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

Inspection report children's home: SC062013 1 SC062013 Registered provider: After Care (NW) Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

A private organisation operates this children‟s home. It is registered to care for up to three young people. The home cares for young people 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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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: Requires improvement

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Enforcement action since last inspection

None Inspection report children's home: SC062013 2

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Key findings from this inspection

 The young people feel safe and well cared for. They are happy and enjoy living at the home.  Young people make good progress in their lives because they are living at this home. They grow in self-awareness and, over time, learn to manage their emotions and to develop positive and trusting relationships with others.  Young people experience care that focuses on their individual needs and builds on their strengths, talents and interests. Staff are attuned to the impact of previous life experiences upon young people, and provide nurturing and holistic care.  Effective collaborative work with placing authorities, parents and other agencies has led to improvements in the emotional well-being, social skills and educational achievements of young people. All feedback gained during this inspection was very positive.  A wide variety of stimulating activities are available and young people enjoy opportunities to experience new things.

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Key findings from this inspection

 Behaviour management strategies are effective and the consistency of approach has meant that some young people have made noticeable improvements in their behaviour.  Relationships between staff and young people are caring and supportive.  Young people, parents and professionals hold this setting in high regard.  Young people‟s well-being is central to the care provided.

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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

 Physical interventions are not routinely recorded within the correct documentation. This is contrary to the home‟s own policies and procedures.  The quality of recording in some records is variable and lacks sufficient detail.  Some staff members‟ training has not been updated to meet the individual needs of young people, for example training in self-harm. Furthermore the bank staff have not received safeguarding training.  Monitoring and review of the quality of care in the home is not routinely carried out. Inspection report children's home: SC062013 3

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Inspection date Inspection type Inspection judgement

28/03/2017 Full Requires improvement 06/09/2016 Interim Not judged 08/02/2016 Interim Not judged 24/11/2015 Interim Not judged Inspection report children's home: SC062013 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children‟s Homes (England) Regulations 2015 and the „Guide to the children‟s homes regulations including the quality standards‟. The registered person(s) must comply within the given timescales.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

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

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; and 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)(2)(a)(iii)(v)(b))

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Requirement Due date

In particular, ensure that all visitors to the home are suitably vetted and sign in and out of the home. 19/07/2017

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home‟s statement of purpose; ensure that staff have the experience, qualifications and skills to meet the needs of each child; 19/07/2017 Inspection report children's home: SC062013 5 understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; and 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)(c)(f)(h))

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Requirement Due date

In particular, ensure that all staff including bank staff receive the appropriate safeguarding and self-harm training to meet the needs of the young people. Furthermore, ensure that robust systems are in place to monitor and evaluate the quality of care provided.

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Requirement Due date

35: Behaviour management policies and records

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Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— (i) the name of the child; (ii) details of the child‟s behaviour leading to the use of the measure; (iii) the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the need to use the measure; (vi) the name of the person who used the measure (“the user”), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)— (i) has spoken to the user about the measure; and (ii) has signed the record to confirm it is accurate; and (c) within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(b)(c)) 19/07/2017 Inspection report children's home: SC062013 6

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Recommendations

 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 between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. In particular, ensure that all documented is dated. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.4)  Staff should ensure that when they have a question or concern about a child‟s medication they should approach an expert such as a General Medical Practitioner, community pharmacist or the designated nurse for looked-after children. („Guide to the children‟s homes regulations including the quality standards‟, page 35, paragraph 7.15)

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Overall experiences and progress of children and young people: good

Young people make very good progress in all aspects of their lives. Their experiences through living at the home are rewarding, and nurture their emotional growth. Staff members offer sensitive responses to young people. Their responses are well informed and thoughtful and take account of each young person‟s background, temperament and strengths. Young people say that they feel listened to and that staff care about them.

