Children's Home run by Quality Protects Children Ltd in Knowsley

Inspection report children‟s home: SC356929 1 SC356929 Registered provider: Quality Protects Children 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

A private company owns this home. It is registered to provide care and accommodation for up to three young people who have emotional and/or behavioural difficulties.

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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: inadequate

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Enforcement action since last inspection:

One compliance notice was issued on 25 August 2017 in respect of regulation 35. This inspection visit has found that suitable action has been taken and the compliance notice has been met. Inspection report children‟s home: SC356929 2

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Key findings from this inspection

 The registered manager has taken decisive action to resolve the weaknesses identified at the last inspection in relation to young people‟s health and well- being, safety, behaviour management practice and records, the standard of accommodation, the supervision of staff, staff rosters, and informing Ofsted and other relevant people of serious events involving young people.

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Key findings from this inspection

 Young people are now living in a safe, supportive and comfortable home. They are receiving a good quality of care that is bringing structure, reliability and emotional security to their lives. They have strong and positive attachments with their staff and very much feel that this is their home.

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Key findings from this inspection

 Young people feel safe and supported. Staff provide them with individualised support tailored to meet their assessed needs. As a result, they are making progress in their education, health and emotional well-being, and in building relationships with important people in their lives. Young people are also encouraged to use their creativity to explore and understand their feelings in a constructive way.

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Key findings from this inspection

 The registered manager and staff have the skills to identify, understand and manage risk appropriately. They have well-established and effective partnerships with the police and social workers that are helping to protect young people from harm.

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Key findings from this inspection

 The improved management oversight and scrutiny of the home is enabling the registered manager to identify, understand and address weaknesses.

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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

 The registered manager and the responsible individual should clarify the criteria for admitting young people to the home. They must also ensure that the home‟s statement of purpose reflects these arrangements, and that it includes up-to- date information about the people working at the home.

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Key findings from this inspection

 Behaviour plans and risk assessments need to include the arrangements for when staff are concerned that a young person may be under the influence of alcohol, drugs or other substances, and for when young people return home after being missing.

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Key findings from this inspection

 Staff supervision records should show that staff have been able to reflect on their work with young people, their performance, practice and training. Inspection report children‟s home: SC356929 3  The young people‟s guide needs updating to make sure that the information is accurate and in a format that young people living at the home will easily understand.

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Key findings from this inspection

 The decoration and furnishing of the house should be completed to ensure that children always live in a safe and comfortable home environment.

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Inspection date Inspection type Inspection judgement

21/08/2017 Full Inadequate 15/03/2017 Interim Declined in effectiveness 22/11/2016 Full Good Inspection report children‟s home: SC356929 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 keep the statement of purpose under review, and where appropriate, revise it, and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3) (a) & (b).

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Requirement Due date

In particular, the registered person should confirm in the statement the criteria used for the admission of children to the home and if children will be admitted in an emergency; include the details of the experiences and qualifications of every member of staff working at the home; and the arrangements for supporting children when they return home after being missing, including offering children interviews with an independent person. 12/11/2017

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Recommendations

 Ensure that the children‟s guide is made available to all children when their placement in the home is agreed, and it is age appropriate, provided in an accessible format and explained to each child to make sure they understand it. („Guide to the children‟s homes regulations including the quality standards‟, page 24, paragraph 4.21)

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Recommendations

 As part of reviewing and revising where appropriate the statement of purpose (regulation 16(3)(a)) the registered person should review and update the children‟s guide as necessary, and make sure children are given an explanation of any changes. („Guide to the children‟s homes regulations including the quality standards‟, page 24, paragraph 4.23)

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Recommendations

 Complete the decoration and furnishing of the house to ensure that children always live in a safe and comfortable home environment that demonstrates that they are cared for and valued as individuals. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraphs 3.7 & 3.9) In particular, complete the decoration and Inspection report children‟s home: SC356929 5 refurbishment of the bedrooms, make sure children have receptacles for their toothbrushes and personal toiletries in the bathroom; and that children choose pictures and ornaments to decorate the home.

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Recommendations

 Ensure that each child has up-to-date written risk assessments that assess the risks to the child and the arrangements in place to protect them. („Guide to the children‟s homes regulations including the quality standards‟, page 42, paragraph 9.5) This relates to the arrangements for supporting children when they return home after being missing, including offering children interviews with an independent person, and the arrangements for safeguarding a child‟s welfare when they are suspected to be under the influence of alcohol, drugs or other substances.

