Children's Home run by Quality Protects Children Ltd in Knowsley

children and young people since the most recent full inspection

This home was judged good at the full inspection. At this interim inspection Ofsted judge that it has sustained effectiveness .

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children and young people since the most recent full inspection

Young people continue to live in a positive and nurturing home that enables them to feel safe and to make good progress. They feel welcomed when they first move in, and quickly build trusting relationships with the staff and a strong sense of belonging. A young person said, ‘The staff are very bubbly, kind and respectful.’ She was worried about moving in, but ‘when I arrived I felt calm and relieved. Another young person helped to get my room ready for me. I get on with all the staff. They are all very chilled out and easy going. It is somewhere I’m proud to call home.’ A social worker and an independent reviewing officer both said that they feel that the home is providing positive placements. The social worker said, ‘He appears positive and really relaxed. His self-harming has reduced, and he is benefiting from the open, calm, nurturing and supportive atmosphere. He feels more trusted than in his previous placement. It is a safe place for him to live.’ The independent

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children and young people since the most recent full inspection

reviewing officer said, ‘She appears genuinely happy here. I am heartened she has good rapport with staff, and I’m sensing it is going to be a good place for her.’ The manager and staff play an active role in making sure that young people who live a long way from their homes have prompt and easy access to health and education services in the local area. Young people enjoy education, and attend suitable alternative programmes that are promoting meaningful learning and preparing them to return to school. One young person starts a new school next week and said she was ‘super excited about going to school and making friends’. Young people are also getting appropriate help from local psychological and children’s mental health services, which enables them to understand their needs and promotes their emotional well-being. Young people are treated with dignity and respect. They feel accepted and valued as individuals. A young person said, ‘I can be myself here.’ Staff listen to their

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children and young people since the most recent full inspection

wishes and feelings, always take into account their views, and support them to take part in all the decisions about their lives. They are sensitive and responsive to their identity and background, including gender identity, sexuality, ethnicity, race and faith or belief. They help young people to build a positive self-view, emotional resilience and a sense of their own identity. They thoughtfully support young people to overcome the anxieties and challenges that they face in the community, including those about feeling comfortable in crowds and using public toilets. They help young people to find out more about the questions they have about their feelings and identity, by making links with relevant support services, including lesbian, gay, bisexual and transgender groups. The staff are friendly, positive and supportive people, who work together well to get to know the young people, to understand their needs, talents and interests,

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children and young people since the most recent full inspection

and to provide them with personalised support that meets their assessed needs. They have good communication and social skills that enable them to build positive relationships with young people. They understand that young people may need time to feel comfortable and to trust adults. They accept that they have to be patient and get to know the young person on the the young person’s terms. The manager and staff are very positive about each young person as an individual, and they recognise their achievements. They are committed to helping to make a real difference to the quality of their lives, regardless of the challenges young people face. They are quick to praise young people’s achievements, no matter how small, whether they are helping with the shopping, taking part in education or successfully wallpapering the dining room. The manager and staff work hard to protect young people from harm and, as a result, the young people have become safer since they first moved in, with

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children and young people since the most recent full inspection

significant reductions in the risks of sexual exploitation, going missing and self- harm. The young people feel safe and able to talk to staff about their worries. The staff clearly understand young people’s vulnerabilities, and take suitable action to try to minimise the risks to their safety. They make informed judgements that enable young people to take risks, based on their age and individual needs, as part of growing up. For example, young people have mobile phones and access to social media after taking part in e-safety training and agreeing to allow staff to monitor their online activities. The result is that they have the same access to social media as other young people of their age who have suitable parental supervision, and they are developing an understanding of its benefits and risks. Some young people are currently struggling to sustain improvements to their safety. The manager has identified that a young person is at serious risk of harm,

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children and young people since the most recent full inspection

from being exploited by adults involved in drugs and further criminal activity in the local area. He is concerned that the young person is no longing taking part in education or activities that he enjoys, such as climbing. Despite their best efforts, staff are finding it difficult to protect the young person, and are concerned about the potential risks to other young people. The manager is working with his placing authority, safeguarding agencies and police to share information, to understand the nature and seriousness of the risks, and to take action to reduce risks. This means helping the placing authority to find a suitable placement that is away from the local area and which meets his needs. In the meantime, staff are taking suitable protective measures, including reporting him as a cause of concern to the police if he goes missing during the day and staff are unable to find him, and expecting him to come in much earlier in the evening. They are also persistently

