Children's home run by After Care (NW) Limited in Sefton

Inspection report children’s home: SC063673 1 SC063673 Registered provider: After Care (NW) 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 owned children’s home provides care and accommodation for up to four young people who have emotional and behavioural needs.

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

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Inadequate

Overall judgement at last inspection: Sustained effectiveness

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Inadequate

Enforcement action since last inspection: None Inspection report children’s home: SC063673 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 have not been met across aspects of their welfare, particularly their safety, their health and their education.  Risks to young people are not clearly identified, understood or managed by staff. The failure of staff, including managers, to act on information shared by professionals or recognise and respond appropriately to potential or actual safeguarding concerns has left children at risk.  Health plans are not in place for young people. Therefore, staff do not know what young people’s individual health needs are and how they are to be met.  Identified health needs are poorly managed, and risks relating to health are unassessed.  The procedures for the administration and the recording of the administration of medication are unsafe and at times dangerous. This exposes young people to the maladministration of prescribed medication.  A failure by staff at the home to secure required care planning documentation

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Key findings from this inspection

from placing authorities and the lack of internal placement plans means that it is unclear how each young person is to be cared for and how their needs are to be met. This has a detrimental impact on the experiences of all young people living in the home.  Internal and external monitoring of the home is ineffective because potential risks are not identified or addressed. In particular, the internal monitoring of the home fails to identify weaknesses in practice, such as those found at this inspection . The children’s home’s strengths

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Key findings from this inspection

 The home environment has improved and is more homely in presentation.  The senior managers took immediate action to establish a robust management response to the shortfalls identified in this report.  There was some evidence of positive relationships between young people and staff. Inspection report children’s home: SC063673 3

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Inspection date Inspection type Inspection judgement

08/03/2017 Interim Sustained effectiveness 05/05/2016 Full Requires improvement 30/03/2016 Interim Sustained effectiveness 19/01/2016 Full Good Inspection report children’s home: SC063673 4

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Statutory requirements

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 education 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

promote opportunities for each child to learn informally;

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Requirement Due date

and that they help each child who is above compulsory school age to participate in further education, training or employment and to prepare for future care, education or employment.

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Requirement Due date

(Regulation 8(1)(2)(a)(v)(ix)) 13/06/2017

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Requirement Due date

10: The health and well-being standard *

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Requirement Due date

The health and well-being standard is that the health and well- being needs of children are met; children receive advice, services and support in relation to their health and well-being; and children are helped to lead healthy lifestyles.

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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

help each child to achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

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Requirement Due date

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and 13/06/2017 Inspection report children’s home: SC063673 5 well-being, in a way that is appropriate to the child’s age and understanding;

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Requirement Due date

take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs;

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Requirement Due date

and understand and develop skills to promote the child’s well- being.

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Requirement Due date

The registered provider must ensure that each child is registered as a patient with a general medical practitioner and a registered dental practitioner; and that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require.

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Requirement Due date

(Regulation 10(1)(a)(b)(c)(2)(a)(i)(ii)(iii)(iv)(b)(c))

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Requirement Due date

12: The protection of children standard *

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies.

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Requirement Due date

The registered person must ensure that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. 13/06/2017 Inspection report children’s home: SC063673 6 (Regulation 12(1)(2)(a)(i)(ii)(iii)(v)(vi)(vii)(b))

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Requirement Due date

13: The leadership and management standard *

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that helps children aspire to fulfil their potential;

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Requirement Due date

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

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Requirement Due date

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;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

(Regulation 13(1)(a)(b)(2)(a)(c)(f)(h)) 13/06/2017

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Requirement Due date

The care planning standard is that the registered person must ensure that children receive effectively planned care in or through the children’s home; and

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Requirement Due date

have a positive experience of arriving at or moving on from the home.

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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 children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose; 13/06/2017 Inspection report children’s home: SC063673 7 that arrangements are in place so that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose.

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which—

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Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

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Requirement Due date

are signed and dated by the author of each entry.

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

(a) a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation;

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Requirement Due date

(b) an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious;

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Requirement Due date

(c) there is an allegation of abuse against the home or a person working there;

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Requirement Due date

(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

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Requirement Due date

(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— (a) must include details of— (i) the matter; (ii) the other persons, bodies or organisations (if any) who or which have been notified; and 13/06/2017 Inspection report children’s home: SC063673 8 (iii) any actions taken by the registered person as a result of the matter;

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Requirement Due date

(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))

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Requirement Due date

* These requirements are subject of a compliance notice.

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Overall experiences and progress of children and young people: inadequate

The current standards of care and support provided at this home mean that young people’s safety, health, emotional well-being and education needs are not met. The lack of coordinated placement planning to effectively support young people is placing them at significant risk. One young person living in the home does not have a local authority care plan in their case records that sets out the specific needs of the young person and relevant information to inform their support needs. It remains unclear as to what is expected of the home in order to help and support the young person to make progress. This is further confused by the fact that the staff were unable to demonstrate that they have compiled their own placement plan for the young person, to identify the young person’s individual needs and how these are to be met. The lack of information fails to show what the purpose of the placement is and significantly compromises the staff’s

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Overall experiences and progress of children and young people: inadequate

capacity to assess the appropriateness of the placement, especially when other factors are taken into account, for example, the needs of other young people already living at the home. The lack of important information to inform practice and risk management extends across young people’s education and health needs.

