Children's home run by Nugent Care 2019 in Liverpool

Inspection report children’s home: SC371267 1 SC371267 Registered provider: Nugent Care

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Inspected under the social care common inspection framework

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Information about this children’s home

The home is operated by a voluntary organisation and is registered for up to 36 children and young people between the ages of seven and 19 years, who have a range of Special educational needs that require either a residential-only provision or residential and specialist-school provision.

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Information about this children’s home

The manager has been registered with Ofsted since March 2018.

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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 and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded, and the care and experiences of children and young people are poor, and they are not making progress.

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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: SC371267 2

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Inspection date Inspection type Inspection judgement

05/07/2017 Full Good 01/02/2017 Interim Sustained effectiveness 14/09/2016 Full Good 25/02/2016 Interim Improved effectiveness Inspection report children’s home: SC371267 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 educational potential and are helped to do so.

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Requirement Due date

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

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Requirement Due date

(Regulation 8 (1)(2)(a)(viii)) 21/09/2018

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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.

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Requirement Due date

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 available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding; and understand and develop skills to promote the child’s well-being.

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Requirement Due date

(Regulation 10 (1)(a)(b)(2)(a)(i)(ii)(iv)) 21/09/2018

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual trust and respect; an understanding about acceptable behaviour; and positive responses to other children and adults.

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Requirement Due date

In particular, the standard in paragraph (1) requires the 21/09/2018 Inspection report children’s home: SC371267 4 registered person to ensure— that staff— meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans; encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding; help each child to develop and practise skills to resolve conflicts positively and without harm to anyone; communicate to each child expectations about the child’s behaviour and ensure that the child understands those expectations in accordance with the child’s age and understanding; strive to gain each child’s respect and trust; understand and communicate to children that bullying is unacceptable; and have the skills to recognise incidents or indications of bullying and how to deal with them.

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Requirement Due date

(Regulation 11 (1)(2)(i)(iii)(iv)(v)(viii)(xii)(xiii)) *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—

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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; 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; are familiar with, and act in accordance with, the home’s child protection policies; that the home’s day-to-day care is arranged and delivered 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;

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Requirement Due date

that the premises used for the purpose of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health; and that the effectiveness of the home’s policies is monitored 21/09/2018 Inspection report children’s home: SC371267 5 regularly.

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Requirement Due date

(Regulation 12 (1)(2)(a)(i)(ii)(iii)(iv)(b)(d)(e)) *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.

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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

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; demonstrate that practice in the home is informed and improved by taking into account and acting on— feedback on the experiences of children, including complaints received; use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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Requirement Due date

(Regulation 13 (1)(2)(a)(f)(g)(ii)(h)) 21/09/2018

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Requirement Due date

children can access all areas of the children’s home’s premises.

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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; and a record is kept of the administration of medicine to each child.

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Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it. 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— 21/09/2018 Inspection report children’s home: SC371267 6 details of the child’s behaviour leading to 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 effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; Also ensure that, 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’)

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Requirement Due date

has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within five 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.

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Requirement Due date

(Regulation 35 (2)(3)(a)(ii)(iv)(v)(vii)(viii)(b)(i)(ii)(c))

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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

The experiences and progress of children and young people have been compromised because of the poor quality of care, unsafe practice and ineffective management at the home.

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Overall experiences and progress of children and young people: inadequate

The quality of care provided to children and young people is poor. This is a clear finding from this inspection is further demonstrated in the comments made by some children and young people, staff and stakeholders. One young person wrote in an ‘all about me’ feedback form, ‘I don’t want to live in this house, I want to live in a different house, I want to be moved today, I feel unsafe and threatened and I should not be made to stay here.’ A social worker reported on a feedback form that the quality of care, consultation and how well risks are managed are poor. The registered manager did not take any action in response to either of these concerning comments. This does not demonstrate that she leads a culture that aspires to provide the best possible care for children and young people.

