Children's Home run by Milestones Care Homes Ltd in Wirral

Unique reference number SC065780 Inspector Sharon Lloyd Type of inspection Full Provision subtype Children's home

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Registered person Milestones Care Homes Limited Registered person address 32 Fieldway Maghull LIVERPOOL L31 5NB

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Responsible individual Stephen Armstrong Registered manager Mark Christopher Armstrong Date of last inspection 21/03/2014 2 of 11 Inspection date 11/11/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness adequate

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

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Overall effectiveness

The quality of care is good. Individually tailored placement plans promote improvements in outcomes for young people. The home supports contact with families and prepares young people for future independence. Some young people make exceptional progress but others make no more than adequate progress in their development.

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Overall effectiveness

Young people influence the day to day running of the home and their individual placement plans. They express a range of views about the quality of care. All agree the home keeps them safe. Most benefit from strong and supportive relationships with staff.

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Overall effectiveness

The home communicates and collaborates effectively with partner agencies. Professionals concur that the home is pro-active in the way it safeguards and promotes improved outcomes for young people.

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Overall effectiveness

There are a number of shortfalls in the leadership and management of the home, including the monitoring of the home and the supervision of staff. The home is not operating in accordance with minimum standards and is in breach of some regulations. Most have minimal impact on the quality of care to young people. However, shortfalls in recruitment and health and safety practices undermine the 3 of 11 home's otherwise good safeguarding procedures. This could pose a risk to young people's safety. 4 of 11

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Information about this children’s home

This children's home cares for up to three children with emotional and behavioural difficulties. It is owned and managed by a private limited company.

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Inspection date Inspection type Inspection judgement

21/03/2014 Interim good progress 20/12/2013 Full good 10/01/2013 Interim satisfactory progress 10/05/2012 Full good

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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) supply to HMCI a report in respect of any review conducted to monitor the matters set out in Schedule 6 at least once in every three months and make the copy of the report available on request to placing authorities where the placing authority is not the parent of a child accommodated in the home (Regulation 34 (2)) 07/12/2014

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Reg. Requirement Due date

(2001) ensure that visits by the independent person shall take place at least once a month and provide a copy of the independent person's written report of the visit to HMCI (Regulation 33 (7)(9)) 07/12/2014

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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 07/12/2014 5 of 11 of the admission of a child into; and the discharge of a child from the children's home (Regulation 12B (1))

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Reg. Requirement Due date

(2001) do not employ a person to work at the children's home unless that person is fit to work at a children's home. Ensure that full and satisfactory information is available in relation to him in respect of each of the matters specified in Schedule 2 (Regulation 26 (1)(a),(3)(d)) 07/12/2014

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Reg. Requirement Due date

5 (2001) notify HMCI of any revision of the Statement of Purpose within 28 days (Regulation 5(b)) 07/12/2014

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Reg. Requirement Due date

(2001) maintain in the children's home the records specified in Schedule 4 and ensure they are kept up to date. In particular, ensure the Admissions and Discharge book and staff rotas are appropriately maintained (Regulation 29 (1)) 07/12/2014

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Reg. Requirement Due date

(2001) ensure that all parts of the children's home used by children are of sound construction and kept in good structural repair internally and externally. In particular, ensure the exit door from the kitchen to the garden opens freely and does not stick during wet weather. (Regulation 31 (2)(d)) 07/12/2014

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Recommendations

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

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Recommendations

 ensure that all care staff have access to support and advice and are provided with regular supervision by appropriately qualified and experienced staff (NMS 19.4)  ensure there are clear and effective procedures for monitoring and controlling the activities of the home (NMS 21.1)  ensure that written records kept by the home when a child goes missing detail action taken by staff, the circumstances of the child's return, any reasons given by the child for running away from the home, and any action taken in light of those reasons. Share this information with the responsible authority and where appropriate, their parents. (NMS 5.10) 6 of 11

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Outcomes for children and young people adequate

Some young people make excellent progress across all areas of their development. They thrive on nurturing and supportive relationships with staff and benefit from clear boundaries and very good emotional support. This enables the development of secure attachments and emotional resilience. One said, 'I am really happy here, they look after me really well.’

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Outcomes for children and young people adequate

Attendance at school for some young people is excellent and their educational achievements are exceptional. Risk taking behaviours significantly reduce over time, so that young people's lives are much improved. They enjoy a range of activities and interests, develop appropriate relationships with peers and develop increasing self- esteem. They learn self-care skills that prepare them well for future independent living. They benefit from the re-establishment of contact with families and the support that the home provides to facilitate this.

