Children's Home run by Building Bridges Care Homes Ltd in St Helens

Inspection report children’s home: SC063284 1 SC063284 Registered provider: Building Bridges Care Homes Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned by a private company. The home provides care and accommodation for up to five children who have 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: improved effectiveness

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good

Enforcement action since last inspection: none Inspection report children’s home: SC063284 2

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Key findings from this inspection

 Young people enjoy living in this friendly and supportive family home. The very high standard of individualised care consistently meets young people’s needs and improves their lives.  Well-planned and reflective direct work is helping young people to make progress. They are happier, healthier, taking part in education, building positive relationships and enjoy the same social experiences and opportunities as other young people.  Good safeguarding practice is protecting young people from harm. Young people feel safe and are able to talk to staff if they are worried or concerned.  Well-established and highly effective safeguarding partnerships ensure that when risks to young people are identified they are managed exceedingly well. This is making a difference to young people’s lives because they are considerably safer from the risks of neglect, abuse and sexual exploitation.  A positive and emotionally warm environment with consistent boundaries is

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Key findings from this inspection

providing young people with the structure that they need to develop a strong sense of belonging and emotional security.  Young people have trusting and meaningful relationships with staff.  Effective care planning and productive working relationships between the staff, families, social workers, schools and health workers mean that young people receive the best possible support in meeting all their needs.  Under the manager’s strong and effective leadership, caring, experienced, skilled, qualified and well-supported staff provide a high quality of care for each young person. The staffing arrangements are efficiently organised to provide young people with a continuity of care that meets their needs and provides them with opportunities to form positive attachments.

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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

 To continue to improve the physical environment to provide young people with a homely and comfortable place to live.  To encourage and support young people to attend the dentist and have the treatment that they require.  The manager should always let Ofsted know when he has serious concerns about a young person.  Always take into account the view of young people and professionals when reviewing the performance of each member of staff. Ensure that each member of staff has a development action plan. Inspection report children’s home: SC063284 3  Improve the clarity of risk assessments and individual plans to help staff understand how best to support the young people.

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Inspection date Inspection type Inspection judgement

16/03/2017 Interim Improved effectiveness 13/12/2016 Full Good 17/03/2016 Interim Sustained effectiveness 30/11/2015 Full Outstanding Inspection report children’s home: SC063284 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

6: The quality and purpose of care standard The quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and the outcomes it seeks to achieve for children and use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. In particular, the standard in paragraph (1) requires the registered person to ensure that staff provide to children living in the home the physical necessities they need in order to live there comfortably. (Regulation 6 (1)(2)(b)(vii)) Specifically, that the kitchen and all of the children’s bedrooms are clean, decorated, maintained and furnished to a good standard which ensures that they are pleasant environments for children to use. Also take steps to ensure that fire doors into the kitchen and at the bottom of the stairs and bathroom floors enhance the domestic feel of the home.

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Requirement Due date

10: The health and well-being standard The health and well-being standard is that the health and well- being needs of children are met, children receive advice and services in relation to their health and well-being and children are helped to lead healthy lifestyles. In particular, the standard in paragraph (1) requires the registered person to ensure that staff help each child to have access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (1)(2)(c)) This relates to making sure that there is a clear and effective plan to support and encourage all children to go to the dentist regularly and ensure that they receive the dental treatment that they need. 30/10/2017 Inspection report children’s home: SC063284 5 40: Notification of a serious event The registered person must notify HMCI and each other relevant person without delay if a child is involved in or subject to, or is

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Requirement Due date

suspected of being involved in or subject to, sexual exploitation or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(a)(e)) 22/09/2017

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Recommendations

 Ensure that appraisals of staff’s performance and fitness to carry out their role always take into account, where reasonable and practical, the views of children, and of other professionals who have worked with the staff member. Also, ensure that staff have clear action plans for the professional development agreed at their performance review meetings. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.5)  Ensure that staff understand the importance of careful and clear recording. In particular, that children’s case records provide an in-depth picture of each child’s experiences and progress that contribute to the understanding of their lives. Also, that written records should avoid using generalised terms that are not clearly and explicitly explained. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)

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Overall experiences and progress of children and young people: good

Young people enjoy living in this safe, friendly and supportive family home. They receive a very high standard of individualised care that consistently meets their needs, brings stability to their lives and helps them to make good progress. A young person said that, ‘It’s really good. I like it here. The staff are kind and help me with my homework. They make sure that I have what I need.’

