Children's home run by Birtenshaw in Bolton

Requires improvement

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

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because:

 Young people receive care from an inconsistent staff team, which has an impact upon their ability to make and sustain relationships with carers.

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because:

 Consultation with young people about the quality of care they receive is limited to meal and activity choices. Young people are rarely involved in meaningful communication about aspects of their care.

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because:

 Risk assessments are insufficiently updated following serious incidents. This has the potential to cause confusion in future about strategies to minimise potential harm to young people.

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because:

 Behaviour management plans are not sufficiently updated to include strategies for staff to manage behaviour firmly and consistently. Some young people’s challenging behaviours have escalated.

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because:

 Records do not demonstrate consistent management oversight or debrief of incidents of control and restraint. Therefore, young people and staff are not given the opportunity to discuss their feelings and learn from the experience.

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because:

 Not all incidents are recorded or stored in an accessible location. Therefore, monitoring and oversight of incidents is insufficient and the ability to reflect critically on events is diminished.

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because:

 Serious events are not routinely notified to Ofsted. This means that such incidents are not afforded appropriate independent scrutiny.

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because:

 Staff supervision and formal team meeting support structures are not in place. This limits the opportunities for staff to have practice discussions and develop new strategies to manage difficult behaviour.

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because:

 Young people do not experience a varied enough range of activities, which limits their ability to explore interests or develop new talents and does not expand their preferences.  Key documentation is missing from young people’s files, which means that the home could be unclear on how best to support young people to achieve their goals in line with their plans.

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The children’s home’s strengths

 Managers and staff have demonstrated a wealth of knowledge about the needs of children cared for in the home.

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The children’s home’s strengths

 The home’s admissions policy operates on the basis of an assessment period. During this time, the home advocates strongly on behalf of young people and successfully negotiates additional resources with placing authorities. This ensures that they are equipped to meet the complex needs of the young people in their care.

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The children’s home’s strengths

 Recruitment, training and development are robust, and result in retention of good staff across the organisation. Staff report that they have access to good quality training that prepares them well for their roles.

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The children’s home’s strengths

 Young people readily have access to good quality, in-house, specialist education and health provision. The home is prioritising the educational and health needs of children.

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The children’s home’s strengths

 The home has adopted a consistent approach to communication and behaviour management with the school. This is recorded on a numbered scale, which allows trends and patterns to be readily identified and acted upon in the future.

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The children’s home’s strengths

 The manager has articulated detailed and realistic plans to address all of the shortfalls identified within this report. In the five weeks she has been at the home, she has already begun work to improve many areas of practice.

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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

Ensure that staff regularly consult children and seek their feedback about the quality of the home’s care. (Regulation 7 (2)(iv)) 28/02/2017

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Requirement Due date

Ensure that the home’s workforce provides continuity of care to each child. (Regulation 13 (2)(e)) 31/01/2017

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Requirement Due date

Provide adequate means of escape from the home in the event of a fire, in particular to complete a personal emergency evacuation plan for young people and ensure that keys to the home are easily identifiable. (Regulation 25 (b)) 31/01/2017

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Requirement Due date

Ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b)) 28/02/2017

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Requirement Due date

Ensure that within 48 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, the registered person has spoken to the user about the measure, signed the record to confirm it is accurate and within five days has added to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(b)(i)(ii)(c)) 31/01/2017

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Requirement Due date

The registered person must maintain records, in particular a copy of any education healthcare plan or statement of special educational needs in relation to the child and records of serious events. (Regulation 36 Schedule 3 (17)) 28/02/2017

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Requirement Due date

Ensure that the registered person notifies without delay, incidents which relate to a young person which the registered person considers to be serious. (Regulation 40 (4)(e)) 31/01/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Staff should continually and actively assess the risk to each child and the arrangement in place to protect them, with particular regard to incidents that have occurred in or around the home. When there are safeguarding concerns, their placement plan, agreed between the home and the placing authority, must include the details of the steps the home will take to manage any assessed risks on a day-to-day basis. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)

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Recommendations

 The behaviour management strategy should be understood and applied at all times by staff, and must be kept under review and revised where appropriate. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.34)

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Recommendations

 Staff should understand the system for rewarding and celebrating positive behaviour and recognising where children have managed situations well. (‘Guide to the children’s homes regulations including the quality standards’, page 47, paragraph 9.39)

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Information about this children’s home

This is a private children’s home registered to provide care and accommodation for up to three children who may have learning disabilities. It is part of a wider company that includes other children’s homes, a short-break service and specialist education provision.

