Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

Inspection report children’s home: SC386003 1 SC386003 Registered provider: Appletree Treatment Centre Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The children’s home is one of three owned by a private organisation. It provides care and accommodation for up to five young people who have emotional and/or behavioural difficulties and/or learning disabilities.

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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

Date of last inspection: 13 December 2016

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good

Overall judgement at last inspection: Good

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Key findings from this inspection

 The home has undergone extensive redecoration since the last inspection and now provides a warm, welcoming environment to children. Children’s bedrooms in particular are personalised and individualised.  There is a clear focus on attachment relationships, and children make excellent progress in learning to attach and develop strong bonds to adults whom they trust. Inspection report children’s home: SC386003 2  Managers and staff are committed to children. Staff work constantly to improve children’s experiences of living in the home.  When children regularly show aggression and violence towards staff, staff are patient, understanding and forgiving, which lets children know that they are valued and cared for and will not suffer rejection.  Staff at the home are well trained and most have completed the company’s own diploma. The ethos is embedded into the staff team and care is delivered in line with the principles and values delivered in the training. This enhances the

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Key findings from this inspection

children’s experiences while living in the home.  Monthly progress reports provide tangible evidence that children are generally making good progress. Managers understand the reasons for some children’s progress faltering and make every effort to help them address any issues they have.  Children’s cultural needs are understood. Staff are sensitive about the differences in culture between the children and work hard to ensure that children do not feel isolated due to their cultural requirements.  Children are kept safe through vigilant staff support and a good understanding of risk. Methods such as weighted blankets are used to help children feel safe at night in the home, which has resulted in huge improvements for one child.  The home’s manager has a detailed understanding of each child’s needs and progress. He works hard to ensure that the staff team provides tailored support to children and to constantly improve children’s relationships and outcomes.

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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

 One child’s anger and aggression is having a negative impact on other children at the home. Although there are strategies in place to minimise the impact of this, the children continue to report that they sometimes feel scared of the child and their behaviour.  One incident has occurred where safeguarding information was not shared in a timely manner with a child’s social worker.  External monitoring does not evidence regular consultation with children’s parents, family members and social workers, which limits its effectiveness.

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Inspection date Inspection type Inspection judgement

13/12/2016 Full Good 06/07/2016 Interim Sustained effectiveness 28/01/2016 Interim Sustained effectiveness 02/06/2015 Full Good Inspection report children’s home: SC386003 3

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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 manager must ensure that staff help each child to develop and practise skills to resolve conflicts positively and without harm to anyone.

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Requirement Due date

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

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Requirement Due date

The registered person must ensure that staff take effective action whenever there is a serious concern about a child’s welfare.

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Requirement Due date

In particular, information should be shared in a timely manner with children’s social workers. 06/11/2017

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires.

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Overall experiences and progress of children and young people: good

Children spoken to as part of this inspection were overwhelmingly positive about their experience of living at the home. They report having very strong relationships with staff, Inspection report children’s home: SC386003 4 feeling cared for and enjoying themselves in their day-to-day lives and in a variety of activities.

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Overall experiences and progress of children and young people: good

Children generally make very good progress in the home. Staff record progress in children’s monthly progression reports. When it is clear that children are making slow progress, staff and managers spend time discussing the reasons for this and implementing strategies to address children’s faltering progress. Staff consult therapists on a regular basis for assistance in identifying the best ways to support children to progress.

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Overall experiences and progress of children and young people: good

The home is welcoming and homely with numerous photographs of the children on the walls. Pictures show children enjoying themselves with each other and with staff. Redecoration has modernised the home’s interior and has significantly improved the presentation of the home. Each child has a highly individualised bedroom with posters and photographs of their choice and a wide range of toys and games to play with.

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Overall experiences and progress of children and young people: good

Staff have a clear understanding of attachment theories and how they affect relationships. This topic is covered in detail in the home’s own diploma course. All staff complete this as well as the diploma level 3 in residential childcare. Attachment relationships are developed with those children who can be very resistant. Staff are helped by managers to understand the importance of persevering with children and giving them continuous positive regard and emotional warmth to ensure that they know they are cared about and deserve to be loved. Where children show continuous violent, aggressive and damaging behaviour, staff are persistent and tenacious in their patient and positive approach.

