Children's Home run by Meadows Care Limited in Rochdale

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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The children's home provision requires improvement because:

 Staff have not been able to prevent older young people from placing younger children at risk of harm. Fortunately, those children do not appear to have come to actual harm.  Since the last inspection in February 2015, two young people’s placements have needed to be terminated abruptly because of safeguarding concerns. This has not promoted good outcomes for those young people.  Children and young people have experienced very high levels of restraint. This is in part due to inconsistent staff practice; use of reserve staff who did not know the children well and were not familiar with their risk management plans; and a period of time when there was insufficient managerial oversight of the home. This situation has very recently improved.  Records of restraints do not always comply with regulation. Specifically, it is not clear in some cases what de-escalation techniques were used. This inhibits learning from those situations.

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The children's home provision requires improvement because:

 Staff in the core team are not all fully trained in the provider’s positive behaviour management model. This compromises those staff in acting in a confident and skilled way to manage children and young people’s complex needs.  Allegations against staff have not always been investigated promptly in appropriate consultation with relevant agencies. They have also not been notified to Ofsted in line with regulation. This compromises external scrutiny of practice.  The physical environment of the home needs attention to bring all areas up to a good standard and to ensure that external fire safety advice is followed.

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The children's home strengths

 The manager has worked effectively to pull the home out of a period of crisis. He has achieved this by stabilising the staff team and establishing much clearer risk management strategies in relation to the current child in placement.  With the implementation of revised risk management strategies, there has been a significant reduction in the use of restraints. This has enabled staff to start to develop relationships of trust with the child.  Children and young people benefit from good support to engage with their education. The provider is appropriately assertive with education professionals and placing authorities to ensure that suitable education provision is found within reasonable timescales.  Children and young people are supported to address their health needs in consultation with specialist health professionals.  Children and young people enjoy fun activities within the community so that they interact with peers and learn new skills.

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The children's home strengths

 The manager ensures consistently positive working together with partner agencies in the wider system.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

12: The protection of children standard: 12.—(1) 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

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

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Requirement Due date

d) 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; with specific reference to installation of a recommended smoke detector and attention to various minor maintenance shortfalls. 14/12/2015

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Requirement Due date

12: The protection of children standard: 12.—(1) 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

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

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Requirement Due date

(vii) are familiar with, and act in accordance with, the home's child protection policies; with specific reference to the prompt management of allegations. 12/01/2016

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Requirement Due date

13: The leadership and management standard: 13.—(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—

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Requirement Due date

(a) helps children aspire to fulfil their potential; and (b) promotes their welfare.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the 12/01/2016 registered person to—

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Requirement Due date

c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; with specific reference to restraint and safeguarding training.

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Requirement Due date

13: The leadership and management standard: 13.—(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—

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Requirement Due date

(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—

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Requirement Due date

(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; with specific reference to ensuring adequate managerial cover at all times. 14/12/2015

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Requirement Due date

13: The leadership and management standard: 13.—(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—

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Requirement Due date

(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—

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Requirement Due date

(e) ensure that the home's workforce provides continuity of care to each child; with specific reference to use of reserve staff. 12/01/2016

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Requirement Due date

35: Behaviour management policies and records: The registered person must ensure that 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 details of any methods used or steps taken to avoid the need to use the measure. (Regulation 35 (3) (v)) 12/01/2016

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Requirement Due date

40: Notification of a serious event: The registered person must notify HMCI and each other relevant person without delay if there is an allegation of abuse against the home or a person working there. (Regulation 40 (4) (c)) 12/01/2016 12: The protection of children standard: 12.—(1) 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

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

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Requirement Due date

(iv) manage relationships between children to prevent them from harming each other. 14/12/2015

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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

  The registered person must have systems in place so that all staff receive supervision of their practice; with specific reference to new staff receiving supervision twice monthly in line with the home’s statement of purpose (Guide, page 61, paragraph 13.2)

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Recommendations

 Staff appraisals should take into account, where reasonable and practical, the views of children in the home's care (Guide, page 61, paragraph 13.5)

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Recommendations

 For children's homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments that seek as far as possible to maintain a domestic rather than 'institutional' feel; with specific reference to display of photographs and pictures. (Guide, page 15, paragraph 3.9) 

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Information about this children's home

This is one of a number of children’s homes operated by a private company. The home is registered to provide care and accommodation for up to two children and young people with emotional and behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

10/02/2015 CH - Interim improved effectiveness

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requires improvement

Staff strive to establish and maintain positive, nurturing relationships with children and young people based on the values of good parenting and trust. For example, with the current child they play Lego, play board games, offer to read him stories, run him a bath, and get his pyjamas ready at bedtime. It is still early days though in helping him to trust staff and feel relaxed in the home. Staff recognise that establishing good relationships with him will take time. As the child’s social worker commented: ‘I think that staff are managing a very difficult situation well. They are meeting all his needs as best they can. It will take a considerable amount of time for his behaviour to settle down. I’ve no current concerns. I did have some initially when the older young person was in the home and her behaviour towards him was so aggressive. There has been a lot of restraint used but I feel staff have to do