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Overall experiences and progress of children and young people: inadequate

Aspects of young people’s health needs are either not identified or, if they are, decisive action is not taken to manage these. For example, a young person living in the home has a nut allergy, which is not documented in any of the young person’s records. There had been no action taken by the manager or staff to establish the extent of the risk or to agree a plan to respond should the young person experience an allergic reaction. Another young person, who has recently come to live in the home, has no health plan in place. At the time of the inspection, he was not registered with any health professionals in the local area. This was only rectified on the first day of the inspection when he was eventually registered with a general practitioner (GP); no appointment was made for the young person to be seen to establish his current health needs. This means that staff are unaware of what the young person’s health needs are and what measures should be in

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Overall experiences and progress of children and young people: inadequate

place to support them. This is especially relevant as the initial referral form for this young person states that he suffers from epilepsy. This failure to act on or clarify the young person’s health needs potentially places him at risk of harm. These shortfalls highlight significant gaps by staff in identifying health needs or managing known health risks of young people in this home. This can seriously affect young people’s well-being. Inspection report children’s home: SC063673 9 Young people living at the home have had poor school attendance and, when they are not in education, they do not engage in purposeful activity. For example, a young person did not have a clear structure or routine in place for staff to support them with their preparation and revision for their upcoming GCSE examinations. Another young person’s attendance at college has dropped from 91% to 61% in the last three months. The

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Overall experiences and progress of children and young people: inadequate

registered manager commented, ‘The 61% is her signing into college, not actually going to classes. That is much lower.’ Insufficient action has been taken to address these concerns to help young people to rebuild their confidence and increase their participation in education. The lack of education plans for individual young people means that the staff at the home do not adequately promote the importance of learning and education for all young people, and this lack of aspiration impacts on young people’s learning and future life chances.

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Overall experiences and progress of children and young people: inadequate

The arrangements for admission to the home are poor. One young person moved into the home without important information being shared about their individual needs and with only the clothes that they were wearing. Despite the responsible individual allocating £200 for the purchase of clothes for the young person, the registered manager failed to ensure that the young person had adequate clothing at the earliest opportunity. The young person commented, ‘I was bought another tracksuit and I just wear it one day and wash the other, so I always have something clean.’ The registered manager arranged for staff to buy the young person further clothing on the second day of the inspection. However, the delay in meeting such a basic need is unacceptable. It fails to show a nurturing approach to young people that have moved into a new setting and are adjusting to new circumstances. It also demonstrates the lack of attention in the home’s

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Overall experiences and progress of children and young people: inadequate

approach to effective care planning, which means that young people’s needs are not always understood and addressed.

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Overall experiences and progress of children and young people: inadequate

On a positive note, some young people have been supported to develop and maintain family contact. This involved staff making sure that safe and suitable arrangements are in place for young people who live a distance from their families. This helps to maintain contact and allows young people to maintain their sense of belonging in their families.

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

Safeguarding practice in this home is poor and does not promote the welfare and safety of young people. Managers and staff are not sufficiently aware of their roles and responsibilities in relation to protecting young people. Effective action is not always taken in a timely way when there is a serious concern about a young person’s welfare. This means that young people are not robustly protected from harm.

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

Staff do not take action to protect young people when they are alerted to serious safeguarding concerns. On one occasion, a professional shared information with a member of staff regarding a young person’s alleged serious offending behaviour. Despite this information being shared with the staff member and, subsequently, the registered manager, no action was taken to assess any potential risk to the other young people living in the home. The failure to update young people’s risk assessments and to Inspection report children’s home: SC063673 10 implement strategies to minimise potential risks and guide staff practice places young people at significant harm.

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

Partnership working with multi-agency safeguarding teams is ineffective. Although the registered manager attends multi-agency child sexual exploitation (MACSE) strategy meetings, he does not implement the agreed safeguards to protect young people at risk. The registered manager has failed to follow an agreed multi-agency safety plan, potentially compromising the young people’s safety.

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

Contrary to the home’s admissions policy and procedures, not all young people have benefited from a detailed compatibility risk assessment or a thorough appraisal of their needs. The registered manager offered a placement to a new young person without clearly identifying, assessing and addressing their full range of needs and the subsequent impact on others living in the home. For example, the deputy manager completed a compatibility assessment on 17 March 2017. He recorded, ‘Not known’ against a range of criteria, including alcohol and substance misuse, allegations, assault, absconding, smoking, verbal abuse, controlling behaviours, violence and aggression, bullying and threatening behaviours, intimidation, theft, self-harming behaviour and fire setting. No further information was recorded to demonstrate what action the registered manager and deputy manager had taken to carefully consider which, if any, of these

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

significant risks were relevant. Consequently, a full appraisal of the young person’s needs, including the potential risks posed and how the staff team is to support the young person, was not completed prior to the decision to accept the placement. This fails to demonstrate that managers and staff have taken the necessary steps to ensure that they have sufficient information about the young person, that they are aware of all known risks and that there are appropriate strategies in place to keep the young person and others safe.

