Children's home run by Pebbles Care Limited in Hyndburn

Inspection report children’s home: SC456271 1 SC456271 Registered provider: Nurture Childcare Services Ltd

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a private children’s home. It is registered to provide care and accommodation for up to four young people at any given time who are experiencing 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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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 5 September 2017

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requires improvement to be good

Overall judgement at last inspection: inadequate

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Key findings from this inspection

This children’s home requires improvement to be good because:

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Key findings from this inspection

 This home is still not fully functioning in line with its four main aims, as detailed Inspection report children’s home: SC456271 2 in its statement of purpose.

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Key findings from this inspection

 Young people still do not receive all the health checks and specialist support required to meet their assessed physical and mental health needs.

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Key findings from this inspection

 Sanction records do not consistently demonstrate fair and proportionate practice.

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Key findings from this inspection

 Medication records do not demonstrate safe and effective practice.

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Key findings from this inspection

 The home’s risk assessment has not been reviewed, as recommended by the fire service in February 2017.

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Key findings from this inspection

 The home has not responded in writing to concerns raised by young people.

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Key findings from this inspection

 The last six-monthly internal review process on the quality of care provided by the home did not ascertain and consider the views of young people, their parents, stakeholders and staff.

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Key findings from this inspection

 Documentation about the needs of young people is not up to date. Therefore, this does not ensure that staff at the home have the necessary knowledge to meet young people’s assessed needs.

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Key findings from this inspection

 The home’s lone-working risk assessment has not been agreed and finalised with the placing authority.

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Key findings from this inspection

 New and inexperienced staff are not receiving more frequent supervision despite lone working.

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Key findings from this inspection

 The one young person living at this home is happy and settled, and feels safe and secure in the knowledge that she can remain until she feels ready to move into independence.

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Key findings from this inspection

 This home ensures that young people enjoy regular constructive contact with family and friends, in line with any legal directions and personal preferences.

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Key findings from this inspection

 Young people’s individual interests and talents are actively encouraged and supported, which increases competencies and boosts self-esteem.

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Key findings from this inspection

 The staff at this home have the ability to quickly and effectively de-escalate some extremely challenging behaviours without resorting to physical intervention.

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Key findings from this inspection

 Young people are enabled to take age-appropriate risks as a natural development into adulthood. Inspection report children’s home: SC456271 3  The new manager of this home is suitably qualified and experienced, and has a proven history of successfully improving failing services.

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Key findings from this inspection

 The home’s décor and furnishings are maintained to a good standard throughout, and the young person loves her bedroom.

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Key findings from this inspection

 External monthly monitoring of the home is particularly good. The comprehensive and evaluative reports of these visits demonstrate a robust process informed and enriched by the views of young people, their parents and other relevant stakeholders.

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Inspection date Inspection type Inspection judgement

05/09/2017 Full Inadequate 02/03/2017 Interim Declined in effectiveness 24/08/2016 Full Good 02/02/2016 Interim Improved effectiveness Inspection report children’s home: SC456271 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The registered person must ensure that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services, as the child requires. (Regulation 10(c)) 31/12/2017

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

The registered person must lead and manage the home in a way that helps children aspire to their full potential, promotes their welfare and delivers the outcomes set out in the home’s statement of purpose. In particular: ensuring a safe environment; access to full-time education; good quality healthcare; and preparation for independence. (Regulation 13(1)(a)(b) and (2)(a)) 31/12/2017

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Requirement Due date

35: Behaviour management policies and records

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control a record is made which includes all the particulars detailed in the regulations. (Regulation 35(3)(a)) 30/11/2017

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Requirement Due date

The registered person must ensure robust arrangements are in place for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23(1)) 30/11/2017

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Requirement Due date

The registered person must take adequate precautions against the risk of fire and in particular; review the home’s fire risk assessment. (Regulation 25(1)(a)) 30/11/2017

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Requirement Due date

7: The children’s views, wishes and feelings standard

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Requirement Due date

The registered person must demonstrate how the child’s views, 30/11/2017 Inspection report children’s home: SC456271 5 wishes and feelings have been taken into account and give the child reasons for decisions made in relation to the child. This is in particular regard to; responding in writing to comments made by the young person in sanction records; and, providing written feedback to young people’s complaints. (Regulation 7(2)(iii)) 45: Review of quality of care

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Requirement Due date

The registered person must complete a review of the quality of care provided for children at least every six months and this process must ascertain and consider the opinions of children, their parents, placing authorities and staff. (Regulation 45(1)(5)) 31/03/2018

