Children's home run by Underley Schools Limited in Bolton

Inspection report children’s home: SC038276 1 SC038276 Registered provider: Underley Schools Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

 The 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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Information about this children’s home

Inspection dates: 28 to 29 November 2017

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Overall experiences and progress of

children and young people, taking into account

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Good

How well children and young people are helped and protected Good

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Good

The effectiveness of leaders and managers Good

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Good

The children’s home provides effective services that meet the requirements for good.

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Good

Date of last inspection: 11 October 2017

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Good

Overall judgement at last inspection: inadequate

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Enforcement action since last inspection:

A compliance notice was issued following the last full inspection on 11–13 October 2017, when the home was judged to be inadequate in the areas of ‘how well children are helped and protected’ and the ‘overall progress and experiences of children’. The compliance notice was served under regulations 12(2)(a)(i), 12(2)(a)(v) and 12(2)(b). Inspection report children’s home: SC038276 2 The compliance notice was considered to be met by regulation inspection manager Claire Deary at a case review held on 30 November 2017 following this full inspection.

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Key findings from this inspection

 Children benefit from safe care because of the actions taken by managers to improve staff’s knowledge of children’s risks, and actions that need to be taken to manage and reduce risks.  Managers have worked tirelessly and creatively to address the concerns identified at the previous inspection, which results in a better standard of care being provided to children.  All staff have received additional training in safeguarding and most have received training in risk assessment, which has further developed their awareness of risk and safeguarding procedures.  All children’s risk assessments have been updated, as has the safeguarding policy. Bath time risks and off-site risks are clearly identified and new procedures mean that risks in these areas are reduced.  Staff are passionate about their roles and committed to achieving the best for children in their care. They take pride in the children’s achievements and

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Key findings from this inspection

progress.  Staff continue to be well supervised and supported to carry out their roles. Changes to the supervision document ensure that safeguarding practice and recording and reporting are covered at each supervision session, thus ensuring that staff are knowledgeable in these areas.  The quality of recording has improved. Records provide an accurate reflection of children’s day-to-day lives and are clear to read and understand.  Weekly analysis of physical intervention records clearly identifies patterns and trends. This information helps managers to better understand how physical interventions may be reduced or avoided.  Parents are highly positive about the care that their children receive and the progress that they make at the home.  Very good communication with external agencies ensures a holistic approach to the provision of care.  Children are listened to in a variety of ways. A recent survey was completed by

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Key findings from this inspection

most children and will be used to contribute to the review of quality of care.

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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

 Medication of children continues to be an area for improvement because an additional medication error has occurred.  Some staff who have worked in the home for over two years have not yet Inspection report children’s home: SC038276 3 completed the diploma level 3 in residential childcare, although staff are enrolled on the course.

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Inspection date Inspection type Inspection judgement

11/10/2017 Full Inadequate 21/03/2017 Full Outstanding 10/11/2016 Interim Sustained effectiveness 11/02/2016 Interim Improved effectiveness 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 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)) 22/12/2017

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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 (4)(a), 5(a) and (b)) 23/02/2018

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Overall experiences and progress of children and young people: good

Children make very good progress at the home from their starting points. Some make better than expected progress. Parents speak highly positively about the progress that their children make and the care that they receive. One parent commented, ‘I am over the moon with the placement, staff are brilliant... he is making great progress, better than I expected. I can’t praise them enough.’ One young person in particular has settled extremely well into the home. He has developed positive relationships, gained weight and improved communication far sooner than his parent and social worker anticipated. Managers have good systems in place for monitoring progress to help identify whether this home is the most appropriate placement for a child and can fully meet their needs.

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Overall experiences and progress of children and young people: good

Managers commission specific specialist support where they feel that a child’s complexity requires this. Staff report the advice and training they have been given in respect of one individual child to be extremely useful. One member of staff has also been able to access an intensive interaction course to help interaction with a child who finds interacting and communicating difficult.

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Overall experiences and progress of children and young people: good

Staff are very knowledgeable in respect of children’s individual needs, and take on board advice and support from external sources where children have very complex needs. For example, one child uses a weighted blanket and pressure jacket and needs his environment (including staff clothing) to be calm, neutral and non-stimulating.

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Overall experiences and progress of children and young people: good

Where children are not making progress or are not having a positive experience of living at the home, managers take action to address this. The staff work proactively with Inspection report children’s home: SC038276 5 external agencies to try to best meet the child’s needs and, where appropriate, they advocate strongly on the child’s behalf for an alternative placement that will better meet their needs.

