Children's home run by Lifetime Opportunities Limited in Bolton

Inspection report children’s home: SC060750 1 SC060750 Registered provider: Lifetime Opportunities 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

The home is privately owned. It is registered to provide care and accommodation for up to three children and young people who have learning disabilities.

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Information about this children’s home

Inspection dates: 22 to 23 November 2017

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected good

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outstanding

The effectiveness of leaders and managers good

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Overall judgement at last inspection: Not judged

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Enforcement action since last inspection:

None Inspection report children’s home: SC060750 2

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Key findings from this inspection

This children’s home is outstanding because:

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Key findings from this inspection

 The young person benefits from outstanding care and support, which is carefully planned to meet his individual needs and wishes.  The young person has made outstanding progress since his admission. In particular, he has experienced significant improvements in his general health and well-being.  The young person benefits from regular opportunities to engage in enjoyable activities and to socialise.  Staff have supported the young person to develop his communication skills, which enables him to express his views and wishes on a daily basis.  Young people moving in or out of the home receive carefully planned, effective support.  Staff are skilled in identifying risks to the young person’s safety and well-being. Risks are carefully managed to protect the young person from harm.  Staff receive a good level of support and training to equip them for their role.  Managers use quality assurance tools in an effective way, which helps to

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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

 A clear profile containing information about the suitability and skills of all agency staff should be maintained in the home.  All staff should receive regular one-to-one supervision to support reflective and professional practice.

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Inspection date Inspection type Inspection judgement

02/01/2017 Interim Not judged 26/07/2016 Full Outstanding 10/02/2016 Interim Sustained effectiveness 06/10/2015 Full Good Inspection report children’s home: SC060750 3

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Recommendations

 A record of supervision should be kept for staff, including the manager. The record should provide evidence that supervision is being delivered in line with regulation 33(4)(b). (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.3)  The use of external agency staff can be a positive choice to complement the skills and experiences of the permanent workforce. Evidence should be maintained in the home to demonstrate that any external agency staff meet the requirements in regulation 32(4) regarding mandatory qualifications and that the registered person has considered their skills, qualifications and any induction necessary before they commence work in the home. The use of agency staff should be carefully monitored and reviewed to ensure children receive continuity of care. (‘Guide to the children’s homes regulations including the quality standards’, page

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Overall experiences and progress of children and young people: outstanding

The young person who lives in this home has made outstanding progress due to the high standard of care he receives. In particular, the young person’s health and general well-being have greatly improved and, as a result, the day-to-day quality of his life has been enhanced. A social worker who works with the young person said, ‘He has made more progress than we could ever have envisaged. The home has been brilliant for him. He is having a lovely life now.’ On admission to the home, the young person was unable to have oral foods and received his nutrition solely through a percutaneous gastrostomy tube. Managers and staff have worked closely with community health professionals and, over time, have supported the young person to adapt to partial oral feeding. This has been highly successful and the young person is now enjoying three oral meals each day. Not only has this improved the young person’s weight and general health, but it has opened up

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Overall experiences and progress of children and young people: outstanding

new opportunities for him to try new tastes and foods on a daily basis. A staff member described how the young person is developing his own understanding of his favourite foods, and has recently started to choose foods with the use of communication aids. When he arrived at the home, the young person had, for some time, been prescribed a potent medicine, designed to assist him to sleep at night. With support from staff, the young person has developed a settled night time routine and sleep pattern. As a result, the young person no longer requires the medicine. Staff worked with healthcare professionals to ensure that the reduction, and eventual discontinuation, of the medicine was managed safely. This has been of great benefit to the young person, as the daily Inspection report children’s home: SC060750 4 side effects he experienced included headaches and drowsiness. The overall improvement in the young person’s health has supported his progress in

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Overall experiences and progress of children and young people: outstanding

many areas. The young person’s social worker described how his mobility is strengthening and advised that he is developing new communication skills. She said, ‘He is more alert and moving around much more. He is in better health than he has ever been. He is truly thriving.’ The young person is developing a range of vocal sounds and signs, which assist him to express his needs. This is a significant step forward, and staff are working closely to assist him in building on these new skills. Staff were observed engaging meaningfully with the young person, encouraging him to make choices, such as what television programme to watch. Staff understood what the young person was communicating and responded appropriately. Helping young people to express their needs and wishes supports their independence and enables them to make choices in their day-to-day lives. Staff members have developed some innovative communication tools. These include an

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Overall experiences and progress of children and young people: outstanding

easy-read, pictorial review tool, designed to help young people understand the purpose of their review and how they can contribute to it. Pictorial menus, staff rotas and activity boards have been developed to further support the young person’s ability to express his wishes. Staff support the young person’s learning by playing an active role in his education. Positive communication takes place between the home and school to ensure that the young person has effective support. In particular, discussions regarding the young person’s developing communication skills take place regularly, to ensure that he receives consistent support in this area. The young person is supported to engage in a variety of fun and fulfilling activities. He attends a youth club and local sports club, where he plays in the boccia team. He enjoys trips out on a regular basis to places of interest and local facilities. These activities

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Overall experiences and progress of children and young people: outstanding

provide him with the opportunity to develop new skills and to socialise. The support provided to young people who move in or out of the home is a strength of this service. Since the last inspection, one young person has transitioned to adult services. This transition was carefully planned and strongly supported by staff from the home. The young person’s key worker continued to support him in his new setting for several months, to help him settle and to assist his new staff team in developing an understanding of his needs. The social worker of the young person who currently lives in the home described his transition as ‘excellent’. They commented that highly effective planning and support on the part of the staff team has resulted in the young person adapting very quickly to his new surroundings.

