Children's home run by Underley Schools Limited in Bolton

Inspection report children’s home: SC038276 1 SC038276 Registered provider: Underley Schools Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

 The home may only provide care and accommodation for up to 48 children.  The home may provide care and accommodation for children who may have emotional and/or behavioural difficulties and/or learning disabilities.  The home must reduce the number of children by the number of people aged 18 and over for whom it also provides care and accommodation.  The service is also registered with the Care Quality Commission for young adults, post 19 years old, accommodated on-site.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers requires improvement to be good

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inadequate

There are serious failures that mean children and young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: outstanding

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Enforcement action since last inspection:

A monitoring visit took place on 18 August 2017 due to concerns raised with the regulator relating to insufficient staff numbers and staff working hours, which may affect Inspection report children’s home: SC038276 2 the quality of care and safety of young people in the home. Concerns were also raised about managers putting undue pressure on staff to work long shifts followed by waking night duties. The conclusion of this monitoring visit was that no evidence was available which would suggest that young people’s safety or welfare was compromised by the numbers of staff, or the hours that staff work.

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Key findings from this inspection

This children’s home is inadequate because:

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Key findings from this inspection

 Some children are not always protected and kept safe in line with their plans. There has been an incident where a child was inadequately supervised, which poses a risk to their safety.  One child’s risk assessment document was not adhered to, leaving the child at risk of harm, for example, a child safety harness has not been used for a child whose risk assessment clearly identifies the need for such a harness.  A failure to follow good safeguarding practice means a child was placed at risk of harm. For example, on one occasion a young person who alleged that he had been assaulted by staff was not taken for a medical examination until staff were told to do so by an external agency.  A medication error has occurred which potentially placed a child at risk of harm.  Records of physical interventions are not always clear. Some do not provide an accurate description of events, poor handwriting makes them difficult to understand

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Key findings from this inspection

and on one occasion, there was no record of a physical intervention that had taken place.  One case record did not provide an accurate reflection of an incident. One record contained false information that a child had been bathed and put to bed, when this was not the case.  Complaint records are not completed for children who allege that they have been hurt by staff.  There has been a failure to notify Ofsted of two serious incidents which have occurred, which hinders the regulators ability to monitor and risk assess the setting.  Although there are systems in place to gather children’s views and feelings, there is no system in place for children’s views, wishes and feelings to be collated to inform internal monitoring and development of the home.  Some staff who have worked in the home for over two years have not yet completed the diploma level 3 in residential childcare, although staff are enrolled on the course.

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Key findings from this inspection

 There is no formal system in place for analysing patterns and trends in physical interventions to plan for reduction or identify triggers.  On one occasion staff contacted police unnecessarily for assistance in managing a child’s behaviour. Inspection report children’s home: SC038276 3 The children’s home’s strengths:

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Key findings from this inspection

 Children at the home are making good progress, particularly in developing life and social skills.  The home produces detailed plans and assessments for children, which are individualised and identify strategies to support the young person.  Positive relationships exist between children and staff.  There is an on-site multi-disciplinary health team to ensure that children’s physical and emotional health needs are met.  Children are supported to participate in a wide range of activities and to develop their own interests irrespective of any disability that they may have.  Children who cannot communicate verbally are supported to express themselves.  The home has very strong links with its on-site education provision and school attendance is high.  Staff are positive about working in the home. They feel well supported and report that the managers are approachable and visible.  Managers responded to shortfalls identified and took appropriate action.

