Children's home in Preston

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.

p.2

The children's home provision requires improvement because:

 Care plans and risk assessments for young people newly admitted to the home are not clear on how to promote their welfare.  Care plans for established residents are generic and do not ensure individualised care.  Staff do not have up-to-date training.  Internal and external monitoring systems fail to include consultation with young people, parents, relatives and staff.  External monitoring does not sufficiently report on how young people are kept safe and their welfare promoted.  Locality risk assessments do not include any information gained from consultation with external partners.  The statement of purpose does not provide an accurate reflection of the operation of the home.  Additional shortfalls relate to an omission in a safeguarding record, failure to ensure a de-brief occurred following a physical intervention and failure to provide a range of snacks and healthy food for young people to access at all

p.3

The children's home strengths

 Since the last inspection, a new, highly motivated and experienced manager is in post. The registered individual and manager have implemented a range of changes to rectify previous shortfalls and promote improvement with the operation of the home.  The home benefits from a newly recruited staff team. They have a broad range of experience, training and knowledge of working in the children’s residential sector.  The registered provider is investing significantly in the home to drive up standards of care.

p.4

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.

p.5

6. The quality and purpose of care standard

In order to meet the quality and purpose of care standard, the registered person must: (3)(c) ensure that the care is delivered by a person who— (i) has the experience, training, knowledge and skills to deliver that care. 7 June 2016

p.5

14. The care planning standard

In order to meet the care planning standard, the registered person must: (1)(a) ensure that children and young people receive effectively planned care in and through the children’s home. 7 June 2016

p.5

14. The care planning standard

The registered person must compile in relation to the children's home a statement (‘the statement of purpose‘) which covers the matters listed in Schedule 1. Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose (Regulation 16 (1) (5)). 7 June 2016

p.5

14. The care planning standard

The registered person must ensure that an independent person visits the children's home at least once each month and that the independent person must produce a report about a visit (‘the independent person's report’). The registered person must help the independent person to interview, if they consent, in private, children, their parents, relatives and persons working in the home. The report should set out, in particular, the independent person's opinion as to whether children are effectively 7 June 2016 safeguarded and the conduct of the home promotes children's well-being (Regulation 44 (1) (4) (a) (b)).

p.5

14. The care planning standard

The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once every six 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 feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it (Regulation 45 (2) (b)). 7 June 2016

p.6

14. The care planning standard

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year, taking into account the requirement in regulation 12(2)(c) (the protection of children standard). When conducting the review, the registered person must consult, and take into account the views of, each relevant person (Regulation 46 (1) (2)). 7 June 2016

p.6

Recommendations

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

p.6

Recommendations

 The registered person should ensure that children are provided with nutritious meals suitable for each child's needs. In particular, that a range of healthy food is available at all times, to enable children to prepare and eat snacks in between main meals (‘Guide to the children's homes regulations including the quality standards’, page 15, paragraph 3.8).

p.6

Recommendations

 Staff need the knowledge and skills to recognise and be alert for any signs that might indicate a child is in any way at risk of harm. Specifically to ensure risk assessments, from the commencement of placements are completed ( ‘Guide to the children's homes regulations including the quality standards’, page 43, paragraph 9.12).

p.6

Recommendations

 Any child who has been restrained should be given the opportunity to express their feelings about their experience of the restraint as soon as is practicable, ideally within 24 hours of the restraint incident, taking the age of the child and the circumstances of the restraint into account. In some cases, children may need longer to work through their feelings, so a record that the child has talked about their feelings should be made no longer than five days after the incident of restraint (Regulation 35(3)(c)). Children should be encouraged to add their views and comments to the record of restraint (‘Guide to the children's homes regulations including the quality standards’, page 49, paragraph 9.60).

p.6

Recommendations

 The home's records relating to notification of serious events must include a description of the action taken and the outcome of any resulting investigation, including accurate information about the content of information relayed to safeguarding professionals (‘Guide to the children's homes regulations including the quality standards’, page 63, paragraph 14.14).

p.7

Information about this children's home

This is a privately owned children’s home, registered to provide care for five children and/or young people with emotional and behavioural difficulties.

p.8

Recent inspection history

Inspection date Inspection type Inspection judgement

p.8

Recent inspection history

15 December 2015 Full Requires improvement

p.8

Requires improvement

Two social care regulatory inspectors conducted this inspection over a one-day period.

