Children's home run by Cherished and Devoted Care

Inspection report for children’s home - monitoring visit: 2503316 1

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Cherished and Devoted Care

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This home was registered in May 2019. The home is registered to offer care and accommodation for up to five children who have learning disabilities.

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Information about this children’s home

There is currently no registered manager for this home.

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Information about this children’s home

Children were spoken to as part of this inspection.

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This monitoring visit

The home had its first full inspection on 6 November 2019 and was judged as inadequate. Inspectors identified poor practice relating to safeguarding, risk management, and health and care planning. The arrangements for leadership and management of the home were poor. Following the inspection, a decision was made to issue an emergency suspension. The home remained suspended until 9 March 2020. This urgent on-site inspection took place due to notifications received by Ofsted that demonstrated that staff and managers were unable to manage the behaviour of the children and police intervention had been required.

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This monitoring visit

During this monitoring visit, the inspectors identified that the current standards of care and support provided at this home mean that the children’s safety, health and emotional well-being needs are not being adequately met. The lack of coordinated placement planning to support the children effectively at a critical period in their lives is placing them at significant risk.

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This monitoring visit

Children are not protected from harm. The provider has failed to ensure that there are enough permanent, experienced and trained staff caring for the children. Due to staff sickness, there is a reliance on agency staff who do not know the children. On the day of the inspection, of the three members of staff on duty, only one was a permanent member of staff known to the children. The lack of continuity of care Inspection report for children’s home - monitoring visit: 2503316 2 compromises the children’s health, well-being and safety. It does not enable the children to build positive relationships with a consistent team of staff who they can get to know well.

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This monitoring visit

The poor leadership and management structures, coupled with a fluctuating and inexperienced staff team, mean that children continue to display challenging and aggressive behaviour, which compromises their safety and well-being. This has had an adverse impact on the welfare and safety of the children living in the home. The responsible individual, the manager and parents spoken to during the visit all raised significant concerns around safeguarding practices within the home. They consistently said they cannot ‘keep children safe’, that staff are ‘intimidated and scared of [child’s name]’ and that the risk ‘is just too high’.

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This monitoring visit

The staff do not have the skills and knowledge to manage the behaviours of the children living in the home, including one child who requires safeguarding from self- injurious behaviours. For example, staff have not had training in the safe management of self-harm for children who are known to place ligatures around their neck. This means that risks are not safely managed or minimised. Staff do not have the experience or confidence to utilise physical restraint to safeguard one of the children living in the home due to feeling ‘intimidated’, which has resulted in escalating behaviours and potential harm to both children and staff.

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This monitoring visit

Additionally, where physical restraint has been used within the home, the manager and staff have failed to use restraint as agreed in the home’s own policies and procedures. For example, the responsible individual has been involved in physical restraints of another child, with no separate management overview of the incident to determine if this was appropriate. Relevant paperwork has not been sufficiently completed and children and staff have not been appropriately debriefed. Consequently, limited recording and lack of robust monitoring and oversight do not assist in the analysis or evaluation of the interventions used and whether behaviour management strategies are appropriate to safeguard children.

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This monitoring visit

Contrary to the home’s admissions policy and procedures, not all children have benefited from a detailed impact risk assessment. The lack of robust analysis of children’s needs has resulted in the home admitting children with needs that it cannot meet. Furthermore, the impact risk assessment also failed to fully consider the impact on another child already living in the home. Challenging and disruptive behaviour by some children has been unsettling for other children, problematic for staff to manage and has required police assistance at times. This has contributed to children’s progress being hindered and their experiences being of a poor quality.

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This monitoring visit

Care plans and risk assessments do not accurately reflect or address the current needs of children and lack managerial oversight. Insufficient action has been taken to ensure that all risk assessments are reviewed and updated following significant incidents. The manager has failed to ensure that all assessments satisfactorily detail Inspection report for children’s home - monitoring visit: 2503316 3 how risk is to be reduced or managed. Consequently, these plans do not provide staff with effective strategies to enable them to keep children safe.

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This monitoring visit

The home does not have clear and consistent boundaries or effective behaviour management strategies to support the children in improving their behaviour. This means that children continue to display violent, aggressive behaviour, which places themselves and others at risk of harm.

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This monitoring visit

The arrangements for the administration of medication to children are not robust. There have been errors in the recording and handling of medication. This represents a failure to follow the home’s own policies and procedures for the handling, recording, safekeeping and safe administration of medicines, and potentially places children at serious risk of harm.

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This monitoring visit

There has not been a registered manager in the home since May 2019. Internal monitoring is significantly hindered by the lack of a suitable registered manager for the home. The home’s management have failed to identify through the internal monitoring any patterns and/or trends in the practice of the home, including children’s behaviours. The lack of rigour has not helped the home to sufficiently protect the children and maintain good enough standards of care.

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Recent inspection history

Inspection date Inspection type Inspection judgement 06/11/2019 Full Inadequate Inspection report for children’s home - monitoring visit: 2503316 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

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 and that they 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

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on mutual respect and trust, have an understanding about acceptable behaviour; and positive responses to other children and adults.

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Requirement Due date

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—

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Requirement Due date

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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

manage relationships between children to prevent them from harming each other; 28/09/2020 Inspection report for children’s home - monitoring visit: 2503316 5 understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due date

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.

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Requirement Due date

(Regulation 12 (1)(2)(a)(i)(ii)(iii)(v)(vi)(vii)(iv))(d)) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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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 staff work as a team where appropriate;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home’s workforce provides continuity of care to each child;

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Requirement Due date

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; and

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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.

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Requirement Due date

(Regulation 13 (1)(a)(b)(2)(a)(b)(c)(e)(f)(h)) 28/09/2020 Inspection report for children’s home - monitoring visit: 2503316 6 The care planning standard is that children— receive effectively planned care in or through the children’s home; and have a positive experience of arriving at or moving on from the home. In particular, the standard in paragraph (1) requires the registered person to ensure— 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.

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Requirement Due date

(Regulation 14 (1)(a)(b)(2)(a)) 28/09/2020

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

The registered provider must appoint a person to manage the children’s home if there is no registered manager in respect of the home; and the registered provider is an organisation or a partnership; does not satisfy regulation 28; or is not, or does not intend to be, in day-to-day charge of the home. If the registered provider appoints a person to manage the home, the registered provider must, without delay, give HMCI notice of the name of the person so appointed; and the date on which the appointment takes effect.

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Requirement Due date

(Regulation 27 (1)(a)(b)(i)(ii)(iii)(2)(a)(b)) 28/09/2020

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Requirement Due date

The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs.

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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 28/09/2020 Inspection report for children’s home - monitoring visit: 2503316 7 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 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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Requirement Due date

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;

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Requirement Due date

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

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Requirement Due date

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. Inspection report for children’s home - monitoring visit: 2503316 8 (Regulation 35 (1)(a)(b)(3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(2)(c)) 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.

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4;

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Requirement Due date

In particular, maintain a clear recording of the staff roster. 28/09/2020

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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— children are effectively safeguarded; and the conduct of the home promotes children’s well-being.

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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.

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Children’s home details

Registered provider: Cherished and Devoted Care

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Children’s home details

Registered provider address: 4 Duncan Street, St Helens, Merseyside WA10 3TE

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Children’s home details

Registered manager: Post vacant Inspection report for children’s home - monitoring visit: 2503316 9

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Inspectors

Elaine Allison, social care inspector Suzanne Birchall, social care inspector Inspection report for children’s home - monitoring visit: 2503316 10 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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