Children's home run by Exceptional Care Limited

Inspection report for children’s home - monitoring visit: 2537801 1

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Exceptional Care Limited

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

The home is one of a number operated by a private provider. It is registered to care for three young people with emotional and/or behavioural difficulties.

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Information about this children’s home

The home is currently operating without a registered manager. Senior managers are in the process of recruiting a manager, who will submit an application to Ofsted.

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This monitoring visit

The visit was prompted by several notifications in relation to a vulnerable young person frequently going missing from home over a significant number of days. Ofsted was notified of an internal investigation being conducted which related to concerns raised by a young person. Following the visit, two compliance notices have been served under regulations 12 and 13.

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This monitoring visit

Inspectors found that the management of allegations is thorough, with young people and social workers kept up to date as investigations are carried out. Where necessary, restorative work is completed with young people and staff to rebuild relationships. Managers liaise appropriately with local authority designated officers. That said, team meetings do not address staff’s knowledge of allegation management, despite this having been an area of risk in the home.

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This monitoring visit

The management of the home has changed regularly. A previously registered manager, a proposed manager, the service manager and most recently the responsible individual, have all taken responsibility for the oversight of the home in the last few months. Staff reported that because of this, there has not been consistent direction from a single person responsible for the home. Staff are unclear on strategies that they are expected to follow, to safeguard and reduce the risks of young people going missing from the home. Inspection report for children’s home - monitoring visit: 2537801 2 Inspectors found that on three separate occasions staff failed to supervise a young person effectively on a one-to-one staff ratio and have not taken suitable action to prevent them from going missing from home. As a result, the young person was able to repeatedly go missing and be placed at significant risk. There is lack of evidence

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This monitoring visit

to demonstrate that managers have discussed lessons learned with the staff team, to improve staff’s understanding of their roles and responsibilities to protect young people who go missing from home.

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This monitoring visit

There are significant shortfalls in staff training, specific to young people’s individual needs and risks. Most of the staff team has not received missing-from-home training. Some staff also require training in relation to child sexual exploitation and radicalisation. The lack of training and development means that staff do not have up-to-date skills and knowledge to safeguard young people.

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This monitoring visit

Managers’ oversight of risk assessments is poor. Risk assessments do not include risks associated with young people going missing from home. For example, they do not include that a young person has been picked up by an unknown person in a vehicle outside of the home. Risk assessments do not enable the staff to have a clear understanding of young people’s vulnerabilities, and staff are not provided with clear strategies or guidance to keep young people safe if they attempt to go missing from home.

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This monitoring visit

Referrals to other agencies to support and educate young people about the risks associated with going missing from home and exploitation are not identified as a reduction strategy in risk assessments. In addition, return home interviews with young people do not always take place following an incident when a young person has gone missing from the home.

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This monitoring visit

Team meetings have not been used effectively by managers. The meetings do not set out clear guidance for staff in relation to strategies to manage young people who may try to go missing while being supervised by staff. Lessons learned from previous missing-from-care episodes have not been discussed at team meetings. Therefore, staff are not prepared to respond effectively to young people who may continue to go missing from the home.

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This monitoring visit

Young people spoken to by inspectors say they feel safe, have staff that they can talk to and trust. Social workers reported that young people have made progress since living at the home. They said that staff work ‘over and above’ to support young people, and the team has positive working relationships with other agencies to meet the needs of young people.

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This monitoring visit

Young people frequently engage in individual sessions with staff, to help identify and discuss risks that are relevant to them. Young people are encouraged to write letters to staff about how they are feeling when their mood is low or they feel anxious. Young people say that this is a positive way of breaking any communication barriers and helps them to talk to staff. Inspection report for children’s home - monitoring visit: 2537801 3 In response to concerns raised by inspectors, the responsible individual implemented an immediate plan to place a young person on a two-to-one staff ratio with waking night staff in place. All staff were required to read an updated safety plan to ensure strategies to minimise the risks were understood, should the young person try to go missing from home. A strategy meeting took place the following day, where all professionals, including the placing authority, agreed the plan.

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This monitoring visit

The staff team communicates consistently with social workers to keep them updated on young people’s risk-taking behaviour. However, managers have failed to escalate their concerns with placing authorities in relation to delays in receiving safety planning documents and obtaining referrals to external agencies for young people who are potentially at risk of exploitation.