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Overall experiences and progress of children and young people: good

The manager and staff have the right personal qualities and skills to build a warm and welcoming environment where young people feel safe and loved. A young person said that, ‘Staff are not snide or say hurtful things. They can be sarcastic but in a funny way.’ Young people have built trusting relationships and strong attachments with staff, regardless of the complexity of their needs. Staff’s perseverance and unconditional support help young people to understand that staff care about them and are interested in their welfare. A young person said, ‘It’s better than other places I’ve been. Staff are sound. They listen to you. They are upbeat and friendly. They care about me.’

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Overall experiences and progress of children and young people: good

Importantly, the manager and staff enable the young people to express themselves as individuals. Young people are encouraged to make decisions about their clothes, the food they eat and how they would like to spend their spare time. The young people Inspection report children’s home: SC063284 6 confirmed that the manager and staff really listen to what they have to say. For example, young people suggested that the staff convert two spare rooms into an activity room and make-up room. This helps young people to feel valued and that their wishes are important.

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Overall experiences and progress of children and young people: good

Staff balance young people’s preferences against what they judge to be in the young person’s best interests. Young people are involved in the decisions about their lives, including choices around seeing their family, education, training and plans for their future. Staff encourage and support young people to go to their review meetings and to talk to those in attendance about their wishes and feelings. Young people know how to complain when they are unhappy and staff respond appropriately to concerns raised. Staff routinely show young people what they write about them and encourage young people to add their own comments and views. Young people are involved in devising their care plan and helping staff to understand how best to help them.

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Overall experiences and progress of children and young people: good

Detailed and effective care planning systems mean that the manager and staff have a good understanding of young people’s individual assessed needs and the arrangements for supporting them. Before the manager agrees for a young person to move in, he makes every effort to get all the available information about the young person’s needs. He completes thorough assessments of the young person’s assessed needs, staff’s ability to meet them and the young person’s compatibility with the other young people already living in the home.

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Overall experiences and progress of children and young people: good

Staff engage naturally with young people and provide them with a high quality of personalised support tailored to their individual needs. Staff provide support and advice around potential risk and personal safety, building positive relationships, managing feelings and behaviour, personal care and health needs and education and activities. The staff show that they plan their work carefully, understand the issues that they need to work on and how they will go about it. They evaluate and reflect on the outcomes for young people and gain an insight into the young person’s life. For example, a member of staff analysed the reasons why a young person was reluctant to take part in activities and found that offering him things to do on the spur of the moment and allowing him to lead the activity worked well.

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Overall experiences and progress of children and young people: good

Young people’s placement plans and records give a detailed and up-to-date picture of their experiences and progress. The manager routinely reviews the plans to ensure that they remain relevant to the young person’s needs. The manager and staff work effectively with each young person’s wider support network to make sure that young people receive the best possible support. Staff are also good at keeping the social worker, independent reviewing officer and parents up to date with the progress that young people make. When young people move out of the home to other accommodation, the manager and staff work hard to make sure that the move takes place as positively and sensitively as possible. This is also the case when young people have moved out quickly; the manager and staff have taken responsibility for explaining the reasons to the young person and taking them to their new home.

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Overall experiences and progress of children and young people: good

Carefully planned arrangements help young people to spend time with their parents, Inspection report children’s home: SC063284 7 brothers and sisters, friends and other people who are important to them. Staff work actively and positively to help young people maintain and build meaningful relationships, understand their identity, feel part of their family and improve their self-esteem. Staff work sensitively with young people and their parents, brothers and sisters and grandparents to try to overcome any difficulties and rebuild relationships. They always make sure that seeing family and friends is a safe and positive experience for young people and takes into account any restrictions.

