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

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:

 Some of the records in the home are variable in quality and lack sufficient detail. For example, health plans have the incorrect information and have not been updated. This hinders the formal processes needed to monitor young people’s progress and to properly address how identified needs are met.

p.3

The children's home provision requires improvement because:

 Measures of control, discipline and restraint are not consistently evaluated for effectiveness. Neither do they provide sufficient detail of the measure used, nor include the young person’s view. They are not, therefore, compliant with the Children’s Home’s Regulations 2015.

p.3

The children's home provision requires improvement because:

 Physical interventions are not routinely recorded. This is contrary to the home’s own policies and procedures.

p.3

The children's home provision requires improvement because:

 Fire arrangements are not consistently in line with good practice. For example, the back door of the home is locked, with the key placed in the office, although this is a fire door.

p.3

The children's home provision requires improvement because:

 Monitoring and review of the quality of care in the home is not routinely carried out.

p.3

The children's home provision requires improvement because:

 Not all incident reports are complete, which means that there is no full account of all incidents recorded, the way in which they are managed, and whether suitable actions are taken to keep young people and staff safe. This means that unsafe care practices could continue unchecked.

p.3

The children's home provision requires improvement because:

 Young people’s and staff files are not stored securely within the home.

p.3

The children's home provision requires improvement because:

 Maintenance within the home is not routinely carried out. Young people’s beds were broken and cupboard doors were missing from wardrobes. This does not present a homely environment for the young people living in the home.

p.3

The children's home strengths

 The home has made very good links with a variety of professionals. These professionals speak highly of the home and the progress that some young people have made.

p.4

The children's home strengths

 Young people said that they have good, trusting and respectful relationships with staff and are able to talk to them if they are worried or concerned.

p.4

The children's home strengths

 Staff understand the importance of contact for children and their families, and support this.

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 within the given timescales.

p.5

Requirement Due date

In order to meet the education standard the registered person must ensure:

p.5

Requirement Due date

(2)(a) that staff— (i) help each child to achieve the child's education and training targets, as recorded in the child's relevant plans (ii) support each child's learning and development, including helping the child to develop independent study skills and, where appropriate, helping the child to complete independent study (iii) understand the barriers to learning that each child may face and take appropriate action to help the child to overcome any such barriers (iv) help each child to understand the importance and value of education, learning, training and employment (v) promote opportunities for each child to learn informally (vi) maintain regular contact with each child's education and training provider, including engaging with the provider and the placing authority to support the child's education and training and to maximise the child's achievement (vii) raise any need for further assessment or specialist

p.5

Requirement Due date

provision in relation to a child with the child's education or training provider and the child's placing authority (viii) help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible. 13/03/2017

p.5

Requirement Due date

In order to meet the health and well-being standard the registered person must ensure that: 13/03/2017 1) (a) the health and well-being needs of children are met

p.5

Requirement Due date

(b) children receive advice, services and support in relation to their health and well-being

p.6

Requirement Due date

(c) children are helped to lead healthy lifestyles.

p.6

Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to ensure—

p.6

Requirement Due date

(a) that staff help each child to: (i) achieve the health and well-being outcomes that are recorded in the child's relevant plans (ii) understand the child's health and well-being needs and the options that are available in relation to the child's health and well-being, in a way that is appropriate to the child's age and understanding (iii) take part in activities, and attend any appointments, for the purpose of meeting the child's health and well-being needs (iv) understand and develop skills to promote the child's well-being

p.6

Requirement Due date

(b) that each child is registered as a patient with a general medical practitioner and a registered dental practitioner

p.6

Requirement Due date

(c) that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require.

p.6

Requirement Due date

In order to meet the protection of children standard the registered person must ensure:

p.6

Requirement Due date

(2)(a) that staff— (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 (ii) help each child to understand how to keep safe (iii) have the skills to identify and act upon signs that a child is at risk of harm (iv) manage relationships between children to prevent 13/03/2017 them from harming each other (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person (vi) take effective action whenever there is a serious concern about a child's welfare (vii) are familiar with, and act in accordance with, the home's child protection policies

p.6

Requirement Due date

(b) that the home's day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm

p.7

Requirement Due date

(c) that the premises used for the purposes of the home are located so that children are effectively safeguarded

p.7

Requirement Due date

(d) that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child's health

p.7

Requirement Due date

(e) that the effectiveness of the home's child protection policies is monitored regularly.

