Children's Home run by Birtenshaw in Bolton

Inspection report for children’s home - monitoring visit: 1232380 1 Registered provider : Birtenshaw

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Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

The home is part of a charitable organisation providing short-break services to six young people who may have physical disabilities and/or learning disabilities and/or emotional and behavioural difficulties.

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Information about this children’s home

The manager registered with Ofsted in July 2018

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This monitoring visit

This monitoring inspection was conducted in response to a notification of a serious event in the home and after a concern was received by Ofsted in relation to the home’s management of the incident, which resulted in a young person being taken to hospital.

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This monitoring visit

While staff were observed caring for young people during their morning routines, staff could not access some young people’s care and health plans as they were unavailable in the home. On the day of the inspection, staff could not access electronic records due to a system failure. This means that staff could not check the content of care plans for some children and were thus unable to follow the agreed care protocols in their care of the children.

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This monitoring visit

A young person who no longer uses the service was admitted after the usual introductory programme. However, early on during their first short stay, it became apparent that the staff group could not meet the young person’s complex needs. This resulted in a critical incident, a hospital admission and placement disruption for the young person.

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This monitoring visit

During the inspection, the manager was asked about the decision-making in relation to accepting the placement. Apparently, the first planned admission was delayed by Inspection report for children’s home - monitoring visit: 1232380 2 management who felt that the home was not ready to care for the young person, but the manager was unable to advise the inspectors about what had changed to enable the first overnight stay to go ahead. This indicates a lack of management clarity about the ability of the home to meet identified young people’s needs.

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This monitoring visit

The risk assessment documents available in the home, to guide staff in the care of young people, appear very generic and not specific to the individual needs of the young person and their care needs. While staff have signed each document, the lack of risk management guidance for specific tasks such as hoist use in moving and handling means that the staff remain ill informed on such matters.

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This monitoring visit

The senior staff do not maintain records in the home of the safety checks on the specialist aids and adaptations such as mobile hoists, ceiling-tracked hoists, rise-and- fall beds and bath and the shower seat. The latter was seen to be in a very poor state of repair and cleanliness during the inspection. Without the records, staff cannot check when the equipment is due for service checks or guarantee that the equipment is safe for use.

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This monitoring visit

The home’s approach to continence management programmes is flawed and means that appropriate levels of hygiene cannot be maintained. The disposal bags for continence products are in use in general bins, which means that general waste and continence product waste are not separated to stop cross-infection. The home does not provide a changing bed for children, who use their sleeping bed for product changes, which is unhygienic. Certain areas of the home are malodorous and unclean. A dining table is heavily damaged and in need of replacement.

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This monitoring visit

The home’s log of accidents is in place. However, the detailed records of the accidents are not maintained in the respective young person’s file, but stored at head office, which means that the young person’s file is incomplete. This impedes the manager’s monitoring of any patterns or trends. Some care records relating to resident young people were not available at the time of the inspection, having been destroyed by a young person. Such records must be stored securely, and staff should have ready access to them for reference and use during their shifts to guide their care of young people. Not all staff are trained in moving and handling, which prevents them from completing their care duties with young people.

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This monitoring visit

The living areas for young people are heavily damaged in places, with broken-down lighters, damaged furniture and water-damaged ceilings. These shortfalls mean that the home appears unkempt and unhomely. Young people lack opportunity for stimulating play or activities, and there is no evidence of toys or play materials for them to make use of and no pictures on the walls.

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This monitoring visit

The assistant director of care had notified Ofsted of one critical incident relating to a young person having an initial stay in the service. However, an earlier incident involving the same young person going to hospital was not notified to Ofsted as required. This impedes the overview of incidents and the inspector’s ability to check for patterns and trends. Inspection report for children’s home - monitoring visit: 1232380 3 A notice of suspension has been served on the service and three compliance notices, which will be closely monitored by Ofsted.

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Recent inspection history

Inspection date Inspection type Inspection judgement 14/08/2018 Full Good 24/08/2017 Full Good 07/03/2017 Interim Declined in effectiveness 27/04/2016 Full Outstanding Inspection report for children’s home - monitoring visit: 1232380 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

*14(1) The care planning standard is that children— (a) receive effectively planned care in or through the children’s home; and (b) have a positive experience of arriving at or moving on from the home.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) 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; (b) that arrangements are in place to— (i) ensure the effective induction of each child into the home; (ii) manage and review the placement of each child in the home; and (c) that each child’s relevant plans are followed. (Regulation 14 (1)(a)(b)(2)(a)(b)(i)(ii)(c)) 30/04/2019

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Requirement Due date

12(1) 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

(2) In particular, the standard in paragraph (1) requires the registered person to ensure— (b) 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. (Regulation 12 (1)(2)(b)) 30/05/2019

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Requirement Due date

36(1) The registered person must maintain records (‘case records’) for each child which— (a) include the information and documents listed in Schedule 3 in relation to each child. (Regulation 36 (1)(a)) 30/05/2019

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Requirement Due date

*13(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— (a) helps children aspire to fulfil their potential; and 30/04/2019 Inspection report for children’s home - monitoring visit: 1232380 5 (b)promotes their welfare.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to— (a) 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; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (d) ensure that the home has sufficient staff to provide care for each child; (f) 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)(c)(d)(f)) 12(1) 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

(2) In particular, the standard in paragraph (1) requires the registered person to ensure— (d) 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)(2)(d)) 30/05/2019

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Requirement Due date

*6(1) The quality and purpose of care standard is that children receive care from staff who— (a) understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; and (b)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

(2) In particular, the standard in paragraph (1) requires the registered person to— (b) ensure that staff— (ii) protect and promote each child’s welfare; (iii) treat each child with dignity and respect; (iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; (vii) provide to children living in the home the physical necessities they need in order to live there comfortably; (viii) provide to children personal items that are appropriate for their age and understanding; and (ix) make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and 30/04/2019 Inspection report for children’s home - monitoring visit: 1232380 6 choice; (c) ensure that the premises used for the purposes of the home are designed and furnished so as to—

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Requirement Due date

(i) meet the needs of each child; and (ii) enable each child to participate in the daily life of the home. (Regulation 6 (1)(2)(b)(ii)(iii)(iv)(vii)(ix)(c)(i)(ii)) 36(2) Case records must be kept— (c) securely in the children’s home during the period when the child to whom the case records relate is accommodated there. (Regulation 36 (2)(c)) 30/05/2019

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Requirement Due date

40(4) The registered person must notify HMCI and each other relevant person without delay if— (e) there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 30/05/2019

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Requirement Due date

9(1) The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff help each child to— (ii) participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and (b) that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1)(2)(a)(ii)(b)) 30/05/2019

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Requirement Due date

*These requirements are subject to a compliance notice.

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: 1232380 7

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Children’s home details

Registered provider address: Birtenshaw, Darwen Road, Bromley Cross, Bolton BL7 9AB

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Inspectors

Jo Hornby, social care inspector Karen Forster, social care regulatory inspection manager Inspection report for children’s home - monitoring visit: 1232380 8 to 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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