Children's home run by Nugent Care 2019 in Liverpool

Inspection report children’s home: SC371267 1 SC371267 Registered provider: Nugent Care

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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 operated by a voluntary organisation and is registered for up to 36 children and young people who may have emotional and/or behavioural difficulties, learning disabilities or a mental disorder.

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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: 1 February 2017

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good

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC371267 2

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Key findings from this inspection

 Young people have made significant progress in all areas of their lives since moving into the home. In particular, in relation to their education, health, relationships, behaviour and a reduction in the risks they face.  Young people have positive experiences living in this home. They have good relationships with the managers and staff who clearly want what is best for them. The views, wishes and feelings of young people are central to the day-to- day arrangements in the home. Staff respond positively to the views, wishes and feelings of young people and either act on these or explain clearly to the young people why they are unable to do so.  Young people’s attendance and engagement in education is good. This has contributed to the academic progress they make. The home is working collaboratively with the on-site education professionals to ensure that the young people’s education needs are met.  The health needs of the young people are known and understood by the

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Key findings from this inspection

managers and staff and medication is administered in line with young people’s prescriptions.  The young people are supported to maintain positive relationships with people who are important for them. The staff encourage regular, safe contact for young people with their family and friends. Furthermore, family and friends are encouraged to visit the home and staff maintain regular contact with family members.  Relationships between the young people and staff are good. The staff spend time with the young people, engaging in various social and recreational activities in and out of the home. Most young people feel confident to talk to staff about any worries or concerns they may have. Young people feel that the staff keep them safe from harm.  The communication between the staff team and management in the home is good. Daily briefings and handovers are detailed and relevant information is shared across the teams. In addition, team meetings regularly take place that

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Key findings from this inspection

allow staff to reflect on their practice and to ensure that there is a consistent approach to the care provided in the home. All staff know the young people well.

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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

 Although the health needs of young people are met well, not all healthcare plans clearly outline the young person’s health needs and how these are being addressed.  There are shortfalls in the training of staff. Records in the home do not demonstrate that all staff receive regular training and development Inspection report children’s home: SC371267 3 opportunities that support their continuous professional development. Furthermore, the records do not demonstrate that the staff are fully equipped with the relevant skills, knowledge and understanding to provide a good quality of care to meet the needs of the young people and keep them safe.  The supervision of staff does not take place on a regular basis. This does not demonstrate that staff regularly review and reflect on young people’s progress and needs, as well as on their own performance and professional development, in order to develop and improve the standard of care and support.

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Key findings from this inspection

 Monitoring and review systems in the home need to be strengthened. The internal and external monitoring systems have not identified the shortfalls found during this inspection, such as omissions in records and plans, as well as the training and supervision of staff.  Some records and plans in the home are not signed by all staff to show that they have read and understood them. Therefore, staff may not always be clear on the current circumstances and plans for each young person. Furthermore, some of the records do not reflect careful, objective and clear recording about individual children in a non-stigmatising way.  Collaborative working with partner agencies is not robust. Some professionals indicated during the inspection that the level of communication from the home was poor. This needs to improve to ensure that there is more a collaborative approach to meeting the needs of young people.

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Inspection date Inspection type Inspection judgement

01/02/2017 Interim Sustained effectiveness 14/09/2016 Full Good 25/02/2016 Interim Improved effectiveness 28/10/2015 Full Requires improvement Inspection report children’s home: SC371267 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

36: Children’s case records The registered person must maintain records (‘case records’) for each child that include the information and documents listed in Schedule 3 in relation to each child. The records must be kept up to date and must be signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 04/09/2017

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Requirement Due date

46: Review of premises 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 in regulation 12(2)(c) (the protection of children standard). When conducting the review the registered person must consult, and take into account the views of, each relevant person. (Regulation 46 (1)(2)) 04/09/2017

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Requirement Due date

33: Employment of staff The registered person must ensure that all employees undertake appropriate continuing professional development and receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(a)(b)) 04/09/2017

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Recommendations

 Ensure that the registered person actively seeks independent scrutiny of the home and makes best use of information from independent and internal monitoring (including under regulations 44 and 45) to ensure continuous improvement. Those undertaking the role should be skilled in anticipating difficulties and reviewing incidents, such as learning from disruptions and placement breakdowns. They are responsible for proactively implementing lessons learned and sustaining good practice. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24) In particular, if the information provided is inaccurate, this will need to be challenged and amended. Inspection report children’s home: SC371267 5  Ensure that staff are familiar with the home’s policies on record-keeping and that they understand the importance of careful, objective and clear recording. Staff should ensure that they record information on individual children in a non-