p.7

Requirement Due date

13. The leadership and management standard

p.7

Requirement Due date

In order to meet the leadership and management standard the registered person must ensure:

p.7

Requirement Due date

(1) that the registered person enables, inspires and leads a culture in relation to the children's home that—

p.7

Requirement Due date

(a) helps children aspire to fulfil their potential (b) promotes their welfare.

p.7

Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to—

p.7

Requirement Due date

(a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home's statement of purpose

p.7

Requirement Due date

(b) ensure that staff work as a team where appropriate

p.7

Requirement Due date

(c) ensure that staff have the experience, qualifications and skills to meet the needs of each child 13/03/2017 (d) ensure that the home has sufficient staff to provide care for each child

p.7

Requirement Due date

(e) ensure that the home's workforce provides continuity of care to each child

p.8

Requirement Due date

(f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home

p.8

Requirement Due date

(g) demonstrate that practice in the home is informed and improved by taking into account and acting on— (i) research and developments in relation to the ways in which the needs of children are best met (ii) feedback on the experiences of children, including complaints received

p.8

Requirement Due date

(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

p.8

Requirement Due date

The registered person must ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 and any regulations made under it are complied with in respect of the home. In particular, ensure that all fire doors are accessible. (Regulation 25(2)(b)) 13/03/2017

p.8

Requirement Due date

35. Behaviour management policies and records

p.8

Requirement Due date

The registered person must prepare and implement a policy ("the behaviour management policy") which sets out—

p.8

Requirement Due date

(1)(a) how appropriate behaviour is to be promoted in the children's home

p.8

Requirement Due date

(b) the measures of control, discipline and restraint which may be used in relation to children in the home.

p.8

Requirement Due date

(2) The registered person must keep the behaviour management policy under review and, where appropriate, revise it. 13/03/2017 (3) The registered person must ensure that—

p.8

Requirement Due date

(a) within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— (i) the name of the child (ii) details of the child's behaviour leading to the use of the measure (iii) the date, time and location of the use of the measure (iv) a description of the measure and its duration (v) details of any methods used or steps taken to avoid the need to use the measure (vi) the name of the person who used the measure ("the user"), and of any other person present when the measure was used (vii) the effectiveness and any consequences of the use of the measure (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure

p.9

Requirement Due date

(b) within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so ("the authorised person")— (i) has spoken to the user about the measure (ii) has signed the record to confirm it is accurate

p.9

Requirement Due date

(c) within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure.

p.9

Requirement Due date

(4) Paragraph (3) does not apply in relation to restraint that is planned or provided for as a matter of routine in the child's EHC plan or statement of special educational needs. (Regulation 35 (1)(a)(b)(2)(3)(a)(b)(c)(4)) 36. Children's case records

p.9

Requirement Due date

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.

p.9

Requirement Due date

c) securely in the children’s home during the period when the 13/03/2017 child to whom the case records relate is accommodated there

p.9

Requirement Due date

(d) in a secure place after the child has ceased to be accommodated in the home. (Regulation 36 (1)(a)(b)(c)(2)(c)(d))

p.10

Recommendation

To improve the quality and standards of care further the service should take account of the following recommendation:  Ensure that the home provides a nurturing and supportive environment that meets the needs of its children and is a homely, domestic environment. (‘Guide to the children’s home regulations including the quality standards’, page 15, paragraph 3.9) In particular, the provider should consider the necessity of having the televisions used by young people contained in wooden cabinets with a Perspex front.

p.10

Information about this children's home

This service provides residential accommodation for up to five young people who have a learning disability. The home is owned by a private company.

p.11

Recent inspection history

Inspection date Inspection type Inspection judgement 01/03/2016 Interim Sustained effectiveness 21/07/2015 Full Requires improvement 23/07/2014 Full Good 06/06/2014 Full Inadequate

p.11

Requires improvement

There are several shortfalls identified that have the potential to impact on young people’s welfare and safety. These include risk assessments not being in place, or not having been updated, physical restraints that have not been documented, shortfalls in the standard of the home environment and lack of management oversight. While the shortfalls have not directly affected young people’s safety, they have the potential to do so. This means that although the home has a number of strengths, it is not yet good.