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Requirement Due date

The registered person must maintain all required information and documents in relation to each child as listed in Schedule 3 of the regulations. In particular; an up-to-date care plan, pathway plan, personal education plan and minutes of the young person’s statutory review and education meeting. (Regulation 36(1)(a), Schedule 3) 31/12/2017

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Recommendations

 If there is only one member of staff on duty at any time the manager should make a formal assessment of the implications for children’s care including any likely risks. This assessment should be recorded and available for inspection by Ofsted and placing authorities. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.18)

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Recommendations

 The registered person is responsible for maintaining good employment practice. They must ensure that supervision and performance management of staff safeguards children and minimises potential risks to them. (’Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1)

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improvement to be good

The one young person currently living at this home is happy and settled, and enjoys frequent and positive family contact. She is particularly pleased that staff recently Inspection report children’s home: SC456271 6 successfully advocated for her to have regular overnight stays with her mum. An independent reviewing officer highlighted the fact that, ‘The staff travel numerous times a week to support family contact and are actively supporting her to better understand her identity.’

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improvement to be good

The young person said, ‘Everything is going well here at the moment. I am happy here and the staff are supportive. I like the way my bedroom is decorated and the rest of the house because I picked all the colours. It’s much more homely. I have surprised myself about school. I like going and I get on with everyone. My family contact is going amazingly. I love it so I asked at my review to have more overnights. We had a Thriller party last night and everyone dressed up. I was Michael Jackson and did his famous moonwalk. I was made up that staff who used to work here came to surprise me. It was a sick night and I’ve never felt so happy for ages.’

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improvement to be good

Her mum said, ‘I am really happy with everything at the moment. Contact is going well and staff always call my daughter to check she is okay. I can approach any of the staff, I feel listened to and I am kept updated on her progress. She is doing really well at school. The décor is outstanding.’

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improvement to be good

Since moving to this home the young person has benefited from healthier meals, a signification reduction in cannabis and alcohol misuse and more physical exercise. This has resulted in appropriate weight loss, which has demonstrably boosted her self- esteem. Consequently, incidents of self-injurious behaviour have also reduced in frequency and severity. However, there is still no specialist support in place to meet her mental health needs.

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improvement to be good

She also continues to smoke and frequently refuses breakfast, which is recognised to be the most important meal of the day. These habits may have a negative impact on her long-term health. Her key worker said, ‘There has been no evidence of alcohol or cannabis misuse since the last inspection. She has cut down her cigarette intake and has not once pushed the boundary of having her last cigarette at 10.30pm.’

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improvement to be good

This school term the young person has maintained 95% school attendance of the hours allocated, and her punctuality has improved. At the recent parents evening she was rightly proud to receive very positive feedback. In particular, her teacher highlighted her ‘caring nature’ and said, ‘She is the best behaved pupil in the class and when she applies herself can produce some fabulous pieces of work.’

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improvement to be good

Communication with the school has improved since the last inspection, with the introduction of a weekly report from her class teacher. An extract from her latest school progress report reads, ‘You have settled well this year and made positive changes with your attitude and engagement. Your excellent attendance and attending two off site trips is a massive personal achievement for you. You are a lovely caring individual who likes to help peers when you can.’

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improvement to be good

However, she is still not receiving the minimum 25 hours per week to which she is legally entitled. Moreover, a recent incident in school resulted in the whole class being Inspection report children’s home: SC456271 7 excluded, and only returning for one hour a day. This was challenged effectively by the home, and plans have been put in place to address this.

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improvement to be good

The young person’s increased confidence means that she is now positively contributing more to her day-to-day care, and her future. Examples include key-worker sessions, young people’s meetings, her statutory review and personal educational planning meeting. She also helped to produce her current behaviour management plan and education plan. She wrote, ‘Before this year I had been out of school for a while because I was bullied. Now I want to keep up my good attendance and start applying for college places.’

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improvement to be good

Individual interests and talents are actively encouraged and supported at this home, which increases young people’s competencies and confidence. Current examples include football, pool, boxing, animal welfare and drumming. The young person said, ‘I enjoyed mountain biking. It was a really steep hill but I did it. I have also started drum lessons and have my own kit so I can practise. Staff say I am really good at it.’

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improvement to be good

The young person enjoys cooking and baking. She has tried gardening, and financial incentives are in place for helping with basic daily household chores. However, she is nearly 16 and there is still limited evidence of any formal programme in place to help her prepare to live independently in line with her care plan and the stated purpose and function of this home.

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improvement to be good

The young person has lived at this home for 21 months, and feels secure in the knowledge that she can remain until she feels ready to move into independence. She is also enjoying being in a solo placement and sharing quality time with staff. She said, ‘I trust all the staff who work here now.’