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Overall experiences and progress of children and young people: good

Children are supported to have contact with their families, including those who are placed a long distance from home. New procedures in place ensure that staff follow the correct processes before taking children off site. This ensures that children have everything they need when going off site, either for home contact, or an off-site activity. Contact is supported and supervised by staff where necessary, which allows children to continue to have contact even when their parents are unable to achieve this without support. Parents are also made welcome to visit their children in the home and spend time with them there.

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Overall experiences and progress of children and young people: good

Staff are enthusiastic, knowledgeable and committed to the children they care for. They take great pride in any progress that the children make and work hard to improve communication with children who are non-verbal. Staff are highly attuned to children’s efforts to communicate with them and are alert to any small signs that children make. Staff have fun with children, they support them to develop their interests and play with them on a daily basis. Staff are encouraged to contribute ideas about how to further improve the children’s care. One member of staff has put together a personalised ‘kitbag’ for a young person, with a small laminated book about the young person and a variety of things that are important to them either to communicate, play, stimulate or soothe.

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Overall experiences and progress of children and young people: good

Children are helped to become increasingly independent. Where children’s disabilities limit their independence skills, staff praise them for making small steps and achieving targets in their independence progress. One child was observed to receive a high level of praise for pouring drinks for others at the table in preparation for a meal.

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Overall experiences and progress of children and young people: good

High-quality placement plans and one-page profiles help staff to understand and meet children’s needs. Where staff are not familiar with children (e.g. agency staff), there is a clear procedure in place for these staff to read children’s key documents before they undertake any direct work with a child. This ensures that the staff have some understanding of their needs, likes and dislikes and communication methods. Permanent staff are reminded on a daily basis to update themselves by reading children’s files and any additions/amendments that have been added. Each bungalow has a display board identifying children’s one-page profiles, targets and other key information about children to ensure that staff are fully aware of each child’s needs.

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Overall experiences and progress of children and young people: good

A recent change has been implemented to allocate specific staff to individual children and record this on a shift-by-shift basis in each bungalow. This ensures that staff know which child they are responsible for. This also prevents any confusion and clearly makes individual staff accountable for ensuring that each child’s needs are fully met and their routine followed.

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Overall experiences and progress of children and young people: good

Staff are well trained to meet the needs of the children and have recently received additional training in a number of areas which were identified at the previous full Inspection report children’s home: SC038276 6 inspection.

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Overall experiences and progress of children and young people: good

Children have the opportunity to be involved in a variety of activities, both on and off site. Photographs of children participating in activities are collated into individual scrapbooks for the children and parents to enjoy.

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Overall experiences and progress of children and young people: good

Children’s health needs are met by the multidisciplinary on-site health team that works in conjunction with care and education staff. Medication of children continues to be an area for improvement because an additional medication error has occurred. Robust procedures were in place prior to this error taking place. These procedures have been further tightened to ensure that there is no recurrence. Staff are fully aware of the new procedures in place.

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

The home was previously judged to be inadequate in how well children are helped and protected due to some significant safeguarding incidents that occurred. Since the last inspection, the home has made good progress in improving staff’s understanding of safeguarding processes and procedures and in their recording and reporting of any safeguarding incidents.

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

All staff have received in-house training in safeguarding. Additionally, the staff are all booked onto safeguarding level 2 external courses, some of which have already been completed.

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

Managers in the home have been creative and determined in their efforts to improve the staff team’s knowledge around protecting children. Staff have been educated in small groups via scenario training. They have also completed risk assessment training where they matched risks to individual children. Staff report that they gained a lot from these activities and that safeguarding practice has improved as a result. Further safeguarding scenario training is planned due to the positive response from staff.

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

Managers have met with the designated officer to clarify thresholds for referral and to improve partnership relations. The designated officer reported very positively of this meeting and has had no further concerns regarding the home since the previous inspection. The home has had one allegation and has taken advice from both the police and the designated officer in dealing with this matter. The allegation is also recorded as a complaint by a child as required.

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

The home’s safeguarding policy has been amended. This has been issued to all staff and staff have been required to read this and sign to say that they have read and understood its content.

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

The home has implemented a system of allocating individual staff to children in bungalows so accountability is clearly identified. Staff report this to be a positive development mainly because it ensures that they are clear about who is responsible for ensuring that routines are followed for each child in their bungalow. Inspection report children’s home: SC038276 7 Risks in respect of bath time and going off site are clearly displayed for all staff to follow. Children who are high risk at bath time are identified and are fully supervised. Procedures for going off site are now clarified and are more robust in respect of ensuring that staff have the correct equipment and medication for each child and have confirmed this with a deputy manager before leaving the site.

