Children's Home run by Nurture Support Services Limited in St Helens

Inspection report for children’s home: 2711439 1 Registered provider: Nurture Support Services Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is registered to provide care for up to two children who may experience social and emotional difficulties.

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Information about this children’s home

At the time of the visit, there was one child living in the home.

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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: inadequate

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Enforcement action since last inspection:

This home was judged inadequate at the full inspection on 16 May 2023. Following this inspection, two compliance notices were issued under section 22A of The Care Standards Act (2000). These compliance notices related to regulation 12, the protection of children standard and regulation 13, the leadership and management standard. Inspection report for children’s home: 2711439 2

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Inspection date Inspection type Inspection judgement

16/05/2023 Full Inadequate Inspection report for children’s home: 2711439 3

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inadequate

This children’s home was judged to be inadequate in May 2023, and compliance notices were subsequently issued due to the significant and serious shortfalls at the home. However, despite reassurances from leaders and managers, the home was judged to be inadequate at this return inspection as further serious shortfalls were identified in relation to safeguarding practice and the leadership and management at the home.

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inadequate

Managers and staff are not delivering safe and effective care in line with the child’s complex needs and plans. Ineffective leadership and management and poor safeguarding practice affect the child’s daily experiences and limit their progress.

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inadequate

The child’s experiences, quality of care, safety and protection are compromised as the staff team is inexperienced. It does not have the skills or training to meet the child’s individual needs and lacks the knowledge to safely support the child.

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inadequate

Staff do not have access to local authority care plans. This does not provide staff with sufficient information to help them understand the range of needs of the child and the expectations of the care to be provided. Consequently, the child is not receiving well-planned, effective and safe care that addresses their vulnerabilities.

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inadequate

Staff ensure that the child has access to primary healthcare services when required. However, staff do not ensure that the child has the necessary support in relation to their emotional well-being and have not always acted when the child has sustained an injury. On one occasion, managers and staff did not consider how an injury could have occurred to the child or determine if medical treatment was required. This meant the child did not get the medical attention they required in a timely way.

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inadequate

Despite the serious shortfalls in practice, the child has access to a range of activities and opportunities in the community. This includes joining a local football club and volunteering for a food bank. The child was proud to show the inspector the artwork that they have completed with staff in the home.

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inadequate

The child’s education provider reported that staff support the child to attend and engage with education.

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

Leaders, managers and staff do not understand their roles and responsibilities in keeping the child safe. They have not taken appropriate action when there have been serious concerns about the child’s safety and welfare. Not all staff understand the risks for children and are unclear of actions to take to minimise the risk of harm. Inspection report for children’s home: 2711439 4 Incidents of self-injurious behaviour have not been responded to appropriately. Staff are not provided with a clear plan to manage these risks and provide the child with a safe environment.

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

There has been a reduction in incidents of the child being reported missing from the home. However, staff are still not being provided with a sufficiently clear plan with detailed strategies to follow. This lack of clarity does not support staff to take effective and consistent action in response to missing-from-home incidents.

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

Restraint practice is not safely supporting the child during periods of crisis. There is poor oversight of restraint records by leaders and managers. Poor practice, together with ineffective oversight from leaders and managers, does not ensure that restraint is only used as a last resort and in accordance with legislative guidance.

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

When the child made an allegation about staff, this matter was appropriately referred to the local area designated officer and social worker. However, the registered provider did not ensure that there was effective and independent oversight of the incident, in line with the home’s policies.

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

Risk management plans are not sufficiently robust as they do not contain relevant information about the child’s known vulnerabilities. Staff are not provided with clear information that helps them to manage the child’s risk and vulnerabilities safely and effectively.

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

When new risks emerge or risks change, plans to manage these risks are not updated swiftly or shared effectively with the staff team. For example, following an incident of unsafe behaviour in the home’s vehicle, staff were not provided with the current plan to manage this risk. This poor communication placed the child at risk of harm.

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

Leaders and staff have not reviewed the fire risk assessment in line with the child’s individual needs. Therefore, there has been a failure to ensure that current fire safety measures are sufficient.

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

Staff promote positive behaviour through praise and rewards. However, the consequences imposed on the child have failed to provide opportunities for the child to reflect on and learn from their behaviour.

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The effectiveness of leaders and managers: inadequate

There is inadequate management oversight of the home. Leaders are not sufficiently reviewing and evaluating the quality of care provided. There is currently no registered manager in post. The deputy manager and responsible individual are currently overseeing the management of the home. They are not sufficiently reviewing and evaluating the quality of care provided. Inspection report for children’s home: 2711439 5 Management oversight is poor. This has resulted in insufficient review of incidents and reflection on whether the actions taken were appropriate. This is not effective and does not ensure robust oversight and scrutiny of the quality of care provided to the child.

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The effectiveness of leaders and managers: inadequate

Staff have not undertaken relevant training to support their understanding of, and ability to meet, the child’s identified needs. For example, staff have not had training in mental health awareness.

