Midmeadows

Unique reference number SC457025 Inspector Matthew Hedges Type of inspection Full Provision subtype Children's home

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Registered person Cambian Childcare Limited Registered person address Pinnacle House 2 Oakwood Square, Cheadle Royal Business Park CHEADLE Cheshire SK8 3SB Responsible individual Stephen James Nevitt Registered manager Philippa Carla Condliffe Date of last inspection 11/02/2014 2 of 9 Inspection date 29/07/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness adequate

Outcomes for children and young people inadequate Quality of care adequate Keeping children and young people safe adequate Leadership and management adequate

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Overall effectiveness

The home provides personalised care for young people in line with detailed placement plans. Some young people make positive comments about the home, the staff team and improvements they have noticed.

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Overall effectiveness

Outcomes for young people are generally poor in relation to educational attendance and offending behaviour. Staff work hard to engage with young people through positive activities and there are positive relationships within the home. However, children are often missing from the home and this absence hampers the ability of staff to effectively support them. In addition the impact of new young people moving into the home is not always adequately assessed and on several occasions has resulted in an increase in unsafe behaviours. Staff work hard to identify and reduce risk taking behaviours but are not always successful in engaging young people.

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Overall effectiveness

The Registered Manager understands the strengths and weaknesses of the home and puts action plans in place that support improvement. There are shortfalls relating to impact assessments, some aspects of staff training, the homes statement of purpose, maintenance tasks, reporting process and monthly monitoring visits. These impact on the quality of the service and in some areas increase the risk to young people. 3 of 9

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Information about this children’s home

This home is registered to accommodate up to four young people. The service is owned by a private company. The home provides care and accommodation for young people with emotional and behavioural difficulties.

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Inspection date Inspection type Inspection judgement

11/02/2014 Interim good progress 19/04/2013 Full adequate

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

4 (2001) The registered person shall compile in relation to the children’s home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of a statement as to the matters listed in Schedule 1. (Regulation 4 (1)) 15/09/2014

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Reg. Requirement Due date

(2001) The registered person shall ensure that the children’s home is conducted so as to promote and make proper provision for the safeguarding and welfare of children accommodated there, this relates specifically to the assessment of new young people referred to the home. (Regulation 11 (1) (a)) 15/09/2014

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Reg. Requirement Due date

(2001) The registered person shall ensure that all persons employed by him receive appropriate training, 15/09/2014 4 of 9 supervision and appraisal; and are enabled from time to time to obtain further qualifications appropriate to the work they perform, specifically this relates to identity. (Regulation 27 (4) (a) and (b))

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Reg. Requirement Due date

(2001) If, in relation to a children’s home, any of the events listed in column 1 of the table in Schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table. (Regulation 30 (1)) 15/09/2014

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Reg. Requirement Due date

(2001) The registered person shall ensure that all parts of the children’s home used by children are of sound construction and kept in good structural repair externally and internally. Regulation 31 (2) (d)) 15/09/2014

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Reg. Requirement Due date

(2001) Visits by the independent person under paragraph (1) shall take place at least once a month. The independent person, shall interview, such of the children accommodated there and their parents and relatives. (Regulation 33 (7) (8) (a)) 15/09/2014

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 Staff have the skills they need to intervene and reduce bullying behaviours by young people in their care. (Children Act 1989 guidance and regulations - volume 5: children's homes (2.84) 5 of 9

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Outcomes for children and young people inadequate

Outcomes for young people are generally poor. Young people spend a lot of time away from the home missing from care. This affects the amount of influence staff have on their lives. This has been particularly problematic when new young people have moved in. The majority of young people have had a history of going missing. This mix, coupled with a city centre location and good access to transport links has made missing episodes more common and placed young people at greater risk.

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Outcomes for children and young people inadequate

One young person commented positively on their current education and the support they were receiving, however educational attendance is generally low. This hampers young people’s ability to achieve positive outcomes and impacts on their self-esteem and sense of achievement.

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Outcomes for children and young people inadequate

Staff support young people to work through independence workbooks and to practice skills needed for independence like cooking and laundry. Although some young people do engage in this work, this is limited. This means that young people are not as prepared as they should be moving into adulthood.

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Outcomes for children and young people inadequate

Since the last inspection young people’s offending behaviour has not reduced and in some cases has increased. This includes offences committed while missing but also damage and aggression within the home. This has impacted on young people’s feelings of worth and their positivity for the future particularly when looking for employment.

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Outcomes for children and young people inadequate

Young people’s physical health is generally good although drug and alcohol misuse is present, particularly when young people are missing. Young people are well supported to attend health care appointments and are encouraged to take on increasing ownership of this as they get older. This supports their independence.

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Outcomes for children and young people inadequate

Young people are supported to keep in touch with the people important to them. This ensures relationships are maintained and young people are helped to have a better understanding their backgrounds.

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Quality of care adequate

Positive relationships exist between staff and young people. One young person said ‘the staff are particularly good’. Staff work hard to engage young people in meaningful activities, understanding the link between positive relationships and improved outcomes. The home has implemented a weekly activity programme that all young people have access to as well as their individualised programmes. Particular 6 of 9 favourites included trips to various theme parks. One young person was also very excited about a trip that he had planned to go to London. Although these opportunities are available young people do not always wish to use them.

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Quality of care adequate

Staff encourage young people to attend their education placements and offer clear incentives to do this. However young people’s attendance remains generally poor. Similarly the Registered Manager ensures young people have access to specialist supports where required including support for their mental health.

