Children's home run by Holywell Children’s Services Limited

Inspection report for children’s home: 2662751 1 Registered provider: Holywell Children’s Services Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

This home is operated by a private provider and offers care for one child with social and emotional difficulties, and/or learning disabilities.

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Information about this children’s home

One child was living in the home at the time of the inspection. The child spoke with the inspectors during the inspection.

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Information about this children’s home

There is a new manager in post, who started work at the home in July 2025. He has applied to register with Ofsted.

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Information about this children’s home

This home was registered on 31 January 2022.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Date of last inspection: 26 February 2025

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report for children’s home: 2662751 2

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Inspection date Inspection type Inspection judgement

26/02/2025 Full Good 13/09/2023 Full Requires improvement to be good 25/10/2022 Full Requires improvement to be good Inspection report for children’s home: 2662751 3

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Overall experiences and progress of children and young people: inadequate

There are serious and widespread failures in the safeguarding arrangements for children and the leadership and management of the home. These failures have a negative impact on the experiences and progress of children.

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Overall experiences and progress of children and young people: inadequate

The child’s move into the home was not well planned. There was a lack of a thorough assessment by the manager, who did not fully assess if and how the child’s identified needs and risks would be managed.

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Overall experiences and progress of children and young people: inadequate

The child does not receive the care and supervision necessary to support their safety and well-being. Staff struggle to implement routines and boundaries in the home. Incidents of challenging behaviour have escalated, and staff provide inconsistent responses to manage the child’s behaviour. The child’s care plan and risk assessments are not regularly reviewed and updated, which limits staff’s ability to care for the child effectively. Incidents where staff have intervened to keep the child safe are not reviewed so as to identify learning and inform any changes required to keep the child safe. As a result, staff do not have adequate guidance on how to provide consistent care to the child in order to meet their needs.

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Overall experiences and progress of children and young people: inadequate

Staff do not consistently talk to the child to help them to understand their risk-taking behaviour and identify ways for them to keep themselves safe. Staff do not ensure that the child is offered the required support. For example, the child has still not received direct work relating to knife crime, following an incident that took place a short time after they moved in. This does not ensure that the child has the opportunity to learn, and it fails to provide assurances that staff understand their role in supporting the child.

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Overall experiences and progress of children and young people: inadequate

The home is not maintained to a suitable standard. Areas of the home require redecoration, and communal areas feel cold and need to be improved. The home does not provide children with a nurturing and homely environment and does not promote a sense of self-worth for the child.

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Overall experiences and progress of children and young people: inadequate

Despite the significant failings, education is promoted in the home. The manager and staff support the child to engage in education, which enhances their educational opportunities.

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Overall experiences and progress of children and young people: inadequate

Staff have a good understanding of the importance of the child spending meaningful time with those who are important to them. They communicate well with social workers to review the arrangements for the child to spend quality time with their families. The child maintains important relationships with family members. As a result, the child benefits from this care and understanding and retains a sense of identity. Inspection report for children’s home: 2662751 4

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

The child is not adequately helped or protected because of the failings in safeguarding arrangements in the home. Safeguarding practice does not promote the safety or welfare of the child. Leaders, managers and staff do not have a clear understanding of their roles or responsibilities in ensuring that the child is safeguarded effectively.

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

There are significant failures in how risk is managed. The child’s risk management plan has not been regularly reviewed or updated, meaning that staff do not have the most up-to-date information to help them to keep the child safe. Furthermore, staff do not follow risk assessments or risk management plans, leaving the child vulnerable to harm. For example, staff did not adhere to procedures when the child went missing, resulting in delays in notifying key professionals.

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

The response from managers and staff when children go missing from home is poor. Staff do not follow the child’s missing-from-care protocol. When the child was on increased supervision levels, they left the home unchallenged by staff. This placed the child at risk of harm as they met with an unknown peer, went missing and was involved in an incident that led to their arrest by the police. Staff did not show any professional curiosity about the identity of the other child.

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

Staff do not always take a strong or proactive approach in managing the child’s behaviour safely. There are occasions when staff do not take swift action to prevent an escalation of incidents. Furthermore, the child is not supported to understand or safely manage their own behaviour.

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

Physical interventions on the child are not always carried out safely or in line with regulation. Furthermore, records lack sufficient detail about the reason for the measure, the holds used and the appropriateness of the actions taken. The child and staff are not spoken to following incidents of physical intervention about the measure used. Therefore, the manager and staff do not have the opportunity to identify learning from incidents to prevent further incidents.

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The effectiveness of leaders and managers: inadequate

Since the last inspection, the previous manager has left, and a new manager has been appointed. There has not been a permanent manager of the home since March 2024.

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The effectiveness of leaders and managers: inadequate

The manager does not have a clear understanding of his role in reviewing, monitoring and evaluating the quality of care. The manager has failed to review records with respect to the child going missing from the home. This has led to the child not always receiving return home interviews to check on their well-being and to explore why they went missing from the home. Behavioural incidents have not been reviewed in a timely manner. On one occasion, this meant that the child did not have the opportunity to talk through an incident that led to an allegation being made. This lack of effective oversight prevents managers from being able to clearly identify and act on shortfalls in staff Inspection report for children’s home: 2662751 5 practice, identify patterns and trends and make improvements to the way in which staff manage the child’s challenging behaviour.

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The effectiveness of leaders and managers: inadequate

The independent person does not provide a thorough or impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the child. This does not support leaders and managers to make improvements and develop the home.

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The effectiveness of leaders and managers: inadequate

Managers and staff do not receive regular supervision. Therefore, they do not receive appropriate levels of guidance and support to develop their practice. In addition, staff do not have their annual appraisals to monitor and support their ongoing professional development.