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Overall experiences and progress of children and young people: good

Some children’s behaviour can be aggressive. They can present as very angry and have been destructive. This can be frightening for other children living in the home. Managers and staff are aware of the impact of these behaviours on all children. However, children reported that they feel scared at times.

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Overall experiences and progress of children and young people: good

Children’s physical health needs are met by staff with the support of a nurse employed by the company. They receive a very high level of healthcare, and one child has made great progress in addressing her fear of going to the dentist. Where health needs, such as weight gain, arise, staff try to address these in a sensitive and consistent way. One child has been supported to stop taking medication for a diagnosed behavioural condition. He has succeeded in this, and has continued to regulate his behaviour very well. Children’s emotional health needs are met. They attend weekly therapy sessions. Therapists provide additional support to staff in identifying strategies to support children’s emotional well-being and to identify and address behavioural issues.

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Overall experiences and progress of children and young people: good

Children’s attendance at the company’s nearby school is very good. Many of the children have the opportunity to attend a local mainstream primary school for a period of time each week. This helps to promote their social and educational development. Children also attend community clubs and activities, such as football and dance clubs. This has also enabled them to make new friendship groups. Some children have an opportunity to Inspection report children’s home: SC386003 5 have independent free time to play in the local park. One child was particularly proud of this achievement.

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Overall experiences and progress of children and young people: good

Children’s cultural needs are well understood. Some children are resistant to adhering to their cultural requirements, which is the wish of their family. Staff work sensitively with these children to help them understand their culture and ensure that they do not feel segregated or marginalised because they have different cultural needs to other children in the home.

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

Risk assessments clearly identify areas of risk for children and strategies to be implemented to reduce and minimise risk. For many children at this home, the most significant risk is their ability to regulate their emotional responses, which results in risk- taking behaviour. Staff understand the risks and have implemented individual strategies to de-escalate children’s behaviours. Where a child’s high levels of aggression make their behaviour difficult to manage, managers recognise the need for increased support and staffing. Managers have attempted to address this with the child’s social worker. When this is not forthcoming, senior managers within the company have agreed to the home employing additional staff. This ensures that there is a high level of support to meet the individual need of each child.

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

Any allegations made against staff are dealt with appropriately, and strategies are implemented to protect both children and staff from allegations. For example, for one child staffing has increased to two to one staff at all times. In addition, the manager liaises with the local area designated officer, the police and the child’s placing authority in the management of allegations. However, when a child shared information with her social worker about another child in the home (in relation to a potential safeguarding concern) there was a delay in sharing this information with the second child’s social worker. This was due to staff at the home assuming that the first child’s social worker would share the information. This has resulted in a requirement being made, as there was a delay in sharing important safeguarding information.

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

Due to incidents that had occurred when children had accessed each other’s bedroom during the night, the manager took appropriate action and ensured that the home had two waking-night staff. This robust response has resolved the issue and there have been no further incidents.

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

Some children’s behaviour is such that physical management is necessary to keep the children safe. Staff work hard to understand children’s triggers and to implement techniques for de-escalating behaviour. When the number of incidents of physical intervention are not decreasing, staff try to identify methods of helping the children self- regulate and thus avoid the need to be held. The recording of incidents is of a good standard. Managers and staff always talk to children about their views of the incident and about any holds used. In many instances, restorative work is undertaken to help the children mend relationships and take some responsibility for their actions. The manager completes a monthly analysis of restrictive physical intervention in order to identify any Inspection report children’s home: SC386003 6 emerging patters and trends that may be useful in reducing the number of holds being used.

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

Staff and children have completed online training on radicalisation and extremism to educate them about the risks. One child in particular has been affected by terror incidents, having had a trip to London postponed due to an extremist incident. This direct work has helped children to develop an age-appropriate understanding of extremism.

