Children's Home run by Courtyard Care Limited in Warrington

Inspection report children’s home: 2620865 1 Registered provider: Courtyard Care Limited

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This children’s home is run by a private organisation. It is registered to provide care for up to six disabled children. At the time of the inspection, six children were living in the home.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

inadequate

How well children and young people are helped and protected inadequate

p.1

inadequate

The effectiveness of leaders and managers inadequate

p.1

inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded.

p.1

inadequate

Overall judgement at last inspection: good

p.1

inadequate

Enforcement action since last inspection: none Inspection report children’s home: 2620865 2

p.1

Inspection date Inspection type Inspection judgement

18/07/2023 Full Good 05/07/2022 Full Good 14/12/2021 Full Good Inspection report children’s home: 2620865 3

p.2

Overall experiences and progress of children and young people: inadequate

Since the last inspection there has been significant changes in the staff team. Fourteen members of the core staff team, including the registered manager, resigned from their posts. The existing staff team have been working additional hours to try to keep any changes to a minimum for the children they care for. However, they have been unable to do this safely.

p.3

Overall experiences and progress of children and young people: inadequate

Staff spoken to said, some of the reasons for leaving is the instability of the management team and the additional pressures placed on more experienced staff to care for children with high levels of complex health and medical needs.

p.3

Overall experiences and progress of children and young people: inadequate

Each child has a robust and detailed plan that includes their health needs. The plans provide clear strategies for staff to follow to ensure that the children’s complex health needs are met. However, staff have not followed the strategies in place.

p.3

Overall experiences and progress of children and young people: inadequate

Not all children have had their physiotherapy needs met and one child has not received respiratory physio each day as outlined in their plan. Staff have failed to record when a child has been supported in their standing frame or follow the guidance provided in another child’s sleep system plan. This does not demonstrate that all staff understand their roles and responsibilities in following key guidance to keep children safe.

p.3

Overall experiences and progress of children and young people: inadequate

Planning for childrens moves in and out of the home is robust. This helps children during this transition period and helps them to settle.

p.3

Overall experiences and progress of children and young people: inadequate

Although the safeguarding shortfalls have put children at an increased risk of harm, children have made progress in education. The children’s educational needs are fully assessed. Staff work well with education staff to support children to engage and achieve.

p.3

Overall experiences and progress of children and young people: inadequate

Children share positive relationships with some of the staff. Each child has an individual communication plan, which most staff follow. Staff support children to express their wishes and feelings by using a variety of communication tools. Positive interactions between staff and children were observed during this visit.

p.3

Overall experiences and progress of children and young people: inadequate

Children live in a warm, comfortable home. Each child’s bedroom is designed to meet their needs and is unique to the individual child, with family photos and personalised colour schemes. However, some children’s bedrooms need redecorating due to damage and stains that have not been addressed by the staff in a timely way.

p.3

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

The children that live at this home have complex health care needs. Children require the staff to carry out clinical procedures and personal care daily to ensure that they remain Inspection report children’s home: 2620865 4 healthy and safe. However, there are significant shortfalls with regards to staff practice and management oversight in this area. This means children’s healthcare needs are not being met, nor their wellbeing promoted.

p.3

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

Most of the children at this home require support with enteral feeds. Staff have been robust in their care of these children closely monitoring them to ensure that they receive the correct nutrition and hydration. Staff have followed guidance to ensure that appropriate hygiene practices have been followed when caring for the feeding tube to prevent infection and complications. However, for one child the staff have not followed guidelines as instructed by healthcare providers with regards to the need to use single use syringes. This practice has the potential to cause infection.

p.4

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

One child who had spent time in hospital was discharged with notes advising that they may require a respiratory physiotherapy plan. However, the manager did not follow up with health professionals to ensure that these plans were in place. This created a delay in the child receiving their respiratory physiotherapy in a timely way and increased the risk of infection.

p.4

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

Children in this home are assessed as requiring some restrictions to keep them safe and to promote their welfare. For example, the use of a specialised harness when in the vehicle to keep them safe in their wheelchairs and the use of audio monitors. However, the use of some restrictions is not clearly recorded, and staff practice is inconsistent in the way restrictions are implemented. This lack of recording prevents the restrictions being regularly reviewed.

p.4

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

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

p.4

The effectiveness of leaders and managers: inadequate

The previous registered manager resigned from their post in April 2024, prior to this the manager was away from work. Management cover was provided by a senior manager from within the organisation. These changes created a lack of clear leadership. Staff said that changes in senior management have contributed to some staff deciding to leave the organisation.

p.4

The effectiveness of leaders and managers: inadequate

The management team’s capacity is limited. The manager post is vacant, two team leader posts are also vacant. Staffing vacancies have made it necessary for managers to provide care to children. Although senior managers continue to offer additional support, these gaps have compromised managerial capacity and oversight and contributed to several significant management shortfalls.

p.4

The effectiveness of leaders and managers: inadequate

Currently, a manager from a sister home is supporting the operation of the home until a new manager is recruited. The manager is experienced and child centred. Staff said that Inspection report children’s home: 2620865 5 they already noticed a difference in support since the manager began working in the home.