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Quality of care adequate

Residents meetings and keywork sessions are well used to capture young people’s views and these are acted on by the Registered Manager where this is appropriate. One of the outcomes of a residents meeting was that young people were actively encouraged to help with decorating around the home. The results of this are very impressive and have greatly improved the overall appearance of the interior of the home. The Registered Manager has identified that this is a key part of the home’s work to reduce missing episodes. It also encourages a greater sense of pride and ownership by both staff and young people.

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Quality of care adequate

There is an improved system in place to address maintenance issues. One young person said that ‘recently (over the last three months) maintenance work has been quicker’. This has had a positive impact on the overall environment of the home but improvement is still required. An example of this is that a window broken two weeks prior to the inspection was not yet fixed. This hampers the efforts made by the staff and young people in this area.

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Quality of care adequate

Young people know how to complain and complaints are dealt with effectively. One young person said ‘staff listen…and the manager always sorts things out’.

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Quality of care adequate

Young people are cared for in line with their placement plans which are both detailed and individualised. These plans are updated regularly and there are clear attempts to try and involve young people in their plans. Young people’s cultural needs are identified and discussions within residents meetings include different cultures and backgrounds. This is embedded through practical activities such as evenings themed around particular countries. This helps to ensure that young people live in a home that promotes tolerance and respects difference.

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Keeping children and young people safe adequate

Young people regularly go missing from the home, sometimes for extended periods. This impacts on every area of young people’s lives and exposes them to serious risk of harm. Staff understand the impact of this and work hard to reduce these incidents. Staff actively look for young people who are missing and work effectively with other agencies. A professional working in safeguarding said ‘as a service the home wants to ensure young people are safe. They don’t just report young people missing. They are very proactive in continuing to try and contact missing young people, their 7 of 9 families and friends. They go out looking for young people who are missing and keep the placing authority and police informed of any news or new information’.

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Keeping children and young people safe adequate

Restraint is regularly used for a small number of young people. However its use is well monitored by the Registered Manager, is in line with an agreed plan and only used in response to aggressive behaviours. Overall the pattern shows a decrease in frequency and a general improvement in behaviour. Restraints are well recorded and young people are spoken to following any incidents. A young person said that the staff had ‘found ways of helping him stay calm and listen’ the young person felt his behaviour had improved while being at the home.

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Keeping children and young people safe adequate

Young people are adequately protected from bullying at the time of the event and incidents are reduced following some young people moving from the home. A young person said they felt safe with the people they were living with now. Keywork sessions and restorative meetings are well used and help young people to develop a greater understanding of their behaviour and take responsibility for it. Tasks are identified following these sessions although these are not always followed up. This reduces the effectiveness of the work and leaves young people at greater risk.

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Keeping children and young people safe adequate

Young people are protected from unsafe adults working with them by the recruitment processes followed by the home. Staff files evidence that all checks are in place.

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Leadership and management adequate

The Registered Manager has been in post at the home since 29 October 2012. She has previous experience of working with young people in children’s homes. She is qualified to level four and is currently working towards a level five qualification in leadership and management. The Registered Manager understands the strengths and weaknesses of the home and a development plan is in place.

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Leadership and management adequate

Impact assessments are completed prior to young people moving into the home. Although these generally outline key issues, the impact of these behaviours on the existing group is not always clearly assessed. On several occasions young people’s behaviour has significantly deteriorated when new young people have moved in. This has placed young people at risk.

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Leadership and management adequate

Monthly monitoring visits are undertaken; however there are frequent delays in visits and reports are not always produced in a timely way. This does not effectively support the Registered Manager to identify shortfalls and areas for improvement.

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Leadership and management adequate

The Registered Manager reviews the effectiveness of the service and identifies patterns and trends. Young people, parents and social workers are consulted as part of this process and a detailed action plan is produced. This promotes improvements within the home and ensures key areas, such as the use of restraint, are effectively monitored. 8 of 9 Complaints are logged and responded to appropriately. When young people make complaints the Registered Manager's response ensures that they feel their views are taken seriously.

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Leadership and management adequate

Two requirements were made at the last inspection. One relating to staff supervision has been met. Staff generally receive appropriate levels of supervision and comment positively about this. One requirement has not been fully met. There is a new cooker in the home and staff confirm that this meets the needs of the young people. There is a new maintenance system in place which has ensured work is quickly identified and logged. This has had a positive impact on the environment. However some work is still not completed in a timely manner.

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Leadership and management adequate

The home's statement of purpose is incorrect and lacks sufficient detail in some areas. For example, details are not correct for the Registered Manager or the Responsible Individual. In addition the therapeutic support offered to the home is not sufficiently detailed. This results in some confusion and leaves readers unclear as to the support the home provides.

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Leadership and management adequate

The Registered Manager actively requests and follows up outstanding meetings and reviews with the placing authority. This ensures that information is shared, risks are identified and young people are better protected.

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Leadership and management adequate

Notifications to Ofsted are not always sent within appropriate timescales. This impacts on the quality of the service and limits the effective sharing of information. This happens when events occur and the Registered Manager is not at the home.

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Leadership and management adequate

Staff receive appropriate training and any shortfalls are addressed quickly by the Registered Manager. Staff speak positively about the training offered and feel it helps them in their role. Although general training is available in relation to equality and diversity there is no training offered regarding supporting young people with more specific aspects of their identity. Opportunities are therefore missed to help young people come to terms with key issues for them. Website: www.ofsted.gov.uk

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Leadership and management adequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information about this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

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