Children's Home run by Theracare Homes Limited in Lancashire

Inspection report for children's home: 2673338 1 Registered provider: Theracare Homes 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 by a private company. It is registered to provide care for up to two children who may experience social or emotional difficulties.

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Information about this children’s home

Between January 2023 to October 2023 the home was closed. A variation of the home’s conditions of registration was in place that required the provider to give Ofsted three months’ notice of their intention to care for children. The provider wrote to Ofsted in July 2023 with notice of their intention to care for children again from October 2023. A monitoring visit took place in October 2023 and following that visit the three-month condition was removed.

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Information about this children’s home

At the time of this inspection, one child was living in the home. The child spoke with inspectors about their experiences living in the home.

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Information about this children’s home

The manager registered with Ofsted in April 2024.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 2 November 2022

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requires improvement to be good

Overall judgement at last inspection: inadequate

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requires improvement to be good

Enforcement action since last inspection: none Inspection report for children's home: 2673338 2

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Inspection date Inspection type Inspection judgement

02/11/2022 Full Inadequate 27/07/2022 Full Inadequate Inspection report for children's home: 2673338 3

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improvement to be good

The child living in the home is being helped to make progress. This is due to the care and attention provided by the staff team. However, shortfalls in safeguarding practice and management oversight mean that children’s experiences are variable and are not always positive.

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improvement to be good

Two children have lived in the home since it reopened. One child had a positive experience of moving in. However, the child who previously lived in the home moved in in an emergency, meaning that their needs were not well understood. The child left the home 10 days later, with immediate notice. This did not provide the child with a positive experience of living in the home.

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improvement to be good

The home is bright and modern. However, basic maintenance such as fixing a broken curtain rod in the child’s bedroom had not been addressed. The child has personalised her bedroom but lacks sufficient storage for all of her belongings. This reduces opportunities for the child to develop a sense of pride and belonging in the home.

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improvement to be good

Staff have developed positive and trusting relationships with the child. This has enabled the child to settle into the home and accept boundaries that are put in place.

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improvement to be good

Staff support the child with her education and have helped her to identify goals. Staff are supporting her to develop her independence skills and to learn how to take care of herself. The child has now been accepted by a number of colleges and has aspirations for her future.

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improvement to be good

Staff have supported the child to access health services, which is something she struggled with in the past. The child is now up to date with all her health appointments and her emotional well-being is prioritised.

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improvement to be good

Staff involve the child in her care planning and gain her views on how she wants to be supported. The child says that staff listen to her wishes and feelings and make changes for her when they can. The child has recently been bought two pet rabbits, which she is very fond of.

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improvement to be good

Staff take the child out on various activities, which include going to ‘goat yoga’ and ‘rage rooms’. The child says she has fun with the staff team. Staff give the child rewards and incentives to help her work towards her goals. Time with her family is well supported and she is helped to understand and maintain her family identity. Inspection report for children's home: 2673338 4

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improvement to be good

The child feels safe and has positive relationships with the staff team. Staff have shown clear commitment to the child and, as a result, her risks have reduced significantly. However, the child who previously lived in the home did not experience the same level of commitment. She did not live in the home long enough for her risks to reduce.

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improvement to be good

When children go missing from home, or attempt to go missing, staff responses have been effective and have helped to keep children safe. Staff have clear guidance on what action they should take to keep children safe and understand what restrictions they can or cannot use for children.

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improvement to be good

The majority of risks for children are known and well understood. Risk plans are updated regularly to reflect changes in behaviour. However, when a child has disclosed a serious risk, managers have not taken effective action to ensure staff have the skills to manage this. Incidents are not well recorded or stored in one place. This impacts on the manager’s ability to monitor and evaluate staff practice and the safety of children.

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improvement to be good

The social worker for one child says communication is good and they are informed of incidents when they occur. However, for the child who previously lived in the home, there is no evidence that safeguarding concerns were sufficiently explored or shared with professionals. In addition, not all serious incidents have been reported to Ofsted as required by regulation and there was a delay in reporting one significant incident. This does not enable the regulator to have sufficient oversight of practice in the home.

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improvement to be good

Incidents of staff holding children to keep them safe are rare. When this has happened, it has been as a last resort. Records of holds do not contain information as required by regulation. On one occasion, an incident when a child was held was not recorded or evaluated as a hold and the child and staff were not given the opportunity to speak about the incident. Recording shortfalls had not been identified by leaders or managers. This does not allow sufficient oversight of staff practice and does not ensure the safety of children.

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improvement to be good

Staff responses to the child vaping are not consistent. The child uses a vape regularly and has been allowed to use this in the garden. Minimal attempts have been made to discourage her from using the vape but the practice has not been sufficiently challenged by staff or managers. Despite being aware of who is selling vapes to the child, the manager has not taken action to report this. This does not ensure the child is protected, impacts on her health and is not in line with the organisation’s policy on the use of e- cigarettes.