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Recommendations

 Ensure that staff supervision records show that staff have had the opportunity to reflect on their practice and the needs and progress of the children. („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraphs 13.2 & 13.3)

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Overall experiences and progress of children and young people: good

Young people are living in a friendly and supportive home environment. Since the last inspection, the registered manager and staff have been able to provide young people with a calm environment with consistent boundaries and daily routines that are meeting young people‟s assessed needs. Placement plans are now up to date and contain detailed information about the young people. Staff have a fuller understanding of young people‟s needs and are providing them with individualised support that is making a positive difference to young people‟s lives.

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Overall experiences and progress of children and young people: good

There are currently two young people living in the home and both are making progress in taking part in education and meaningful activities. They are building relationships with staff and important people in their lives and are managing their feelings safely. The risks to young people from sexual exploitation, going missing and involvement in criminal activity have significantly reduced. Staff are working closely with the youth offending service to help a young person to stay away from criminal activity and to understand the risks and dangers of using cannabis.

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Overall experiences and progress of children and young people: good

Young people are happy living here and have a strong sense of belonging. The staff‟s ability to engage young people has helped young people to build trusting relationships and positive attachments with them. A social worker said that, „(Name of young person) is doing amazingly well. This is the longest placement she has had and the most settled – this is down to the staff. She couldn‟t make connections with her foster carers, but has made strong connections with the staff and some of her tutors at school. She feels it is very much her home; she says she wants to stay Inspection report children‟s home: SC356929 6 there as “it is where I‟m comfortable”.‟

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Overall experiences and progress of children and young people: good

The registered manager and staff know the young people well and tailor their support to meet their needs as individuals, regardless of the challenges involved. A social worker said that the young person, „Tests staff and can be stubborn at times, but their person-centred approach helps to make breakthroughs. For example, getting her involved in writing her own care plan by saying to her “you‟re not happy with us doing it this way – you tell us how best to help you”.‟ Staff encourage young people to influence the arrangements for their care on a daily basis and to take part in the decisions affecting their lives, including helping young people to have an active voice in their review meetings.

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Overall experiences and progress of children and young people: good

Both young people live a long way from their families. However, the registered manager and staff sensitively manage complex arrangements for young people seeing their parents, brothers and sisters. They ensure that young people can see those people who are important to them and that it is a safe and positive experience. Staff provide transport, accompany young people and enable young people‟s families to visit the home. Their hard work is helping young people to maintain important links with their families and improve their relationships. A social worker said that their young person, „Is unable to visit the city where his family live, so his family visit him instead, once a month. Staff always make his mum feel welcome, and suggest activities and cultural events going on in the city for them to enjoy together.‟

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Overall experiences and progress of children and young people: good

Education is a challenging area for both young people, but they are making pleasing progress in their attendance and attainment. They have clear education plans and are attending schools that meet their learning needs and interests. Creative morning routines and incentives support young people to be up and ready to go to school. The arrangements for their education are encouraging and developing their talents for music and poetry. One of the young people is studying performing and urban arts and is recognising the importance of education and qualifications in helping to achieve his ambitions in the music industry. Staff actively promote young people‟s aspirations and celebrate their talents and achievements. They work effectively with young people, teachers, school nurses and psychologists to overcome any barriers to taking part and doing well in education. A teacher said that the registered manager

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Overall experiences and progress of children and young people: good

and staff „keep us informed regularly and are very supportive of education, ensuring that the young people have the best possible care and support, which improves their life chances‟.

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Overall experiences and progress of children and young people: good

Young people‟s health and emotional well-being are improving. Staff fully understand each young person‟s specific health needs and ensure that they receive support, treatment and guidance to be healthy and lead healthier lifestyles. Staff‟s advice is helping young people to understand their bodies and how to keep themselves fit and healthy. Staff help young people to understand the risks associated with drugs, substance misuse sexual activity and inappropriate relationships. Staff monitor young people‟s physical health and emotional well-being and they make sure that young people get the treatment they need when they are unwell. Inspection report children‟s home: SC356929 7 Staff understand young people‟s emotional needs. They provide young people with opportunities to build their confidence and self-esteem through activities they enjoy with other young people. Staff provide young people with a consistent and reliable

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Overall experiences and progress of children and young people: good

environment that helps them feel emotionally secure and loved. Over time, young people are developing positive strategies to help them understand their feelings and to manage them constructively. Young people feel able to talk to staff about their worries and use their creativity with music and poetry to make sense of their lives. Staff are aware of areas where young people need additional support and help. They are developing plans for key staff to work with young people to help them understand their previous experiences and trauma, supported by a clinical psychologist.