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Overall experiences and progress of children and young people: good

The manager and staff provide structure, stability, encouragement and opportunities for young people to take part in education and to learn and develop their knowledge, skills and talents. Young people’s participation in education is improving. Staff clearly understand the barriers to learning and like any good parent, they encourage and support young people’s ambitions and fight for them to have the chance to learn and do well. A young person said, ‘They push you to do the best you can do, like getting you ready to go back to school.’ Staff work well with schools, education providers and the virtual school headteachers to support and improve young people’s education opportunities.

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Overall experiences and progress of children and young people: good

All of the young people have clear plans for their education. When young people are on a reduced timetable, they have opportunities to develop skills and knowledge through individualised ASDAN programmes. A qualified teacher designs the programmes. The programmes have included a focus on developing creative talents by renovating old furniture. One programme helped to prepare a young person for adult life through learning about managing money.

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Overall experiences and progress of children and young people: good

The manager and staff give young people many opportunities to enjoy leisure time and develop their talents and interests, including playing football, fishing, swimming, going to the gym and cinema and going on holiday. Staff do their utmost to ensure that young people have every opportunity to take part in activities that they show an interest in. This is helping young people to gain confidence in their abilities, have fun, acquire new skills and improve their social and emotional skills. They also have the same opportunities as other young people to spend time with their friends.

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Overall experiences and progress of children and young people: good

Young people’s physical health and emotional well-being continue to improve. They have a healthy diet and staff encourage them to get plenty of physical exercise. Staff ensure that young people get support from health services to meet their needs and help them to understand about healthy lifestyles. Staff have an excellent understanding of young people’s specific health needs and manage young people’s health with sensitivity and confidence. Staff are helping a young person to manage his diabetes appropriately and develop his skills for managing the condition more independently. He said, ‘Staff help me manage my diabetes and they make sure I take my insulin. They know what to do because my nurse has trained them. I tell them if I am unwell. If my blood sugar is low, I get dizzy. They do my bloods before I have food. [They] help me choose healthy food. They always check on me to make sure I’m right.’ Staff closely monitor young people to

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Overall experiences and progress of children and young people: good

make sure that they are healthy, and ensure that young people always get suitable medical advice and treatment when they are feeling unwell or they are concerned about their health. Staff are usually good at encouraging young people to attend medical Inspection report children’s home: SC063284 8 appointments. However, they have not been able to get two young people to go to the dentist and one of the young people requires treatment.

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Overall experiences and progress of children and young people: good

The home is located in an area that supports young people’s safety and well-being. It is a large house that is mostly decorated and furnished to provide young people with a welcoming and comfortable home. Young people have their own personal space. They choose how to decorate and arrange their bedrooms to make them their own. However, not all of the young people’s bedrooms are decorated and furnished to a good standard. One bedroom contained a damaged chair, the furniture did not match and the young person did not have a wardrobe to hang his clothes in. The style of the bathroom floors and fire doors at the bottom of the stairs and into the kitchen give an institutional impression, which distract from providing young people with a homely environment.

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

Young people feel safe and are protected from harm. They feel able to talk to staff and know that they are listened to and that their worries are always taken seriously. A young person said, ‘I can talk to all of the staff. When I needed to speak to someone, they help me. When I’m upset, they make sure I’m safe.’ Another young person said, ‘I feel safe here. I’m not bullied. I used to get hit at the other home.’

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

The manager and staff are vigilant and take prompt and effective action to deal with any concerns about the young people’s safety. The safeguarding arrangements protect young people, promote their welfare, manage risk safely and meet all the statutory requirements. Staff have a good understanding of the risks that young people may face from sexual exploitation and radicalisation. However, on one occasion, the manager did not inform Ofsted of a serious concern about a young person. Nevertheless, he took suitable and effective action to protect the young person and other young people.

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

Young people are becoming increasingly safer from the risks of abuse, neglect, bullying, self-harm and exploitation. They have effective relationships with the local police, social workers, the local authority, schools and health professionals. This well-established professional network work together successfully to identify the risks that young people face and they take appropriate action to protect young people. The manager acted appropriately when he had concerns that the risks that young people were placing themselves at were too high for them to continue living in the home safely. He worked effectively with social workers and the police to work out how best to protect a young person who was going missing persistently and was at risk of exploitation.

