Children's Home run by Crossway Services Limited in St Helens

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:

 The young person is making progress in some aspects of his life. However, there was limited evidence within the home to demonstrate his overall progress and experiences since moving in.  Care planning is not consistently effective to meet the needs of the young person. The young person‘s care plan omits significant information and does not include factual information relating to his bedtimes. His local authority documentation is not up to date.  Allegations against staff members by the young person are not adequately investigated or addressed.  The administration and recording of medication in the home need to be strengthened.  The recording systems in the home are not robust. Records are not detailed and do not show the young person‘s journey. Records are not always signed and dated by the author.  Although risk assessments are in place, they do not address all current risks and are not regularly reviewed and updated.

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The children's home provision requires improvement because:

 Behaviour management in the home is not clear.  The use of physical intervention has increased in the home and not all staff have been adequately trained in the restraints used. Furthermore, not all incidents of physical intervention have been effective. Insufficient action has been taken to evaluate the effectiveness of physical interventions.  Safeguarding in the home is compromised due to the front door being unlocked at times. This does not prevent any unwanted visitors entering the home.  Recommendations for improvement made at the last full inspection have not been fully met. Consequently, case records including the health plan and placement plan are not up to date.  The young person‘s education needs are not being met. He does not have an education plan and is currently not receiving an appropriate level of education.  Staff do not receive regular practice-related supervision. The records for

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The children's home provision requires improvement because:

supervision could not be located during the inspection.  The records of training for staff in the home could not be located during the inspection.  Staff rosters do not clearly outline which members of staff are on duty at a given time.  The home does not have a visitor‘s signing in book. Not all visitors are recorded on the electronic visitor‘s log.  The records relating to accidents recorded in the home could not be located during the inspection.  The home does not have a registered manager. Therefore, no one has day- to-day responsibility for the management of the home.

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The children's home strengths

 The young person and staff have developed good relationships, which contribute to the reduction in the severity of incidents for the young person.  The home supports the young person to have regular contact with family members.  The young person benefits from a wide range of social and recreational activities.  The transition for one young person leaving the home was well planned and fully supported the young person to move on to semi-independence with ongoing contact and support from the home.  The young person benefits from an incentive and reward scheme that has contributed to some improvements in his behaviour.  The home took appropriate action by having a window restrictor fitted in response to the young person climbing out of an upstairs window.  The home has increased the staffing levels to 2:1 to manage the behaviours of the young person.  Monitoring and review systems in the home are robust.

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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

12: The protection of children standard In order to meet the protection of children standard the registered person must ensure that: (2)(a) the 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; (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; and (vii) are familiar with, and act in accordance with, the home's child protection policies; (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

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Requirement Due date

from harm; and (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. 05/05/2017

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Requirement Due date

8: The education standard In order to meet the education standard the registered person must ensure: (1) that children make measurable progress towards achieving their educational potential and are helped to do so. (2) In particular, the standard in paragraph (1) requires the 05/05/2017 registered person to ensure— (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 the 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;

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Requirement Due date

(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 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; and (x) help each child to attend education or training in accordance with the expectations in the child's relevant plans.

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Requirement Due date

33: Employment of staff The registered person must ensure that all employees undertake appropriate continuing professional development and receive practice-related supervision by a person with appropriate experience and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(a)(b)(c)) 05/05/2017

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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. In particular, the 05/05/2017 registered person must ensure that— medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them; medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and a record is kept of the administration of medicine to each child. (Regulation 23 (1)(2)(a)(b)(c))

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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 (1)(2)) In particular, a record of all visitors to the home, including the visitor‘s name and reason for their visit, a copy of the staff roster of persons working at the home and a record of the actual rosters worked. 05/05/2017

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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 a record of supervision is kept for staff that provides evidence that supervision is being delivered in line with regulation. (‗Guide to the children‘s homes regulations including the quality standards‘, page 61, paragraph 13.3)  Ensure that staff continually and actively assess the risks to each child and the arrangements in place to protect them. Where there are safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps that 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)  Ensure that records of restraint are kept and enable the registered person and staff to review the use of control, discipline and restraint to identify effective