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Overall experiences and progress of children and young people: inadequate

When children and young people are not in full-time education, there are no arrangements in place to ensure that they are provided with structured educational activities. Furthermore, there are no education plans in place to support and encourage children and young people’s learning and educational progress. Consequently, their educational needs are not always met. Inspection report children’s home: SC371267 7 There are significant shortfalls in how well the health and well-being needs of children and young people are met. For example, when a young person declined to take prescribed medication and attend medical appointments, staff did not address this with the child or seek professional medical advice to identify how to tackle the issue. In addition, there was no medical consent in place for a young person, which had the potential to delay emergency medical treatment for him. Consequently, the health and

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Overall experiences and progress of children and young people: inadequate

well-being of children and young people is unnecessarily compromised.

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Overall experiences and progress of children and young people: inadequate

The way in which staff interact with children is not conducive to a supportive and nurturing home that will help and support children to flourish. For example, inspectors observed a lack of interaction between an agency member of staff and a young person. When this was highlighted to senior members of staff, it was confirmed that this lack of interaction had already been identified as a concern, yet this member of staff continued to work at the home. This demonstrates a lack of care and commitment to children and young people.

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Overall experiences and progress of children and young people: inadequate

The poor conditions at the home pose a hazard to children and young people’s health. Some parts of the home are poorly maintained. Some young people’s bedrooms were unclean, and they had clothes, stale food and rubbish strewn across the floor and surfaces. During the inspection, the inspectors brought the significantly poor condition of one young person’s bedroom to the attention of staff. While staff took immediate action to rectify the issues raised, they informed inspectors that they had not dealt with it sooner because of a potential negative response from the young person. Furthermore, children and young people are not allowed access to the downstairs toilet in the houses. Consequently, some children must ask staff to unlock their bedrooms so that they can use the toilet in their own bedroom. This does not instil a sense of independence or reflect respect for the children from the staff.

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

Safeguarding practice at the home is inadequate because the registered manager and staff fail to identify, manage and minimise risks to children and young people. When there is a serious concern about children and young people’s welfare, effective action is not always taken to protect them from harm. For example, concerns were identified that a young person posed a risk to other children and young people, who either live at the home or in the local community. Despite this information, staff did not identify or implement strategies to manage these risks and keep children and young people safe from harm.

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

The arrangements for administering and recording children’s medication do not ensure that children’s medical needs are met. There are errors in the amount of medication recorded for one young person, with one tablet being unaccounted for by up to one week before the tablet reappeared. Staff could not explain this error. Furthermore, records relating to the administration of controlled medication for one young person does not accurately record the time and dosage given; this potentially placed the young person at risk of being given an incorrect dosage. In addition, records do not demonstrate when children have been offered medication in line with their prescription. Inspection report children’s home: SC371267 8 The medication audits completed at the home have failed to identify or tackle these shortfalls.

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

Fire safety at the home is a serious concern because of several issues and failings. All the upstairs windows at the home have restrictors fitted externally to the window frames. These prevent escape from an open window in an emergency. Fences to the rear of the property are very high and back gates had padlocks on them, making escape from the rear of the house extremely difficult. Action was taken to remove the restrictors and padlocks when this was raised by inspectors during the inspection. Monthly and weekly fire checks are not routinely undertaken at the home. In addition to such shortfalls in practice, fire safety is further compromised because of the fire setting behaviour of some children that has not been assessed or managed effectively. Consequently, children and young people are not safeguarded from the risk of fire.

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

Risk plans for children and young people contain significant deficiencies. This means that the plans do not direct staff in the provision of safe care to children. The levels of risk identified are not fully and accurately assessed and lack robust strategies to manage and reduce these risks. For example, a self-harm risk plan for one young person states that staff should look out for any signs of self-harm. It does not provide further detail on what staff should do to manage and reduce the risk of self-harm or to support the young person. Another risk plan for a young person accessing the ‘dark web’ also failed to identify the appropriate strategies for staff to follow and manage this risk. The plan simply states that a member of staff will sit down with the young person and complete an internet safety booklet and there was no evidence of this basic task being done. Therefore, children continue to be at risk of harm.

