Children's Home run by Exceptional Care Limited in Lancashire

Inspection report children’s home: 1227335 1 Registered provider: Exceptional Care Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately run children’s home provides care and accommodation for up to two young people with emotional and/or behavioural difficulties.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Date of last inspection: 13 October 2016

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good

Overall judgement at last inspection: Requires improvement

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Key findings from this inspection

 Young people have positive experiences while living at the home. They make progress in most areas of their lives, including the levels of risk that they face, and their health, emotional development and behaviour. Inspection report children’s home: 1227335 2  Young people are cared for by a committed and supportive manager and staff team who know them well, listen to them, and promote their safety and well- being at all times.  The manager and staff strive to ensure that the needs of young people are met well and their outcomes are improved.  Relationships between the manager, staff and young people are positive. The staff spend time with young people and engage them in various activities to enhance their social interaction, self-esteem and confidence.  Young people’s views, wishes and feelings are given the highest priority. There is regular consultation with young people through daily discussions, key-work

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Key findings from this inspection

sessions and young people’s meetings.  The quality of the records and plans in the home are much improved. Records are clearer and more detailed, and show young people’s progress.  Risk assessments are comprehensive and outline the risks associated with each young person, and how these are being managed and reduced.  The home’s internal monitoring systems are robust and enable the manager to review professional practice and the quality of care provided to young people. Consequently, any shortfalls are quickly addressed.  Transition support for young people moving into the home is good. Detailed referrals and transition arrangements support smooth transitions into the home. Impact and compatibility assessments are completed prior to young people moving into the home.  The home works collaboratively with other professionals to ensure that young people are receiving the most appropriate support to meet their needs. This

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Key findings from this inspection

supports young people to make progress and have improved outcomes.  The staff feel supported by the manager and each other. They regularly share information at handovers and team meetings. Training and development opportunities allow them to further their skills and knowledge. Supervision for staff is supportive and allows staff to reflect on their practice.

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Key findings from this inspection

The children’s home’s areas for development

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Key findings from this inspection

 The educational needs of young people are not being met. The young people are not provided with suitable education provision to meet their needs. However, the home has taken appropriate action to address this with the relevant placing and host local authorities.  The home does not have education timetables in place for young people. This does not demonstrate that it is supporting each young person’s learning and development, helping them to develop independent study skills or, where appropriate, helping them to understand the importance and value of education, learning, training and employment.  The external monitoring systems for the home need to be strengthened. Inspection report children’s home: 1227335 3 Although the manager provides his written response to the independent person in relation to the recommended actions, this is not recorded in the monthly reports sent to HMCI.  Staff supervision takes place regularly. However, the frequency of supervision is

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Key findings from this inspection

not always in line with the policies and procedures of the home.  Records relating to physical intervention do not clearly outline the impact or duration of the intervention.  Although consultation with young people regularly takes place, this is not demonstrated in all of the home’s records.

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Inspection date Inspection type Inspection judgement

13/10/2016 Full Requires improvement Inspection report children’s home: 1227335 4

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Statutory requirement

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so.

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Requirement Due date

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

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Requirement Due date

that staff 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; understand the barriers to learning that each child may face and take appropriate action to help the child to overcome any such barriers; help each child to understand the importance and value of education, learning, training and employment; and promote opportunities for each child to learn informally. (Regulation 8(10(2)(a)(ii)(iii)(iv)(v)) 16/06/2017

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Recommendations

 Ensure that the home makes best use of the information from the report provided as a result of the independent person’s visit, to ensure continuous improvement. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 13.2)

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Recommendations

In particular, the independent visitor reports should include the manager’s response to the recommended actions.

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Recommendations

 Ensure that children are encouraged by staff to see the home’s records as ‘living documents’ supporting them to view and contribute to the record in a way that reflects their voice on a regular basis. (‘Guide to the children’s homes regulations including the quality standards’, page 58, paragraph 11.19)

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Recommendations

 Ensure that records of restraint enable the registered person and staff to review Inspection report children’s home: 1227335 5 the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure it meets the needs of each child. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

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Recommendations

In particular, records should clearly outline the impact and duration of the restraint.

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Recommendations

 Ensure that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2)

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Recommendations

In particular, ensure that the frequency of supervision is in line with the home’s own policies and procedures.

