Coniston House

Inspection report children's home: SC379123 1 SC379123 Registered provider: Cove Care Residential Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately owned children’s home offers care for up to five children with mental health, psychological and/or emotional difficulties and associated complex care needs.

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Information about this children’s home

The registered manager left in June 2021 and the post is vacant. The responsible individual is recruiting to this position and supporting the day-to-day management arrangements for the home. A registered manager from another home in the organisation is supporting the responsible individual.

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Information about this children’s home

Due to COVID-19, at the request of the Secretary of State, we suspended all routine inspections of social care providers on 17 March 2020.

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Information about this children’s home

We visited this setting on 28 January 2021 to carry out a monitoring visit. The report is published on Ofsted’s website.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children's home: SC379123 2

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Inspection date Inspection type Inspection judgement

04/03/2020 Interim Sustained effectiveness 05/06/2019 Full Good 13/02/2019 Interim Declined in effectiveness 24/09/2018 Full Requires improvement to be good Inspection report children's home: SC379123 3

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Inspection judgements

Overall experiences and progress of children and young people: requires improvement to be good

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Inspection judgements

Five children have lived in the home since September 2020. Two children have moved on from the home, one child is in hospital and will not be returning and so two children were living at the home at the time of the inspection.

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Inspection judgements

Children do not feel that managers and staff always listen to their views. Both children have experienced staff not responding well to them after they have spoken to independent people about their experiences of living in the home. One child said that after speaking to the independent visitor, staff made comments about her discussion that made her feel uncomfortable. Another child explained that the previous manager and staff were not happy that she had discussed her cultural needs not being met with an Ofsted inspector. One child was concerned that she would not get an opportunity to speak with the Ofsted inspector during this inspection and so she wrote an email to Ofsted explaining her experiences of living in the home. Not feeling comfortable in being able to share their views does not promote children’s welfare. In addition, these experiences mean that children do not live in a home where staff always value and act on what they have to say.

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Inspection judgements

In recent months there have been changes to the management and staffing arrangements at the home. Children have found these changes difficult to adjust to. Both children expressed that they were not happy about the circumstances that led to the previous manager leaving the organisation. One child spoke about the impact of staffing changes and described an incident when she woke up and went downstairs in the night to find someone she did not know in her home. This person was a member of staff, but no one had explained to the children that somebody new would be caring for them overnight. One child, who has lived in the home for a while, feels that staff are not as nurturing as they used to be. Inconsistent care received by children is influencing children’s emotional health and well-being.

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Inspection judgements

The circumstances in which the registered manager recently left the home, together with the departure of the therapists, have had an impact on children and undermined their stability and sense of trust. The responsible individual and remaining staff are working hard to mitigate the impact of this, which will take time.

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Inspection judgements

Managers and staff do not always support children’s cultural needs. One child told the inspector that she misses eating food that she associates with her heritage. She feels that her preferred food is expensive, and staff do not help her to access these foods easily. Instead, the child looks forward to her mum visiting as she brings her food that she enjoys eating. In their plans, both children have recorded wanting to visit their chosen places of worship. This was not possible during COVID-19 and the national restrictions imposed by the government. However, this has not been explored with children since restrictions have eased. Children’s care plans are not implemented in full and so children’s individual cultural and religious needs are not Inspection report children's home: SC379123 4 met.

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Inspection judgements

Most areas of the home are decorated and furnished to a reasonable standard, and children have access to a range of facilities, including fitness equipment, football, hockey and table tennis. However, during a tour of the home, the formal dining room was kept locked without good reason and some aspects of the home require cleaning and repair. In addition, staff do not recognise when a child needs support with managing their bedroom space. As a result, one child’s clothing has been left in bin bags for a number of days following an incident. These shortfalls impact on the day-to-day experiences of children living in the home.

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Inspection judgements

Care plans for children are child led and children clearly contribute to their plans. This is good practice. Staff need to add more detail to plans to ensure that there is sufficient guidance for staff to follow. For example, one child recorded that they want support to be woken up by staff on workdays. However, the plan does not describe what the child’s workdays are and what time they need to be woken. The lack of detail does not support all staff to fully understand what is expected of them to ensure that the child’s needs are being met consistently.

