SC386651 Registered provider: Broadwood Education Services Full inspection Inspected under the social care common inspection framework Information about this children’s home The home is operated by a private national provider of education and social care for children and young people. It provides care and accommodation for up to three young people with emotional and/or behavioural difficulties. The home is situated in a very rural location. Young people can attend education within the company school or via external provision. Inspection dates: 18 to 19 July 2017 Overall experiences and progress of children and young people, taking into account inadequate How well children and young people are helped and protected inadequate The effectiveness of leaders and managers 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. Date of last inspection: 4 November 2016 Overall judgement at last inspection: sustained effectiveness Enforcement action since last inspection Two requirements were made at the last full inspection; following this inspection, both requirements remain unmet. Inspection report children's home: SC386651 1 Key findings from this inspection This children’s home is inadequate because:  There are serious and significant shortfalls in the day-to-day practice carried out in the home. Young people are not safeguarded.  There are ongoing issues in respect of staff employment and retention. This was a feature at the previous two inspections. There are staff shortages; agency staff are being used on a regular basis, which impacts negatively on the care young people receive.  The registered manager and staff who work at this home do not demonstrate that they have the skills and knowledge required to ensure that care can be delivered effectively and safely.  While independent visitor reports are regular, the independent visitor’s reports have not identified any of the shortfalls in safeguarding practice seen in this inspection. The children’s home’s strengths:  Young people are supported to have regular and meaningful contact with their families. The home is set in a peaceful and rural location. Recent inspection history Inspection date Inspection type Inspection judgement 04/11/2016 Interim Sustained effectiveness 08/06/2016 Full Good 08/03/2016 Interim Sustained effectiveness 07/10/2015 Full Good Inspection report children's home: SC386651 2 What does the children’s home need to do to improve? Statutory requirements This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, 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. Requirement 6. The quality and purpose of care standard Due date 30/09/2017 (1) The quality and purpose of care standard is that children receive care from staff who— (a) understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; (b) use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) understand and apply the home’s statement of purpose; (b) ensure that staff— (i) understand and apply the home’s statement of purpose; (ii) protect and promote each child’s welfare; (iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; (v) help each child to understand and manage the impact of any experience of abuse or neglect; (vi) help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult; (vii) provide to children living in the home the physical necessities they need in order to live there comfortably; (viii) provide to children personal items that are appropriate for their age and understanding; and (ix) make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice; (c) ensure that the premises used for the purposes of the home are designed and furnished so as to— (d) ensure that any care that is arranged or provided for a child that— (i) relates to the child’s development (within the meaning Inspection report children's home: SC386651 3 of section 17(11) of the Children Act 1989) or health; and satisfies the conditions in paragraph (3). (3) The conditions are— (a) that the care is approved, and kept under review throughout its duration, by the placing authority; (b) that the care meets the child’s needs; (c) that the care is delivered by a person who— (i) has the experience, knowledge and skills to deliver that care; and (ii) is under the supervision of a person who is appropriately skilled and qualified to supervise that care. 7. The children’s views, wishes and feelings standard 30/09/2017 (1) The children’s views, wishes and feelings standard is that children receive care from staff who— (a) develop positive relationships with them; (b) engage with them; and (c) take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) ensure that staff— (i) ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare; (ii) help each child to express views, wishes and feelings; (iii) help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child; (iv) regularly consult children, and seek their feedback, about the quality of the home’s care; (v) help each child to understand how the child’s privacy will be respected and the circumstances when it may have to be limited; (vi) help each child to prepare for any review of the child’s relevant plans and to make the child’s views, wishes and feelings known for the purposes of that review; and (vii) make each child aware of and, if necessary, remind them of each of the matters in sub-paragraph (d)(i) to (iii); (b) ensure that each child— (i) is enabled to provide feedback to, and raise issues with, a relevant person about the support and services that the child receives; (ii) has access to the home’s children’s guide, and the home’s complaints procedure, when the child’s placement Inspection report children's home: SC386651 4 in the home is agreed and throughout the child’s stay in the home; and (iii) is given appropriate advocacy support. 11. The positive relationships standard 30/09/2017 (1) The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— (a) mutual respect and trust; (b) an understanding about acceptable behaviour; and (c) positive responses to other children and adults. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans; (ii) help each child to develop socially aware behaviour; (iii) encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding; (iv) help each child to develop and practise skills to resolve conflicts positively and without harm to anyone; (v) 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; (vi) help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful; (vii) help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship; (viii) strive to gain each child’s respect and trust; (ix) understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children; (x) are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same; (xi) de-escalate confrontations with or between children, or potentially violent behaviour by children; (xii) understand and communicate to children that bullying is unacceptable; and (xiii) have the skills to recognise incidents or indications of Inspection report children's home: SC386651 5 bullying and how to deal with them; and (b) that each child is encouraged to build and maintain positive relationships with others. 