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Overall experiences and progress of children and young people: good

Young people have made good progress in most areas of their lives since moving into the home. Their experiences are rewarding, and promote their social and emotional development. Furthermore, they lead to improved outcomes for them. One young person said: ‘This is the best home that I have lived in. The manager and staff are really good and want what is best for me.’ Young people have strong and trusting relationships with the manager and staff.

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Overall experiences and progress of children and young people: good

Young people’s health needs are understood by the manager and staff. Healthcare plans identify their individual health needs, and they are fully supported in this area. Statutory health assessments have been completed and young people have attended all required medical appointments. Appointments with the general practitioner (GP) take place as and when necessary. For example, one young person recently visited their GP for treatment for a chest infection and was prescribed antibiotic medication. Another young person visited the GP in relation to addressing outstanding immunisations. All medical appointments and treatment are clearly recorded in young people’s healthcare plans. Furthermore, young people are well supported to adopt healthy lifestyles. They are provided with healthy meal options, and encouraged to attend the gym and to participate in activities such as going walking with staff. The home also has strong links

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Overall experiences and progress of children and young people: good

with the sexual health nurse, who offers appropriate support, advice and guidance to staff and young people in relation to sexual health.

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Overall experiences and progress of children and young people: good

The therapeutic support for young people to address their emotional needs and development is good. The home works collaboratively with the therapeutic service that it commissions for young people. This helps to ensure that they are receiving the best possible support to address their individual needs. The therapeutic service provides Inspection report children’s home: 1227335 6 young people with regular sessions to promote their individual well-being and to address any issues that may be having an emotional impact on them. Detailed reports from these sessions are completed, and appropriate information is shared with the home’s staff so that they are aware of the issues addressed and can continue to offer young people support following therapy sessions. The therapist said: ‘The home is in regular communication with me. Staff often identify any specific issues relating to young people that should be addressed in sessions.’ Consequently, young people are receiving

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Overall experiences and progress of children and young people: good

appropriate therapeutic support to meet their current needs, which improves their emotional well-being. A professional working with one young person said: ‘The progress that she has made in relation to her attitude and positive thinking is really good.’

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Overall experiences and progress of children and young people: good

The education needs of young people are not currently being met. Prior to moving into the home, neither young person was accessing suitable education provision. This situation has continued since moving into the home. The registered manager has continually raised this with the placing and host local authorities. A social worker said: ‘The manager has continued to pursue the lack of education provision for the young person. It is not the home’s fault that the young person does not have suitable education provision, and we are working together on this with education professionals to resolve this’. However, the home does not have interim arrangements in place, such as education timetables and routines for young people, to demonstrate that it is supporting each young person’s learning and development while they await confirmation of suitable placements. Consequently, young people are not progressing educationally. Some

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Overall experiences and progress of children and young people: good

progress was made during the inspection, following discussions with the placing local authority about one young person, to fund an education proposal that the home had identified from an independent provider. This will hopefully commence soon. The home has also supported the other young person to enrol on an information technology course later in the year, and is looking at other opportunities for him in the meantime.

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Overall experiences and progress of children and young people: good

Consultation with young people takes place regularly through key-work sessions, young people’s meetings and life space meetings following any incidents. The manager and staff ascertain young people’s views, wishes and feelings and, where possible, will act upon these. For example, one young person requested a double bed in her bedroom, so this was provided for her. The young person has expressed a wish to move to a foster placement several times, both prior to and since moving into the home. The young person is unclear why this cannot happen at this point in time. The manager has discussed this with the young person’s social worker, and arrangements have been made for him to visit and discuss this with the young person. This demonstrates that the staff listen to young people’s views, wishes and feelings, and take appropriate action in response to these. However, not all records in the home demonstrate that consultation

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Overall experiences and progress of children and young people: good

has taken place with young people. For example, healthcare plans, risk assessments and other records do not include the views, wishes and feelings of young people, nor do they demonstrate that young people have read and understood them.

