Children's home run by Exceptional Care Limited

Inspection report children’s home: 1247212 1 Registered provider: Exceptional Care Limited Interim inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This is a privately run children’s home that is registered for four children who may present with a range of complex needs and functioning complications, including emotional and/or behavioural difficulties. The home caters for three children in the main part of the house and one child in the attached apartment. The registered manager’s contract of employment was terminated in November 2019 and the deputy manager was promoted to the role of manager. He has not submitted his application to be registered with Ofsted.

p.1

Information about this children’s home

Four children were accommodated at the home during the inspection. All four children were spoken to by inspectors.

p.1

Information about this children’s home

Date of last inspection: 4 September 2019

p.1

Information about this children’s home

Judgement at last inspection: requires improvement to be good

p.1

Information about this children’s home

Enforcement action since last inspection: none Inspection report children’s home: 1247212 2

p.1

children and young people since the most recent full inspection

This home was judged requires improvement to be good at the last full inspection. At the interim inspection, Ofsted judges that it has declined in effectiveness.

p.2

children and young people since the most recent full inspection

Since the last inspection, the provider has failed to demonstrate that it inspires and leads a culture in the home that promotes children’s welfare and enables children to fulfil their potential. The care being provided does not meet the individual needs of children or promote their safety and welfare.

p.2

children and young people since the most recent full inspection

Managers and staff do not appropriately respond to incidents that occur, nor do they implement effective strategies to safeguard and protect children living in the home. In addition, poor risk management, a lack of appropriate boundaries and structures, and unsafe practice place the children living at the home at unnecessary risk.

p.2

children and young people since the most recent full inspection

Managers and staff do not fully understand their roles and responsibilities in safeguarding children. Consequently, children are not appropriately safeguarded by the adults who are caring for them. For example, on one occasion a child had reported to staff that they had been assaulted by a member of care staff. Staff failed to follow child protection procedures and did not report the incident to all relevant professionals or accurately record the actions taken. This does not demonstrate that care practice is consistently safe.

p.2

children and young people since the most recent full inspection

Not all children benefit from a thorough appraisal of their needs. A placement was offered to a child without the provider identifying, assessing and addressing the child’s full range of needs or considering whether the staff team had the skills and experience to keep the child safe and meet his needs. This has had a detrimental effect on all children living in the home as there has been a significant increase in violent, threatening and aggressive behaviours and significant damage to the property.

p.2

children and young people since the most recent full inspection

Behaviour management strategies are poor, and staff do not demonstrate sufficient skills and experience to manage children with complex behaviours. Staff report that the home is in ‘absolute chaos’ and that some staff are ‘frightened’ of the children. Risk management plans do not provide up-to-date information of all known risks to children and detailed strategies or preventive measures for staff to follow to protect children from harm. Furthermore, the provider has failed to notify the regulator of several serious and significant incidents that have occurred in the home. This does not assure the regulator that appropriate action is being taken to safeguard children.

p.2

children and young people since the most recent full inspection

Records of restrictive physical intervention for children are inaccurate, insufficiently detailed and not completed in line with regulatory requirements. For example, some records of restraint do not include details of the antecedents and strategies that staff used to manage the behaviour of the child, to demonstrate that the use of physical intervention was necessary to keep the child safe. Some records are missing Inspection report children’s home: 1247212 3 or do not include details of the intervention used and its duration, whether any injuries were sustained or whether medical treatment was offered. Records lack sufficient information about debriefings with staff and children or management oversight and evaluation. As a result, the provider is unable to identify effective practice or respond promptly where any issues or trends of concern emerge. Furthermore, the provider is unable to amend practice to ensure that it meets the

p.2

children and young people since the most recent full inspection

Care plans for children are not always followed. For example, the care plan for one child clearly states that he should have 2:1 staffing at all times to keep him safe. However, the provider has failed to ensure that sufficient and competent staff are on shift, and the child’s risk assessment contradicts the care plan for 2:1 staffing at all times. The record completed following a significant incident for the child indicated that both staff left him on his own as they felt that they wanted ‘a breath of fresh air and a change of scenery’. This failed to safeguard the child and was contrary to the local authority care plan.

p.3

children and young people since the most recent full inspection

Children spoken to during the inspection do not feel that they have positive relationships with the manager and staff. They do not have confidence in the care provided by staff, which impacts on their relationships with them. Children who have lived at the home for a significant period told inspectors that they do not feel listened to or supported by the care staff responsible for them. Children said, ‘Staff are constantly shouting at us and we feel that no one listens to us or helps us.’ Furthermore, some children’s records and plans do not include their views, wishes and feelings or demonstrate that they have viewed or contributed to their records.

