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

Inspection report children's home: SC461787 1 SC461787 Registered provider: Care Assist Children’s Services 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 home provides care and accommodation for up to four young people who have emotional and/or behavioural difficulties. The home is owned by a private organisation.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and/or widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and/or the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Date of last inspection: 18 October 2016

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inadequate

Overall judgement at last inspection: Requires improvement

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Enforcement action since last inspection

Inadequate judgement, four compliance notices issued. A further monitoring visit was completed and a full inspection on the 18 October 2016. Inspection report children's home: SC461787 2

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Key findings from this inspection

This children’s home is inadequate because

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Key findings from this inspection

 Young people’s needs are not being met and as a consequence their safety and emotional well-being is compromised.  Young people’s health needs have not been adequately addressed, specifically in regards to alcohol and substance abuse and mandatory health checks.  Medication systems are unsafe and do not show that young people are provided with all medication, as prescribed by a medical practioner.  Care plans and risk assessments are not robust or effectively reviewed to address the changing needs of the young people.  Compatibility assessments lack detail and clarity and do not enable informed judgements to be made about placements at the home.  Staff have failed to follow their own safeguarding procedures when young people have been identified as at high risk of alcohol and substance misuse.  Staff do not recognise or respond to potential or actual safeguarding concerns within the required timescales.

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Key findings from this inspection

 Poor recording fails to provide a factual record of young people’s care experience.  Staff are not sufficiently supervised, or skilled or competent to meet the needs of the young people.  The management review and evaluation of the home’s records lacks rigour. This hinders improvements in how staff understand and respond to young people’s needs and behaviour.  Safer recruitment procedures have not been adhered to and fail to safeguard the young people and to minimise any potential risks to them.  Parts of the home environment and the company’s vehicle are unsafe and this potentially affects the safety and well-being of young people.  Health and safety have been compromised, as fire evacuations have not taken place as required within the home’s own policies. In addition, fire risk assessments have not been fully complied with.

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Key findings from this inspection

 Most young people are attending education and have made progress since their starting points.  Independence plans and transition plans are individualised.  The registered manager has appropriately challenged local authorities when there have been delays in the care planning processes. Inspection report children's home: SC461787 3

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Inspection date Inspection type Inspection judgement

18/10/2016 Full Requires improvement 05/07/2016 Full Inadequate 15/03/2016 Interim Declined in effectiveness 07/12/2015 Full Requires improvement Inspection report children's home: SC461787 4

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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Requirement Due date

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

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Requirement Due date

(1) 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

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

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Requirement Due date

(a) that staff— (v) promote opportunities for each child to learn informally; (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 (b) that each child has access to appropriate equipment, facilities and resources to support the child’s learning. 31/05/2017

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Requirement Due date

10: The health and well-being standard In order to meet the health and well-being standard, the registered person must ensure— (2)(a)(i) that staff help each child to achieve the health and well-being outcomes that are recorded in the child’s relevant plans. 31/05/2017

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Requirement Due date

12: The protection of children standard*

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Requirement Due date

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

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Requirement Due date

(1) that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the 31/05/2017 Inspection report children's home: SC461787 5 registered person to ensure— (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; (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; (b) that the home’s day-to-day care is arranged and delivered

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Requirement Due date

so as to keep each child safe and to protect each child effectively 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. 13: The leadership and management standard*

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Requirement Due date

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

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Requirement Due date

(1) that the registered person enables, inspires and leads a culture in relation to the children’s home that— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to: — (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; (b) ensure that staff work as a team where appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (e) ensure that the home’s workforce provides continuity of care to each child; (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; and (h) use monitoring and review systems to make continuous 31/05/2017 Inspection report children's home: SC461787 6 improvements in the quality of care provided in the home. 16: Statement of purpose The registered person must keep the statement of purpose

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Requirement Due date

under review and, where appropriate, revise it, and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16(3)(a)(b)) 31/05/2017

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23(1)(2)(c)) 31/05/2017

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Requirement Due date

If the regulatory reform (Fire Safety) Order 2005(a) applies to the home-the registered person must ensure that the requirements of that order and any regulations made under it, except for article 23(duties of employees), are complied with in respect of the home.

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Requirement Due date

The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. The registered person must ensure that, at all times, at least one person on duty at the home has a suitable first aid qualification.

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Requirement Due date

Ensure that the registered person recruits staff using recruitment procedures that are designed to ensure children’s safety, in particular that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2.

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Requirement Due date

Ensure that all employees receive practice-related supervision by a person with appropriate experience. 31/05/2017 Inspection report children's home: SC461787 7 (Regulation 33 (4)(b)) 35:Behaviour management

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out how appropriate behaviour is to be promoted in the children’s home; and the measures of control, discipline and restraint which may be used in relation to children in the home. The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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Requirement Due date

36: Children’s case records The registered person must maintain records (‘case records’) for each child, which include the information and documents listed in Schedule 3 in relation to each child, are kept up to date and are signed and dated by the author of each entry.

