Children's home run by Exceptional Care Limited

Inspection report children’s home: 1247212 1 Registered provider: Exceptional Care Ltd

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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 is a privately run children’s home that is registered for four young people presenting emotional and/or behavioural difficulties. The home caters for three young people in the main part of the house and one young person in the attached apartment, which is designed to support young people on a 2-to-1 basis.

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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 requires improvement to be good

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good

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

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good

Overall judgement at last inspection: Not applicable

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good

Enforcement action since last inspection: None

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Key findings from this inspection

 Young people have made progress in all areas of their lives, including, their health, education, risk-taking behaviour and relationships. Inspection report children’s home: 1247212 2  The registered manager and staff in the home have built positive relationships with young people and the views, wishes and feelings of young people are central to the day-to-day arrangements in the home.  Robust procedures to manage young people who are missing from home have resulted in a significant reduction in the number of incidents and length of time that young people have been missing from home.  The self-harm for one young person has reduced since she moved into the home.  Good relationships with staff allow the young person to inform staff when she is feeling low or has self-harmed. This ensures that appropriate medical attention, support and/or intervention is sought to address this.  The registered manager and staff have a full understanding of the risks in

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Key findings from this inspection

relation to child sexual exploitation for one young person. Her risk assessment clearly details the risks and the strategies in place to safeguard the young person from child sexual exploitation.  Behaviour management in the home is robust and contributes to improvements in the behaviour of young people. There have been no incidents of physical intervention due to the robust behaviour management and positive relationships between staff and young people.  Room searches take place when staff have concerns about the safety and well- being of young people.  The home supports young people to engage in education. It has worked collaboratively with education professionals to ensure that appropriate education provision is in place to meet the education needs of young people.  The young people receive therapeutic support to meet their emotional needs. Furthermore, staff receive therapeutic supervision, advice and guidance from a

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Key findings from this inspection

therapist regularly in team meetings.  The health needs of young people are met well. The home ensures that young people receive appropriate healthcare to meet their individual health needs.  The registered manager of the home took immediate action during the inspection to rectify the shortfalls identified. This demonstrates her commitment to improving the quality of care to young people, professional practice and the quality of the records held in the home.  Partnership working is good. This ensures a collaborative approach to meeting the needs of young people to ensure that they receive the most appropriate support to meet their individual needs and keep them safe.  The staff team is well supported by the registered manager. Team meetings take place regularly, with the focus being on the young people. Staff supervision is regular and reflective in nature to support staff to meet the needs of young

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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 leaders and managers of the home should ensure that all staff are aware of and implement the home’s policies and procedures, in particular in relation to safeguarding young people.  Records in the home should be detailed and provide detailed up-to-date Inspection report children’s home: 1247212 3 information relating to young people and the home.  Monitoring and review systems in the home need to be strengthened. In particular , the registered manager should ensure that the records and plans in the home are detailed and include all information relating to young people. The independent visitor should ensure that the monthly monitoring reports sent to Ofsted include the registered manager’s response to the recommended actions from the visits.  When young people appear under the influence of substances, appropriate monitoring of young people should occur to ensure that they are safeguarded.  Plans for young people should clearly outline their health and education needs

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Key findings from this inspection

and how these are to be met.  Risk assessments should be detailed and regularly reviewed and updated to provide current information relating to the individual risks and strategies in place to safeguard young people from the risks they face.

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Inspection date Inspection type Inspection judgement

None Inspection report children’s home: 1247212 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

13: The leadership and management standard In order to meet the leadership and management standard the registered person must ensure— 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; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— 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; ensure that staff work as a team where appropriate; ensure that the home’s workforce provides continuity of care to each child; 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; demonstrate that practice in the home is informed and improved

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Requirement Due date

by taking into account and acting on— research and developments in relation to the ways in which the needs of children are best met; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(a)(e)(f)(g)(i)(h) 23/06/2017

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Recommendations

 Staff skills for safeguarding should include being able to identify signs that children may be at risk, and support children in strategies to manage and reduce risks. Staff should support children to understand how to ask for help to stay safe and that the home is an environment which supports this. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph Inspection report children’s home: 1247212 5 9.10)  The registered person should actively seek independent scrutiny of the home and make best use of information from independent and internal monitoring (including under regulations 44 and 45) to ensure continuous improvement. Those undertaking the role should be skilled in anticipating difficulties and reviewing incidents, such as learning from disruptions and placement breakdowns. They are responsible for proactively implementing lessons learned and sustaining good practice. In particular, if the information provided is

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Recommendations

inaccurate this will need to be challenged and amended. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24)  Ensure that staff continually and actively assess the risks to each child and the arrangements in place to protect them. Where there are safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any assessed risks on a day-to-day basis. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)  Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes fact, opinion and third party information. Information about the