p.9

Requires improvement

The operation of this home has improved considerably since the last inspection. New management arrangements are having a clear impact on progression. The manager and a small, but highly committed, staff team have provided care for young people through a recent process of team restructuring. However, the home is not yet good.

p.9

Requires improvement

Since the last inspection, two young people who resided in the home have since left and a further young person was preparing to leave the home. Changes of placements have been in agreement with placing authorities and essential to ensure that young people are compatible and do not pose a risk to one another. The home environment is now calmer, structured and safe.

p.9

Requires improvement

Care planning for young people requires improvement. The home has admitted a young person as an emergency admission, and at the time of the inspection, the home did not have a clear or detailed care plan or risk assessment in place for them. The manager did have critical information and arranged an urgent meeting with the social worker to gain full information. However, a failure to ensure clear plans and risk assessments, at the point of admission, are in place means that staff will not be able to fully promote the well-being of young people. Care planning for established residents is also generic. While plans contain essential information, they do not capture information which would promote highly individualised care.

p.9

Requires improvement

Staff work hard to ensure that young people have consistency in their day-to-day routines, including the provision of daily cooked meals. Staff have, however, restricted access to food, due to the chaotic behaviours of some young people. This means that not all young people have been able to make themselves snacks at a time of their choosing. This limitation is unfair as all young people are penalised for the actions of others. This does not reflect individualised care. Educational engagement and attendance has been variable within this home. However, staff work consistently to promote the educational potential of young people. One young person, who prior to this placement had very poor school attendance, has achieved nearly full attendance for a whole school term. This has resulted in improved attainment. Consequently, some young people progress and develop in line with their potential.

p.9

Requires improvement

Staff support young people to prepare and attend interviews for training and apprenticeship opportunities. Staff persevere with young people who struggle to sustain placements. The deputy manager said: ‘We do not give up.’ This encouragement and support is essential in enabling young people to access opportunities essential for eventual working life.

p.10

Requires improvement

Health outcomes for young people improve because of routine healthcare. When young people are ill or have injuries, staff respond in a timely manner and seek appropriate medical attention. Some young people seriously compromise their health through substance misuse. Staff are proactive in working with substance misuse agencies to promote improved health outcomes for young people. A social worker confirmed that the support of staff had enabled a young person to engage with a specialist agency to manage his substance misuse. Advice, guidance and support from alternative external agencies means that staff and young people have a heightened understanding of key health risks.

p.10

Requires improvement

Young people benefit from appropriate contact with families and significant people. The staff team collaborate with professionals and families and promote positive contact in line with the arrangements agreed in individual care plans. Some young people have enjoyed improved relationships and increased frequency of contact with family members because of staff support.

p.10

Requires improvement

The home provides independence training plans and has a designated separate annexe, which has the function of providing an independent living ‘experience’. The manager advised that they have had limited success in preparing young people to be sufficiently equipped for independence. This is not a failing of the home, but due to the chaotic behaviours of ex-residents. The manager has clear plans in place for new admissions and the current young people in the home. Judgement grade

p.10

Requires improvement

Staff do not routinely use physical interventions as a method of behaviour management in this home. Since the last inspection, there have been five physical interventions necessary to prevent young people causing harm to themselves and others. All staff have had up-to-date physical intervention training. However, staff do not consistently ensure that they record or provide young people with an opportunity to talk about their feelings following a physical intervention. This fails to capture the impact of the incident on the young person.

p.11

Requires improvement

There has been one unsubstantiated allegation since the last inspection. This related to a bruise sustained by a young person. Managers acted appropriately, ensuring that the local designated safeguarding officer had oversight of the process. She undertook an initial fact finding investigation. Internal investigation records demonstrate a robust investigation. However, records did not provide full details of information conveyed to the designated safeguarding officer. This limits oversight of the context of information shared with safeguarding professionals.

p.11

Requires improvement

A major shortfall identified at the previous full inspection related to the lack of staff knowledge to manage and respond to challenging behaviours. Since this time, the staff team have improved ability to understand and meet the individual needs of young people. The use of sanctions and incentives is proportionate and appropriately used to promote improved behaviours. Staff communicate expectations and establish a consistent routine in the home. This enables young people to feel more settled and secure.

p.11

Requires improvement

Incidents of young people who go missing from the home are low. Staff work in accordance with missing from care protocols. They are proactive in working alongside agencies to locate young people in a timely manner. Incidents of young people absent and missing from care show that when young people have been missing, staff have maintained contact with them and ensured that they are offered return interviews to explore the risks when they are missing.

