Children's Home run by Nugent Care 2019 in St Helens

Inspection report children’s home: SC022447 1 SC022447 Registered provider: Nugent Care Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is owned and run by a charitable organisation. It is registered to provide care and accommodation for up to three children who have emotional and/or behavioural difficulties.

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Overall experiences and progress of

children and young people, taking into account

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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: 11 January 2017

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Requires improvement to be good

Overall judgement at last inspection: improved effectiveness

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Requires improvement to be good

Enforcement action since last inspection: none

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Key findings from this inspection

This children’s home requires improvement to be good because: Inspection report children’s home: SC022447 2  Young people are not in full-time education and staff do not engage them in purposeful learning activities at the home. This is not conducive to effective learning.  Care plans and risk assessments are not robust or reviewed effectively to address the changing needs of the young people. Furthermore, one young person did not have a local authority care plan or signed medical consent form on file.  Risks to children and young people are not clearly identified, understood and managed. Behaviour management in relation to restraint is not recorded safely. This means that young people are not protected from harm.  Some staff’s training has not been updated to meet the individual needs of young people, for example training around self-harm.  The monitoring of the home and its quality of care are not strong. The

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Key findings from this inspection

manager’s monitoring has not been robust enough to identify the shortfalls found at this inspection.  Visitors to the home require to be signed in and out of the home and identification needs to be more thoroughly scrutinised.  The home fails to present as a warm, comforting environment for young people and may possibly be a risk to young people’s health and safety.

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Key findings from this inspection

 Independence plans are bespoke and individualised.  Young people are very well supported with their presenting health needs.  Young people benefit from having regular and positive contact with family members and those significant in their lives. They reported feeling happy at the levels of contact. In addition, parents report high levels of satisfaction at the support that staff provide to their children and in how well staff support contact.  The registered manager and responsible individual acknowledge the shortfalls found during this inspection and are committed to making improvements.

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Inspection date Inspection type Inspection judgement

11/01/2017 Interim Improved effectiveness 28/04/2016 Full Good 24/02/2016 Interim Declined in effectiveness 28/09/2015 Full Good Inspection report children’s home: SC022447 3

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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 education standard is that children make measurable progress towards achieving their education potential and are helped to do so. In particular, the standard in paragraph (1) requires the registered person to ensure that staff— help each child to understand the importance and value of education, learning, training and employment; help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible; and that staff help each child who is above compulsory school age to participate in further education, training or employment and to prepare for future care, education or employment. (Regulation 8 (1) and (2)(a)(iv)(viii)(ix)) 28/01/2018

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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; help each child to understand how to keep safe; have the skills to identify and act upon signs that a child is at risk of harm; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action whenever there is a serious concern about a child’s welfare; and are familiar with, and act in accordance with, the home’s child protection policies. Also, that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child

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Requirement Due date

effectively from harm. 28/01/2018 Inspection report children’s home: SC022447 4 (Regulation 12 (1)(2)(a)(i)(ii)(iii)(v)(b)(d)) In particular, ensure that all identified risks and effective strategies to reduce those risks are recorded in the relevant plans and this is completed in a manner that enables staff to follow them in the delivery of care. That staff understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. That care is delivered in a manner which takes into account the risks identified in relevant plans, and that measures identified to reduce those risks are implemented and delivered by staff so that those receiving care are safe and protected. That the home environment is free from hazards and that each visitor to the home is duly signed in and out of the home and full designation of the person is recorded. The leadership and management standard is that the registered

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Requirement Due date

person enables, inspires and leads a culture in relation to the children’s home that helps children aspire to fulfil their potential and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. Ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13 (1)(a)(b) and (2)(a)(c)(f)(h)) 28/01/2018

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Requirement Due date

The care planning standard is that children receive effectively planned care in or through the children’s home. In particular, the standard in paragraph (1) requires the registered person to ensure— that each child’s relevant plans are followed; that the child’s placing authority is contacted, and a review of that child’s relevant plans is requested, if the registered person considers that the child is at risk of harm or has concerns that the care provided for the child is inadequate to meet the child’s needs or 28/01/2018 Inspection report children’s home: SC022447 5 the child is, or has been, persistently absent from the home without permission. (Regulation 14 (1)(a)(2)(a)(c)) In particular, ensure that all care planning documents and agreed local authority plans are adhered to by managers and staff. Ensure that the home has a copy of the local authority care plan and consents for medical treatment and ensure that placement

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Requirement Due date

plans held for individual children meet the identified needs as set out in the local authority care plan. The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out the measures of control, discipline and restraint which may be used in relation to children in the home. 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— a description of the measure and its duration; and the name of the person who used the measure (‘the user’), and of any other person present when the measure was used. (Regulation 35 (1)(b)(2)(vi)) In particular, that all records of restraint are duly recorded showing who carried out the intervention, what hold was used and the duration of the restraint. 28/01/2018

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which— include the information and documents listed in Schedule 3 in relation to each child and are kept up to date and are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 28/01/2018

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improvement to be good

There are several shortfalls identified that have the potential to have an impact on young people’s welfare and safety. These include risk assessments not being updated, physical restraints not being fully documented, shortfalls in staff training and a lack of management oversight. While this has not directly affected young people’s safety, it has Inspection report children’s home: SC022447 6 the potential to do so. This results in a home that has a number of strengths but is not yet good.

