Children's home run by Atlas Healthcare Ltd in Cheshire East

Inspection report children's home: SC429778 1 SC429778 Registered provider: Atlas Healthcare Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The children’s home provides care an accommodation for up to 15 children and young people who have a learning disability. The home provides long-term placements and short breaks. A private provider operates the home.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious failures that mean the children and young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report children's home: SC429778 2

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Inspection date Inspection type Inspection judgement

24/07/2017 Full Good 28/02/2017 Interim Sustained effectiveness 25/04/2016 Full Good 14/10/2015 Full Requires improvement Inspection report children's home: SC429778 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 quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; and

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Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff—

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

treat each child with dignity and respect;

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provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

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Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. Regulation (6)(1)(a)(b)(2)(ii)(iii)(iv)(c)(i)) 12/08/2018

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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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff—

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Requirement Due date

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;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm; 12/08/2018 Inspection report children's home: SC429778 4 take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies. Regulation (12)(1)(2)(a)(i)(iii)(vi)(vii)) *The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child; and

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Requirement Due date

demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

research and developments in relation to the ways in which the needs of children are best met; and

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation (13)(1)(a)(b)(2)(c)(d)(g)(i)(h)) 12/08/2018

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Requirement Due date

The registered person must ensure that the privacy of children is appropriately protected. (Regulation (21)(a)) 12/08/2018

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure the children’s safety. The registered person may only employ an individual to work at the children’s home if the individual satisfies the requirements in paragraph (3). The requirements are that full and satisfactory information is available in relation to the individual in respect of each matter in Schedule 2. (Regulation (32)(1)(2)(a)(3)(d))

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Requirement Due date

In particular, ensure that if a person has previously worked in a position involving children or vulnerable adults, verification so far as reasonably practicable of the reason why the employment 12/08/2018 Inspection report children's home: SC429778 5 or position ended; and documentary evidence of any qualifications which the person considers relevant for the position. Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home. The registered person must maintain in the home the records in Schedule 4 and ensure that the records are kept up to date. (Regulation (37)(1)(2)(a)(b))

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Requirement Due date

In particular, ensure there is a copy of the duty roster of persons working at the home, and a record of the actual hours worked. 12/08/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any incident relating to a child which the registered person considers to be serious. A notification made under this regulation must include details of the matter and any actions taken by the registered person as a result of the matter. Regulation (40)(4)(e)(5)(i)(iii)). 12/08/2018

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Requirement Due date

* These requirements are subject to a compliance notice.

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Overall experiences and progress of children and young people: inadequate

How well the children and young people are protected is judged inadequate. This is a defining judgement, which means that all the outcome areas are judged inadequate.

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Overall experiences and progress of children and young people: inadequate

The overall care and support given to the children and young people provides them with stability. They are making good progress and achieving good outcomes. The children and young people are happy, and they have positive relationships with the staff and with each other.

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Overall experiences and progress of children and young people: inadequate

A parent said: ‘My son is really settled, and the staff are great. He is doing great since he came to the home, and he has come on in leaps and bounds.’

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Overall experiences and progress of children and young people: inadequate

Activities are a strength. The children and young people are given many opportunities to experience new adventures and educational outings. The staff take the children and young people’s wishes into account when choosing individual and group activities, which respects their participation.

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Overall experiences and progress of children and young people: inadequate

A young person said: ‘I went to Paris on holiday and I went on the coach and stayed in a hotel. It was great, and I will be going on another holiday again.’

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Overall experiences and progress of children and young people: inadequate

The registered manager and the staff seek to support the children and young people and their families. Parents are fully involved in the care of their children, and they are made Inspection report children's home: SC429778 6 to feel very welcome when they visit. This approach ensures that the children and young people maintain important family relationships.

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Overall experiences and progress of children and young people: inadequate

A parent said: ‘The staff are great. They have become more like friends and I am always made to feel very welcome.’ A social worker commented: ‘I cannot fault the staff. The support for my young person’s dad has been remarkable.’

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Overall experiences and progress of children and young people: inadequate

The home has progressed by meeting a requirement from the last inspection to improve how it supports young people who are making their transition into adulthood. The young people are learning practical independence skills, and the staff are understanding of the young people’s trepidation about leaving their home. This supports the young people to make smooth transitions.

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Overall experiences and progress of children and young people: inadequate

This home was previously a care home for elderly people before being registered as a children’s home. It is a very large building that has been adapted into four ‘apartments’ and a short-breaks unit. Successful interior design has vastly improved parts of the home to create a welcoming, homely environment.

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Overall experiences and progress of children and young people: inadequate

However, there are still areas that present an ‘institutionalised’ feel. For example, there are long corridors that are painted white, not carpeted, and have very few soft furnishings or pictures. Several internal doors still have key-pad locks in place even though these are not used, and all the staff carry keys that are clearly visible and some carry alarms that are attached to their clothing.

