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

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 Young people live in a caring and supportive children’s home that is making a positive difference to their lives. They are making excellent progress in all areas of their development. A young person said ‘I feel safe, get on with staff, can talk to them about anything they listen. ’

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The children's home provision is good because:

 The manager and staff have a clear understanding of the risks that individual young people face and work very effectively with other agencies to reduce any risk of harm to them, including those associated with aggression, sexual exploitation and social media.

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The children's home provision is good because:

 The manager and staff engage exceptionally well with partner services to ensure young people’s needs are fully met and they get the best possible support. They are skilled at identifying areas of unmet need and actively finding the right support for the young people at the right time. They have successfully worked with education providers to enable young people to return to school and collaboratively with mental health services to understand young people’s feelings and behaviour to promote emotional well-being and resilience.  The home is effectively managed in the best interests of the young people. The staff are highly skilled and enjoy working with the young people. They understand how their work and commitment is helping to make a difference. A member of staff said, ‘She is a lot happier. We are getting to know her and getting better at knowing what to do to help her.’  The home would benefit from a more systematic review of its quality of care

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The children's home provision is good because:

that included formal consultation with young people, parents and its partner. More thorough scrutiny would have identified and improved weaknesses in relation to the written records, gaps in the monitoring of restraints, and the accuracy of the statement of purpose. In addition, young people would benefit from more in-depth and independent interviews when they have been missing from home and the chance to decorate the house in their style.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)(b)) 31/07/2015

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes details of the child's behaviour leading to the use of the measure and details of any methods used or steps taken to avoid the need to use the measure. Also 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 has spoken to the user about the measure; and has signed the record to confirm it is accurate; and 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)(a)(ii)(v) & (3)(b) & (c)) 31/07/2015

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Requirement Due date

The registered person must ensure that the independent person provides a copy of the independent person's report to HMCI (Regulation 44(7)) 31/07/2015

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Requirement Due date

The registered person must complete a review of the quality of care provided for children ("a quality of care review") at least once every 6 months. In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating the quality of care provided for children; the feedback and opinions of children about the children's home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. In particular review the effectiveness 31/07/2015 of the arrangements for therapeutic services in achieving better health outcomes for children. (Regulation 45 (1) & (2)(a)(b)(c))

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Ensure children are consulted regularly on their views about the home's care to inform and support continued improvement in the quality of care provided. They are supported and encouraged to use young people's meetings to express their views and influence the running of the home and the quality of care (The Guide to the Quality Standards, page 22, paragraph 4.11)

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Recommendations

 Ensure staff record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. In particular show a detailed picture of children's daily lives; use specific language that shows how they spend their time and what they do; and record accurately their comments and views (The Guide to the Quality Standards, page 62, paragraph 14)

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Recommendations

 Ensure when a child is found after they have been missing from home they are offered an independent return interview. Independent return interviews provide an opportunity to uncover information that can help protect children from the risk of going missing again, from risks they may have been exposed to while missing or from risk factors in their home. The interview should be carried out within 72 hours of the child returning to their home or care setting. This should be an in- depth interview and is normally best carried out by an independent person (someone not involved in caring for the child) who is trained to carry out these interviews and is able to follow-up any actions that emerge. (Statutory guidance on children who run away or go missing from home or care, page 14, paragraphs 31 & 32)

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Recommendations

 Ensure the home meets children’s basic day to day needs and physical necessities. In particular enhance further the décor and clean the carpets; and include the children in making choices about how their home is decorated and furnished. (The Guide to the Quality Standards page 15, paragraph 3.7)

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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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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

04/03/2015 CH - Interim Sustained effectiveness

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good

Young people receive a high quality of care that is making a significant difference to their lives. Staff ensure that they get the personalised support and guidance they need. In the relatively short time they have lived in the home they are healthier, becoming increasingly safer, taking part in meaningful education and enjoyable activities, and managing their feelings more constructively. The young people said, ‘I love it here. I’m getting the right help to make me feel safe’ and ‘I think it is outstanding because it is nicely decorated, I’m well looked after, staff are kind, and make me feel safe.’ A social worker said, ‘I saw her last week and it was the best I had seen her in a long time, staff have worked really hard to move her forward. She is back in education, not as stressed, healthier and brighter.’

