Children's Home run by Continuum Support - Care Services Limited in Knowsley

Unique reference number SC473375 Inspector Nick Veysey Type of inspection Full Provision subtype Children's home

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Registered person Continuum Support - Care Services Ltd Registered person address 40 Fenwick Road Great Sutton ELLESMERE PORT CH66 4UF Responsible individual Julie Frances Collings Registered manager Louise Dolores Tierney Date of last inspection N/A 2 of 11 Inspection date 21/07/2014

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Previous inspection N/A Enforcement action since last inspection There has been no enforcement action since the children's home was registered.

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Overall effectiveness good

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

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Overall effectiveness

This is the children’s home’s first inspection since it was registered with Ofsted in January 2014. Young people have not lived in the home long enough to be able to identify that they are currently achieving good outcomes. However, there are signs of progress since they moved in. The strengths and good practice found in the quality of care, the arrangements for keeping young people safe and leadership and management means that overall effectiveness is good.

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Overall effectiveness

Young people live in a safe and caring environment that is starting to make a positive difference to their lives. Young people are making positive progress with their welfare and development, including in their health and emotional well-being, forming positive relationships with staff and accepting the advice and guidance available to them. Young people are positive about how well they are being looked after. Social workers are also positive about the staffs’ commitment to young people and the standard of care and support they provide.

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Overall effectiveness

Staff are fully committed to promoting young people’s welfare. They have a good understanding of young people’s needs, circumstances and risks to their safety. They contribute to the planning for young people’s care, support and management 3 of 11 of risk. They work effectively in partnership with young people, social workers and support services to ensure that young people are safe and get the help, guidance and advice they need on a daily basis. Staffs’ child-centred approach ensures that the support young people receive is personalised and tailored to meet their individual and diverse needs.

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Overall effectiveness

The provider and manager have a realistic understanding of what they are doing well, the impact on young people’s welfare and development, and areas for improvement. As a result the home shows a good capacity for further improvement. However, there are areas for further development in relation to consultation with young people, parents and social workers about the quality of care; the sharing of monitoring reports with Ofsted; the detail of medication records; ensuring a development plan is in place for the home; management reviews of incidents of restraint; and the quality of the recording. 4 of 11

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Information about this children’s home

This children's home in run and managed by a private company. It provides care and accommodation for up to two children and young people with emotional and behavioural difficulties or mental disorders. The provider has a service level agreement with a mental health community service, registered with the Care Quality Commission, to provide a range of clinical support to children and young people accommodated at the home and the staff supporting them.

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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

(2001) ensure there are suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the home. This relates to ensuring that records accurately show the amount of medicines received into the home and the amount used; disposing of medicines when they are no longer required; and thorough auditing of the medication records (Regulation 21(1)) 30/09/2014

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Reg. Requirement Due date

(2001) provide a copy of the independent person's report to HMCI (Regulation 33(9)(a)) 30/09/2014

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Reg. Requirement Due date

(2001) supply to HMCI a report in respect of any review conducted for the purposes of regulation 34 paragraph 1. (Regulation 34 (2)) 30/09/2014

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Recommendations

To improve the quality and standards of care further the service should take 5 of 11 account of the following recommendation(s):

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Recommendations

 ensure incidents of restraint are reviewed to ensure the measure has been used in line with the home's behaviour management policy, relevant government guidance on restraint and approved approaches to the application of restraint (NMS 3.14)  prepare a written development plan, reviewed annually, for the future of the home, either identifying any planned changes in the operation or resources of the home, or confirming the continuation of the home's current operation or resource (NMS 15)  ensure children, parents, social workers, and other agencies working with children are regularly involved in contributing to monitoring the operation of the home, and their views and any concerns are seriously taken into account (NMS 21.1)  ensure records are clear, up to date, signed and dated by the author and contribute to an understanding of the child's life; in particular provide a detailed and evaluative picture of children's experiences and progress.

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Outcomes for children and young people adequate

Young people have not been living in the home long enough to see any sustained progress in achieving better outcomes including in their education. However, they are settling in well to the home and there are signs of pleasing progress. They are forming positive relationships with staff including feeling confident enough to initiate conversations, engage positively and express their wishes and feelings constructively. Their behaviour is very good and there has been a significant reduction in young people going missing since they moved in.

