Children's Home run by Time-Out Children’s Homes Limited in Rochdale

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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because:

 The manager has failed to address all of the requirements and recommendations raised at the previous inspection.  The young person‟s safety is potentially compromised because there is a lack of rigour in the implementation and monitoring of medication procedures.  Evacuation plans do not provide sufficient detail for staff. They do not consider the young person‟s known behaviours and do not make clear what action staff should take if the young person refuses to exit the building in the event of a fire.  Promotion of education is inconsistent. Some staff do not consistently implement the young person‟s care plan by following the identified routine for getting the young person up to attend school or college.  The manager‟s monitoring activity is weak and has failed to identify shortfalls pertaining to staff practice, the quality of the homes records and unmet requirements and recommendations from the previous inspection.

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The children's home strengths

  Staff have persevered and supported the young person to make good progress in many aspects of their lives. Their efforts have contributed to the young person making better choices about his personal safety resulting in a significant reduction in risk taking and unsafe behaviour.   The staff, in particular his keyworker, are good at promoting individual identity. His keyworker has encouraged him to explore his own identity and that of others as well as a number of current social issues including radicalisation.  The daily running of the home is influenced by the young person‟s likes, dislikes and choices. Staff are good advocates for the young person and ensure that his views and wishes are represented when making decisions about his care and future.  Risk and vulnerability are considered and effectively managed. Responses to safeguarding concerns and allegations are robust and ensure the young person‟s

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The children's home strengths

safety is given the highest priority.  Organisational support is in place to ensure the manager can build on his residential care experience and develop his skills as an effective manager.

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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

In order to meet the education standard, in particular the standard in paragraph (1), the registered person must ensure that staff-

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Requirement Due date

(2) (a)(iii) understand the barriers to learning that each child may face and take appropriate action to help the child overcome any such barriers;

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Requirement Due date

This is with particular reference to ensuring all staff are consistently proactive in their efforts to encourage and support each child to attend their education provision. 15/01/2016

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines into the children‟s home. In particular, they should ensure that an accurate record is maintained of any medication brought into the home. A detailed record should be kept of the administration of medicine to each child including when a child refuses or is not given that medicine. (Regulation 23 (1)(2)(c)). 15/01/2016

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Requirement Due date

13 The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, in particular the standard in paragraph (1), the registered person must-

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Requirement Due date

(2) (h) use monitoring and review systems to make continuous improvement in the quality of care provided in the home. 15/01/2016

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Requirement Due date

The registered person must maintain records (“case records”) for each child which are kept up to date. This is with specific reference to ensuring that all records are fully complete and 15/01/2016 maintained in accord with the homes policies and procedures. (Regulation 36 (1)(b))

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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 there is a procedure in place to provide independent return home interviews when a child returns to the home after going missing from care or away from home without permission, and that this procedure is agreed with each child‟s placing authority and fully recorded in each child‟s placement plan. (The Guide to the Quality Standards, page 45, paragraph 9.30)

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Recommendations

 Staff should continually and actively assess the risks to each child and the arrangements in place to protect them. Where there are potential safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any assessed risks on a day to day basis. This is with specific reference to ensuring that there is clear written guidance for staff about what action they should take if a child refuses to evacuate the building in the event of a fire. (The Guide to the Quality Standards, page 42, paragraph 9.5)

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Recommendations

 The registered person is responsible for leading a team which provides high quality care for all children living in the home. They must lead and manage the home in a way that delivers the ethos, outcomes and approach set out in the home‟s Statement of Purpose. This is with specific reference to ensuring that sufficient oversight is maintained to identify shortfalls in staff practice. (The Guide to the Quality Standards, page 50, paragraph 10.4)

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Information about this children's home

This section should only be included for homes that require improvement or for an inadequate home if there are key headline strengths to report. For good and outstanding home the key strengths will have already been set out above.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

