Children's Home run by Meadows Care Limited in Oldham

Unique reference number SC066072 Inspector Stella Lovie Type of inspection Full Provision subtype Children's home

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Registered person Meadows Care Limited Registered person address Egerton House Wardle Road ROCHDALE Lancashire OL12 9EN Responsible individual Niel David Shelmerdine Registered manager Catherine Veronica Donnelly Date of last inspection 10/09/2014 2 of 11 Inspection date 07/11/2014

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Previous inspection inadequate Enforcement action since last inspection Four compliance notices have been issued:

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Regulation 11 (1) (a) 03/11/2014; Regulation 11 (1) (b) 03/11/2014; Regulation 25 (1) 03/11/2014; Regulation 34 (1) (a) (b) (3) 12/12/2014.

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Overall effectiveness adequate

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

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Overall effectiveness

The home was last inspected on 10 September 2014. It was found to be inadequate in all areas. Four compliance notices were issued along with five additional requirements to improve. There were a further four recommendations made to improve practice. This follow-up inspection eight weeks later confirms that significant progress has been made. Compliance notices have been met within timescale, and all the requirements addressed. Two out of the four recommendations are implemented. This demonstrates that the leadership team is committed to ensuring that quality of care is of a significantly improved standard.

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Overall effectiveness

Young people make some measurable progress during their time at the home. Care planning effectively addresses young people's basic needs. Young people are safe within the environs of the home. They have generally cordial relations with each other and staff, though meaningful engagement with staff is still to be achieved. 3 of 11 Young people say they feel safe here. However, they continue to place themselves at risk in the community despite recent strenuous efforts by the home, the placing authority and relevant local agencies.

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Overall effectiveness

Management arrangements are suitably robust and have been strengthened since the last inspection. This has contributed to the evidenced improvements in the home. However, there is still some way to go to embed the changes in practice and show improvement in young people’s outcomes. Consequently, an improvement plan is identified with two further requirements and seven recommendations. One compliance notice remains in force as it is not due to be completed until 12 December 2014. There are no breaches of regulations or failures to meet national minimum standards that place young people at risk of harm. 4 of 11

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Information about this children’s home

This privately owned home provides care for three young people with emotional and behavioural difficulties. This home is also registered as a school.

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Inspection date Inspection type Inspection judgement

10/09/2014 Full inadequate 20/03/2014 Interim good progress 17/12/2013 Full adequate 07/02/2013 Interim good progress

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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

12B (2001) ensure that the registered person notifies, in writing, the local authority for the area in which the children's home is located without delay of the admission of a child into, and the discharge of a child from, the children's home (Regulation 12B (1) (a) (b)) 09/01/2015

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Reg. Requirement Due date

(2001) ensure that the employment of any persons on a temporary basis at the children's home will not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 25 (2)) 09/01/2015 5 of 11

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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

 promote children's physical health, with specific regard to smoking cessation (NMS 6.1)  ensure risk reduction does not lead to an institutional feel, with specific regard to use of bedroom door alarms (NMS 10.3)  ensure that the Statement of Purpose shows how the service will meet outco9mes for children, with specific regard to not accepting emergency placements (NMS 13.2)  ensure that staff appraisals take into account any views of children the service is providing for (NMS 19.6)  take action to address any issues of concern that the Regulation 33 visitor identifies or which is raised with the registered person (NMS 21.9)  work with the responsible authority to ensure effective sharing of information about the child, with specific regard to up-to-date local authority care plans (NMS 22.7  ensure that each child's placement plan is monitored by a key worker, with specific regard to up-dating it in relation to outcomes from statutory

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Outcomes for children and young people adequate

Some young people are now in structured education for the first time in many months. So far there is overall satisfactory attendance and engagement but it is too early to demonstrate significant achievement in these areas. It is therefore premature to predict what the eventual educational outcomes will be. Progress can be limited when young people choose to disengage from their education sessions. However these small steps clearly give young people a sense of achievement and boost to their self-esteem.

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Outcomes for children and young people adequate

Young people are at different stages of individual growth and development, with some young people still relatively newly placed in the home. Securing positive outcomes in terms of building their personal resilience and understanding of their situation is therefore at an early stage for those young people. There are sound plans in place to support their individual growth and development. However, young people sometimes show intermittent cooperation with those plans and this can restrict progress. Young people benefit from appropriate contact with family so that important relationships are maintained. This promotes their sense of well-being.

