Children's Home run by New Foundations Care Homes Limited in St Helens

Inspection report children’s home: SC406636 1 SC406636 Registered provider: Building Bridges Care Homes Limited Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This is a privately owned children’s home. The provider states in its statement of purpose that it provides care for children of mixed genders who need a resettlement plan of care, whose behaviour is unmanageable, who have suffered abuse and significant neglect and have behavioural difficulties.

p.1

Information about this children’s home

Due to COVID-19 (coronavirus), at the request of the Secretary of State we suspended all routine inspections of social care providers on 17 March 2021.

p.1

Information about this children’s home

Ofsted last visited this setting on 21 October 2021 to carry out a monitoring visit. The report is published on the Ofsted website.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

inadequate

How well children and young people are helped and protected Inadequate

p.1

inadequate

The effectiveness of leaders and managers Inadequate

p.1

inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and the care and experiences of children and young people are poor and they are not making progress.

p.1

inadequate

Overall judgement at last inspection: Requires improvement to be good Inspection report children’s home: SC406636 2

p.1

Enforcement action since last inspection:

Compliance notices were issued after the assurance visit under regulation 12, the protection of children standard, regulation 13, the leadership and management standard, and regulation 40, notification of a serious incident. Compliance notices were met on 21 October 2020. Inspection report children’s home: SC406636 3

p.2

Inspection date Inspection type Inspection judgement

11/03/2020 Full Requires improvement to be good 11/04/2018 Full Good 25/07/2017 Full Good 27/02/2017 Interim Improved effectiveness Inspection report children’s home: SC406636 4

p.3

inadequate

Children’s overall care and experiences are compromised by poor safeguarding practice and ineffective leadership and management. This means that children are not supported to fulfil their potential.

p.4

inadequate

Children have experienced inconsistency in their care because of frequent changes and movement of staff. This has led to instability in relation to both the staff and care practices, meaning children are often unsure which staff members will be caring for them. This also limits their opportunities to make safe, protective and caring relationships with staff. A child commented on the continued changes of staff to the inspectors and how this made them feel unhappy.

p.4

inadequate

The emotional health needs of children are not consistently prioritised. Staff do not fully understand the child’s health and well-being needs and the support options that are available, in a way that is appropriate to the child’s age and understanding. Consequently, there has been a delay in children receiving sufficient support to address their mental health needs.

p.4

inadequate

Care planning is not robust and does not address all children’s needs in line with local authority plans. This means that children’s placements end prematurely because staff cannot meet children’s needs and keep them safe.

p.4

inadequate

Not all children’s plans are up to date and do not include accurate information. For example, some children’s placement plans do not include current information in respect of children’s health needs and how they will be supported to spend quality time with their family and friends.

p.4

inadequate

The premises are not suitably designed or maintained to meet the needs of each child. Parts of the home are locked to prevent children from accessing rooms in their home. These include the downstairs toilets and the corridor that children’s bedrooms are positioned on. Furthermore, parts of the home are unclean and require improvement.

p.4

inadequate

Children said that they like the new staff who are working in the home and have an adult they can talk to. Children understand how to make a compliant.

p.4

How well children and young people are helped and protected: inadequate

Safeguarding practice in this home is not robust and does not promote the safety and welfare of the children. Staff fail to take sufficient action to address safeguarding concerns. An example of this is when a child was found in their bedroom with several empty sleeves of paracetamol tablets. Staff failed to take appropriate action to monitor the child or seek urgent medical guidance to ensure Inspection report children’s home: SC406636 5 that the safety and well-being of the child was paramount. This failure to respond immediately left the child at risk and the child was subsequently hospitalised.

p.4

How well children and young people are helped and protected: inadequate

Managers do not demonstrate that there is a strong and proactive response to managing risk and reducing harm. This means that children have been left at risk of harm in the home and when they are out in the community. In one situation, a decision was made to transport a child to an area where he is known to be at risk of criminal exploitation. Managers and staff did not robustly assess the risks in respect of this situation and take effective action when the child shared specific safeguarding information with them. This failure to take any action meant that the child was at risk of significant harm.

p.5

How well children and young people are helped and protected: inadequate

Children’s risk assessments do not include clear plans for staff to follow in practice to reduce the risk of harm. For example, when children go missing from home staff do not provide a consistent response to protect them. Therefore, children’s safety is compromised because staff do not follow the same plan. Not only does this leave children vulnerable, but this also means that children do not receive consistent care.

p.5

How well children and young people are helped and protected: inadequate

When physical intervention has been required, paperwork is not consistently completed in line with regulations. Although the manager has signed off the interventions as appropriate, there is no information in some of the documentation about the holds used or a clear rationale for the intervention. This fails to demonstrate that children are managed and supported safely.