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Recommendations

child must always be recorded in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)  The registered person is responsible for ensuring that each child’s day-to-day health and well-being needs are met. (‘Guide to the children’s homes regulations including the quality standards’, page 33, paragraph 7.3) In particular, they should ensure that children’s individual health plans set out the day-to-day arrangements for meeting all their health and well-being needs.  In addition to the requirements of this standard, the registered person has specific responsibilities under regulation 34 to prepare and implement policies setting out: arrangements for safeguarding of children. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.19) In particular, the registered manager and staff should be aware of the

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Recommendations

information in the home’s safeguarding policies and procedures.  When commissioning a placement in a children’s home the placing authority must establish how the home will support the child’s educational needs. The home should have processes that enable staff to share their experience and understanding of the child’s educational needs and progress with other services. (‘Guide to the children’s homes regulations including the quality standards’, page 27, paragraph 5.7) In particular, the information relating to young people’s education should be clearly recorded in their placement plan or education plan.

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Overall experiences and progress of children and young people: good

Inspection report children’s home: 1247212 6 Young people have made progress in all areas of their lives since they moved into the home. Individual progress is evident in the home’s records for young people in relation to their health, education, associated risks, the number and frequency of missing from home incidents and their relationships with staff, peers, family and friends. A parent said, ‘The home has worked hard to care for the young person and keep him safe. He has made progress since living there. I have no concerns about the home .’

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Overall experiences and progress of children and young people: good

The home has been proactive in ensuring that the education needs of young people are met. When both young people moved into the home, they were not in full-time education, so the registered manager and staff took appropriate action to identify some education provision for them. To prevent delay in attendance at education, the home funded the education placement for one young person with a private company. Arrangements are now in place for him to attend a formal education provision to meet his needs and allow him to study for his GCSEs. Another young person is attending a functional skills course to prepare her for a college course in health and social care that she is due to start in the near future. Furthermore, the home has clear, structured routines in place that support young people’s regular attendance and achievement in education. However, plans in the home do not clearly outline the education

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Overall experiences and progress of children and young people: good

arrangements, targets and achievements in education for young people. Consequently, although the home has been proactive in sourcing appropriate education for young people, it does not have clear plans in place to demonstrate their arrangements and progress in education.

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Overall experiences and progress of children and young people: good

The health needs of young people are met. Young people are up to date with routine health and development checks, including dental and optical checks and statutory health assessments. Staff support young people to seek medical attention when required to ensure that their health is promoted. One young person has recently had a small operation to meet a specific long-term health issue that was not addressed prior to him moving into the home. Staff have also ensured medical advice and intervention for other young people when they have self-harmed. Furthermore, the registered manager and staff support young people to adopt healthy lifestyles by encouraging them to eat healthily and take part in regular exercise. Key-work sessions take place between staff and young people on specific issues relating to their individual health needs. However, not all healthcare plans demonstrate the good level of healthcare that young people

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Overall experiences and progress of children and young people: good

require to meet their health needs. For example, a healthcare plan did not provide up-to- date information relating to the recent operation a young person had or the results relating to a nut allergy.

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Overall experiences and progress of children and young people: good

Young people have positive relationships with the registered manager and the staff working in the home. Their views, wishes and feelings are regularly sought to ensure that the care they receive is appropriate and meets their needs. Regular young people’s meetings and key-work sessions take place, which contribute to the positive relationships, progress and achievements of young people. The home has a separate apartment attached for one young person, and the registered manager is planning to combine the young people’s meeting for both sides of the home to ensure that all of their views are central to the decisions made for the home. Young people benefit from a Inspection report children’s home: 1247212 7 minimum of two key-work sessions a week, which explore and address individual issues for young people, such as health, education, behaviour – including risk-taking behaviour – and relationships. A young person said, ‘I have good relationships with staff, they

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Overall experiences and progress of children and young people: good

always listen to me and do what is best for me, even if I don’t agree with it. They are only doing their job.’ Consequently, young people feel listened to and their needs are being met at the home.

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Overall experiences and progress of children and young people: good

The home has commissioned a therapeutic support service to work with staff and young people. This ensures that young people receive the most appropriate therapeutic support to meet their emotional and behavioural needs. In addition to working with the young person, the therapist also offers consultancy and training to the members of the residential team to assist them in supporting the young people and manage any challenging behaviours young people may display. The therapist regularly attends team meetings and provides staff with therapeutic supervision to support them in their role. Consequently, the emotional health and behaviour of young people is well supported and improved.

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Overall experiences and progress of children and young people: good

Young people are supported to maintain regular contact with friends and family members. One young person has regular contact with his family at the home and the staff support and promote this. The home provides transport to and from the train station for the young person’s family and provides them with a meal during contact. Furthermore, they maintain regular contact with young people’s families to ensure that they are regularly updated on young people’s progress and achievements. A parent said, ‘The home keeps in regular contact with me and supports me to maintain regular contact with my son.’

