Children's Home run by Achieve Care Homes Limited in Bolton

Inspection report for children's home: 2624578 1 Registered provider: Achieve Care Homes Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately run children’s home provides care for up to two children who may present with needs that are associated with social and emotional difficulties.

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Information about this children’s home

The manager has been registered with Ofsted since August 2021.

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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 carried out under the social care common inspection framework (SCIFF) on 17 March 2020. We returned to routine SCCIF inspections on 12 April 2021.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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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.

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inadequate

Overall judgement at last inspection: not applicable

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inadequate

Enforcement action since last inspection: none Inspection report for children's home: 2624578 2

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Inspection date Inspection type Inspection judgement

Not previously inspected Inspection report for children's home: 2624578 3

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inadequate

The registered manager and staff have failed to meet the basic care needs of children. One child has been significantly neglected and he has not bathed, changed his clothes or been provided with a home-cooked meal since he moved into the home in September 2021. Similarly, another child has been placed at risk of harm by staff carrying out cardiac pulmonary resuscitation on them when this was not necessary.

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inadequate

Managers and staff have not entered a child’s bedroom for over four months despite there being evidence of flies and a pungent smell coming from the room and spreading throughout the home. This demonstrates that managers and staff do not understand their roles and responsibilities in providing basic nurturing care or appropriate support to children that they are responsible for.

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inadequate

Children’s education is not sufficiently supported or encouraged. The registered manager reported that one child has a tutor for up to thirty minutes every other day. However, staff reported that this does not consistently take place and there are no records to show if the child has attended or not. Education plans for children lack information about the educational needs of each child. The registered manager has not ensured that children with special educational needs and/or disabilities have a copy of their education, health and care plan readily available to staff.

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inadequate

Staff are not effective in supporting children’s health and well-being. The registered manager and staff fail to take action when children refuse to take their medication. Staff do not understand the complexities of the children’s health needs or how to meet them in practice. Healthcare plans are ineffective as they only contain basic information alongside a chronology of events. They do not include clear strategies for staff to follow to support children and promote children’s health. Consequently, one child has not attended any routine healthcare appointments since they moved into the home.

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inadequate

Staff spend very little time with some children, and this means that they are unable to build a positive and meaningful relationship with them. One child spends most of their time in their bedroom, including eating all their meals in there. The daily records show that staff carry out a ‘welfare check’ approximately every hour during the day, with very little interaction recorded. This is not a caring or nurturing environment for the children.

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inadequate

Transitions in and out of the home are poorly recorded. Impact risk assessments are compiled without consideration of all relevant knowledge about children. These assessments do not carefully consider the risk factors for each child and their compatibility with other children already living in the home. Furthermore, the Inspection report for children's home: 2624578 4 manager has failed to ensure that staff have the skills and experience to ensure that staff can safely support the children in their care

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inadequate

The registered manager and staff have failed to challenge professionals to ensure that the children have received the best possible care and support. Furthermore, the registered manager and staff have been naïve to accept guidance from others without considering the impact on the child, such as not entering a child’s bedroom or performing emergency first aid. As a result, staff have failed to safeguard children.

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

The registered manager and staff do not appropriately respond to safeguarding incidents that occur or implement effective strategies to safeguard the children living in the home. Consequently, children are not appropriately safeguarded by the adults who are caring for them.

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

Managers do not always share accurate information with external professionals. This inhibits other professionals to make safe and suitable decisions about the welfare of children at this home. Safeguarding notifications to Ofsted are often delayed and do not contain the same information as records in the home. Therefore, professionals make decisions without being aware of important detail. As a result, some of these decisions may not always be in children’s best interests

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

Risk management strategies are poor. The risk assessments are a chronology of events and do not include any strategies for staff to follow to minimise risks and keep children safe. Staff do not understand or take appropriate action when children display harmful behaviours. Furthermore, despite the children having complex care and health needs, these have not been considered when implementing risk management strategies to ensure that strategies are individualised to the needs of each child.

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

Behaviour management strategies are ineffective. These are a chronology of events with little guidance as to how to support each child. Staff lack the skills to challenge inappropriate behaviour effectively, such as the children refusing to allow staff to access their bedrooms. Consequently, staff left a child living in squalid conditions, which placed them at the risk of harm.

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

Physical intervention records are poor and do not demonstrate that appropriate action has been used to safely support children in times of crisis. Records do not include the holds used and other pertinent information. The registered manager has failed to evaluate the effectiveness of the measures used by staff and has also failed to identify when holds that are not included in the home’s policy and staff training are used. This fails to safeguard all involved.

