Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

Inspection report children’s home: SC032838 1 SC032838 Registered provider: Appletree Treatment Centre Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a private children’s home. It provides a service for up to eight children who may have emotional and/or behavioural difficulties.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected outstanding

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Overall judgement at last inspection: Declined in effectiveness

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Enforcement action since last inspection

The home was asked to provide a critical reflection of an incident that occurred in January 2017 and which contributed to a judgement of declined effectiveness at the last interim inspection in March 2017. This was provided within the required timescale and the home’s response to the incident and its learning were considered to be appropriate. Additionally, requirements made at the interim inspection relating to the incident in January 2017 were met at this inspection. Inspection report children’s home: SC032838 2

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Key findings from this inspection

This children’s home is outstanding because:

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Key findings from this inspection

 Children develop highly positive relationships with adults caring for them, and they learn to trust adults. They feel cared for and loved.  Children make good and often exceptional progress form their starting points. This is best evidenced through improvements in their behaviour and increasing ability to self-regulate.  The home has a highly proactive approach to managing risks for children. These risks are well understood and reduce over time.  Incidents of physical intervention reduce over time for almost all children. The manager works collaboratively with school staff to identify patterns or trends and has a very good analysis of these.  Staff understand the importance of family contact and ensure that this takes place. They also understand, and are sensitive to, the impact family contact can have on children’s emotions and behaviour.  The home is exceptionally good at ensuring that children are listened to.

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Key findings from this inspection

Children’s feedback is sought in a variety of ways on all aspects of their care.  Transitions into and out of the home are managed carefully and sensitively. Children’s arrivals at the home are well planned and children are fully prepared for their departure.  The staff team is motivated, enthusiastic, nurturing and caring. Staff engage positively with the children and offer them lots of different opportunities and activities.  The registered manager leads the home with passion and enthusiasm. She provides a positive role model to staff and conveys her high expectations of them in a way that motivates them to achieve the best for children.

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Inspection date Inspection type Inspection judgement

09/03/2017 Interim Declined in effectiveness 12/07/2016 Full Outstanding 17/02/2016 Interim Improved effectiveness 22/06/2015 Full Good Inspection report children’s home: SC032838 3

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Overall experiences and progress of children and young people: outstanding

The home delivers high-quality individualised care to each child living there. Staff know children exceptionally well and adapt their responses to each child, dependent on their needs. The children’s plans clearly reflect the individual approach to be taken with each child, and frequent discussion amongst staff ensures that the approach is consistent within the whole staff team. Children have positive experiences while living at the home. They consistently report that they are happy at the home and happy with the care they receive. Some children specifically asked to speak with the inspector to express how happy they were and how much they had progressed since the start of their placement. Children are given opportunities to experience a wide range of activities, many of which are healthy, active outdoors experiences which take advantage of the beautiful location of the home and its proximity to a national park. The home is decorated with innumerable photos, and

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Overall experiences and progress of children and young people: outstanding

photograph albums, of the children out and about, enjoying themselves with each other and staff. Additionally, each of the children have a memory book that documents their time in the home and which they take with them when they leave. A new member of staff has shown great creativity in making short, digital photo montages set to music which the children love. Children also have opportunities to engage in clubs and activities outside the home to develop their social skills and widen their friendship network. Examples of activities are; youth club, football teams, church, swimming lessons and a holiday at Center Parcs. Staff and children enjoy highly positive relationships. Staff are advised by the therapeutic team on best approaches to use with children. Staff put these approaches into effect with highly positive results. Observation of relationships in the home evidences a high level of emotional warmth and a positive approach to supporting children. Children freely

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Overall experiences and progress of children and young people: outstanding

go to staff for hugs and it is evident that they know that staff care about them. Where necessary, children who are unsettled at night have been rocked to sleep in staff’s arms in order to meet previously unmet needs, to calm them and make them feel safe and secure. Admissions into the home are planned in great detail and with a lot of thought. Pre- placement activity involves preparing and decorating children’s bedrooms according to the child’s requests, and preparing the children’s choice of meal for their first night. Children are visited, often more than once, in preparation for admission. Children already resident are encouraged to remember how they felt when they were new to the setting, and are keen to support and help new residents to settle in and feel at home. Likewise, transitions out of the home are extremely well managed. Children are prepared for their departure in a structured and well thought through way. Children can be integrated into

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Overall experiences and progress of children and young people: outstanding

mainstream school if this is their plan, and have ample opportunities to visit their identified foster placement and get used to spending time with their new family before they move on. The placement endings are celebrated. A particular strength of the home is in ensuring that children have opportunities to express how they feel about moving on Inspection report children’s home: SC032838 4 from the home, so that the pace of the move is in line with their needs. The interior décor of the home is highly personalised to the children living there. Each child has an individualised bedroom with posters and soft furnishings of their choice. They all have lots of toys and teddies in their rooms, which gives a homely feel. Equal attention has been paid to the outside areas of the home, with a new fairy garden installed, solar lighting around the decking area, toadstool seats and a swinging chair. Children also enjoy playing out on bikes and in the large paddling/swimming pool that