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Outcomes for children and young people adequate

One young person has moved on to independent living and two young people have been admitted to the home since the last inspection. Their experiences, progress and outcomes are less positive. They are not engaging in education or employment. The quality of their relationships with staff has a positive impact on their lives but this is not sufficient to promote significant changes in their experiences and outcomes.

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Outcomes for children and young people adequate

Young people learn to lead healthy lives. They develop skills in planning and preparing healthy meals. They grow their own vegetables in the garden. This encourages them to eat more vegetables and helps them to understand the importance of fresh vegetables in a well-balanced diet. They have regular check-ups with health professionals and their particular health needs are very well met.

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Outcomes for children and young people adequate

Young people benefit from psychological support provided by the Child and Mental Health Service (CAMHS) in line with their care plans. The home makes referrals to CAMHS for those young people who need it, as soon as they are admitted. Delays in receiving a service mean that young people wait, on average, six to eight weeks for an appointment. Young people benefit from sexual health counselling from a specialist service. They develop an understanding of how to stay safe on-line when using social media as well as how to engage in safe sex.

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Quality of care good

Young people are confident that they can influence the day to day running of the home and their views are taken into account in their individual placement plans. Young people engage in regular house meetings, key worker sessions and fortnightly 7 of 11 reviews of their own placement plans. In addition they speak to staff informally at any time about matters that concern or interest them. For example, they engage in planning holidays, refurbishment of the home, weekly activities and menu planning. They have opportunities to participate in a wide range of activities in accordance with their own individual interests. They recognise that staff care about them and want what is best for them.

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Quality of care good

Young people receive good written information about the home when they visit the home before placement. They know how to make a complaint and are confident it will be addressed. There have been no complaints made about the home since the last inspection and no allegations against staff.

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Quality of care good

Staff care for young people in accordance with their agreed placement plans. They regularly review young people's plans and progress and implement individual behaviour management and support strategies. This reduces the likelihood of drift and ensures staff are knowledgeable and up-to-date about changes in young people's lives and their individual plans.

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Quality of care good

Positive behaviour management strategies promote improvements in young people's behaviour. For example, bonus schemes encourage the development of good habits and are individually tailored to help young people develop their self-care, independence and social skills. Targets are carefully set to ensure they are achievable and this engenders a sense of achievement and self-worth in each young person.

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Quality of care good

Staff are highly pro-active in promoting good educational outcomes for young people and in assisting them to gain work experience and employment. Partner agencies say the home is 'motivating and encouraging' of young people who are difficult to engage. They go 'way above and beyond other care homes' in their efforts to help young people turn their lives around.

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Quality of care good

The home promotes an understanding of other cultures and an interest in the wider community by encouraging young people to participate in voluntary work and local clubs. It holds regular theme nights where together staff and young people explore information and foods from around the world. This helps to raise young people's awareness and understanding of different customs and cultures.

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Keeping children and young people safe adequate

Young people are safe and feel safe. They are confident they can tell someone if they feel unsafe. They report there is no bullying in the home. Individual risk assessments guide staff in how to protect young people from known risks to their safety and welfare. These are updated following incidents that threaten young people's safety.

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Keeping children and young people safe adequate

Routine health and safety checks ensure that the home is maintained to a high standard and provides a safe environment for young people and staff. One shortfall 8 of 11 was noted in that the back door has become swollen as a result of wet weather and is once again beginning to stick. The provider stated his intention of replacing the door shortly as this exit is a fire exit and not to do so could compromise young people's safety in the future.

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Keeping children and young people safe adequate

Staff, visitors and young people are protected from the risk of fire. They are made aware of fire safety procedures when they arrive at the home. Fire drills are carried out each month and young people actively participate and are familiar with the evacuation procedures. The fire safety risk assessment is regularly reviewed and a member of staff with lead responsibility for the fire safety of the establishment ensures that the risk of fire is minimised.

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Keeping children and young people safe adequate

Staff are trained in the safe use of restraint but this is not a method of behaviour management that is used in the home. There have been no restraints since the last inspection. Sanctions are rarely used because the home finds using positive strategies of behaviour management is more successful in supporting young people to manage their behaviour.