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

The administration and recording of medication are poor. Children are not supported to take prescribed medication on a regular basis to improve their general health and well-being. Furthermore, records are confusing and do not show if children have Inspection report for children's home: 2624578 5 refused medication or staff failed to administer it at the time identified in the child’s prescription.

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

Fire evacuation processes are poor. One child has refused to leave the home during fire drills for over three months. Despite this knowledge, the registered manager and staff have failed to ensure that there are suitable systems in place to protect the child should they need to evacuate the home in an emergency.

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The effectiveness of leaders and managers: inadequate

The home registered in August 2021 and this is their first inspection. The registered manager is in the process of completing her level 5 qualification. During the inspection, she failed to demonstrate that she understands the ethos and vision for the home or that she has adequately supported and guided the staff team to promote the safety and welfare of children in her care.

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The effectiveness of leaders and managers: inadequate

Currently, only two members of staff hold a childcare qualification; one of these is the registered manager. The staff team is very inexperienced to care for two very complex children. Staff have not been supported by the manager to safely care for these children.

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The effectiveness of leaders and managers: inadequate

Staff rotas do not demonstrate the actual hours staff have worked in the home. Gaps in rotas indicate that sufficient staff have not been available to cover shifts. This fails to demonstrate that children have had the sufficient staff to care for them safely. The registered manager reported that, when necessary, she had covered shifts herself, but this was not evident in documents provided.

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The effectiveness of leaders and managers: inadequate

The provider has admitted children into the home outside of their conditions of registration. This is an offence under the Care Standards Act 2015, demonstrating a lack of regulatory knowledge by the manager and responsible individual.

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The effectiveness of leaders and managers: inadequate

In addition, the registered manager and staff lack the knowledge and skills to keep children safe. Despite staff attending training in supporting children with complex needs, they are unable to demonstrate that they can put this learning into practice. Some staff have not had training in first aid and despite the children requiring this on a regular basis, these staff have been left alone to care for children. This is not safe practice.

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The effectiveness of leaders and managers: inadequate

The registered manager has failed to notify Ofsted of several serious incidents in the home as required. This does not promote transparency and fails to enable the regulator to be aware of incidents that have taken place at the home. It also fails to demonstrate the actions taken by staff to protect children from further harm.

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The effectiveness of leaders and managers: inadequate

Monitoring by the registered manager is ineffective and has failed to identify the numerous shortfalls at this inspection. This is not conducive with effective safeguarding. Reporting by the independent person has only raised concerns in the last two reports. Internal and external monitoring are therefore inadequate and fail Inspection report for children's home: 2624578 6 to provide opportunities to safeguard children and for continued improvements in the home.

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The effectiveness of leaders and managers: inadequate

Ineffective action has been taken to investigate a complaint made by a healthcare professional. The responsible individual and manager have failed to make a detailed record of the complaint and its investigation. They have failed to consult with the local safeguarding board. This is poor safeguarding practice. Supervision of the member of staff regarding this issue has not taken place. Overall, the quality of supervision in the home is poor and does not help staff to reflect on their practice.

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The effectiveness of leaders and managers: inadequate

Recording in the home is poor and lacks accountability. The registered manager was not aware of the extent of the safeguarding concerns identified at the visit. Management oversight of the quality of care is sparse and records reflect that oversight is of a poor quality.

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The effectiveness of leaders and managers: inadequate

Due to the serious safeguarding concerns, Ofsted took immediate action and suspended the registration of the home. Consequently, there are no children living at the home. Inspection report for children's home: 2624578 7

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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; and

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5(a)(b)(c)(d)) 16 February 2022

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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

understand and apply the home’s statement of purpose;

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Requirement Due date

ensure that staff— 16 February 2022 Inspection report for children's home: 2624578 8 understand and apply the home’s statement of purpose;

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

treat each child with dignity and respect;

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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;

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Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably;

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Requirement Due date

provide to children personal items that are appropriate for their age and understanding; and

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Requirement Due date

make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice.

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Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to—

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Requirement Due date

enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(iii)(iv)(vii)(viii)(ix)(c)(i) (ii))

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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so.