p.11

Requires improvement

A newly recruited staff team are in the process of commencing their posts and starting a structured induction process. The organisation’s recruitment procedures enable the careful selection and recruitment of staff. Robust recruitment processes and the recording and monitoring of visitors to the home ensure the protection of young people from potential harm.

p.11

Requires improvement

The health and safety of young people, staff and visitors within the home is a priority. Generic and specific risk assessments cover all aspects of daily living. The home has a continual programme of maintenance, which ensures timely repair and remedial work. Health and safety checks, including fire equipment and drills, are current, and environmental risks assessments are in place. The prescribed level of public and employee liability insurance is in place.

p.12

Requires improvement

The new manager started in post in January 2016. He has substantial child care and management experience within the residential sector. He has submitted an application for registration with Ofsted and has applied to study the level 5 diploma in leadership in health and social care. This qualification will ensure compliance with children’s homes regulations.

p.12

Requires improvement

The impact of team restructuring and focus on providing direct care has inhibited opportunities for staff to refresh their training. This means that the existing staff team do not have the training as outlined in the statement of purpose. This does not ensure that staff have the appropriate knowledge or understanding to promote young people’s welfare. The registered individual and manager are immediately attending to the training needs of newly recruited and existing staff.

p.12

Requires improvement

The statement of purpose provides a guide to parents and placing authorities about the aims and objectives of the home and care provided. However, the home has not fully operated in line with this guide. For example, the guide states that it will not accept young people who are ‘drug dependent’. However, the home has accommodated young people who are habitual drug users. The document needs to be explicit and clear in regards to purpose and function. Additionally, the guide outlines that the home provides medium to long-term care. However, some placements have been short-term. The emphasis on promotion of recreational activities is not an accurate reflection of current care practice. The statement of purpose requires a fundamental revision to accurately reflect how the home operates.

p.12

Requires improvement

External quality assurance visits have been problematic. The visits by an independent person have not been monthly and reports fail to show consultation with children, parents and staff. Moreover, the reports do not provide an evaluation of how the home safeguards and promotes young people’s well-being. The registered individual recognises that current external monitoring arrangements are not rigorous and do not promote improved practice.

p.13

Requires improvement

The new manager has ensured that internal monitoring arrangements are in accordance with regulation and the six-monthly report demonstrates that the manager has robust systems in place to monitor, review and evaluate the quality of care and actions necessary to promote improvement. The manager’s monitoring does not, however, include the feedback and opinions of the young people who are resident or have resided in the home. Therefore, the report does not fully capture valuable insight into the homes performance.

p.13

Requires improvement

The manager has ensured that an up-to-date locality risk assessment is in place. This document highlights potential hazards and risks within and around the community. However, a lack of consultation with local partners and agencies means the manager and staff are unable to develop a more comprehensive understanding of known risks.

p.13

Requires improvement

The registered individual and manager have a joint remit to raise standards in this home. They have the combined capacity and knowledge to implement and sustain positive change. Although this home is not yet good and requires improvement, progress is evident. One social worker said: ‘I feel they have turned a corner, but they have a way to go!’

p.13

Requires improvement

Since the last inspection, improvements to the home have meant that all previous statutory requirements made have been met. These include significant improvements to the interior and exterior of the building. The home appears much smarter and presentable. Work is continuing with the renovation of the kitchen and bathrooms.

p.13

Requires improvement

Significant improvements to supervision arrangements mean that managers and staff receive regular and meaningful supervision. Consequently, the monitoring, support and professional development of the staff team ensure that young people receive safe care which holistically supports their needs.

p.13

Requires improvement

Additionally, the manager has an up-to-date development plan in place which outlines plans and targets for the home. This document demonstrates that the manager understands the impact that the quality of care provided in the home is having on the progress and experiences of each young person. He is using this knowledge to drive the development of the quality of care provided in the home and promote improvements. This is an effective planning tool, as the manager can measure and monitor improvements.

p.14

Requires improvement

The registered individual and registered manager are aware of the shortfalls in the home and identified in this inspection. They have agreed to ensure that shortfalls receive their full and immediate attention and that no more young people will be admitted to the home until such time as these are addressed. The management team are committed to driving up standards to ensure that all young people benefit from a minimum of good quality of care.

p.14

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’.

p.15

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 children looked after 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

p.15

What the inspection judgements mean

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

p.15

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

p.16

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 .

p.16

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,

p.17

Information about this inspection

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

p.17

Information about this inspection

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

p.17

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

p.17