Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

Inspection report for children’s home: SC033268 1 s SC033268 Registered provider: Appletree Treatment Centre Limited

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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 provides care for up to 12 children who may experience social and emotional difficulties. At the time of this inspection, nine children were living in the home.

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Information about this children’s home

The home does not currently have a registered manager.

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Information about this children’s home

There is a school on the same site as the home. The inspectors only inspected the social care provision at this site. All children from the home currently attend this school.

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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.

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inadequate

Date of last inspection: 4 September 2023

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none

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Recent inspection history

Inspection report for children’s home: SC033268 2

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Inspection date Inspection type Inspection judgement

04/09/2023 Full good 22/11/2022 Full good 20/04/2021 Full good 04/06/2019 Full good Inspection report for children’s home: SC033268 3

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Overall experiences and progress of children and young people: inadequate

Children experience inconsistent responses from staff. This does not provide children with stability or help them to understand what is expected of them.

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Overall experiences and progress of children and young people: inadequate

Staff do not provide children with care in accordance with the home’s statement of purpose. Managers say that consequences are not used within the agreed model of care. However, rules and restrictions are used which are not detailed in children’s individual plans. These are not acknowledged as consequences or recorded. This does not ensure that children’s individual needs are met. For example, staff remove the remote controls for televisions in communal areas of the home for all children. Staff say that this is to stop children arguing or throwing the remote controls.

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Overall experiences and progress of children and young people: inadequate

Staff remove all toiletries from some children. Staff say this is because they have squirted them at each other. However, staff have not completed work with individual children to help them resolve these behaviours. This means that some children are not supported to develop self-care routines and skills in line with their individual abilities.

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Overall experiences and progress of children and young people: inadequate

Staff restrict children’s movements around the home. To manage behaviour staff lock some internal doors on communal rooms to prevent children from accessing them. Restrictions on children’s movements around the home is not always in line with their individual needs and should only be used when necessary to keep children safe.

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Overall experiences and progress of children and young people: inadequate

Children’s views about the care that they receive are routinely sought. This enables children to contribute to decisions made about their care. Most children said that they know how to make a complaint. However, when children raise concerns they are not always acknowledged as a complaint. As a result, children do not always get a response to concerns that they have raised. This does not enable children to understand how their views have been acted on.

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Overall experiences and progress of children and young people: inadequate

Some areas of the home are welcoming and spacious. However, some children’s bedrooms are unclean, have graffitied walls and contain damaged furniture. This detracts from the environment being a nurturing place for children to live in.

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Overall experiences and progress of children and young people: inadequate

Staff support children to maintain relationships with connected people by arranging for them to see each other. However, feedback from families shows a variation in their experiences of working with the staff team. Some parents say that they do not get timely updates when there has been an incident involving their child. This does not ensure that parents feel included in decisions made about their child’s day-to-day care.

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Overall experiences and progress of children and young people: inadequate

Children’s physical health needs are met. Staff encourage children to be active and lead healthy lifestyles through exercise and sports. Staff provide children with opportunities to take part in a range of activities and hobbies. This helps children to build their Inspection report for children’s home: SC033268 4 confidence and pursue their own interests. All the children attend school. Staff have routines in place which maximise children’s educational opportunities.

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

Staff do not always understand the needs of children or the steps that they need to take to keep children safe. Staff do not always use the agreed strategies in children’s plans. This has escalated the risk for some children.

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

Staff do not always exhaust all other options before holding children. Staff hold children when this is not needed to safeguard the child or those around them. This is a view shared by one child’s social worker. Staff do not record a detailed description of how children have been held. This means that it is not possible to assess whether the holds are safe, proportionate or appropriate. Staff do not always remind children that they can speak to an advocate or make a complaint following a physical intervention

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

Staff do not follow the agreed medication policy when children refuse prescribed medication. Staff do not record accurate details about the administration instructions for prescribed medications. Staff do not maintain accurate records of administration of medication. Managers say that they are unable to differentiate from records when a child has refused medication from when a child has not needed medication.

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

Monitoring is in place for all children at nighttime. Bedroom door alarms are used at nighttime, which is not assessed in line with children’s individual needs or kept under review. Staff have not ensured that the home environment is a physically safe space for children. Managers have not taken steps to mitigate the risk for one child when it is known that this child climbs onto their furniture to reach toys which are suspended from their ceiling.

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

Staff complete direct work with children to help them understand risks and how to stay safe. The recording of this work is variable in quality. Some records do not clearly capture what work was completed with the children or what the child’s views were.

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The effectiveness of leaders and managers: inadequate

There has been no registered manager in place since September 2023. There is an interim manager in place who has applied to Ofsted to be the registered manager. The manager is supported by the responsible individual and a deputy manager.

