Children's Home run by PIC Children’s Services in St Helens

Inspection report children’s home: SC022442 1 SC022442 Registered provider: PIC Children’s Services 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 one of several owned by a private company. The home is registered to care for one child or young person who has emotional and/or behavioural difficulties. There is currently no registered manager for this 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 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

Date of last inspection: 7 November 2017

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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: SC022442 2

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Inspection date Inspection type Inspection judgement

07/11/2017 Full Good 16/03/2017 Interim Sustained effectiveness 06/12/2016 Full Good 15/03/2016 Interim Sustained effectiveness Inspection report children’s home: SC022442 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 need 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; and that each child has access to such dental, medical, nursing, psychiatric and psychological advice, and other services as the child may require. (Regulation 10 (1)(a)(b)(c)(2)(a)(i)(c)) 27/01/2019

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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; and that staff are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12 (1)(2)(a)(i)(vi)(b)) * 27/01/2019

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Requirement Due date

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 ensure that the home’s workforce provides continuity of care to each child;understand the impact that the quality of care provided in the home is having on the progress 27/01/2019 Inspection report children’s home: SC022442 4 and experiences of each child and use this understanding to inform the development of the quality of care provided in the

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Requirement Due date

home; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(a)(c)(e)(f)(h)) * The care planning standard is that children— receive effectively planned care in or through the children’s home. In particular, the standard in paragraph (1) requires the registered person to ensure— (b) that arrangements are in place to— (ii) manage and review the placement of each child in the home; and (iii) plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority and that each child’s relevant plans are followed. (Regulation 14 (1)(a)(2)(b)(ii)(iii)(c)) * 27/01/2019

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Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in Schedule 1. The registered person must keep the statement of purpose under review and, where appropriate, revise it and notify HMCI of any revision and send HMCI a copy of the revised statement within 28 days of the revision. The registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (1)(3)(a)(b)(5)) 27/01/2019

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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. (Regulation 23 (1)(2)(c)) 27/01/2019

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b)) 27/01/2019

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Requirement Due date

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 27/01/2019 Inspection report children’s home: SC022442 5 of any other person present when the measure was used; 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; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person

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Requirement Due date

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 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 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)) 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)) In particular, ensure that the records include a copy of the staff duty roster of persons working at the home, and a record of the actual rotas worked, and a record of any persons who work at any time at the home. 27/01/2019

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii)(e)) 27/01/2019

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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

Inspection report children’s home: SC022442 6 The current standards of care and support provided at this home mean that the young person’s safety, health and emotional well-being needs are not being adequately met. The lack of coordinated placement planning to support the young person effectively at a critical period in her life is placing her at significant risk and potentially compromising her future life chances.

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Overall experiences and progress of children and young people: inadequate

Care plans and risk assessments do not accurately reflect or address the current needs of the young person. Furthermore, insufficient action has been taken to ensure that all risk assessments are reviewed and updated. Managers and staff have failed to devise a risk assessment which clearly identifies strategies to reduce or minimise incidents or prevent harm. This ineffective approach to risk management demonstrates a lack of analysis and understanding about the risks that the young person may be exposed to. Furthermore, it fails to demonstrate that all known risks are carefully considered and does not satisfactorily set out how risk is to be reduced or managed.

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Overall experiences and progress of children and young people: inadequate

Records do not provide a full insight into the young person’s life. For example, the few records that are on the young person’s files detail informal discussions, rather than a more comprehensive record of planned sessions that address the individual needs of the young person. This is particularly evident in the lack of recorded key-working sessions in relation to what constitutes an appropriate relationship and domestic violence, to show the work undertaken to educate the young person about the risks that she is exposing herself to. Therefore, there is limited information to measure the young person’s progress or to identify the effectiveness of the support provided. This may have a significant impact on the decisions made regarding the subsequent plans for the young person as she prepares to leave the placement.

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Overall experiences and progress of children and young people: inadequate

Relationships between the young person and permanent care staff are generally positive. However, in recent months the home has relied heavily on an increasing number of agency care workers and staff from the provider’s other homes to provide care for the young person. On the day of the inspection, a staff member from another of the provider’s homes was on duty. This staff member had not previously met the young person living in the home. The staff member told the inspector that she had been on shift with an agency worker, but she could not supply the name of this agency worker. The lack of continuity of care compromises the young person’s health, well-being and safety. It does not enable the young person to build positive relationships with a consistent team of staff who she can get to know well. Consequently, this has had a negative effect on her overall care and experiences.

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Overall experiences and progress of children and young people: inadequate

The young person living in the home has significant health needs that require careful and sensitive support. However, there are no plans within the home that address how staff will support her through an imminent life-changing experience. Health plans fail to show how the young person is to be provided with the necessary emotional and practical support, for example in receiving a healthy, balanced diet and offering appropriate guidance and advice during this period.