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Overall experiences and progress of children and young people: good

The manager and staff have a good understanding of the individual needs of young people, and source appropriate support and interventions to meet these needs. For example, they identified appropriate support for one young person to meet her cultural needs. The young person is now actively involved in a Black Caribbean community group Inspection report children’s home: 1227335 7 to support and meet her cultural needs. The young person is engaging really well with this. It is supporting not only her cultural needs, but also her social, emotional and identity needs. Furthermore, the community group has made a proposal to meet her education needs, which has now been agreed by her placing local authority. A member of staff from the community group said: ‘This is one of the best placements that the young person has had. The home is very supportive and has made the effort to identify a service for her to meet her cultural, social and educational needs. The home maintains

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Overall experiences and progress of children and young people: good

regular communication with us and invites us to important meetings. This is really important, so we can offer the young person the best possible support.’

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Overall experiences and progress of children and young people: good

Young people benefit from engaging in a wide range of social and recreational activities with the staff team, peers and individually, such as Laser Quest, playing pool, roller skating, beauty treatments, going to the cinema and shopping. Young people are well supported to pursue their individual interests and receive additional monies to enable them to do this. For example, one young person enjoys having her nails done, so arrangements and funding are in place for her to do this. A young person jokingly said, ‘I enjoy playing Laser Quest with staff, as I always win against them.’ When talking to the other young person about her appearance and beauty treatments, she explained that she had lacked confidence in her appearance, then went on to say: ‘The staff tell me every day how beautiful I am.’ The wide range of opportunities available and the emphasis on praise for young people support them to build their social interaction,

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Overall experiences and progress of children and young people: good

Transitions for young people moving into the home are robust. Detailed referral forms lead to in-depth impact and compatibility assessments being completed to establish whether the home can appropriately meet the needs of the young person. Furthermore, they outline the impact that the placement would have on the staff and other young people living at the home. Young people only move into the home when it is felt both to be in the best interests of the young person and that the home is able to meet their needs. Prior to young people moving into the home, arrangements are made for them to visit to meet the staff and other young people living at the home. The registered manager also liaises with other professionals and family members, where appropriate, to obtain as much information as possible about the young person to enable staff to prepare for their arrival. With regards to young people moving out of the home, the

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Overall experiences and progress of children and young people: good

home offers good levels of support to young people by ensuring that they visit their new placements prior to moving and that all relevant information about the young person is shared with the new carers. Furthermore, young people are supported by staff who accompany them on visits and when they move. Young people are encouraged to keep in contact with the home after they leave, if they wish to do so. The registered manager has identified that the transition for young people moving out of the home would be strengthened by having clear, detailed transition plans in place, so will adopt this practice for any future moves. The robust practice in relation to young people moving in and out of the home ensures that transitions are smooth. Inspection report children’s home: 1227335 8

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How well children and young people are helped and protected: good

Young people living at the home are safeguarded. The manager and staff have a good understanding of the individual risks to young people, such as self-harm, going missing from care, and alcohol and substance misuse. Safeguarding practice at the home is good, due to the knowledge, skills and experience of the manager and staff. Consequently, the risks to young people have been reduced since they moved into the home. For example, both young people living at the home have had episodes of being missing from home in previous placements, and occasional alcohol and substance misuse. However, since moving into the home they have not been missing or engaged in alcohol or substance misuse. A young person said: ‘I feel safe, living at the home.’

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How well children and young people are helped and protected: good

Risk assessments and risk management plans are detailed and clearly outline the individual risks for young people. They include relevant detailed information about potential risks, such as known triggers and warning signs, and prevention strategies, risks to other young people and intervention strategies. Risk assessments are regularly reviewed and updated, and are signed by all staff to confirm that they have read and understood them. Key-work sessions take place regularly with young people, some of which address safeguarding issues with young people. For example, sessions have taken place in relation to positive relationships, sexual health, risks of smoking and fire setting. However, risk assessments could be strengthened further to include information about how young people are consulted on their views, wishes and feelings in relation to the risks that they face.