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This monitoring visit

Debriefs with young people following restraint are thorough and have helped young people to understand their behaviour. Some restraint records do not evidence debriefs with staff and because of this, there is a missed opportunity for reflective practice to identify any lessons learned following the incident. Some records do not include clear oversight by managers in relation to the suitability or effectiveness of the restraint.

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This monitoring visit

Managers have failed to notify Ofsted, under regulation 40, of a serious incident involving a young person. For example, Ofsted was not notified that a young person at significant risk had been missing from the home overnight.

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This monitoring visit

The rest of the requirements raised at the last full inspection were not looked at during this visit. Therefore, they remain as requirements and recommendations until the home’s next inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 18/02/2020 Full Good Inspection report for children’s home - monitoring visit: 2537801 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

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

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Requirement Due date

seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans;

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Requirement Due date

seek to secure the input and services required to meet each child’s needs;

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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 (a)(b)(c))

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Requirement Due date

This specifically relates to escalating concerns to appropriate professionals within a local authority when specific information to meet young people’s needs has not been received. For example, referrals being made to external agencies to work with young people to reduce risks and safety plans in place that have been agreed with the local authority. 4 January 2021

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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; 4 January 2021 Inspection report for children’s home - monitoring visit: 2537801 5 have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

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

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(i)(iii)(v)(vi)(b))

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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—

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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

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)(a)(b) (2)(a)(b)(c)(f)) 4 January 2021

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Requirement Due date

The registered person must compile in relation to the children’s home a statement ("the statement of purpose") which covers the matters listed in Schedule 1.

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Requirement Due date

The registered person must— 27 March 2020 Inspection report for children’s home - monitoring visit: 2537801 6 keep the statement of purpose under review and, where appropriate, revise it; and

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Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2.

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Requirement Due date

(Regulation 32 (1) (2)(a) (3)(d)) 27 March 2020

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Requirement Due date

within 48 hours of the use of a measure of control, discipline or restraint, 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. (Regulation 35 (3)(b)(i)(ii)) 4 January 2021

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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.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1) (2)(a)(b)) 27 March 2020

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— 4 January 2021 Inspection report for children’s home - monitoring visit: 2537801 7 there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e))

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. (Regulation 45 (2)(a)(b)(c)) 27 March 2020

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendations

 The registered person should ensure that children have access to a computer and the internet to support their education and learning, unless there are specific safeguarding reasons why this would be inappropriate. In such cases, the home should consider whether and how it can support the child to access a computer and the internet safely. (‘Guide to the children’s homes regulations including the quality standards’, page 29, paragraph 5.19)  The registered person should ensure that medicines are administered in line with a medically approved protocol. Records must be kept of the administration of all medication, which includes occasions when prescribed medication is refused. Regulation 23 requires the registered person to ensure that they make suitable arrangements to manage, administer and dispose of any medication. These are fundamentally the same sorts of arrangements as a good parent would make but

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Recommendations

are subject to additional safeguards. Where the home has questions or concerns about a child’s medication, they should approach an expert such as a General Medical Practitioner, community pharmacist or designated nurse for looked-after children. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.15)  The registered person should ensure that where there is a possibility that a child will run away or go missing from a children’s home placement, their placement plan should include a strategy to minimise this risk. If the child is looked after, their care plan (arranged by their placing authority) should include such a strategy. (‘Guide to the children’s homes regulations including the quality standards’, page 45, paragraph 9.24) Inspection report for children’s home - monitoring visit: 2537801 8  The registered person should ensure that when a child returns to the home after

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Recommendations

being missing from care or away from the home without permission, the responsible local authority provides 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)  The registered person should ensure that the behaviour management strategy is understood and applied at all times by staff, and this must be kept under review and revised where appropriate. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.34)  The registered person should actively seek independent scrutiny of the home and make best use of information from independent and internal monitoring (including under regulations 44 and 45) to ensure continuous improvement. In particular,

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Recommendations

independent visits should primarily be unannounced. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24)  The registered person should maintain good employment practice. They must ensure that supervision and performance management of staff safeguards children and minimises potential risks to them. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1)

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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: 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

Cheryl Field, Social Care Inspector Kathryn Grindrod, Her Majesty’s Inspector, Social Care Inspection report for children’s home - monitoring visit: 2537801 9 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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