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Inspection date Inspection type Inspection judgement

21/03/2017 Full Outstanding 10/11/2016 Interim Sustained effectiveness 11/02/2016 Interim Improved effectiveness 13/10/2015 Full Good Inspection report children’s home: SC038276 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 protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph 1 requires the registered person to ensure that staff— assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; and that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. Regulation 12 (2)(a)(i)(v) and (2)(b) 24/11/2017

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Requirement Due date

The registered person must ensure that medicine, which is prescribed for a child is administered as prescribed to the child for whom it is prescribed. Regulation 23 (2)(b) 24/11/2017

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Requirement Due date

The registered person may only employ an individual if the individual who works in the home in a care role has, by the relevant date, attained the Level 3 Diploma for Residential Childcare. Regulation 32 (4)(a), (5)(a) and (b) 24/11/2017

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Requirement Due date

The registered person must ensure that— within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— (i) the name of the child; (ii) details of the child’s behaviour leading to the use of the measure; 24/11/2017 Inspection report children’s home: SC038276 5 (iii) the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the need to use the measure; (vi) the name of the person who used the measure ("the user"), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure. Regulation 35 (3)(i)–(viii) The registered person must maintain records (‘case records’) for

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Requirement Due date

each child which are kept up to date; and are signed and dated by the author of each entry. Regulation 36 (1)(b) and (c) Specifically, recordings must be factually accurate and be a true representation of a child’s day-to-day life. 24/11/2017

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response and the outcome of any investigation. Regulation 39 (3) 24/11/2017

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Requirement Due date

The registered person must notify HMCI without delay if an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; or there is any other incident relating to a child which the registered person considers to be serious. Regulation 40 (4)(b) and (e) 24/11/2017

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it. Regulation 45 (2)(b) 24/11/2017

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Requirement Due date

* These requirements are subject to a compliance notice. Inspection report children’s home: SC038276 6

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Recommendations

 The registered person should agree with their local police force, procedures and guidance on police involvement with the home to reduce unnecessary police involvement in managing behaviour and criminalisation of behaviours. (‘Guide to the children’s homes regulations including the quality standards’, page 47, paragraph 9.40)  Records of restraint must be kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

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Overall experiences and progress of children and young people: inadequate

Children in the home make progress from their starting points. Some significant issues were identified during the inspection that had an impact on the children’s safety, resulting in a judgement of inadequate in how well children are helped and protected.

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Overall experiences and progress of children and young people: inadequate

Children have positive relationships with the staff who care for them. Observation of interactions between staff and children demonstrated emotional warmth, trust and fun. Many children have limited communication and staff show skills in understanding the children and helping them to express themselves. Social workers and parents spoken to as part of this inspection commented that staff had developed positive relationships with children.

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Overall experiences and progress of children and young people: inadequate

Children have plans and assessments, which are written in the first person and are illustrated to help children understand their content. There are strategies documented within the plans to identify how staff will support children. However, on two occasions staff have failed to follow the child’s plan, which has placed them at risk of harm. Monthly summary reports provide an overview of the outcomes that young people have achieved over the month linked to their progress trackers, and give a general synopsis of the month, progression and activities.

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Overall experiences and progress of children and young people: inadequate

There is a multi-disciplinary team on-site, which helps to ensure that children’s needs are identified. Many children have specific and complex health needs and a wide range of health professional’s work together with care and education staff to provide the children with a coordinated approach. Children’s health needs are identified within their plans, which also state how the child should be supported to meet their health needs. While there are robust systems in place to ensure that medication is administered safely, on one occasion a staff member re-administered a child’s evening medication. This had the potential for serious side effects and placed the child at potential risk of significant harm. Inspection report children’s home: SC038276 7 Children access a wide range of activities and are encouraged to develop their own interests. They are helped to express their preferences and choose activities that they

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Overall experiences and progress of children and young people: inadequate

enjoy. One child who is highly anxious outside of the home environment has started to go out of the home and participate in activities. Another child is supported to volunteer at a local nature reserve through which she has developed her interest and knowledge of birds.

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Overall experiences and progress of children and young people: inadequate

Most children are educated at the on-site school where their attendance is good and they are making educational progress. Education and care staff work together to provide young people with a joined-up approach. For example, one child was struggling to understand another child’s cultural differences, so the school provided additional support through PSHE (personal, social and health education) lessons to educate the child in this area and to address the inappropriate comments that she had made.

