Children's home run by Halliwell Homes Limited in Staffordshire Moorlands

Inspection report children‟s home: SC470224 1 SC470224 Registered provider: Halliwell Homes 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 is registered to provide medium- to long-term placements for up to 10 children who have emotional and/or behavioural difficulties. The home forms part of an independent social care company.

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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

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection: none

Inspection report children‟s home: SC470224 2

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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

 Managers do not always ensure that young people‟s needs are taken into account carefully, or that impact risk assessments are used in an effective way, when considering the admission of new young people to the home.  Communication between staff and the organisation‟s clinical team is not always effective, which means that young people may not receive care that meets their individual needs.  Young people are not always supported to explore things that are important to them, such as their culture or religion.  Managers and staff do not consistently identify and manage risks to young people‟s safety and well-being in an effective way.  Relationships between young people are not always managed in a way that protects young people from bullying.  Records of restraint are not consistently clear and are not reviewed in an effective manner.  Young people are not helped to manage their behaviours in a positive or

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Key findings from this inspection

consistent way.  Systems to monitor quality and safety across the home are not consistently used in an effective manner. This results in a failure to identify shortfalls and missed opportunities for improvement.

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Key findings from this inspection

 Young people are supported to achieve in education and make positive progress in this area.  Most young people make positive progress from their starting points, and as a result are able to make the successful transition to family and foster care at the end of the therapeutic placement.  Some young people experience positive health outcomes as a result of the care that they receive at the home.  In general, young people have positive relationships with staff.  Young people are supported to access independent advocacy services to assist them in expressing their views.

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Recent inspection history

Inspection report children‟s home: SC470224 3

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Inspection date Inspection type Inspection judgement

14/03/2017 Interim Sustained effectiveness 07/11/2016 Full Good 25/01/2016 Interim Sustained effectiveness 22/07/2015 Full Good Inspection report children‟s home: SC470224 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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12: The protection of children standard

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; have the skills to identify and act upon signs that a child is at risk of harm; manage relationships between children to prevent them from harming each other; that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child‟s health. (Regulation 12(1) and (2)(a)(i)(iii)(iv)(d)) 17/11/2017

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13: The leadership and management standard

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that— promotes children‟s welfare. In particular, the standard in paragraph (1) requires the registered person to— use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1) and (2)(h)) 17/11/2017

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14: The care planning standard

The care planning standard is that children— receive effectively planned care in or through the children‟s 17/11/2017 Inspection report children‟s home: SC470224 5 home. (Regulation 14(1)(a)) In particular, that young people‟s needs are fully assessed and addressed within their care plans.

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35: Behaviour management policies and records

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out— how appropriate behaviour is to be promoted in the children‟s home; and 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— the name of the child; details of the child‟s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and

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35: Behaviour management policies and records

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35(1)(a)(b) and 3(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii) and (b)(i)(ii)and(c)) 17/11/2017 Inspection report children‟s home: SC470224 6

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36: Children’s case records

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; are kept up to date; and are signed and dated by the author of each entry. (Regulation 36(1)(a)(b)(c)) 17/11/2017

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Recommendations

 The manager should work closely with the placing authority to understand the child‟s relationship history and the impact that the child‟s arrival may have on the group living in the home. („Guide to the children‟s homes regulations including the quality standards‟, page 38, paragraph 8.3)  The manager should ensure that staff understand what they must do to prevent bullying of children by other children or adults. Staff should be able to recognise and address different types of abuse, such as peer abuse, cyber-bullying and bullying in day-to-day relationships in the home. Registered persons must ensure that procedures for dealing with allegations of bullying are in place and staff have the skills required to intervene, protect and address bullying behaviours effectively. (See regulation 34(3) on the policy for the prevention of bullying.) („Guide to the children‟s homes regulations including the quality standards‟, page

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Recommendations

39, paragraph 8.16)  The manager should ensure that children are able to maintain and develop their cultural or religious beliefs as far as practicable and where appropriate, through participation and instruction, and by observing religious requirements including dress and diet and cultural awareness. („Guide to the children‟s homes regulations including the quality standards‟, page 17, paragraph 3.22)  For children‟s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. This should be considered, in particular, with regard to cleanliness and areas in the home requiring improvement. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraph 3.9) Inspection report children‟s home: SC470224 7

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improvement to be good

Although most young people have made positive progress from their starting points in areas such as education and health, some young people have made limited progress in areas such as developing safe behaviours. Progress is limited due to inconsistent care and support of young people. Feedback gathered from external professionals as part of the inspection is, in the main, positive. Social workers were positive about how well children respond to the care that they receive, and about children being able to receive therapeutic support and experience stability. A social worker said, „I think the staff are great and have a positive relationship with the children.‟ However, one social worker went on to say that they felt more one-to-one work, where young people could share their views confidentially, was needed. Young people report that they got along well with staff. This was confirmed by their social workers and supported by observations of young people and staff interacting

