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

Inspection report children’s home: SC063498 1 SC063498 Registered provider: Pebbles Care

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This privately run children’s home can provide care and accommodation to one young person who has emotional and/or behavioural difficulties.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

Requires improvement to be good

How well children and young people are helped and protected Requires improvement to be good

p.1

Requires improvement to be good

The effectiveness of leaders and managers Requires improvement to be good

p.1

Requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

p.1

Requires improvement to be good

Overall judgement at last inspection: Requires improvement Inspection report children’s home: SC063498 2

p.1

Key findings from this inspection

This children’s home requires improvement to be good because

p.2

Key findings from this inspection

 The young person’s local authority placement plan has not been updated. As a result, it states that he is in a foster placement rather than a children’s home.  Staff do not consistently give the young person his medication as prescribed. Additionally, his medication is not stored safely.  Records of restraint have not been fully completed. The acting manager has not completed the debrief section or the effectiveness section and has not signed the record. This fails to ensure that there is a robust system in place to monitor the use of restraint.  The young person displays some negative behaviours. These have not been risk assessed. This means that staff do not have agreed strategies to best manage his behaviour.  A lot of the young person’s records have not been signed by the author, agency staff, acting manager or the social worker. This does not ensure that everyone agrees and understands the plan for the young person.

p.2

Key findings from this inspection

 Staffing at the home is supported by three regular agency workers. Agency staff have not signed any of the young person’s documents to demonstrate that they understand his care needs.  Three identified agency staff have been working at this home for over three months. They do not receive formal supervision. This means that their practice is not monitored. Further to this, the home’s statement of purpose does not detail timescales for agency staff supervision.  The home’s statement of purpose has been updated after changes to the company but it has not been sent to Ofsted.  The home’s location risk assessment has not been updated. This does not ensure that young people are suitably placed here.  The acting manager does not have a workforce plan that can fulfil the workforce- related requirements of regulation 16, schedule 1.  Regulation 44 visits are carried out by an independent visitor but they have not

p.2

Key findings from this inspection

been sent to Ofsted within timescales. Similarly, the acting manager’s regulation 45 report has not been sent to Ofsted.  The home requires some decoration to make it look and feel homely.  The acting manager has recently been appointed. She also manages another single-bed home. Due to shortfalls in staffing, she has been covering a large number of shifts. This means that she has been unable to complete all of her managerial tasks. Therefore, some requirements and recommendations from the last inspection have not been addressed. Inspection report children’s home: SC063498 3 The children’s home’s strengths

p.2

Key findings from this inspection

 The acting manager has focused on ensuring that the home is fully staffed. She has recently been part of a successful recruitment drive. Four new staff are currently undergoing an induction period and will be shortly joining the team. In the interim, she has ensured that the same agency staff work at the home to give consistency of care to the young person. In addition to this, a deputy manager has been identified to support the acting manager in her role.  The acting manager has successfully challenged the local authority regarding the young person’s education. A school was identified, and planning meetings were held prior to his attending. The young person has started a phased induction to the school.  The home is working closely with a range of health professionals to ensure that the young person’s mental and emotional health needs are met. Following effective direction given by the health professionals, the young person’s

p.3

Key findings from this inspection

behaviour is steadily improving.  The young person has lots of opportunities to engage in the community. A variety of activities ensures that he is active, having fun and experiencing new things.  The young person has been able to maintain contact with his family. Staff take him to and support contact, even though it is a good distance from the children’s home.

p.3

Inspection date Inspection type Inspection judgement

07/03/2017 Full Requires improvement 12/12/2016 Interim Not judged 14/01/2016 Full Good 07/07/2015 Interim Sustained effectiveness Inspection report children’s home: SC063498 4

p.3

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.

p.4

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

p.4

Requirement Due date

that staff 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. (Regulation 12(1) and (2)(a)(i)) 31/07/2017

p.4

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

p.4

Requirement Due date

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. (Regulation 12(1) and (2)(a)(b))

p.4

Requirement Due date

In particular, all agency staff must read and sign to acknowledge that they have read the young person’s risk assessment and individual plans. 31/07/2017

p.4

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.