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good

The staff have created a warm and supportive environment where young people feel valued and know that people like and care about them. This has helped them to settled in quickly and build positive relationships. Young people trust staff. One said ‘staff help me because they listen and sort things out.’ Because of these positive relationships they feel confident asking for staff to help them make changes to their lives. They are making good use of the support and guidance available from the staff and other services, including schools and therapists. The results have been very encouraging: young people are no longer using drugs and alcohol or getting into trouble with the police. A member of staff said a young person had struggled to settle in at first but now ‘is making progress. We have seen a lot of improvement and she shows a commitment to try to make it work here. She is attending school, and engaged in the work. I’ve seen changes in her

p.6

good

demeanour, colour of the clothes she chooses to wear are brighter; she is taking pride in her appearance; showing some signs of maturity; and is responding well to structure routines, clear expectations and boundaries.’

p.7

good

Young people are encouraged and supported to express their wishes and views and take part in all the decisions about their lives. They make choices about what they have to eat, how their rooms are decorated, how they spend their time and what they want to happen in the future. They are also interview new staff. The staff also help them to understand their wishes may not be always followed when it may not be in their best interests or that of other people. The recent introduction of weekly young people’s meetings is a positive step in helping them to express their views appropriately. However, the meetings need to provide more opportunities for the young people to take more control and playing a more active role in leading the discussions by setting the agenda, raising issues and concerns, and see their views influencing their quality of care.

p.7

good

The staff work extremely well with social workers, schools, health workers and therapists to build a detailed understanding of young people, their individual needs, views, the risks they face, and how best to help them. The young people have detailed placement plans that clearly show the full range of their individual needs and the priorities for their care. Staff consistently follow the plans and ensure that young people receive good individual support and guidance. They routinely review and adapt these plans to reflect on changes in young people’s lives and ensure the arrangements continue to meet their needs.

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good

Both of the young people live a long way from their homes and the staff have played an active role in making sure that they have easy access to health, education, and therapeutic services in the local area. The staff have worked extremely hard to make the young people get the right support at the right time. When young people have asked for help and been ready to talk about their experiences support is available. This has included, when there have been delays in providing services, quickly finding appropriate alternative support around child exploitation, drugs and alcohol, and emotional well-being and identity. Young people speak regularly to their family and other significant people; helping them to maintain important relationships. Their families often come to see them and take them out at the weekend. The staff make sure this is a safe and positive experience for everyone.

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good

The manager and staff clearly value education and enthusiastically encourage young people to learn and develop their knowledge and skills. Both young people have successfully returned to education. They are motivated to learn and do well, attending every day and working hard. A young person came home from school after feeling unwell she asked for work to take home. When she was feeling a little better she finished off working on learning her times tables with staff and reading Romeo and Juliet. Staff are working hard with the young people, schools and education services to tackle any barriers to learning and participation. An education officer said, ‘the home actively supports the girls’ education, work very well with the local authority and schools. They are very willing to support school and find solutions.’ For example, staff resourcefully found a young person work experience at a local riding stables rather than allow her to miss out. The young people also

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good

enjoy a wide range of interesting and fun activities in the community, including football training, dance, horse riding, clothes shopping, cinema and going out for meals. Staff enable them to enjoy the same experiences and opportunities of other young people, including celebrations. A young person said, ‘I had loved my birthday party, I felt special.’

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good

Young people live in a healthy environment that actively promotes their physical health emotional well-being. They are healthy, enjoy balanced and nutritious diets and get plenty of physical exercise. They have a good understanding of the importance of healthy lifestyles and are making positive choices about their health, including choosing not to use drugs and alcohol, and to attend health appointments. Staff have a good understanding of the young people’s specific health needs, including the management of long standing conditions. They take prompt action when young people are unwell, ensuring that they get the medical attention, assessment, treatment and advice they require. The arrangements for storing and managing medication are safe.

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good

The young people also have excellent support around their psychological and emotional needs. The staff work closely with the community mental health services to understand young people’s emotional needs and deliver personalised care that reduces their anxieties and builds resilience. A therapist said, ‘staff prioritise young people’s mental health. They have a good understanding of mental health and good at adapting to work differently with each young person’s individual needs.’

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good

The house is suitably located, designed, and provides a pleasant and homely domestic environment. The young people have their own personal space and comfortable bedrooms that reflect their characters and interests. However, the house is showing signs of wear and tear, including chipped paint and small marks on the walls and carpets. The young people are relatively new to the home and would benefit from the chance to help choose how the whole house is decorated and put their personal styles on their home.