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How well children and young people are helped and protected: good

Young people benefit from clear and consistent behaviour management at the home. They clearly understand what is expected of them and how inappropriate behaviour will be managed at the home. The approach that the manager and staff take when young people become anxious or struggle to manage their behaviour has a calming influence. Therefore, incidents are rare and, when they do occur, they are dealt with in a timely manner to prevent a prolonged unsettled situation for young people. The home’s response to an allegation from a young person that they had been scratched by a member of staff during a physical intervention was effectively managed. Discussions took place with the local authority designated officer, the young person and staff members. A thorough investigation took place and the allegation was found to be unsubstantiated. The young person was happy with the response and the decision made. On the rare occasions that physical intervention has been necessary, it has been

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How well children and young people are helped and protected: good

undertaken appropriately and only in order to ensure that young people are not harmed. Records relating to these incidents clearly outline the reason for the physical intervention, the type of intervention used, any injuries caused and the actions taken following the intervention. Debriefings generally take place with young people following any physical intervention and are well recorded. However, after one incident there was no debriefing with the young person. Another physical intervention record did not clearly outline the duration of the intervention. This detail is important to enable the manager and staff to review the use of control, discipline and restraint, to identify effective practice and respond promptly when any issues or trends of concern emerge. Similarly, recording could be improved to show that young people are given the opportunity to Inspection report children’s home: 1227335 9 express their views, wishes and feelings about the restraint.

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How well children and young people are helped and protected: good

Young people are encouraged and supported to have positive relationships with each other in the home. The manager and staff recognise that the two young people currently living in the home have different needs, issues and interests. Therefore, each young person’s placement plan is individualised to reflect this. However, the young people do spend time together in the home, and staff look to use key-work sessions to build positive relationships and to address any disagreements at an early stage. For example, the staff responded appropriately to one incident when play fighting between the young people escalated into a disagreement. Key-work sessions took place in response to this, and both young people now clearly understand that play fighting is not acceptable in the home, in order to ensure that they are safeguarded and that positive relationships continue.

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How well children and young people are helped and protected: good

The number of incidents when young people are missing from home have been significantly reduced. However, there are clear policies and procedures in place to guide staff in how to address incidents, should they occur. This is in line with statutory guidance on children who run away or go missing from home or care. Further training for staff in relation to managing incidents when young people go missing from home is being sought to ensure that all staff are fully equipped with the knowledge, skills and understanding to safeguard young people from the risks associated with being missing from home.

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How well children and young people are helped and protected: good

The home has developed robust relationships with safeguarding professionals, such as the police community support officer, youth offending service and local authority safeguarding professionals. This supports a collaborative approach to safeguarding young people at the home. The manager is proactive in ensuring that the police community support officer visits the home to meet with staff and young people regularly to share safeguarding information and offer advice, support and guidance. The home’s location risk assessment identifies all known risks in the community and how these are managed. Consequently, young people and staff are aware of the safeguarding issues in the community and the measures in place to ensure that young people are safeguarded from these.

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How well children and young people are helped and protected: good

Young people benefit from access to a computer and the internet when living at the home. They are encouraged and supported to understand the risks associated with the use of the internet and social media, and to act responsibly when using them. The home has appropriate safeguards in place to ensure that this is safe, including clear policies and procedures for young people, who sign a contract when they move into the home that explains about the safe use of the internet.

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How well children and young people are helped and protected: good

The health and safety practices at the home are good. Staff carry out regular health and safety checks, including fire safety checks and fire drills. When young people move into the home, fire drills take place to ensure that they are aware of the procedures and how to respond if a fire was to occur in the home. Medication is stored securely in a locked cabinet in the office, and records relating to the administration of medication are clear and accurate. The robust health and safety practice at the home ensure that young Inspection report children’s home: 1227335 10 people’s safety and well-being remain paramount.

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How well children and young people are helped and protected: good

The procedures in place for the recruitment of staff working at the home are robust, and ensure that staff working at the home are appropriately vetted and selected. The recruitment process is rigorous and ensures that new staff have the experience, skills, values and motivation for working at the home. This safe recruitment practice ensures that young people receive a good quality of care and are safeguarded from potentially unsuitable people.

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The effectiveness of leaders and managers: good

The manager of the home is suitably experienced and is working towards a national vocational qualification at level 5. He has taken appropriate action to address the requirement and recommendations from the last inspection, and to improve the professional practice and quality of care for young people living at the home. He has recently appointed a new deputy manager who will support him and the staff team to continue to ensure that the needs of young people are met to a good standard. The home runs efficiently and consistently with the objectives set out in its statement of purpose and in the best interests of young people. The culture and ethos of the home reflect a strongly child-centred approach and commitment to promoting and safeguarding young people’s welfare.