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improvement to be good

positively. One staff member was observed discretely and kindly encouraging a young person to eat his meal and positively praising him. Another staff member was observed supporting young people with positive distraction techniques when they were becoming impatient while waiting for an activity. Young people are encouraged to express their views about the day-to-day running of the home. They confirmed that they are able to make choices such as what to have to eat. Regular key-work sessions take place in which young people can discuss their own progress and care. It was also noted that one young person, who had recently left the home, had been supported to access an independent advocate to assist her in expressing her views. The home‟s statement of purpose describes a structured, therapeutic programme that all young people undertake during their stay. However, it is not clear how the programme is incorporated into young people‟s day-to-day care. Managers advised that the clinical

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improvement to be good

team did not routinely meet young people, and that clinical input was generally provided through monthly meetings with staff, where young people‟s progress would be discussed. It was identified during the inspection that information sharing between the home and clinical team was not always effective. For example, one young person made a very concerning statement about his state of mind during a one-to-one session with a staff member, but this was not passed on to the clinical team. In another example, a young person had reported feeling low and upset in a key-worker session and had been told „it was normal to feel like that‟. Again, the clinical team were not made aware of these concerns. Ineffective communication between the home and clinical team means that young people may not receive responsive care and support. A young person said, „I don‟t know why they say this is a therapeutic home. It‟s not

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improvement to be good

therapeutic.‟ When asked what they thought a therapeutic home should be like, the young person said, „Calm and soothing. It‟s never like that here.‟ Inspection report children‟s home: SC470224 8 Young people make positive progress in their education. The home has a school on site, which the majority of young people attend. However, one young person has successfully transitioned to mainstream school and is achieving good attendance. The young person said she was very happy about this and was enjoying making new friends. Some young people have also experienced positive outcomes in relation to their health. One young person was admitted to the home with a severe skin condition. This has improved significantly due to the support the young person has received. Another young person has enjoyed learning with his key worker about maintaining a healthy lifestyle and has improved his diet. He is taking part in more physical activity and has managed

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improvement to be good

to achieve a healthier weight. It was identified in this inspection that young people are not consistently supported to explore things that matter to them. One young person talked about her wish to learn more about her culture. Records of key-worker sessions showed that the young person had requested some reading material to assist her in this. However, this had not been provided. The young person also said that her requests to have food at mealtimes from her country of heritage had not been met. This failure does not support the young person‟s sense of identity or self-worth. Young people have the opportunity to take part in activities, although these have previously been largely on a group basis. One young person said that they did not often have the opportunity to enjoy individual activities which they would like to do. This comment was supported by a staff member. However, the registered manager has

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improvement to be good

identified this as an area for development and is in the process of reviewing the programme to ensure that it is more responsive to young people‟s individual needs. The standard of accommodation provided to young people requires significant improvement. This has at times impacted on young people. For example, one young person disclosed in a key-worker session that he did not want to have a bath because the bath was „dirty‟ and „murky‟. Managers advised that an improvement plan has commenced, and some evidence of this was seen as some improvement work was ongoing at the time of the inspection. It is recommended that this should be completed as a matter of priority, to reduce further impact on young people, as young people will benefit from living in a comfortable and pleasant environment.

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improvement to be good

The overall arrangements for safeguarding young people require improvement to help to promote the safety of young people and to ensure that their well-being is promoted. Inconsistent practice means that some risks to young people‟s safety and well-being are not always well managed. Each young person has a range of risk assessments in place. However, these are largely generic and mainly relate to the environment. In some examples, managers and staff have failed to assess significant risks to the safety and well-being of young people, despite being made aware of such risks at the point of the young person‟s admission. For example, there had been previous, significant concerns about one young person‟s vulnerability to self-harm, but a risk assessment and risk management plan had not been Inspection report children‟s home: SC470224 9 completed until a concerning incident occurred several weeks after his admission.

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improvement to be good

In other examples, evidence was found that managers and staff had failed to identify and respond effectively to risks, despite there being clear indicators that these risks existed. For example, an incident occurred during which it was identified that a young person had hidden some dangerous items in his bedroom. However, no action was taken to address and plan for the risk of this happening again. Failure to identify and implement plans to manage significant risks means that young people‟s safety and well- being are not consistently protected. The arrangements to protect young people who may go missing from home are unclear. The deputy manager advised that no young people who live in the home are identified as being at risk of going missing and, as such, missing from home risk assessments and protocols are not in place. However, a record of an incident involving three young people demonstrated that this information was inaccurate.

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improvement to be good

Despite a large number of concerning incidents at the home between young people, including some physical assaults and an incident of racial abuse, managers and staff do not assess the risks to each young person as a potential victim of bullying. A peer risk assessment is in place for most young people, but this only assesses the young person‟s behaviour towards others and not their own vulnerability to being bullied. Until recently, incidents of bullying had not always been logged. However, this shortfall has been identified and managers have recently improved their systems so that incidents of bullying are logged and monitored more effectively. Some positive work in relation to bullying has been carried out in group sessions with young people. However, following incidents of bullying, direct one-to-one work is variable in quality. All staff are provided with safeguarding training at the start of their employment. This is

