Children's home run by Birtenshaw in Bolton

Inspection report children‟s home: SC483533 1 SC483533 Registered provider: Birtenshaw

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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 part of a large charitable organisation. It provides care and accommodation for up to three young people who have learning disabilities and/or sensory impairment. The manager has been registered with Ofsted since January 2015. The manager has the necessary experience and the required level 5 management qualification.

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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

Overall judgement at last inspection: requires improvement to be good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: SC483533 2

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Inspection date Inspection type Inspection judgement

15/05/2018 Full Requires improvement to be good 26/07/2017 Full Good 06/03/2017 Interim Sustained effectiveness 20/09/2016 Full Outstanding Inspection report children‟s home: SC483533 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

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

if the registered person considers, or staff consider, a placing authority‟s or a relevant person‟s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child‟s needs are met in accordance with the child‟s relevant plans. (Regulation 5 (c)) 30/05/2019

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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;

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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—

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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—

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Requirement Due date

meet the needs of each child. (Regulation 6 (1)(a)(b)(2)(c)(i))

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Requirement Due date

In particular, the wet room should be maintained and cleaned to ensure that it is a pleasant and appropriate space for young people to wash. Furthermore, staff should ensure that mats used in the event of a young person having an epileptic seizure are clean. 30/05/2019

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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— 30/05/2019 Inspection report children‟s home: SC483533 4 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;

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Requirement Due date

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

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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)(a)(d)(h)) The registered person must— keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)(b))

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Requirement Due date

In particular, the registered manager should ensure that the statement of purpose accurately reflects how and when external door alarms and epilepsy monitoring sensors will be used. 30/05/2019

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if—

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Requirement Due date

the child‟s placing authority consents in writing to the monitoring or surveillance;

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Requirement Due date

the monitoring or surveillance is no more intrusive than necessary, having regard to the child‟s need for privacy. (Regulation 24 (1)(b)(d))

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Requirement Due date

In particular, the registered manager should ensure that the use of epilepsy monitoring systems is kept under review. There should be a record of the local authorities‟ written consent for the use of such systems. 30/05/2019

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children‟s home; and

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Requirement Due date

the measures of control, discipline and restraint which may be 30/05/2019 Inspection report children‟s home: SC483533 5 used in relation to children in the home.

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Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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Requirement Due date

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—

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Requirement Due date

details of the child‟s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

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 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

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Requirement Due date

within 5 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

Paragraph (3) does not apply in relation to restraint that is planned or provided for as a matter of routine in the child‟s EHC plan or statement of special educational needs. (Regulation 35 (1)(a)(b)(2)(3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(4)) Inspection report children‟s home: SC483533 6 In particular, the registered manager should ensure that the home‟s behaviour management policy sets out the circumstances in which external doors can be locked. The locking of external doors should be recorded as a measure of control unless exempt (as outlined in paragraph 4 or if a deprivation of liberty order is in place). The registered person must maintain records (“case records”) for each child which include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c))

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Requirement Due date

In particular, the registered manager should ensure that personal education plans, education and healthcare plans and local authority care plans are on file. 30/05/2019

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Requirement Due date

The registered person must ensure that an independent person visits the children‟s home at least once each month.

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person—

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Requirement Due date

if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires; and

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Requirement Due date

to inspect the premises of the home and such of the home‟s records (except for a child‟s case records, unless the child and the child‟s placing authority consent) as the independent person requires.

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Requirement Due date

A visit by the independent person to the home may be unannounced.

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Requirement Due date

The independent person must produce a report about a visit (“the independent person‟s report”) which sets out, in particular, the independent person‟s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children‟s well-being.

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Requirement Due date

The independent person‟s report may recommend actions that the registered person may take in relation to the home and timescales within which the registered person must consider whether or not to take those actions. (Regulation 44 (1)(2)(a)(b)(3)(4)(a)(b) (5)) 30/05/2019 Inspection report children‟s home: SC483533 7

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improvement to be good

Since the last inspection, the home has had some redecoration. This means that there have been improvements in the communal spaces in which young people spend most of their time.

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improvement to be good

Young people‟s bedrooms are personalised and reflect their personalities and interests. However, not all areas of the home have been maintained to a good enough standard. For example, inspectors found that the young people‟s bathroom had a strong and unpleasant odour. The cause of this could not be determined. Cleaning during the inspection was not enough to address the issue. Externally, the rear garden was overgrown, there was a damaged handrail and a young person‟s bike had been abandoned and left to perish. This means young people experience a home environment of mixed quality.

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improvement to be good

A mat used to reduce the risk of one young person hurting themselves in the event of an epileptic seizure was observed to be dirty and heavily stained. This does not demonstrate that staff consistently prioritise the dignity of young people. When the concern was brought to the attention of staff, immediate action was taken to replace the mat.