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Overall experiences and progress of children and young people: inadequate

Although this is a very large home, children live in groups in bungalows, which feel homely and are all individually decorated and furnished according to the child’s needs and preferences. Children’s bedrooms are personalised and staff involve them in choosing how their room is decorated and furnished.

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Overall experiences and progress of children and young people: inadequate

Children use a range of communication methods to express themselves. Staff are trained in different types of communication and support children with PECS (picture exchange communication system) and Makaton. Children participate in key-worker sessions where they are asked about their care, their likes and dislikes, their meals and activities. They also take part in children’s meetings. Children are provided with information about how to make a complaint. However, when children have complained that they have been hurt during physical interventions by staff, this is not recorded as a complaint but solely as an allegation. Complaints should be recorded with signposting to the allegation record as a means to ensure that a clear record is made that the child has complained and what the home’s response to this has been.

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Overall experiences and progress of children and young people: inadequate

Children being admitted to the home or moving on from the home are prepared for the move wherever possible. However, the child’s understanding and the timescale for the transition can limit this. Children are supported to become increasingly independent and have targets set to develop independence skills to prepare them for adult life. Staff understand the impact of change on children and prepare them as much as possible to manage the change.

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Overall experiences and progress of children and young people: inadequate

Most children have contact with their family. Staff support contact visits and transport children to and from contact on a regular basis. Families are also welcomed to the home to visit their children. Staff understand the importance of contact for children and reassure them about when they will next see their family.

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

A small number of children have not been helped and protected as they should have been at this home. Since the previous full inspection at the home in March 2017, there Inspection report children’s home: SC038276 8 have been some serious safeguarding incidents. This shows a significant deterioration in that way children are safeguarded. Staff do not always follow children’s plans and deliver care in line with those plans. An example of this is when staff forgot and left a child unsupervised in the bath for an extended period. Although there was no observable negative impact on the child, the outcome of this could have been serious. The child’s plan identified that he should be supervised by staff while in the bath. However, staff had failed to follow the plan. Another example is a child not being transported in the correct vehicle safety harness, which resulted in an incident where she placed at serious

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

risk of harm. This child’s plan clearly identified the necessity of the harness when she was in a vehicle.

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

Staff do not always follow good safeguarding practice. For example, when a child alleged that a member of staff had assaulted him, he was not taken for an independent medical examination until the home was advised to do so by the local area designated officer. A further example of staff not following safeguarding procedures is that staff involved in the incident, where a child was left unsupervised in the bath, neither recorded nor reported the incident to any manager for more than two days. This fails to demonstrate that staff are fully aware of their roles and responsibilities and indicates that they did not understand the severity of the incident and the risk to the child.

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

Where managers have identified serious safeguarding issues, they have they taken immediate action to address the risks, and responded positively by putting in place detailed plans to try to ensure that high-risk incidents do not recur.

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

The home uses physical means of restraint for some children. Numbers and levels of physical intervention are very high for some individual children. Although there is evidence to show that staff repeatedly try to withdraw from the hold, two restraints did occur intermittently for several hours, including restraints in the front ground recovery team teach position. Staff and managers work hard to reduce the level and frequency of restraint, although there is no formal system in place to monitor and evaluate for patterns and trends, which could help to reduce the frequency or level by identifying triggers or strategies that work.

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

Some issues were identified in respect of the recording of physical interventions. One intervention was not recorded at all. Others are unclear and some handwriting in the records is very difficult to decipher. One record omitted significant details of the restraint which it was important to record because the child subsequently made a complaint that she had been assaulted.

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

On some occasions management of allegations is not good at the home. This is due in part to staff and managers not always knowing the protocol for managing allegations, and in part to staff not reporting and recording in a timely manner when allegations have occurred.

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

Children rarely go missing from this home. There are clear protocols in place should a child go missing which staff follow. This is a very large home and there is clear identification of those children who would be at immediate risk should they go missing Inspection report children’s home: SC038276 9 necessitating immediate police involvement.