p.5

How well children and young people are helped and protected: inadequate

Medication is not administered and recorded in regard to controlled drugs. Information in medication records is confusing and, on some occasions, left blank. This does not demonstrate that children receive medication in line with their prescription and has the potential to impact on their health and well-being.

p.5

How well children and young people are helped and protected: inadequate

The registered provider has not ensured that, during the recruitment process, full and satisfactory information is obtained for staff prior to employment in the home. This includes ensuring that each staff member has completed a full application form, that references are requested, obtained and verified and gaps in employment are carefully considered. This means that children are cared for by staff who have not been suitably vetted.

p.5

The effectiveness of leaders and managers: inadequate

The registered manager resigned from her post in May 2021. She is now working as the deputy manager. The provider took appropriate action when concerns were identified about the management in the home. It devised an action plan to improve safeguarding practices in the home. However, managers have not received the levels of supervision and support identified and continue to be responsible for decisions about safeguarding. This does not demonstrate that leaders take the necessary action to improve practice in the home and ensure that children are safe. Inspection report children’s home: SC406636 6 Training records provided and discussions with staff members confirmed that not all staff have attended training in safeguarding, self-harm and child exploitation, despite children living in the home being at risk of these concerns. Therefore, not all staff have the skills and knowledge to be able to deliver consistent, good-quality

p.5

The effectiveness of leaders and managers: inadequate

care that promotes positive experiences and progress for children and keeps them safe.

p.6

The effectiveness of leaders and managers: inadequate

Flawed admission procedures mean that staff are not familiar with the risks and behaviour management strategies for all children who have moved into the home. This means that children are supported by staff who do not understand their needs.

p.6

The effectiveness of leaders and managers: inadequate

The provider’s monitoring and review systems are ineffective, and they have failed to identify significant shortfalls in the quality of care and protection provided to the children. Recording in children’s plans and documents is variable. This means that leaders and managers cannot review and evaluate practice in the home to ensure that children’s safety is prioritised, or that improvements are made to improve children’s day-to-day experiences and overall progress.

p.6

The effectiveness of leaders and managers: inadequate

Staff report that they feel supported by the managers. However, staff do not have access to regular supervision that should give them the opportunity to discuss matters such as the children, training, personal development or any concerns. This does not demonstrate that staff are given an opportunity to discuss or reflect on the individual needs of the children or identify any strengths or improvements required in care practices. Staff duty rotas fail to accurately detail the actual staff on duty. In addition, when there are shortfalls in the rota, records do not include the full name of the staff member or any other information to indicate whether the shift was covered and by whom. This prevents a clear audit trail of who is working in the setting.

p.6

The effectiveness of leaders and managers: inadequate

There have been failings in management oversight and monitoring of the home to identify areas of weakness and to take decisive action to resolve these. Internal monitoring does not take place regularly and, as a result, the quality and standard of care have fallen to an unacceptable level. The manager has not reviewed some records in the home, or evaluated incidents that have occurred, in order to identify shortfalls in staff practice and to highlight patterns and trends. This means that leaders and managers are not taking action to improve the experiences, care and safety of children. As a result, children’s progress, welfare and safety are compromised. The director has recently taken over the management of the home and understands the areas of improvement that are required. She has arranged a meeting with the staff team to identify the improvements required and discussed the new routines and structures that will be introduced to improve consistency in the home.

p.6

The effectiveness of leaders and managers: inadequate

Following the inspection, two compliance notices were issued under regulation 12, the protection of children and regulation 13, leadership and management. Inspection report children’s home: SC406636 7

p.6

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.

p.7

Requirement Due date

The health and well-being standard is that—

p.7

Requirement Due date

the health and well-being needs of children are met;

p.7

Requirement Due date

children receive advice, services and support in relation to their health and well-being; and

p.7

Requirement Due date

children are helped to lead healthy lifestyles.

p.7

Requirement Due date

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

p.7

Requirement Due date

achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

p.7

Requirement Due date

understand the child’s health and well-being needs and the options available in relation to the child’s health and well- being, in a way that is appropriate to the child’s age and understanding;

p.7

Requirement Due date

take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs; and

p.7

Requirement Due date

understand and develop skills to promote the child’s well- being. (Regulation 10 (1)(a)(b)(c)(2)(a)(i)(ii)(iii)(iv)) 1 October 2021

p.7

Requirement Due date

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

p.7

Requirement Due date

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

p.7

Requirement Due date

that staff— 1 October 2021 Inspection report children’s home: SC406636 8 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;

p.7

Requirement Due date

help each child understand how to keep safe;

p.8

Requirement Due date

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

p.8

Requirement Due date

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

p.8

Requirement Due date

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

p.8

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)(ii)(iii)(v)(vi)(b))

p.8

Requirement Due date

The manager needs to ensure that all risks in respect of children are assessed and that risk assessments include strategies to reduce risk. Furthermore, the manager needs to ensure that strategies to manage risk are closely monitored and reviewed. *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.8

