Children's Home run by Birtenshaw in Bolton

Inspection report for children’s home: SC397344 1 SC397344 Registered provider: Birtenshaw Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This children’s home is operated by a private organisation. It offers care for up to four children who have been diagnosed with a learning disability and/or physical disability.

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Information about this children’s home

The acting manager is in the process of applying to Ofsted to be registered.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers requires improvement to be good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Date of last inspection: 26 January 2022

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good

Overall judgement at last inspection: declined in effectiveness

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good

Enforcement action since last inspection: none Inspection report for children’s home: SC397344 2

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Inspection date Inspection type Inspection judgement

26/01/2022 Interim Declined in effectiveness 13/09/2021 Full Requires improvement to be good 27/01/2020 Full Good 07/01/2019 Full Good Inspection report for children’s home: SC397344 3

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Overall experiences and progress of children and young people: good

The children living in this home have complex needs and disabilities. These are fully understood and managed effectively by staff who deliver compassionate care in an increasingly well structured way. This is helping children to overcome barriers and make good progress in many aspects of their lives. A social worker wrote: ‘The approach taken while [name of child] has lived at the home has presented opportunities that were not considered previously. This has been a huge positive.’

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Overall experiences and progress of children and young people: good

School attendance is promoted and supported. All children attend school and are making progress relative to their individual needs. Communication between the home and school is effective. This ensures that any emerging needs or concerns are shared and managed.

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Overall experiences and progress of children and young people: good

Staff provide appropriate levels of support to help children understand their health. Dietary needs are taken into consideration when planning menus, and staff are proactive in ensuring that routine and specialist appointments are kept. Medication is only given by trained and competent staff. Detailed medication administration records are maintained. It is not routine practice to dispose of medication quickly when it is no longer required.

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Overall experiences and progress of children and young people: good

Many areas of the home have been redecorated and carpets and furniture have been replaced. Work is ongoing to make the home more sensory and stimulating for the children. This includes the development of the sensory room and garden area.

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Overall experiences and progress of children and young people: good

There has been a renewed focus on providing children with stimulating, fun and purposeful activities. This has been a significant positive for all children, who have developed a tolerance of being together. During the inspection, it was a pleasure to see and hear the laughter and joy of children playing in the garden together, a significant contrast to what was seen previously.

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Overall experiences and progress of children and young people: good

Some progress has been made in advancing the plans for one child to move into his own home. This has been raised as a requirement at both the full and interim inspection. The failure to be proactive in this respect means that the home is now accommodating the same number of adults as children. The manager is aware that this situation needs addressing within agreed timescales if the home is to meet the requirements of being a children’s home.

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

Individual risks, including those linked to disability, are managed effectively by staff who know the children well. Staff offer high levels of supervision and support that helps children to stay safe at home or when spending time in the community. Inspection report for children’s home: SC397344 4 Staff recognise when children are unsettled. They use positive relationships and de- escalation strategies to help children manage their anxieties and frustrations. Since the last inspection, staff have focused on teaching children to be tolerant of each other. While this is work in progress, it was pleasing to see them all spending time in each other’s company without incident.

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

Staff are trained in the use of physical restraint, which has been used 11 times since the interim inspection. In all cases, these interventions were done in a caring and proportionate manner with most being very brief breakaway techniques, guides and low-level holds. The quality of restraint records has improved and the manager is now routinely evaluating incidents. The manager is currently working on a more child-friendly debrief that considers each child’s communication needs.

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

Overall, the organisation is good at keeping Ofsted informed when serious incidents occur. However, leaders have failed to make Ofsted aware of one incident of concern that was raised by a social worker regarding staff practice. Suitable action was taken to investigate the allegation and the matter was concluded to the satisfaction of the placing authority. The investigation record is detailed. However. there is no record of the incident itself, which involved a member of staff taking hold of a child briefly.

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good

There has been a lack of consistent and good-quality leadership since the full inspection in September 2021. The previous registered manager resigned her registration in February 2022, having been registered for less than two months.

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good

An experienced manager was appointed in April 2022. He has a good understanding of the challenges ahead and has started to implement a well-thought-out plan for improvement. Integral to this plan is a focus on ensuring that children have the best care experiences possible, and that they are not marginalised because of their disabilities. A social worker said: ‘The manager is keen on implementing new things and giving the children new experiences. [Name of child] has done more in the last two months than he has done in a long time.’

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good

Staffing is a major challenge. There continues to be a reliance on agency staff and staff who are employed by the organisation, although this is starting to reduce. Regular use of the same support staff goes some way to reducing the impact on continuity of care. A creative recruitment drive and changes to rotas, pay and conditions are helping to move towards a more permanent staffing model.

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good

Improved planning means that staff have started to receive regular supervision. All staff have had at least one supervision since the manager arrived. Records reflect that these are significantly more purposeful than sessions held previously. In addition, the manager is in the process of completing annual appraisals which he is using to identify and support the developmental needs of individuals and the team. Inspection report for children’s home: SC397344 5 The manager has a good understanding of the home’s strengths and improvement needs. He has been effective in starting to address the shortfalls from the previous inspection, including the requirements and recommendations. Relative to time passed, suitable progress has been made, although addressing many of the shortfalls remains work in progress.

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good

Improved oversight, checks and balances are beginning to have a positive influence on the home. The manager is keen to develop these processes further to build on the changes made so far. An essential component of this is the six-monthly review of quality of care. The last report, completed in April 2022, is significantly lacking in analysis and evaluation and provides very little purposeful information that can be used for improvement. In addition, there is no evidence that children, their parents, placing authorities or staff have been involved in the process. This is a missed opportunity for the new manager to complete a thorough audit of quality of care. Inspection report for children’s home: SC397344 6

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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, 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.

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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.

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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

plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority. (Regulation 14 (1)(a) (2)(b)(iii))

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Requirement Due date

Specifically, ensure that appropriate transition plans are in place for every young adult living at the home and that these are implemented in a way that ensures that their stay in the children’s home is appropriate, and that these plans take into consideration the need for the home to accommodate more children than young adults. 6 July 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; 6 July 2022 Inspection report for children’s home: SC397344 7 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. (Regulation 35 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii))

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Requirement Due date

Specifically, ensure that all incidents of physical intervention are recorded in full and that a record of these is kept in the child’s file in the home.

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Requirement Due date

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

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Requirement Due date

there is an allegation of abuse against the home or a person working there. (Regulation 40 (4)(c)) 6 July 2022

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

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”).

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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 (2)(a)(b)(c)(3) (5)) 6 July 2022 Inspection report for children’s home: SC397344 8

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Recommendations

 The registered person should ensure that they continue to implement plans to improve the condition of the home and garden area. (‘Guide to the Children’s Homes Regulations, including the quality standards, page 14, paragraph 3.9)  The registered person should ensure that any medication that is no longer required is disposed of in a timely way. (‘Guide to the Children’s Homes Regulations, including the quality standards, page 35, paragraph 7.15)  The registered person should ensure that children receive continuity of care by further reducing the use of agency staff. (‘Guide to the Children’s Homes Regulations, including the quality standards, page 54, paragraph 10.16)

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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 for children’s home: SC397344 9

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Children’s home details

Registered provider address: Birtenshaw, Darwen Road, Bromley Cross, Bolton BL7 9AB

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Inspector

Paul Scott, Social Care Inspector Inspection report for children’s home: SC397344 10 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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