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Recommendations

stigmatising way that distinguishes fact, opinion and third party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including the quality standards’, page 62 paragraph 14.4)  Ensure that the registered persons develop the home’s effective working relationships with each child’s placing authority and with other relevant persons which may include services, individuals (including parents), agencies, organisations and youth offending teams (regulation 5 - engaging with the wider system to ensure that children’s needs are met). These working relationships will also be key to success in delivering the care planning standard (regulation 14) (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.3)  Ensure that the children’s home is a nurturing, supportive and homely

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Recommendations

environment that meets the needs of the children. Children’s homes must comply with relevant health and safety legislations (alarms, food, hygiene, etc.); however, in doing so, ensure that the home is, as far as possible, able to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the children’s homes regulations including the quality standards’, page 15, para 3.9)  Ensure that, when a child returns to the home after being missing from care or away from the home without permission, the responsible local authority provides an opportunity for the child to have an independent return home interview. Ensure that the home takes account of information provided by such interviews when assessing risks and putting arrangements in place to protect each child. (‘Guide to the children’s homes regulations including the quality standards’, page 45, paragraph 9.30)

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Overall experiences and progress of children and young people: good

Young people have made good progress across all areas of their lives from their starting point when they first moved into the home. They receive a good quality of care that is contributing to the progress they are making. The registered manager, care managers and staff have a good understanding of each young person’s needs. Consequently, these are met well. The young people have good attendance in education and are achieving well. Attendance for young people who have a history of poor school attendance has significantly improved. The home has been instrumental in ensuring that the most appropriate education provision is in place to meet each young person’s educational needs. Staff provide the young people with a stable environment and good routines that support their regular attendance at education. Furthermore, staff maintain regular communication with Inspection report children’s home: SC371267 6 the on-site education professionals through weekly meetings when they discuss any

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Overall experiences and progress of children and young people: good

issues and the progress relating to each young person. Transition plans are in place for the young people who are due to finish their formal education this term. The home is continuing to work with education professionals to ensure that the most appropriate training courses are in place for the young people to progress to. The young people are fully involved in this process. As a result, the education needs of the young people are well met and their educational outcomes have improved. The interim manager, care managers and staff team have a good understanding of the health needs of the young people. Healthcare plans are in place; however, they do not consistently outline all of the young people’s health needs and how they are to be met. One healthcare plan failed to highlight a previous incident of self-harm for a young person, although this was recorded in the young person’s risk assessment. Health issues

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Overall experiences and progress of children and young people: good

are addressed with young people during key-work sessions and staff encourage and support all of the young people to adopt a healthy lifestyle and attend health and development appointments as and when necessary. Issues relating to self-harm and substance misuse are managed effectively and young people receive appropriate support in relation to these from specialist services. Medication records in the home demonstrate that robust procedures are in place for the safe storage, administration and recording of prescribed and non-prescribed medication that is in line with the young people’s prescriptions. Young people are supported to have regular contact with people who are important to them, including family and friends. They are encouraged and supported to build new relationships with peers and other young people who live in the home. Family and friends are welcome to visit the home when pre-arranged plans are in place for this. For

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Overall experiences and progress of children and young people: good

example, arrangements were in place for one young person’s parent to visit him at the home at the time of the inspection and for them to prepare the evening meal together for the other young people living in the home. All of the young people were happy about this and were looking forward to it. The staff support direct contact with the young people’s families by offering transport and supervision of contact when necessary. Furthermore, regular communication between the staff and family members supports young people to maintain positive relationships with their family and to have safe, quality contact time with them. Young people benefit from a wide range of social and recreational activities inside and outside of the home. Each young person has a weekly activity budget and can choose how this is spent. They use their budgets appropriately and some young people often choose to save up for a more expensive activity later. Other young people have used

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Overall experiences and progress of children and young people: good

money from their activity budget to purchase games consoles and games. The young people also engage in unpaid activities, such as using the on-site games field, sports hall and tennis courts. This helps to build relationships between the young people living in the home and the staff team. One young person said, ‘I love the amount of activities on offer as there is always something for me to do.’ The wide range of social and recreational activities on offer to the young people supports them to develop positive relationships with staff and young people in the home and builds their self-esteem and confidence. Young people have positive relationships with the interim manager, care managers and Inspection report children’s home: SC371267 7 the staff working in the home. Their views, wishes and feelings are regularly sought at young people’s meetings and via key-worker sessions to ensure that the care that they

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Overall experiences and progress of children and young people: good

receive is appropriate and that it meets their needs. During a young people’s meeting, the plans for the forthcoming summer holidays were discussed. Each young person had the chance to contribute to the planning of days out, as well as the proposed holiday in Wales. Young people benefit from regular key-work sessions, which explore and address individual issues, such as health, education, behaviour, including risk-taking behaviour, and relationships. When young people make a complaint, they are taken very seriously and appropriate action is taken to address the issue. For example, one young person was unhappy when changes were made to the staff team in the house he was living in. He raised this issue through the home’s complaints procedure. In considering the complaint, the manager recognised this member of staff was a significant person in the young person’s life. Therefore, a decision was made for this member of staff to return to work