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Requirement Due date

The registered person must— (a) maintain in the home the records in schedule 4; and (b) ensure that the records are kept up to date.

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Requirement Due date

In particular, this relates to staff rosters.

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— (a) a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; (b) an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; (c) there is an allegation of abuse against the home or a person working there; (d) a child protection enquiry involving a child— (i) is instigated; or (ii) concludes (in which case, the notification must include the outcome of the child protection enquiry); or (e) there is any other incident relating to a child which the registered person considers to be serious.

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Requirement Due date

(5) A notification made under this regulation— 31/05/2017 Inspection report children's home: SC461787 8 (a) must include details of— (i) the matter; (ii) the other persons, bodies or organisations (if any) who or which have been notified; and (iii) any actions taken by the registered person as a result of the matter; (b) must be made or confirmed in writing.

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Requirement Due date

(Regulation 40 (4)(a)(b)(c)(d)(e)(5)(a)(b)) 44: Independent person: visits and reports

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Requirement Due date

The independent person must produce a report about a visit (‘the independent person’s report’) which sets out, in particular, the independent person’s opinion as to whether children are effectively safeguarded; and the conduct of the home promotes children’s well-being.

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Requirement Due date

The registered person must complete a review of the quality of care provided for children ("a quality of care review review") at least once every 6 months.

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Requirement Due date

* These requirements are the subject of a compliance notice.

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Overall experiences and progress of children and young people: inadequate

Young people live in a home that has suffered a period of uncertainty. Several changes in staff have led to inconsistent care and young people’s individual needs not being consistently met. Although the young people felt that there had been some improvements since the new manager had been in post, including one young person stating that ‘it’s more professional’, young people were still unhappy that staff had left the home without telling them and that different agency staff were on shift on a regular basis. One young person said, ‘I understand we have to have enough staff, but imagine how it feels walking into your own home with a stranger sitting at your table and they start talking about what’s happening next.’ The lack of staff working permanently in the home has disrupted the stability and consistency of care provided to young people. In addition, frequent changes in staffing have further impacted upon young people’s

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Overall experiences and progress of children and young people: inadequate

opportunities to develop warm and trusting relationships with the adults caring for them.

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Overall experiences and progress of children and young people: inadequate

Contrary to the admissions policy and procedures, not all young people have benefited from a detailed compatibility risk assessment. The registered manager offered a Inspection report children's home: SC461787 9 placement to a new young person without clearly identifying, assessing and addressing their full range of needs. This included known concerns around self-harmful behaviours and internet safety. Consequently, a detailed assessment of the young person’s needs was not available to staff working directly with the young person. This does not demonstrate that staff are aware of all known risks and that there are strategies in place to keep young people safe.

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Overall experiences and progress of children and young people: inadequate

Some young people have made progress in their college courses. One young person talked proudly to the inspector about achieving ‘student of the month’ and gaining a ‘distinction’ in their coursework. However, since moving to the home, one young person was no longer accessing full-time education. She had initially received one hour a day tuition, which had been increased to ten hours. However, the young person was unhappy and told the inspector, ‘It’s unfair as I need a work placement. I want to be a paramedic and I’m not sure it’s going to happen.’ Although the registered manager had challenged the placing authority and education professionals about the delays in the education planning, there were no records to indicate what the new education plan was or any proposed timescales to work towards. This fails to demonstrate to the young person that her views were being listened to.

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Overall experiences and progress of children and young people: inadequate

In addition, education plans in the home had not been updated and young people did not benefit from a clear structure or routine to support their attendance and learning. This was specifically evident for young people who refused to attend their education setting. Furthermore, at the previous inspection the provider had agreed to provide resources, including a computer, to enhance young people’s education and learning. However, this was not actioned. This requirement will be repeated.

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Overall experiences and progress of children and young people: inadequate

Staff have failed to adequately address the health needs of young people. For example, one young person required a health appointment and even though some staff were aware of this, they failed to arrange it. The registered manager only became aware of the outstanding appointment, when the young person spoke directly to staff members, about their concerns. Despite this subsequently being arranged and completed, the delays had impacted on the young person’s emotional well-being. Following the last inspection, the new registered manager had introduced revised health plans. However, staff have failed to update these as expected after each health appointment. This does not provide a clear overview of young people’s current health needs. This was a requirement at the last inspection and will be repeated.

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Overall experiences and progress of children and young people: inadequate

Independence planning for young people is individualised. Young people have been supported to learn a variety of independence skills including cooking, budgeting and general household skills. The registered manager has spent time with young people and encouraged them to add their views to reflect what they feel they have learned, for example from budgeting and timekeeping sessions.

