Children's Home run by Birtenshaw in Bolton

Inspection report children's home: SC397344 1 SC397344 Registered provider: Birtenshaw

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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 part of a charitable organisation. It provides care and accommodation for up to four young people who have a physical disability and/or learning disability.

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Information about this children’s home

There is a condition in place. This states that the provider must reduce the number of children by the number of people aged 18 and over who are provided with care and accommodation in the home.

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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: 16 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: SC397344 2

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Key findings from this inspection

 Young people live in a caring and supportive home that makes a positive difference to their lives. As a result, young people make sustained progress across all aspects of their development.  Young people and the core staff team share strong and positive relationships.  Staff have a good understanding of young people’s behaviour, risks and vulnerabilities. They work cohesively with a range of agencies to develop well thought out strategies. This enables young people to become increasingly safe.  Care planning is highly personalised to meet young people’s individual and complex needs. Placement plans and risk assessments are detailed and subject to regular review. This ensures that young people receive a high level of care.  Parents and professionals are extremely complimentary about the level of care and support that young people receive. They confirm that young people make great progress because of living in this home.

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Key findings from this inspection

 The manager and staff work closely with a range of services such as education, care, health and adult services. This ensures that young people receive the support and services they need.  The manager has a good understanding of the home’s strengths and areas for development. She is committed to making positive changes in the home to ensure that young people continue to benefit from the opportunities provided to them. The children’s home’s areas for development:

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Key findings from this inspection

 The home’s statement of purpose does not include the details of all staff working in the home. Furthermore, Ofsted and commissioners are not provided with any revisions of this document within the required timescale.  A range of different staff covers staff vacancies. This includes flexible support staff, learning support assistants and agency workers. This does not support continuity of care or consistency for young people who have additional and complex learning needs.  Staff do not receive supervision in line with the timescales identified within the home’s supervision policy and procedures.  The systems for recording staff attendance are insufficient, as the logbook and online rotas are not fully maintained or accurate. Furthermore, records viewed would suggest that young people do not always receive one-to-one care and support, as identified within their individual placement plans.  The manager is making attempts to improve the quality of record keeping for

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Key findings from this inspection

incidents, accidents and physical interventions. However, she has not maintained a system to ensure that the original draft versions of these records Inspection report children's home: SC397344 3 are kept.  The provider does not implement its own safeguarding policy when young adults raise their concerns about care practice.

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Inspection date Inspection type Inspection judgement

16/02/2017 Interim Sustained effectiveness 15/11/2016 Full Outstanding 09/03/2016 Interim Improved effectiveness 30/09/2015 Full Good Inspection report children's home: SC397344 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

12: The protection of children standard (1) In order to meet the protection of children standard, the registered person must ensure that children are protected from harm. (2) In particular, the standard requires the registered person to ensure that they— (vi) take effective action whenever there is a serious concern about a child’s welfare; and (vii) are familiar with, and act in accordance with, the home's child protection policies. In particular, the registered person must ensure that they act in accordance with their own safeguarding policies following an allegation or complaint made by young adults living in the home. A full and thorough fact-finding exercise should be undertaken. All information should be clearly recorded and shared with all relevant safeguarding agencies. This includes the adults safeguarding team. 01/09/2017

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Requirement Due date

13: The leadership and management standard (1) In order to meet the leadership and management standard the registered person must enable, inspire and lead a culture in relation to the children’s home that— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard requires the registered person to— (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (d) ensure that the home has sufficient staff to provide care for each child; (e) ensure that the home’s workforce provides continuity of care 01/09/2017 Inspection report children's home: SC397344 5 to each child. In particular, the registered person must ensure that all care staff have, or are working towards, the required childcare qualification, that staff receive refresher training in fire safety, and that there are sufficient numbers of regular staff available

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Requirement Due date

to meet the identified needs of all young people.