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

Unsafe practice relating to restraints put the children and young people at risk. Some children and young people have been restrained using unrecognised techniques, and these have not been adequately challenged by leaders and managers. It is not clear that the children and young people are accessing medical attention following these restraints to ensure that no injury has been caused. In addition, risk assessments have not been adequately reviewed to ensure that safe handling techniques are clearly identified for future behaviour management.

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

There are no clear policies or protocols that set out what actions should be taken following an inappropriate restraint, for example seeking guidance from the appropriate designated safeguarding officer to ensure that the children and young people’s safety has not been compromised. In addition, some new staff have not had training in restraints and some established staff have not had their training refreshers to ensure that their practice is up to date.

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

Behaviour management plans have improved, in that they set out the steps to take to de-escalate behaviours. However, they do not set out preferred methods of physical intervention to ensure that the children and young people’s needs are considered when deciding the most appropriate handling methods. This is particularly important for younger children who are in the early stages of physical development, and those children and young people who have recognised physical disabilities or known health Inspection report children's home: SC429778 7 problems.

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

There are some strengths in the home’s safeguarding practice, in particular the detail about how allegations against staff are managed. The registered manager takes active measures to respond to allegations, and she works closely with the appropriate designated safeguarding officer to ensure that the children and young people are cared for by safe carers.

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

There are no children or young people who are at risk from exploitation, radicalisation or extremism. The home promotes a ‘no tolerance’ approach to bullying, which is effective. Incidents of children and young people going missing are very rare. When they do happen, the staff respond quickly and positively.

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

Shortfalls in safe staff recruitment potentially put the children and young people at risk. There are examples where some safety checks have not been undertaken, and some important documentation, for new staff members, is not available in the recruitment files.

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The effectiveness of leaders and managers: inadequate

The registered manager has been in post since March 2017. She has a wealth of valuable experience and has gained the qualifications that she needs to carry out her role. She is highly respected by her staff team and other professionals. The registered manager is supported by a motivated deputy manager, who is committed to delivering positive outcomes for the children and young people.

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The effectiveness of leaders and managers: inadequate

Feedback from parents and social workers about the progress of their children and young people is extremely positive. They provided individual examples of good outcomes and how the children and young people are achieving. However, the home’s residential care plans are disorganised and inconsistent.

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The effectiveness of leaders and managers: inadequate

The children and young people’s case files are poorly presented and over-filled with irrelevant information. This makes it very difficult to locate individual support plans. The written plans, and risk assessments, are onerous and they do not clearly set out specific needs, identified risks, or how these will be met. This way of working makes it difficult for the staff to navigate the plans to ensure that they are providing the children and young people with the bespoke care and support that they need.

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The effectiveness of leaders and managers: inadequate

Where children and young people have specific needs, such as sensory issues, that significantly impact on them, these are not always clearly set out alongside individual behaviour management strategies. This has resulted in some children and young people being exposed to situations that cause them undue distress. In addition, there are examples of inappropriate recording in the case files and other documentation that compromise the children and young people’s privacy and dignity. For example, some comments written in the home’s ‘rewards book’ refer to private and confidential information. The home employs a large staff team to meet the needs of the children and young Inspection report children's home: SC429778 8 people. Recruitment is in progress to fill vacant posts, and the staff try where possible to cover additional shifts to provide consistency and continuity. Overall, staff training is good but there are some shortfalls, particularly for first aid and physical intervention

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The effectiveness of leaders and managers: inadequate

The team structure includes team managers and seniors who deputise in the absence of the manager. However, it is not always clear who is responsible for the home when the registered manager and the deputy manager are not at work. The staff rosters do not identify ‘persons in charge’ and there are no other records that provide this information. The duty rosters do not include the full names of the staff or the hours they work. In addition, the registered manager and the deputy manager are not included in the staff roster to show when they are working in the home.

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The effectiveness of leaders and managers: inadequate

The home has improved by meeting previous recommendations to ensure that all the staff have had ‘PREVENT’ training and to ensure that the staff receive regular supervision.

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The effectiveness of leaders and managers: inadequate

The registered manager has met a previous requirement to improve the home’s monitoring. Her latest regulation 45 report includes meaningful consultation and she has written a good-quality document. However, the home’s monitoring systems have failed to identify and address the shortfalls identified during this inspection, so a new requirement has been set. In addition, failing to notify Ofsted of significant events has impacted on this inspection’s outcome judgement.

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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: SC429778 9

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Children’s home details

Registered provider: Atlas Healthcare Ltd

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Children’s home details

Registered provider address: Norcliffe House, Station Road, Wilmslow, Cheshire SK9 1BU

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Children’s home details

Responsible individual: Maureen Richardson

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Inspector

Debbie White, social care inspector Inspection report children's home: SC429778 10 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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