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Overall experiences and progress of children and young people: good

The registered manager has resolved the shortfalls found at the last inspection in the administration of medication. The medication records are thoroughly completed and checked routinely to ensure that young people receive the treatment they need. The disposal of medication is recorded clearly, including the reasons why medication may no longer be required and the safe disposal of medication at the local pharmacist. The registered manager is also reviewing each member of staff‟s understanding of the medication policy and procedures, as well as testing staff‟s competence to administer medication safely. At the time of the inspection, no controlled drugs were prescribed for either of the young people living in the home, so the inspectors were unable to evaluate the arrangements for managing this type of medication.

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

Young people are now living in a safer environment. At the time of the last inspection, the registered manager and staff were struggling to respond effectively to a young person‟s complex needs and to manage his aggressive behaviour. The level of aggression resulted in significant damage to the house and disruption to the lives of all the young people living in the home. After this young person moved out at the beginning of September 2017, things in the home have been calmer. A young person said that, „It was a terrible time that affected everyone. The staff spent most of their time dealing with him. It is nice now to have the staff spending time with meand the other young person again.‟ She also said that she now „feels safe and happy living in the home and it has got better since I first moved in‟.

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

The young people are receiving a good standard of care that is protecting them from harm. The registered manager and staff understand their responsibilities in protecting young people from harm. Since the last inspection, the registered manager has identified and taken effective action when there have been serious concerns about young people being at risk of exploitation. He followed the safeguarding procedures and regulations by contacting the young person‟s placing authority, the police and Ofsted with his concerns. The registered manager and staff worked effectively with these partners to understand and manage the risks. A police officer said that the registered manager and staff, „Showed good insight into safeguarding issues. They reported a concern through immediately about a young person associating with an adult. They reported their concerns quickly, shared Inspection report children‟s home: SC356929 8

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

information appropriately, we held a multi-agency meeting within a week and devised and followed a suitable safeguarding plan.‟ Likewise, the registered manager and staff work well with other partner agencies. This has helped to reduce the number of times young people have gone missing from the home.

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

The registered manager and staff show a good understanding of the risks to the young people‟s safety, including risks associated with self-harm, exploitation, crime, seeing friends, taking part in activities, using alcohol, drugs, the internet and social media. Staff identify and understand risk and use suitable and proportionate protective measures to handle situations safely. Behaviour and risk management plans are regularly reviewed and identify the changing needs of each young person. Plans are routinely updated following significant incidents and concerns about the young people‟s welfare. However, the plans do not include the arrangements for supporting young people when they return home after being missing, including offering them interviews with an independent person and the arrangements for safeguarding their welfare when they are suspected to be under the influence of alcohol, drugs or other substances.

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

Staff carefully balance young people‟s protection with providing them with an appropriate level of freedom, supervision and choice about how they spend their free time. The registered manager has checked out the legal situation for young people under 16 years of age performing music in a club and has taken reasonable precautions to ensure that the young person can take part safely in an activity he loves. Likewise, staff are actively supporting another young person to develop the social skills to build appropriate friendships with other young people, including advice about how to talk to other young people and get to know if they have things in common. Staff also help the young person understand what makes a healthy and nurturing relationship. Staff have encouraged the young person to have friends come to spend time with her at the home. This is helping the young person to build her confidence socially in a safe environment, while allowing staff to observe the nature

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

of the relationship and be on hand if the young person needs their advice.

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

Since the last inspection, the quality of the records when staff have used restraint has improved. The registered manager is actively reviewing and evaluating behaviour management strategies and the appropriateness of the use of restraint. The restraint records now provide a clear and detailed account of what happened in each incident and are recorded sequentially within 24 hours of the incident. They also now include a detailed record of any injury the young person may have sustained and the action taken to check on a young person‟s welfare and, if needed, to secure medical assistance. The records observed clearly showed that the young person who has recently moved on had not sustained any injuries that needed medical support after being restrained in the period between the last inspection and this. The young person‟s views and comments about their experience of restraint were clearly recorded. Staff asked the young person straightforward questions that took into

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

account the young person‟s age and level of understanding. These included asking: „what made you angry and upset?‟, „are you hurt in any way?‟, „have we done anything that upset you when we had to hold you?‟, „do you want me to speak to Inspection report children‟s home: SC356929 9 anyone about this?‟ and „how can we help you when you are feeling upset and angry?‟ Staff recorded the young person‟s verbal and non-verbal responses. The registered manager had also asked the manager of the young person‟s new home to complete the questions with him following a restraint on the day he left the home and included the outcome of this in the restraint record. The view of the young person about what happened is important information in developing effective behaviour management strategies that help the young person manage their feelings and control their behaviour safely.

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

The damage to the house caused by the young person who has since moved on has now been repaired. The house is now providing young people with a comfortable, tidy and pleasant environment. Young people have enough personal space to meet their needs and they are able to use the living room and activity room freely. The registered manager has planned further decoration and refurbishment to improve the quality of the accommodation, including two of the bedrooms. This work needs to be completed as soon as possible, and young people should have receptacles in the bathroom for their toothbrushes and personal toiletries and be able to choose pictures and ornaments to decorate the home.