12. The protection of children standard * 30/08/2017 (1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) 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; (ii) help each child to understand how to keep safe; (iii) have the skills to identify and act upon signs that a child is at risk of harm; (iv) manage relationships between children to prevent them from harming each other; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is a serious concern about a child’s welfare; and (vii) are familiar with, and act in accordance with, the home’s child protection policies; (b) 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; (e) that the effectiveness of the home’s child protection policies is monitored regularly. 13. The leadership and management standard * 30/08/2017 (1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) 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; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (d) ensure that the home has sufficient staff to provide Inspection report children's home: SC386651 6 care for each child; (e) ensure that the home’s workforce provides continuity of care to each child; (f) 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; (g) demonstrate that practice in the home is informed and improved by taking into account and acting on— (i) research and developments in relation to the ways in which the needs of children are best met; and (ii) feedback on the experiences of children, including complaints received; and (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 14. The care planning standard 30/09/2017 (1) The care planning standard is that children— (a) receive effectively planned care in or through the children’s home; and (b) have a positive experience of arriving at or moving on from the home. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) 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; (b) that arrangements are in place to— (i) ensure the effective induction of each child into the home; (ii) manage and review the placement of each child in the home; and (iii) plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority; (c) that each child’s relevant plans are followed; (d) that, subject to regulation 22 (contact and access to communications), contact between each child and the child’s parents, relatives and friends, is promoted in accordance with the child’s relevant plans; (e) that the child’s placing authority is contacted, and a review of that child’s relevant plans is requested, if— (i) the registered person considers that the child is at risk of harm or has concerns that the care provided for the Inspection report children's home: SC386651 7 child is inadequate to meet the child’s needs; (ii) the child is, or has been, persistently absent from the home without permission; or (iii) the child requests a review of the child’s relevant plans; and (f) that staff help each child to access and contribute to the records kept by the registered person in relation to the child. 23. Medicines 30/09/2017 (1) The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. 31. Staffing of children’s homes 30/09/2017 The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. 44. Independent person: visits and reports 30/09/2017 (1) The registered person must ensure that an independent person visits the children’s home at least once each month. (2) When the independent person is carrying out a visit, the registered person must help the independent person— (b) 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. (3) A visit by the independent person to the home may be unannounced. (4) 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— (a) children are effectively safeguarded; and (b) the conduct of the home promotes children’s wellbeing. * These requirements are subject of a compliance notice. Inspection judgements Inspection report children's home: SC386651 8 Overall experiences and progress of children and young people: inadequate The arrangements for staffing the home are poor. These arrangements do not create the circumstances that enable staff to develop positive, trusting relationships with young people. Young people report that they are unhappy with the number of different staff who come into their home to cover shifts. Young people and staff report that, at times, there are communication difficulties with some staff who do not speak English fluently. Care planning documents fail to provide clear guidance to staff about how to manage and respond to young people’s behaviour. Staff on duty have called the police on two occasions to report young people for assault. Young people have been criminalised due to this approach to their care. A system of consequences used to manage young people’s behaviour is often ineffective. The registered manager fails to consider the effectiveness of the consequences used, and the system is reactive rather than well thought out and predefined. Records of incidents of young people’s behaviour are poor, and the consequences put in place are not always clear. Consequences are not always appropriate. Young people are not spoken to about these consequences, and their views are not considered. Sometimes, young people have been refused permission to see significant people in their lives as a sanction for poor behaviour. In addition, consequences are used inappropriately in respect of children going missing from home. The home does not manage complaints and allegations made by young people well. When young people make complaints or allegations, the current organisational policy is to send the young person a holding letter; this letter is not child-focused. Two young people received these letters recently. This approach to young people’s concerns compounds their feeling of not being listened to or believed. Young people are well supported to have regular and meaningful contact with their families. One young person who has lived at this home for some time is making positive progress towards moving home. Others are being supported to have increased contact with their families. How well children and young people