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improvement to be good

This feeling of security has directly resulted in a demonstrable reduction in risk-taking behaviours. To her credit, there have been no incidents of going missing since the last inspection, thus reducing the known high risk of sexual exploitation. There has been no criminal damage in the home, and no assaults on staff. She said, ‘Things are better here now. The new manager gets things done. We are having a fresh start.’

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improvement to be good

One member of staff said, ‘The new behaviour management plan introduced in September has really helped the young person to make progress and the staff to be more consistent. No criminal damage is a vast improvement.’ Another said, ‘Six months ago she would not have been able to cope with any upset and would react by causing damage. She is now asking for advice and listening to it. In fact she is a dream to work with now. Still a typical teenager who tells me I’m pecking her head, but that’s good because it shows she is listening to me.’

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improvement to be good

The young person is noticeably engaging more in relevant key-work sessions around Inspection report children’s home: SC456271 8 keeping herself safe, appropriate relationships and building resilience. Staff say that she is showing a better understanding and is beginning to make wiser choices. Consequently, with appropriate risk management plans in place she is enabled to take age-appropriate risks as a natural development into adulthood. In particular, she is enjoying increased free time with family and friends in the community, and is now adhering to the rules to keep herself safe.

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improvement to be good

A key strength of this home is the ability to de-escalate some extremely challenging behaviours without resorting to physical intervention. There has also been a noticeable increase in rewarding good behaviour and effort, which has had the desired effect. The young person is currently on a specific incentive plan which she is fully involved in, with the aim of getting her own rabbit.

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improvement to be good

The use of sanctions has also decreased. However, the records still do not consistently include all the required details to evidence fair and proportionate practice.

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improvement to be good

The manager acknowledges that the matching process prior to her appointment was not sufficiently robust, which resulted in an inappropriate admission. As a result, there was an increase in serious incidents, including criminal behaviour, both inside and outside the home. Young people were frequently missing from home. In a four-week period in June and July, 26 calls were made to the police to help the staff manage these challenging behaviours. Staff were unable to keep young people safe and, consequently, the placement was disrupted.

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improvement to be good

In sharp contrast, since the last inspection, staff have not required any police assistance. The organisation also made the decision not to make any new admissions, which has ensured a period of stability for the young person and staff.

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improvement to be good

The manager said, ‘The staff team are more cohesive and the young person’s behaviour has improved incredibly. The placing authority feel that this was all due to the previous poor match, but I have now looked back and her behaviours were challenging when she was here on her own so progress has been made.’

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improvement to be good

Due to financial viability, staff are now lone working. A number of the team have moved to other roles within the company. However, the home’s lone-working policy has not been adhered to. In particular, a risk assessment was not in place prior to the decision to introduce lone working, to safeguard the young person and the staff. A draft risk assessment was produced during the course of this inspection. However, it has not yet been discussed with the staff or the placing authority, in line with their own policy. This is particularly significant given the associated risks for this young person.

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improvement to be good

Medication records still do not demonstrate safe and effective practice. In particular, they do not detail the reason for the administration of a particular prescription, or that the specific directions for use have been followed.

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improvement to be good

All external health and safety checks are undertaken, and certificates are in place to evidence a safe environment. However, there are no details on file to demonstrate that Inspection report children’s home: SC456271 9 the actions required in the ‘Oil firing report’, dated 17 January 2017, have been addressed.

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improvement to be good

Since the last inspection, internal fire checks are now consistently undertaken at the required frequency. However, the fire safety risk assessment has not been reviewed as recommended by the fire service in February 2017. This compromises the safety of young people, staff and visitors, especially as young people are known to have smoked in their bedrooms.

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improvement to be good

Staff files reflect that robust checks are undertaken to ensure a safe and competent workforce.

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

The new manager of this home is suitably qualified and experienced, and has a clear vision for this home. However, she has only been in post for five months and inherited a significant number of shortfalls. This resulted in an inadequate judgement at the last full inspection on 6 September 2017.

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

This manager has a demonstrable history of successfully turning failing services around. She also demonstrated the significant progress made, both at the previous inspection and during this inspection, but acknowledged, ‘There is still a long way to go.’

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

Consequently, her four main aims are still not fully being realised for the young person. These are: ‘To prov i de a safe and stab l e env i ronment w i th a strong focus on educat i on, bu il d i ng sk ill s to ensure a successfu l trans i t i on i nto i ndependence and access to good quality healthcare.’

