Children's home run by Care Assist Children’s Services Limited in West Lancashire

inspection

Four compliance notices were issued and a further monitoring visit has been completed.

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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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The children's home provision requires improvement because:

 Some of the records in the home are variable in quality and lack sufficient detail. This hinders the formal processes needed to monitor young people‟s progress and to properly address how identified needs are met.  Medication records in the home are confusing and do not demonstrate that medication is administered safely to young people.  Staff are not adequately trained to meet the needs of the young people in the home.  Supervision of staff does not take place regularly.  Monitoring and review of the quality of care in the home are not routinely carried out.  Independent reports have not been provided to HMCI.  The statement of purpose and children‟s guide are currently being updated. They should reflect the ethos and objectives of the home and provide key stakeholders and young people with all the information that they need to know.

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The children's home strengths

 Young people are supported with their education to ensure that they achieve successful outcomes.  Young people are safeguarded due to the good safeguarding practices in place at the home.  The number of times that young people go missing from the home has significantly reduced. The home now has appropriate strategies in place, and direct work sessions are now complete with young people in respect of risks.  Staff morale has improved and staff are working together to ensure that consistent practice is in place in the home.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meet(s) 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

10: The health and well-being standard In order to meet the health and well-being standard, the registered person must ensure: (2)(a)(i) that staff help each child to achieve the health and well- being outcomes that are recorded in the child's relevant plans. 30/11/2016

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Requirement Due date

12: The protection of children standard In order to meet the protection of children standard, the registered person must ensure that staff: (2)(a)(i) assess whether each child is at risk of harm, taking into account information in the child's relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; and (iii) have the skills to identify and act upon signs that a child is at risk of harm. 30/11/2016

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Requirement Due date

13: The leadership and management standard In order to meet the leadership and management standard, the registered person must (2)(c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 30/11/2016

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Requirement Due date

16: Statement of purpose The registered person must keep the statement of purpose under review and, where appropriate, revise it, and notify HMCI of any revisions and send HMCI a copy of the revised statement within 30/11/2016 28 days of the revision. (Regulation 16(3)(a)(b))

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Requirement Due date

23: Medicines The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children‟s home. (Regulation 23(1)(2)(c)) In particular, the registered person must ensure that a record is kept of all medicines for each child. 30/11/2016

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Requirement Due date

36: Children's case records The registered person must maintain records („case records‟) for each child, which include the information and documents listed in Schedule 3 in relation to each child, are kept up to date and are signed and dated by the author of each entry. (Regulation 36(1)(a)(b)(c)) 30/11/2016

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Requirement Due date

37. Other records The registered person must maintain in the home the records in schedule 4. (Regulation 37(2)(a)) In particular, this refers to a record of all visitors to the home, including their names and reasons for visiting. 30/11/2016

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Requirement Due date

44: Independent person: visits and reports The independent person must produce a report about a visit („the independent person‟s report‟) which sets out, in particular, the independent person‟s opinion as to whether children are effectively safeguarded, and the conduct of the home promotes children‟s well-being. (Regulation 44(4)(a)(b)) 30/11/2016

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Information about this children's home

This is a privately run children‟s home for four young people who have emotional and/or behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

02/02/2015 Interim Sustained effectiveness

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Requires improvement

Young people living in the home have made progress since the last full inspection and monitoring visit. The staff now have a good understanding of all young people‟s individual needs and have strategies in place to meet them. During the inspection, young people spoke positively about the home and the improvements that are now in place. One young person said, „All the staff now respond in the same way. If one says “no”, then they all say “no”.‟ Young people have returned to their education provisions after the summer break and are reported to be making good progress. Staff are supportive of young people and provide praise, incentives and encouragement. Staff have established good relationships with education professionals to ensure that young people are appropriately supported to achieve successful outcomes. However, young people do not have access to a computer in the home to support their education and

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Requires improvement

learning. A discussion took place with the responsible individual, who reported that a computer would be made available for all young people. Staff have a clear understanding of the health needs of young people. They have ensured that young people now have access to appropriate support systems and interventions. For example, they have liaised with the substance misuse service, in relation to the cannabis use of a young person. Through direct work sessions, they helped the young person to understand the long-term impact on his health and well-being. He agreed for a referral to be made and told inspectors, „I am pleased to be working with [Name of service], as I know I need their help because I use too much cannabis, particularly at weekends.‟ The home now has a clear system in place to monitor the young person when he is under the influence of cannabis. However, healthcare plans have not been updated to reflect the current health and

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Requires improvement

development needs of young people and how these are being met, or the health appointments that they have attended. This requires further improvement. Some improvement has been made in the home‟s decor. For example, the kitchen has new worktops, and some areas of the home have been painted. However, further decoration is required to ensure that all areas of the home are of a good standard. The young people have raised their concerns over bedroom furniture that required replacing and a faulty cooker. This was discussed with both the interim manager and the responsible individual, who agreed that a new cooker was being prioritised. The outstanding decoration and replacement of items are essential to ensure that young people live in a comfortable, homely environment and that they can make use of the facilities to develop their independence skills. Young people are supported to maintain regular contact with family and friends.