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The effectiveness of leaders and managers: inadequate

Leaders and managers do not have a clear understanding of staff practice, or the impact this has on children’s experiences. Monitoring and reviewing systems are ineffective. Managers say that they are unaware that some staff lock internal doors to manage children’s behaviour. When leaders and managers are aware of unsafe practice, they then do not always take steps to resolve this. As a result, shortfalls in staff practice continue. Inspection report for children’s home: SC033268 5 Leaders and managers ensure that there are enough staff in place to meet the needs of the children. However, leaders and managers have not ensured that there is an accurate roster of staff working in the home. Leaders and managers have failed to take steps to ensure that there are suitable arrangements in place for staff who sleep in the home. Some staff have been sleeping in communal areas of the home in their nightwear. This is

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The effectiveness of leaders and managers: inadequate

unsafe practice and is not assessed in line with children’s individual experiences and needs.

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The effectiveness of leaders and managers: inadequate

Feedback from external professionals is variable about their experiences of working with leaders and managers in the home. Staff send weekly updates to social workers about the children. Leaders and managers have appropriately challenged external professionals when children’s needs are not met.

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The effectiveness of leaders and managers: inadequate

Staff say that they enjoy working in this home and that they feel supported by the management team. Staff have supervision and team meetings, which provides them with opportunities to learn and develop. Staff access a range of training which gives them the skills and knowledge to meet the needs of the children. Inspection report for children’s home: SC033268 6

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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, The Children’s Homes (England) Regulations 2015 and the ‘Guide to the Children’s Homes Regulations, including the quality standards.’ The registered person must comply within the given timescales.

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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

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 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. 27 September 2024 Inspection report for children’s home: SC033268 7 (Regulation 12 (1) (2)(a)(i)(iii)(v)(vi)(b)(d)(e))

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Requirement Due date

Specifically, the registered provider must ensure that all staff have read the children’s risk assessments and individual plans and understand the known risks for the children in their care.

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Requirement Due date

The registered provider must ensure that all staff understand their roles and responsibilities in relation to protecting the children in their care. This must include following children’s individual plans.

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Requirement Due date

The registered provider must ensure that children can access all appropriate areas of the home. Any restriction on children’s movements, including the locking of doors, must only be used to safeguard the children, be necessary and proportionate and be kept under review. Any assessed restriction of liberty must be included within the children’s risk assessment and plans.

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Requirement Due date

The registered provider must ensure that the home is designed, furnished and maintained so as to protect each child from avoidable hazards.

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Requirement Due date

The registered provider must review the medication policy and the recording of medication processes.

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Requirement Due date

The registered provider must ensure that there is a medication recording system in place for staff to differentiate between children refusing medication and children not needing medication in records.

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Requirement Due date

The registered provider must ensure that staff understand what to do when children refuse their prescribed medication.

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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— 27 September 2024 Inspection report for children’s home: SC033268 8 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 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

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) (2)(a)(c)(d)(f)(h))

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Requirement Due date

The registered provider must review all staff’s training needs to ensure that they have the experience, skills and knowledge to meet the needs of the children in their care. Training must be arranged if any shortfalls are identified.

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Requirement Due date

The registered provider must review their management monitoring and auditing processes to ensure that they have a clear understanding of the quality of care that is being provided to the children by the staff. The registered person must also ensure that when shortfalls in staff practice are identified, this is acted on.

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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

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

The registered person must ensure that— 27 September 2024 Inspection report for children’s home: SC033268 9 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

a description of the measure and its duration;

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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)(b) (2) (3)(a)(iv)(c))

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Requirement Due date

The registered provider must ensure that the behaviour management policy sets out the measures of control and restraint which may be used in relation to children in the home.

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Requirement Due date

The registered provider must ensure that all managers and staff understand each child’s individual behaviour management plan and what specific steps staff should take for each child to avoid the need to use a physical intervention.

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Requirement Due date

The registered provider must ensure that children are only being held by staff as a last resort.

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Requirement Due date

The registered provider must ensure that when children are held by staff they are given the opportunity to share their views about this with an independent person and reminded that they can make a complaint or access advocacy. The registered provider must ensure that all staff and children understand this.

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Requirement Due date

The registered provider must ensure that when a child is held by staff there is a detailed description of how the child was held and its duration.

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1) (2)(a)(b)) 27 September 2024 Inspection report for children’s home: SC033268 10 The registered provider must ensure that there is a copy of the staff roster of persons working in the home, and a record of the actual rosters worked.

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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—

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Requirement Due date

understand and apply the home’s statement of purpose;

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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.

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Requirement Due date

The registered provider must ensure that staff follow the agreed strategies in children’s individual plans to manage behaviour.

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Requirement Due date

The registered provider must ensure that there is a record of all rewards and consequences used, and that children’s views are routinely sought about these.

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Requirement Due date

The registered provider must also ensure that there are suitable sleeping arrangements in place for staff which take into account the individual needs of children. 27 September 2024

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Requirement Due date

*These requirements are subject to a compliance notice. Inspection report for children’s home: SC033268 11

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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: SC033268 12

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Appletree Treatment Centre Limited

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Children’s home details

Registered provider address: Meathop Park, Meathop, Grange-over-Sands, Cumbria LA11 6RF

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Inspectors

Sally Griffiths, Social Care Inspector Lisa Summers, His Majesty’s Inspector Sally Croft, Social Care Inspector Inspection report for children’s home: SC033268 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 looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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Inspectors

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