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Outcomes for children and young people adequate

The young people enjoy good health. They are starting to enjoy healthier diets and plenty of physical exercise. They understand about the importance of healthy lifestyles and key health risks and take responsibility for their personal care. They are starting to develop practical life skills by routinely taking part in the running of the house. They help staff to plan meals and go shopping.

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Outcomes for children and young people adequate

Young people speak to their family regularly and this is helping them to maintain positive relationships with the important people in their lives. They see their families who visit them at the children’s home. Staff are very aware that young people and families sometimes may find seeing each other stressful, and make sure they are suitably and sensitively supported. A social workers said, ‘The manager and staff are very good at keeping in touch with the young people’s parents to let them know how things are going. The parents find this reassuring.’

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Quality of care good

Staff provide young people with a consistently good standard of care in a friendly and supportive atmosphere. Young people are responding well to the routine and structure provided. They know what is expected of them and what is happening each day and this provides them with a sense of security. Staff care about the young people as individuals and clearly enjoy spending time with them. One member of staff said, ‘(Young person) is really good company and funny. We’ve had a lovely time together today.’ Staff have aspirations for the young people to do well, regardless of the challenges their needs and circumstances may present. Staff also take seriously young people’s views and take them into account. Young people feel that staff are interested their lives and are concerned about their welfare.

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Quality of care good

The staff are developing a good understanding of young people’s needs and how best to support them. Young people have detailed placement plans that clearly show the full range of their individual needs and the priorities for their care. The plans are consistent with the expectations of the placing authority's plan. Staff’s day-to-day 7 of 11 practice ensures that young people receive good individual support and guidance designed to meet their needs. The manager and staff are developing effective working relationships with parents, social workers, health, and education services to promote the young peoples’ development. A social worker said, ‘I have been impressed that the manager and staff attended a planning meeting to fit in with the parents’ needs and commitments.’ The manager and staff share information about young people appropriately with parents, social workers and health services. Consequently all the people involved in the young people’s care are kept up to date

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Quality of care good

about the young people’s experiences and progress.

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Quality of care good

The manager and staff value education and understand its importance as part of young people’s development. Staff work well with the young people, social workers and education providers to promote the young people’s participation in education.

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Quality of care good

One of the young people said, ‘It’s boring here, there is nothing to do.’ However, staff are making every effort to find out what is important to individual young people, understanding their needs, things they like to, talents and interests. As a result, they are starting to plan a range of activities for the summer holidays including ice skating, swimming, gymnastics, clothes’ shopping, cinema and horse riding. They are also looking at the events at local youth clubs to help the young people to get to know the area and provide opportunities to make friends.

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Quality of care good

Young people live in a healthy environment that actively promotes their physical health and emotional well-being. They have good access to health services. Staff have a good understanding of the young people’s specific health and emotional needs and ensure their needs are met on a daily basis. They take prompt action when young people are unwell, ensuring that they get the medical attention, assessment and treatment they require. Where young people have been reluctant to go to hospital, staff are effective in encouraging young people to get medical assistance they need. When young people have needed to spend time in hospital, staff have provided them with excellent support including staying in hospital with them. The manager and staff work well with a community mental health service to promote the young people’s emotional health and well-being. A senior mental health practitioner said, ‘All the professionals involved, including care staff, worked together

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Quality of care good

in (Young person’s) best interests, resulting in a safe and satisfactory outcome for the young person.’

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Quality of care good

Medicines are stored safely and young people receive the medication they require to promote their physical and emotional health. However, the medication records did not accurately show the amount of medicines received into the home. The routine auditing of the medication records did not immediately identify the issue, until the Registered Manager returned to work from annual leave. Therefore, the arrangements to ensure medication is safely managed are not effective at finding errors promptly. Although there has been no negative impact on young people, practice does not effectively safeguard against potential errors with medication. 8 of 11 The house is suitably located, designed, in very good condition and provides a pleasant and comfortable domestic environment for young people. All parts of the premises are decorated, furnished and maintained to a high standard. Young people's bedrooms are comfortable and meet the needs of individual young people.