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improvement to be good

The lack of coordinated placement planning to support young people effectively has the potential to place young people at risk. One young person living at the home does not have a local authority care plan in their case records that sets out the specific needs of the young person and relevant information to inform their support needs. It remains unclear as to what is expected of the home in order to help and support the young person to make progress. The lack of information fails to show what the purpose of the placement is and significantly compromises the staff’s capacity to assess the appropriateness of the placement, especially when other factors are taken into account, for example the needs of other young people already living at the home. The lack of important information to inform practice and risk management extends across young people’s education needs.

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improvement to be good

Young people living at the home have had poor school attendance and, when they are not in education, they do not engage in purposeful activity. Insufficient action has been taken to address these concerns to help young people to rebuild their confidence and increase their participation in education. While the home has taken some action through speaking with the headteacher of the virtual school and arranging meetings to address the concerns, the daily routine of the home is disorganised and does not actively encourage educational attendance. The lack of education plans for individual young people means that the staff at the home do not adequately promote the importance of learning and education for all young people, and this lack of aspiration affects young people’s learning and future life chances.

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improvement to be good

When young people go missing, staff are very proactive in their response. They actively search for missing young people and are fully aware of young people’s vulnerability in the community. Staff respond appropriately and according to risk. They work well with the police and other professionals to ensure that young people are as safe as they can be. A placing social worker said that, ‘They are really proactive in their response to [young people going] missing, they actively go out searching for young people and they don’t just rely on reporting it and going through the motions. They do all they can to find them.’

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improvement to be good

Staff support and nurture young people’s relationships with their families, friends and others who are important to them. The young people have regular contact that is subject to careful assessment and monitoring, and deemed to be in their best interests. Staff members promote contact by providing the young people with both practical and emotional support. When contact is considered appropriate, staff supervise the young people and their families sensitively. A relative commented that, ‘I couldn’t fault staff. When social services failed to put in arrangements for transport, staff from the home did it and made sure that she was allowed home overnight. They [staff] also stayed close by.’ Consequently, young people enjoy good-quality, safe contact with family and friends in the knowledge that staff are on hand to provide any assistance that may be required. Contact with families has become a much more positive experience, steadily increasing

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improvement to be good

Inspection report children’s home: SC022447 7 and extending to the wider family. This build-up of positive contact has resulted in overnight contact over Christmas for one young person.

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improvement to be good

Independence planning for young people is bespoke and individualised. Young people have been supported to learn a variety of independence skills, including cooking, budgeting and general household skills. Plans are written with young people who are encouraged to add their views about any areas they may need support in, for example managing their monies better. Young people are also supported to prepare for the move to their new homes. When young people move on to other services, staff work exceptionally well with the new provider to ensure that young people’s needs and preferences are known. For example, a young person who has a planned move into an adult provision in her placing authority has received very good practical and emotional support from staff.

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improvement to be good

The practice in relation to helping and protecting young people needs to improve. This inspection has found failings. While there is nothing to show that these have led to young people suffering harm, unchecked they have the potential to do so.

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improvement to be good

Young people say that they feel safe at the home and that they can identify someone whom they can talk to if needed. Placing authority social workers said that they are confident in the staff team’s ability to keep young people safe. A young person commented that, ‘Although I don’t want to live this far from home, I do feel safe here.’

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improvement to be good

The home’s behaviour management policy is not consistently implemented. On occasions, responses to challenging behaviour do not provide a consistent, positive message to young people. Consequences can be disproportionate, confusing and punitive, with no clear overview of why this decision was agreed. For example, one young person was given a consequence of ‘DVD player removed’. There was no clear indication of why this measure was appropriate or the timescales involved. In addition, the records did not show that the consequences given resulted in the young person learning from their actions. This does not help staff to evaluate and identify the effectiveness of the measure used in helping young people make changes to their behaviours. Furthermore, young people do not have individual behaviour management plans. This means that staff do not have an agreed, planned response to help young people manage their behaviours.

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improvement to be good

The recording of measures of restraint is poor. For example, a staff member had recorded on a physical restraint record that a restraint had taken place. However, there was no description on the holds used, duration of the restraint or any injury sustained. This meant that managers were unable to evaluate effectively if the measure of control used was appropriate, proportionate and safe. Additionally, young people and staff had not had the opportunity to have a debrief meeting after the incident. The failure of staff to follow robust physical intervention procedures places young people at risk of harm. Inspection report children’s home: SC022447 8 Risk assessments are not routinely updated after incidents. For example, a young person who was deemed at a high risk of child sexual exploitation was suspected of having three mobile phones in her possession. The records at the home did not outline any planned strategy to ensure the young person’s safety. The registered manager

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improvement to be good

responded to this information on the second day of the inspection and took appropriate action to keep the young person safe. However, the lack of updated risk assessments failed to give staff the adequate direction to respond effectively to a known risk and consequently this could have placed the young person at significant risk of harm.