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improvement to be good

updated periodically to help to ensure that staff keep up to date with any changes in practice. Records demonstrate that safeguarding concerns are reported to the relevant agencies and managed appropriately Managers and staff do not support young people‟s behaviours in a consistently positive manner. Each young person has a behaviour support plan in place which provides information about potential problematic behaviours and strategies for staff to follow when they need to respond. However, records of incidents demonstrate that managers and staff do not always follow this guidance. For example, a record showed that staff had told one young person to „calm down‟ during an incident, which was an approach stated in his behaviour support plan as likely to exacerbate the situation, and not to be used. In another example, a young person‟s plan advised staff to ask him to sit with a staff member when his behaviour was becoming heightened, but this was not identified

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improvement to be good

as being used as a strategy in the lead-up to any incident. There is no evidence of clinical input into young people‟s behaviour support plans, and records of incidents that have occurred demonstrate that staff do not consistently work in accordance with the therapeutic ethos of the home. For example, a frequent consequence for young people is to be sent to their bedroom. In one example, one very young child was sent to his bedroom for what was recorded as „naughty behaviour‟, despite the child having only moved into the home the previous day. Inspection report children‟s home: SC470224 10 Significant shortfalls were identified in relation to the recording of incidents that have involved some physical intervention or restraint of a young person. In some cases, records of such incidents were incomplete or did not contain adequate detail. In one example, information in a report directly conflicted with other recorded information

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improvement to be good

about the same incident. Managers have failed to identify these shortfalls, demonstrating that they are not monitoring the records effectively. It was also noted that appropriate debriefs were not taking place in a consistent manner. Failure to properly record and monitor these significant incidents means that young people are not sufficiently safeguarded. During the inspection, some work was ongoing to make improvements to the environment. However, a number of easily identifiable and avoidable hazards were noted. These included the presence of potentially harmful items, for example a broken mirror and an unguarded razor in one young person‟s bedroom, poor food hygiene practices resulting in several items of out-of-date food being in use, broken radiator covers, and broken or missing window restrictors. This demonstrates that young people‟s health and safety is not consistently protected. In addition, several areas in the home,

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improvement to be good

including bathrooms and toilets, were visibly unclean, which means that young people are not adequately protected against the risks of poor hygiene or infection. A staff member said, „The problem is there is no cleaner and staff just don‟t have the time to keep on top of it. It just isn‟t possible to look after the young people properly and keep on top of a house this size.‟ Managers ensure that careful recruitment procedures are followed when employing new staff. All prospective staff members are required to undergo a range of background checks before they are offered employment. These checks include employment histories, police record checks and references from previous employers. This helps to minimise the risk of young people being in contact with adults of unsuitable character.

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

There is a suitably qualified and experienced registered manager in place. The registered manager carries out some additional duties for the organisation, including training, which limits the time she can spend at the home. This is a large home accommodating up to 10 young people at any one time. Recently, four young people left the home and four new young people were admitted. However, impact risk assessments viewed for the most recently admitted young people did not consider the needs of the existing young people. It was also noted that, despite the home‟s statement of purpose advising, „We almost always try to allow five days between admissions‟, the four young people moved into the home within a seven-day period. The deputy manager advised that the timeframes were due to the young people needing the placements urgently. However, there was no evidence to demonstrate that the impact of the high number of admissions in such a short space of time was duly considered.

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

Staff report a good level of support from the management team and express satisfaction with the training that they receive. One new member of staff was very positive about his induction process and felt managers and staff were helpful and approachable. The deputy manager ensures that all team members receive support through regular Inspection report children‟s home: SC470224 11 supervision sessions. Team meetings are held on a monthly basis and are well attended by staff. There is a training programme in place which includes a variety of courses designed to develop the staff team‟s skills and knowledge. This is generally satisfactory. However, it was noted that the training programme could be better adapted in line with the complex needs of some young people who live at the home. Currently, no care workers or senior care workers hold nationally recognised qualifications in caring for young people, although all staff are in the process of obtaining these. In discussion, the registered

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

manager advised that the requirements for senior posts had now been amended to include the requirement for this qualification. The standard of record-keeping in the home requires significant improvement. Throughout the inspection, a number of errors, incomplete entries and inaccurate recordings were identified. In one example, a young person‟s behaviour had been described in an unhelpful manner, which was not factual and was potentially damaging. There was no evidence that the shortfalls had been identified through the home‟s own internal monitoring systems. There are systems in place that enable the registered manager to monitor quality and safety across the service. However, these are not consistently used in an effective way. In a number of examples, monthly care plan audits had not taken place for some time. In other examples, audits were signed as being completed but had failed to identify obvious shortfalls.

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

A lack of effective monitoring of areas, such as behaviour management and risk assessment, has led to shortfalls not being identified or addressed. This means that shortfalls are allowed to continue and improvement is not supported. A number of requirements and recommendations have been raised in this report to support the improvement of the service.

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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: SC470224 12

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Children’s home details

Registered provider: Halliwell Homes Limited

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Children’s home details

Registered provider address: 1 Tape Street, Stoke On Trent ST10 1BB

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Children’s home details

Responsible individual: Karen Mitchell-Mellor

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Inspectors

Marie Cordingley, social care inspector Lisa Gregoire-Parker, social care inspector Inspection report children‟s home: SC470224 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 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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