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

Children have risk assessments that identify their individual risks, with strategies to manage and reduce the risks. Risks are graded red, amber or green to alert staff to the severity of the risk. Positive behaviour support plans are also detailed and helpful to staff by identifying what a child’s behaviour will look like and how to support them, including the use of de-escalation or distraction techniques.

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

Managers undertake investigations when incidents occur in order to identify why a child has been at risk and to learn from these incidents.

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

On one occasion, staff contacted the police for support to manage a child’s behaviour without exhausting strategies to manage her behaviour in the first instance. The child had previously been told that the police would be called if her behaviour did not change. This is not an appropriate use of the police and is a reactive and unnecessary way to manage a child’s behaviour, which potentially criminalises them.

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

The home’s manager was registered with Ofsted in March 2017. He is relatively new into post and has not yet attained his level 5 diploma in leadership and management for residential childcare. At the time of this inspection he had identified and acted upon most of the issues raised at this inspection in respect of safeguarding children and record keeping. The manager is aware of the home’s strengths and weaknesses and is transparent, open and committed to making improvements. He has high aspirations for children and demonstrates commitment to helping them achieve their potential. He also has high expectations of staff.

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

The manager recognises that many of the staff team members are relatively inexperienced and unqualified, and the difficulties this causes in ensuring that each bungalow has an appropriate mix of new and experienced staff. Although the requirement made at the previous inspection in relation to staff qualifications is not yet met, the home has made progress in this area and is working towards getting all staff qualified. Several new staff members have been recruited since the last full inspection, although there is still regular reliance on bank and agency staff to ensure that the correct staffing levels for each child are achieved. Managers ensure as much as possible that bank and agency staff are consistent so the children are not cared for by people who are unfamiliar to them.

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

Staff spoken to at this inspection were very positive about the management team, feeling that they were well supported through good quality, regular supervision and training. The manager has worked hard to ensure that staff feel valued, which he hopes will improve staff retention. Annual appraisals are in the process of being undertaken for all staff, which meets a recommendation made at the previous inspection.

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

Some records in the home were unclear, one was factually incorrect and one omitted significant detail. Other records, such as individual children’s placement plans and risk Inspection report children’s home: SC038276 10 assessments, are of a good quality, however staff do not always follow what is recorded in the plan.

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

Two serious safeguarding incidents have not been notified, which hinders the regulator’s ability to monitor and risk assess the home effectively.

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

There are monthly monitoring processes in place as well as systems for each bungalow’s senior member of staff to monitor and audit their bungalow. There are systems in place to gather children’s views and feelings although there is no formal system to collate these and use them to inform the home’s development.

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

Managers and staff work well alongside partner agencies. There is a multi-disciplinary team on-site comprised of care staff, health professionals (including learning disability nurses, occupational therapists, speech and language therapists and a psychologist) and education staff. Care planning is joined-up and effective from a multi-disciplinary perspective. The home also works well with external stakeholders such as social workers and general practitioners to ensure that children’s broad range of needs are met.

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

Managers are strong advocates for children and challenge placing authorities when they do not put suitable plans in place to meet children’s needs. For example, when one child was due to move on from the home, the manager challenged his placing authority due to them not identifying a suitable provision for him to move to. The manager put plans in place to move the child to a local adult provision run by the same company, which has been a success.

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

Managers are alert to issues of equality and diversity. The children at the home come from a range of cultural backgrounds and have various disabilities. Children are supported to be tolerant of each other. Staff help them to access their culture and religion as identified in their plans. Where children express different views about their culture to their parents, managers try to work sensitively with the child’s social worker to ensure that their views about culture and religion are heard. Children complete work in school about diversity and equality to help educate them and to increase their understanding of difference. Inspection report children’s home: SC038276 11

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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: SC038276 12

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Underley Schools Limited

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Children’s home details

Registered provider address: 1 Merchants Place, River Street, Bolton BL2 1BX

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Children’s home details

Registered manager: Christopher Kirkbride

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Inspector(s)

Charlie Bamber: social care inspector Gillian Walters: social care inspector Inspection report children’s home: SC038276 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 looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

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