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Information about this children’s home

This is the first inspection since the home registered with Ofsted.

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Recent inspection history

Inspection date Inspection type Inspection judgement N/A N/A N/A

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Requires improvement

This home registered with Ofsted in September 2016. Two young people with complex needs and learning difficulties moved in within a short time of each other.

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Requires improvement

The home operates under an organisation-wide admissions policy. It successfully negotiates with placing authorities the specialist resources that are required in order to meet the needs of children in their care. This could include adaptations and aids to enhance physical mobility; staffing ratios and transport needs. This practice is sound and provides a solid foundation for young people commencing their placement.

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Requires improvement

The home has had a number of resourcing challenges since opening in September, partially due to the higher levels of supervision required for one of the young people. This has had an impact upon young people building relationships with trusted adults. A social worker stated that one young person had, ‘a good rapport with some staff’. There were notable difficulties in one young person building relationships with night staff in particular, which increased his anxiety and became a trigger for him exhibiting difficult behaviour. There is now a team of staff in place which the manager states will offer the stability and consistency required to deliver a high quality of care to all young people going forward.

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Requires improvement

One young person has been moved to alternative provision at the request of the home, due to his escalating challenging behaviour and increased risk-taking, which meant that the staff could not keep him safe. This was a difficult decision but it was appropriate. He did not make progress while at the home, although there is evidence of pockets of positive experiences when his behaviour settled, and he reported good relationships with staff to his social worker.

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Requires improvement

The other young person has made some progress in spite of the difficulties presented by living in an environment where staff changes are high and the focus is frequently shifting to managing incidents from another young person. Incidents of aggression have reduced and on the day of the inspection the manager referred proudly to her having achieved ‘eight incident free days in a row’. A social worker stated ‘I am happy with her progress, she is meeting targets but it does make me question where she could have been.’ He explained how her ability to interact socially had improved notably, ‘Three months ago you could not have sat next to her without being assaulted, and she gave me a hug after her review meeting.’

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Requires improvement

The home has a children’s guide and complaints procedure available in an accessible format. Records show that staff spend time helping young people, on admission, to understand the guides in their own pictorial communicative style. One young person has recently accessed an independent advocacy service. Consultation with young people has not yet developed beyond meal and activity choices. The manager has plans to expand this and to use pictorial methods to understand their preferences better in other aspects of their care.

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Requires improvement

Young people access specialist educational provision within the organisation. Systems are in place to ensure that an individual’s behaviour management and communication strategies are consistent across education and the home. One young person did attend educational provision previously but would not engage with staff and other young people. She is now interacting and progressing in her ability to communicate with others and be in a group setting. Another young person completed a pottery picture of a building he had shown a very keen interest in, and there are plans to display this within the school.

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Requires improvement

The home prioritises health needs and there is evidence that they promote a healthy diet for young people. Staff are supporting one young person to improve her diet and she has already made progress in introducing a wider range of fruit and reducing the amount of chocolate. This has resulted in improved health outcomes as she has visibly lost weight. Medication arrangements are robust and well managed. Staff identified an unmet mental health need for one young person and quickly expedited the matter to ensure that he received an appropriate service.

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Requires improvement

Young people are encouraged to develop skills for independence. Both young people have been learning to cook and make snacks. There are plans to introduce key-working sessions on areas such as personal hygiene, emotional well-being, keeping safe, and building further skills for independence.

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Requires improvement

Young people do enjoy activities both in and outside of the home. One young person went to a castle, enjoyed trips eating out and going for walks with staff. Staff have created a sensory room, and one young person has a preference for her toys and tablet, which are available routinely. The manager agrees that outdoor activities should be accessible more frequently as they need to encourage a more active lifestyle and help young people to access community resources. A parent has bought a trampoline for the garden, which should help to encourage a more active lifestyle outside of school. One social worker remarked on missed opportunities to encourage more positive behaviour by offering more activities and outings.

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Requires improvement

Young people benefit from structure and appropriate nurturing routines, such as bedtime stories, playtime with staff and mealtimes at the table. Staff meet the privacy needs of young people who require assistance with personal care. This means that their dignity is preserved.