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Outcomes for children and young people adequate

Young people are encouraged to take responsibility for their behaviour but not all provide their fullest cooperation. Despite this, the service is responding to individual changing needs and has had some success with some of the strategies it adopts to support behaviour changes. However, young people’s challenging behaviour can mean that their progress in developing social skills is slow. This impacts adversely on future economic life chances.

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Outcomes for children and young people adequate

Young people are regularly consulted about their care and how it is delivered. There is frequent dialogue and discussion about both future and day-to-day plans. The independent visitor consults young people for their views, and young people have additional regular contact with children’s rights officers. This means that young people feel listened to and valued, even though on occasions they are advised that it is not possible to act upon their wishes in all cases.

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Outcomes for children and young people adequate

Young people’s physical health is promoted through routine and specialist health appointments in accordance with need. Direct work with staff and external agencies helps young people to know their rights and responsibilities in areas such as sexual health and respectful relationships. However, some young people are still at an early stage of using that information to change their risk taking behaviours, particularly in relation to sexual exploitation. That said, interventions by the home and specialist services are persistent in raising young people’s awareness of the risks around sexual exploitation. This work is underpinned by close liaison with specialist professionals so that key messages are reinforced in the context of daily life in the home. 7 of 11

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Quality of care adequate

The home supports young people’s education through appropriately registered in- house arrangements. Staff help young people to see that engagement with education is integral to emotional stability and development of self-esteem. As a result, there is evidence of some initial good participation and attainment by young people at the beginning of their placements. However, despite staff encouragement, recently young people have shown limited commitment to their personal education plans. This means learning and attendance have not been as good as they could be.

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Quality of care adequate

Young people have a lot to say for themselves. They say they are confident about discussing concerns with the manager, staff, and external professionals and know how to make a formal complaint. They are active in their care planning processes and ensure that their opinions and wishes are heard, if not always conceded to. Young people now have access to a landline in the home without needing to ask staff. This promotes their ability to contact the outside world if they are worried about anything. Staff maintain sound links with parents to ensure they are kept informed of young people’s well-being and progress.

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Quality of care adequate

Young people now enjoy a well decorated and maintained home. The feel of the home is very comfortable and welcoming, and young people exercise choice in the personalisation of their bedrooms and communal areas. This promotes their sense of self-worth.

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Quality of care adequate

Care planning is adequate. This ensures that young people's basic needs, including those in relation to culture and personal identity, are identified and met. Staff implement all elements of the care planning process, such as providing reports for statutory reviews and ensuring that young people have access to the resources, services and interventions that they require. However, placement plans are not always up-dated in relation to key statutory meetings. This creates inconsistency in the daily management of young people, particularly where health, education and leisure needs are concerned. Furthermore, despite efforts, the home still does not have all young people’s up-to-date care plans from their placing authorities. This inhibits staff having a clear understanding of the direction of travel for some young people.

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Quality of care adequate

Generally, staff work hard to build positive relationships with young people and understand their unique characters and personality. They show insight and understanding of young people’s needs and family histories and, as a result, young people learn to appreciate and value the efforts staff make. That said, despite clearly established boundaries for young people, staff are sometimes inconsistent in their implementation of agreed behaviour management strategies. This is compounded by insufficient shift planning so that young people experience a number of different reserve workers coming into the home. This undermines core staff’s attempts to 8 of 11 develop meaningful relationships with young people, and can leave young people unclear about boundaries. It puts staff in a vulnerable position and impacts on the quality of care of everyone at the home.

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Keeping children and young people safe adequate

Young people say they feel safe at the home. They identify individuals who they would speak to if they were unhappy or felt unsafe, including Ofsted. They are confident that they will be supported and listened to, and that their concerns will be addressed. Good behaviour is promoted through support, praise and a token economy. There is no use of physical restraint, and sanctions are used sparingly and appropriately. The home has a strong culture that bullying and discriminatory behaviour is not tolerated. This is supported by rigorous policies and procedures that counter bullying and discriminatory attitudes.

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Keeping children and young people safe adequate

Young people come to the home with high levels of risk-taking behaviours. Some continue to put themselves at risk by going missing from the home. These incidents are responded to promptly, and are reported by external professionals to be less frequent than in previous placements. There is evidence of good working together with relevant agencies within clear protocols. This helps with trying to understand why young people choose to go missing, and thereby reduce the frequency of further incidents .