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requires improvement

what they can to safeguard him.’ Specialist advice and clearer boundaries now help staff to make better decisions. They challenge the child appropriately and help him to understand that he is safe and is worth keeping safe. Staff are clearly aware of the key focuses for the child and what goals he is working towards. Throughout, he is encouraged to make choices and see the consequences of his actions, both good and bad. Children and young people have the opportunity to express their wishes, feelings and views. They influence their day to day care. They understand how to complain and feel able to do so. Records demonstrate that the current child has opportunities to choose activities, meals and the decoration of his room. He has voiced his wishes and feelings in the young people’s meetings. For example, he commented that he no longer wants reserve staff to be used in the home. There is evidence that the manager listens to his views and helps him to understand when

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requires improvement

they cannot always be acted upon. The child came to the home with a background of very limited prior education. The manager has ensured that he is in the process of being assessed to establish his baseline needs. He is attending a non-registered education provision on a farm where he does some formal academic work interspersed with practical tasks. These help his learning through practice of cooperation, taking instructions and team work. Staff attend with the child to promote consistency of care and his sense of safety. The manager has agreed a traffic light system in relation to the child’s behaviour in the education provision to avoid the need to send him home when there are behaviour issues. For example, he had been sent home for just not engaging but now has three levels of warning before that sanction is applied. He attends well and enjoys going. This represents considerable progress from his

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requires improvement

starting point. Staff recognise his achievements both in the education setting and in the home and celebrate these. This helps him to experience success and develop his confidence. The provider is proactive in working with relevant education professionals and the placing authority to try to identify a suitable school for him, with a view to an introduction in the winter term. While he is waiting for this education placement to be identified, the home provides the child with structured programmes of timetabled activities geared towards maintaining his motivation and enthusiasm for learning. There are good collaborative links with health professionals and other agencies. This allows helpful guidance and support to be provided when children and young people are most in need. Physical exercise is encouraged and smoking discouraged. Staff work hard to redress past health neglect, manage current health difficulties and promote a healthy lifestyle for the present and future. Health plans

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requires improvement

show clear and measurable actions and targets. This means that children and young people’s progress can be monitored. The home has access to in-house therapeutic services from qualified and registered therapists. Therapeutic support is being gradually introduced to the current child in placement with a view to understanding the right type of support for his emotional and psychological needs. Future work is planned in respect of project work in a child-friendly way about gangs, criminality and sexualised behaviour. Staff ensure that children and young people are not isolated in the community where they are living and that they become as integrated as possible in the local leisure, education and community facilities. For example, the current child attends a rugby club and enjoys a wide range of fun activities in the local area such as swimming, bowling and going to the park. This helps to address disadvantage and

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requires improvement

social exclusion, and encourages him to begin to more effectively manage behaviour issues which have an impact on friendships and educational progress. Staff promote constructive, safe relationships between children and their birth families so that important attachments are maintained as much as possible. They maintain links with parents to ensure they are kept informed of children and young people’s well-being and progress.

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requires improvement

Staff in the core team present as supportive and attuned caregivers. They help to buffer children and young people from some of the destructive consequences of previous trauma they have experienced. However, the current child in placement initially experienced a very high level of restraints by a range of staff, sometimes as high as ten restraints in one day. The manager has recently effectively addressed this through the development of more considered restraint strategies and limitations on the use of reserve staff. Consequently the level of physical interventions has significantly reduced. As the child’s independent reviewing officer observed in the child’s first statutory review: ‘That meeting was a difficult one. His behaviour was quite wild at times. I observed staff to be calm with him. He was possibly at the peak of his behaviour challenges then. I understand he has begun to calm down since. The social worker has been pleased to see a slow but gradual

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requires improvement

reduction in the restraints.’ That early situation of high levels of restraint was compounded by inconsistent practice by some reserve staff who did not know the child well and were not completely familiar with his behaviour and risk management plans. In addition, even now some staff are still not fully trained in the provider’s behaviour management model. This compromises their ability to undertake restraint with the right skill and confidence. The adverse impact of this is mitigated by the fact that they are always on duty with an experienced and trained colleague. The manager has ensured basic refresher training with the whole team in respect of restraints for the current child. However, restraint recording still sometimes fails to reflect the de-escalation techniques tried prior to undertaking an actual physical intervention. The manager has taken external psychological advice which endorses the new

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requires improvement

behaviour and risk management strategies. Their more consistent implementation helps the child to learn that making mistakes is not catastrophic and that relationships can survive difficult interactions and be repaired. It serves to bolster his sense of self. The manager has also arranged for staff to undertake some play therapy training so that they can use every opportunity to help the child to communicate his feelings more constructively. The child has tested the new boundaries and found staff to be much more consistent. This contributes to him feeling safer in the home, with the consequent reduction in his high level of aggression. The manager has devised a child-friendly restraint book; it is less formal in style, shows pictures of the holds, and prompts discussion about feelings through use of images of different emotions. This helps the child to understand why he has had to be held and encourages reflection about the circumstances