p.4

Requirement Due date

In particular, the registered person must ensure

p.4

Requirement Due date

that medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them; 31/07/2017 Inspection report children’s home: SC063498 5 that medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

p.4

Requirement Due date

a record is kept of the administration of medicine to each child. (Regulation 23(1) and (2)(a)(b)(c)) 13: The leadership and management standard

p.5

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 (a) helps children to aspire to their full potential and promotes their welfare.

p.5

Requirement Due date

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

p.5

Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1) and (2)(g)(iii)) 31/07/2017

p.5

Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in schedule 1. The registered person must keep the statement of purpose 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(1) and (3)(a)(b)) 31/07/2017

p.5

Requirement Due date

The registered person must ensure that all employees

p.5

Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b))

p.5

Requirement Due date

In particular, staff, including agency staff, should receive regular supervision. 31/07/2017

p.5

Requirement Due date

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

p.5

Requirement Due date

are kept up to date and are signed and dated by the author of each entry. (Regulation 36(1)(b)(c)) 31/07/2017

p.5

Requirement Due date

44: Independent person: visits and reports 31/07/2017 Inspection report children’s home: SC063498 6 The independent person must provide a copy of the independent person’s report to HMCI (Regulation 44(7)(a)) 45: Review of quality of care

p.5

Requirement Due date

The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once a month. In addition to this, the registered person must supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed. (Regulation 45(1) and (4)(a)) 31/07/2017

p.6

Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year, taking into account the requirement 12(2)(c) (the protection of children standard). (Regulation 46(1)) 31/07/2017

p.6

Requirement Due date

35: Behaviour management policies and records

p.6

Requirement Due date

within 24 hours of the use of a measure of control or discipline or restraint in relation to a child in the home, a record is made which includes

p.6

Requirement Due date

the effectiveness and any consequence of the use of the measure

p.6

Requirement Due date

and that they have signed the record to confirm it is accurate. (Regulation 35(3)(vii) and (b)(ii))

p.6

Requirement Due date

In particular, ensure that the record is fully completed. 31/07/2017

p.6

Recommendations

 Ensure that the children’s home is a nurturing and supportive environment that meets the needs of their children. Children’s homes should be, in most cases, homely and domestic environments. This is particularly in relation to redecorating the home and fixing the bath panel. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)  The registered person should have a workforce plan which can fulfil the workforce-related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should detail the necessary management and staffing structure, the experiences and qualifications of staff, any further training required, the process and timescales for staff to achieve induction, probation and core training, the Inspection report children’s home: SC063498 7 process for managing poor performance and the process and timescales for supervision of practice. (‘Guide to the children’s homes regulations including the

p.6

Recommendations

quality standards’, page 53, paragraph 10.8)  The manager should be visible and accessible to staff and be able to deliver their leadership and/or management responsibilities. Any registered manager employed in the home should have sufficient capacity to ensure that the quality standards are met for each child in the home. This is specifically in relation to the manager having sufficient time off the home’s rota to carry out managerial tasks. (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.7)

p.7

improvement to be good

The young person has been living at this home for five months. In the initial discussions with the acting manager, she informed the inspector that the young person had difficulty engaging with strangers. However, the young person did speak briefly with the inspector about the care that he receives at this home. He was able to say that he is happy and feels safe at the home and that staff are really good.

p.7

improvement to be good

A good impact risk assessment shows that all of the young person’s needs were fully explored before a placement was offered. Most of his local authority information was gained at the start of the placement, but his placement plan still requires updating as it refers to the young person being in a foster placement. It was amended once but it still has incorrect information in it. The acting manager has continued to request an update, but the young person’s social worker and team manager are both off work due to long- term illness.

p.7

improvement to be good

The young person’s history of attending education, prior to coming to this home, was poor. As a result of this, his academic ability is unknown. At the start of the young person’s placement, it was agreed that he would have a tutor provided by the local authority. However, this did not happen, and the acting manager challenged the local authority about the young person’s education. As a result of this, a specialised school was identified. A meeting took place to discuss all of the young person’s needs, and a phased introduction to the school was agreed. The school is currently undertaking an assessment of his academic ability. Further meetings are planned to ensure that his transition into the school, full time, is successful. In addition to this, some health assessments will be completed in school by health professionals, in conjunction with the children’s home. This will give a clear picture of the young person’s emotional,

p.7

improvement to be good

The young person’s physical health has significantly improved since he has been at this home. He has attended the opticians and received glasses to improve his sight. He has Inspection report children’s home: SC063498 8 also been to the dentist and, although prescribed a mouthwash to use daily, records show that staff do not give it to him daily. One entry states, ‘Staff forgot.’ This does not demonstrate that young people receive their medication in line with their prescriptions. Furthermore, the mouthwash contains menthol ethanol and was on a shelf in the staff office. The young person has access to the staff office. Thus, prescribed medication is not stored safely.