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Recommendations

practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure that it meets the needs of each child. ('Guide to the children's homes regulations including the quality standards', page 49, paragraph 9.59)  Ensure that all children's case records (Regulation 36) are kept up to date and stored securely while they remain in the home. Case records must be kept up to date and signed and dated by the author of each entry. (‗Guide to the children‘s homes regulations including the quality standards‘, page 62, paragraph 14.3)  Implement a workforce plan which can fulfil the workforce related requirements of Regulation 16, schedule 1 (paragraphs 19 and 20). The plan should detail the processes and agreed timescales for staff to achieve induction, probation and any core training (such as safeguarding, health and safety and mandatory

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Recommendations

qualifications.) The plan should be updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home's manager. ('Guide to the children's homes regulations including the quality standards', page 53, paragraphs 10.8 and 10.9)  Review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home's location and strategies for managing these. ('Guide to the children‘s homes regulations including the quality standards', page 64, paragraph 15.1)  The registered person must ensure that each child's day-to-day health and well- being needs are met. ('Guide to the children's homes regulations including the quality standards', page 33, paragraph 7.3)

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Recommendations

In particular, they should ensure that children's individual health plans set out the day-to-day arrangements for meeting all their health and well-being needs.  Ensure the use of agency staff is carefully monitored and reviewed to ensure that children receive continuity of care. ('Guide to the children‘s homes regulations including the quality standards', page 54, paragraph 10.16)

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Information about this children's home

The home is owned and managed by a private organisation. It provides care and accommodation for one young person who has emotional and/or behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement 12/12/2016 Interim Not judged 14/01/2016 Full Good 07/07/2015 Interim Sustained effectiveness 14/01/2015 Full Good

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Requires improvement

The young person living in the home has developed good relationships with staff. The staff spend time with him, listen to him and support him in managing his behaviour. The young person said, ‗The best thing about the home is the staff.‘ The staff encourage and support the young person to engage in social and recreational activities, such as attending Cubs and being part of a local football team. This helps the young person to build his confidence and self-esteem and enables him to make new friendships. The young person is making some progress across some aspects of his life. For example, there has been an improvement in his behaviour with a reduction in the number of incidents and an increasing ability to manage his emotions and frustrations more constructively. There has also been a reduction in the levels of risk that the young person exposes himself to. However, there is limited evidence in the records maintained in the home to show his overall progress from his

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Requires improvement

starting point since first moving in. For example, his local authority placement plan and care plan are out of date and relate to his previous placements. The young person does not have an education plan in place. The home‘s own care plan omits significant information and includes factually inaccurate information such as that which relates to the young person‘s bedtime routine. Overall, this makes it difficult to measure any meaningful progress. The young person has been out of formal education for some time, including the time prior to moving into the home. There is currently no education plan in place for him. Although the staff at the home do some educational work with the young person, such as playing games and undertaking visits to local parks and museums, they do not have a timetable in place for the young person to participate in suitably planned educational activities. The home has liaised with the local authority to

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Requires improvement

make arrangements for the young person to receive tuition in the home. However, the initial plan only offers five hours of tuition and so far this has not been consistently provided due to the irregular attendance of the tutor. This means that the young person‘s education needs are not being adequately met. The home is not challenging the local authority sufficiently to secure appropriate education to meet the young person‘s needs. The staff have taken action to address the emotional well-being of the young person. They have liaised with the young person‘s social worker, the child and adolescent mental health services and the company‘s own psychologist in order to provide appropriate support and intervention for the young person. However, the young person‘s health plan does not include the information to adequately demonstrate this. The young person‘s health plan also omits significant information relating to the young person‘s current health needs. For example, the action taken

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Requires improvement

to support dental treatment needs, details of the young person‘s immunisation history and details of his looked after children health assessment. Consequently, the health and development needs for the young person are unclear. The young person‘s views, wishes and feelings are appropriately considered in decisions affecting the running of the home. The young person has regular consultations with staff in relation to incidents which occur and other issues that are having an impact on him, such as how he spends his pocket money, rewards and incentives as well as matters such as choosing the decoration for his bedroom. He also benefits from regular young people‘s meetings when an action plan is put in place for him and the staff team to complete. Therefore, the young person feels that he has a voice in the home and that staff listen and respond to his views, wishes and feelings. The staff support the young person to maintain regular contact with his family.

