Children's Home run by Nestlings Care Limited in Cheshire West and Chester

Inspection report for children’s home: 2731922 1 Registered provider: Nestlings Care Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned and operated by a private organisation. It is registered to provide care for up to three children who may experience social and emotional difficulties and/or may have a learning disability.

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Information about this children’s home

The manager registered with Ofsted in July 2023. The manager also manages another setting.

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Information about this children’s home

At the time of the inspection, two children were living in the home.

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Information about this children’s home

This is the first inspection after registration.

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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. Inspection report for children’s home: 2731922 2

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inadequate

Since the home was registered in July 2023, two children have lived in the home.

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inadequate

Children do not have opportunities to build trusted and secure relationships with the adults who are looking after them. A high number of agency staff work in the home, and few staff know the children well. This does not help children to develop an appropriate sense of permanence and belonging.

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inadequate

Children are not currently attending school or engaging in alternative education provision. The staff have tried to support the children to engage in education. However, staff are inconsistent in their approach. Leaders and staff do not ensure that children are supported with a daily routine, and this does not prepare the children for participating in education during the day.

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inadequate

The children are supported by an in-house clinical team. The team’s mental health nurse and occupational therapist visit regularly to provide advice and support to the staff team, and work with the children individually. However, there has been a decline in engagement from one child, and staff do not always follow the children’s therapeutic plan. The children’s risk assessments and behaviour support plans do not always include the individual therapeutic approaches identified by the therapist and specific information relating to the child. This does not promote a holistic approach to the children’s individual care.

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inadequate

Individual keyworker sessions are carried out with one child on important issues, such as internet safety, dental health, and religious views. The sessions are specific to the children’s needs and daily experiences. However, the records do not always include children’s views, or contain information to assess if the sessions were helpful for children.

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inadequate

Managers and staff do not implement consistent routines and boundaries for the children. One child spends lengthy parts of their day in their bedroom on their games console. This is socially isolating and demotivating for the child. Furthermore, children are not always provided with opportunities to engage in activities in the community. One child does not go out in the community and staff do not have the relevant skills to improve this for him. This limits the child’s opportunities.

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inadequate

Staff support the children to see their families. This helps the children to maintain their identity and continue to spend quality time with the people who are important to them. Inspection report for children’s home: 2731922 3 Staff support the children to maintain good physical health. Children are encouraged to eat healthily and attend all their health appointments. This helps children to access specialist support to improve their physical health and well-being.

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inadequate

One child has an independent visitor who visits once a month. This provides the child with a reliable and consistent adult role model who they can spend time with.

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inadequate

Children who are new to the home are welcomed sensitively. Staff developed a social story to help children to understand about the plan for moving to the home. This helped the children to experience a smooth and positive transition into the home.

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

Safeguarding practice in the home does not promote the safety and welfare of children. Staff do not have the training and skills to safeguard children. New and inexperienced staff are left to work with children who they have only just met. This presents a risk to both children and staff.

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

Not all staff who are responsible for the care of children are trained to use physical intervention in a safe way. Furthermore, despite one child having epilepsy, not all staff are trained in how to safely support the child during a seizure, including how to administer rescue medication. This is a safeguarding concern for all involved.

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

Records do not demonstrate that there are sufficient staff to meet the children’s needs and ensure their safety. Both children require a high level of supervision. However, there were only two staff on each shift. This presents a risk to both children and staff, and is not in line with the placing authorities’ care planning expectations.

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

Risk assessments contain conflicting information. This do not support staff to keep children safe in practice. The information in some of the children’s plans and records is confusing and contains inaccurate information. Individual risk assessments do not accurately reflect the current risks for one child.

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

Physical intervention is used as a last resort. The records show that de-escalation strategies are used to help avoid physical intervention. However, the police have been called to support staff in several incidents. This could lead to the criminalisation of children.

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

When children go missing from the home, staff actively look for them and follow the missing-from-home protocol. However, independent return-home interviews do not take place in a timely way.

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

Staff have not read and signed the children’s updated risk assessments and care plans. This means that staff are not clear on how to effectively safeguard the children. One staff member had not read a child’s health plan and was unaware of Inspection report for children’s home: 2731922 4 the medication the child is prescribed. The child’s health plan contains conflicting information. For example, in relation to the administration of medication.

