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 receive a high quality of individualised care that consistently meets their needs and helps them to achieve better developmental outcomes. They are happier, healthier, safer, doing well at school, making friends and managing their feelings constructively. They enjoy an interesting and fun range of activities that build their confidence in their skills.  The registered manager and staff provide young people with stability and consistency, which is leading to sustained improvements to the young people’s day-to-day experiences and personal development. The staff are upbeat, resilient, skilled and experienced. They are developing a reflective approach that helps them to understand how young people’s experiences impact on feelings and behaviour and devise strategies to assist young people’s recovery.  The registered manager and staff work very effectively with other people in the wider health and social care system to ensure that young people get the

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The children's home provision is good because:

best possible support to meet their assessed needs. Young people’s placements are sensitively planned. The close working relationship with a community mental health service is resulting in young people making some remarkable progress in their emotional literacy and starting to develop effective coping strategies.  Young people feel safe and are protected. They feel able to talk to staff and therapists about their worries. Staff listen to young people’s concerns, take them seriously and respond appropriately to promote their safety. Over time, the risks of self-harm, exploitation, aggressive and destructive behaviour and going missing have significantly reduced.  The registered manager and staff take account of the particular needs of young people that live a long way from home. They help them to maintain important links with their family and important people in their lives and make sure that these young people have access to suitable local education

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The children's home provision is good because:

and health services.  The registered provider has not carried out all the required recruitment checks to ensure that only suitable people are employed to work in the home. This does not minimise potential risks to young people’s safety. Also, the registered manager’s review of the quality of care and written records do not always show young people’s views about the home.

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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 within the given timescales.

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Requirement Due date

The registered person may only employ an individual to work at the children's home if the individual satisfies the requirements in paragraph (3) and full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. In particular, two written references, including a reference from the person's most recent employer, and if a person has previously worked in a position involving work with children or vulnerable adults, verification so far as reasonably practicable of the reason why the employment or position ended (Regulation 32 (2) and (3)). 10 June 2016

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Requirement Due date

The registered person must ensure that the quality of care review monitors, reviews and evaluates the feedback and opinions of children about the children's home, its facilities and the quality of care they receive in it. In particular, that children's views are included in the quality of care report (Regulation 45 (2)(b)). 30 June 2016

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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 children's views about their experiences, progress and the quality of care that they receive are recorded in the monthly review of their placement plan to inform and support their continued progress, improve the quality of care and to develop a clear understanding of children's views about their lives ('Guide to the children's homes regulations including the quality standards’, page 22, paragraph 4.11).  Ensure that the workforce plan clearly outlines plans for the recruitment of additional staff. The plan should be updated to include any new training and qualifications completed by the staff and is used to record the ongoing training and continuing professional development needs of the manager and staff, including identifying further qualifications relevant to their roles and needs of the

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Recommendations

young people ('Guide to the children's homes regulations including the quality standards’, page 53, paragraph 10.8).  Ensure that recruitment of staff safeguards children and minimises potential risks to them. In particular, where possible, request written references from people independent of the home who can comment on a candidate's suitability, and keep a written record of the enquiries made when a person wishing to work at the home has a criminal conviction and the assessment of that person's suitability ('Guide to the children's homes regulations including the quality standards', page 61, paragraph 13.1).  Ensure that the written monthly reviews of children's placement plans provide an in depth analysis of children's progress, reflect critically on the support that children are receiving and identify priorities for the children's individual care and personal development (‘Guide to the children's home regulations including the

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Recommendations

quality standards’, page 62, paragraphs 14.3, 14.4 and 14.5).