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Overall experiences and progress of children and young people: outstanding

has been purchased for them. The home promotes contact and develops positive relationships with children’s families and their placing authorities. Social workers and parents speak very highly of the home. One parent reported that, although her contact was supervised by the child’s keyworker, it did not feel intrusive, but was more liking having a friend along. Staff are highly intuitive to children’s presentation and understand when they are experiencing a difficult time. Children are sensitively helped, through the provision of therapy and key-worker sessions to work through issues that are affecting them. When issues impact on children’s behaviour, then this is understood, planned for and dealt with sensitively. The home’s records show that children are consulted in every aspect of their care. Their wishes and feelings are considered to be highly important and there are numerous ways these are gathered. Children all participate in a community meeting each week where

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Overall experiences and progress of children and young people: outstanding

they are encouraged to have their say, express their views and to respect and listen to each other. This works amazingly well and the children respect and empathise with each other to an unusually high degree. Children enjoy good health. They have a healthy, balanced diet and consistently report that they love the food and have a positive relationship with the chef. They are also taught about food, allowed to choose a meal and help the chef to prepare it, which promotes their independence. For those who have a very limited diet on arrival at the home, constant efforts are made to try to broaden the variety of foods they will eat. The company employs a school nurse who oversees the children’s health needs. The home is currently experiencing a high level of success in the use of weighted blankets to help children feel more secure and settled. All children access therapy. Some children are working through difficult issues; the staff at the home are sensitive to this and ensure

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Overall experiences and progress of children and young people: outstanding

that the children are well supported and feel understood during periods of upset and anxiety. All children attend the on-site education provision, although some make partial transitions into the local mainstream primary when they are ready for this. The children were observed to be happy in school and to manage the transition from home to school seamlessly. Transitions between care and school are noted to be triggers for some difficult behaviours and home and school work together to try to adapt routines to meet each child’s needs. Children make good progress in school and this can clearly be evidenced in their attainment levels. Some children are excelling in certain subjects and working at above age-related expectations. In the classroom, children are enthusiastic about learning, and are especially interested in the chicken eggs they have incubated and hatched, which they now care for in the classroom.

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Overall experiences and progress of children and young people: outstanding

Inspection report children’s home: SC032838 5

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

Children at this home are well protected through the provision of high levels of supervision. Due to their ages, and the level of adult supervision they require, there are no issues with missing from care, criminalisation or drug or alcohol misuse. Many of the children have experienced early life trauma and/or neglect and they are helped to make sense of their lives and improve their sense of personal safety through therapy and nurture. The home works in a positive way to help children manage their behavioural responses to situations. One social worker commented that the home is ‘really good at celebrating success, it doesn’t remind [name] of his mistakes. They work in a positive way.’ Observation of children’s progress in respect of emotional regulation and ability to manage their own behaviour is remarkable. This is supported by discussions with parents, staff and social workers. Some children need support through very difficult experiences, such as involvement as

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

witnesses in criminal proceedings. The home is extremely sensitive to the children’s needs and is understanding of the impact these experiences have on their emotional presentation and their behaviours. Staff support the child in the best way possible, and show compassion, understanding and empathy. Incidents of restrictive physical intervention generally show a significant decrease over the course of a child’s placement. Where an increase in frequency is noted, this is analysed for patterns or trends and a narrative account is provided to explain why increases have occurred. The manager works alongside school staff to jointly analyse patterns. Where issues are identified, for example with the transition from home to school, plans are put in place to address these. Children also have a ‘what helps me’ sheet for staff to better understand ways to avert and avoid situations where a physical intervention may become necessary. Records of incidents are detailed and show that

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

staff use many techniques to de-escalate children prior to and during incidents. The home employs a variety of techniques to help children manage their anxieties and to reduce their worries. These include the use of weighted blankets, which are bespoke to each individual, worry monsters (handmade by staff) which ‘eat’ the children’s worries, and ‘safe space’ tents. Children’s behaviour improves significantly over time. The home uses a system of targets and rewards which is individual to each child and is reviewed with them regularly through key-worker (house tutor) sessions. Rewards are linked to small and large targets so children feel a sense of achievement when they reach their goals. The home recognises small achievements, which helps children to feel they are constantly making progress. The manager has systems in place to monitor behaviour for patterns and trends and makes changes to children’s routines and plans where necessary.

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

Children benefit from consistent routines and also from being informed and consulted about their plans for the day, ensuring that they are well prepared and know what to expect. There are clear boundaries which are implemented by very patient staff, who work tirelessly to help children understand and stay within the boundaries without Inspection report children’s home: SC032838 6 resorting to consequences or punitive measures. Bullying is not an issue in the home. Staff are highly vigilant in monitoring children’s behaviours towards each other. They praise children for being kind and getting along well. Where incidents of children being unkind do occur, the home uses a process whereby the child reflects on their behaviour with the support of an adult, and is helped to think about their behaviour and about how they may have made the other child feel. They are helped to restore their relationships, for example by writing a letter of apology.