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Inspection judgements

Staff promote children’s education well. One child has worked hard to complete their exams and has a conditional offer to attend the college course of their choice. Another child is undertaking regular volunteer work for a charity. Children make remarkable progress with their education and employment. These achievements support children to develop knowledge and skills that will help them as they progress through to adulthood.

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Inspection judgements

Staff are good at supporting children to register with local health services. They ensure that children attend routine health appointments at the opticians and dentist. When required, staff help children in making arrangements to have consultations with their doctor and looked after children’s nurse. There are good systems in place to manage children’s medication. This ensures that staff administer medication to children safely.

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Inspection judgements

Managers work well with parents and social workers to support children to enjoy time with people who are important to them. Careful consideration is given to gradually increasing the time children spend with their family members so that children do not become overwhelmed. Associated risks are well considered in the planning process. This approach has resulted in children spending more time with family members, and staff manage any risks and vulnerabilities well.

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Inspection judgements

Staff work hard to motivate children to attend activities. During the inspection children went on a day trip with staff to the beach, both children enjoyed this time. Staff are exploring different netball clubs, with the intention for one child to join a team.

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Inspection judgements

How well children and young people are helped and protected: good Inspection report children's home: SC379123 5 Children’s emotional health has improved significantly because of the care and the support they have received. This has had a positive impact on children’s behaviours and the frequency and severity of incidents of self-harm have reduced for both children. For one child, this has resulted in them no longer requiring a deprivation of liberty order to keep them safe. Staff understand children’s risks and, following incidents, staff speak to children about what happened to understand more about this and seek their views on how staff can support them. This information helps staff to recognise behaviours and put measures in place to reduce the likelihood of incidents happening. This helps to keep children safe. Risk management plans are not always kept up to date by staff. This recording shortfall has the potential to

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Inspection judgements

cause confusion for staff and in particular, any new staff who will read these records to learn about children’s needs.

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Inspection judgements

Managers ensure that health and safety, including fire safety assessments, are completed by a competent individual and that these are regularly reviewed. Any recommendations made are acted upon. Children live in a safe environment.

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Inspection judgements

Managers use agency staff and staff from other homes within the organisation to ensure that children have the right level of support. One new member of staff has started working at the home. Robust safer recruitment processes reduce the risk of children being cared for by unsuitable individuals.

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Inspection judgements

Staff support children to gradually increase their free time in the community. For example, one child who was recently accompanied by staff in the community, is now able to go the local shop by herself. Children develop age-appropriate independence skills at a pace that feels right for them, while also developing their confidence.

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Inspection judgements

Staff respond well when children go missing from home. They actively look for children and have established positive working relationships with the local police service. Return home interviews are undertaken by children’s social workers, giving children the opportunity to talk to someone independent of the home about why they went missing and what happened while they were away. However, managers and staff do not follow up with social workers to ensure that they share information that would help to inform the children’s risk assessments.

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Inspection judgements

Physical interventions happen rarely. One incident was lengthy and several physical intervention techniques were used to keep the child and others safe from harm. However, the recording of this incident lacked clarity. A lack of detail affects the ability of managers to assess the appropriateness and effectiveness of the interventions applied.

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Inspection judgements

Children know how to complain. However, complaints raised by children are not always recorded. For example, one child raised a concern about a member of waking-night staff falling asleep as this was worrying her. The responsible individual was made aware of this and investigated the concern. However, no record of this complaint was kept at the home. A lack of clear record keeping in respect of complaints means that there is no audit trail to understand how and when concerns Inspection report children's home: SC379123 6 have been acted on. In addition, while the child noticed some improvement the child says that this has started to happen again. The responsible individual is going to look into this once more.

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Inspection judgements

The effectiveness of leaders and managers: requires improvement to be good

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Inspection judgements

The previous registered manager was not working in the home from May 2021 and left the organisation in June 2021. The deputy manager took on day-to-day management responsibility for a brief period before resigning. Another deputy manager was allocated to support the home; however, she is currently absent from work. The responsible individual continues to have oversight of the home with support from another manager within the organisation. These changes have been difficult and unsettling for the children. The responsible individual is looking to recruit an experienced manager to take on the permanent registered manager’s role.