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Keeping children and young people safe good

Young people are safe and protected from harm. Staff have been carefully selected and vetted to help prevent unsuitable people from being recruited. Staff consistently apply effective safe caring practices to promote vulnerable young people’s welfare. They have a clear understanding of safeguarding issues and child protection procedures, including the risks associated with child sexual exploitation and self- harm. They know exactly what they need to do when they have concerns and act decisively to protect the young people.

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Keeping children and young people safe good

Young people benefit from a calm and friendly atmosphere and their behaviour is very good. Staff are skilled at helping young people to manage their feelings constructively. They work effectively with young people to promote their personal safety and manage risk well. They put into practice detailed written risk assessments and behaviour management plans that clearly identify risks and protective factors for individual young people. The plans include clear guidance for staff about how they should manage potentially harmful behaviour. This enables staff to help young people manage their feelings and frustrations safely. The assessments and plans are routinely reviewed to ensure that the young people continue to receive the support they require.

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Keeping children and young people safe good

Staff rarely use physical restraint with young people. They are suitably trained in physical restraint though and keep detailed records of when it is used. It has been used appropriately to prevent immediate injury to young people. However, the manager has not completed a written review of incidents of restraint to ensure these measure have been used in line with the home's behaviour management policy.

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Keeping children and young people safe good

Staff understand the need to achieve a suitable balance between protection and enabling young people to take reasonable risks as part of their growth and development. The home has developed suitable policies and practices around young people’s use of social media and the internet based on a reasonable assessment of the young people’s needs.

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Keeping children and young people safe good

Staff actively encourage young people not to go missing: They understand the reasons why they go missing, work with them and social workers to help them understand the dangers, and think about what needs to change to reduce the risk of them going.

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Keeping children and young people safe good

No young person has gone missing recently. When they have been missing previously, staff have made every effort to ensure they are protected as far as 9 of 11 possible and responded to positively when they return. Staff work closely and effectively with the police and other agencies when young people have gone missing to locate them, share information and manage the potential risks. Staff follow the local protocol and statutory guidance including holding risk management meetings with the relevant agencies. Staff have followed young people when they have left the house and calmly tried to persuade them to return home. They have tried to locate the young people by keeping in contact with them by mobile phone and using social media to encourage them to keep themselves safe, come home quickly and let staff know where they are.

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Keeping children and young people safe good

Young people are protected from any hazards by a comprehensive range of detailed health and safety procedures and risk assessments. Staff carry out regular health and safety checks, including fire drills, to ensure the premises are safe and young people know what to do in case of an emergency.

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Leadership and management good

The Registered Manager has been in charge of the home since it was first registered in January 2014. She has a suitable professional qualification, considerable experience of working with young people and managing and leading children's homes. She ensures that the home runs consistently with its objectives and in the best interests of young people. The home has developed a positive working relationship with its partner mental health community service. The culture and ethos of the home reflects a strongly child-centred approach and commitment to promoting and safeguarding young people’s welfare.

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Leadership and management good

The home shows a good capacity for continued improvement. The provider and manager make good use of the monitoring of the home to understand the strengths and key areas for development. They have identified further work as necessary in relation to written records and training for staff to enhance their skills and knowledge relevant to the particular needs of individual young people. However, they have not completed a written development plan to show how they intend to make the improvements they have identified. Although the provider and manager prepare detailed monitoring reports, they have not supplied the regulator Ofsted with copies. The manager’s monitoring reports do not include consultation with young people, parents, social workers, and other agencies working with the young people about the quality of the home. As a result the manager is not taking into account how others view and experience the support provided in order to develop the home.

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Leadership and management good

Young people are looked after by enthusiastic, skilled and caring people. The numbers of staff on duty are sufficient to meet their needs. The deployment of staff promotes continuity of care and provides opportunities for the young people to form positive attachments with the staff.

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Leadership and management good

Staff feel very well supported by the manager through regular professional 10 of 11 supervision. They have opportunities to review and reflect young people’s progress and needs, their own performance and development needs, the running of the home and how best to develop and improve the standard of care and support. All the staff are either suitably qualified or working towards gaining their qualifications. Staff also receive good quality training to develop their individual skills and knowledge, relevant to the young people they are caring for.

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Leadership and management good

Overall written records provide a clear picture of young people’s experiences and the support they receive. However, these records are not always dated or signed by the author and do not include an evaluation of young people’s progress. This does not have a direct impact on the welfare of the young people. 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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