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

The children’s bedrooms are not always clean and tidy. This was raised by the inspector and action was taken to clean the room for one child. However, the other bedroom remained in a poor state.

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The effectiveness of leaders and managers: inadequate

The leadership and management of the home is poor. There has been no registered manager in post since August 2023 and this has impacted on the stability of the home. The interim management arrangements are unclear. A new staff member reported that they did not know who to contact when the interim manager was not in work.

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The effectiveness of leaders and managers: inadequate

There has been a high turnover of staff since the home was registered in July 2023. There are several vacancies, and agency staff regularly work in the home. Leaders and managers try to ensure that there is consistency with agency staff although staff rosters do not demonstrate this. This does not provide children with a stable and consistency staff team.

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The effectiveness of leaders and managers: inadequate

All staff have not completed a robust induction or access to training that they require to keep children safe. This includes training in managing epilepsy and seizures, and how to use physical intervention safely.

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The effectiveness of leaders and managers: inadequate

Management oversight of the children’s records is poor. The records include inaccurate and contradictory information, and several documents are missing. This is confusing for staff, especially for agency staff who do not know the children. Furthermore, this is not helpful for the children to understand their journey in the home.

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The effectiveness of leaders and managers: inadequate

There are ineffective systems in place to monitor and review children’s progress in accordance with the targets in their plans. Management oversight of incidents is poor. This means that the managers and staff cannot always identify and act on shortfalls to improve the quality of care that the children receive.

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The effectiveness of leaders and managers: inadequate

Staff are not receiving supervision in line with the company’s statement of purpose. For example, one staff member has had supervision twice since the home was registered in July 2023. Staff who are new to the home have not had supervision. This limits the manager’s understanding of staff strengths and areas for development. Inspection report for children’s home: 2731922 5

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Statutory requirements

This section sets out the actions that the registered person must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the Children’s Homes Regulations, including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

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

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Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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Requirement Due date

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

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Requirement Due date

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background. (Regulation 6 (1)(a)(b) (2)(b)(iv))

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Requirement Due date

In particular, the registered person must ensure that the children’s relevant plans and documents are obtained from the placing local authority to inform care planning to meet the children’s needs. 29 February 2024

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Requirement Due date

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

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Requirement Due date

develop positive relationships with them;

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Requirement Due date

and take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. 29 February 2024 Inspection report for children’s home: 2731922 6 In particular, the standard in paragraph (1) requires the registered person to ensure that staff—

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Requirement Due date

ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare;

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Requirement Due date

help each child to express views, wishes and feelings;

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Requirement Due date

help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child; regularly consult children, and seek their feedback, about the quality of the home’s care. (Regulation 7 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv))

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Requirement Due date

In particular, the registered person must ensure that children are supported to communicate their views, wishes and feelings and participate as fully as possible in all aspects of their care planning and daily care. The registered person must ensure that children can see the results of their views being listened to and acted on, and that these are detailed in the children’s records.

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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 that staff—

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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;

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Requirement Due date

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; 29 February 2024 Inspection report for children’s home: 2731922 7 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;

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Requirement Due date

help each child to attend education or training in accordance with the expectations in the child’s relevant plans; and that each child has access to appropriate equipment, facilities and resources to support the child’s learning. (Regulation 8 (1) (2)(a)(i)(ii)(iii)(iv)(v)(viii)(x)(b))

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Requirement Due date

In particular, the registered person must ensure that the staff support children to attend school as detailed in their relevant plans. When a child is unable to attend school, the staff need to support children to engage in home learning and independent study, and provide them with educational activities. Furthermore, the registered person must ensure that there are consistent routines and boundaries in place for the children.