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Information about this children's home

This children's home is 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

18 February 2016 Interim Sustained effectiveness

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Recent inspection history

4 March 2015 Interim Sustained effectiveness

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Good

This children’s home provides young people with a positive, nurturing and supportive place to live. They receive a high quality of individualised care that consistently meets their needs and helps them to achieve better developmental outcomes. They enjoy positive experiences and make continuous good progress in all aspects of their lives. Overall, they are happier, healthier and safer. They are more outgoing and more involved in education and enjoyable activities outside the home. Young people live in a friendly and warm atmosphere where they enjoy positive and safe relationships with the staff and each other. The improved continuity of staff is enabling young people to develop meaningful relationships with the people looking after them every day. Staff support young people to develop the skills to build positive relationships and understand what makes a healthy relationship. Staff reflect on their own behaviour and made changes to improve how they get on

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Good

with young people. For example, a member of staff found that instead of asking a young person how they were feeling it was more productive to give her space and time to share her feelings when she was ready. This change of approach has helped the young person to feel more comfortable talking to the member of staff. Young people know that staff care about their welfare and that they are trying to help them, regardless of how difficult things may be. The registered manager and staff support young people to make choices, influence the running of the home and take part in decisions affecting their lives. Young people make decisions about what they have to eat, how the house is decorated and how they spend their spare time. The registered manager always carefully considers their ideas and has bought a trampoline, paddling pool and football net for the garden. She also balances their wishes against what is in the young

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Good

person’s best interests. She carefully explains the reasons for reaching any decision in ways that young people can easily understand. For example, she explained to young people that she did not agree with their request for more television channels because she wanted to encourage them to take part in activities outside the home to keep fit and healthy. Staff actively encourage and support young people to take part in a wide range of interesting activities outside of the home and try activities that are new for them. Young people enjoyed having a go at sailing and canoeing with staff in North Wales. They also enjoy arts and crafts, cooking and baking, playing music, going for walks in the countryside, picking strawberries, airplane spotting, going to the beach and cinema and relaxing pamper nights. Through the activities, they have more opportunities to meet other young people of their age and make friends in

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Good

the community. They are becoming more outgoing and are making friends. Effective care planning and strong working relationships between the staff, placing authority, schools, youth offending and mental health services mean that young people are receiving the support that they need daily. Everyone works extremely well together to ensure that the relevant plans for each young person’s care are reviewed on an ongoing basis to reflect their progress and continue to meet their needs and circumstances. The registered manager makes informed decisions about young people coming to live at the home. She only agrees when she is satisfied that the staff can respond effectively to the young person’s assessed needs and after considering the impact on the young people already living there. A young person’s recent move into the home has been managed extremely well. The staffing arrangements changed to reflect the needs of the young people and to ensure that any identified risks can be

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Good

effectively managed. The young person was warmly welcomed and said that he was made to feel at home. The other young person contributed to his introduction to the home, including helping staff to decorate his room. The existing young person said that she felt ‘a bit up and down’ since he moved in, ‘but it is ok and they do get on’. The registered manager and staff take account of the particular needs of young people that live a long way from home. They help them maintain important links with their family and important people in their lives. They provide transport and enable family members to visit the home. A young person’s family was coming to have a barbecue for his birthday. The registered manager also makes sure that these young people have easy access to local education and health services. She is working hard with the virtual school headteacher and local authority to identify suitable arrangements to support the new young person’s education.

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Good

Some young people are making excellent progress in education. Their school attendance has improved to 100% and they are spending longer days in school. They are becoming more sociable with other young people and working hard. One young person wants to work in childcare and has been offered a place at a local college. Staff have arranged for her to have taster days at the college to get used to it and to meet her lecturers and other students in preparation for starting her course. She is also enjoying volunteering at dance school to build up her experience of working with younger children. The staff work extremely well with schools, education providers and careers workers to enable young people to have the opportunities to develop their confidence skills and knowledge to enhance their future prospects. Young people live in a healthy environment. They are physically health and their emotional well-being is improving. They have healthy and nutritious diets, and get

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Good

plenty of physical exercise. Staff provide them with good advice to help them understand the importance of healthy lifestyles. A young person said, ‘I’m OK about not smoking here, I’d still be smoking if I’d stayed at home.’ Staff support and encourage young people to take more responsibility for their own healthcare and treatment. Some young people are making their own health appointments, expressing their views about their treatment and medication and choosing to go to the dentist to improve their dental care. Young people’s vaccinations are kept up to date and their health needs are routinely assessed by the placing authority. They receive 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. They manage the arrangements for young people’s

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Good

medication safely to ensure that they get the medicines that they need. The young people live in a pleasant family home. It is designed, maintained and decorated to a high standard. Young people’s family photographs and art work decorate the walls. They have their own personal space and comfortable bedrooms that reflect their preferences and interests.