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

The young person is supported by a small, core staff team that knows him well. The staff have a good understanding of the risks to the young person’s safety and well-being and follow agreed strategies to help ensure that he is protected from harm. There are specific risks relating to the care that the young person requires. These relate Inspection report children’s home: SC060750 5 to his complex healthcare needs. Managers and staff are skilled in identifying such risks and work closely with external professionals to ensure that clear risk management guidelines are in place. For example, a well-detailed safe swallowing plan has been developed through consultation with speech and language therapists. The clear step-by- step guidance means that staff have clear instructions about how to support the young person in a safe manner. Managers ensure that staff have the appropriate skills to meet the young person’s needs

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

safely. A specific training programme is in place, which includes a range of learning in relation to the young person’s healthcare needs. This is supported by community health professionals, who conduct regular competence assessments for all the staff who support the young person. This helps to ensure that staff have the skills to provide safe care, which promotes the young person’s safety and well-being. All staff receive safeguarding training at the start of their employment. This is updated periodically to help ensure that staff retain their knowledge and are aware of changes in procedures or good practice. There are well-established safeguarding procedures in place which help to ensure that any concerns are addressed in an appropriate manner. Staff demonstrate a clear understanding of their safeguarding responsibilities and express confidence in managers to deal with any concerns effectively. Information about subjects such as bullying, safeguarding and receiving personal care is

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

provided to young people in easy-read, pictorial formats. This accessible information helps to support young people’s learning about their personal safety and the action that they should take if they feel worried or concerned. Young people receive consistently positive support to manage their feelings and express them in a safe and appropriate way. This support, along with the skills of staff to communicate meaningfully with young people, results in young people’s complex behaviours reducing over time. This is demonstrable for the young person who currently lives in the home, as he no longer presents with some complex behaviours he presented at the point of his admission. No incidents of physical intervention have occurred in the home since the last inspection. However, there are clear reporting and monitoring procedures in place, should such an incident occur in the future. Consequences are not used for the current young person, as

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

it is agreed that these would not be effective. Staff recognise and strongly encourage positive behaviours, which the young person responds to well. The young person is provided with safe, comfortable accommodation, which is designed to meet his individual needs. A variety of equipment is in place to help ensure that the young person can be safely supported. For example, ceiling tracking enables the staff to assist the young person in transferring in a safe and effective way. Staff work closely with professionals such as occupational therapists to ensure that all the young person’s equipment is suitable for his needs and safely maintained.

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The effectiveness of leaders and managers: good

At the time of the inspection, the home’s manager was commencing the process of registration with Ofsted. The proposed registered manager has responsibility for another Inspection report children’s home: SC060750 6 service within the organisation. Suitable arrangements have been agreed, including the appointment of a full-time assistant manager, to ensure ongoing, effective oversight and leadership. The manager confirmed that she is provided with adequate resources to run the home effectively. It was noted that only one young person has lived at the home for several months. The provider was clear that this would remain the case until the young person was well settled and until additional staff were recruited to support a second young person. This demonstrates that the home is managed in young people’s best interests. Highly effective care planning and partnership working with a range of external professionals means that the young person receives care which is centred on his needs

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The effectiveness of leaders and managers: good

and wishes. Changes to the young person’s needs are identified and addressed so as to ensure that his care continues to be effective. The organisation as a whole has experienced difficulties in recruiting staff over a period of time. Measures have been taken to address this, which include improvements to the terms and conditions offered to staff. The staff team does have some vacancies at the present time and recruitment is ongoing to address this. There has been some use of agency staff. However, this has been well managed to minimise the impact on the young person. The registered manager ensures that only a small number of agency staff are used at the home, and that any agency staff who do work are always on shift with a member of the core team. Staff are well motivated and express satisfaction with the training and support that they receive. A comprehensive training programme means that staff have access to a range

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The effectiveness of leaders and managers: good

of courses to aid their professional development. In addition, all staff are provided with additional training specifically relating to the needs of the young person they support. Staff describe the manager as approachable and report a good level of ongoing support. However, some shortfalls were noted in relation to the frequency of staff supervision during the inspection. The manager has identified this and was able to demonstrate that she is taking steps to address the shortfalls, and to ensure that all staff have regular opportunity to benefit from one-to-one supervision. There are well-established quality assurance processes in place. These include regular monthly checks of various aspects of safety and quality across the home. The manager has identified that, prior to her arrival, some of these checks have fallen behind and, during the inspection, was working to address them. It is important that quality

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The effectiveness of leaders and managers: good

assurance processes are consistent as they are a valuable tool in identifying and addressing areas for development. Appropriate systems are in place to notify Ofsted and other relevant persons of significant events that occur. This means that people are kept informed and young people’s welfare is promoted. Managers are able to recognise learning opportunities and act on them. For example, recent concerns regarding staff recruitment have led to a thorough review of the area and, as a result, a number of measures have been taken to address the issue. The ability to reflect and learn on an ongoing basis helps managers to minimise risks and supports further improvement. Inspection report children’s home: SC060750 7

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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: SC060750 8

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Children’s home details

Registered provider: Lifetime Opportunities Ltd

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Children’s home details

Registered provider address: Windsor House, Bayshill Road, Cheltenham, Gloucestershire GL50 3AT

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Inspector

Marie Cordingley, social care inspector Inspection report children’s home: SC060750 9 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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