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Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in Schedule 1, and ensure that any revisions of this document are sent to HMCI within 28 days of the revision. (Regulation 16(1)(3)(b)) In particular, this document must include the experience and qualifications of all care staff working in this home. 01/09/2017

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b)) In particular, the registered manager must ensure that all care staff who are used in this home receive supervision in line with the timescales identified within the home’s supervision policy and procedures. 01/09/2017

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Requirement Due date

The registered person must ensure that all case records are kept for 75 years from the child’s date of birth. (Regulation 36(2)(b)) In particular, any records which are completed in draft form which pertain to any incident, accident or physical intervention must be retained as part of a young person’s case records. 01/09/2017

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4. (Regulation 37(2)(a)) In particular, the registered manager must ensure that the Rota accurately identifies the members of staff on duty. 01/09/2017 Inspection report children's home: SC397344 6

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Overall experiences and progress of children and young people: good

Staff provide good quality care to meet the complex needs of all young people. This ensures that the young people make sustained improvements in all areas of their lives. Parents and professionals are positive about the care and support young people receive. They attribute the progress that young people continue to make, in particular, their social and emotional well-being, to this. Feedback from professionals included, ‘[Name of young person] has made amazing progress. I could not have asked for a better placement. It is outstanding.’ and: The staff always meet [name of young person’s] needs to a high standard. Communication is excellent and the staff encourage young people’s independence skills. There is also a high level of staff supervision. A parent commented on the ‘outstanding’ levels of care and support provided by the staff team. Young people also share these positive views about the home and the care

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Overall experiences and progress of children and young people: good

they receive. Staff have built up effective working relationships with education professionals. All young people attend an education provision that meets their individual needs. Young people have achieved 100% attendance at their full-time education placements. They have made great progress in achieving their own individual targets and goals. Staff support young people to attend their routine health appointments. This includes medicals and appointments with opticians and doctors. Staff review and develop young people’s individual skills and interests. This promotes improved health. For example, individual placement plans identify specific areas of development. This includes improving diet and personal care. This ensures that young people enjoy improved health and have a varied and healthy diet. Staff support young people to take more control over their personal care needs, such as hair washing, hair brushing, bathing and dental

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Overall experiences and progress of children and young people: good

care. This enables young people to maintain their dignity and privacy. In addition, the managers have improved the medication processes. This includes the introduction of ‘grab sheets’ which contain detailed information about the individual health needs of the young people. Staff receive good training and have access to detailed medication procedures. This ensures that the health needs of young people are met. The manager and staff are positive about the young people living at the home. They recognise and celebrate their achievements. Staff understand young people’s limitations. They are aware of the barriers that young people face due to their complex level of need. Despite this, the manager and staff challenge any barriers, for example access to buildings. This ensures that young people have opportunities to enjoy new and exciting activities. Staff support young people to attend end-of-year school proms. They take

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Overall experiences and progress of children and young people: good

young people to activity and play centres and other social activities. This enhances their social growth and development. Staff are creative in obtaining the wishes and views of young people. They ensure that young people remain central to their care plans. Keyworkers spend time with young people identifying holidays and activities that they may enjoy. They also identify the food that young people like. Staff update all information in the young people’s daily routines Inspection report children's home: SC397344 7 and activity plans. Staff support young people who are reluctant to engage in new activities. They look at different ways to encourage the young person to take part. This broadens young people’s childhood experiences and promotes development and confidence. Young people enjoy regular contact with those people who are significant to them. Staff are aware of their roles in maintaining and supporting contact sessions. They keep

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Overall experiences and progress of children and young people: good

detailed records, which provide full details about all contact arrangements. Staff are sensitive when planning contact for young people. When appropriate, staff support young people to have contact in the family home. Staff have also arranged overnight visits and weekend stays. In some instances, young people have had the opportunity to go on family holidays. This has enabled them to enjoy extended time with their family. This ensures that young people maintain a positive sense of identity. Staff support young people to increase their independence and self-care skills. This is in line with their level of understanding and abilities. Young people are becoming more independent as they develop skills associated with adolescence. Staff support young people to keep their bedrooms tidy and help with their laundry. They also encourage skills in making simple snacks and drinks. The high level of support provided by the staff

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Overall experiences and progress of children and young people: good

team helps young people as they move into adulthood. Transition planning in the home is detailed and individualised. Staff support young people to understand and take part in their long-term care planning. This supports young people to move into adult services. Throughout the planning process, the manager seeks the views of young people. She also works in conjunction with professionals and parents. This ensures that young people understand when it is time to move on. Staff provide young people with all information in a sensitive, careful way. This ensures that young people are kept involved and informed.