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

All children’s risk assessments have been updated. Staff are required to read these and sign to say they that are read and understood. Each handover clearly identifies that staff have to read and sign risk assessments, personal behaviour support plans and children’s one-page profiles.

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

Discussions with staff evidence that they are fully aware of individual risks for young people and know how to minimise and address risks. They feel positive about managers’ efforts to raise standards and believe that this has improved risk management for children.

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

Physical intervention data still shows a high number of physical interventions taking place, and the home continues to use the front ground recovery team teach hold for some children. Two children account for the vast majority of the holds. For one child, the duration and level of holds have significantly reduced since the previous inspection, which has resulted from specialist support and improved communication with the child. The other young person with a high level of physical interventions has been admitted to hospital due to experiencing a mental health crisis. The home has concluded that they cannot meet her needs or keep her safe at this time due to her high-risk presentation and her mental health needs and she is to be discharged from their care.

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

Several physical intervention records were reviewed as part of this inspection and no serious issues or concerns were identified in respect of the recording of incidents. The manager has begun to analyse physical intervention data on a weekly basis with staff from education in order to identify patterns and trends and actions to reduce or minimise interventions; this is proving to be positive and useful.

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

There have been several notifiable incidents since the last full inspection. These have all been notified to the regulator within a suitable timescale and have been detailed and informative. There is no evidence to suggest that incidents had occurred which required notification that have not been notified.

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The effectiveness of leaders and managers: good

The registered manager and responsible individual accepted the judgements made at the previous inspection and understood the concerns raised. Managers have worked extremely hard to address the compliance notice and the requirements and recommendations made at the previous inspection to improve standards across the site in order to prevent recurrence of incidents which resulted in the inadequate judgement. Managers have shown dedication, tenacity and creativity in their efforts to make improvements. Inspection report children’s home: SC038276 8 Managers are committed to driving improvement within the home. They have high expectations in respect of the progress that children can achieve and have set high standards of care. The home developed a targeted action plan following their previous inspection which has been met, and have further implemented a workforce development plan and a home development plan. Managers have taken effective action to address

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The effectiveness of leaders and managers: good

Managers fully understand the progress that children are making. They monitor progress closely and are alert to any child who is not making progress. They seek to address this through working in partnership with health and placing authorities. Where children are not making progress or the home is not fully meeting their needs, managers acknowledge this and try to work with placing authorities to identify an alternative placement.

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The effectiveness of leaders and managers: good

Managers provide a supportive environment for staff. Staff speak highly of the managers’ and deputies’ availability and visibility in the home. The manager has appointed two new deputies and several new seniors to strengthen the management team and provide greater management support to staff. Supervision sessions now include a section for discussion about safeguarding and a section on reporting and recording in order to continue to develop and revisit staff knowledge in this area. Staff have had additional training to improve their knowledge of risks and safeguarding procedures.

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The effectiveness of leaders and managers: good

The manager is yet to attain his level 5 diploma and is still relatively new to the registered manager post. Many members of the staff team are also relatively inexperienced and unqualified. The manager recognises this as an area for ongoing improvement. The requirement made at the previous inspection is made again at this inspection in respect of staff qualifications. Managers are closely monitoring this and are working with the local college and the identified staff members to help them achieve their level 3 diploma in residential childcare.

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The effectiveness of leaders and managers: good

Close working relationships have been developed with external agencies, including placing authorities, the designated officer and police. The home also works in close partnership with parents. This ensures a joined-up approach to caring for children. Parents appreciate the regular communication maintained by staff.

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The effectiveness of leaders and managers: good

When necessary, the home advocates strongly on behalf of young people. An advocate visits the home on a regular basis to speak with young people and gather their views. When managers feel that the home is not meeting a child’s needs, they clearly communicate this to their placing authority. When children ask to speak to their social worker following an incident, the home makes extensive efforts to contact the social worker and arrange for them to visit.

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The effectiveness of leaders and managers: good

The home has had a number of compliance monitoring visits, welfare checks and statutory visits since the last inspection. No serious or safeguarding concerns have been raised either with the home or with the regulator in respect of these visits, and no Inspection report children’s home: SC038276 9 authority has expressed concern about the welfare of a child placed at the home.

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The effectiveness of leaders and managers: good

Children’s views are actively sought in many ways. This can be difficult for staff where children are non-verbal and have very limited communication, which is an area identified for improvement by managers. Most children have recently taken part in a survey about the home, which will be repeated at regular intervals to gather their views to inform the review of quality of care. Children have input into the decor and furnishings in their homes and have personalised bedrooms.

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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 10

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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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Inspectors

Charlie Bamber, social care inspector Gillian Walters, social care inspector Inspection report children’s home: SC038276 11 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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