p.7

improvement to be good

The acting manager has worked hard to ensure that the young person’s psychological and emotional needs are addressed. She has instigated meetings and challenged health services and the local authority to get the right support for the young person. The young person had previously been diagnosed with post-traumatic stress syndrome. A psychologist has given the staff team an insight into the young person’s history and ideas on how to address some of the young person’s negative behaviour. For example, sanctions for negative behaviour do not work with this young person. Thus, there is now a very good reward system in place for positive behaviour. This has been successful, and incidents of negative behaviour are reducing daily. A further meeting was taking place with the psychologist on the last day of the inspection. This is to evaluate the young person’s progress and discuss his future care needs. Additionally, the child and

p.8

improvement to be good

adolescent mental health service (CAMHS) is undertaking an assessment to see whether the young person has any psychological or emotional conditions, such as attention deficit hyperactivity disorder (ADHD). The young person’s mental and emotional health is being met as a result of coordinated and collaborative interagency communication.

p.8

improvement to be good

This children’s home is a long distance from the young person’s home town. Members of staff are transporting and supervising contact. They are able to do this because they receive regular training in contact issues. This means that the young person is able to maintain relationships with people who are important to him.

p.8

improvement to be good

The range of activities offered to the young person is excellent. He enjoys going to the beach and has started to bring seashells home to decorate a patch in the garden. He loves animals and he told the inspector that his recent trip to the zoo was ‘fantastic’. He has joined the cubs and has tried various activities that he has not done before, such as wall climbing. This means that he is experiencing new things and is part of the local community. The home is also having a competition to see who can grow the tallest sunflower. Each member of staff and the young person have a named plant pot. The young person is very excited about this competition and monitors the flowers daily.

p.8

improvement to be good

In the initial months, the young person damaged a lot of property in the home. These items were replaced quickly. However, there is much damage to the paintwork and wallpaper throughout the home. This does not make the home look homely. The acting manager has made a formal request to the company for redecoration but is still waiting for a set date. She is also working with the young person to choose a colour for his room. As he is undecided, staff have bought sample pots of paint and painted different strips of colour on his walls so he can see the effect. On the first day of inspection, the young person was helping a member of staff to build his new bed. He told the inspector that he had slept well in it. This shows that the young person feels involved in the decoration of the home. Inspection report children’s home: SC063498 9

p.8

improvement to be good

The young person said that he is safe at this home. The home has relevant personal and local authority safeguarding procedures in place. There have been no safeguarding issues to report. Members of staff demonstrated that they are clear about their roles and responsibilities in reporting any incident. They receive regular training in safeguarding, child exploitation, e-safety, and health and safety. This is regularly updated to ensure that they are kept up to date with changes in legislation, law and practice. The young person has not been reported missing from this home, and a good risk assessment shows the vulnerabilities of the young person and the actions that staff would need to take if an incident occurred.

p.9

improvement to be good

At the home’s last inspection, a requirement was set for the home to assess the risk of harm to young people; for members of staff to have the skills to identify risks and understand their role and responsibilities to protect young people; to take effective action when there is a serious concern and that the home’s day-to-day care should be arranged and delivered so as to keep each child safe and to protect them effectively from harm.

p.9

improvement to be good

This has only partially been met. The young person’s risk assessments now contain clear information about his history, the risk that this presents, warning signs and strategies to reduce the risk. However, the home’s approach to assessing risk factors is not robust. This is because not all known risks have been assessed. The young person has a history of and has displayed physical aggression towards others and damaged property while being at the home. There are no risk assessments in place for these issues. Therefore, it is unclear whether members of staff have clear information on how to address situations, whether to use the same strategies and how to de-escalate situations. In addition to this, agency members of staff have not signed that they have read and understood the information provided. This does not show that everyone is clear about the approach that they are taking when the young person displays negative behaviour.

