Children's home run by Exceptional Care Limited

Inspection report children’s home: 1247212 1 Registered provider: Exceptional Care Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a privately run children’s home that is registered for four young people who may present with a range of complex needs and functioning complications, including emotional and behavioural difficulties. The home caters for three young people in the main part of the house and one young person in the attached apartment. The registered manager’s post is vacant.

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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 2018

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requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: 1247212 2

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Inspection date Inspection type Inspection judgement

11/01/2018 Interim Sustained effectiveness 10/05/2017 Full Good Inspection report children’s home: 1247212 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 health and well-being standard is that— the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being; and children are helped to lead healthy lifestyles. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff help each child to— achieve the health and well-being outcomes that are recorded in the child’s relevant plans; understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding; take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs; and understand and develop skills to promote the child’s well-being; and that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other

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Requirement Due date

services as the child may require. (Regulation 10 (1)(a)(b)(c)(2)(a)(i)(ii)(iii)(iv)(c)) 28/09/2018

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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 28/09/2018 Inspection report children’s home: 1247212 4 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

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Requirement Due date

so as to keep each child safe and to protect each child effectively from harm and 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)(ii)(iii)(v)(vi)(vii)(b)(d)) The leadership and management standard is that the registered 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; ensure that staff work as a team where appropriate; ensure that staff have the experience, qualifications and skills to meet the needs of each child; and

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Requirement Due date

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. (Regulation 13 (1)(a)(b)(2)(a)(b)(c)(f)) 28/09/2018

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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; and have a positive experience of arriving at or moving on from the home. In particular, the standard in paragraph (1) requires the registered person to ensure— that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14 (1)(a)(b)(2)(a)) 28/09/2018

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. In particular 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 and to no other child. (Regulation 23 (1)(2)(b)) 28/09/2018 Inspection report children’s home: 1247212 5

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Recommendations

 Staff should be familiar with the home’s policies on record-keeping and understand the importance of careful, objective and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)  Statutory guidance on children who run away or go missing from home or care sets out the steps local authorities and their partners should take to prevent children from going missing and to protect them when they go missing. Children’s homes should have regard to the relevant aspects of this guidance. Records must be kept detailing all individual incidents when children go missing from the home. (‘Guide to the children’s homes regulations including the quality standards’, page 45, paragraph 9.25 and page 46, paragraph 9.31)  The registered person should actively seek independent scrutiny of the home and make best use of information from independent and internal monitoring

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Recommendations

(including under Regulations 44 and 45) to ensure continuous improvement. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24) In particular, the independent monitoring should include consultation with stakeholders.  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. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9) In particular, staff should not congregate outside the home and smoke in front of young people.  Under Regulation 46 the registered person should review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home’s location and strategies for managing these. (‘Guide to the

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Recommendations

children’s homes regulations including the quality standards’, page 64, paragraph 15.1)  The registered person should ensure that staff can access appropriate facilities and resources to support their training needs, and should understand the key role they play in the training and development of staff in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.11)  The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2) Inspection report children’s home: 1247212 6

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improvement to be good

Progress for young people is mixed, with young people doing well in some areas and not progressing so well in others. Similarly, experiences are varied, with young people living through some difficult experiences but also enjoying some positive experiences and developing positive relationships with staff.

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improvement to be good

The attendance, engagement and provision of education for young people is variable. Two young people have suitable arrangements in place that are meeting their educational needs. The arrangements in place for other young people are not clear and will not help them to achieve positive outcomes in education. However, the registered manager is consulting appropriately with education professionals to address the gaps in education.

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improvement to be good

Healthcare plans for young people do not demonstrate that staff have a good understanding of the health and well-being needs of each young person. When young people have missed health appointments, such as asthma reviews, substance misuse appointments and child and adolescent mental health service (CAMHS) appointments, further appointments have not been made. Furthermore, there are shortfalls in the recording and administration of medication. Consequently, the health and well-being needs of young people are not met.

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improvement to be good

There have been several staff changes at the home since the last inspection which have contributed to an unsettled time at the home. Young people and new staff are getting to know each other and starting to develop relationships. This has been made difficult in relation to one young person who has recently moved into the home as the staff have not been provided with a placement plan for the young person. Consequently, staff cannot effectively plan the young person’s care.

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improvement to be good

The home environment does not always provide a positive and nurturing welcome. Staff were observed to be congregating and smoking at the front of the house while talking to a young person. However, the interior of the home is much more welcoming. The home’s decor is maintained to a good standard and maintenance and repairs are completed as necessary.

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improvement to be good

Safeguarding practice at the home does not effectively safeguard all young people all of the time.

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improvement to be good

The arrangements in place for a young person’s overnight stay at a friend’s home are not good. Relevant checks have not been completed and information has not been Inspection report children’s home: 1247212 7 obtained to enable the manager and staff to effectively safeguard the young person. Furthermore, the manager and staff do not know where the young person is staying or who she is with. Therefore, the young person is not kept safe from harm.

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improvement to be good

There is a high number of going missing from home incidents for young people. The 2-1 staffing arrangements in place to prevent one young person from going missing from home are not effective. However, when young people are missing from home, staff take appropriate action to locate them and encourage their safe and prompt return. Records relating to going missing from home incidents do not demonstrate that independent return interviews always take place in line with statutory guidance.

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improvement to be good

Window restrictors at the home are often damaged by young people and do not appear to be fit for purpose. However, the manager addressed this during the inspection and it is anticipated that more robust restrictors will now be in place. This will help to keep young people safe and reduce the number of times that they are missing from home.

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improvement to be good

An action plan was implemented following a complaint investigation completed by the home’s responsible individual. The action plan included an action for the manager to review and update the home’s location review. However, the location review still does not include details of the risks identified in the complaint. Consequently, this does not keep young people safe from all known risks in the community.

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

The registered manager has recently resigned from her post. A new manager is in place and has submitted his application to Ofsted. The manager joined the home at a difficult time with several staff changes and unsettlement at the home. He is getting to know the young people and staff team and getting to know the systems and processes in the home. The support that he has received has been limited due to the absence of senior staff in the home. However, he anticipates that this will now improve due to senior staff now being in place.

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

Staff feel valued and supported by the new manager and responsible individual. However, staff supervision records do not demonstrate that supervision takes place in line with the company’s own timescales or that staff reflect on their practice and the needs of the young people in their care. Furthermore, not all staff have completed or are up to date with the company’s mandatory training. This does not ensure that the staff have the necessary knowledge and skills to meet the needs of the young people.

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

Monitoring and review systems at the home need to be strengthened. The independent monitoring of the home does not include regular consultation with stakeholders. This does not enable the independent person to make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the young people in the home’s care. Furthermore, young people’s records lack management oversight and require improvement to ensure that they are up to date and demonstrate the young person’s journey. Inspection report children’s home: 1247212 8 There is evidence of some collaborative working with other professionals and family members who are involved in each young person’s care to support positive outcomes for them. However, there is a lack of appropriate challenge by the manager and staff who feel that the local authority care plan does not enable them to keep the young person safe. Feedback from professionals is varied. There are some positive comments, but

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

some comments identify areas of improvement in relation to meeting the needs of the young people.

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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: 1247212 9

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Children’s home details

Registered provider: Exceptional Care Limited

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Children’s home details

Registered provider address: 147 Moss Delph Lane, Aughton, Ormskirk, Lancashire L39 5BH

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Inspector

Lisa Mulcahy: social care inspector Inspection report children’s home: 1247212 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 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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