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Overall experiences and progress of children and young people: good

The home has only been open for a few months and is decorated and furnished to a high standard throughout. The exterior of the home is welcoming and the gardens are well maintained. A member of staff was working in the garden during the inspection. The home is well maintained, suitably equipped and provides young people with a homely and welcoming environment.

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

Safeguarding practice in the home is generally good. Although there has been one incident when the home did not take appropriate action to safeguard a young person, records demonstrate numerous incidents of robust safeguarding practice in relation to incidents that have occurred and the identified risks young people face. On one occasion when staff considered a young person to be under the influence of an unknown substance, they did not take appropriate action in line with the company’s policies and procedures to monitor him or record the incident as a safeguarding incident to the home’s management. However, the registered manager and staff accepted this shortfall during the inspection and demonstrated the actions they would take if a similar incident occurs in the future. The home has taken appropriate action in response to the risks young people face in relation to criminal exploitation, child sexual exploitation, self-harm

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

and missing from home. Therefore, although there has been one incident when young Inspection report children’s home: 1247212 8 people have not been fully safeguarded, there have been numerous incidents when effective action has been taken to safeguard young people.

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

The home takes effective action to safeguard young people from child sexual exploitation and criminal exploitation. They have made referrals to the safeguarding board of the local authority in which the home is placed, to ensure a multi-agency approach to managing the risks. Unfortunately, the local authority does not yet have effective systems in place to address the issues relating to criminal exploitation. The risk assessment for one young person, who is considered to be at risk of child sexual exploitation, clearly demonstrates how this is being managed to safeguard her. However, the risk assessment for a young person who has been subject to criminal exploitation did not clearly outline the level of risk and the strategies to manage this. The registered manager accepted this shortfall during the inspection and took immediate action to update the risk assessment to demonstrate the risk and the strategies in place to

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

manage this. Therefore, all risk assessments are now detailed and provide accurate information relating to the individual risks young people face and the strategies implemented by the home to ensure that young people are safeguarded.

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

The registered manager and staff have strategies in place to manage incidents when young people go missing. They take effective action to locate young people when they are missing and welcome them back when they return home. Young people always receive an independent return interview in line with statutory guidance on children who run away or go missing from home or care. This helps the home to identify and deal with any harm the young person may have suffered, understand and try to address the reasons why the young person ran away, and prevent future incidents. Consequently, the number of times and length of time young people have been missing from home has significantly reduced since they moved into the home.

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

A young person living in the home has a history of self-harm, which is clearly outlined in their risk assessment along with the strategies the home has implemented to manage this and safeguard the young person. Daily logs demonstrate that the home has taken effective action to support and monitor the young person when they are feeling low and the risk of self-harm has increased. Furthermore, their risk assessment also outlines the strategies in place should the young person be feeling low or self-harm. Regular room searches take place to ensure that the young person does not have anything in their possession with which they could self-harm. The support and intervention the young person receives in relation to feeling low and self-harming has resulted in her being able to inform staff when she is feeling low or has self-harmed. Consequently, incidents of self-harm have reduced in frequency and severity.

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

The home has a review of the appropriateness and suitability of the location of the premises in place. This incorporates information from safeguarding professionals in the area, including the police and the local safeguarding children board. The review outlines all known risks in the community and the strategies in place to manage these to ensure that young people are safeguarded. In addition, the registered manager has met with the home’s neighbours to build a positive relationship with them so that they are able to address immediately any issues at the home that may have an impact on the Inspection report children’s home: 1247212 9 neighbours. This demonstrates the home’s commitment to ensuring that young people are safeguarded in the community and relationships with neighbours are good.

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

Behaviour management in the home is good. The positive relationships between staff and young people and the consequence and reward systems in place promote generally positive behaviour from young people. Young people respond well to the reward and consequences in place and generally receive their rewards. The robust behaviour management in the home has resulted in no physical interventions taking place. Consequently, young people respond well to the behaviour management in the home and their behaviour is mainly positive.

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

The home responded well to a complaint made to Ofsted by a young person. The staff discussed the allegation with the young person, their parent and Ofsted in detail. This demonstrated to the young person and Ofsted that all complaints are taken seriously, fully investigated and the young person is listened to.

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The effectiveness of leaders and managers: requires improvement to be good

The home is led and managed by a suitably experienced and qualified registered manager.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager and staff did not demonstrate that they have a good understanding of the home’s policies and procedures in relation to safeguarding. However, the responsible individual for the home has now taken action to ensure that the registered manager is aware of the policies and procedures and that she will share the information with the staff team. This will ensure that all staff are fully aware of the home’s policies and procedures and how to implement them.