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Requirement Due date

The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff help each child to—

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Requirement Due date

develop the child’s interests and hobbies;

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Requirement Due date

participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and

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Requirement Due date

make a positive contribution to the home and the wider community; and

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Requirement Due date

that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1) (2)(a)(i)(ii)(iii)(b))

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Requirement Due date

In particular, the registered person must ensure that the staff support the children to engage in activities within and outside of the home on a consistent basis. 29 February 2024

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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— mutual respect and trust; 29 February 2024 Inspection report for children’s home: 2731922 8 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

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

help each child to develop and practise skills to resolve conflicts positively and without harm to anyone;

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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

help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful;

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Requirement Due date

help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship;

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Requirement Due date

that each child is encouraged to build and maintain positive relationships with others. (Regulation 11 (1)(a)(b)(c) (2)(a)(ii)(iii)(iv)(v)(vi)(vii)(b))

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Requirement Due date

In particular, the registered person must ensure that each child is provided with individual sessions that are planned and based on the child’s presenting needs and feelings.

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Requirement Due date

Furthermore, the registered person must ensure that there is clear evidence within the records of the impact of individual work sessions completed with children by staff. This can then be used to help further inform the children’s assessments and plans. Inspection report for children’s home: 2731922 9 *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

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 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 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)(iv)(v)(vi)(b)(d))

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Requirement Due date

In particular, the registered person must ensure that children’s risk assessments and plans are understood and followed by all the staff team. Furthermore, the registered person must ensure that the staff help the children to understand how to keep themselves safe.

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Requirement Due date

In particular, the registered person must ensure that the children live in a home that is clean, tidy and maintained to a good standard throughout, especially the children’s bedrooms. 31 December

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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— 02 January 2024 Inspection report for children’s home: 2731922 10 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

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

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

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Requirement Due date

feedback on the experiences of children, including complaints received;

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Requirement Due date

and 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)(g)(ii)(h))

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Requirement Due date

In particular, the registered person must maintain an effective leadership team. Furthermore, leaders and managers must maintain effective oversight of children’s care, children’s records and significant incidents.

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Requirement Due date

The registered person must ensure that all staff continue to be provided with training that is specific to the children’s individual needs, such as de-escalation training, managing epilepsy and seizures, physical intervention, and first aid. Inspection report for children’s home: 2731922 11 The registered person must keep the statement of purpose under review and, where appropriate, revise it; and

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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 (3)(a)(b))

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Requirement Due date

Specifically, the registered person must ensure that the statement of purpose is up to date, and a copy of the revised statement is sent to HMCI within 28 days of the revision. 29 February 2024

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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.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

a record is kept of the administration of medicine to each child. (Regulation 23 (1) (2)(c))

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Requirement Due date

In particular, the registered person must ensure that the children’s records detail the correct time for the administration of medication. Furthermore, the registered manager should ensure that staff follow the company policy for the recording of the administration of medication to children. 29 February 2024

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Requirement Due date

The registered person must ensure that each employee completes an appropriate induction. (Regulation 33 (1)(a))

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Requirement Due date

In particular, the registered person must ensure that new staff complete an appropriate induction. 29 February 2024

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Requirement Due date

The registered person must maintain records ("case records") for each child which—

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

In particular, the registered person must ensure that the children’s records are up to date and contain accurate information. Furthermore, the registered person should ensure that the staff are familiar with the home’s policies on 29 February 2024 Inspection report for children’s home: 2731922 12 record-keeping and understand the importance of careful and clear recording.

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Recommendations

 The registered person should ensure that an independent return-home interview takes place within 72 hours of a child returning home when they have been missing. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 45, paragraph 9.30)

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Recommendations

 The registered person should ensure that the individual therapeutic approaches identified by the psychotherapist for each child are incorporated into their assessments and plans. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 16, paragraph 3.15)

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Recommendations

 The registered person should ensure that staff encourage children to keep appropriate memorabilia of their time living at the home. (Guide to the Children’s Homes Regulations, including the quality standards page 62, paragraph 14.5) Inspection report for children’s home: 2731922 13

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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: 2731922 14

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Children’s home details

Registered provider: Nestlings Care Limited

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Children’s home details

Registered provider address: Suite 4, 1 Derby Street, Leigh WN7 4PF

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Children’s home details

Responsible individual: Anthony Thompson

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Inspector

Dawn Walker, Social Care Inspector Inspection report for children’s home: 2731922 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.

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Inspector

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Inspector

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Inspector

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