Children's Home run by Crossway Services Limited in St Helens

Inspection report children’s home: SC068206 1 SC068206 Registered provider: Crossway Services Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is owned and managed by a private organisation. It provides care and accommodation for one young person who has emotional and/or behavioural difficulties.

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Information about this children’s home

Inspection dates: 20 to 21 September 2017

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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 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: sustained effectiveness

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good

Enforcement action since last inspection: none Inspection report children’s home: SC068206 2

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Key findings from this inspection

 A committed and supportive staff team cares for the young person.  The young person feels safe living in the home. The staff team has the necessary knowledge, skills and understanding to ensure that it protects him.  The registered manager had taken appropriate action to liaise and challenge professionals to ensure that appropriate education provision is in place to meet the young person’s educational needs.  The home has implemented a new points and rewards system for the young person, which he has responded exceptionally well to. Consequently, his behaviour has improved and he is choosing rewards for his positive behaviour.  The young person is engaging in a wide range of social and recreational activities, which promotes his confidence, self-esteem and social skills.  Monitoring and review systems in the home support the registered manager to identify strengths and weaknesses and areas for development. The registered

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Key findings from this inspection

manager takes swift action to address any identified shortfalls in practice.  The staff team members feel supported by the registered manager and each other. The team meets regularly at handovers and team meetings to share relevant information.  Staff supervision is up to date and is reflective in nature.  Relationships between the staff and young person are positive. Regular consultation meetings take place with the young person to address specific issues relating to him.  Safer recruitment practices are in place to ensure that only suitable members of staff care for the young person.

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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 intervention records require improvement. Not all physical intervention records include the required information. Furthermore, the records do not demonstrate that an independent debrief has taken place with the young person.  Records and plans do not always contain detailed information to show the young person’s progress and experiences or their journey since moving into the home.  Some case records include minor errors and omissions. Inspection report children’s home: SC068206 3  The home’s location risk assessment does not include details of information obtained from consultation with relevant persons.  Staff have not always included the views of the young person into his records and plan. Furthermore, some records do not demonstrate that the young person has read or understood them.

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Inspection date Inspection type Inspection judgement

01/03/2017 Interim Sustained effectiveness 20/12/2016 Full Good 25/02/2016 Interim Sustained effectiveness 08/10/2015 Full Outstanding Inspection report children’s home: SC068206 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 registered person must ensure that— 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— the name of the child; details of the child’s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (‘the user’), and any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; 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’)—

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Requirement Due date

has spoken to the user about the measure; and has signed the record to confirm it is accurate; and 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)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)) 30/10/2017

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Requirement Due date

The registered person must maintain records (‘case records’) for each child, which include the information and documents listed in Schedule 3 in relation to each child, are kept up to date and 30/10/2017 Inspection report children’s home: SC068206 5 are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 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) and (2)) 30/10/2017

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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 fact, opinion and third party information. Information about the child must always be recorded in a way that will be helpful to the child. All children’s case records (Regulation 36) must be stored securely whilst they remain in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraphs 14.3)  Children should be encouraged by staff to see the home’s records as ‘living documents’ supporting them to view and contribute to the record in a way that reflects their voice on a regular basis. (‘Guide to the children’s homes regulations including the quality standards’, page 58, paragraph 11.19)  For children’s homes to be nurturing and supportive environments that meet the

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Recommendations

needs of their children, they will, in most cases be homely, domestic environments. Children’s homes must comply with relevant health and safety legislations (alarms, food, hygiene and so on). However, in doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)

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Overall experiences and progress of children and young people: good

The young person is happy and settled and said that he feels safe living in the home. When the young person recently had trouble in his life, the registered manager and staff responded well and offered appropriate support. A new points and rewards system and specific training relating to the young person’s individual needs has supported the home to meet the young person’s needs effectively. The young person said, ‘Things are pretty Inspection report children’s home: SC068206 6 good in the home now. Things are getting sorted out after a difficult time for me.’ A member of staff said, ‘The young person is great. He is doing brilliant now.’