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Requires improvement

They take the young person to direct contact sessions once a month in his home town, which is some distance from the children‘s home. In addition, they support the contact officer in supervising the contact in line with the contact plan. The staff also support the young person to maintain regular telephone contact and ensure that all contact is safe and in the young person‘s best interests. Consequently, the young person maintains positive relationships with people who are important to him. The planning and preparation for the young person moving into the home could have been better. A member of staff said, ‗It was quite rushed preparing for him to move in. We had little time to prepare due to the young person moving in quite quickly after a decision was made for him to move from one of the other homes within the company.‘ However, the transition for another young person who has recently left the home was well-thought-out. The young person was supported to

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Requires improvement

visit and choose an appropriate semi-independent placement to move on to and to meet her new staff team. Furthermore, she was encouraged and supported to enhance her independence skills prior to moving and a clear transition plan ensured that the young person continued to receive support and intervention from the staff team after she left the home. The young person has maintained contact with the home since moving on and appears to be settling in well to her new placement. Therefore, the transition for young people moving out of the home offers them appropriate support and intervention to achieve a successful transition.

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Requires improvement

The safeguarding of young people is generally good at this home. The staff take appropriate action to keep young people safe. However, the risk assessments for the current young person living in the home do not adequately demonstrate this. For example, the young person has been subject to a number of physical interventions, yet his risk assessment about physical intervention has not been reviewed and updated for several months, despite the assessment stating that it will be reviewed weekly. Other risk assessments are also not reviewed regularly to ensure that they are up to date and remain relevant. Therefore, the safeguarding for the young person is potentially compromised. There have been two incidents when allegations have been made against a member of staff. Actions identified as an outcome following a safeguarding meeting held by the local authority designated officer regarding one incident have

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Requires improvement

yet to be implemented. The actions included the member of staff having more frequent supervision and additional training. This means that the home has not taken appropriate action to support the member of staff involved and allow them to enhance their safeguarding practice by having updated safeguarding training and reflective supervision. The young person had experienced occasions when they went missing from home in a previous placement. However, the home has a robust risk management plan in place, which has resulted in the young person not having any incidents during his time here. Although there have been incidents when the young person has climbed out of his upstairs bedroom window, he has not been reported missing due to the quick response by the staff team. Staff have also taken appropriate action by having a restrictor fitted to his bedroom window so as to prevent possible accidents or injury from the young person trying to climb out of the window.

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Requires improvement

Since moving into the home, the young person has made some progress with managing his emotions and behaviour. Incidents are reducing in severity due to the behaviour management strategies implemented by the home, such as an increased emphasis on rewards and incentives, de-escalation and increased 2:1 staffing ratios. The young person‘s social worker said, ‗The efforts by the staff team are evident in the reduction in incidents for the young person.‘ However, the staff team is unclear on the plans to manage the young person‘s behaviour following recent recommendations made by the company psychologist. Sanctions and consequences do not appear to be proportionate or in line with the young person‘s individual needs. For example, his computer console was removed from him for seven days following an incident. However, due to a further incident occurring on the sixth day, the seven days started again. A member of the company‘s

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Requires improvement

management team acknowledged that sanctions and consequences in place are not realistic and very difficult for the young person to achieve. Furthermore, they are not restorative in nature, which would allow the young person to reflect on his behaviour and learn from the sanction or consequence. Therefore, the home needs to be clear on what sanctions should be implemented, the reason for the sanction and whether they are effective. The young person has been subject to a number of physical interventions in response to their challenging behaviour. The physical interventions have been undertaken to prevent the young person from harming himself, others or causing damage in the home. In some instances, the use of physical intervention was not always effective because not all staff had been adequately trained in the home‘s chosen techniques for physical intervention. Some injuries have been sustained by the young person and staff following incidents. The accident records relating to