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improvement to be good

Safer recruitment practices are followed to ensure that staff are safe to work with vulnerable children. However, full employment dates are not recorded when applicants submit previous work history. This does not allow managers to fully explore gaps in employment, which could impact on the safety of children. Inspection report for children's home: 2673338 5

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The effectiveness of leaders and managers: requires improvement to be good

Staff say that they feel supported by the manager and have the guidance they need to do their jobs well. Staff receive regular supervisions and attend monthly team meetings, which they find useful.

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The effectiveness of leaders and managers: requires improvement to be good

The manager supports staff to develop their knowledge and skills, setting tasks for them each month and reflecting afterwards on their experiences. Staff are provided with ongoing development opportunities and find the training offer helpful.

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The effectiveness of leaders and managers: requires improvement to be good

Children’s case records are not complete. There are a number of documents missing for one child. If children return later to read their case files, they will not have a full understanding of their time living in the home. In addition, the files are unstructured, making it difficult to find the relevant records. This means reports are often recorded in the wrong places and are easily missed.

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The effectiveness of leaders and managers: requires improvement to be good

The manager provides minimal challenge to other professionals. He is very accepting of their responses and does not escalate challenge further. This does not ensure that children’s needs are being met.

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The effectiveness of leaders and managers: requires improvement to be good

Management oversight of the care provided to children is poor. Due to poor record- keeping, the manager is not able to evaluate patterns to determine what is contributing to children’s progress or challenges. The manager is not aware that many records are missing and has not challenged staff when reports are not written. The manager does not consistently record his views or analysis. This has contributed to his difficulty in identifying when additional reports are required, establishing outcomes and highlighting positive practice.

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The effectiveness of leaders and managers: requires improvement to be good

Insufficient action has been taken to address the requirements made at the previous inspection and six requirements have been restated. Inspection report for children's home: 2673338 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

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. (Regulation 5 (a)(b)(c))

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Requirement Due date

Specifically, the registered person must ensure that concerns are escalated when a response is not satisfactory. The registered person must report illegal activity by retailers when they are aware of such activity. 25 June 2024

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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; 25 June 2024 Inspection report for children's home: 2673338 7 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;

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Requirement Due date

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

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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

Specifically, the registered person must ensure that children are supported to maintain their health and understand the dangers of smoking. Staff must be provided with clear guidance on how to respond when children bring smoking paraphernalia into the home.

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Requirement Due date

This requirement was issued at the last inspection and is restated.

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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 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 25 June 2024 Inspection report for children's home: 2673338 8 are familiar with, and act in accordance with, the home’s child protection policies; 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. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(d))

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Requirement Due date

Specifically, the registered person must ensure that necessary risk assessments are in place and contain steps for staff to follow should an incident arise. Ensure all staff are trained to assess and respond to all risks that children may present with. Ensure all incidents are clearly recorded in the correct place, with sufficient oversight from the manager.

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Requirement Due date

This requirement was issued at the last inspection and is restated.

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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

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; and

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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)(f)(h))

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Requirement Due date

Specifically, the registered person must ensure that they have oversight of all work being carried out. Ensure work is evaluated to establish patterns and trends, and identify areas of learning in order to make continuous improvements.

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Requirement Due date

This requirement was issued at the last inspection and is restated. 25 June 2024 Inspection report for children's home: 2673338 9 The registered person must ensure that—

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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;

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

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Requirement Due date

Specifically, the registered person must ensure that all physical interventions are recorded as an intervention. Ensure that all records of behaviour management include all required documents.

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Requirement Due date

This requirement was issued at the last inspection and is restated. 25 June 2024 Inspection report for children's home: 2673338 10 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

Specifically, the registered person must ensure that children’s files are complete and all key documents are available. Children’s files must provide children with a full and clear understanding of their experiences living in this home.

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Requirement Due date

This requirement was issued at the last inspection and is restated. 25 June 2024

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

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Requirement Due date

Specifically, the registered person must ensure that all serious incidents are reported to the regulator.

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Requirement Due date

This requirement was issued at the last inspection and is restated. 25 June 2024

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Recommendations

 The registered person should ensure that safe recruitment practices are in place. In order to ensure there are no gaps in employment, applicants should provide exact dates of employment rather than months. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 61, paragraph 13.1)  The registered person should ensure that the home’s records on each child represent a significant contribution to their life history. In particular, ensure that children’s files are in good order and that the language used in children’s records is helpful for them. Inspection report for children's home: 2673338 11 (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 62, paragraph 14.5)  The registered person should ensure each child has a clear and thorough transition that is planned in their best interests. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 57, paragraph 11.9)

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Recommendations

 The registered person should ensure that the home is a well-kept environment which supports children’s physical, mental and emotional health. Ensure children have sufficient storage space for their belongings and their furniture is in good condition. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 33, paragraph 7.3)

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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: 2673338 12

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Children’s home details

Registered provider: Theracare Homes Limited

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Children’s home details

Registered provider address: 10 Ambassador Place, Stockport Road, Altrincham, Cheshire WA15 8DB

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Inspectors

Aislinn Cooper, Social Care Regulatory Inspector Sophie Thomson, Social Care Regulatory Inspector Inspection report for children's home: 2673338 13 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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