Children's home run by Nestlings Care Limited

Inspection report for children’s home – monitoring visit: 2510604 1

p.1

Nestlings Care Limited

Monitoring visit Inspected under the social care common inspection framework

p.1

Information about this children’s home

The home is privately operated and is registered to provide care and accommodation for up to four children or young people who may have mental disorders and/or learning disabilities. The same four young people live at the home as when the previous monitoring visit was completed. This visit focuses on one young person in particular.

p.1

This monitoring visit

This visit took place due to Ofsted receiving two notifications relating to self-harm incidents. The visit took place off site by reviewing evidence remotely using technology. Professionals were spoken to as part of the visit.

p.1

This monitoring visit

The young person, who was previously placed in hospital under the Mental Health Act, was discharged back to the home in December 2020. The young person was able to settle in relatively well until after Christmas. Due to further incidents, she has returned to hospital.

p.1

This monitoring visit

An order restricting liberty is in place that gives clear instruction to staff about the level of supervision required to keep the young person safe. The manager introduced additional staffing in response to an increase of self-harm incidents. Staff have been present, supportive and have remained calm.

p.1

This monitoring visit

It is clear that the young person has gone to great lengths to self-harm on several occasions. On one occasion, staff stopped the young person from suffering serious harm. Staff have taken the young person for psychological assessment when necessary and provided support at the hospital.

p.1

This monitoring visit

The young person has not swallowed batteries since being discharged from hospital, which meets a previous requirement. However, staff could have prevented similar incidents. On one occasion, the young person was able to swallow a blade from a Inspection report for children’s home – monitoring visit: 2510604 2 pencil sharpener. Staff did not check the contents of the make-up bag before the young person had access to it. As part of the risk management plan, items such as this should be kept locked in the office and be checked. As a result, the young person required a further operation to remove the blade.

p.1

This monitoring visit

Ligatures are a known high risk for the young person. The young person had access to a dressing gown cord and used it as a ligature. Staff responded to this effectively and the young person was not harmed. However, the manager and staff had not considered the cord as a high-risk item previously, or when the incident was reviewed. This allowed unnecessary and easy access to a potentially life-threatening item.

p.2

This monitoring visit

The manager has begun to explore each incident more thoroughly and provide support to the staff involved. The manager needs to ensure that the risk of incidents is reducing by encouraging reflection and learning. Since September 2020, a number of staff have started working in the home and need ongoing training and development. This has previously been set as a requirement.

p.2

This monitoring visit

A number of agency staff have worked in the home since the last visit due to the increased staffing ratio in place. A plan is given to each agency staff member to help them to quickly review the risks presented by each young person. Although strategies are not included in the plan, staff also have access to the risk management file. The manager needs to continue to review the number of agency staff used to ensure that the consistency of care provided is not affected. Full names need to be recorded on rotas to enable clear tracking of who is in the home and when.

p.2

This monitoring visit

There have been some improvements since the visit in November 2020. Parents and professionals have been kept informed of the incidents. They have also been able to see young people, which meets a previous requirement. The effect of the incidents on the other young people living in the home has been well considered. Staff have tried to engage other young people with activities and build peer relationships.

p.2

This monitoring visit

Managers have raised concerns with the placing authority about the delays in finding an appropriate adult placement. This uncertainty about future plans has had an impact on the young person’s mental health.

p.2

This monitoring visit

The manager and social worker both agree it would not be appropriate for the young person to be discharged back to the home. This is due to the impact on the other young people placed and the fact that the young person is nearly 18 years old.

p.2

This monitoring visit

The requirements and recommendations set to be completed by the end of January 2021 have not been fully reviewed at this visit. An inspector will review progress at the next inspection. Inspection report for children’s home – monitoring visit: 2510604 3

p.2

Inspection date Inspection type Inspection judgement

10/03/2020 Full Outstanding Inspection report for children’s home – monitoring visit: 2510604 4

p.3

Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, the 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.4

Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

p.4

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

p.4

Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

p.4

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.

p.4

Requirement Due date

This relates to staff implementing the risk management plans to ensure that young people are kept safe.

p.4

Requirement Due date

This also relates to managers identifying when improvements can be made and developing the staff’s skills. 31 March 2021

p.4

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 maintain in the home the records in Schedule 4.

p.4

Requirement Due date

This relates specifically to recording full names on rotas, including agency staff. 31 March 2021

p.4

Requirement Due date

The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. 31 January 2021 Inspection report for children’s home – monitoring visit: 2510604 5 In particular, the standard in paragraph (1) requires the registered person to ensure—

p.4

Requirement Due date

help each child to participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and

p.5

Requirement Due date

that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies.

p.5

Requirement Due date

This relates to ensuring that young people are able to spend time enjoying activities out of the home, that is not limited due to other young people requiring additional support.

p.5

Requirement Due date

This has been carried over from a previous inspection and has not been reviewed as part of this visit.

p.5

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—

p.5

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.5

Requirement Due date

ensure that staff work as a team where appropriate;

p.5

Requirement Due date

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

p.5

Requirement Due date

demonstrate that practice in the home is informed and improved by taking into account and acting on—

p.5

Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

p.5

Requirement Due date

(Regulation 13 (1)(b) (2)(b)(c)(g)(ii)(h))

p.5

Requirement Due date

This relates to the registered person identifying weaknesses in staff practice and implementing steps to improve practice and ensuring that the team is consistent. 31 January 2021 Inspection report for children’s home – monitoring visit: 2510604 6 This also relates to staff receiving training to meet the needs of the young people, and accurate records being kept monitoring training.

p.5

Requirement Due date

This has been carried over from a previous inspection and has not been reviewed as part of this visit.

p.6

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—

p.6

Requirement Due date

the date, time and location of the use of the measure;

p.6

Requirement Due date

a description of the measure and its duration;

p.6

Requirement Due date

the name of the person who used the measure (“the user”), and any other person present when the measure was used;

p.6

Requirement Due date

within 24 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.6

Requirement Due date

has spoken to the user about the measures; and

p.6

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.

p.6

Requirement Due date

(Regulation 35 (3)(a)(iii)(iv)(vi)(viii)(b)(i)(c))

p.6

Requirement Due date

This has been carried over from a previous inspection and has not been reviewed as part of this visit. 31 January 2021

p.6

Requirement Due date

The registered person must maintain records (“case records”) for each child which—

p.6

Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

p.6

Requirement Due date

(Regulation 36 (1)(a)(b)) 31 January 2021 Inspection report for children’s home – monitoring visit: 2510604 7 This has been carried over from a previous inspection and has not been reviewed as part of this visit.

p.6

Recommendations

 The registered person should ensure that there is a robust cleaning regime in place and ensure that any damage is repaired in a timely manner. This recommendation has been carried over from a previous inspection and has not been reviewed as part of this visit. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9) This has been carried over from a previous inspection and has not been reviewed as part of this visit.

p.7

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.

p.7

Information about this inspection

This inspection was carried out under the Care Standards Act 2000.

p.7

Children’s home details

Registered provider: Nestlings Care Limited

p.7

Children’s home details

Registered provider address: Suite 4, 1 Derby Street, Leigh, Lancashire WN7 4PF

p.7

Children’s home details

Responsible individual: Anthony Thompson

p.7

Inspector

Sylvia Eboigbe, Social Care Inspector Inspection report for children’s home – monitoring visit: 2510604 8 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.7

Inspector

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 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.8

Inspector

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

p.8

Inspector

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

p.8