21/08/2014 CH - Interim sustained effectiveness

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Recent inspection history

28/05/2013 CH - Interim Satisfactory Progress

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requires improvement

The home accommodates one young person. This is in line with their placement plan which currently promotes a solo placement, although progress has been such that alternative accommodation arrangements are being considered. A social worker stated: „One to one support appears to have served its time. In view of the change in (Name‟s) behaviour and needs a review of his care provision is needed.‟

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requires improvement

The young person has benefited from the undivided attention and support that living in a solo home brings. He has made good progress in many areas of his development, which can be attributed to the efforts of a number of staff. On the whole relationships are positive, in particular those with his keyworker. Staff demonstrate high levels of patience and are mostly persistent in their efforts to engage him in a positive and success promoting routine. A statement in the placing authority‟s placement audit made by a social worker states: „Although there is limited engagement by (Name), asserted effort is being made to meet his needs. For example looking at alternative education provision, college, local schools, trying to motivate (Name) to attend activities and regular therapeutic support.‟

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requires improvement

There are ample opportunities for the young person to influence the daily running of the home and decisions relating to his care. The daily routine is planned around his individual preferences and choices. Staff are strong advocates and will endeavour to provide good support which enables full participation in all aspects of care planning. An independent reviewing officer was extremely complimentary about the „likes and dislikes‟ document which staff had completed with the young person and presented at the review meeting. They said: „This was extremely useful as (Name) will not engage with me. I am quite impressed with the manager who was the one who prompted the next steps with placement planning.‟

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requires improvement

Participation in education has improved over recent months. The manager and staff have worked with the organisation‟s school in an effort to overcome barriers to participation. The recent introduction of a college placement has seen a dramatic rise in attendance, which now needs to be sustained. However, not all staff have been consistent in their promotion of education. For example, on a number of occasions some staff have not been persistent in their efforts to get the young person up for school, calling them once then leaving them in bed until after midday. This does not reinforce the importance of education or the implementation of the young person‟s care plan.

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requires improvement

Good support is provided to help the young person be healthy. They eat a good diet which is based on their cultural needs, individual food choices and preferences. They are encouraged to do regular exercise and on the whole they are healthy. Staff encourage them to attend routine and specialist health appointments with varying degrees of success, although levels of engagement are improving. For example, the young person is now taking his medication. This has impacted significantly on improving his sleep patterns. There are opportunities for the young person to receive specialist support from the organisation‟s therapist who leads staff in their delivery of targeted interventions. This has been particularly effective in reducing the number of aggressive outbursts as the young person has developed alternative coping mechanisms to manage his anxieties and frustrations.

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requires improvement

Staff encourage the young person to positively plan his recreation time. This can at times be challenging as the young person‟s levels of engagement vary. Staff are aware of the potential for social isolation and the need to involve the young person in activities in the community. Some inroads have been made in this area including initial engagement in clubs that promote cultural heritage. Free-time is risk assessed and there are regular time-limited opportunities to spend time with his friends in the community.

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requires improvement

Staff realise the importance of family contact. The manager has worked with parents and the placing authority to ensure that distance does not limit the opportunities for regular and purposeful contact. For example, staff travel with the young person to his home area and remain in local accommodation until the visit is over. This means that the young person has been able to sustain positive relationships with his mum by spending quality time at home, including overnights.

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requires improvement

Staff fully understand safeguarding policies and procedures and receive regular and relevant training which enables them to respond appropriately to any safeguarding concerns. They demonstrate a good understanding of risk and vulnerability and have been effective in the management and reduction of these over time. They talk to the young person about the consequences of risk taking behaviour. This has resulted in them making better choices about their own behaviour and safety, culminating in a reduction in offending behaviour, incidents of aggression and missing from home. They take an educational approach to helping the young person develop social awareness and an understanding of current themes and issues. For example, his keyworker has done work around radicalisation, e-safety and child sexual exploitation. Staff have developed good links with a range of safeguarding agencies including the police. Clear responses are in place in the event of any welfare concern or

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requires improvement

missing from home. However, there is not currently an agreed process for young people to be seen by an independent person should they go missing. The manager has recognised this shortfall and is in the process of taking steps to ensure this arrangement is in place and agreed with the placing authority for any future incidents.