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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

help each child to achieve the child’s education and training targets, as recorded in the child’s relevant plans;

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Requirement Due date

support each child’s learning and development, including helping the child to develop independent study skills and, where appropriate, helping the child to complete independent study; 16 February 2022 Inspection report for children's home: 2624578 9 understand the barriers to learning that each child may face and take appropriate action to help the child to overcome any such barriers;

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Requirement Due date

help each child to understand the importance and value of education, learning, training and employment;

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Requirement Due date

promote opportunities for each child to learn informally;

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Requirement Due date

maintain regular contact with each child’s education and training provider, including engaging with the provider and the placing authority to support the child’s education and training and to maximise the child’s achievement;

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Requirement Due date

raise any need for further assessment or specialist provision in relation to a child with the child’s education or training provider and the child’s placing authority;

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Requirement Due date

help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible. (Regulation 8 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii))

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

children are helped to lead healthy lifestyles.

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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

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

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Requirement Due date

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding; 16 February 2022 Inspection report for children's home: 2624578 10 take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs; and

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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))

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

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Requirement Due date

an understanding about acceptable behaviour; and

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Requirement Due date

positive responses to other children and adults.

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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

meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans;

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Requirement Due date

help each child to develop socially aware behaviour;

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Requirement Due date

encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding;

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Requirement Due date

communicate to each child expectations about the child’s behaviour and ensure that the child understands those expectations in accordance with the child’s age and understanding;

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Requirement Due date

strive to gain each child’s respect and trust;

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Requirement Due date

understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children;

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Requirement Due date

are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(v)(viii)(ix)(x)) 16 February 2022 Inspection report for children's home: 2624578 11 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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

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

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Requirement Due date

manage relationships between children to prevent them from harming each other;

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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

are familiar with, and act in accordance with, the home’s child protection policies;

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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;

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Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(b)(d) 16 February 2022

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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

promotes their welfare. 16 February 2022 Inspection report for children's home: 2624578 12 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

ensure that the home has sufficient staff to provide care for 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

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

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

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

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Requirement Due date

have a positive experience of arriving at or moving on from the home.

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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 children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14 (1)(a)(b) (2)(a)) 16 February 2022

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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. (Regulation 23 (1)) 16 February 2022 Inspection report for children's home: 2624578 13 After consultation with the fire and rescue authority, the registered person must—

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Requirement Due date

provide adequate means of escape in the event of fire. (Regulation 25 (1)(b))

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Requirement Due date

In particular, the registered person should ensure that all necessary steps are taken to ensure the safety of children who refuse to leave the building in the event of fire 16 February 2022

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development;

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Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(a)(b)) 16 February 2022

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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—

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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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;

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Requirement Due date

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

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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; 16 February 2022 Inspection report for children's home: 2624578 14 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

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Requirement Due date

has signed the record to confirm it is accurate; and

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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 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c))

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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. (Regulation 37 (1)(2)(a))

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Requirement Due date

In particular, ensure that the staff rotas reflect the actual hours worked. 16 February 2022

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Requirement Due date

Subject to paragraph (6), the registered person must establish a procedure for considering complaints made by or on behalf of children.

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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. (Regulation 39 (1)(3)) 16 February 2022

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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

a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation;

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Requirement Due date

an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious;

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Requirement Due date

there is an allegation of abuse against the home or a person working there;

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Requirement Due date

a child protection enquiry involving a child —

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Requirement Due date

is instigated; or 16 February 2022 Inspection report for children's home: 2624578 15 concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii)(e))

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Requirement Due date

The registered person must ensure that an independent person visits the children’s home at least once each month.

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person—

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Requirement Due date

if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires; and

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Requirement Due date

to inspect the premises of the home and such of the home’s records (except for a child’s case records, unless the child and the child’s placing authority consent) as the independent person requires.

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Requirement Due date

A visit by the independent person to the home may be unannounced.

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Requirement Due date

The independent person must produce a report about a visit ("the independent person’s report") which sets out, in particular, the independent person’s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children’s well-being.

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Requirement Due date

The independent person’s report may recommend actions that the registered person may take in relation to the home and timescales within which the registered person must consider whether or not to take those actions. (Regulation 44 (1)(2)(a)(b) (3) (4)(a)(b) (5) 16 February 2022

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Requirement Due date

* These requirements are subject to a compliance notice.

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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, Inspection report for children's home: 2624578 16 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 for children's home: 2624578 17

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Children’s home details

Registered provider: Achieve Care Homes Limited

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Children’s home details

Registered provider address: High Bank, Bank Street, Turton, Bolton BL7 0RY

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Children’s home details

Responsible individual: Robin McLoughlin

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Inspectors

Chris Scully, Social Care Inspector Michelle Edge, Regulatory Inspection Manager Inspection report for children's home: 2624578 18 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

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

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