Children's home run by Exceptional Care Limited

Inspection report children’s home: 1247212 1 Registered provider: Exceptional Care 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

This is a privately run children’s home that is registered for four young people who may present with a range of complex needs and functioning complications, including emotional and/or behavioural difficulties. The home caters for three young people in the main part of the house and one young person in the attached apartment. The manager started working at the home in October 2018 and was registered with Ofsted in March 2019.

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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: inadequate

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Enforcement action since last inspection:

Compliance notices were issued under regulations 12 and 13 of The Children’s Homes (England) Regulations 2015 following the last inspection. A monitoring visit took place on 2 July 2019 to monitor the progress made against the notices. The two compliance Inspection report children’s home: 1247212 2 notice were met.

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Inspection date Inspection type Inspection judgement

15/05/2019 Full Inadequate 08/08/2018 Full Requires improvement to be good 11/01/2018 Interim Sustained effectiveness 10/05/2017 Full Good Inspection report children’s home: 1247212 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 quality and purpose of care standard is that children receive care from staff who— understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; 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— understand and apply the home’s statement of purpose; ensure that staff— understand and apply the home’s statement of purpose; protect and promote each child’s welfare; provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background. (Regulation 6 (1)(2)(a)(b)(i)(ii)(iv)) 18/10/2019

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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 respect and trust; 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 registered person to ensure— that staff— meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans; help each child to develop socially aware behaviour; encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding; 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; help each child to understand, in a way that is appropriate 18/10/2019 Inspection report children’s home: 1247212 4 according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful; strive to gain each child’s respect and trust; understand how children’s previous experiences and present emotions can be communicated through behaviour and have the

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Requirement Due date

competence and skills to interpret these and develop positive relationships with children; are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same; that each child is encouraged to build and maintain positive relationships with others. (Regulation 11(1)(2)(a)(i)(ii)(iii)(v)(vi)(viii)(ix)(x)) 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

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; help each child to understand how to keep safe; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation (1)(2)(i)(ii)(v)) 18/10/2019

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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.

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Requirement Due date

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; 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)(2)(a)(f)) 18/10/2019

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Requirement Due date

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 18/10/2019 Inspection report children’s home: 1247212 5 registered person to ensure— that arrangements are in place to— ensure the effective induction of each child into the home; that staff help each child to access and contribute to the records kept by the registered person in relation to the child. (Regulation 14(a)(b)(i)(f)) The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out— how appropriate behaviour is to be promoted in the children’s home; and the measures of control, discipline and restraint which may be used in relation to children in the home.

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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 of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; and 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 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. (Regulation 35(1)(3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)) 18/10/2019

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which— are kept up to date and are signed and dated by the author of each entry. (Regulation 36(1)(b)(c)) 18/10/2019

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home. The registered person must— 18/10/2019 Inspection report children’s home: 1247212 6 maintain in the home the records in Schedule 4; ensure that the records are kept up to date. (Regulation 37(1)(2)(a)(b))

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Requirement Due date

In particular, ensure that staff rosters are accurate.

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Recommendation

 Where children placed in a home are not participating in education because they have been excluded or are not on a school roll for some other reason, the registered person and staff must work closely with the placing authority so that the child is supported and enabled to resume full-time education as soon as possible. (‘Guide to the children’s homes regulations including the quality standards’, page 27, paragraph 5.15)

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improvement to be good

Some young people have made progress from their starting points and say that they feel happy, safe and well cared for. However, this is not the case for all four young people currently living at the home. Some shortfalls in staff’s practice, safeguarding, and leadership and management are potentially jeopardising young people’s welfare and progress.

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improvement to be good

The registered manager and staff have not been able to provide a suitably structured routine so that each young person has a positive experience and can make good progress. One young person spends a considerable amount of time isolated in his bedroom, often playing on his games console for long periods. Additionally, the young person does not eat regular nutritious meals and on occasion does not eat until mid or late afternoon. Furthermore, he tends to eat meals alone in his bedroom after preparing them himself. The lack of structure and routine and a poor quality of care for the young person is having a detrimental effect on his social and emotional well-being.

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improvement to be good

Relationships between the young people, as well as between the young people and staff, are not always promoted well. Plans to encourage positive relationships, such as engaging in weekly activities together, have not always been consistently followed through. As a result, not all young people have positive relationships with the staff and each other.

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improvement to be good

Improvement has been made in how well the manager and staff encourage and support young people to take part in meaningful education. Three of the four young people have suitable education placements for the start of the new school year. However, one young person is yet to be enrolled at a school. The young person will continue to receive ten hours of home tuition each week, but the continued lack of a suitable educational placement continues to affect her education opportunities and has the potential to have Inspection report children’s home: 1247212 7 an impact on her future life chances.