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improvement to be good

Young people’s health and well-being are promoted at the home and their individual health needs are being addressed. Staff spend time talking to young people about their health and general well-being and provide support to attend all appointments, such as dental and optician appointments. Medication, where used, is safely stored and carefully administered. Detailed records of medication are routinely checked for accuracy. This ensures that any errors are quickly identified and promptly resolved.

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improvement to be good

Managers ensure that safe recruitment practices are utilised to ensure that young people are protected, and that all staff at the home are suitable and safe to work with young people.

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improvement to be good

The physical environment of the home is not maintained to a high standard. The home presents as worn in places. For example, a phone plug, which was attached to the wall, had bare wires hanging from it, the pull cord for the toilet was missing and the couches had tears and stains on them. This is not conducive to a warm, comforting environment for young people and may possibly be a risk to young people’s health and safety.

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improvement to be good

Visitors to the home are not routinely asked to sign in and out. This potentially could place young people at risk of harm and does not allow the manager to have an overview of who visits and when visitors are in the home.

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

Since the last inspection, there have been changes to the senior management team in the organisation. This includes the appointment of a new responsible individual who shares responsibility for the delivery of the service with the registered manager. The manager has been registered with Ofsted since January 2015. She is suitably qualified to diploma level 5 in the management of a children’s social care provision. She has many years’ experience as a children’s social care practitioner and manager, and has worked for this organisation with children in care for 26 years. She is very well respected by staff, colleagues and other professionals.

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

Records do not provide an insight into the young people’s lives and care experiences and there is limited information to measure their progress or identify the effectiveness of the support provided. For example, the records of key-worker sessions are very limited in detail. They only reflect informal discussions, rather than offering a more comprehensive account of what the objective of the planned session was and how this links to the wider support to meet each young person’s individual needs. Inspection report children’s home: SC022447 9 Similarly, care planning is poor and does not promote the continued progress of young people. Internal placement plans and risk management plans are not reviewed effectively to identify the changing needs of individual young people. They also fail to address the issues of risk and how these should be managed safely to promote consistency of care.

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

Staff receive regular, good-quality supervision that supports and challenges practice in order to improve the care given to young people. This is further supported by team meetings that provide opportunities to reflect on practice and that ensure that young people are at the centre of discussions. Staff comments include, ‘I value my supervision’, ‘It’s a good opportunity to discuss my work with young people’ and ‘I have support from the manager and the staff. We are a good team.’ A handover was observed as part of the inspection. This was very much child- and young-person focused. Staff presented throughout the meeting as professional, knowledgeable and passionate about their work.

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

There are good professional relationships between the registered manager, staff, family members and professionals involved in the lives of young people. This promotes good information sharing for the benefit of young people. A social worker commented, ‘Communication is very good and I am kept updated.’

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

The monitoring and review systems at the home need to be strengthened. Although external monitoring of the home is in place, it is not yet robust. The reports from external monitoring have not identified the shortfalls found on this inspection, for example the lack of local authority care planning documents. This lack of rigour has not helped the home to sufficiently protect young people and maintain good enough standards of care. Systems that are more robust are needed to ensure that the safety and well-being of the young person is promoted at all times.

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

The provider has a centralised training matrix document for the home. This document was not up to date, therefore the manager was unable to have a clear overview of the staff’s training needs. Furthermore, some staff had not received training around self- harm, despite some young people displaying self-harming behaviour.

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

The service has recently moved to a paperless system for young people’s records and now uses a computer programme. The majority of shortfalls in care planning and recording have stemmed from this change. The system is described by staff as ‘cumbersome’ and ‘not fit for children’s services’. The new system of recording also does not lend itself to be easily accessible to young people should they want to read their own planning documentation. Furthermore, the pre-populated wording on the forms describes young people as ‘service users’. This distracts from the homely, caring environment that the manager and staff are trying to create for young people who live at the home.

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

The registered manager fully acknowledges all shortfalls raised at this inspection. She recognises how they affect the day-to-day running of the home and the outcomes for young people. She shows the capacity and enthusiasm to make all the required Inspection report children’s home: SC022447 10 improvements, including introducing systems that are more robust to ensure that young people’s care planning, safety and well-being are prioritised.

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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: SC022447 11

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Children’s home details

Registered provider address: 99 Edge Lane, Edge Hill, Liverpool L7 2PE

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Children’s home details

Responsible individual: Gary Thistlewood

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Inspector

Elaine Allison: social care inspector Inspection report children’s home: SC022447 12 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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