Children's Home run by Lancashire County Council in Lancashire

Inspection report children‟s home: SC035428 1 SC035428 Registered provider: Lancashire County Council

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This home is one of several operated by a local authority. The home provides care and accommodation for up to two young people who may have complex emotional and/or behavioural needs.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

p.1

requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

p.1

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.

p.1

requires improvement to be good

Date of last inspection: 18 September 2018

p.1

requires improvement to be good

Overall judgement at last inspection: good

p.1

requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: SC035428 2

p.1

Inspection date Inspection type Inspection judgement

18/09/2018 Full Good 29/05/2018 Interim Not judged 26/03/2018 Interim Not judged 02/03/2018 Interim Not judged Inspection report children‟s home: SC035428 3

p.2

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.

p.3

Requirement Due date

The children‟s views, wishes and feelings standard The children‟s views, wishes and feelings standard is that children receive care from staff who— take their views, wishes and feelings into account in relation to matters affecting the children‟s care and welfare and their lives. In particular, the standard in paragraph (1) requires the registered person to— ensure that staff— help each child to express views, wishes and feelings; ensure that an explanation is given to each child as soon as reasonably practicable after the child‟s arrival about— how to make a complaint or representations in relation to the home or the care the child receives and how any such complaint or representations will be dealt with. (Regulation 7(1)(c)(2)(a)(ii)(d)(ii)) 28/06/2019

p.3

Requirement Due date

The protection of children standard 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; 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)(a)(i)(d)) 28/06/2019

p.3

Requirement Due date

The leadership and management standard 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— 28/06/2019 Inspection report children‟s home: SC035428 4 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; use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b)(2)(f)(h)) The care planning standard The care planning standard is that children— receive effectively planned care in or through the children‟s home. (Regulation 14(1)(a))

p.3

Requirement Due date

Children‟s case records 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)) 28/06/2019

p.4

Recommendations

 Care must be taken to ensure that prescribed medicines are only administered as they are prescribed. Where a child is prescribed a medication on an „as and when required‟ basis, there must be clear guidance in place for staff regarding how decisions to offer or administer the medication are to be made. („Guide to the children‟s homes regulations including the quality standards‟, page 34, paragraph 7.15)  When a child returns to the home after being missing from care or away from the home without permission, the responsible local authority must provide an opportunity for the child to have an independent return home interview. Homes should take account of information provided by such interviews when assessing risks and putting arrangements in place to protect each child. („Guide to the children‟s homes regulations including the quality standards‟, page 45, paragraph 9.30)  Staff should have clear expectations of children‟s behaviour. Individualised

p.4

Recommendations

strategies should be in place for each young person and staff should apply these when managing challenging behaviours. In particular, de-escalation techniques should be agreed and consistently implemented by staff. („Guide to the children‟s homes regulations including the quality standards‟, page 39, paragraph 8.11)  The use of external agency staff can be a positive choice to complement the skills and experiences of the permanent workforce. Any external agency staff should meet the requirements in regulation 32(4) regarding mandatory qualifications and the registered person should consider their skills, qualifications and any induction necessary before they commence work in the home. The use of agency staff Inspection report children‟s home: SC035428 5 should be carefully monitored and reviewed to ensure that children receive continuity of care. („Guide to the children‟s homes regulations including the

p.4

Recommendations

quality standards‟, page 54, paragraph 10.16)  The registered person should have a workforce plan which can fulfil the workforce related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should detail the necessary management and staffing structure (including any staff working on a casual basis), the experience and qualifications of staff currently working within the staffing structure and any further training required for those staff, to enable the delivery of the home‟s statement of purpose, and detail the process and timescales for supervision of practice (see regulation 33 (4) (b)) and keep appropriate records for staff in the home. („Guide to the children‟s homes regulations including the quality standards‟, page 53, paragraph 10.8)

p.5

improvement to be good

This home provides care for young people who have complex needs. In most cases, young people who live at this home have struggled to engage in previous placements and have experienced multiple placement breakdowns. Young people who have lived at this home have experienced varied outcomes. One young person engaged well and developed positive relationships with staff. Her discharge to a placement with less intensive support was well planned and well supported. For some young people, there have been increasing concerns regarding aspects of their high-risk behaviours. This has led to some placement breakdowns. However, there is evidence that these young people had some good experiences and developed some positive relationships with the registered manager and staff during their stays. A parent spoke highly of the home. She told inspectors that her son had lived in a number of children‟s homes, but that this home was the first one that had provided him

p.5

improvement to be good

with positive support. The young person‟s social worker echoed these sentiments and said, „This home has demonstrated a commitment that other placements have not.‟ Staff encourage young people to lead healthy lifestyles and attend healthcare appointments. This has resulted in a good outcome for one young person, who attended for dental treatment having previously refused to attend. Another young person has benefited from input from the child and adolescent mental health services (CAMHS) and a full medication review during a relatively short time at the home. Young people are encouraged to engage in education. One young person in particular has made progress, as he is now engaging in education. Although he is following a reduced timetable, this is the first time he has attended education in several years. For other young people, there has been less engagement. Staff ensure that young people who have reduced education provision have regular learning opportunities and

p.5

improvement to be good

structured activities. Inspection report children‟s home: SC035428 6 There are some good examples of positive consultation and direct work with young people. However, there are also aspects that require improvement. For example, direct work with young people does not always cover areas that have particular relevance to them. Furthermore, when young people have shared their views or raised concerns, it is not always evident that managers and staff have taken action in response to the young people‟s concerns. Therefore, young people cannot always be confident that their opinions or concerns are heard or acted upon.

