leadership and management good

The home's written records are securely stored and provide a comprehensive insight into young people's individual needs, progress and areas for development. The organisation is in the process of improving information sharing practices, specifically relating to accidents, which will further promote confidentially. 10 of 11 There are procedures in place for notifying relevant parties when significant events occur. However, there have been two occasions when young people have had accidents that have been deemed serious enough to call emergency services on one occasion and attend accident and emergency on both. These incidents were managed in the best interest of young people. However, the manager failed to notify Ofsted of these events, contrary to Regulation 30. Website: www.ofsted.gov.uk

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Leadership and management good

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Judgement Description

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

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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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.

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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.

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