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Overall experiences and progress of children and young people: inadequate

The registered manager had developed transition plans for young people moving into and out of the home. One young person said, ‘I’m ready to go and live on my own now. The manager has helped me have taken me to visit a flat and then helped me fill in the forms.’ Another young person said, ‘Although it was a bit scary as I have not been in a Inspection report children's home: SC461787 10 children’s home before, (Name of manager) talked to me about the home and what I could expect, this helped.’ This ensures that young people receive support throughout the transition process.

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

Safeguarding practice in this home is not sufficiently robust, and does not promote the safety and welfare of young people. Staff have failed to follow child protection procedures to address serious safeguarding concerns. For example, a young person was collected by staff and was suspected to be heavily intoxicated. The young person went to bed, and no safety or welfare checks were completed. Staff also failed to notify their colleagues on shift about their concerns. Furthermore, the young person’s risk assessments were not updated and their daily records did not indicate any safeguarding concerns. Staff did not take any action and thus failed to follow their own safeguarding policies and procedures, although the registered manager took formal action when she became aware. The failure to follow the necessary checks to ensure that the young person was safe and well during the night has significant implications for the young

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

person’s safety and does not demonstrate safe practice in the home.

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

The registered manager, staff and young people all raised significant concerns to the inspector about the home environment and the company’s vehicle. Parts of the home environment are poor. Upstairs there is a strong smell of damp. A staff member stated, ‘On certain days it is stronger and raw sewage can also be smelled.’ This potentially impacts on the health of young people living at the home who are asthmatic. In an upstairs laundry room area, the wooden floorboards are rotten. There is also a constant leak from the upstairs area, directly into the kitchen. This fails to ensure that the building is safe. The provider took no immediate action to remedy this, despite the inspector bringing the matter to their attention.

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

The company’s vehicle is in a poor condition. A number of safety concerns about the condition of the company vehicle had been raised by the registered manager, staff and young people. These include doors and windows that do not open, staff being unable to read the speedometer at night, and a constant leak from the sunroof. Young people and staff told the inspector that they do not feel safe in the company vehicle. Even though concerns had been raised directly with the provider, limited action has been taken to rectify these concerns, which potentially impact on the safety and welfare of young people and staff using the vehicle.

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

The administration and recording of medication is not robust. On occasions, young people have not been provided with the correct dosage of medication. For example, a young person’s prescription indicated that medication should be administered on three occasions throughout the day. However, staff had failed to follow the prescription. This means young people do not get the medication they need to promote their health. Furthermore, despite the registered manager introducing a system where both members of staff on shift are required to sign the records, this had not been followed. Audit checks had also failed to identify the errors. The registered manager acknowledged that the recording of medication was not sufficiently robust and that it failed to demonstrate Inspection report children's home: SC461787 11 that safe systems are in place to administer and monitor medication given to young people. This requirement is repeated.

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

Young people do not always benefit from clear and consistent boundaries or effective behaviour management strategies. On occasions, staff had not recorded the disciplinary measures used to manage young people’s behaviours. For example, young people had their mobile phones confiscated. They also had planned activities stooped. However, behaviour management records did not reflect this. This is in breach of the home’s own policy that states, ‘Confiscation or withdrawal of phones to protect a child are deemed to be a sanction and must be recorded as one.’ Additionally, some records do not always provide a clear overview of the behaviour that led to such measures, the proposed time frame, or the young person’s views. Neither had the manager evaluated the appropriateness or effectiveness of all measures used. Consequently, staff continue to use ineffective behaviour management strategies, and young people are not learning to

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

reflect upon and improve their behaviour.

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

Safer recruitment procedures are not always followed. Application forms were not available for review, and references had not always been obtained or verified. Gaps in employment had not always been explored. In addition, staff have been in the home with young people before all safeguarding checks had been completed, including disclosure and barring checks. These significant shortfalls in recruitment practice places young people at risk because managers fail to ensure that a safe and suitable staff team is in place. This requirement will be re-issued.

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

Health and safety in the home have been compromised. Regular fire drills have not always taken place within the recorded timescales. In addition, staff had failed to complete all information accurately, including the timings of evacuations. Furthermore, the independent fire risk assessment, dated 16 August 2016, has not been adhered to, and actions identified to ensure that the home is safe in the event of a fire have not been adequately addressed. The provider said that this is in breach of the home’s own health and safety policies. It indicates that staff are not working within their own procedures to maintain young people’s safety. This requirement will be re-issued.

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

When there have been significant events involving young people living at the home, including requests for police assistance or hospital treatment, not all notifications have been sent to Ofsted. This does not allow the regulator to have a clear overview of all safeguarding incidents, and is in breach of the Children’s Homes Regulations 2015.