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children and young people since the most recent full inspection

trying to encourage him to take part in meaningful activities and to make safer choices. The staff have the relevant knowledge and skills to be able to respond to the health needs of young people, including dealing with their emotional well-being and mental health. They intervened calmly and effectively when a young person was struggling with strong emotions and threatening to harm himself. His social worker saw what happened and said, ‘The staff managed his distress really well, and de-escalated things quickly and calmly, and made sure he was safe.’ The staff are working extremely well with young people to help them manage their feelings constructively, resulting in a notable reduction in the times when they are feeling anxious and distressed, and in self-harming. They follow young people’s suggestions about what helps them to feel calm, including being given space and time to go for a walk, or expressing their feelings in poetry.

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children and young people since the most recent full inspection

Staff on occasion have given a young person when-required medication, when he has been distressed, to help him to feel calm. The arrangements for the use of this when-required medication are not recorded in his support plans. This means that potentially it may not be consistently used as intended to relieve his symptoms. A member of staff said that they have given this medication on the advice of the prescribing doctor when the young person has been highly distressed. She also said that, in these circumstances, the young person has asked for the medication to help him. A letter from the prescribing doctor states as part of the treatment plan that medication may be given ‘when required’, but it does not provide clear advice about the arrangements for giving the medication, including the reasons for giving it, how much to give, what the medicine is expected to do, and the minimum time between doses if the first dose has not worked. When this was

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children and young people since the most recent full inspection

pointed out, the member of staff took immediate action to confirm the use of the medication, and to request written confirmation from the prescribing doctor. In the meantime, based on the medical advice, staff will not give the medication in line with the prescription. The manager provides clear and effective leadership that ensures that the home is always run in the best interests of the young people. He has applied for registration and is waiting to be interviewed by Ofsted. His review of the quality of care provides a realistic understanding of the strengths of the home and the areas where it needs to develop. He has started to make improvements, including reviewing the deployment of staff to better meet young people’s needs through an improved continuity of care. He is developing the knowledge and expertise of the staff team, for example, by employing a person with education experience to further promote young people’s learning and their return to school, and identifying

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children and young people since the most recent full inspection

areas for development through training relevant to the needs of the young people. These areas include mental health, child sexual exploitation, self-harm, and lesbian, gay, bisexual and transgender issues. The independent person carrying out the external monitoring of the home now has agreement to review each young person’s records. However, this monitoring still does not provide a thorough and rigorous assessment of the home's arrangements for safeguarding and promoting the young people’s welfare. There is little in-depth scrutiny of the quality of social care practice and its impact on young people’s lives. Moreover, the report for January 2016 does not review the recommendations made by the visitor at their previous visit to see if they have been effectively put in place. The home’s recruitment of staff has strengthened to better safeguard young people and to minimise potential risks to them. The manager now plays an active

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children and young people since the most recent full inspection

role in the careful selection and vetting of his staff. He ensures that they have the right experience and skills, values and motivation to fit in with the culture of the home, and to complement the existing skills in the staff team.

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Information about this children's home

This home is owned by a private company. It is registered to provide care and accommodation for up to three young people with emotional and behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

30/03/2015 Interim Sustained effectiveness

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Recent inspection history

26/03/2014 Interim Satisfactory progress

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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 ensure that medicine which is prescribed for a child is administered as prescribed (regulation 23(2)(b)). 26/03/16

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendations  Ensure that when-required medicines are administered to children in line with a medically approved protocol, and that the National Institute for Health and Clinical Excellence (NICE) guidelines for managing medication in care homes (March 2014) are followed. In particular, the arrangements for the use of when- required medicines are recorded in the child's care plan, including the reasons for giving the when-required medicine, how much to give, what the medicine is expected to do, the minimum time between doses if the first dose has not worked, and when to check with the prescriber when there is any confusion about which medicines or doses are to be given (‘Guide to the Quality Standards’, page 35, paragraphs 7.15 and 7.17).

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Recommendations

 Ensure that any individual appointed to carry out visits to the home as an independent person must make a rigorous assessment of the home's arrangements for safeguarding and promoting the welfare of the children in the home's care (‘Guide to the Quality Standards’, page 65, paragraph 15.5).

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What the inspection judgements mean

At the interim inspection, we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the ‘Inspection of children's homes: framework for inspection’.

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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 focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

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 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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