Children's Home run by Idem Living Limited in Knowsley

Inspection report children’s home: 1240449 1 Registered provider: Idem Living 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

The home is registered to provide care and accommodation for up to three children who may have learning disabilities and/or physical disabilities. It is privately owned.

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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

Date of last inspection: 19 October 2016

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good

Overall judgement at last inspection: Good

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Key findings from this inspection

 Children make positive, steady and sustained progress from their starting points as a result of the consistent care provided by supportive and committed staff. Parents and professionals recognise the positive impact of practice on children’s Inspection report children’s home: 1240449 2 development and growing independence.  Staff work in partnership with children’s schools so that children are able to make good progress in their education. Staff have high aspirations for children to achieve and work together to reduce any barriers to learning.  Children are observed to enjoy trusting and secure relationships with staff, who respond with warmth and genuine positive regard for their achievements, despite any challenges they might present. Children are safe within the home due to the support that staff provide them with.  Staff are supported by specialists to provide consistent strategies to enable

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Key findings from this inspection

children to reduce unwanted behaviours. Staff carefully observe and recognise triggers to be able to redirect children and help them to manage their emotions.  Children are encouraged to try new activities, which increases their participation in society. Shared activities encourage children to interact socially, develop tolerance and broaden their experiences.  Complex health needs are proactively supported. The home works with other professionals, including occupational therapists, to ensure that children’s needs are met and that they are able to access aids to support increased mobility and comfort.  The new manager has reviewed systems in the home and involves the staff team in developing and improving records to make them more easily accessible and meaningful.  Where there are any shortfalls in practice of external professionals, the home robustly and effectively challenges to ensure that children’s needs are met.

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Key findings from this inspection

Concerns are appropriately escalated so that staff have all relevant plans to inform practice.  Children’s wishes and feelings, identity and sense of individuality are sensitively explored and supported. The home reflects their personalities, and they are clearly at the centre of practice in the home.  Shortfalls found in this inspection have not directly impacted on children’s welfare. Improvements have already been implemented or plans are in place to address areas for development.

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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 home recognises that it needs to improve understanding, skills and access to tools in regard to supporting diverse communication needs and to encourage all children to express themselves fully.  Care planning, particularly for children who have complex health needs, should clearly demonstrate their progress and the actions that staff take to ensure that their needs are met. These need to be recorded in a way that helps children to understand their own health journey. Inspection report children’s home: 1240449 3  Children must be registered with a dentist as soon as practicable on their admission to the home.  Central records of the use of any measures to manage behaviour need to incorporate the manager’s evaluation of their effectiveness and to identify any trends in practice.  Staff must receive supervision on a regular basis that is of sufficient duration and quality to evaluate practice effectively. However, it is recognised that there

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Key findings from this inspection

is more recent evidence of improvement.  Recruitment procedures must robustly ensure verification of qualifications and suitability of any individual prior to the commencement of their employment.  External monitoring systems need to provide an evaluative assessment of the care provided in the home to assist the manager to drive further improvements. The assessment should incorporate consultation with children and professionals to provide a holistic overview.  The home’s external fencing should be reviewed to keep the outside area safe and secure.

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Inspection date Inspection type Inspection judgement

19/10/2016 Full Good Inspection report children’s home: 1240449 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 Leaders and managers ensure that staff have the experience and skills to meet the needs of each child. (Regulation 13 (2)(c)) In particular, ensure that staff know how to support and promote individual communication needs. 09/01/2017

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Requirement Due date

14: The care planning standard Children receive effectively planned care in or through the children’s home. (Regulation 14 (1)(a)) This relates specifically to showing their progress within their records and any action taken by staff to secure positive action. 14/07/2017

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Requirement Due date

10: The health and well-being standard The registered person is required to ensure that each child is registered as a patient with a registered dental practitioner. (Regulation 10(2)(b)) 14/07/2017