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

On occasions, staff duty rosters fail to accurately reflect the actual staff on duty, and lack transparency. In addition, when agency staff have cover shortfalls in the rota, records do not include their name or any other information to indicate who they are. This prevents a clear audit trail of who is working within the setting, when or where. During discussions with the registered manager, she accepted that the rotas did not contain all required information. The lack of transparency of who is on duty potentially places young people at risk and compromises the continuity of care. This was a requirement at the last inspection and will be repeated. Inspection report children's home: SC461787 12 Despite the failings in safeguarding, when the registered manager has become aware of staff failing to follow the procedures, she has taken formal action. Although this has been outside of the required timescales, it has ensured that action has been taken and

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

continues to re-enforce to staff their duties and responsibilities to safeguard young people.

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The effectiveness of leaders and managers: inadequate

Since the last inspection, there has been a new registered manager in post. She has attended her formal interview with HMCI and had recently enrolled on the Diploma, level 5. She has previous experience of managing children’s homes and is an enthusiastic manager. Since moving to the home there have been a number of changes within the staffing structure and there is currently no deputy manager in post. The registered manager was working on a shift pattern with staff that included a limited number of direct management hours. This has impacted on her ability to have a clear overview of practice issues in the home, and she has failed to use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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The effectiveness of leaders and managers: inadequate

The statement of purpose and the policies and procedures within the home do not provide accurate and up-to-date information. The statement of purpose has not been updated since August 2016 and refers to previous managers and staff. This requires updating and a copy providing to Ofsted. This was a requirement at the last inspection and will be repeated.

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The effectiveness of leaders and managers: inadequate

There are shortfalls in staff skills, training and development; this includes a lack of refresher training for courses that had previously been valid for one year. This included physical intervention training, first aid training, medication, and food hygiene and fire safety. In discussions with the registered manager, she reported that she had raised her concerns with the provider on more than one occasion about the lack of staff training and development at the home. At the time of the inspection, no staff were equipped with up-to-date training in first aid, medication or physical intervention. This fails to Inspection report children's home: SC461787 13 ensure that all staff have the skills required for their role and does not enable them to provide a safe environment for young people to live in.

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The effectiveness of leaders and managers: inadequate

Monitoring by the registered manager has failed to identify and address the shortfalls found in records, such as out of date risk assessments, records not being signed and dated by the author, incomplete records of sanctions, and room search records. This lack of management action to ensure that young people’s records accurately reflect incidents in a timely manner further places young people at potential risk of harm.

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The effectiveness of leaders and managers: inadequate

The inspector interviewed staff, talked to young people and viewed the rotas, logbook and case records during the inspection. The inspector found evidence of inconsistent staffing within the home. One staff member commented, ‘We have continued to have agency staff, which means there are inconsistencies in dealing with young people. It’s like today, I don’t know the person I am working with.’ A young person commented, ‘I understand we have to have enough staff, but imagine how it feels walking into your own home with a stranger sitting at your table and they start talking about what’s happening next.’

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The effectiveness of leaders and managers: inadequate

Rotas fail to clearly show which staff are on shift and the hours they have worked. On both the 19 and 27 March 2017, records indicated that there was only one staff member on shift. The registered manager indicated that there had been sufficient staff as agency staff covered shortfalls. However, records had not been updated. In addition, staff and the manager have not received regular supervision and when they have highlighted concerning practices within the home, including the safety of young people, with the responsible individual, there is no evidence of the actions taken as a result. This fails to demonstrate that the provider clearly understands their roles and responsibilities in protecting young people. Furthermore, the lack of transparency of who is on duty, potentially places young people at risk and compromises the continuity of care.

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The effectiveness of leaders and managers: inadequate

Care planning is poor and does not promote the continued progress of young people. Internal placement plans and risk management plans are not reviewed effectively to identify the changing needs of individual young people. They also fail to address the issues of risk and how these should be managed safely to promote consistency of care. Records do not provide an insight into the young people’s lives and care experiences, and there is limited information to measure their progress or identify the effectiveness of the support provided.

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The effectiveness of leaders and managers: inadequate

The registered manager fully acknowledges all shortfalls raised at this inspection. She recognises how an inconsistent staff team impacts on the day-to-day running of the home and the outcomes for young people. She shows commitment to make all the required improvements, including training and supervision for all staff and more robust systems, to ensure that young people’s safety and well-being are prioritised. Inspection report children's home: SC461787 14

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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 who 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: SC461787 15

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Children’s home details

Registered provider: Care Assist Children’s Services Limited

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Children’s home details

Registered provider address: 1 High Barn, Back Lane, Aughton, ORMSKIRK, Lancashire L39 6SX

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Inspector

Michelle Edge, social care inspector Inspection report children's home: SC461787 16 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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

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