Children's Home run by Pinnacle Care NW Ltd in Knowsley

Inspection report for children’s home: 2824003 1 Registered provider: Pinnacle Care NW Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home registered with Ofsted in February 2025 and is privately owned. It provides care for one child who may experience social and emotional difficulties and/or have learning disabilities.

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Information about this children’s home

At the time of this inspection, one child was living at the home.

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Information about this children’s home

The manager registered with Ofsted in June 2025.

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

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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: 2824003 2

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Inspection date Inspection type Inspection judgement

09/07/2025 Full Good Inspection report for children’s home: 2824003 3

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Summary of findings

The child’s overall safety has been adversely affected by poor staff practice. A lack of vigilance by staff has led to avoidable incidents where the child has been put at risk of harm.

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Summary of findings

Staff practice is reactive rather than proactive. Staff react appropriately to incidents to ensure that the child receives the care needed. However, some incidents are caused by poor decision-making by staff in the first instance.

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Summary of findings

The registered manager responds to incidents by supporting reflective staff practice and putting additional training in place. However, this is reactive and follow-up activity lacks the essential learning and exploration to ensure that staff become better equipped to manage complex behaviours.

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Overall experiences and progress of children and young people: inadequate

The child’s experience of living in the home is negatively impacted by poor safeguarding practices that have placed them at risk of significant harm. Plans to manage risks associated with the child’s day-to-day activities are inconsistent.

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Overall experiences and progress of children and young people: inadequate

The manager is keen for the child to engage with their peers by attending a youth group. However, the child’s social worker advised that this activity had not been agreed due to concerns about risk. The social worker had not seen a risk assessment and was only informed after the event had taken place. No evidence was available to demonstrate that decisions had been discussed or agreed. Despite this, the child’s social worker was positive about the care provided to the child.

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Overall experiences and progress of children and young people: inadequate

Staff supervise the child’s time with their family to ensure that important relationships are maintained and developed. However, a risk assessment for family time is not in place, despite the child’s family presenting as a potential risk to them.

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Overall experiences and progress of children and young people: inadequate

The child said they are happy living in the home and have positive relationships with staff. They talk to staff about any concerns they have and know that staff will listen and act on their wishes.

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Overall experiences and progress of children and young people: inadequate

The child has not attended education for some time and had spent only 3 months in a school environment before the provision closed unexpectedly. Managers are working with a new education provider to identify and mitigate potential risks for the child. In the meantime, the child continues to engage in independent learning based on their interests, and tests carried out at the last education provision showed limited impact on the child’s level of attainment. Inspection report for children’s home: 2824003 4 The staff team understands the child’s complex health needs. A psychologist spends time with the child each week and recognises the progress they are making in recognising their behaviours. However, this information does not support staff to improve their safeguarding practices. This is specifically in relation to self-injurious behaviour.

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Overall experiences and progress of children and young people: inadequate

The child is encouraged to engage in activities that benefit their wellbeing and emotional regulation, including Reiki and trampolining. Staff also support the child to develop their interests in music and caring for pets.

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

Poor safeguarding practices and a lack of staff vigilance have resulted in several safeguarding incidents. As a result, the child has been able to access items that posed a risk of harm. Incidents have often escalated and, on some occasions, have resulted in the child going missing from home.

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

Staff understand the child’s vulnerabilities; however, they sometimes lack the foresight and curiosity to understand the child’s behaviours. When new risk-taking behaviours have emerged, staff have not always responded in a way that mitigates risk. Risk assessments are not regularly updated following incidents and do not reflect the current circumstances.

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

Some staff members lack the skills and experience to be able to safely manage escalating, complex behaviours. Additional agency staff have been used with the agreement of the local authority. However, this can have a negative impact on the child, as they are not always cared for by staff they are familiar with.

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

On one occasion, staff gave the child incorrect medication. The child told the staff that this had happened. The manager’s response to this concern was appropriate. However, the measures in place to mitigate mistakes were not followed by staff. On another occasion, the child was able to access locked medication, which they consumed above the prescribed limit.

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

On other occasions, staff respond to incidents and support the child. Debriefs are consistently carried out with staff and, at times, are detailed and reflective. Staff work with family members and professionals to help ensure that, when the child goes missing from the home, they are returned safely. However, there are gaps in the recording of incidents, and the quality of records is inconsistent.

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

There are safer recruitment practices in place. This helps to ensure that only suitable staff care for children.

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The effectiveness of leaders and managers: inadequate

Management oversight is not effective in preventing avoidable risks to the child. Leaders and managers do not sufficiently challenge staff about practice issues to ensure that Inspection report for children’s home: 2824003 5 learning is embedded quickly enough to reduce the likelihood of similar incidents recurring.

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The effectiveness of leaders and managers: inadequate

The manager does not notify Ofsted of all serious incidents. When incidents are notified, they are not submitted in accordance with regulatory requirements.

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The effectiveness of leaders and managers: inadequate

The manager has a positive relationship with the child and advocates on their behalf in relation to education. She also advocates for the child regarding restrictions on their time in the community. However, a decision about the child spending time in the community was made without the agreement of the child’s social worker. This does not demonstrate that the manager works with the local authority to manage the child’s care.

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The effectiveness of leaders and managers: inadequate

The manager uses team meetings to speak to staff about any incidents that have occurred. This supports staff to reflect on what they could have done differently. The manager is clear on their expectations of staff, and actions agreed are monitored.

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The effectiveness of leaders and managers: inadequate

While staff receive training that is relevant to the child’s needs, this has not prevented incidents from occurring. Resources relating to aerosol misuse were only introduced for staff during the inspection. Managers have systems in place to monitor staff training and follow up on training courses that are due.

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The effectiveness of leaders and managers: inadequate

Staff receive regular supervision, as well as subject-specific discussions when required. These are effective in reviewing staff wellbeing and encouraging reflective practice. However, they lack appropriate levels of challenge in relation to practice issues. Inspection report for children’s home: 2824003 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 registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

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Requirement Due date

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

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Requirement Due date

This specifically relates to ensuring that the child is witnessed taking their prescribed medicine and that clear records are maintained of who administered the medication.

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Requirement Due date

This requirement is restated. 25 October 2025

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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; 25 October 2025 Inspection report for children’s home: 2824003 7 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

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(b))

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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

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

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Requirement Due date

ensure that staff work as a team where appropriate;

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Requirement Due date

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

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Requirement Due date

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)(a)(b) (2)(a)(b)(c)(f)(h)) 25 October 2025

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— 25 October 2025 Inspection report for children’s home: 2824003 8 a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation;

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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 an allegation of abuse against the home or a person working there;

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Requirement Due date

a child protection enquiry involving a child—

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Requirement Due date

concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious.

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Requirement Due date

A notification made under this regulation—

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Requirement Due date

the other persons, bodies or organisations (if any) who or which have been notified; and

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Requirement Due date

any actions taken by the registered person as a result of the matter;

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Requirement Due date

must be made or confirmed in writing. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii)(e) (5)(a)(i)(i)(iii)(b))

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendation

 The registered person should ensure that staff understand the importance of careful, objective and clear recording. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 62, paragraph 14.4) Inspection report for children’s home: 2824003 9

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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: 2824003 10

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Children’s home details

Registered provider: Pinnacle Care NW Ltd

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Children’s home details

Registered provider address: Sinclair Accounting Co Ltd, 300 St Marys Road, Garston, Liverpool L19 0NQ

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Inspector

Andrea Foreman, Social Care Inspector Inspection report for children’s home: 2824003 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 looked-after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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