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improvement to be good

One young person requires an epileptic seizure monitor in his bedroom. However, staff are not using this system in line with the home‟s statement of purpose. Specifically, written consent has not been obtained from the local authority. Furthermore, staff have received mixed guidance on when this monitoring system should be used. This does not ensure that a consistent, safe approach is maintained.

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improvement to be good

Staff understand young people‟s health needs and support them to access the required health services. In one example, staff have worked proactively with the child and adolescent health service to reduce the medication that a young person is administered. This has had a positive impact on the young person.

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improvement to be good

Young people have good relationships with most staff. However, due to staff vacancies young people are looked after by several agency staff, whom they are unfamiliar with. This does not ensure that young people are looked after by a consistent staff team.

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improvement to be good

Staff who know young people well ensure that they are given lots of opportunities to contribute to the care that they receive, even when their verbal communication skills are limited.

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improvement to be good

Encouragement and support from staff means that young people make progress in certain aspects of their lives. For example, some young people have developed their self- Inspection report children‟s home: SC483533 8 care skills and are now more able to dress and wash themselves.

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improvement to be good

Staff ensure that young people lead active and fun lives. Young people engage with a wide variety of activities both in and out of the home. This means that young people learn new skills, develop their social skills and grow in confidence.

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improvement to be good

Staff understand young people‟s vulnerabilities. Risk assessments provide staff with clear guidance on how to keep young people safe. However, not all young people have all relevant looked after children documentation. This does not ensure that staff have access to all known information about young people to fully inform risk management plans and consistently keep young people safe.

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improvement to be good

Staff lock external doors to reduce the potential risk of young people going missing. However, the home‟s behaviour management policy does not cover the practice of locking doors. As such, staff are not given clear guidance about the circumstances in which this would be appropriate. Staff do not record the locking of doors as a measure of control. This is a missed opportunity to review the appropriateness of this behaviour strategy.

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improvement to be good

The statement of purpose does not always reflect the day-to-day arrangements for looking after young people. This means that parents and local authorities are not provided with accurate information about the care that young people will receive. For example, the statement of purpose states that external door alarms are used as a safety measure. Inspectors found that these devices were missing or broken. The registered manager advised that there are no plans to replace these alarms. This fails to demonstrate that the procedures in place to safeguard young people are adhered to.

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improvement to be good

Staff are quick to learn the triggers and signs of a young person becoming agitated or upset. This means that staff can act proactively to support young people to make positive choices and avoid placing themselves or others at risk.

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improvement to be good

Staff support young people to develop their own emotional regulation skills. For example, one young person is now able to use his bedroom as a space to calm down. This is real progress for the young person.

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

The registered manager‟s internal monitoring systems do not enable her to appropriately review the quality of care provided to young people. Similarly, external monitoring by the independent visitor has also lacked rigor. This means that the registered manager has not been able to identify and address shortfalls in practice. These shortfalls have impacted on the overall experiences of young people who live in the home. Inspection report children‟s home: SC483533 9 The registered manager does not ensure that copies of young people‟s local authority care plans, education and healthcare plans or personal education plans are on file. This is because the oversight of case records is chaotic. Managers do not know what information is on young people‟s files, and as a result they fail to challenge partner agencies about the delay in documentation being provided. In other examples, managers request duplicate copies of documents as they are not aware that they have

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

been received. This means that vital information related to the care planning for young people is missing or not read by staff. This does not demonstrate effective leadership or care planning.

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

The registered manager‟s challenge of partner agencies is limited. For example, when social workers do not complete actions within agreed timescales, the registered manager does not utilise the local authority‟s escalation procedures to address the delay. This means that, in some instances, the registered manager does not act as a strong advocate for young people.

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

Since the last inspection, new staff have been recruited. Despite this, ongoing vacancies mean that agency staff continue to be required. As a result, young people are sometimes looked after by a staff team that includes unfamiliar staff.

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

The need for the registered manager to personally pick up extra shifts, as well as her responsibility for other roles within the organisation, has impacted on her capacity to provide the required oversight of this home.

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

Despite this, staff say that they feel well supported by the management team. This is because they receive regular supervisions and team meetings.

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

Several of the staff have worked at the home for a long period and are therefore experienced and knowledgeable. Access to training ensures that staff can develop and maintain their skill base.

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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 Inspection report children‟s home: SC483533 10 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: SC483533 11

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Children’s home details

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

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Inspector’s

Paul Robinson, social care inspector Jo Hornby, social care inspector Inspection report children‟s home: SC483533 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 looked after children, safeguarding and child protection.

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Inspector’s

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Inspector’s

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Inspector’s

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