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Overall experiences and progress of children and young people: good

in the house. The young person said, ‘Thank God for getting this member of staff back.’ Consequently, young people feel listened to and their needs are being met in the home. The transition support and the processes in place for young people when moving in and out of the home are good. Compatibility assessments are completed prior to young people moving in to identify if the placement is appropriate. Consideration is given to the impact the placement will have on the young people already living in the home, as well as the young person who may move in. The risks for all the young people are considered and then they are matched to a house where it is felt that they are all best placed. On occasion, the recording in the compatibility assessments is unclear as to which young person the details are referring. The interim manager accepts the need for clearer recording in these assessments. Transition plans are being developed for the young

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Overall experiences and progress of children and young people: good

people who are due to move on from the home in the near future. Furthermore, regular care planning meetings take place, which result in transition plans being regularly reviewed and updated. The home environment is generally well maintained, furnished and decorated. Young people’s bedrooms are personalised and they are supported and encouraged to keep their bedrooms clean and tidy. One young person received a monetary reward for his efforts to clean and tidy his bedroom, of which he was rightly pleased. The houses provide young people with a very welcoming and homely environment. Some of the houses are being, or have recently been, refurbished. This is an ongoing task for all of the houses. However, window restrictors on the outside parts of the houses are worn and rusty and would benefit from being painted or replaced. There are also a number of external hazards identified during the inspection. These included a broken fence and

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Overall experiences and progress of children and young people: good

safety guard on which young people can easily injure themselves. The interim manager informed the maintenance team of these issues during the inspection to ensure that swift action is taken to address these hazards.

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

Safeguarding practice in the home is robust. Records demonstrate numerous incidents of effective safeguarding practice. The home has ensured that there is a collaborative response to safeguarding incidents by arranging multi-agency strategy meetings and ensuring that robust risk assessments and plans are in place. Staff have taken Inspection report children’s home: SC371267 8 appropriate action in response to the risks young people face in relation to child sexual exploitation, self-harm and being missing from home. Appropriate action was also taken in response to a safeguarding incident that became known following a whistle-blowing matter. The police undertook a full investigation and an ongoing internal investigation is nearing its conclusion. The designated officer and other relevant professionals have been fully involved throughout the investigation. Furthermore, the young person has been spoken with and has received appropriate levels of support.

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

Young people are supported to develop positive relationships with each other. There are no concerns with regard to bullying. This means that young people enjoy good relationships that are marked by fun and the ability to relate well to each other. This has created a calm and pleasant environment to live in and, as a result, young people have developed new friendships. The interim manager, care managers and staff have strategies in place to manage incidents when young people go missing. They take effective action to locate young people when they are missing and, when they return home, young people are welcomed. However, young people do not always receive an independent return interview in line with statutory guidance on children who run away or who go missing from home or care. This is important, as it helps to identify and deal with any harm the young person has suffered; to understand and try to address the reasons why the young person ran away;

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

and to prevent future incidents. The interim manager amended the template for missing from home incidents during the inspection to ensure that a record of all independent return interviews is now recorded. Positively, young people do receive support and intervention via key-work sessions to address missing from home incidents. Individual risk assessments are in place for the young people. They identify risk areas and how the home will manage these, but some lack in-depth detail and analysis Behaviour management in the home is good. The positive relationships between staff and young people and the consequence and reward systems in place promote positive behaviour. Young people respond well to the rewards and consequences in place. However, these are not always appropriately recorded. For example, one record outlined that the young person was in ‘good spirits’ leading up to an incident when he broke a

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

window. The record failed to outline specific detail as to what led to the window being broken. Other records lacked details, such as the dates and times and the effectiveness of the consequence. The shortfalls in the recording have not been identified through the monitoring and review systems in the home. However, the young people are actively involved in agreeing the nature of the consequences and rewards. They say that they are fair, proportionate, and consistent for the behaviours presented. For example, rewards for 100% attendance in education are the same for all young people. Rewards far outweigh consequences for some young people. Overall, young people respond well to the behaviour management strategies used in the home and their behaviour is generally positive. Physical intervention is used in the home when it is necessary to safeguard young people from harming themselves or another person. In response to a requirement made at the

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

last inspection, the interim manager has recently completed a survey with all of the young people to gain their views and understanding about the use of physical intervention in the home. She wants to ensure that all young people have a clear Inspection report children’s home: SC371267 9 understanding of the procedures in place and whether their use is fair and reasonable. Questions in the survey included, ‘Do you know why staff sometimes restrain young people?’, ‘Have you ever been unhappy with the way you were restrained?’ and ‘Who would you tell if you were unhappy?’ The young people responded well to the survey, showing that they have a good understanding of why physical intervention is used and, importantly, that they would be able talk to someone if they were unhappy about the use of an intervention on them. Young people and staff are spoken to following the use of physical intervention to review the effectiveness of the intervention and consider if the