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Good

The registered manager and staff work extremely hard to help young people feel safe. They protect young people and help them to become increasingly safer. Young people feel safe and are able to talk to staff about their worries. Staff listen to young people’s concerns, take them seriously and respond appropriately to reduce risks to their safety, including any concerns about child sexual exploitation. Staff work very effectively with social workers, the police, designated officers, mental health workers and the multi-agency safeguarding hub to protect young people. Detailed and up-to-date written risk assessments and plans guide staff successfully to manage and considerably reduce the risks of abuse, self-harm, aggressive and destructive behaviour and going missing. The staff have a good understanding of risks to individual young people’s safety, arising from their complex needs and mental and emotional health. Staff recognise

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Good

when young people are struggling with their feelings and intervene appropriately to help them. For example, they know that when a young person closes her bedroom door she is feeling low and it is a sign that she needs their support. They also think creatively to help young people let them how they are feeling, including encouraging young people to use cards and emoticons when finding it difficult to talk. The registered manager and staff ensure that young people have the right structure and daily routines that help them to feel emotionally secure. Young people have fair and consistent boundaries that help them to know what is safe and socially acceptable behaviour and that they be will be looked after by the staff. They appear to be happier and increasingly confident in taking part in activities outside of the home with other young people. The number of times when young people show aggressive or destructive behaviour have significantly reduced.

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Good

A young person, who has lived there for some time, is making impressive progress in being able to recognise and talk about her feelings. She accepts help and guidance from staff and therapists and is developing her own coping strategies to manage her feelings safely. Staff listen to her views about what helps when she feels upset and follow her ideas. For example, they encourage her to talk when she is feeling fed up and keep her active, instead of letting her have quiet time thinking about what is upsetting her. They suggest she may like to go for a walk, use the trampoline or simply help them to make a cup of tea. She also likes staff reading to her because it helps to soothe her. She is now much more settled and resilient, and starting to look at difficult areas of her life with her therapists, including looking at the reasons why she does not live with her family. The staff have developed a good understanding of the impact of young people’s

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Good

experiences on how they see themselves and their abilities to form relationships, feel safe and handle their feelings. They understand the factors and times that affect young people’s emotional well-being. They work effectively with young people to help them cope with significant times of the year, including birthdays and religious festivals. They helped a young person to plant flowers in the garden in memory of an important person in her life, which sensitively helped her to constructively recognise her feelings of sadness and grief. Staff’s calm and consistent approach supports young people at times when they struggle to manage strong emotions and show aggressive behaviour. Staff manage challenging behaviour safely and appropriately. They help young people to build skills to resolve disagreements and sort out problems to show that together they can try to put things right. The registered manager systematically reviews incidents

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Good

of aggression to reflect on what happened and to continue to improve the support that young people receive.

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Good

The registered manager has been in charge of the home since January 2016. She is a vastly experienced manager and she is suitably qualified. Her effective leadership has brought structure and consistency to the quality of care provided and sustained improvements to the young people’s day-to-day experiences and personal development. Importantly, she has established an enthusiastic, resilient, skilled and experienced staff team. The staff are knowledgeable and clearly understand their role and responsibilities to promote young people’s welfare. They have relevant qualifications and continue to build their knowledge and expertise through continued professional development and appropriate training. Once they have completed the level 3 diploma for Residential Childcare, the registered manager and provider support them to move on to the level 5 diploma. The workforce plan clearly shows how the registered manager ensures that

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Good

enough suitable staff are available to meet the assessed needs of young people and meet the aims of the home’s statement of purpose. However, it does not clearly outline plans for the recruitment of additional staff or identify the further qualifications and training for staff relevant to their roles and needs of the young people. The registered provider has not carried out all of the required recruitment checks to ensure that only suitable people are employed to work in the home. In the cases of three out of five staff, the registered provider had not received written references about them from their most recent employer. As a result, the decision to employ them was made before obtaining satisfactory information about their experience, qualities and skills, if their previous employer had concerns about their integrity or practice and their reasons for leaving their previous job. This does not minimise potential risks to young people’s safety.