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Overall experiences and progress of children and young people: good

Young people‟s life chances significantly improve due to the registered manager and staff prioritising young people‟s involvement in education and training. All young people are either attending school, college or training. With the support of staff young people achieve and maintain good school attendance and remain on the right track to achieve success. A young person commented, „(name of staff member) has helped me to get a placement on a farm over the summer and I am starting college in September. It‟s what I always wanted to do.‟ Another young person enjoys staff reading to him every evening. This not only enhances his interest in reading but also helps him to settle into a good bedtime routine. A parent commented, „They got him into his exams, which was excellent. I honestly didn‟t think they would. All credit to the staff team.‟

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Overall experiences and progress of children and young people: good

As a result of the good quality care and the staff modelling positive ways to interact, young people learn to appreciate others‟ views and share their thoughts and feelings in an acceptable way. Young people learn to trust the adults who care for them, and they begin to talk about what is difficult in their lives. A young person said, „I think it is awesome living here. I always have someone to talk to.‟

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Overall experiences and progress of children and young people: good

Young people make significant emotional and social progress. Interactions between the staff and young people are warm and considerate. A social worker for one young person said that their young person is „in a much better place because staff really listen to him Inspection report children's home: SC062013 7 and this has helped him to manage his emotions‟. A staff member said, „Our team is really good, we all enjoy working with the kids, they surprise us every day.‟

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Overall experiences and progress of children and young people: good

Staff have registered young people with a range of external services such as general practitioners, opticians and dentists. They proactively liaise with external colleagues to review each young person‟s physical health and matters of well-being. Health plans help the team to keep up to date with individual young people‟s current issues. This prioritises their unique needs and results in them making significant progress in meeting agreed milestones. Medication is safely administered by staff who are fully trained. However, a young person within the home declined to finish a full course of antibiotics prescribed to him by his general practitioner. Staff failed to seek advice from a medical practitioner on the adverse effects of not continuing the full course. This was a missed opportunity to ensure that the ongoing health needs of the young person were met.

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Overall experiences and progress of children and young people: good

Staff support and nurture young people‟s relationships with their families, their friends and others who are important to them. The young people have regular contact that is subject to careful assessment and monitoring when deemed to be in their best interests. Staff members promote contact by providing the young people with both practical and emotional support. When contact is considered appropriate, staff supervise the young people and their families sensitively. Consequently, young people enjoy good quality, safe contact with family and friends in the knowledge that staff are on hand to provide any assistance that may be required.

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Overall experiences and progress of children and young people: good

The home provides young people with a multitude of experiences that enrich their lives, both within the home and in the community. For example, a young person is an active member of a young farmers‟ club and he attends weekly meetings. He also enjoys fishing trips with staff. Another young person, who is significantly younger, enjoys playing in the garden of the home, where staff have sourced a sand pit, goal posts and age-appropriate toys. Staff organised a birthday party for a young person attended by all staff, some of whom came in on their day off. Previous foster carers also attended. They all enjoyed a birthday cake made by a young person at the home. This promotes the engagement and inclusion of young people in the local and wider community. It also increases their sense of worth and self-confidence.

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

Young people feel safe and are kept safe. They appear comfortable and relaxed around the staff who are caring for them. Young people‟s comments included, „It is awesome‟, and „I feel safe living here, it doesn‟t look like a children‟s home.‟ A health professional commented, „Staff work very well in meeting his emotional needs. He (young person) tells me this is his safe place and it is the happiest he has been.‟

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

Staff work in partnership with other agencies to improve safeguarding. For example, the staff team makes use of information from local police intelligence about any particular concerns in the area or local community which may impact on the safety or welfare of young people. The home has excellent communication with fellow professionals. This collaborative approach means staff are working together to ensure that young people Inspection report children's home: SC062013 8 are kept safe. A social worker said, „I receive weekly updates, which are very important to care planning. They also keep me updated on any significant incidents.‟

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

Staff are calm and consistent in their approach to supporting young people in times of high anxiety. Effective behaviour management helps to keep the young people safe. Young people are encouraged to behave well. They receive positive and constructive praise for good behaviour while receiving fair and balanced restorative consequences for negative behaviour. Staff implement clear and unwavering boundaries consistently, and this helps young people to develop an understanding of what acceptable behaviour is. The use of negotiation, discussion and compromise have become the preferred methods of resolving difficulties. Where sanctions are used, they are fair and proportionate. A young person commented, „They are always fair.‟

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

Some young people, for whom going missing from home was a feature of their lives, experience a significant drop in the frequency of these episodes. There have been no missing episodes since the last inspection. A parent said, „He used to be missing all the time. He hasn‟t gone missing from there at all, and I feel that he is safe living there.‟

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

Comprehensive risk assessments are in place for young people when out in the community and also while in the home. These outline potential risks, along with strategies for staff to manage these safely. These are reviewed monthly and amended if needed. Staff understand the importance of young people managing certain risks, according to their age and understanding. The manager and staff team have an excellent understanding of the individual risks relating to each young person. They use effective risk management plans to identify risk and to develop strategies to support the young people. For example, self-harm risk assessments, which include strategies to support the young people, have led to a reduction in self-harming behaviours.