p.5

improvement to be good

There are risks associated with the care of some young people. They have been admitted to the home amid high levels of concern around unsafe lifestyles. The registered manager and staff attempt to work with partner agencies to promote young people‟s safety and well-being. A social worker described positive multi-agency working and regular collaborative care planning. Although there is a clear commitment to keeping young people safe and protecting them from harm, safeguarding practice is not consistently underpinned by robust risk management. Some risk assessments lack detail and context, and strategies for minimising risk are not always clearly described. This means that staff may not have enough information to ensure consistently safe practice. There have been some instances of young people going missing from the home. Individualised protocols are in place for each young person, which have been developed

p.6

improvement to be good

in partnership with external agencies, such as the police and social care services. The protocols provide staff with guidance about the actions that they must take to help safeguard young people when they are missing. A recommendation was made at the last inspection regarding return home interviews for young people who have been missing from home. There has been improvement, in that the registered manager now ensures that these interviews are carried out. However, further efforts must be made to ensure that pertinent information and learning from the interviews are used to inform risk management and minimise future risks. Staff demonstrate good insight into young people‟s complex behaviours. A social worker of a young person who recently left the home commented, „The staff team worked hard to try to support [Name of young person]. They saw past the challenging behaviours and were able to see that his responses were trauma-based.‟

p.6

improvement to be good

Individualised guidance about how to support young people‟s behaviours varies in quality. In some cases, there is a lack of clarity, and strategies to de-escalate challenging situations are unclear. As a result, young people‟s behaviour support is not consistent. This does not support young people to develop safer and more appropriate behaviours. The environment is well maintained and, in general, young people are provided with safe accommodation. However, during the inspection, an easily identifiable safety concern was noted. On further investigation, it came to light that this issue had been present for several weeks. The registered manager took immediate action to rectify the matter. However, it is of concern that this matter had not been identified and addressed sooner. Inspection report children‟s home: SC035428 7

p.6

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

There is a suitably qualified and experienced manager in place who has been registered since September 2018. The registered manager exudes warmth and is particularly skilled in engaging harder-to-reach young people. External professionals and staff recognise the registered manager‟s strengths and speak highly of her. The registered manager has high expectations of the staff team. However, it is apparent that not all staff are as skilled or confident in supporting young people with highly complex behaviours. To her credit, the registered manager has recognised this and is in the process of making significant changes to the staff team. There has been a high turnover of staff and a relatively high use of casual and agency staff. However, the registered manager has ensured that, where possible, the pool of casual and agency staff is small, so that young people receive their care from staff they are familiar with.

p.7

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

Staff are provided with a training programme designed to enhance their skills and assist them in carrying out their roles effectively. Training for core staff is carefully monitored to ensure that they remain up to date in all areas of learning. However, arrangements to monitor training for casual and agency staff could be improved. Core staff benefit from regular supervision as well as the opportunity to discuss and reflect on significant incidents, as and when they occur. However, some casual staff have not had the benefit of regular supervision, despite working regular hours in the home. It is important that all staff have regular opportunities to meet on a one-to-one basis with a manager to discuss areas such as personal development, performance and any concerns. The matching of young people who have complex needs is a challenge. It is important to ensure that thorough impact risk assessments are completed to help ensure that the

p.7

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

needs of young people being considered for the home can be safely met, and that their admission will not have an adverse impact on young people already living in the home. Some shortfalls were identified in this process during the inspection. Some young people‟s impact risk assessments did not demonstrate full consideration of their needs and whether they could be met effectively. The registered manager demonstrates a good understanding of the strengths and some weaknesses of the home and is able to discuss her plans for development. However, systems to monitor safety and quality across the service are not consistently used in an effective manner. A number of shortfalls were identified in relation to monitoring young people‟s progress and the home‟s performance. In addition, where matters of concern are raised or identified, action taken to address them is not always clear. This means that opportunities for learning and improvement could be lost.

p.7

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 Inspection report children‟s home: SC035428 8 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.

p.7

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: SC035428 9

p.8

Children’s home details

Registered provider address: PO Box 78, County Hall, Fishergate, Preston PR1 8XJ

p.9

Inspectors

Marie Cordingley, social care inspector Jessica Forshaw, social care inspector Inspection report children‟s home: SC035428 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.

p.9

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.10

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.10

Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

p.10