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The effectiveness of leaders and managers: good

The registered manager is suitably qualified and experienced and has been in charge of the home since December 2016. He has taken decisive action to resolve the weaknesses identified at the last inspection in relation to young people‟s health and well-being, safety, behaviour management practice and records, standard of accommodation, the supervision of staff, staff rosters, and informing Ofsted and other relevant people of serious events involving young people. Consequently, young people are now living in a safe, supportive and comfortable home.

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The effectiveness of leaders and managers: good

The registered manager acknowledges and understands the weaknesses identified at the last inspection. He has recognised that he did not have all the available information about a young person before making the decision to accept the young person in an emergency. As a result, he did not have a full understanding of the complexity of the young person‟s needs in order to assess the staff‟s ability to meet the young person‟s needs and to keep him and others safe. The registered manager now only intends to accept young people in a planned way and not in an emergency. If this is the case, the home‟s statement of purpose will need to be revised to show the new arrangements for the admission of young people to the home.

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The effectiveness of leaders and managers: good

Furthermore, the statement of purpose does not show the details of the experiences and qualifications of every member of staff working at the home or the arrangements for supporting young people when they return home after being missing, including offering young people interviews with an independent person. Also, the young people‟s guide will need to be updated to reflect these changes and to be available to all young people in ways that make sure they can understand it, taking into account their age and level of understanding. Inspection report children‟s home: SC356929 10 The registered manager is now routinely monitoring the quality of care provided at the home. He has thoroughly evaluated each incident of restraint to ensure that an accurate record is kept. He has also ensured that staff check the young person‟s welfare after the incident and that the young person has the opportunity to talk about what happened. The registered manager‟s monitoring is providing him with the

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The effectiveness of leaders and managers: good

opportunity to identify any weaknesses and take action to improve the experiences, care and safety of young people. This is supported by improved external scrutiny of the running of the home. For example, the independent monitoring report for August 2017, carried out on 1 September 2017, provides a detailed assessment of the times when staff have restrained a young person and the quality of the restraint records. The registered manager has completed all of the recommendations made in this report.

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The effectiveness of leaders and managers: good

The registered manager shares information with Ofsted, social workers, the police and other relevant people about significant events involving young people. This shows that the registered manager is following the procedures and statutory guidance to protect young people from harm. In addition, this means that Ofsted is able to carry out its monitoring function to ensure that all the appropriate action is taken to safeguard young people.

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The effectiveness of leaders and managers: good

Staff clearly understand the ethos of the home and ways of working, their roles and responsibilities, and the systems for the protection of young people and administration of the home. Young people are currently being looked after by enough suitably experienced, qualified and competent staff to meet their assessed needs. The staff rosters accurately show the staff working on duty. Any changes to the rosters are clearly recorded to make sure that they are up to date. Staff are working suitable hours with the appropriate time off between shifts. The staffing arrangements mean that young people are being looked after by people they know and who provide them with good continuity of care.

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The effectiveness of leaders and managers: good

The registered manager ensures that recruitment, supervision and performance management of staff protect young people and minimise potential risks to them. New members of staff go through a sound recruitment and selection process that reduces the risk of unsuitable people working at the home. The registered manager makes sure that staff have the right personal qualities, experience, skills and values to work with vulnerable young people. He collects all the available information to make the right decisions about a person‟s suitability. This includes verifying by telephone information about a person‟s practice, experiences and 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 has used well-attended staff meetings productively to enable staff to reflect on the difficulties the home has faced recently and to focus on what they need to do to improve things. During these meetings, staff have had training in recording and report writing and the impact of this can be seen in the improvements made in recording of restraints and young people‟s case records. In addition, staff are now receiving regular opportunities through practice-related supervision to discuss young people‟s progress, the expectations for good childcare practice and Inspection report children‟s home: SC356929 11 their own performance. When staff have needed additional support and guidance, the registered manager formally supervises them more often. However, staff supervision records do not always show the member of staff‟s individual reflections on their work with young people. This means that they do not have an accurate

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The effectiveness of leaders and managers: good

record of their discussion with their manager.

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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: SC356929 12

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Children’s home details

Registered provider: Quality Protects Children Limited

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Children’s home details

Registered provider address: Quality Protects Children Ltd, Hill House, Archway Road, Huyton, Liverpool L36 9XB

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Inspectors

Nick Veysey, social care inspector Lisa Mulcahy, social care inspector Inspection report children‟s home: SC356929 13 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children‟s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children‟s services, and inspects services for children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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