are helped and protected: inadequate Leaders and managers fail to respond effectively to allegations made by children about the staff who care for them. Two children have made allegations. The registered manager fails to give sufficient attention or take sufficient action in response to the children’s allegations. The registered manager made a decision Inspection report children's home: SC386651 9 that the staff involved should be redeployed to work in other children’s homes within the organisation. This decision has resulted in the safety of children being potentially compromised. The manager is insufficiently aware of potential indicators that young people are being exploited, such as returning to the home with new possessions. Therefore, he has not always taken action to ensure young people’s safety. The registered manager fails to ensure that appropriate steps are taken to reduce the risk of online abuse and harm. Young people’s internet access is not restricted or monitored, and they have access to the internet overnight. Staff report that late night use of the internet prevents young people from having sufficient sleep, so they are reluctant to get up in the morning to attend school. Incidents of young people going missing from home have increased. One young person told inspectors that they have arranged for adults to come, collect them in vehicles from the country lanes near their home, and take them into the local large towns. One young person went missing from home overnight without staff noticing until the following morning. The lack of monitoring systems obstructs the manager in understanding the triggers and themes that emerge from these incidents in order for them to be well managed and reduced. Systems to ensure that young people receive a return-from-missing interview from an independent person following their return home are poor. The documentation does not reflect current guidance and expectations. The registered manager did not demonstrate appropriate knowledge of the importance of these interviews taking place. As a result, young people are not always afforded an independent person to talk to, should they have any worries or concerns about their home. The registered manager fails to ensure that the friendships young people form are safe, and that the level of contact that they have with other young people is appropriate and fully informed by an assessment of risk. The registered manager has failed to identify incidents of bullying and act on them. One missing-from-home record states that one reason the young person does not want to return to this home is due to bullying. This statement was reinforced during the inspection when inspectors noted offensive and inappropriate graffiti that had been written on the young person’s door by other residents. This had not been immediately removed by staff. The arrangements for the storage and effective administration of medication are not always safe. While there is managerial oversight, the sample reviewed by inspectors identified both recording errors and an error in the administration of medication, none of which had been identified. Care planning records are not kept up to date to include all current, relevant information. This weakness reduces staff’s ability to manage and intervene Inspection report children's home: SC386651 10 effectively in young people’s worrying behaviour. The effectiveness of leaders and managers: inadequate Leaders and managers have failed to ensure that requirements made at the previous two inspections were met and sustained. The first requirement is in respect of staffing. The organisation has failed to ensure that there is appropriately skilled staffing in this home. During this inspection, phone calls were being made to try to arrange staffing for the following day. A lack of permanent, experienced and skilled staff is reducing the quality of care children receive. This has been a feature at the previous two inspections. In addition, the organisation employs some staff who do not speak English fluently and are unable to communicate effectively with the young people. The second requirement is in respect of the independent visitor’s reporting. During this inspection, further concerns in this area were highlighted. Not all reporting makes clear statements about the safety of young people. The independent visitor has also failed to identify and act on the significant and widespread poor practice in respect of safeguarding children. Despite increased numbers of staff coming in and out of the home to undertake shifts, care planning records are not kept up to date. They do not include all current, relevant information. Not all staff working in the home receive regular and meaningful supervision and some are unclear what is expected of them, reducing their ability to manage and intervene effectively in young people’s worrying behaviour. The registered manager recognises that the staffing issues in the home mean that it is inappropriate to introduce new young people in the home. However, he reports that he felt under pressure from the organisation to take an additional young person and his objections were overruled. Leaders and managers were unable to provide acceptable evidence about why the young people have been allowed to have unrestricted access to the internet when this is not agreed in young people’s care plans. Young people are reported to be on ‘Facetime’ and talking to others into the night. This approach to care is preventing young people engaging effectively the following morning, and compromises their safety. Information about this inspection Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the Inspection report children's home: SC386651 11 effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people whom it is trying to help, protect and look after. 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: SC386651 12 Children’s home details Unique reference number: SC386651 Provision sub-type: Children’s home Registered provider: Broadwood Education Services Registered provider address: New Hall Hey Road, Rossendale BB4 6HR Responsible individual: Janet Porter Registered manager: Michael Ratcliff Inspector(s) Tracey Ledder, social care inspector Guy Mammatt, social care inspector Inspection report children's home: SC386651 13 The Office for Standards in Education, Children’s Services and Skills (Ofsted) 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. 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 http://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. 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