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good

The young people are considerably safer because of the staff’s strong safe care practices. A social worker confirmed that a young person is now, ‘much safer, does not have opportunities to go missing, is no longer using drugs or alcohol and significantly less at risk of being sexually exploited.’

p.9

good

The young people feel safe and able talk to staff about their worries. The staff take concerns about young people seriously and respond decisively to reduce any risk of harm to them, including those associated with sexual exploitation and social media. They work very effectively with social workers, the police, local designated officer and multi-agency safeguarding hub to protect the young people. They have a clear understanding of risks to individual young people’s safety. Detailed written risk assessments guide them successfully to manage and reduce the risks. They help young people to understand risk and promoted their own personal safety. A member of staff said, ‘She appears to understand why we are concerned. We are working with her on her perception of risk, help her to understand how she has been manipulated and how to stop this from happening again.’

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good

Young people very seldom go missing from home. On the rare occasions they have, the staff worked well with social workers, the police and parents to make sure they return as soon as possible. The young people were welcomed home warmly and the police visited to check on their welfare. However, they were not offered a more in-depth interview with an independent person. This may provide an opportunity to uncover information that can help protect children from the risk of going missing again; help to understand the reasons for going missing; what risks they may have been exposed to and any possible risk factors in their home.

p.9

good

The staff provide young people with the level of structure and routine they need to feel safe and secure. Young people have clear and fair boundaries that help them to know what is safe and acceptable, and how they will be looked after by the staff. This is helping the young people to feel less anxious, and manage their feelings and behaviour more safely.

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good

Staff work closely with mental health services to get insight into young people’s emotional needs and develop well-coordinated support plans. A therapist said, ‘Staff developing a better understanding of the young person and how to manage her behaviour, including responding early and developing preventative strategies such as distraction and making sure she has a structured and busy day.’ Consequently, her behaviour continues to improve. A social worker said, ‘The staff are managing her behaviour well. Incidents soon are resolved in minutes, previously they would have gone on for hours.’ Young people are showing encouraging signs of being able to reflect about what happened, understand their feelings better, and develop their own coping strategies.

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good

The management of aggressive behaviour is effective and the number of restraints has significantly reduced over time. The staff use restraint appropriately and safely to protect young people and those around them. A young person said ‘Staff have to restrain me when I’m upset to stop me hitting them, kicking and spitting. Staff never hurt me. It does not last for long and staff give me a hug. I like the hug it makes me feel wanted. They talk to me about what happened and about what was upsetting me and what will help me.’

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good

However, the quality of the restraint records is not always good enough to provide accurate information, which can be used to improve the support to young people. Some records do not show a detailed picture of what happened and use general terms, such as ‘distraction’ without explained what this means. They do not always record what young people said about what happened using their own words. In addition, every use of restraint has not been reviewed by the manager to gain a better understanding of the incidents.

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good

The Registered Manager has been in charge of the home since it opened 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 culture and ethos of the home reflects a strongly child-centred approach and commitment to promoting and safeguarding young people’s welfare. It has developed a strong working relationship with its partners, including parents, mental health community service, schools, the police, and social workers to make sure young people receive the best possible support.

p.10

good

Young people are looked after by enthusiastic and caring people. They clearly enjoy their work and are proud of young people’s progress. The deployment of staff promotes young people’s safety and suitable daily routines. The use of additional temporary staff has been thoughtfully planned to limit any disruptions to young people’s lives, provide them with continuity of care and opportunities to form positive relationships with the staff. The staff are very well supported by the managers through regular professional 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. All staff, including temporary people, receive good quality training to develop their individual skills and

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good

knowledge, relevant to the young people they are caring for, including restraint, safeguarding and child sexual exploitation.

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good

The leaders and managers have a reasonably clear understanding of the home’s strengths and key areas for development. However, the quality of care is not being systematically reviewed to provide a full picture of the home’s performance and to make sure improvements are made. For example, the monitoring did not identify weaknesses in the restraint records. The statement of purpose has not been reviewed to take into account recent staff changes and the new regulations. The quality of the written records continue to be variable; as a result they do not always provide a comprehensive picture of young people’s lives and the support they are receiving. Some of the records do not clearly distinguish between fact and analysis. The monitoring does not include consultation with young people, parents, social workers, and other agencies about the quality of the home. As a result it is not taking into account how others view and experience the support provided in

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good

order to develop the home. Also the effectiveness of the arrangements for therapeutic services in achieving better health outcomes for children has not been reviewed. In addition, the independent visitor has not provided Ofsted with his reports since January 2015. These provide important information about effectiveness of the home in promoting young people’s welfare.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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