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Requirement Due date

32: Fitness of workers The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. The registered person may only employ an individual to work at the children’s home if the individual satisfies the requirements to be of integrity and good character and has the appropriate experience, qualifications and skills for the work that the individual is to perform and full and satisfactory information is available in respect of each of the matters in Schedule 2. (Regulation 32 (1)(2)(a)(3)(a)(b)(d)) In particular, all recruitment procedures should be adhered to in relation to confirming documentary evidence. 14/07/2017

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Requirement Due date

33: Employment of staff The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b) In particular, ensure that staff receive regular, good-quality supervision in line with company policy and that this is recorded. There should be a clear record of the registered manager’s supervision programme. 14/07/2017

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Requirement Due date

35: Behaviour management policies and records 14/07/2017 Inspection report children’s home: 1240449 5 The registered person must ensure that a record is made which includes the effectiveness and any consequences of the use of the measure. (Regulation 35 (3)(vii) In particular, the main record should include the registered person’s evaluation of practice and identify any trends.

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Recommendations

 The independent person appointed must make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the home’s care. This should provide an evaluative scrutiny of practice to assist the registered person to drive continued improvement and include regular consultation with young people and professionals as well as parents. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5)  Staff should provide a nurturing environment that is welcoming and that meets children’s basic needs and physical necessities, recognising that many children in residential care have experienced environments where these needs have not consistently been met. This refers to the review of the property’s external fencing to ensure safety and security. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.7)

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Overall experiences and progress of children and young people: good

Children enjoy new experiences and make sustainable progress as a result of living at the home. Families report high levels of satisfaction for the care provided to their children and feel welcomed by staff when they visit. Contact is promoted well, with families visiting regularly during the week, and one child also enjoys overnight stays at home. Parents confirmed that they are updated of any important events between their visits. They stated that children are safe and ‘are loved by staff’, and that they can see that children ‘go from strength to strength’ because staff understand their needs and are ‘in tune’.

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Overall experiences and progress of children and young people: good

Staff show pride in children’s achievements and developing independence. One social worker was impressed by how staff encourage a child’s self-care skills, the ‘small but significant steps’ in his progress and how they have ‘extended his horizons with activities’. Another child continues to make positive progress in his independence skills, social interactions and is better able to tolerate progressive changes in routines. He was observed to leave his activity to seek reassurance from staff, indicating that he has built trusted and secure relationships with them. He indicated that he was relaxed around the inspector by gentle touch and smiling. The team’s understanding and sensitive Inspection report children’s home: 1240449 6 observations ensure that children’s views and needs are acknowledged and supported. Independent advocates are also used effectively to gain young people’s views and explore any identity needs, and external agencies are identified to support individuals.

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Overall experiences and progress of children and young people: good

Staff recognise the emergence of teenage behaviours and the importance of children being able to access support to understand their developing emotions, sexuality, and sexual health. They encourage children to express their individuality and help them to exercise choice in personal style. Children are treated with dignity and respect by staff.

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Overall experiences and progress of children and young people: good

Since the last inspection, a child has settled into the home well, due to careful planning with professionals and family. Social stories were used to prepare the child already in placement for the new admission. Staff shadowed shifts at the previous placement for the child before he moved, attended specialist training and gathered information to develop a good understanding of his needs. This promoted a smooth transition into the home. Although the placement was planned to be short-term, the child is now to remain until adulthood. The home’s new manager is keen to work closely with the school to replicate their communication systems at the home. Staff recognise that some emerging behaviours may result from frustration at barriers to communication and the need to support him to express himself more fully. Some records identify that staff use complex verbal concepts that the child will struggle to process. The manager accepts that staff

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Overall experiences and progress of children and young people: good

need to improve their understanding and skills to better meet the child’s assessed communication needs. The school’s speech and language therapist will be providing this support to the team. With help from staff, the child was able to confirm to the inspector that he likes the home, the staff and is happy living there. He likes going to school and was looking forward to returning after the holidays.