p.12

Requires improvement

Young people said that they enjoyed living at this home and that they had members of staff who they could talk to if they were upset or worried. The staff provide nurturing care that meets young people’s presenting needs. Young people start to build relationships with staff who provide warm, parental-style role models. Staff have realistic expectations of young people and work hard towards building attachments with them. This has had a positive influence, as good rapport and positive relationships are evident. Young people are tactile and warm towards staff; they enjoy their company and respond well to the guidance that staff provide.

p.12

Requires improvement

Staff do not always manage to get a young person to attend an education placement. This can mean having a tutor coming into the home to provide education. However, in the absence of the tutor there is no alternative education plan in place for young people. Although the registered provider has recently escalated their concerns about the lack of education placement, this situation has been ongoing for five months for one young person and five weeks for another. A young person commented, ‘I don’t have to go to school, so get up when I want. It’s boring, like today I have nothing to do.’ There has been a lack of evidence as to how the registered provider has used the role of the virtual headteacher to secure an education placement.

p.12

Requires improvement

The home does not present as a homely environment. The downstairs rooms were clean and well decorated. However, the fire exit was locked with a key, which was located in the office, therefore only available to staff. This is a health and safety hazard and could place both young people and staff at risk of harm. Young people’s bedrooms were poor, and one young person’s bed was significantly damaged with a hole in the mattress. The manager attended to the mattress immediately and a new bed was delivered on the day of the inspection. In another young person’s bedroom, the sink was hanging off the wall and the carpet was significantly damaged. Furthermore, the young people’s bathrooms were bare and contained no cleaning items such as soaps and towels. Furthermore, both the garage area and the staff second office contained numerous rubbish bags, which held confidential information. This had been ripped up or was

p.12

Requires improvement

strewn across the floor in the garage. Currently, televisions used by young people are contained in a wooden cabinet with a Perspex front. There is insufficient rationale about the need for these cabinets. Their appearance detracts from a welcoming environment and they are not typically found in a family-style home.

p.13

Requires improvement

Children are supported to have contact with their families and other significant people in their lives. Staff help them to develop and maintain relationships with people who are important to them by ensuring that they get to their arranged contact, providing transport when required.

p.13

Requires improvement

Young people’s inclusion in community life is good. Some young people are active members of the local church and are supported by staff to attend. The church provides opportunities for socialising outside of the residential group. These experiences, which are bespoke to individual young people’s preferences, add to their overall feeling of well-being and increase their self-esteem.

p.13

Requires improvement

The practice in relation to helping and protecting children needs to improve. This inspection has found failings. While there is nothing to show that these have led to children suffering harm, unchecked they have the potential to do so.

p.13

Requires improvement

Young people say that they feel safe at the home and that they can identify someone whom they can talk to. Placing authority social workers said that they are confident in the staff team’s ability to keep young people safe.

p.13

Requires improvement

Some risk assessments are written to cover major aspects of a young person’s care. They are of a variable standard, and in one case a young person who was known to display self-harming behaviour did not have a risk assessment in place to help staff manage this behaviour. Furthermore, managers do not regularly review them, with the result that they are not always up to date. This means that it is not possible to measure their success against a young person’s starting points and, consequently, they are not as effective as they might be in providing evidence of how risks are managed.

p.13

Requires improvement

The staff support children to attend medical appointments. However, these appointments are not documented in the young people’s health plan. Medication arrangements in the home have improved significantly since the last inspection, ensuring that children’s medical needs are met and their well-being safeguarded effectively. For example, medication records are accurate and demonstrate that children receive the correct medication. Staff who administer medication have received suitable training, and their competence to administer medication is assessed.

p.13

Requires improvement

The home’s behaviour management policy is not consistently implemented. On occasions, responses to challenging behaviour do not provide a consistent, positive message to young people. Consequences can be disproportionate, confusing and punitive, with no clear overview of why the decision was agreed. For example, a young person stated, ‘I’ve been stopped from all activities for one week. I think it’s a bit much.’ There was no clear indication of why this measure was appropriate or any written documentation to show that the consequences given resulted in the young person learning from their actions. This does not help staff to evaluate and identify the effectiveness of the measure used in helping young people make changes to their behaviours.