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The effectiveness of leaders and managers: inadequate

There is poor oversight of the training that staff have received. Leaders do not ensure that they obtain the relevant certificates to evidence what training staff have received. This poor oversight does not ensure that staff have the skills and experience to meet the child’s complex needs.

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The effectiveness of leaders and managers: inadequate

Supervision is taking place, which does cover some areas of practice. However, supervision is not reflective. Staff report that they feel supported and that their well- being is promoted. However, staff practice is not being developed through effective supervision or debriefs following incidents. This results in poor practice continuing, which places the child at risk of harm.

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The effectiveness of leaders and managers: inadequate

Professionals who were spoken to felt that communication had recently improved. However, poor communication with relevant professionals about the child’s recent risks and behaviours prevented a robust multi-agency evaluation and response to reduce these risks.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to notify Ofsted of all significant events. This prevents external monitoring of the home and evaluation of safeguarding incidents.

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The effectiveness of leaders and managers: inadequate

Following this inspection, Ofsted issued a notice restricting accommodation at the home. This is to prevent the admission of further children. Ofsted will monitor the provider’s compliance with this notice.

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The effectiveness of leaders and managers: inadequate

Ofsted has also issued three compliance notices under section 22A of The Care Standards Act (2000). These relate to regulation 10, the health and well-being standard; regulation 12, the protection of children standard and regulation 13, the leadership and management standard. Ofsted will carry out further visits to monitor these notices. Inspection report for children’s home: 2711439 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 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.

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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 each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (1)(a)(b) (2)(c))

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Requirement Due date

Specifically, the registered person must ensure that staff caring for the child have the knowledge and experience in supporting the child’s mental health needs.

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Requirement Due date

Furthermore, staff must take any necessary action in association with the relevant plans regarding the child’s self- injurious behaviours.

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Requirement Due date

The registered person must also ensure that staff seek appropriate health advice and treatment as required. This includes seeking treatment in relation to accidents and self-injurious incidents. 20 July 2023

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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

assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if 11 August 2023 Inspection report for children’s home: 2711439 7 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

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

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; and

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Requirement Due date

that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(v)(vi)(d)(e))

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Requirement Due date

Specifically, the registered person must ensure that the child’s risk assessment outlines the risks to the child and provides clear strategies for staff to follow to reduce risks to the child.

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Requirement Due date

Further to this, the registered person must ensure that staff take effective action, in line with the risk assessment, in response to safeguarding concerns.

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Requirement Due date

The registered person must ensure that avoidable hazards to the child’s health are addressed.

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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; 11 August 2023 Inspection report for children’s home: 2711439 8 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)(c)(f)(h))

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Requirement Due date

Specifically, the registered person must ensure that staff have the skills and knowledge to meet the needs of the child that lives in the home.

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Requirement Due date

The registered person must ensure that staff receive training to support the child’s mental health needs.

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Requirement Due date

The registered person must ensure that they develop staff skills and knowledge through practice-based supervision and debriefs following incidents.

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Requirement Due date

The registered person must implement an effective monitoring system to ensure improved oversight and evaluation of safeguarding and incidents in the home.

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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 each child’s relevant plans are followed. (Regulation 14 (1)(a)(b) (2)(c))

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Requirement Due date

Specifically, the registered person must ensure that the child’s relevant plans, including education, health and care plans, local authority plans for the child’s care and health reports, are used to inform the home’s plans for the child. 11 September

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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

mutual respect and trust; 11 September Inspection report for children’s home: 2711439 9 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

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. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(ix))

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must—

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Requirement Due date

take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home;

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Requirement Due date

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

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Requirement Due date

This relates specifically to ensuring that there is an adequate number of fire doors in the premises. 11 September

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Requirement Due date

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

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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, 11 September Inspection report for children’s home: 2711439 10 if the individual satisfies the requirements in paragraph (3).

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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 (2)(a)(b) (3)(d))

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Requirement Due date

This relates specifically to ensuring that a copy of relevant training certificates is obtained.

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out—

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

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

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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 11 September Inspection report for children’s home: 2711439 11 a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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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”)—

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Requirement Due date

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

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Requirement Due date

Specifically, the registered person must ensure that records of consequences and restraints contain the information that is required by legislation.

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Requirement Due date

Further to this, the registered person must ensure that restraints are only used, when necessary, as a last resort and in accordance with legislative guidance.

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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

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

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(b)(c)(e)) 11 September

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Requirement Due date

* These requirements are subject to a compliance notice. Inspection report for children’s home: 2711439 12

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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: 2711439 13

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Children’s home details

Registered provider: Nurture Support Services Limited

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Children’s home details

Registered provider address: 35 Prescot Road, St. Helens WA10 3UF

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Inspector

Emma Thornton, Social Care Inspector Inspection report for children’s home: 2711439 14 regulates and inspects 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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