p.4

The effectiveness of leaders and managers: inadequate

Staff practice and knowledge is inconsistent. Not all staff have the required training to be able to safely manage and support each child’s complex health needs. Furthermore, only six members of the current staff team hold a childcare qualification.

p.5

The effectiveness of leaders and managers: inadequate

Due to children’s complex needs the provider has not historically used agency staff. This means that the remaining staff have picked up additional hours resulting in exhaustion. This has impacted on the continuity of care for some children.

p.5

The effectiveness of leaders and managers: inadequate

The internal review of the quality of care did not include any feedback from children, their parents, placing authorities or staff. This fundamentally limits the opportunity for leaders and managers to learn and take action to improve the quality of the home.

p.5

The effectiveness of leaders and managers: inadequate

Staff practice related supervision is not being completed consistently. This limits the opportunity for staff reflection and learning. When supervisions have taken place, staff have raised concerns about each other’s practice. It is not clear what action leaders and managers have taken to address these concerns.

p.5

The effectiveness of leaders and managers: inadequate

The statement of purpose has not been revised and updated regularly to reflect the changes in staff since the last full inspection in July 2023. This means that the regulatory body is not informed of any changes, specifically relating to staffing changes. Inspection report children’s home: 2620865 6

p.5

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.

p.6

Requirement Due date

*The health and well-being standard is that—

p.6

Requirement Due date

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

p.6

Requirement Due date

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

p.6

Requirement Due date

children are helped to lead healthy lifestyles.

p.6

Requirement Due date

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

p.6

Requirement Due date

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

p.6

Requirement Due date

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding;

p.6

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

p.6

Requirement Due date

understand and develop skills to promote the child’s well-being;

p.6

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.

p.6

Requirement Due date

(Regulation 10 (1)(a)(b)(c) (2)(a)(i)(ii)(iv)(c))

p.6

Requirement Due date

The registered provider must ensure that children receive physiotherapy therapy in line with their individual plans, including following the sleep system plan for one child. 13 May 2024 Inspection report children’s home: 2620865 7 The registered provider must ensure that children receive respiratory therapy in line with their individual plans.

p.6

Requirement Due date

The registered provider must ensure that staff follow guidance in health plans. Staff should not be using single use care giving sets by washing them, this places children at risk of infection. *The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that helps children aspire to fulfil their potential; and promotes their welfare.

p.7

Requirement Due date

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

p.7

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;

p.7

Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

p.7

Requirement Due date

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

p.7

Requirement Due date

The registered provider must ensure that staff receive training so they can meet children’s physiotherapy and respiratory needs. The registered provider must ensure that they have sufficient oversight of children’s health plans to ensure that all their needs are being met. The registered provider must ensure that there are sufficient staff with the skills and knowledge to care for each of the children each day, without this having an impact on other children’s experiences and progress.

p.7

Requirement Due date

The registered provider needs to ensure they follow up with health colleagues to ensure any follow up treatment for children is completed in a timely way. 13 May 2024

p.7

Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if- 1 June 2024 Inspection report children’s home: 2620865 8 a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child — is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii)(e)) The registered person must ensure that significant incidents are notified to Ofsted. The registered person must ensure that— within 24 hours of the use of a measure of control, discipline or

p.7

Requirement Due date

restraint in relation to a child in the home, a record is made which includes— the name of the child; details of the child’s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; and

p.8

Requirement Due date

1 June 2024, Inspection report children’s home: 2620865 9 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))

p.8

Requirement Due date

Any restriction used on a child, needs to be regularly reviewed, and on each occasion recorded. The restriction used on one child requires multiagency review at the child’s EHCP review. The registered person must ensure that all employees-

p.9

Requirement Due date

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

p.9

Requirement Due date

This relates to the registered provider ensuring that all staff are supervised regularly, which allows them to reflect on their practice and the needs of the children in their care.

p.9

Requirement Due date

This further relates to ensuring that matters raised in supervisions by the staff regarding staff practice is addressed. 1 June 2024

p.9

Requirement Due date

* These requirements are subject to a compliance notice.

p.9

Recommendations

 The registered person should ensure that they have a system in place which allows them to monitor the matters set out in the regulations at least every six months. This should include feedback from each child’s placing authority, family and staff. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 64, paragraph 15.2).

p.9

Recommendations

 The registered person should ensure that the home is maintained and quickly repaired, such as the damage to a child’s bedroom wall. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 15, paragraph 3.9).

p.9

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 children’s home: 2620865 10

p.9

Children’s home details

Registered provider: Courtyard Care Limited

p.10

Children’s home details

Registered provider address: 3 Siskin Drive, Middlemarch Business Park, Coventry CV3 4FJ

p.10

Children’s home details

Responsible individual: Jacqueline Hills

p.10

Inspectors

Jennifer Quest, Social Care Inspector Kerri Lynch, Social Care Inspector Inspection report children’s home: 2620865 11 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.

p.10

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.11

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.11

Inspectors

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

p.11