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Requires improvement

these incidents could not be located in the home. However, appropriate training has now been provided to all members of the staff team. There is a home location assessment in place, but it has not been updated within the last 12 months in line with regulation nor does it provide a sufficiently evaluative assessment of the risks in the area that the children‘s home is located. The records relating to the management of medication do not demonstrate a robust system. For example, the young person was prescribed mouthwash medication by the dentist. The medication sheet for this indicates that staff have forgotten on a number of occasions to give the young person this medication. Furthermore, the record is unclear as to when the young person should have the medication. This means that the young person is not benefiting from receiving the necessary attention to his dental health. The home does not have a robust system in place to record visitors to the home.

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Requires improvement

They do not have a visitor‘s book for visitors to sign in and out. Currently, the staff record in the daily log book and electronic visitor‘s log when visitors arrive and leave the home. However, the records show that this is not consistently and accurately recorded. A member of staff said, ‗I have raised this in the team meeting a few times as staff often forget to record who has visited the home.‘ The lack of adequate recording of visitors to the home does not fully safeguard young people.

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Requires improvement

The home does not currently have a registered manager in post. However, plans are in place for a registered manager from one of the company‘s other homes to take over the responsibility for managing the home. She is adequately trained and experienced to complete this role and is keen to make improvements, in particular with regard to the quality of the recording systems. The home has made limited progress on the recommendations made at the last full inspection. As a result, there continue to be shortfalls in the quality and detail in records held in the home as well as the quality of the plans for the young person. The records do not provide a true reflection of the issues for the young person, how his needs are being met and the quality of care provided to him. This means that the quality of care provided by the staff team is compromised as they do not have sufficient detail about the young person‘s current needs to inform their

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Requires improvement

practice or that of the regular agency workers who support the young person. The staff team members do not receive regular reflective supervision at which time they can regularly reflect on their practice and develop their understanding of the young person‘s behaviour and emotional needs. Furthermore, the training for the staff team is unclear and does not appear to take place on a regular basis. As a result, this has an impact on their professional practice and the progress that the young person makes. The staff team members do report that they feel supported and that they work well together to ensure that the young person‘s needs are met. A member of staff said, ‗The external monitoring and review systems in the home are robust.‘ The home benefits from external monitoring by the independent visitor each month. The home‘s management usually responds well to the recommended actions from these visits. In addition, there is an internal review of the quality of

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Requires improvement

care provided every six months in line with regulation. However, there is limited evidence of the action being taken to address the current shortfalls in the home. The proposed new manager of this home is well aware of the shortfalls and is keen to make improvements. The home is working in line with its ethos and values as outlined in its statement of purpose. ‗Our ethos and values are derived from a belief that children/young people are best cared for in an environment that provides as ―normal‖ a living experience as possible. We believe children/young people are able to develop and change positively. It is our responsibility to provide the environment and input to help them to develop in a positive manner. We expect children/young people to do well in our care, if they do not we have a responsibility to consider the changes we can make to help the child/young person so they can benefit from the placement.‘

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Requires improvement

The home‘s statement of purpose has recently been updated to include changes in the staffing levels to a 2:1 staffing ratio in order to adequately support the young person living in the home. However, the statement of purpose does not include information relating to the daily use of agency staff in the home or that the post of registered manager is now vacant. Consequently, the statement of purpose does not provide an accurate account of the current staffing in the home. The home has developed good professional relationships with other professionals. This helps to ensure that young people receive the most appropriate support to meet their needs. For example, the home is currently liaising regularly with professionals including the company psychologist and child and adolescent mental health services (CAMHS) to ensure that the young person‘s emotional needs are being addressed. The home also maintains regular contact with the young person‘s

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Requires improvement

social worker. The social worker said, ‗The level of communication from the home is good. I have no concerns about the home whatsoever.‘ The home has regularly liaised with education professionals but has not effectively challenged the placing authority in relation to the lack of education provision in place for the young person The staff have worked hard to build good relationships with the young person‘s family, which supports positive, safe contact between them.

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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 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

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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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