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Overall experiences and progress of children and young people: good

There is good communication between the home and children’s schools to promote their steady progress. One child enjoys reflecting on his school day with staff using his link book, so that staff are able to praise his successes. Another child enjoys after-school clubs twice a week for arts and crafts and cooking activities. Children attend school regularly and enjoy their education. Staff attend all education meetings to ensure that they are able to support children’s progress and promote and celebrate their achievements. Staff prioritise and promote educational achievement as would be expected of good parents.

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Overall experiences and progress of children and young people: good

Staff support children to attend medical appointments to ensure that their physical and mental health needs are met. However, there was considerable delay in registering one child with a dentist, which has now been rectified. While health records are up to date, some information, such as plans, appointment letters and assessments, is located in different areas of the files. Although this does not impact on children’s care, it does not help them to understand their own progress and health journey. The home is proactively seeking medication reviews for children to ensure that they remain appropriate and at the correct dosage. Where requests have been declined by medical professionals, concerns have been escalated to social workers to seek further support. The inspector observed robust challenge of shortfalls by other agencies during the inspection.

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Overall experiences and progress of children and young people: good

Children are involved in planning weekly menus that support them to have a healthy diet. They participate in a range of physical activities, including swimming, ice-skating Inspection report children’s home: 1240449 7 and horse-riding. These are mainly at school, but they also enjoy going bowling and on walks to the local park with staff, and to feed the ducks with staff, to improve their overall physical health and stamina. This has also enabled children to develop their social interaction with, and tolerance of, each other in shared activities. Due to the current occupancy levels in the home, there is space for the children to enjoy time separately. However, staff are aware of the need to encourage more shared activities and social interaction between the children, in preparation for any potential future admissions.

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Overall experiences and progress of children and young people: good

The home’s care planning clearly reflects placing authorities’ relevant plans to meet children’s identified needs, and staff work consistently to overcome any barriers to progress. They enable children to exercise control over their daily lives and fulfil their potential. Children’s wishes and feelings are obtained daily so that they remain central to practice and development in the home.

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

Comprehensive risk assessments are well maintained, regularly reviewed and followed in practice, which ensures that staff help to keep children safe. Staffing levels mean that children are safely supervised, which means that they have not gone missing, minimising any risks of exploitation. One child is subject to a deprivation of liberty order, and there is clear guidance in the home that staff follow to use minimal restrictions. Plans are in place to evacuate the home in an emergency which account for individual needs, including any mobility restrictions.

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

Behaviour management strategies outline what actions staff should take to reduce unwanted behaviours. Appropriate advice is sought for ongoing health monitoring and management of self-injury. Consultation with the positive behaviour support specialist has helped staff to recognise potential triggers of increased anxiety and respond consistently with strategies to reduce them. Records of behaviour analysis indicate a positive impact, as there is a decreasing trend for some behaviours, so that children are happier and feel supported by staff. Physical intervention is used minimally to prevent injury to self or others. Although there are reflective debriefs with staff, this information is not included in the otherwise comprehensive central record. This makes it difficult for the reader to identify easily how managers evaluate practice or any emerging trends. A social worker confirmed how the home has robustly challenged other agencies when

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

mechanical restraint has been used without appropriate assessment.

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

Medication records and audit procedures have been revised, resulting in fewer errors overall, and prompt identification of dispensing issues by pharmacies. Medication that is no longer required is disposed of appropriately, and consent is in place from a general practitioner for medication to be administered in food or drink for a child who otherwise would find it difficult to swallow. Staff ensure that the child is fully aware of the presence of medication so that it is not covertly administered.

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

Children are helped to develop new skills and broaden their range of life experiences. Staff monitor progress carefully and adapt care planning, where necessary, to ensure Inspection report children’s home: 1240449 8 that progress is achievable. They recognise that when children are encouraged to make progress or try new activities, this may result in some negative behaviours. For example, one child has enjoyed trips to a local safari park, but then has become anxious on his return home as this meant he had spent less time on his favoured computer activity. When he does enjoy using the internet, staff are aware of the risks that this might present and have appropriate parental controls in place and monitor activity. While there have been no complaints, children have access to independent advocates if they wish to make them. One complaint from a parent was resolved satisfactorily.