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Overall experiences and progress of children and young people: inadequate

The young person’s health needs are either not identified or, if they are, decisive action Inspection report children’s home: SC022442 7 is not taken to manage these. For example, the young person asked for help in managing her emotional well-being and mental health needs. Other than providing the young person with information about an online provider for young people who may be experiencing mental health issues, no one took responsibility for ensuring that the young person followed through with the initial online consultation. There was no further information to show what action or strategies were put in place to support the young person in addressing her worries and concerns about her emotional and mental health needs.

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Overall experiences and progress of children and young people: inadequate

Leaders, managers and staff do not take young people’s meetings and suggestions seriously. They have failed to respond to the young person’s requests for help and assistance in sourcing grants to assist her in preparing for the next stage of her life. There is no evidence of the action taken by staff and managers to assist the young person. As a result, this has increased the young person’s anxieties and has been detrimental to her emotional and mental health.

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

The young person living in the home has not been kept safe and protected from harm. There has been a failure to follow missing from care protocols, despite the young person being missing from the home on one occasion for six days. A social worker commented, ‘I would have expected the home to report her missing from home. She was in their care and they have a duty of care to support her.’

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

Risk assessments relating to the young person contained significant deficiencies in ensuring the provision of safe care. The risk levels identified were not fully or accurately assessed or revised when new information and risks were evident. The staff do not know how to manage risk effectively. The risk assessments do not reflect prevalent risks that the young person presents. For example, there were no risk assessments in place to inform staff of the action needed to keep the young person safe during this time when she is facing a major life-changing experience. The manager and staff had failed to consider any additional precautions that may be required as the young person’s circumstances change.

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

The home’s environment is not adequately maintained. At the last inspection, a recommendation was made in relation to the shower screen in the bathroom needing repair. This is still outstanding, and the handle on the bathroom window is missing. The risk of injury to the young person is now heightened due to her current health needs.

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

Medication is poorly managed and fails to comply with the provider’s own policy and procedures. For example, on one medication administration record a post-it note was attached with a handwritten note altering the level of medication. There was no other evidence from a medical professional that this had been formally changed and the health plan did not reflect this. This failure to follow the home’s policy and procedures for the handling, recording, safekeeping and safe administration of medicines potentially places the young person at risk of the maladministration of medication. Inspection report children’s home: SC022442 8 There is no management oversight of sanctions and the manager has failed to evaluate the appropriateness or effectiveness of the measures used by staff. Consequently, staff continue to use ineffective behaviour management strategies and the young person is not learning to reflect on and improve her behaviour.

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The effectiveness of leaders and managers: inadequate

There is currently no registered manager for the home. The home is being managed by an interim manager.

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The effectiveness of leaders and managers: inadequate

The young person lives in a home that is poorly managed. Poor leadership means that the home is unable to fulfil its own aims and objectives. Given the serious shortfalls highlighted in this inspection, the home is not acting in accordance with its statement of purpose.

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The effectiveness of leaders and managers: inadequate

There have been failings in management oversight and monitoring of the home in identifying areas of weakness and in taking decisive action to resolve these. Robust internal monitoring does not take place regularly and, as a result, the quality and standard of care have 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. For example, the failures in the safe administration of medication, the number of incomplete key-work sessions and the failure to compile up-to-date and relevant risk assessments.

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The effectiveness of leaders and managers: inadequate

The manager has failed to provide staff with regular supervision. A lack of effective supervision does not provide staff with an opportunity to reflect on their practice and identify any further training that they may need. It also does not provide an opportunity to ensure that they are promoting better outcomes for the young person in their care.

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The effectiveness of leaders and managers: inadequate

The staff do not have up-to-date knowledge and skills to adequately safeguard the young person and meet her individual needs. Some staff had not received training in understanding and responding to self-harm, despite the young person displaying self- harming behaviour. This lack of appropriate training compromises the young person’s safety while living in the home.

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The effectiveness of leaders and managers: inadequate

Significant events involving the young person living at the home have not been reported to Ofsted. A failure to share information with all relevant people compromises the safety and welfare of young people. Furthermore, the regulator is unable to carry out its monitoring function to ensure that appropriate action is taken by the provider to safeguard young people.

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The effectiveness of leaders and managers: inadequate

The statement of purpose is not up to date and contains misleading information. For example, the interim manager is described as ‘working as a teaching assistant, within a school. Furthermore, the locality risk assessment and workforce development documents have not been updated since April 2017. The lack of rigour by the previously registered manager and the current interim manager has not helped the home to sufficiently protect the young person and maintain good Inspection report children’s home: SC022442 9 enough standards of care. More effective systems are needed to ensure that the safety and well-being of the young person are promoted at all times.

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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: SC022442 10

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Children’s home details

Registered provider: PIC Children’s Services Limited

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Children’s home details

Registered provider address: 2 North Street, Haydock, St Helens, Merseyside WA11 0TW

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Inspector

Elaine Allison, social care inspector Inspection report children’s home: SC022442 11 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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