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Inspection judgements

There are different systems used by managers to monitor the quality of care provided to children. However, these are not always effective. For example, managers do not identify inaccuracies in children’s records, an impact risk assessment and some complaints records could not be located and managers do not fully understand how children feel about living at the home. Inconsistent monitoring limits the scope for improvement and also compromises children’s experiences.

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Inspection judgements

Senior managers received a complaint from a commissioned service used by the home. Although the individuals making the complaint did not identify specific children, information contained in the complaint meant that senior managers were able to identify that two of the children referenced in the report lived in this home. Despite this, those investigating the complaint did not speak to these children which potentially limited the information gathered to inform the outcome of the investigation.

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Inspection judgements

Training records verify that staff have recently completed training in key subjects such as safeguarding, behaviour management and mental health. Most staff do not currently hold a qualification relevant to their role, however they are working towards achieving their qualifications.

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Inspection judgements

Staff receive regular appraisals and supervision. However, due to changes in managers and the impact that this has on the responsible individual’s time, the quality of discussions and notes made are compromised. This has the potential for information to be missed.

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Inspection judgements

The responsible individual understands the home’s strengths and some areas for development. She has a clear vision and recognises the importance of recruiting an experienced manager who can support and develop the home in line with the home’s recently reviewed statement of purpose.

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Inspection judgements

The responsible individual and clinical nurse work well with children’s social workers who are pleased with the progress children are making. Requirements from the Inspection report children's home: SC379123 7 previous inspection were reviewed during this inspection and have been met by managers. This shows that the provider is able to learn from inspection. Inspection report children's home: SC379123 8

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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—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

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

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

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Requirement Due date

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)(a)(b)(2)(b)(iv))

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Requirement Due date

This relates to supporting children’s cultural needs. 22 September

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

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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

help each child to express views, wishes and feelings. (Regulation 7 (1)(c) (2)(a)(ii))

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Requirement Due date

This is specific to children feeling empowered to share their views without fear of negative responses from staff or 22 September Inspection report children's home: SC379123 9 managers who work in the home.

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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

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)(b))

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Requirement Due date

This relates to staff remaining awake during the night where it is assessed that this is required to keep children safe. 22 September

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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

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;

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Requirement Due date

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

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Requirement Due date

feedback on the experiences of children, including complaints received; 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. (Regulation 13 (1)(a)(b) (2)(c)(e)(f)(g)(ii)(h))

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Requirement Due date

This relates to children being cared for by consistent staff 22 September Inspection report children's home: SC379123 10 who hold qualifications specific to their role, managers using feedback from children to understand and improve their experiences and monitoring the service effectively, including making sure records are up to date and contain all necessary information.

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Requirement Due date

The registered provider must appoint a person to manage the children’s home if—

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Requirement Due date

there is no registered manager in respect of the home. (Regulation 27 (1)(a)) 22 September

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation.

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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. (Regulation 39 (3) (4)) 22 September

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Recommendations

 The registered person should ensure that homes meet children’s basic day-to- day needs and physical necessities. Staff should seek to meet the child’s basic needs in the way that a good parent would. Specifically, ensure the home is well maintained throughout and children receive support to care for their belongings. (Guide to the children’s homes regulations including quality standards’, page 15, paragraph 3.7)  The registered person should ensure that when a child returns to the home after 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. Specifically, ensure that staff ask social workers to share relevant information from return home interviews that

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Recommendations

they undertake with children. (Guide to the children’s homes regulations including quality standards’, page 45, paragraph 9.30)  The registered person should ensure that records of restraint are kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. The review should provide the opportunity for amending practice to ensure it meets the needs of each child. Specifically, ensure that restraint records contain all required information. (Guide to the children’s homes regulations including quality standards’, page Inspection report children's home: SC379123 11 49, paragraph 9.59)

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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: SC379123 12

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Children’s home details

Registered provider: Cove Care Residential Limited

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Children’s home details

Registered provider address: 16 Waterloo Road, Wolverhampton, West Midlands WV1 4BL

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Inspector

Helen Malanaphy, Social Care Inspector Inspection report children's home: SC379123 13 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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Inspector

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Inspector

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Inspector

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