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Overall experiences and progress of children and young people: good

The young person has responded exceptionally well to the new points and rewards system. He is keen to earn as many reward points as possible and he can choose what rewards he receives. This has resulted in his behaviour improving significantly. The young person has also taken part in more social and recreational activities, including a caravan holiday, trips out for the day and he enjoys attending football and rugby matches. The young person said, ‘This is the best summer I have ever had due to all the activities and experiences I have had.’ This has enabled the young person to build his confidence, self-esteem and social interaction. Furthermore, the relationships between the staff and young person have improved.

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Overall experiences and progress of children and young people: good

Since the young person has moved into the home, he has been home educated. The registered manager and staff have liaised with relevant professionals and challenged them appropriately to ensure that an appropriate education provision was located. The young person starts at his new school in the next couple of weeks. The young person proudly told the inspector on arrival at the home that he was returning to school. He said, ‘Eventually, I have a place in school. I am absolutely fuming (angry) for how long it has taken them (the education professionals). In my eyes there is just no excuse.’ Staff have been to visit the school with the young person and arranged for the headteacher and allocated key worker to visit the young person at the home. This has enabled gradual relationships to be established and provided an opportunity for the young person to ask any questions that he has.

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Overall experiences and progress of children and young people: good

The registered manager and staff understand the health and development needs of the young person. All staff have completed specific training and attended development sessions with experts in the field of autism. This has raised their awareness and understanding within this field. Consequently, this has enabled them to provide individualised care specific to the young person’s needs. However, all known medical conditions have not been recorded in the young person’s health plan. This does not ensure that all staff have up-to-date and accurate information.

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Overall experiences and progress of children and young people: good

Relationships between the staff and the young person are good. The staff spend time with the young person and engage him in various activities. Staff regularly have consultation meetings with the young person to address specific issues, for example contact, education, rewards and consequences. The registered manager and staff listen to the young person and are sensitive to his needs. The young person said, ‘I feel listened to by the staff and manager and they take into account what I say when making decisions.’ Consequently, this supports the young person’s emotional and psychological well-being.

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Overall experiences and progress of children and young people: good

Care planning for the young person is good. However, some of the records require improvement. Although the registered manager and staff understand the needs of the young person, written plans do not provide a complete picture of the young person’s journey since moving into the home or identify changes to his health condition. Therefore, any new staff reading the plans do not have access to all the young person’s Inspection report children’s home: SC068206 7 needs, background and progress.

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Overall experiences and progress of children and young people: good

Staff ensure that appropriate and safe contact is in place for the young person with people who are important to him. Staff maintain regular contact with the local authority to ensure that appropriate contact arrangements are in place. Staff speak to the young person about his views, wishes and feelings and share these with the local authority. As a result, contact with a family member now includes telephone contact. The young person is also encouraged to invite his friends to the home, although he has chosen not to invite them to date.

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

The young person feels safe living in the home and knows that the staff do all they can to keep him safe. He said, ‘The manager and staff do all the checks in the home to make sure it is a safe environment for me to live in.’

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

Staff complete regular health and safety checks in the home. Fire alarm testing and carbon monoxide checks ensure that the home remains a safe place to live. The home now has a clear procedure in place to lock the front door during the night. Staff have involved the young person in the changes and he is fully aware of how to leave the home in an emergency. As an additional safeguard he has been provided with a mobile phone to call for help should the need arise. The young person’s risk assessment has been updated to include this information.

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

Risk assessments outline the risks to the young person and strategies for staff to follow to manage the risks. Staff regularly review the assessments and identify whether the risk is high, medium or low. They show the young person’s progress and the reduction in risk since he moved into the home. However, staff have not always updated assessments when incidents occur, for example when the young person was threatening and abusive to the registered manager and caused damage in the home. The young person also made an allegation against the registered manager, which had not been included in his risk assessment. However, staff had recorded the information in the incident log and the safeguarding record. Furthermore, the home dealt with the incident appropriately and the local authority designated officer undertook a full investigation. The young person’s social worker said, ‘The home has dealt with safeguarding incidents appropriately and in

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

conjunction with [the] local authority designated officer.’