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The effectiveness of leaders and managers: good

The staff feel supported by their manager and each other. A member of staff said: ‘The manager is very supportive and approachable. We do not have to wait for supervision to discuss issues.’ Staff receive regular supervision that is reflective in nature and addresses the needs of young people, as well as the welfare and professional development of staff. Records of supervision are detailed and clearly outline the agreed actions, and these are reviewed at subsequent supervision sessions to ensure that they are being progressed, and that staff are developing their practice and the quality of care that they provide to young people. However, the frequency of supervision is not always in line with the timescales set out in the home’s own policies and procedures. All staff are suitably qualified, or are enrolled and working towards the appropriate qualification, for their role. Regular training and development opportunities are offered to staff to ensure that

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The effectiveness of leaders and managers: good

they are able to meet the needs of young people and the aims and objectives of the home effectively. They discuss training and practice issues at team meetings to ensure that consistent practice is in place and to share knowledge, skills and experience. This provides young people with a consistent level of care in the home from staff who are skilled and suitably trained.

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The effectiveness of leaders and managers: good

The home is adequately staffed and the staff team consists of both female and male staff of varied ages at various levels of experience. Staff rotas demonstrate appropriate staffing levels and management support at all times. This ensures a range of knowledge, skills and experience within the home so that the needs of young people are met well. Furthermore, staff are supportive of each other and work well together, which means that the staff and young people at the home are happy and that there is a very positive atmosphere. Staff are committed to achieving the best possible outcomes for young people. A member of staff said: ‘The staff are very supportive, and I get different ideas Inspection report children’s home: 1227335 11 from them to improve my practice and outcomes for young people. It is a nice place to work, as the staff team and manager are very supportive of each other.’

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The effectiveness of leaders and managers: good

Placement plans for young people are detailed and clearly identify how their needs will be met. Plans are regularly reviewed and updated, and demonstrate the home’s effective response to the ever-changing needs of young people. Furthermore, plans enable the manager and staff to measure the progress that young people make while living at the home. For example, due to the high level of needs and risks of one young person when she moved into the home, she had two to one staffing at all times. Due to the significant progress that she has made in relation to the risks that she faces, her staffing level has now reduced to one to one. Therefore, placement plans ensure that the needs of young people are met, and the plans are a work in progress and change according to the young person’s circumstances and progress.

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The effectiveness of leaders and managers: good

Professional relationships between the home and social workers, independent reviewing officers, health and educational professionals and others are good. Professionals regularly share information about young people to ensure that the appropriate support and interventions are in place to meet their identified needs. A social worker said: ‘The home is working hard to address the needs of the young person, despite the various challenges. The home has been proactive in trying to ensure that appropriate education provision is in place for the young person, and it is certainly through no fault of its why this is not yet in place.’ Consequently, this supports young people in all areas of their development.

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The effectiveness of leaders and managers: good

Monitoring and review systems in the home support the manager to identify the strengths and weaknesses of the home, any patterns and trends, and the action to be taken to address these. There is evidence of actions being taken following visits from the independent person. However, the monthly reports for the external monitoring by the independent person that are sent to Ofsted do not always include the manager’s response to the recommended actions. Therefore, the regulatory body is not kept up to date on the home’s arrangements for safeguarding and promoting the welfare of young people in the home’s care.

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The effectiveness of leaders and managers: good

The leaders and managers ensure that the home provides young people with a nurturing, homely environment. The home is furnished and decorated to a good standard, with young people being involved in choosing furniture and decoration throughout the home. Young people share the main areas of the home, but have their own personal space in their bedrooms. The garage of the home has recently been converted into a spare bedroom and staff office, and a separate room for young people to sit in to watch television and play computer games.

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The effectiveness of leaders and managers: good

Notifications to Ofsted are made in line with regulation 40 when a significant incident has occurred that relates to the welfare and protection of young people at the home. This ensures that the regulatory body is well informed of significant incidents and the actions taken by the home. Furthermore, this demonstrates that the home treats significant incidents seriously, ensuring that appropriate responses are made and that young people receive the necessary support and interventions. Inspection report children’s home: 1227335 12

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: 1227335 13

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Children’s home details

Registered provider: Exceptional Care Limited

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Children’s home details

Registered provider address: 147 Moss Delph Lane, Aughton, Ormskirk, Lancashire L39 5BH

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Inspector

Lisa Mulcahy, social care inspector Inspection report children’s home: 1227335 14 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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