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

Core staff have a good awareness of their safeguarding roles and responsibilities. Staff attend safeguarding training at an early stage in their employment. They also receive regular refresher training. Consequently, staff understand how to identify and respond to all safeguarding concerns or allegations. Due to the complex needs of young people, staff provide a high level of support and close supervision. This promotes young people’s safety and well-being. There have been no incidents of missing or bullying since the last inspection. Incidents of self-harming behaviour are well managed, recorded and evaluated by the manager. This ensures that care practices in the home continue to be safe and appropriate. Staff have a good knowledge and understanding of young people’s risks. They manage all behaviours well. Clear and consistent boundaries help young people to feel safe and secure. Staff have a good understanding of each young person’s individual needs. They

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

are aware of the triggers that create anxiety for young people. Staff remain calm and support young people to de-escalate situations in a safe way. Clear behaviour-management plans support staff in using physical intervention. While this is effective, young people may need a high level of physical support. This helps Inspection report children's home: SC397344 8 them manage their emotional responses in a safe way. Staff keep detailed records of all incidents and the manager has a clear overview. She is able to identify any emerging triggers and trends for young people. This prompt response ensures that extra services and support can be accessed for young people, such as advice from the learning disability nursing team. The advice given to the staff ensures that appropriate and safe strategies are in place. This further reduces the need for physical intervention. Young people live in a safe environment. Their safety is further enhanced by safer

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

recruitment practices in the home. Staff complete detailed risk assessments and regularly update them. They also ensure that all fire, electrical and gas appliances are checked for safety. Young people know how to respond should an emergency happen. One young person was keen to show the inspector what to do if an emergency occurred. This ensures that the home is safe, and that young people’s physical safety and well- being is promoted.

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

A qualified and experienced manager manages the home. She registered with Ofsted in September 2010. The manager continues to show commitment to her ongoing professional development. She has recently completed the level 5 management qualification. The manager undertakes internal monitoring. She considers feedback from young people, their families and professionals. This supports the ongoing developments in the home. The manager has an understanding of the home’s strengths and areas for development. She uses both internal and external monitoring systems well. Systems in place show the progress young people make and identify individual targets and goals. This information enables the manager to review the progress and experiences of young people. In addition, the manager challenges services when their responses fall short, for example when care-planning documentation is not provided. This ensures that the home

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

has the correct information to meet the needs of young people. The statement of purpose provides a clear vision for the home. However, it does not include an accurate list of all staff working in the home, such as flexible support staff and learning support assistants. In addition, when an update is made a copy is not provided to Ofsted within the required timescales. Not all staff have received supervision in line with the organisation’s policies. The manager has supervised permanent staff. However, agency staff, learning assistants and flexible support staff do not receive regular supervision. This does not provide an opportunity for all staff to reflect on their practices and is not in line with the home’s supervision policy and procedures. Staff duty rosters fail to reflect the actual staff on duty accurately and lack transparency. This prevents a clear audit trail of who is working in the setting, and when and where

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

they are working. Although the manager reports that support staff, learning assistants and agency workers cover the gaps in the rotas, the home’s logbook would suggest that there are not always sufficient staff available. This fails to ensure that young people receive one-to-one care as identified in their individual care plan. Inspection report children's home: SC397344 9 The manager does not have good systems to monitor staff training. The inspection identified that most staff do not have the required childcare qualification. Nor do they have access to the additional training that is required. For example, training records viewed for permanent staff demonstrated that there is only one member of staff that is up to date with fire safety training and two who hold the required level 3 childcare qualification. This lack of training hinders the ability of staff to provide a high level of evidence-based care, or to respond to any fire emergency safely.

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

The manager has identified a system to improve the quality of records for physical interventions and incidents. However, this system now means that staff duplicate these records. For example, staff write an account of an event in draft format. This is then scrutinised by the manager. When agreed, staff record the agreed content into the appropriate logbook. The initial record is destroyed. This system is open to error. Not all care practices can be checked against the original account of the event, as these records are not maintained. The manager has taken appropriate action to deal with complaints promptly and effectively. However, when young adults living in the home made allegations, the manager did not follow the adult safeguarding procedure. The manager updated safeguarding agencies, including Ofsted. However, leaders and mangers did not exhaust their own safeguarding policy. For example, while statements were taken from the

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

witnesses who reported the concerns, an account from the young adult making the complaint was not obtained. Furthermore, while this information was shared with the local area designated officer, the provider did not take appropriate action to share all relevant information with the vulnerable adults safeguarding team, as required by the policies and procedures. This does not ensure that all safeguarding concerns are investigated appropriately.

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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 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 and 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: SC397344 10

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Children’s home details

Registered provider address: Birtenshaw, Darwen Road, Bolton BL7 9AB

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Inspector

Janine Shortman-Thomas, social care inspector Inspection report children's home: SC397344 11 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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