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

Children at this home are not of an age where drugs, alcohol and criminalisation are risks to them. They are not at risk of child sexual exploitation as they are always supervised and have very limited and controlled access to the internet. Children do not use social networking sites. Risks such as the danger of the local river and road safety are discussed with children in an age-appropriate way. This ensures that they have a clear understanding of any potential risks.

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

There are strategies in place to help children feel safe at the home. When children find it difficult to settle at night and experience fear, staff provide appropriate support. Staff have sat outside children’s bedrooms where necessary and provided reassurance that they are around if children need them. For one child, the use of a weighted blanket has reduced his night-time insecurities. As a result, his sleep pattern has significantly improved.

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

Behaviour management in the home works largely on positive rewards, celebrating and praising positive behaviour. The consequences that are in place are appropriate and reviewed for effectiveness. Children spoken to felt that consequences were fair and had full understanding of the target and reward system in place, which they had also been consulted about.

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The effectiveness of leaders and managers: good

The home’s recently registered manager shows commitment and drive to achieve the best outcomes for the children in the home. He has strong views about the future plans for children and can advocate on behalf of children when necessary. The manager ensures that all practice in the home is child-centred. He clearly understands the progress children make. He is also aware when action is required if children are not making sufficient progress.

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The effectiveness of leaders and managers: good

The home has a stable and consistent staff team. Additional night staff have been employed since the last inspection and recruitment of an additional full-time member of care staff is underway. This will alleviate some pressure to provide high levels of support and supervision for some children. One long-serving member of staff has been off for some time. This has had a significant impact on some children and the staff team. The manager is working hard to support both staff and children with this.

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The effectiveness of leaders and managers: good

Staff report they are supported and supervised in their roles. Most are qualified to diploma level 3 in residential childcare. In addition, they have completed the company’s Inspection report children’s home: SC386003 7 own diploma course, which is considered by staff to be informative and useful in caring for children who have complex emotional needs. There is a positive team ethos and the staff work well together to meet the needs of the children.

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The effectiveness of leaders and managers: good

The home works in partnership with external agencies to ensure that the children’s broad range of needs are met. Senior managers attend the local forum for independent children’s homes to learn from others and share good practice. If any issues are raised by external agencies, senior managers are happy to meet with representatives to discuss and address.

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The effectiveness of leaders and managers: good

The manager has a weekly system in place for collating monitoring information, which is thorough, although he does not yet formally include feedback from children, parents and other agencies. The manager is able to articulate the ways in which he gathers all feedback and understands how this will inform the ongoing development of the home. The views of children are taken into account on a daily basis and inform the development of the home and the way in which care is delivered. The manager has a very good understanding of the home’s strengths and weaknesses and takes effective action to address any areas identified for development. One example of this was when it was identified that a staff member had not developed a positive relationship with one child. This was addressed effectively through direct discussions and the supervision process. As a result, the member of staff put more effort into developing a positive

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The effectiveness of leaders and managers: good

relationship with the child. This has improved their relationship and the child’s behaviour has become easier for staff to manage.

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The effectiveness of leaders and managers: good

External monitoring visits take place monthly. However, the independent visitor was not regularly seeking feedback from parents and external agencies. This limited the overall monitoring system. The manager at the home had already identified some issues in respect of the independent monitoring and has employed an alternative person to visit the home and complete the monthly report.

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The effectiveness of leaders and managers: good

Case records are generally of a good standard. When areas of improvement have been identified, the managers have worked with staff to make the necessary improvements and improve their recording skills. A recommendation made at the previous inspection relating to documents being signed and dated by the author has been met.

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The effectiveness of leaders and managers: good

The home is achieving its aims and objectives as set out in its statement of purpose. This is kept updated and is sent to the regulator. The ethos of the company is embedded into staff practice and there is a very clear focus on nurturing care, attachment relationships and enabling the children to develop resilience and a positive self-image.

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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 Inspection report children’s home: SC386003 8 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: SC386003 9

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Children’s home details

Registered provider: Appletree Treatment Centre Limited

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Children’s home details

Registered provider address: Meathop Park, Meathop, Grange-over-Sands, Cumbria LA11 6RF

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Inspector

Charlie Bamber, social care inspector Inspection report children’s home: SC386003 10 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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