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The effectiveness of leaders and managers: requires improvement to be good

Because of the shortfalls identified at this inspection, the manager acknowledged her responsibility to ensure that the records and plans in the home are up to date and include detailed information relating to the young people. In particular, in relation to safeguarding incidents, the registered manager showed good insight into how the home would do things differently if a similar incident occurs in future. Furthermore, she took immediate action to update the records where shortfalls were identified. This demonstrates her commitment to ensuring that young people are safeguarded and the home’s records are detailed and accurate.

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The effectiveness of leaders and managers: requires improvement to be good

Monitoring and review systems in the home need strengthening to ensure that robust processes are in place to monitor and review the quality of care and protection provided by staff in this home. An independent person visits the home each month to make an impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of young people. He provides a written report to the home’s registered manager and Ofsted, which includes recommendations for improvement. However, the reports Ofsted receive do not outline the registered manager’s response to these recommendations to demonstrate how the manager is ensuring continued improvements through monitoring. Furthermore, the shortfalls identified during this inspection were not picked up by the current monitoring systems in place. Inspection report children’s home: 1247212 10 Consequently, the shortfalls in the monitoring and review systems mean that the

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The effectiveness of leaders and managers: requires improvement to be good

registered manager is not always aware of the home’s strengths and weaknesses, themes and trends, the quality of care or professional practice in the home. However, the registered manager accepted that the monitoring and review systems in the home needed to improve, and she demonstrated how she would do this following the inspection to ensure that the systems were robust.

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The effectiveness of leaders and managers: requires improvement to be good

The home has developed effective relationships with other professionals and ensures that they are fully up to date on the circumstances of young people. This collaborative working means that young people receive the most suitable intervention to meet their identified needs and improve outcomes for them. For example, the home maintains regular contact with education professionals to ensure that young people are engaging and achieving in education. Arrangements are in place for the most appropriate education provision to meet young people’s educational needs and to support them make progress and to achieve well in education. Weekly and monthly reports are completed for each young person, which are shared with their social workers and other professionals, when appropriate. However, one young person’s monthly reports do not include all information relating to the young person, in particular safeguarding

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The effectiveness of leaders and managers: requires improvement to be good

information. The registered manager accepted this shortfall and expressed her commitment and intention to improve these reports from the home to provide a true and accurate account of the young person’s circumstances each week or month.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has also developed positive relationships with the home’s neighbours. She regularly communicates with them, as do the staff and young people. This promotes positive relationships with neighbours and the local community and supports young people to develop a sense of belonging, security and purpose.

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The effectiveness of leaders and managers: requires improvement to be good

The staff team feels supported by its manager and believes she is a good leader who inspires them to do well and provide a good quality of care to young people. A member of staff said, ‘The manager is supportive and fair but firm.’ Another member of staff said, ‘We have a good team here, which is down to the registered manager’s effective recruitment. The manager leads by example.’ The staff benefit from regular supervision that is reflective in nature and promotes the well-being of young people. Furthermore, it addresses the individual needs of staff and ensures their continuing professional development. Staff report that the registered manager is approachable and staff can have informal supervision with her in-between formal supervision sessions. In addition, regular team meetings take place, with the focus of these being the young people. Detailed records of team meetings demonstrate the lengthy discussions that take place

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The effectiveness of leaders and managers: requires improvement to be good

around each young person’s current situation and the plans in place for them.

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The effectiveness of leaders and managers: requires improvement to be good

The training and development of staff is an integral part of the home’s functioning. The majority of staff hold, or are working towards, the recognised qualification in children’s residential care. The registered manager and staff recognise the importance of their continuous professional development to ensure that they continually meet the needs of young people well and provide them with a good quality of care. The home’s training matrix demonstrates that the registered manager and staff take part in regular training Inspection report children’s home: 1247212 11 and development opportunities to improve their practice. A member of staff spoke about his learning from recent training in restorative practice, and how this has helped him to recognise changes in a young person’s behaviour. This enables him to implement strategies to manage this and deal with behaviours in a restorative way. The home has updated training for the staff team in relation to management of actual or potential

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The effectiveness of leaders and managers: requires improvement to be good

aggression, but unfortunately this was cancelled due to the illness of the trainer. However, arrangements are in place for it to take place next month.

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The effectiveness of leaders and managers: requires improvement to be good

Recruitment of staff for the home is in line with safe recruitment practice, which ensures that young people are safeguarded. The registered manager took effective action in response to a member of staff not working in line with a young person’s risk assessment, which resulted in the member of staff being dismissed. The staff team is diverse and consists of both male and female staff, of varying ages, with different levels of experience. Staff rotas are set to ensure that staff teams include a range of staff that can meet the needs of young people. This demonstrates the registered manager’s commitment to ensuring that she has a diverse staff team which is able to fully care for and safeguard young people.

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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, 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: 1247212 12

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Children’s home details

Registered provider: Exceptional Care Ltd

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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: 1247212 13 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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