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

The physical environment is safe and protects young people from accidental injury. Health and safety processes are robust. Each young person has a detailed individual risk assessment that staff understand. As a result, the home is able to take all necessary steps to reduce the likelihood of young people being at risk of harm. Environmental risk assessments accurately reflect identified risks and potential hazards. Young people and staff understand fire safety systems and how to respond if emergencies occur. The safety of young people is promoted further through good environmental health and food safety practices.

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

The home is decorated and furnished to a very good standard and provides a homely and welcoming environment for young people. Bedrooms have been highly personalised and reflect the individual preferences of young people.

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

The home is presently managed by an interim manager, who is in the process of registering with Ofsted. She is supported in her role by an experienced deputy manager. The provider should seek to consolidate this position to enable a consistent management approach to be embedded within the home. However, staff and social workers all speak Inspection report children's home: SC062013 9 highly of the interim manager and deputy manager‟s knowledge and experience.

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

Although there had been some improvements in the records, this is a further area that requires improvement. For example, the physical intervention plan for one young person stated that „prone‟ restraint could be used. This is incongruent with the home‟s own behaviour management policy and with the young person‟s own placement plan. The interim manager stated that this was an oversight and a clerical error. She immediately amended the record. Furthermore, a physical restraint of a young person was fully recorded on an incident sheet and not on the provider‟s recording system for physical intervention. Improvements in this area will ensure that plans clearly demonstrate the day-to-day care needs of all young people. In addition to this, records need to be regularly reviewed by the manager. This will ensure that records are up to date and truly reflect the progress and experiences of young people.

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

Internal quality assurance still does not take place regularly; therefore some shortfalls have not been addressed. However, the interim manager has now begun to work on this, to ensure that the quality of care provided is regularly monitored and reviewed. This will help identify patterns and trends and improve the overall quality of care provided to young people.

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

Team meetings and individual supervision take place regularly. This allows the staff team to discuss the running of the home and to look at ways to improve the service they offer. Staff also use this time to reflect on young people‟s progress and to decide how best to support young people to reduce risks such as self-harming behaviours. Staffing levels are good and rotas clearly show the management arrangements that are in place on a daily basis. The staff team speaks positively of the support that it receives from management at the home. Staff members commented, „I get really good support,‟ and „help is always at hand if you need it.‟

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

The provider has a centralised training matrix document for the home. This document was not up to date, thus the manager was unable to have a clear overview of the staff‟s training needs. Furthermore, some staff had not received training in self-harm, despite some young people displaying self-harming behaviour. Regular bank staff who were working within the home had not received safeguarding training.

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

Staff practice is supported by comprehensive guidance, policies and procedures. The home has appropriate systems in place to notify Ofsted and other relevant bodies of significant events that occur within the home or with young people. This ensures that those with an interest in young people‟s welfare are kept appropriately informed. Records kept in the home are clear, accurate and up to date.

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

Visitors to the home are not routinely asked to sign in. This potentially could place young people at risk of harm and does not allow the manager to have an overview of who is in the home and when visitors are in the home.

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

The manager and staff are proud of the progress young people have made since moving into the home. They demonstrate a commitment to making further improvement in the Inspection report children's home: SC062013 10 lives of the young people who live in the home. They take pride in the young people‟s achievements and celebrate difference. A staff member commented, „I was so proud when he took his exams.‟

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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: SC062013 11

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Children’s home details

Registered provider: After Care (NW) Limited

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Children’s home details

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

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Children’s home details

Responsible individual: Timothy Blundell

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Inspector

Elaine Allison, social care inspector Inspection report children's home: SC062013 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 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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