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

There is a high number of incidents requiring the use of physical intervention at the home. Records about the use of interventions are not always clear. Some interventions have resulted in injuries to children, with no clear explanation as to how these injuries have occurred. In some incidents, staff who carried out the physical intervention have provided first aid, rather than asking a more independent member of staff to do this. Furthermore, there is no management oversight of physical interventions, so the registered manager is not identifying and addressing shortfalls or unsafe practice. This also means that the intervention of outside agencies is not being sought when required.

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

Arrangements for when children and young people are missing from home do not help to protect them. For example, a 12-year-old child, who is identified as needing two-to- one staffing, went missing for one-and-a-half hours with another child, whom senior staff had deemed to pose a risk to him. Staff did not initiate the missing from home procedures. Staff provided inconsistent accounts to inspectors and senior managers about the action that was taken. There is no evidence that staff searched the local area to locate the child and to ensure that he returned to the home safely and promptly. Furthermore, the missing from home protocol for the child was changed on the same day that the child went missing. The reporting timeframe for when the child goes missing was changed from 60 to 90 minutes. Staff could not provide a reason why the timeframe had been changed. This demonstrates that staff are not alert to the risks that

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

the child faced or to their responsibilities under the statutory guidance on children who Inspection report children’s home: SC371267 9 run away or go missing from home or care.

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The effectiveness of leaders and managers: inadequate

The experiences, progress and protection of children are inadequate. Leaders and managers do not know the strengths and weaknesses of the home. They have been ineffective in prioritising, challenging and making improvements at the home.

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The effectiveness of leaders and managers: inadequate

During the inspection, it became evident that the home is not run in line with the home’s ethos, the outcomes that the home seeks to achieve and its approach to achieving them, as identified in the home’s statement of purpose. For example, the home’s statement of purpose states ‘we provide a structured, stimulating, caring and safe environment’. However, this was not apparent during the inspection.

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The effectiveness of leaders and managers: inadequate

There have been failings in management oversight and monitoring of the home to identify areas of weakness and to take decisive action to resolve these. Effective monitoring does not take place and, as a result, the quality and standard of care has fallen to an unacceptable level. The manager has not reviewed records in the home, or evaluated incidents that have occurred, to identify shortfalls in staff practice and to highlight patterns and trends. Consequently, areas for development are not clearly identified and there is no meaningful development plan to address any areas of concern. This means that leaders and managers are not acting to improve the experiences, care and safety of children. As a result, children’s progress, welfare and safety are compromised.

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The effectiveness of leaders and managers: inadequate

The registered manager has failed to respond to negative feedback from a local authority social worker. The social worker ticked the boxes for ‘poor’ when they were asked questions about the quality of care during a consultation about how well risks are managed. The completed form was filed, and no other action taken. The lack of response and action taken by the registered manager does not demonstrate that she takes effective action when concerns have been raised to improve the quality of care and safeguarding practice at the home.

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The effectiveness of leaders and managers: inadequate

Three children have made a written formal complaint about being bullied. The complaint was filed without the registered manager’s oversight or evaluation. Furthermore, there is no evidence that a response was provided to the children concerned. There was also no evidence of any action being taken to address the issue of bullying. A senior member of staff informed the inspectors that the home’s bullying policy is not good enough. Consequently, the home’s policy and procedures in relation to bullying are ineffective.

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The effectiveness of leaders and managers: inadequate

Staff do not receive regular supervision that provides them with the opportunity to reflect on their practice and the needs of the children assigned to their care. For one member of staff, the supervision records for two consecutive sessions were almost a direct duplication, including the detail of the discussions that had taken place. A lack of effective supervision does not provide staff with an opportunity to reflect on their practice and identify any further training they may need. Nor does it provide an opportunity to ensure that staff are promoting better outcomes for all children. Inspection report children’s home: SC371267 10

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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: SC371267 11

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Children’s home details

Provision sub-type: residential special school

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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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Inspectors

Lisa Mulcahy, social care inspector Elaine Allison, social care inspector Inspection report children’s home: SC371267 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 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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