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Keeping children and young people safe adequate

Since the last inspection, two young people have gone missing for a total of 16 times. Staff actively search for young people and act promptly to secure their safe return. They work collaboratively with placing authorities, the police, safeguarding professionals and families to promote young people's safety. They instigate and attend Missing From Care strategy meetings and contribute effectively to safeguarding plans. They make sure their views are shared and recorded when they disagree with other professionals such as the police about the severity of risks to young people. They continue to raise other professionals' awareness of the risks to young people. This demonstrates they are pro-active in protecting young people who are at risk when they are missing.

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Keeping children and young people safe adequate

Although the home requests independent visits for young people who have returned from being missing, these are not always provided by the police, placing authority or specialist service. This means that young people do not always have the opportunity to speak to someone independent of the home about the reason they went missing. Records of interviews with young people on their return are not well documented and do not demonstrate that staff have followed up concerns about young people's safety with them.

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Keeping children and young people safe adequate

Staff provide advice, guidance and clear boundaries for young people at risk of sexual exploitation. This includes limited and supervised access to social networking sites, regular contact with young people who are out independently and support to access information such as the NSPCC 'Take This Lollipop' application. They help young people to improve their awareness of sexual exploitation, develop self-respect and to seek support from staff to stay safe. The home has successfully intervened to protect young people who are being sexual exploited.

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Keeping children and young people safe adequate

The recruitment of new staff is not robust. This is because employment references 9 of 11 are not always received prior to a new member of staff starting work at the home. This could undermine young people's safety as it does not ensure that suitability checks on new staff are completed before they start work at the home. The impact of this shortfall has not so far been detrimental to young people's safety and welfare.

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Leadership and management adequate

The registered manager is also the provider of this home. He is a qualified and experienced social worker who set up the home in 2006 and took over as registered manager in 2012. He is qualified to NVQ Level 4 in health and social care. His stated intention is to complete the Level 5 Diploma within the timeframes required by regulation. He is ably assisted by a senior care worker who deputises for the manager in his absence.

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Leadership and management adequate

The home is suitably located and maintained to a high standard. It provides a comfortable and welcoming home for young people. The home operates in accordance with its Statement of Purpose. This document has been updated recently to reflect changes in staffing and the regulations. A copy of the new document was available for inspection but has not been forwarded to HMCI. This breach in regulations does not impact on the care of young people.

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Leadership and management adequate

A team of six care staff know and support young people well. Some are qualified to degree level and some have attained NVQ level 3 qualifications in caring for children and young people. Others are working towards this qualification. The staff team has a good range of experience, knowledge and skills in child development and children's social care. Staff are committed to providing a high quality service. They continuously develop their skills through participation in mandatory and specialist training events. The home takes advantage of the local authority's training programme for social care sector workers. This ensures staff have up-to-date training in safeguarding, protecting young people from sexual exploitation and other relevant matters such as supporting bereaved young people and those who go missing.

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Leadership and management adequate

Not all staff receive regular, formal supervision in accordance with their needs. This undermines the otherwise good support they receive and does not ensure they have the opportunity to explore issues of concern and seek advice and guidance within a safe and confidential environment. It does not provide the manager with the opportunity to regularly review each staff member's competence.

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Leadership and management adequate

The capacity for improvement is limited. Recommendations for improvement made at the last inspection have not been fully implemented. This does not show a home that is improving. Quality assurance visits made by an independent person are not routinely forwarded to HMCI. Similarly, reports completed by the registered manager on the operation and development of the home are not always forwarded to HMCI. This impedes the regulator from carrying out on-going assessment and monitoring of the home. These shortfalls do not directly impact on the care provided to young 10 of 11 people.

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Leadership and management adequate

There are further shortfalls in the monitoring of the home. For example, the staff training matrix is not up to date. This does not enable to manager to quickly identify any gaps in staff training.

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Leadership and management adequate

Young people's records are mostly well-maintained but there are some shortfalls in record keeping and administration. For example, the admissions and discharge book does not specify the address to which young people are discharged on leaving the home. This does not impact on young people's care but is an important record to assist young people who return as adults to track their journey through care. The staff rotas maintained in the home do not accurately reflect the actual rotas worked. This information is kept separately by the manager. It is therefore not easy to identify which staff have been on duty on a particular day. The home cannot easily demonstrate that the home is suitably staffed at all times. The home did not notify the local authority of the discharge of a young person from out of area. This impedes the local authority from fulfilling its duty to monitor out of area placements within its

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Leadership and management adequate

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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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