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Keeping children and young people safe adequate

Records of direct work sessions following an episode of being missing from home are maintained. Feedback to the young person highlights the dangers and the risks to which they expose themselves, and reinforces the importance of keeping themselves safe at all times. Return interviews are undertaken by an independent person. These interviews represent the beginning of follow-up work with young people to resolve the situation, help them build resilience and disrupt exploitation. That said, young people continue to place themselves at risk in the community, particularly in relation to sexual exploitation, anti-social behaviour and offending. Efforts by staff to protect young people from damaging experiences in the community have not been effective. This means that young people have been exposed to additional trauma during their time in the home. Managers are very aware of this. They have robust planning

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Keeping children and young people safe adequate

strategies agreed with placing authorities to review young people’s placements if levels of risk become untenable.

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Keeping children and young people safe adequate

Risk assessments identify the impact of any abuse or neglect and the actions required to protect and support the young people concerned. These assessments are carefully monitored and reviewed in light of any new information. This means that young people are suitably supported and protected. The security of the building, care by the staff, staff training and policies and procedures all work to keep young people safe from danger and abuse in the home itself. Fire safety measures have been improved in line with external specialist risk assessment. One shortfall is noted in 9 of 11 relation to excessive use of bedroom door alarms which tends to create an overly institutional impression.

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Keeping children and young people safe adequate

As much as possible is done to assure the suitability of people working in the children’s home. Vetting and safer recruitment practice is thorough and robust so that unsuitable people are deterred from applying to work in the home. Investigations into allegations or concerns about staff practice are handled fairly, quickly and consistently, and in consultation with appropriate external agencies. This provides effective protection for young people, and at the same time supports the person who is subject of the allegation.

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Leadership and management adequate

There is an experienced Registered Manager in the home. She has nearly completed her higher level management qualification. She is now supported by a newly deployed deputy manager who is also very experienced. Together they complement each other well and provide effective leadership. They both have a sound grasp of the strengths and weaknesses of the home, and have development plans in place accordingly. They are further supported in this by the recent creation of an area manager role. This person has an oversight and quality assurance function to improve the quality of care in the home.

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Leadership and management adequate

A lot of intense work has gone on since the last inspection. All the compliance notices have been suitably addressed within timescale. All the requirements have been met. This indicates that managers take appropriate action to resolve concerns. There remains one compliance notice still in force until 12 December 2014 in relation to required managerial monitoring and oversight of the home. Evidence seen in this inspection confirms that the home is on track in complying with this order when it is due.

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Leadership and management adequate

The service now has an established core staff team which is suitably diverse and experienced. Most of the staff are qualified to an appropriate level. However, there are some known systemic problems with the makeup of the team in relation to the needs of young people currently in the home. This has led to excessive use of reserve staff from other homes, with consequent impact on consistency of practice, and on core staff’s ability to build effective relationships with the young people. The provider acknowledges that this is a significant shortfall and has identified strategies to address this.

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Leadership and management adequate

Staff appreciate the approachability and support of managers. Staff training needs are identified and met. For example, all staff have recently had training in the management of substance mis-use. Formal supervision is systematic, robust and challenging. All staff have either had their appraisals or have them booked in the near future. The appraisals completed though have not taken into account young people’s views. This means the manager is missing an important source of 10 of 11 information to improve staff practice.

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Leadership and management adequate

Monitoring of the home has been strengthened with the recruitment of new independent visitors. The reports of their regular visits are appropriately challenging and constructive with a view to improving practice in the home. That said, the manager has not responded promptly to all the recommendations from this external oversight.

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Leadership and management adequate

The home works to the objectives outlined in the Statement of Purpose. However a recent senior manager decision has been made for the home to only accept pre- planned new admissions of young people. The intention is to improve decision- making at point of referral, and ensure good matches with young people already living in the home. This decision needs to be reflected in an amended Statement of Purpose so that placing authorities are clear that the home no longer accepts emergency admissions. In addition, the manager has yet to establish an agreed written system with the local authority where the home is located to inform them of all new admissions and discharges of young people from out of area. This matter is under current discussion with the relevant local authority. 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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