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Requires improvement

The staff are proactive in ensuring that contact arrangements are appropriate, safe, productive and enjoyable for young people. The contact for one young person with family members has now progressed from supervised to unsupervised. This is in line with the young person‟s wishes and the local authority plan. The staff have been influential in bringing about this positive change, through the supportive relationship that they have built with the family, and through their understanding of the risks and concerns during contact sessions. Staff also took appropriate action when they had concerns about inappropriate friendships that a young person had established in the local community. Individual time was spent with the young person to explain their concerns, and the young person made the choice to return to his old friendship group. This ensured that his safety was maintained. The staff have worked with a young person and his social worker to develop a

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Requires improvement

realistic transition plan, for the young person‟s moving on from the home. There is now a pathway plan in place and ongoing independence work with the young person, to ensure that he has developed the necessary skills to successfully live independently. Staff are supporting the young person to liaise with local housing agencies to ensure that good-quality housing is accessed.

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Requires improvement

Safeguarding practice in the home has improved. Young people feel safe in the home because staff understand the risks to them and ensure that appropriate measures are in place to keep them safe. For example, when a young person said that he was staying at a friend‟s home, staff visited the home to assess the suitability of this. Due to staff not considering the address to be a safe place, a decision was made to refuse the request, and the young person was brought back home. The young person was not happy about this decision; however, he understood that staff were doing what they needed to do to safeguard him. The young person said, „[Name of staff member] was only doing his job and made the decision because he cares about me. Although I wasn‟t happy at the time, I get it. I understand they have to make sure I‟m safe.‟ The number of missing from home incidents has significantly reduced. Staff now have a clear understanding of their roles and responsibilities when young people go

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Requires improvement

missing. They have acted appropriately and in a timely manner, notifying the police and local authorities, so that appropriate action can be taken to find them. They have also ensured that the young person was provided with an opportunity on their return to talk to an independent person. This clearly had a positive impact on the young person, as there have been no further incidents of his being missing from the home. Further improvement is required in relation to the health and safety practices in the home. There continue to be some inaccuracies in the records relating to medication. For example, the quantity of medication left in stock was not accurately recorded. In addition, records are confusing and do not demonstrate how medication is administered safely to young people or the correct names of the medication prescribed. This fails to ensure that medication is safely stored and administered. Risk assessments for young people have not been maintained or regularly updated

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Requires improvement

to include all current risks. They also do not provide staff with strategies on how to manage assessed risks on a day-to-day basis. However, the new interim manager identified this as an area for improvement. She had already reviewed the template and was working with the deputy manager, to ensure that all assessments are detailed and include all risks and strategies to safeguard young people. Staff rotas clearly outline the staff that are on duty and who is leading the shift. This provides a clear audit trail of who is working at the home. Staff need to ensure that the visitors‟ book is completed accurately, with full and detailed information, including the name of the person visiting and their arrival and departure times. This will ensure that there is a clear record of who has been at the home and the purpose of their visit. Not all staff are up to date with mandatory training, in particular safeguarding

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Requires improvement

training. Although a date was reported to have been arranged, this was later cancelled. However, the new interim manager has discussed this with the provider, and a new date is pending. This shortfall has not ensured that all staff are equipped with the skills to meet the needs of the young people.

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Requires improvement

There has been no registered manager in place since the inadequate judgement. Another manager from within the company and the deputy manager have maintained the day-to-day management of the home. They have had the full support of the staff team. Together, they have continued to make improvements in practices and paperwork in the home. They were clear that further improvements are still required and have maintained an improvement plan, which highlights the work still to be completed. The week before this inspection, a new manager was recruited. She is in the process of submitting an application form to HMCI, to register as the home‟s full- time manager. She has previous experience of working in and managing children‟s social care settings. Staff in the home made positive comments about the positive impact that she has made in the short time she has been in post. A staff member said, „She clearly knows what she is doing and already has a clear improvement

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Requires improvement

plan in place. She prioritised supervision for us all and planned a team meeting with an agenda, which includes young people‟s needs, our practices and the improvements still needed in our paperwork.‟ During discussions with the manager, as part of the inspection, it was clear that she had already identified the home‟s strengths and weaknesses and has further developed the ongoing improvement plan. Although there have been some improvements in the records, this is a further area that requires improvement. This will ensure that plans clearly demonstrate the day- to-day care needs of all young people. In addition, records need to be regularly reviewed, dated and signed by the author of any changes. This will ensure that records are up to date and truly reflect the progress and experiences of young people. There has been no supervision in place for staff over recent months. The new manager recognised this and completed one-to-one sessions with all staff.

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Requires improvement

However, she had not had the opportunity to compile her notes or update the records in the supervision files. She recognises that staff need to feel supported in order to make improvements. Regular reflective supervision has been planned for the forthcoming months. This will enable staff to reflect on their practice and to identify any further training that they need to support their continued professional development. The monitoring and review systems in the home need to be strengthened. Although external monitoring of the home is in place, it is not yet robust. The reports from external monitoring have not been forwarded to HMCI, in line with regulation. Internal quality assurance still does not take place regularly. Thus, some shortfalls have not been addressed. However, the manager has now begun to work on this, to ensure that the quality of care provided is regularly monitored and reviewed. This will help to identify patterns and trends and to improve the

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Requires improvement

overall quality of care provided to young people. The home‟s statement of purpose needs to be updated to include the staff changes and to provide a clear overview of the home‟s ethos, aims and objectives. A copy of this should be provided to HMCI, in line with regulation. Staff reported that they could see improvements in the home and in staff morale. They feel more supported and accept that practices in the home needed to change to ensure that the needs of young people are being met to a good standard. A member of staff said, „Despite the difficulties, the deputy manager has done a good job over recent months in making the home a much better environment for both staff and young people. Things have started to improve.‟

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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 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

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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 that 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 whom 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

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Information about this inspection

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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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