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

intervention could have been avoided. The interim manager evaluates all physical interventions to identify specific learning from these for the staff team and young people. However, some records of physical interventions are unclear and do not provide all the relevant information. For example, the records do not provide the duration of an intervention or the response to a young person complaining of a sore arm following a physical intervention. Consequently, although the procedure in place for the use of physical intervention in the home is clear, the records relating to when it is used are not sufficiently robust to support the rationale for its use and that is was used safely. The health and safety practices in the home are generally good and ensure that young people’s safety is paramount. Staff carry out regular health and safety checks, including fire drills to ensure that the premises are safe and young people are able to respond in

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

an emergency. Records are clear and accurate. However, a more timely response to repairing the hazards identified on the exterior of the home would safeguard young people further.

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

The previous registered manager of the home has now left and the deputy manager is currently managing the home. She is in the process of submitting her application to Ofsted to become the registered manager. She is a very experienced manager with the relevant knowledge, skills and qualifications for the role. She is highly motivated and clearly committed to the young people and staff in the home. She was already aware of most of the shortfalls in the home, as identified during this inspection, and is currently working on addressing these. The home has a location assessment in place. However, the information contained in this is almost three years old. The interim manager is well aware of this and is taking effective action to address this by contacting safeguarding professionals in the area to request information relating to known risks in the community so that this can be updated. The majority of the staff team are suitably qualified at NVQ level 3, or plans are in place

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

for them to undertake this qualification. However, the training records show that some staff are not up to date with mandatory training, such as safeguarding, first aid, and medication administration, to equip them to safeguard young people effectively. As a result, young people are at increased vulnerability. However, the interim manager has arranged for staff to complete training that remains outstanding at the earliest opportunity. The home has a full staff-training schedule for the coming year, but it is important that staff have the opportunity to attend in order to support their continuous professional development, and to have a positive impact on their professional practice Inspection report children’s home: SC371267 10 and the quality of care they provide. There are significant shortfalls in the frequency of staff supervision. Some members of staff, including care managers, have not received supervision for several months.

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

Furthermore, annual appraisals are incomplete. The lack of supervision and appraisal for some staff fails to show that staff are given the opportunity to reflect on their practice and to identify areas for improvement while working safely and consistently. Furthermore, this lack of supervision does not demonstrate that the personal and professional development needs of staff have been adequately addressed. Regular and effective supervision is of vital importance to improving the quality of care provided to young people. Some of the records and plans in the home do not include detailed or relevant information relating to the young people. Records do not always provide a comprehensive picture of the young person’s current situation, or clearly demonstrate their experiences and progress and the support and guidance they receive. For example, the records do not show consequence and physical intervention records and healthcare

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

plans. Furthermore, records are not always signed and dated by the author, or other staff members, to acknowledge that they have read and understood them. Some of the terminology used fails to demonstrate careful and objective recording about young people in a non-stigmatising way. For example, a young person was referred to as ‘the wrongdoer’ and, when young people are missing, they are described as ‘absconding’. The interim manager acknowledges that there are some shortfalls in the way some records are written and has identified training for staff to improve the quality of recording. Staff meetings are held on a monthly basis and are reflective in nature. Furthermore, they demonstrate key discussions about all areas of the home. The young people are regularly discussed during team meetings and staff reflect on their practice together. The reports and recommended actions from the external monitoring of the home are

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

discussed at meetings so that all the staff in the team are aware of the strengths and weaknesses of the home. Other issues discussed at team meetings include the home’s policies and procedures, current research and issues that could affect young people. There are clear actions and timescales for the identified issues that arise and their progress is reviewed at subsequent meetings. As a result, team meetings enable staff to reflect on practice and discuss current issues relating to the home and young people. Partnership working is not consistent and needs to be strengthened. While there are some good examples of partnership working, such as with the on-site education staff, this is not always evident. Furthermore, some professionals highlighted this as a concern when they were consulted as part of the inspection process. A placing social worker said, ‘The level of communication with me from the home has been poor, which resulted in me

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

having to escalate my concerns to the management team. However, since I escalated my concerns the level of communication has improved.’ An off-site education professional said, ’The home rarely contact us and all communication is usually through the young person’s social worker.’ This does not demonstrate effective partnership working that ensures that all professionals involved with the young people have a good understanding of the current issues, and that young people are receiving the most appropriate support and intervention. Inspection report children’s home: SC371267 11

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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: SC371267 12

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider address: 99 Edge Lane, Edge Hill, Liverpool L7 2PE

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Children’s home details

Responsible individual: Anne-Marie Carney

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Inspectors

Lisa Mulcahy, social care inspector Chris Scully, social care inspector Inspection report children’s home: SC371267 13 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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