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

Staff are keen to promote children’s independence, and a social worker commented on the care taken by staff to research and purchase items, such as specialist cutlery and crockery to support a child to independently feed himself more easily. Staff carefully assess and use social stories with children, being mindful of sensory needs, so that new items can be introduced safely into their living environment. One child now tolerates a new wardrobe and is enjoying going out with staff to buy his own clothes. Practice within the home therefore encourages children to develop and grow within an environment that keeps them safe.

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

An enthusiastic, suitably qualified and experienced manager has recently been appointed. Since assuming the leadership role, he has conducted a thorough review and is implementing improvements to recording systems. This is work in progress, but reflects a clear vision to provide easily accessible plans and information to support practice in the home. The manager is supported by an experienced and competent deputy and a staff team that is keenly embracing opportunities to take greater responsibility for areas of practice. This promotes team members’ professional development and a shared ownership of practice in the home. Staff reported that they are well-led and supported.

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

Partnership working with external professionals enables staff to deliver holistic care and overcome barriers to developing social skills, independence and self-control. Strategies are developed to support children to be better able to manage their emotions and reduce harmful behaviours, through a positive behaviour support model. Where there are shortfalls in the actions of external agencies, the home assertively challenges practice and is persistent in requesting services to enhance the lives of children, for example to secure healthcare and aids to support children’s physical and communication needs. Where relevant plans are not provided by placing authorities, there is clear escalation to ensure that issues are resolved. Parents and professionals confirmed the positive impact that the home has on children’s safety, development and well-being.

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

The manager already demonstrates a good understanding of the needs of young people. He has high aspirations for the children and high expectations of himself, the team and external agencies to deliver an excellent quality of care. This is reflected in changes made to the rota to meet children’s needs. Over half of the current team is undertaking a suitable childcare qualification, and he recognises that future employees should Inspection report children’s home: 1240449 9 already be qualified to provide balance to the workforce. This, in part, reflects a significant turnover in staff, although a strong core team remains. Senior managers do not note any negative trends in the reason for individuals leaving the company. Senior managers also confirm that recruitment procedures are now followed more robustly, following the appointment and dismissal of an individual whose suitability had not been sufficiently scrutinised. Children’s safety and well-being had not been compromised, as

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

The current team members are committed and work together well to provide consistent care to children. They clearly demonstrate their understanding of their roles and responsibilities in safeguarding vulnerable individuals. During the inspection, staff were observed to contribute fully to a team meeting and to demonstrate a positive culture in the home. Records do not show that staff, including the previous registered manager, had consistently received professional supervision in line with company policy. There is now evidence that it takes place regularly and is of sufficient duration to ensure that practice can be thoroughly evaluated. This enables leaders to recognise training needs to support practice within the home and, particularly, to develop newer staff members’ understanding of the positive behaviour support model used.

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

The physical environment is maintained to a high quality and provides a welcoming and homely atmosphere in which children can thrive. Their presence is evident throughout, for example with displays of photographs and personal effects. Improved facilities to support safe and comfortable moving and handling for children who have physical disabilities are to be installed following assessment by an occupational therapist, and additional training is to be undertaken. A recommendation is made to review the external fencing to ensure that the home remains appropriately secure and safe.

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

There are effective systems in place to enable the manager to monitor and review practice within the home to identify any shortfalls and development needs. The manager has met with the independent visitor to outline his expectations of the external scrutiny of practice to drive improvements in the care for children living at the home. Currently, consultation with children and professionals is not regularly sought by the independent visitor as part of the external auditing process. More detailed evaluation of practice will support the manager in driving improvement further.

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

While there have been shortfalls in leadership and management since the last inspection, leaders have clearly identified them and have already taken action and demonstrate capacity to make the remaining necessary improvements.

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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 differences 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 Inspection report children’s home: 1240449 10 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: 1240449 11

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Children’s home details

Registered provider address: Newlands, 1a Huyton Hey Road, Liverpool L36 5SE

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Inspector

Karen Willson, social care regulatory inspector Inspection report children’s home: 1240449 12 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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