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

The number of times that young people have gone missing from the home is reducing. Staff help young people to understand the risks and dangers involved if they go missing, and make sure that young people know how to get help. Staff take reasonable precautions to check on young people’s welfare when they are out. When young people have gone missing, staff always act quickly to try to find them by actively looking for them, making contact with their family and friends and informing the police and social workers. The police missing from home coordinator said that, ‘The staff always try to disrupt young people from going missing. They provide a lot of good intelligence Inspection report children’s home: SC063284 9 because they go out looking for young people.’ When young people return home they always have the opportunity to see an independent person, to talk about what happened and the reasons for them not wanting to come home.

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

Strong relationships with social workers from the child exploitation team and local sexual health advisory service are helping young people to recognise risk and harmful relationships, and to develop the skills to manage risk and keep themselves and others safe. Staff balance effectively protecting young people with enabling them to take appropriate and reasonable risks to promote their personal growth, including spending time with friends in the community. A young person said, ‘Staff keep in touch when I’m out, come to see me and make sure I’m OK.’

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

The manager and staff show a good understanding of the risks to young people’s safety, including risks associated with self-harmful behaviour, exploitation and the use of the internet and social media. Staff have the skills to identify and understand risk, and use suitable and proportionate protective measures to handle situations safely. They use written risk assessments and protection plans as living documents to make sure that information about each young person is up to date and arranged to keep young people safe. However, the risk assessments and plans do not always provide clear strategies to minimise risks. For example, the use of generalised terms, such as ‘settling techniques’ or saying that a young person ‘gets overexcited’, without giving the context, describing the actual behaviours and not what staff need to do to support the young people.

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

The manager and staff provide young people with a warm, friendly and reliable home environment. This has helped young people to form positive relationships with them. Young people appear happy and have a strong sense of belonging. A young person said that, ‘It’s a good place to live because staff really care about me. It’s like a family. They don’t hold things against you. I have been passed around a lot but they have actually kept me. It’s my home, I belong.’

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

The manager and staff provide young people with the structure so that they feel safe. Clear and unambiguous routines and boundaries are in place. Therefore, young people know what is happening each day, understand the expected standard of behaviour and how they will be treated. The manager and staff encourage and reinforce positive behaviour through lots of praise and rewards. For example, they use a simple individualised incentive system to help young people to improve their school attendance, personal care and returning home on time. A young person said that, ‘Staff don’t shout. It’s a nice house. It’s a nice family. They help me know what’s right and wrong.’

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

Staff see beyond young people’s presenting behaviour and clearly understand how young people’s experiences may leave them feeling confused, rejected, anxious and angry. When young people have struggled to manage their feelings, staff have managed the situation well. A young person said, ‘It feels safe because staff are reassuring, support you with everything [and] help you calm down.’ Their consistently calm and reasonable approach helps to take the heat out of the situation and avoids the need to use restraint. Staff use restraint rarely and appropriately, and only when young people are at serious risk of harm. Staff are clearly developing a good understanding of the best Inspection report children’s home: SC063284 10 ways to help each young person to manage their feelings and solve problems. Staff try different techniques, including individual direct work and mediation to help young people to understand the impact of their behaviour, other people’s feelings and solve problems.

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

Young people are learning how to control their feelings positively and to cope with stressful situations. Young people are becoming less confrontational, loud and aggressive. For example, a young person took appropriate action to keep out of an argument with another young person, which he previously would have become involved in. This positive behaviour was praised and rewarded by staff, to help him to see the benefits of positive behaviour.

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

The senior managers and manager ensure that members of staff go through a thorough and careful recruitment and selection process. This prevents unsuitable people from working at the home. They make sure that staff have the right personal qualities, enthusiasm, experience, skills and values to work with vulnerable young people. They collect and record all the available information about candidates to make the right decisions about a person’s suitability. This includes verifying by telephone information about a person’s practice, experiences, abilities and the reasons they left their last job from their previous employers.