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

One of her first priorities was to improve the physical environment, which has been completed to a good standard. This has created a homely and inviting ambience throughout. The young person loves her recently redecorated and highly personalised bedroom which she describes as ‘sick’. Moreover, her strong sense of pride in her environment means there has been no criminal damage since the renovations.

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

The manager is continuing to completely overhaul the previous ineffective systems, and is putting new recording formats in place. She has also begun quality assuring the quality of recordings. Overall, this work has started to improve practice since the last inspection, but shortfalls were still found in one self-harm incident, as well as sanction and medication records. Furthermore, there is no documentary evidence that one young person was informed in writing of the outcome of her complaint.

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

15 requirements were made at the last inspection and progress has been made on them all, but some are not addressed in full. Examples include medication records and fire safety precautions, as detailed under the help and protection section of this report. Also, there has been much improved co-operation by the young person in attending health appointments, but she still needs a dental check. Furthermore, the assessed need for specialist mental health support for the young person, alongside consultation sessions Inspection report children’s home: SC456271 10 with staff, have still not commenced.

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

The manager’s six-monthly review report on the quality of care provided in the home was overdue, but was forwarded to Ofsted as required. This proved to be a challenging task for the new manager because she was not in post during the majority of this review period, and comprehensive records were not in place for her to consider. Also, the report does not include the views of young people, their parents, placing authorities and staff, as is legally required. In response, monitoring processes have been strengthened and regular consultations are now in place to aid, inform and enrich the next report.

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

Sanction records demonstrate a lack of understanding around the recording of sanctions, such as the importance of detailing the precise location of an incident to help identify any patterns and trends. Although there is now more evidence of young people signing sanction records, one negative comment that was made by a young person was not followed through to a satisfactory conclusion.

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

A significant number of policies have been reviewed and revised in the last six weeks. These include the safeguarding policy. A new format has also been developed for the recording of allegations about action taken by staff until outcomes are reached.

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

The regularity of supervision has improved since the last inspection, so the legal requirement is now met. However, the revised supervision policy does not distinguish between the frequency of supervision for qualified and/or experienced staff, and those new to this role. This is despite staff lone working, and the importance placed on supervision in the draft risk assessment. One staff appraisal has taken place, but the record of this is not complete. A recommendation has therefore been made to ensure that the supervision and performance management of staff safeguards young people and minimises potential risks.

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

Amendments have been made to the home’s statement of purpose to accurately reflect the qualifications and relevant experiences of the current staff team of four. Two are still in their probationary period.

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

Improved measures are in place to ensure that young people have the opportunity to talk to someone independent of the home on their safe return from going missing. There is also a new room search recording format in place. As there have been no recent incidents of going missing or the need to search a young person’s room, the effectiveness of these measures cannot yet be assessed.

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

The overarching and most significant improvement in the last six weeks has been the partnership working with the placing authority. A new social worker, leaving care worker and support worker have all recently been allocated, and they confirm good communication with the home. However, the home still awaits an up-to-date care plan and pathway plan, and minutes of the young person’s last statutory review.

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

There is now good evidence of staff promoting and supporting studies when young people are excluded from school or are on reduced timetables. Staff also ensured that a Inspection report children’s home: SC456271 11 personal educational planning meeting took place and targets were set, although the home has not yet received the minutes of this meeting or the updated personal educational plan. With the support of the placing authority, the home has ensured that the young person will be offered a full timetable of education after the October half-term holiday.

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

The staff are positive about the changes made to date by the new manager and feel that their views are listened to. As a result, staff morale has improved. One staff member commented, ‘I have been here two and a half years and I have seen lots of changes. The last manager was only here for five months. This new manager is good and has got to know the staff.’ Another said, ‘This manager is very good. She listens and is very supportive.’ And a third said, ‘This company offers a comprehensive training package and there is always a manager on call to speak to for advice.’

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

Comprehensive and evaluative reports of monthly external monitoring of the home demonstrate a particularly robust process. The new manager clarified that, on commencing her post, she received a report which included 26 recommendations. In response, she drew up an action plan, which she has tirelessly worked through. Consequently, the independent report in October 2017 concludes that, ‘All previous shortfalls identified have now been addressed. The significant re-organisation of systems and files has made reviewing and auditing much easier this month. I am now satisfied with the current arrangements in place for safeguarding and promoting the young person’s welfare.’

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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: SC456271 12

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Children’s home details

Registered provider: Nurture Childcare Services Ltd

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Children’s home details

Registered provider address: 71 Edge End Lane, Great Harwood, Blackburn BB6 7QD

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Inspector

Lynn O’Driscoll, social care inspector Inspection report children’s home: SC456271 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

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Inspector

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Inspector

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