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requires improvement

leading up to the intervention. For example, it has prompted the child to start to talk about dreams that have been troubling him. Staff have not always been able to ensure that older young people did not harm much younger children placed in the home. Matching criteria had been carefully considered and appeared to be suitable but the subsequent relationship between children and young people was poor. Staff attempted to hold restorative meetings between them but this approach was unsuccessful. It finally culminated in the older young person enticing the younger child to go out with her when she went out without authorisation. This placed him at risk of harm, though no actual harm occurred. She also finally physically assaulted him despite staff intervention. Senior managers promptly took the appropriate safeguarding decision to move the older young person to another home within the company. However, they did not give

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requires improvement

enough thought to the match with the young person in the other home at the time. Consequently both those young people’s placements disrupted. In terms of this home, it means that the older young person’s relatively long term placement here culminated in poor outcomes for her. The police report positive working relationships with the home and confirm that staff are proactive in managing all missing from home events. These events were very numerous towards the latter part of the previous young person’s placement. They were associated with sexual exploitation risk, substance abuse and mental ill health. Evidence demonstrates that staff worked closely with all relevant agencies to try to reduce the frequency and severity of these risks, albeit with limited success towards the end of her placement. The manager tries to organise the physical environment of the home so that it is as safe as possible for the current child. For example, he has agreed a risk

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requires improvement

management strategy of a safe zone in the home when the child’s behaviours are escalating. This means that, under certain circumstances, areas of the home will be locked to promote his safety. However, one consequence of the overall risk management strategy is that most pictures and photographs have been removed because they were being used as weapons against the staff. Unfortunately this contributes to making the home feel rather bare and institutionalised. The independent visitor commented on this and suggested use of themed wall stickers to make the place feel more homely. The manager has agreed to look into this. In addition, although in general the home is well maintained, there are some areas that need specific attention to bring them up to a good standard. This includes the need to act on external specialist fire risk assessment advice to have another smoke detector installed to further ensure everybody’s safety in the home.

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requires improvement

Robust and thorough vetting of new staff to the home promotes the safety of children and young people. Recruitment practices ensure that new members are the right fit for the existing team. The manager has just completed allegations management training and has plans in place to cascade the learning from this to the staff. That said, the manager concedes that some investigations into allegations against staff have not been conducted in a timely way and have not involved sufficient consultation with relevant agencies. This does not promote transparency and inhibits the local authority designated officer from being able to maintain appropriate external scrutiny. Such events have also not been notified to Ofsted in line with regulation. This again inhibits that external agency oversight. Judgement grade

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requires improvement

The manager has been in post since July 2015. It is his first full manager role. He has previous deputy manager experience, and has just started his required leadership and management professional qualification. He is in process of applying to be the Registered Manager. He is a committed and positive manager who places children and young people’s needs at the centre of everything the home does. He demonstrates genuine keenness to learn and is therefore a good role model for his team and for the children and young people. As the independent visitor said: ‘I think the new manager is doing well in the role. He is passionate about the children and young people and wants his team to do the best they can.’ The manager has responsibility for two homes in the local area. This means that he divides his time between them. Most of the time he has suitable strategies in place to ensure enough oversight of the home. However, there has recently been a

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requires improvement

short period when the manager was on leave and his deputy was on leave at the same time – a situation not of the new manager’s making and one that he inherited. Although more senior managers came in to the home to provide some managerial support, this was not enough to prevent the home from moving into a state of crisis. Inconsistent implementation of behaviour management strategies and insufficient shift planning involving significant numbers of reserve staff undermined attempts to deal effectively with the situation. This left children and young people unclear about boundaries and created a turbulent environment. It put staff in a vulnerable position and impacted adversely on the quality of care provided to both residents in the home. It is to the credit of the manager that, since his return from leave, he has turned things around so that the current child in placement is much more settled and is no longer exposed to dangerous

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requires improvement

behaviours from other young people. The manager worked decisively to address those practice concerns and to effectively pull the team back together. Staff appreciate the approachability and support of managers. Formal supervision is suitably systematic and challenging. However recent pressures on the service have meant that some supervision sessions for new staff have not been held in line with the provider’s own expectation of twice monthly provision. Staff have their performance individually and formally appraised at least annually. Records of these reviews do not always demonstrate that children and young people are invited to contribute their views to this process. This may mean that significant information is not taken into account in monitoring staff. Reports by the independent visitor show good evaluation of practice in the home and offer constructive criticism to the manager. This promotes effective quality

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requires improvement

assurance and the manager takes action to make improvements accordingly. He regularly monitors the quality of care provided in the home and the progress that children and young people make. He is aware of the strengths and weaknesses of the service and has a development plan in place to reflect these. He has recently completed the required six month report on the performance of the home. It is suitably detailed and demonstrates analysis and learning from events and patterns.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, 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 who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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Information about this inspection

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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