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improvement to be good

Placement plans lack sufficient detail and do not provide accurate, up-to-date information about the needs of the young people or the progress that they are making. There is limited information about young people’s attendance and achievement in education and the arrangements for seeing their family and friends. Furthermore, one young person’s placement plan does not include an accurate account of how the young person’s therapeutic needs are being met or the detail of the therapeutic service commissioned by the home.

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improvement to be good

The registered manager and staff do not always prioritise the views, wishes and feelings of the young people. A young person spoke about feeling that staff do not always listen to her or respond to requests that she makes. Furthermore, records and plans for young people do not show how their opinions have been sought to inform their plans or whether they have viewed their records.

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improvement to be good

The plan for one young person is to move to another placement shortly. The registered manager and staff have carefully considered the needs of the young person and developed a detailed transition plan. This plan will help the young person to move on positively.

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improvement to be good

The arrangements for safeguarding young people are not yet good enough. There is potential to leave the young people at risk of harm. For example, the registered manager and staff are aware that some of the young people smoke; however, they have failed to implement robust risk assessments in relation to the risk. Furthermore, the registered manager has failed to address the identified risks to ensure the safety of everyone in the home.

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improvement to be good

Risk assessments do not adequately demonstrate that all known risks are identified and addressed. They lack sufficient information and analysis as to why risk levels have reduced or heightened. For example, a young person’s risk assessment states that the risks relating to child sexual exploitation have reduced. However, there is limited information and analysis of how this has been achieved and whether this is due to the steps taken by the staff.

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improvement to be good

Young people do not routinely view or contribute to their risk assessments as the registered manager primarily views them as for staff use only. This is not an open and transparent approach to managing risk for young people. Furthermore, it is a missed opportunity for the young people and staff to share information that may help to keep young people safe.

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improvement to be good

Despite the shortfalls identified in risk assessments and risk management, risks and incidents for some young people continue to reduce. For example, the risks relating to child sexual exploitation and gang affiliation have reduced with no significant incidents Inspection report children’s home: 1247212 8 occurring for some time. Young people are now safer than they were when they first moved into the home.

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improvement to be good

The number of incidents when young people are reported missing from home has also reduced. The action taken to locate and ensure the safe return of young people is appropriate. However, independent return home interviews do not always take place. These interviews would provide young people with an opportunity to share information about why they went missing and the risks that they may have faced during the time that they were missing.

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improvement to be good

The staff’s approach to behaviour management is inconsistent. This approach does not help the staff and young people to understand the expectations of behaviour at the home. The young people do not have behaviour management plans in place that set out what is expected in order to promote positive behaviour and reduce negative behaviour effectively. Additionally, consequences for poor behaviour are not recorded to show the type and duration of the measure used, the young people’s comments about the measure or the staff’s and registered manager’s evaluation of its effectiveness.

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

The registered manager and staff have taken some action to address the shortfalls identified at the last inspection, such as improving the management of allegations and the level of management oversight. However, there continue to be several areas that require improvement to ensure that young people receive a good quality of care that improves their life chances and keeps them safe from harm.

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

Since the last inspection, the registered manager has not taken sufficient action to meet all of the requirements or the recommendation issued. Some young people’s progress has not been sustained due to the lack of coordinated placement planning. This has had a direct impact on their welfare, development and safety. For example, the plan for one young person to spend more time out of his bedroom with the objective of avoiding spending excessive time on his games console and taking meals in his bedroom has not been followed. As a result, the young person is continuing to spend a considerable amount of time isolated in his bedroom.

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

The systems in place to ensure that there is a consistent and coordinated level of communication between the registered manager and staff is ineffective. Daily logs and handovers do not ensure that relevant information is shared between the members of the staff team. For example, during one of the days of the inspection, the registered manager and staff were unsure as to whether one young person had eaten. This lack of effective communication has an impact on the quality of care given to the young people.

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

Staff duty rosters do not accurately record the actual staff on duty. When there are shortfalls or changes in the rota, the records do not include information to show whether the shift was covered and if so by whom. Also, staff rosters do not demonstrate whether staff have worked in the main part of the home or the attached apartment. This prevents a clear audit trail of who is working in the setting. The lack of transparency of Inspection report children’s home: 1247212 9 who is on duty potentially places young people at risk and compromises the continuity of care.

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

Staff feel supported by the registered manager. They receive regular supervision that helps them to reflect on their practice and the needs of the young people. The continuous professional development of staff is promoted, and they receive regular training and development opportunities. Regular team meetings allow the manager and staff to discuss the needs and progress of the young people. The team meetings also provide good opportunities for staff to reflect on their practice and to share information from training and research. For example, the staff team has had safeguarding training and a session about motivation at recent team meetings. This focus on reflective practice enhances their knowledge and skills.

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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: 1247212 10

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Children’s home details

Registered provider: Exceptional Care Limited

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Children’s home details

Registered provider address: Malthouse Business Centre, 48 Southport Road, Ormskirk, Lancashire L39 1QR

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Inspectors

Lisa Mulcahy, social care inspector Catherine Fargin, social care inspector Inspection report children’s home: 1247212 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 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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