p.9

improvement to be good

This was evident on the morning of the second day of inspection. The permanent staff team had agreed that the young person could have half an hour on his Xbox prior to going to school. This is a strategy to calm him as his anxiety is heightened before school. An agency member of staff refused him this. As a result, he was climbing the bannister, the back wall and gated area. This does not demonstrate consistency of care.

p.9

improvement to be good

The home has worked closely with a psychologist regarding when to physically intervene and de-escalate situations when the young person is in a heightened state. This, combined with a high level of activities and a very good reward system, has reduced the incidents that have required the young person to be held for his or others’ safety. However, the recording of restraints is not robust. The staff debrief, actions and manager’s effectiveness sections have not been completed, and the record is not signed. This does not ensure that there is good oversight of the reason for the physical intervention, its execution and management and the support given to members of staff. Inspection report children’s home: SC063498 10 All health and safety certificates are renewed when required. The home does not have a visitors’ book but records visitors on a computer system. This links to the home’s logbook and shows that all visitors are logged in and out of the home. The fire

p.9

improvement to be good

evacuation procedure is explained to all visitors. The young person and members of staff routinely practise leaving the building safely.

p.10

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

In February 2017, the home was purchased by another company and the registered manager left. In March 2017, the new company appointed an acting manager with a view to her being registered with Ofsted. The acting manager is waiting for a new criminal database check to be sent with her new change of name, before submitting her application to Ofsted. She is a well-qualified and experienced childcare professional. She is currently a registered manager of another one-bed children’s home within the company.

p.10

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

The home’s statement of purpose has been updated to show the new company’s details but it has not been sent to Ofsted. The statement of purpose also requires further updating to reflect what support agency staff would expect to receive in the form of formal supervision. Additionally, details are required for timescales when new staff start their qualification in childcare, for example after their induction or at the end of their probationary period. As a result, parents, professionals and stakeholders do not have the most up-to-date information available to them. In addition to this, the home does not have a workforce plan that shows the details and the processes and agreed timescales for staff to achieve induction, probation, core training, qualifications, ongoing training or continuing professional development.

p.10

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

Previously, the home has had difficulty in maintaining a full staff team. This led to agency staff being used and the acting manager covering shortfalls in the rota. The acting manager has focused her attention on ensuring that positive steps have been taken to secure permanent staff. A new recruitment drive has been completed and four new staff have been identified for the home. They are currently completing an induction to the company and undertaking mandatory training. It is envisaged that they will start working at the home in early July 2017. In addition to this, the company has now identified a deputy manager to support the acting manager in her role. The deputy manager is well qualified and experienced in childcare and is due to take up this role imminently. In the interim, the acting manager has ensured that the same three agency staff are covering shifts. This enables the young person to make good relationships with

p.10

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

staff who know him well. However, because the acting manager has been covering numerous shifts, this has impacted on her ability to carry out managerial tasks and has led to numerous shortfalls in signing and updating paperwork.

p.10

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

There are four permanent members of staff at the home. Two of the staff members are relatively new to the home. Formal supervision has taken place but not regularly. Furthermore, three agency staff have been working at the home for over three months. They have not received any formal supervision. The acting manager was not clear on Inspection report children’s home: SC063498 11 who or when this should be done. This does not ensure that all members of staff have their performance appraised regularly.

p.10

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

The home has a review of its location, but it has not been updated with new statistics received from the police. This does not show that sufficient consideration is given to all known risks when accepting young people into the home.

p.11

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

There is a new independent visitor. He has been visiting the home on a monthly basis and making an assessment of the care provided by the home. However, the reports have not been sent to Ofsted in a timely manner. Similarly, significant time has elapsed in sending the manager’s six-monthly monitoring form to Ofsted. This does not ensure that there is good oversight of the home and therefore cannot demonstrate continuous improvement.

p.11

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

The shortfalls identified in this report are mainly in respect of updating paperwork. There are no major shortfalls that compromise the young person’s safety.

p.11

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.

p.11

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: SC063498 12

p.11

Children’s home details

Registered provider address: Rouse House, 2 Wyther Lane, Leeds LS5 3BT

p.12

Inspector

Pam Nuckley, social care inspector Inspection report children’s home: SC063498 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.

p.12

Inspector

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.13

Inspector

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.13

Inspector

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

p.13