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requires improvement

Procedures for the management of medication are not robust. At the time of the inspection medication records were found to be incomplete and there was a significant discrepancy between the number of tablets recorded on the medication sheet and the actual number in the home. This is because staff had failed to record when a young person had not had his medication and when new stock had been brought into the home, making a discrepancy of 60 tablets. While this has had no direct impact on the welfare of the young person this lack of rigour clearly has the potential to compromise their safety and wellbeing.

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requires improvement

Staff are trained in behaviour management, including the use of physical restraint. The in-house therapist plays a primary role in helping the young person develop coping strategies to improve their behaviour. The therapist‟s expertise is also used to develop behaviour management strategies as well as providing ongoing support for staff in the implementation of behaviour management plans. There is a focus on the use of de-escalation as a means of avoiding physical intervention, which would be difficult for most staff given that they lone work and the physical stature of the young person. These methods have proven effective in reducing incidents of aggression and there has only been one physical restraint since the last inspection, which was extremely minor.

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requires improvement

There have been no serious safeguarding concerns and only one allegation since the last inspection. Management responses have been robust, including liaising with the Local Authority Designated Officer (LADO) to promote a transparent investigation into the concern. Also, the right action has been taken to protect the young person, giving due consideration to re-deployment or suspension. Discussion with the LADO confirmed that she was happy with the organisation‟s response and that this was consistent with her experiences of working with them.

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requires improvement

The young person and staff are protected by a range of health and safety procedures, risk assessments and routine checks. The environment is well maintained and provides a safe and secure home in which to live. Fire drills are practiced monthly. However, the young person consistently refuses to engage in these drills and has not participated in an evacuation since the last inspection. Staff have attempted to offset this shortfall by providing the young person with relevant verbal guidance. However, the home‟s evacuation plan does not provide written guidance for what staff should do in the event of a real fire, should the young person refuse. This could put staff and the young person at unnecessary risk because staff are unclear about the actions they should take to keep themselves and the young person safe.

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requires improvement

The manager has been registered with Ofsted for this and another home since July 2015. He is qualified to level 4 and is currently undertaking the level 5 Diploma. This is his first post as a Registered Manager, which he recognises as being more challenging than he had originally perceived it would be. His experience of working with young people in residential settings and his child-focused approach provides him with a good foundation to build and develop his management skills. The organisation have recognised this and have provided focused support, supervision and training which is delivered, monitored and evaluated by his first line manager.

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requires improvement

One of the two requirements and three of the four recommendations from the previous inspection have been adequately addressed. However, procedures for the management and administration of medication and the quality of some of the home‟s records continue to be poor. The manager has a good understanding of his own strengths and areas for development and those of the home. He recognises the need to improve his management oversight and be more proactive in identifying and addressing shortfalls. For example, failure to routinely read the log book meant that he did not identify when staff were not diligent in their efforts to encourage the young person to attend education. Also, his monitoring activity failed to identify shortfalls in a number of the home‟s records including incident records and missing from care plans not being on the young person‟s file, and an absence of young person‟s comments on behaviour management records.

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requires improvement

All staff are either qualified or in the process of undertaking a relevant qualification. The small and diverse team of staff work across both of the managers homes. This allows flexibility and options to make changes in order to meet the young person‟s needs. All staff have completed their probationary period and have the right experience, skills and commitment for working one to one with this young person. Risk assessments are in place to support this process. The manager splits his time between the two homes he is registered for. Staff confirm that they are sufficiently supported in their day to day role. Additional support is available via the manager‟s on-call rota, when the manager is unavailable, and staff are confident in the use of these support networks.

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requires improvement

Staff, including the manager, benefit from regular supervision which they say is purposeful and of benefit to their professional development. They are provided with good training opportunities which ensures they have the right skills and knowledge to meet the general and specific needs of the young person. Handovers and team meetings are used effectively for the purposes of sharing information about the running of the home and the emerging needs of the young person.

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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

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Information about this inspection

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Information about this inspection

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Information about this inspection

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