p.14

Requires improvement

Records relating to physical intervention do not demonstrate how they are carried out safely. Debrief sessions for young people and staff following all incidents do not routinely take place. Records are incomplete with sections left blank, including details of the young person’s behaviour that led to the use of the measure. Details of any measures that are taken to avoid restraint are also left blank. The noticeboard within the office indicated that incidents and physical interventions had taken place. However, these were not documented within the young people’s records and the manager could not give any explanation as to why this was the case. The failure of staff to follow robust physical intervention procedures places young people at significant harm.

p.14

Requires improvement

Managers ensure that safe recruitment practices are utilised to ensure that young people are protected, and that all staff at the home are suitable and safe to work with young people.

p.14

Requires improvement

Some young people, for whom going missing from home was a feature of their lives, experience a significant drop in the frequency of these episodes. When young people do go missing, staff are prompt to follow protocols and to liaise with other agencies. However, some of the recording of these missing episodes is not concise or robust. For example, in one young person’s record it stated ‘member of the public called the home and [young person] was collected by members of staff’. The record failed to demonstrate how staff had determined how and why the young person was in the company of this member of the public and failed to assess any potential risk. This potentially could place young people at risk of harm. Judgement grade

p.14

Requires improvement

The impact and effectiveness of leaders and managers require improvement. The inspection identified a large number of shortfalls. The management team was not fully aware of these. Internal monitoring systems have not been strong enough to identify them. As a result, they do not contribute to improving the quality of care that young people receive.

p.15

Requires improvement

Registered in October, the manager has been in post for a short time. She has some previous experience of managing children’s homes and is qualified to undertake the role. Records show that she makes herself available to the children and is quick to act when they bring issues to her attention. She has previous experience of working with and supporting children with learning difficulties.

p.15

Requires improvement

Staffing levels are good, and the majority of staff possess the experience and necessary skills to look after vulnerable young people. The staff team speaks positively of the support that it receives from management at the home and senior management within the organisation. The staff have access to a range of training opportunities. Managers and staff receive supervision. However, some staff had not received training in self-harm, despite some young people displaying self-harming behaviour. Furthermore, managers fail to test staff members’ knowledge after they complete online training. This is a missed opportunity to ensure that staff have the knowledge and skills to meet the individual needs of the young people.

p.15

Requires improvement

Case records and the quality of care are not fully monitored or audited to ensure clarity and accuracy for staff. There are some discrepancies between plans, so that the personalised care to young people is not being provided as per the aims and objectives of the care plan. One member of staff said, ‘Some of the records are confusing.’ Consequently, the quality of care is not being monitored, leaving young people vulnerable to care that may not be meeting their needs.

p.15

Requires improvement

During the inspection, inspectors found that both the garage area and the staff second office contained numerous rubbish bags, which contained confidential information. Some had been ripped up or were strewn across the floor in the garage. The confidential information included young people’s personal information and photographs and details of staff supervision and recruitment files. This fails to demonstrate that the manager and the provider have safely secured records and highlights their inability to maintain confidentiality for both young people and staff members.

p.15

Requires improvement

Management has built some positive relationships with external agencies, such as the local missing police lead and the designated officer. In addition, in response to the ongoing behaviour displayed by a young person in consistently making allegations against the home’s staff and teaching staff, the management proactively organised a meeting with fellow professionals to ensure that any further concerns are appropriately managed. This ensures that young people are protected from harm and promotes a multi-agency response and oversight which ensures that all allegations are closely monitored.

p.15

Requires improvement

The manager has ensured that Ofsted has received information regarding significant events within the home and of the action taken to safeguard children. The registered provider and staff team are young-person-focused. However, staff have lacked robust management direction on occasions. For example, after physical restraint incidents, the registered provider has not reviewed incidents and learned from them. Furthermore, they have not ensured that the staff team has all of the skills and expertise that it needs to be able to support a young person’s progress.

p.16

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.17

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.17

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.

p.17

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 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.18

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.18

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.19

Information about this inspection

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

p.19

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.19

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.19