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

On 4 April 2017, a young person was reported missing from home. The young person briefly returned to the home in the early hours of the following morning to request their prescribed medication. After receiving the medication, the young person then promptly left. No assessment was carried out by staff as to whether the young person was under the influence of alcohol or any other substance that might give cause for concern for their immediate welfare. There was no evidence to suggest that the staff had made any efforts to deter the young person from leaving the home again. Furthermore, no medical advice was sought to establish whether there were any contra-indicators that would negate the safe administering of the medication. This inaction by staff failed to ensure the young person’s safety and well-being. Furthermore, risk assessments were not updated, and the young person’s daily log did not reflect the highlighted concerns. This

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

does not demonstrate that all staff are aware of their roles and responsibilities to adequately safeguard and protect young people and to take the necessary steps to reduce risk.

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

Behaviour management plans, placement plans and risk assessments do not accurately reflect or address the current needs of young people. There are no placement plans, risk assessments or behaviour management plans in place for one young person, even though the placement was agreed on 16 March 2017, which allowed ample time to Inspection report children’s home: SC063673 11 secure relevant information and documentation in preparation for the young person’s arrival. Furthermore, another young person has been reported missing on six occasions since 4 April 2016, and this information was not included in their risk assessment. There was no evidence of return home interviews having taken place in order to attempt to establish the reasons for the young person’s missing episodes. Staff have failed to ensure that all risk assessments are reviewed and updated after incidents and when new information comes to light. For example, one young person has a recent history of being

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

missing over a prolonged period. Despite having this information, no missing from home risk assessments have been completed to guide staff on what actions they should take in the event that the young person goes missing. Additionally, the home’s staff have failed to obtain a recent photograph of the young person so that appropriate details can be shared with other professionals when potentially seeking to locate the young person. When the inspector discussed the lack of information with the registered manager, he stated, ‘Risk assessments should have been updated.’ However, he took no action to immediately rectify this. This failure to update young people’s risk assessments and to implement strategies to minimise the risks and guide staff as to what they should do places young people at continued risk of significant harm.

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The effectiveness of leaders and managers: inadequate

The registered manager is qualified and has the experience to undertake his role. However, his inaction to ensure that effective care planning is in place for each young person and that the staff team strictly adheres to safeguarding procedures to protect young people has led to the serious failings found during this inspection.

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The effectiveness of leaders and managers: inadequate

The young people live in a home that is poorly managed. The staff are unclear about the ethos and philosophy of the home, as described in the statement of purpose. There have been failings in management oversight and monitoring of the home to identify areas of weakness and to take decisive action to resolve these. As a result, young people’s progress and safety are compromised.

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The effectiveness of leaders and managers: inadequate

Records do not provide an insight into the young people’s lives. For example, the records of key worker sessions are very limited in detail. They only reflect informal discussions, rather than offering a more comprehensive account of what the objective of the planned session was and how this links to the wider support to meet each young person’s individual needs. This means that there is limited information to measure the young people’s progress or identify the effectiveness of the support being provided.

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The effectiveness of leaders and managers: inadequate

The statement of purpose contains the following information: ‘The aim of the service is to help by whatever means required, young people to grow and develop in a safe, caring and nurturing environment.’ Given the serious shortfalls highlighted in this inspection, the home is not acting in accordance with its own statement of purpose. Poor leadership means that the home is unable to fulfil its own aims and objectives. This does not adequately protect young people and promote their welfare.

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The effectiveness of leaders and managers: inadequate

Quality internal monitoring does not take place regularly and, as a result, the quality and Inspection report children’s home: SC063673 12 standard of care have fallen to an unacceptable level. The manager has not reviewed records in the home or evaluated incidents that have occurred, to identify shortfalls in staff practice and to highlight patterns and trends. Subsequently, areas for development are not clearly highlighted, and there is no meaningful development plan to address areas of concern. This means that leaders and managers are not taking action to improve the experiences, care and safety of young people.

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The effectiveness of leaders and managers: inadequate

Significant events involving young people resident in the home have not been reported to Ofsted. A failure to share information with all relevant people compromises the safety and welfare of young people. Furthermore, the regulator is unable to carry out its monitoring function to ensure that all appropriate action is taken by the provider to safeguard young people.

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The effectiveness of leaders and managers: inadequate

This lack of rigour has not helped the home to sufficiently protect young people and maintain good enough standards of care. More robust systems are needed to ensure that the safety and well-being of the young people is promoted at all times.

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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: SC063673 13

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Children’s home details

Registered provider: After Care (NW) Limited

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Children’s home details

Registered provider address: 45 Kensington Road, Southport, Merseyside PR9 0RT

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Children’s home details

Responsible individual: Timothy Blundell

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Inspector

Elaine Allison, social care inspector Inspection report children’s home: SC063673 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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