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The effectiveness of leaders and managers: inadequate

The staff training rota is not up to date. Staff have undertaken sufficient training to ensure that they have the knowledge and skills to meet the needs of the child currently living in the home.

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The effectiveness of leaders and managers: inadequate

The quality of care review is not sufficiently detailed about the quality of care provided to children or the leadership and management of the home. This does not provide Ofsted with assurance that leaders and managers understand the purpose of this key document or maintain effective monitoring and review systems.

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The effectiveness of leaders and managers: inadequate

The staffing levels at the home are inconsistent and managers have covered support worker roles to ensure that there are an adequate number of staff on shift. This has undermined the manager’s ability to complete management tasks. The impact of this is evident in the significant shortfalls identified at this inspection. Inspection report for children’s home: 2662751 6

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Statutory requirements

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

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Requirement Due date

*The 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;

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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

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Requirement Due date

(Regulation 12 (1) (2)(a)(i)(iii)(v)(vi)(b)(d))

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Requirement Due date

In particular, the registered person must ensure that managers and staff understand and act on any risks to children’s welfare and safety promptly and effectively. Staff must understand their roles and responsibilities and follow risk assessments. Risk assessment must be reviewed and updated. 2 November 2025 Inspection report for children’s home: 2662751 7 *The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

In particular, the registered person must use monitoring systems effectively to ensure that they have oversight on all incidents in the home.

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Requirement Due date

The registered person must ensure that staff receive the appropriate training to ensure that they have the knowledge and skills to meet children’s needs. 2 November 2025

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

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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— that staff—

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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. (Regulation 11 (1)(a)(b)(c) (2)(a)(v))

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Requirement Due date

The registered person must ensure that key-work sessions carried out are relevant to the child at that time. 2 November 2025 Inspection report for children’s home: 2662751 8 The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home; and

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Requirement Due date

have a positive experience of arriving at or moving on from the home.

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Requirement Due date

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

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Requirement Due date

that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose.

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Requirement Due date

ensure the effective induction of each child into the home; (Regulation 14 (1)(a)(b) (2)(a)(b)(i))

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Requirement Due date

The registered person must ensure that they undertake a full assessment of children’s needs before they move into the home.

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Requirement Due date

Children must have an induction before moving into the home. 2 November 2025

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Requirement Due date

The registered provider must appoint a person to manage the children’s home if—

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Requirement Due date

there is no registered manager in respect of the home; and

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Requirement Due date

the registered provider— is an organisation or a partnership; (Regulation 27 (1)(a)(b)(i))

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Requirement Due date

The registered person must ensure that the new manager is registered to manage the home. 2 November 2025

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year.

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Requirement Due date

(Regulation 33 (4)(b)(c)) 2 November 2025 Inspection report for children’s home: 2662751 9 In particular, the registered person must ensure that the manager and staff receive regular, effective supervision.

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Requirement Due date

The registered person must prepare and implement a policy (‘the missing child policy’) setting out—

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Requirement Due date

the steps taken, and to be taken, to prevent children from being absent without permission; and

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Requirement Due date

the procedures to be followed, and the roles and responsibilities of persons working at the home, in relation to a child who is, or has been, so absent.

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Requirement Due date

Before implementing, or making an amendment which the registered person considers to be substantive to, the missing child policy, the registered person must—

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Requirement Due date

consult, and take into account the views of, each relevant person;

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Requirement Due date

have regard to any relevant local authority or police protocols on missing children. (Regulation 34 (a)(b) (5)(a)(b))

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Requirement Due date

In particular, the registered person must ensure that children’s missing-from-home protocols are followed, and that children are provided with the opportunity to have an independent return home interview after a missing episode. 2 November 2025

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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; 2 November 2025 Inspection report for children’s home: 2662751 10 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

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Requirement Due date

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))

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Requirement Due date

In particular, the registered person must ensure that children and staff are spoken to following an incident requiring physical intervention.

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Requirement Due date

he registered person must ensure that an independent person visits the children’s home at least once each month.

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person—

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Requirement Due date

if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires; and

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Requirement Due date

to inspect the premises of the home and such of the home’s records (except for a child’s case records, unless the child and the child’s placing authority consent) as the independent person requires.

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Requirement Due date

The independent person must produce a report about a visit ("the independent person’s report") which sets out, in particular, the independent person’s opinion as to whether— 2 November 2025 Inspection report for children’s home: 2662751 11 children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children’s well-being.

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Requirement Due date

The independent person’s report may recommend actions that the registered person may take in relation to the home and timescales within which the registered person must consider whether or not to take those actions. (Regulation 44 (1)(2)(a)(b)(4)(a)(b)(5)

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Requirement Due date

In particular, the registered person must ensure that regulation 44 reports provide a thorough and robust assessment of the homes arrangements for providing care to children.

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Requirement Due date

The registered person must complete a review of the quality of care provided for children ("a quality of care review") at least once every 6 months.

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review ("the quality of care review report").

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Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1)(2)(a)(b)(c)(3)(4)(5))

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Requirement Due date

In particular, the registered person must ensure that the quality of care review includes sufficient detail about the quality of care provided and the way the home is managed. 2 November 2025 Inspection report for children’s home: 2662751 12 * These requirements are subject to a compliance notice.

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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: 2662751 13

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Children’s home details

Registered provider: Holywell Children’s Services Limited

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Children’s home details

Registered provider address: Scott & Wilkinson, Dalton House, 9 Dalton Square, Lancaster LA1 1WD

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Inspectors

Dave Carrigan, Social Care Inspector Paul McKay-Smith, Social Care Inspector Inspection report for children’s home: 2662751 14 regulates and inspects to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for 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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