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The effectiveness of leaders and managers: good

The registered manager left the home in May 2017 to take up a new role in the organisation. The deputy manager was appointed to the new manager role and this has provided the management of the home with continuity and stability. The new manager is very experienced and suitably qualified. Ofsted is considering his application for registration. He provides consistently effective leadership with a strong focus on making a meaningful difference to young people’s lives. This ethos is shared by all the members of staff and is firmly embedded in their working practices. The manager and staff work together successfully to ensure that young people live in a friendly, supportive and safe family home where they receive a high standard of individualised care.

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The effectiveness of leaders and managers: good

The manager demonstrates a detailed understanding of young people’s experiences and the support that they need to meet their assessed needs. He listens carefully to the young people’s views about their experiences and works hard to include their views in the development of the home. He has a clear understanding of the progress that each young person is making and the priorities for their care. The manager and staff ensure that young people are cared for in line with their agreed plans. They are also quick to identify when young people are struggling and take the necessary action to make sure that young people get the best possible help. This has included the use of rewards to encourage young people’s school attendance and improve their personal care as well as making sure that young people have support from specialist health and advisory services. The manager and staff have productive working relationships with the social

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The effectiveness of leaders and managers: good

workers, teachers, health workers and the police. They have assertively challenged placing authorities when they see that young people are not receiving the support that they need to meet their assessed needs, for example to make sure that a young person went to a school that gave him opportunities to learn and make progress. During the inspection, the manager negotiated with a placing authority and the manager of another Inspection report children’s home: SC063284 11 children’s home to make sure that a young person moved on in a positive and supportive way.

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The effectiveness of leaders and managers: good

The leaders and manager have created the right environment for staff to provide young people with a high standard of care and consistency. The staffing structure, which includes an experienced deputy manager and three team leaders, means that the day- to-day care of young people is well planned and focused on meeting young people’s needs. Staff share information efficiently in well-managed handover meetings, which ensure that all staff team members know what is happening and what they need to do. The staffing arrangements ensure that there are always enough knowledgeable, experienced and skilful staff available to meet all the young people’s assessed needs. All the staff are suitably qualified to carry out their jobs. The highly motivated and competent members of staff clearly enjoy spending time with young people and are keen to make a positive difference to young people’s lives.

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The effectiveness of leaders and managers: good

The manager and deputy manager provide each member of staff with excellent support, guidance and encouragement. Staff have regular opportunities through practice-related supervision and team meetings to reflect on young people’s progress, their own and performance, share skills and develop their skills and knowledge. The manager supports and encourages staff to develop expertise through good-quality training relevant to the needs of the young people, including training around child sexual exploitation, safeguarding and behaviour management. The manager also makes sure that staff’s training is kept up to date.

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The effectiveness of leaders and managers: good

Regular staff development days and meetings with a clinical psychologist are providing additional opportunities for staff to reflect, share practice and develop their skills and confidence in working with young people. New staff complete suitable induction programmes that equip them to carry out their roles and they are all expected to complete the relevant childcare level 3 diploma. Every member of staff has their performance formally reviewed at least every year. However, appraisals of staff’s performance and fitness to carry out their roles do not always take into account the young people’s views and those of other professionals who have worked with the staff member. In addition, staff do not always have clear action plans for their professional development.

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The effectiveness of leaders and managers: good

Visits by an independent person provide detailed and impartial scrutiny of the running of the home. The independent person’s reports show young people’s progress and experiences and include the views of young people about living in the home. These reports provided a detailed assessment of the home’s arrangements to effectively safeguard and boost young people’s welfare. The manager uses the independent person’s reports and his own monitoring to help him understand the strengths and further areas for development, including improvements to the written records and the physical environment. Inspection report children’s home: SC063284 12

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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: SC063284 13

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Children’s home details

Registered provider: Building Bridges Care Homes Limited

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Children’s home details

Registered provider address: Mill Farm, Bull Bridge Lane, Liverpool L10 6LZ

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Inspector

Nick Veysey: social care inspector Inspection report children’s home: SC063284 14 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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