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

There have been four incidents of physical intervention since the last inspection. However, records do not include all required information. One of the records does not include the duration of the intervention and others do not identify if any injuries occurred because of the intervention. Furthermore, the records do not demonstrate that an independent debrief has taken place with the young person following interventions. Consequently, the procedures in place for the recording and follow up of physical interventions require improvement to ensure that the young person is safeguarded. The registered manager acknowledged that this is a new procedure used in the home and that staff might need more guidance in how to complete all records. Inspection report children’s home: SC068206 8 The home’s review of the appropriateness and suitability of its location outlines all known risks in the community and includes information from the safe area report

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

completed by the police. However, it does not include details of consultation with other relevant safeguarding professionals in the area. Consequently, this means that there may be other risks in the community that the home has not considered. This could potentially place the young person at risk in the community in which the home is located.

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

Recruitment and selection procedures for new staff are good. Records demonstrate that all checks, including an update from the disclosure and barring service, and references are requested prior to staff being appointed. This helps to prevent unsuitable people from working in the home.

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The effectiveness of leaders and managers: good

The home continues to be led and managed by a suitably qualified and experienced registered manager. She also has responsibility for another single-bedded home owned by the company. The registered manager effectively spends her time evenly between the two settings. She has a good understanding of the needs of the young person and works effectively with the staff team and other professionals to provide a good standard of care.

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The effectiveness of leaders and managers: good

The staff team members feel supported by the registered manager and each other. A member of staff said, ‘The manager is great. We all want to do well for her. She has lots of faith in us.’ He also highlighted the individual strengths of staff members and identified how they work together effectively as a team. For example, they regularly communicate with each other at handover and during the team meeting. They share examples of good practice and discuss ideas of how they can support the young person to achieve positive outcomes in all areas of his life.

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The effectiveness of leaders and managers: good

Team meetings take place monthly and the young person has the opportunity to attend. He often sets the agenda and chairs or leads on the discussions about the home and his care. This ensures that his views, wishes and feelings are shared with the staff team. At the end of all team meetings, an action plan is compiled. The registered manager and staff review this to ensure that all agreed actions are completed. Furthermore, a regular feature of team meetings is the discussion of a specific piece of research to enhance the knowledge, skills and experience of the staff team. During one meeting, staff discussed research on self-injury in individuals with autism and learning disabilities. Consequently, this supports the staff team to regularly reflect and review their practice and ensure that the care they provide meets the young person’s needs.

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The effectiveness of leaders and managers: good

The staff benefit from regular training and development opportunities to support their continuous professional development. All mandatory training is up to date and they regularly receive other training and development opportunities to provide them with a greater understanding of how they can best meet the needs of the young person. For example, the home is working very closely with a speech and language therapist who specialises in working with young people with autism. This has provided staff with a Inspection report children’s home: SC068206 9 greater understanding of the young person’s individual needs and how they can best support and manage his behaviour.

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The effectiveness of leaders and managers: good

All staff are up to date with their professional supervision and they see this as another form of support from the registered manager. Supervision records demonstrate that sessions are reflective in nature. Staff are encouraged to consider what has worked well in meeting the needs of the young person and to identify areas for improvement. The staff are also encouraged to reflect on training and development opportunities that they have had and share their learning with the registered manager to enable her to assess the effectiveness of these opportunities. Together the registered manager and staff are then able to identify future learning needs.

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The effectiveness of leaders and managers: good

The registered manager and staff work collaboratively and effectively with a range of professionals to ensure that the young person is receiving the most appropriate support and intervention to meet his needs. They have appropriately challenged professionals, including health and education professionals, when they have felt that the young person is not receiving the best support. This has resulted in appropriate support and intervention being in place for the young person. Consequently, he has made progress in relation to his education and emotional and psychological well-being.

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The effectiveness of leaders and managers: good

The monitoring and review systems in the home enable the registered manager to identify the strengths and areas of weaknesses in the home. She regularly reviews the quality of care provided to the young person and addresses any shortfalls immediately. She recognises that this helps her to drive forward standards and improve the quality of care provided to the young person. She makes best use of the information available to her, to make improvements in the home. The registered manager has identified that the external monitoring system in place is not as robust as she would like it to be. She had already taken action to improve this.

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Information about this inspection

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

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC068206 10

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Children’s home details

Registered provider: Crossway Services Limited

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Children’s home details

Registered provider address: Rouse House, 2 Wyther Lane, Leeds LS5 3BT

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Inspector

Lisa Mulcahy: social care inspector Inspection report children’s home: SC068206 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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