Requirement Due date

helps children aspire to fulfil their potential; and

p.8

Requirement Due date

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

p.8

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;

p.8

Requirement Due date

ensure that staff work as a team where appropriate;

p.8

Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child; 1 October 2021 Inspection report children’s home: SC406636 9 understand the impact that the quality of care 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

p.8

Requirement Due date

use monitoring and review systems to make continuous improvements in the home. (Regulation 13 (1)(a)(b)(2)(a)(b)(c)(f)(h))

p.9

Requirement Due date

In particular, leaders and managers need to ensure that they implement effective monitoring and review systems to review the care that staff provide for children. Furthermore, leaders and managers need to ensure that all staff have the relevant experience and skills to meet children’s needs. The care planning standard is that children—

p.9

Requirement Due date

receive effectively planned care in or through the children’s home; and

p.9

Requirement Due date

have a positive experience of arriving at or moving on from the home. (Regulation 14 (1)(a)(b))

p.9

Requirement Due date

This is particularly in relation to impact risk assessments to ensure that children are well matched. 1 October 2021

p.9

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.

p.9

Requirement Due date

keep the statement of purpose under review and, where appropriate, revise it; and

p.9

Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (1)(3)(a)(b)) 1 October 2021

p.9

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.

p.9

Requirement Due date

In particular the registered person must ensure that—

p.9

Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. (Regulation 23 (1)(2)(b)) 1 October 2021 Inspection report children’s home: SC406636 10 This is particularly in relation to both administering and recording children’s medication. The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

p.9

Requirement Due date

employ an individual to work at the children’s home; or

p.10

Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home,

p.10

Requirement Due date

if the individual satisfies the requirements in paragraph (3).

p.10

Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1)(2)(a)(b)(3)(d)) The registered person must prepare and implement a policy ("the behaviour management policy") which sets out—

p.10

Requirement Due date

how appropriate behaviour is to be promoted in the children’s home; and

p.10

Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home.

p.10

Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

p.10

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.10

Requirement Due date

details of the child’s behaviour leading to the use of the measure;

p.10

Requirement Due date

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

p.10

Requirement Due date

a description of the measure and its duration; 1 October 2021 Inspection report children’s home: SC406636 11 details of any methods used or steps taken to avoid the need to use the measure;

p.10

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;

p.11

Requirement Due date

the effectiveness and any consequences of the use of the measure; and

p.11

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;

p.11

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")—

p.11

Requirement Due date

has spoken to the user about the measure; and

p.11

Requirement Due date

has signed the record to confirm it is accurate; and

p.11

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. (Regulation 35 (1)(a)(b) (2) (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)) The registered person must maintain records ("case records") for each child which—

p.11

Requirement Due date

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

p.11

Requirement Due date

are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 1 October 2021

p.11

Requirement Due date

Schedule 4 sets out the information that the registered person must keep in relation to a children’s home.

p.11

Requirement Due date

maintain in the home the records in Schedule 4. (Regulation 37 (1)(2)(a)) 1 October 2021 Inspection report children’s home: SC406636 12 The registered manager needs to ensure that she records her actual hours worked on the staff rosters. The registered person must complete a review of the quality of care provided for children ("a quality of care review") at least every 6 months.

p.11

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—

p.12

Requirement Due date

the quality of care provided for children;

p.12

Requirement Due date

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

p.12

Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

p.12

Requirement Due date

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review ("the quality of care review report")

p.12

Requirement Due date

supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is competed; and

p.12

Requirement Due date

make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home.

p.12

Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1)(2)(a)(b)(c)(3)(4)(a)(b)(5)) 1 October 2021

p.12

Requirement Due date

* These requirements are subject to a compliance notice. Inspection report children’s home: SC406636 13

p.12

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: SC406636 14

p.13

Children’s home details

Registered provider: Building Bridges Care Homes Limited

p.14

Children’s home details

Registered provider address: Mill Farm, Bull Bridge Lane, Liverpool L10 6LZ

p.14

Inspectors

Catherine Fargin, Social Care Inspector Michelle Edge, Regulatory Inspection Manager Inspection report children’s home: SC406636 15 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.14

Inspectors

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.15

Inspectors

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

p.15

Inspectors

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

p.15