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Requires improvement

The systems that are in place to manage behaviour are very good but there is little evidence of ongoing review in line with changing or escalating behaviour. This means that there is a potential that staff will not have a consistent approach with young people. This is a missed opportunity to identify trends and assist young people to address their own behaviour. There is limited information available about how staff promote and reward positive behaviour. The manager has plans in place to address this with staff and ensure that young people benefit from this in the near future.

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Requires improvement

Staff at the home promote and facilitate contact in accordance with plans. The home communicates daily with one birth parent and have agreed in conjunction with a social worker that they are happy for her to visit the home at any time provided she contacts them first.

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Requires improvement

Risk assessments are clear and detailed, however staff do not update them with sufficient regularity. Leaders and staff in the home are aware of the risks and have demonstrated that they reacted appropriately following incidents to address and mitigate future risk to young people’s safety. They need to ensure that the records reflect the current identified risks and circulate them accordingly to staff to promote a consistent approach and ensure that there are effective information- sharing practices in the home.

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Requires improvement

The have been incidents when one young person has frequently attempted to abscond from the home. He has caused considerable damage to the property. Staff have pursued him closely on every occasion in line with his supervision and support needs outlined in his care plan. They have contacted the police when necessary to ensure his safety and well-being. Staff do not always record incidents sufficiently or store them in an accessible place. This reduces the opportunity to review and debrief them with the appropriate level of management oversight needed to reflect critically on practice and adopt new strategies for future incidents.

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Requires improvement

Managers have handled allegations in accordance with statutory guidance. Leaders have shared information with the appropriate agencies in a timely manner. Young people and staff have received suitable support and have implemented strategies to ensure that young people are safe.

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Requires improvement

Staff completed behaviour management plans for young people on admission. They are detailed and provide a list of strategies to manage difficult behaviour and to de- escalate situations. There is no evidence of continuous review to establish successful strategies to utilise for the future. Physical restraint is only used when attempts to calm the young person are exhausted and it is justified in preventing harm to young people or staff. Records of restraint are detailed, but again records do not demonstrate sufficient management oversight.

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Requires improvement

The home has significant damage in some of the rooms following a spate of recent incidents, however, repairs have already begun. The house is spacious and set over three floors, so there is little impact on the other young person. The rest of the house is homely and free from obvious hazards.

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Requires improvement

The home has commissioned a fire risk assessment and it was recommended that the keys to all the doors in the home are made easily identifiable. This is to ensure that there are adequate means of escape in the event of a fire. This needs to be actioned without delay. Young people also require personalised evacuation plans to ensure that in the event of a fire, staff can support them effectively to leave the building.

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Requires improvement

The registered manager of this home recently resigned the position. The current manager of the home is employed permanently, subject to registration with Ofsted. She is in the process of completing an application to become registered manager. She has several years of care experience. This includes deputy management of a similar home within the same company. She has completed a development programme and is undertaking a level 5 diploma in leadership and management of residential childcare.

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Requires improvement

Staff at the home have not had regular supervision or the supportive fora that team meetings provide. The manager recognises that these structures offer a safe environment for leaders and staff to reflect critically on their practice, meet any welfare needs, review performance and inform future practice. Some supervision has taken place and the manager has plans to extend this across the team.

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Requires improvement

Staff are maintaining daily case records to a good standard, but as already identified, record-keeping practices and reviews following incidents need to be addressed, and some crucial documents, such as statements of educational needs and education and healthcare plans, are missing from young people’s files.

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Requires improvement

Due to the infancy of the service, the manager has not yet completed a development plan or any monitoring reports. She is able to articulate the home’s areas of development clearly. The home is not yet meeting all of the aims and objectives outlined in the statement of purpose but has recently revised this document. The manager has realistic plans to address development areas and shortfalls sufficiently and promptly. She is also enthusiastic about the home’s strengths and has high aspirations for staff and young people. One social worker spoke highly of the manager and progress made since she arrived, stating, ‘She has a reputation for turning things around, which is reassuring. They seem to have the same staffing group now. They are building on things as they go along.’

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Requires improvement

Two social workers stated that communication from the home was not good to begin with. Both remarked upon the difference since the new manager has arrived and were very happy with recent standards. Relationships with other services are strong as the organisation has in-built health and education services.

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Requires improvement

Leaders at the home have proactively raised concerns with a placing authority in relation to one young person whose safety needs had escalated to a level they could no longer meet. They have also demonstrated the ability to challenge insufficient responses appropriately.

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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 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, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after 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

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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