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

Children are consistently encouraged to be kind towards one another and to respect each other. The home has responded positively to issues raised at the previous inspection in respect of safeguarding. All staff have completed (or revisited) online safeguarding training, and additional face-to-face training is planned in safer working practices. All staff spoken to were fully aware of the whistle-blowing policy and procedure and this had been revisited in staff supervision and team meetings. The home has developed positive links with the local police community support officer (PCSO) who visits the home and attends events. This helps children to develop a positive image of the police and to understand that police are here to help and protect people. Due to the ages of the children, and the fact that the home is located in a small rural town, radicalisation and extremism are not significant issues currently. The home

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

addresses the risk of terror attacks in their risk assessments for outings and activities where this is relevant. When planned trips have had to be postponed due to acts of terrorism, this is sensitively explained to children. There are some inevitable accidents due to the children’s ages, the type of activities and play the children engage in. The home always seeks appropriate medical attention for any child involved in an accident and informs the relevant people, including children’s parents. Where significant accidents occur, the home’s manager will visit the activity site to ensure that their risk assessment is robust.

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The effectiveness of leaders and managers: outstanding

The home is led by a suitably qualified and experienced manager. The manager is passionate about her role and about the children in her care. She leads by example and has high expectations of her staff team. The manager is well respected by staff and has a close relationship with all the children, many of whom have developed significant levels of trust in her. She is a strong advocate for the children and is committed to getting the best for them. She shows drive to continuously improve the service and to ensure the best possible outcomes for children. Due to the close managerial oversight and strong relationships with children, managers at this home have a very good understanding of the progress children are making and how best to maximise this. Senior managers, such as the head of care and the responsible individual, are closely involved with the management of the home, thus providing further structure, support

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The effectiveness of leaders and managers: outstanding

and oversight. All managers show a very high degree of commitment to ensuring that Inspection report children’s home: SC032838 7 children are happy and making progress. The company has a positive and supportive ethos and managers ensure that the home is achieving its stated aims and objectives through stringent oversight and scrutiny. Managers have an excellent understanding of the home’s strengths and weaknesses. The home responded very positively to a significant safeguarding issue prior to the last interim inspection, and rigorous safeguards have been implemented to address this issue and prevent recurrence. A full and reflective account has been provided which shows that the managers are able to accept constructive criticism and learn from mistakes. Robust systems are in place to make full use of internal and external monitoring activity. Staff and managers show commitment to continuous improvement, with staff regularly

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The effectiveness of leaders and managers: outstanding

putting forward ideas and making suggestions with the aim of service development. The home is fully staffed and there is a clear staffing structure in place. The manager is proud of her staff, describing them as ‘the dream team’. She feels that they complement each other, and are committed to, and passionate about, their roles. Staff feel supported by managers through the induction process and in progressing in their career development. Staff receive regular supervision, annual appraisals and receive therapeutic support and advice to support them in their role with children. Most staff are qualified to the required level and the company provides further training through the ‘Appletree Diploma’, which uses research-based evidence to provide staff with the theory underpinning their practice, coving issues such as emotional resilience, attachment, emotional competence and self-management. The company has further committed to

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The effectiveness of leaders and managers: outstanding

staff development and research-informed practice through funding the registered manager through a degree course in a practice-related subject. Staff at the home develop high-quality relationships with external agencies. Visiting social workers are welcomed into the home, as are parents (where appropriate) and other agencies, such as the local PCSO. Parents report very positively about the home, including when their contact is supervised by staff, and feedback from professionals is consistently positive. Agencies are confident that any issues they raise relating to aspects of staff practice will be addressed and actioned to improve the service offered to children. Children’s views are gained at every possible opportunity and their expressed wishes are used to inform the home’s practice. This is far from tokenistic, and children genuinely contribute to the way their care is planned and delivered. Children are supported to

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The effectiveness of leaders and managers: outstanding

make a meaningful contribution to their ‘child looked after’ reviews and much of the home’s paperwork is specifically designed for children to understand and contribute to. The home actively promotes tolerance, equality and diversity in numerous ways. Conflicts are resolved through resolution and restoration rather than through punitive measures. Children are helped to understand others’ feelings and to be respectful of each other and the adults caring for them. Children are taught about different cultures in school, and attend cultural events and participate in aspects of different cultures to help them learn. The children are a culturally diverse group and the home celebrates each child’s culture, as much as they wish to do so. The home is also sensitive when a child does not wish to embrace aspects of their culture. Children are supported to worship where this is their wish. Each child has a culture file, which is a meaningful piece of work

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The effectiveness of leaders and managers: outstanding

informing them about where they were born, what is specific about their areas of origin Inspection report children’s home: SC032838 8 or their culture, and what was in the news headlines when they were born. Children also have information about the area and culture of the home’s location. Managers and staff at the home have worked very hard to achieve the high standard of care they deliver to children. They show innovation and creativity, as well as some exemplary practice and record-keeping.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC032838 9

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Appletree Treatment Centre Limited

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Children’s home details

Registered provider address: Meathop Park, Meathop, Grange-over-Sands, Cumbria LA11 6RF

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Inspector

Charlie Bamber, social care regulatory inspector Inspection report children’s home: SC032838 10 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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