Children's home run by Exceptional Care Limited

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

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Exceptional Care Ltd

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. A new manager has been recruited and started her role at the home four weeks prior to this monitoring visit. She will submit an application to Ofsted for registration.

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This monitoring visit

This visit was to monitor two compliance notices that had been served under regulations 12 and 13 at a monitoring visit on 26 November 2020. The compliance notices related to the lack of leadership, structure and guidance in place for staff to enable them to take suitable action to prevent young people going missing from home and safeguarding them when they do so. At the visit, inspectors found that suitable action has been taken to meet both compliance notices. However, some additional requirements have been raised.

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This monitoring visit

The new manager has ensured that the staff team understands the roles and responsibilities of the management team overseeing the home, including the role of the responsible individual as support to the manager. A daily on-call system for advice and guidance is now identified on the weekly rota and the staff have been directed as to when they should use the system.

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This monitoring visit

Inspectors observed nurturing and positive relationships between staff and young people. The young people said they ‘loved’ the manager and felt they could have open and honest conversations with her. Young people told the inspector that they feel happier in the home and have not put themselves at risk by going missing from home recently. Young people said that staff follow them if they leave the home without permission and this has deterred them from attempting to do so. Inspection report for children's home - monitoring visit: 2537801 2 Staff reported to inspectors that they receive clear guidance and direction from the manager, and additional effective strategies have been implemented to prevent children from going missing from home. Staff feel the manager is a positive role model for the team, with high expectations and knowledge in relation to safeguarding young people.

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This monitoring visit

Staff have an improved understanding of missing-from-home procedures, their roles and responsibilities to keep children safe from any associated risks. Staff demonstrated that they understood risk assessments, prevention plans and strategies used to minimise risks. The supervision levels of children in and around the home have also improved, with staff identifying any signs that young people may be planning to go missing.

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This monitoring visit

Risk assessments and prevention plans are comprehensive, accurately reflect the level of risk and, overall, are up to date. They identify strategies individualised to young people and give staff clear expectations about how to respond to missing- from-home episodes, self-harm and allegations made by young people. Young people have been consulted about their safety plans in relation to strategies that help them to reduce their level of going missing from home.

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This monitoring visit

Missing-from-home records are detailed and demonstrate that staff are working together consistently to reduce any missing-from-home incidents. Return home interviews have been key in identifying information to help safeguard young people. Staff have completed creative key-work sessions with young people to address risk- taking behaviour associated with missing-from-home incidents, such as drug and alcohol misuse, child sexual exploitation and radicalisation.

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This monitoring visit

Supervisions have focused on work to develop the staff team’s knowledge of missing-from-home procedures and reflect on incidents to adapt their practice. Where the manager has identified that staff have not followed the correct missing- from-home procedures, the manager has dealt with this directly and shared lessons learned with the staff team. All staff have now completed training in relation to missing-from-home episodes, child sexual exploitation and radicalisation.

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This monitoring visit

Staff take appropriate action to safeguard young people who are at risk of abuse and significant harm. Where necessary, the staff team has liaised with relevant agencies to obtain support and guidance for young people following serious safeguarding incidents. This has included working with the child sexual exploitation team, medical screening centres and preventing radicalisation team.

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This monitoring visit

Since being in post, the manager has conducted a team meeting to address how staff should respond to young people who may attempt to or go missing from home. The manager has used young people’s safety plans and lessons learned from previous incidents to improve staff practice. Team morale has improved and staff have confidence in the manager’s ability to immediately address concerns in relation to safeguarding practice. Inspection report for children's home - monitoring visit: 2537801 3 Where an allegation about a staff member had been made by a young person, the social worker confirmed that the allegation had been managed well. The young person felt listened to and was happy with the action the manager had taken to resolve their concerns. The manager or responsible individual has failed to notify and seek advice from the designated officer in relation to the allegation and the action they should have taken.

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This monitoring visit

A complaint was made and then retracted by a young person about a staff member and the manager provided a written response to the young person to conclude the outcome of the complaint. The written response refers to the manager being disappointed that the young person had not written an apology letter to the staff member. This does not reassure the young person that they are free from reprisal for making and retracting the complaint, should they wish to do so in future.

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This monitoring visit

The quality of case records and documentation within the home needs some improvement. Following two incidents of young people going missing from home, staff failed to record a daily handover with clear direction of action to be taken by staff in relation to the young people’s risks. In addition to this, some young people’s documents do not always have up-to-date chronologies, are not always signed by the author and contain contradictory information in relation to young people’s agreed plans.

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This monitoring visit

Restraint records are generally detailed. However, following the use of restraint, some records do not evidence reflective debriefs with young people to help them discuss their views about the incident and they also do not evidence that young people have been checked for any injuries or offered medical treatment.

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This monitoring visit

The rest of the requirements raised at the last full inspection and previous monitoring visit 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— seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans; seek to secure the input and services required to meet each child’s needs; 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.

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Requirement Due date

Specifically, in relation 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 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. 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.

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Requirement Due date

(Regulation 16 (1) (3)(a)(b)) 27 March 2020

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. The registered person may only— 27 March 2020 Inspection report for children's home - monitoring visit: 2537801 5 employ an individual to work at the children’s home if the individual satisfies the requirements in paragraph (3). The requirements are that— 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

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— a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; 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")— 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.

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Requirement Due date

(Regulation 35 (3)(a)(viii)(b)(i)(ii)(c)) 19 February 2021

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Requirement Due date

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

Specifically, that daily handovers are recorded as part of shift planning to give staff clear direction of action to be taken in relation to young people’s risk-taking behaviour. Risk assessments and young people’s case records should contain up-to-date chronologies, should not contain contradictory information in relation to young people’s agreed plans and should be signed by the author. The manager should document and evidence discussions that take place with young people’s social workers in relation to strategies agreed to reduce risks and safeguard young people. 19 February 2021 Inspection report for children's home - monitoring visit: 2537801 6 Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home. The registered person must— maintain in the home the records in Schedule 4; ensure that the records are kept up to date.

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Requirement Due date

(Regulation 37 (1) (2)(a)(b)) 27 March 2020

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Requirement Due date

The registered person must ensure that no child is subject to any reprisal for making a complaint or representation.

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

there is an allegation of abuse against the home or a person working there; there is any other incident relating to a child which the registered person considers to be serious.

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Requirement Due date

Specifically, the manager must notify Ofsted if a young person has been missing from the home overnight. In addition, the manager must seek advice and guidance from the designated officer should a young person make an allegation about a staff member working in the home. 19 February 2021

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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— the quality of care provided for children; the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

(Regulation 45 (2)(a)(b)(c)) 27 March 2020

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Recommendations

 The registered person should ensure children have access to a computer and the internet to support their education and learning, unless there are specific Inspection report for children's home - monitoring visit: 2537801 7 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 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 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)  The registered person should ensure the behaviour management strategy should be understood and applied at all times by staff and must be kept under review

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Recommendations

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. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24) In particular, independent visits should primarily be unannounced.  The registered person should ensure they 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)  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 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) Inspection report for children's home - monitoring visit: 2537801 8

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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 Ltd

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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 Natalie Bennett, Social Care Inspector 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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