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Good

The registered manager has previously worked with each of the people recently employed to work at the home and provided them with personal written references. The registered provider may wish to review this practice and seek to request written references from people who can comment on a person’s suitability independently of people already working in the home to avoid any potential conflict of interest. Also, the registered provider does not always keep a written record of the enquiries that they make when a person wishing to work at the home has a criminal conviction and the assessment of that person’s suitability. The registered manager and deputy manager have created a positive and supportive working environment that enables staff to enjoy their jobs and prioritise the welfare of young people. The staff are clearly committed to helping young people to develop, they enjoy spending time with them, care about their well-being

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Good

and have high aspirations for them to do well. Staff work cohesively to provide young people with a high standard of care and support that meets young people’s needs. The effective use of daily staff handover meetings, team meetings, professional one-to-one supervision and reflective space meetings with mental health workers means that staff share important information about young people’s experiences, needs and progress to develop consistent approaches to helping them. The registered manager and deputy manager are promoting staff’s understanding and skills through reflective practice. The staff are developing a greater awareness of the factors that affect young people’s mood and behaviours, recognising when things go well and what works with individual young people and identifying problems and thinking about possible solutions that promote young people’s well-being. The registered manager has established strong links with local authority

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Good

safeguarding teams. She appropriately shares information with the relevant designated officer and they work together to reach agreements about how best to protect young people. Any investigations into allegations against members of staff are dealt with fairly, in line with the safeguarding guidance. The registered manager and provider use thorough monitoring systems to understand the home’s strengths and areas for further improvement. Monthly monitoring visits from an independent person provide comprehensive and impartial scrutiny of how effectively young people are protected and have their needs met. The independent visitor routinely seeks young people’s views about their experiences living in the home, and talks to young people’s families, social workers and other people working with them, to assist her to make a realistic assessment of the home. The reports show that the registered manager takes effective action

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Good

to make the changes that the visitor recommends, including ensuring that the effectiveness of restraints is always monitored and recorded to inform future practice. Detailed written records give the registered manager and provider a good and accurate understanding of young people’s progress in meeting the objectives set out in their plans. The quality of the written records continues to improve. Staff record information about young people in ways that will be helpful to the young person and contribute to plans for their care. The records show a detailed picture of young people's daily lives, development, progress and achievements. Staff’s systematic review of young people’s placement plans each month describes their experiences and measures their progress. However, these reviews do not always include an in depth analysis of their progress and reflect critically on the support that they are receiving and identify priorities for their individual care. Although,

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Good

staff and young people carry out these reviews together, young people’s opinions about how things are going are not recorded or show if they agree with staff’s assessment. Since the last inspection, the registered manager has completed a thorough review of the quality of care provided and the effectiveness of the arrangements for therapeutic services in achieving better health outcomes for young people. She has effectively used this review to provide a full picture of the home’s performance, measure the young people’s progress and identify priorities for improvement. The review has influenced the home’s development plan, which is used as a beneficial and dynamic tool to secure improvements. It sets out clear, achievable, relevant and measureable targets, and is kept up to date to map the progress being made, for example, giving young people more social experiences outside the home and opportunities to make friends. The review of the quality of care shows the systems

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Good

used to consult with young people and gain their views, but does not include what they actually said about the support that they receive or their observations of how they experience the quality of care provided. This information would provide useful insight into young people’s experiences to inform the development of the home and their care.

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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 that 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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