p.3

children and young people since the most recent full inspection

Fire safety is not prioritised, despite some children having a known history of fire- setting and there being a recent fire-setting incident at the home. Staff reported that fire extinguishers had been removed to prevent children from using them as weapons. Staff were unaware of where the fire extinguishers had been moved to and could not locate them during the inspection, despite it being clearly recorded in one child’s risk assessment where the fire extinguishers would be stored.

p.3

children and young people since the most recent full inspection

The condition of the home is poor, and the environment does not provide children with a safe, warm and welcoming space. There was significant damage throughout the home that included smashed windows, exposed water pipes, damaged electrical sockets, damaged doors and significant graffiti with expletives on the walls and doors. In addition, children’s bedrooms were unclean, restrictors had been removed from windows and floors were cluttered, posing a tripping hazard. This fails to keep children, staff and visitors to the home safe.

p.3

children and young people since the most recent full inspection

Due to the serious safeguarding concerns identified, Ofsted has issued an emergency suspension notice. Ofsted will monitor compliance with the notice and review the suspension regularly. Inspection report children’s home: 1247212 4

p.3

Inspection date Inspection type Inspection judgement

04/09/2019 Full Requires improvement to be good 15/05/2019 Full Inadequate 08/08/2018 Full Requires improvement to be good 11/01/2018 Interim Sustained effectiveness Inspection report children’s home: 1247212 5

p.4

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.5

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.

p.5

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)) 31/03/2020

p.5

Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who— develop positive relationships with them; engage with them; and take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

p.5

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to— ensure that staff— ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare; help each child to express views, wishes and feelings; help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child; regularly consult children, and seek their feedback, about the quality of the home’s care. ensure that each child— 31/03/2020 Inspection report children’s home: 1247212 6 is enabled to provide feedback to, and raise issues with, a relevant person about the support and services that the child receives; has access to the home’s children’s guide, and the home’s complaints procedure, when the child’s placement in the

p.5

Requirement Due date

home is agreed and throughout the child’s stay in the home; and is given appropriate advocacy support.

p.6

Requirement Due date

ensure that an explanation is given to each child as soon as reasonably practicable after the child’s arrival about— what advocacy support or services are available to the child, how the child may access that support or those services and any entitlement the child may have to independent advocacy provision ensure that the views of each relevant person are taken into account, so far as reasonably practicable, before making a decision about the care or welfare of a child. (Regulation 7 (1)(2)(a)(i)(ii)(iii)(iv)(b)(d)(iii)(e)) 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.

p.6

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 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 competence and skills to interpret these and develop

p.6

Requirement Due date

positive relationships with children; 31/03/2020 Inspection report children’s home: 1247212 7 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.

p.6

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 12(1)(2)(i)(ii)(v)) 31/03/2020

p.7

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.

p.7

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)) 31/03/2020

p.7

Requirement Due date

The care planning standard is that children— receive effectively planned care in or through the children’s home;

p.7

Requirement Due date

In particular, the standard in paragraph (1) requires the 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)) 31/03/2020 Inspection report children’s home: 1247212 8 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)) 31/03/2020

p.7

Requirement Due date

Restraint in relation to a child is only permitted for the purpose of preventing— injury to any person (including the child); serious damage to the property of any person (including the child); or a child who is accommodated in a secure children’s home from absconding from the home.

p.8

Requirement Due date

Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (1)(a)(b)(c)(2)) 31/03/2020

p.8

Requirement Due date

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.

p.8

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’)—

p.8

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 31/03/2020 Inspection report children’s home: 1247212 9 confirmation that they have spoken to the child about the measure. (Regulation 35 (1)(3)(a)(b)(c)) 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)) 31/03/2020

p.8

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 serious incident relating to a child which the registered person considers to be serious. (Regulation 40(4)) 31/03/2020

p.9

Information about this inspection

This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

p.9

Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, 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

p.9

Children’s home details

Registered provider: Exceptional Care Limited

p.10

Children’s home details

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

p.10

Inspectors

Lisa Mulcahy, Social Care Inspector Mandy Nightingale, Social Care Inspector Inspection report children’s home: 1247212 11 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.

p.10

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.11

Inspectors

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

p.11

Inspectors

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

p.11