Children's home run by Meadows Care Limited in Rochdale

Registered person

Meadows Care Limited Registered person address Egerton House, Wardle Road, ROCHDALE, Lancashire, OL12 9EN

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Responsible individual

Niel David Shelmerdine Registered manager Paul David John Smith Date of last inspection 12/02/2014 2 of 10 Inspection date 11/03/2015

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Responsible individual

Previous inspection inadequate Enforcement action since last inspection None

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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

This is a re-inspection of the home following the inadequate judgment made in September 2014. The provider has responded appropriately to addressing the actions set at the last inspection. All requirements and recommendations are now met and the overall effectiveness of the home is now judged as adequate.

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Overall effectiveness

The home has been closed for the majority of time since the last inspection. There has been one admission since the last inspection. This placement was designed to facilitate a time limited transition to a more specialist service. This move was in the process of being actioned during this inspection. Procedures for safeguarding young people and managing their risk taking behaviours have been strengthened. These procedures have been designed to underpin all aspects of care planning and care practice.

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Overall effectiveness

There is a recognised focus on ensuring managers and staff are fully aware of, and implementing their safeguarding responsibilities. It is difficult to measure the true impact of any changes because of the brief period of time that the home has been 3 of 10 occupied. However, early signs of progress are positive.

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Overall effectiveness

The young person has made good progress relative to their time in placement. They are provided with good quality care which is underpinned by effective planning. This has helped them to fully engage with education, sit a number of examinations and ensure risk taking behaviours are managed safely and effectively.

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Overall effectiveness

Organisational oversight has improved. The senior leadership team has been restructured and a number of systems have been introduced to improve monitoring and accountability. The Registered Manager has a better understanding of the strengths and weaknesses of the home and is much more diligent in the application of his responsibilities. Plans to integrate change are in hand and once fully embedded into practice; these changes will further improve the quality of care and outcomes for young people.

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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 young people who may need support with emotional and/or behavioural difficulties.

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Inspection date Inspection type Inspection judgement

25/06/2014 SC Full good 12/02/2014 SC Interim inadequate progress

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Inspection date Inspection type Inspection judgement

15/05/2013 SC Full good 07/02/2013 SC Interim good progress 07/11/2012 SC Full good

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Statutory Requirements

4 of 10 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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Outcomes for children and young people adequate

The home has only been occupied for two weeks since the last inspection. The aims of this placement were clear at the outset that this was to facilitate one young person's transition to a more specialist service. The organisation recognised that it cannot fully meet this young person's needs and has been actively involved in identifying a more suitable placement for them. Staff were in the process of planning this move during the inspection. They demonstrated a great deal of sensitivity and were clearly focused on minimising the distress to the young person.

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Outcomes for children and young people adequate

The young person has engaged positively with staff and has benefitted from the care and support they have received. They have consistently attended education, sat a number of GCSE examinations and gained a place at college. The young person spoke positively about the home and said that he liked living there, demonstrating a good understanding of his life. He spoke positively about his future and his aspirations to go to college and become a football coach.

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Outcomes for children and young people adequate

Staff encourage young people to make positive choices about maintaining a healthy lifestyle. They provide them with relevant information and guidance on a range of subjects including the dangers of smoking, alcohol and substance misuse. Provision is made for young people to access specialist support if required. Despite staff efforts this young person has not consistently engaged with specialist support services and has continued to take part in serious risk taking behaviours that are harmful to their health. These have been managed effectively through the risk management processes in place.

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Outcomes for children and young people adequate

The young person spoke confidently about their skills to manage the practical tasks of day to day living. They are involved in daily tasks such as menu planning and 5 of 10 preparing meals and are encouraged to make informed decisions about their lives.

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Quality of care adequate

Relationships between the young person and staff are positive, despite the relatively short period of time these have had to develop. Staff are interested in the young people's lives and want them to do well. They have an acute awareness of their responsibility to keep them safe and are focused on meeting their individual needs. They encourage the young people to engage in positive routines such as getting up for school, eating at regular times and taking part in constructive activities for example. Young people and staff are clear that it is not acceptable for young people to stay in bed for lengthy periods of time. Policies and practice have been strengthened to ensure young people's welfare is frequently checked and staff actively encourage them to get up at a reasonable time.

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Quality of care adequate

Staff effectively plan for young people's care. Good consideration has been given to the reason for the placement and the levels of support required to facilitate a good transition. This information is detailed in placement plans, risk assessments and behaviour management plans, and has been consistently translated into practice. Staff have persevered in the face of challenges, offering support, advice and guidance to help the young person make improved choices about their lives. This approach has been effective in helping them attend school and other important appointments.

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Quality of care adequate

The manager and staff have established good partnerships with social workers and other agencies that promote positive outcomes for young people. This includes consulting with alcohol and substance misuse services whose guidance and advice has been used to inform practice when working with young people who choose to engage in this type of risk taking behaviour.

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Quality of care adequate

Young people benefit from living in a home that is well maintained and conducive to meeting their needs. All areas of the home have been redecorated during its period of closure. Young people are encouraged to personalise their bedrooms to reflect their individual tastes and personality. 6 of 10

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Keeping children and young people safe adequate

Safeguarding practice is underpinned by improved procedures for managing child protection concerns and allegations against staff. This includes improvements to the critical incident management procedure that further supplement the home’s child protection policy and procedures. The document clearly demonstrates what actions managers need to take to ensure responses to concerns are robustly managed. This includes taking immediate action to protect young people and staff, including removing staff from duty pending investigation. It also highlights how the provider and manager will work with external safeguarding agencies and other relevant professionals, including the police and Ofsted, to promote transparent information sharing and collaborative working. There is a recording process in place to support this procedure. It has not been necessary to initiate this process but when used this will provide a comprehensive record of events and actions taken by the home, which

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Keeping children and young people safe adequate

are routinely monitored by the senior leadership team.

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Keeping children and young people safe adequate

Young people are better protected from harm. Individual risk assessments and behaviour management plans clearly identify and sufficiently consider young people's known risks, vulnerabilities and behaviours. Risk assessments include unambiguous guidance for staff that clearly identifies what action they should take if young people are under the influence of drugs. For example, staff routinely contact NHS Direct and follow their advice to support young people. This process has been necessary on 5 occasions since the last inspection and has included taking a young person to hospital and monitoring them through the night. Detailed records are maintained of the advice given and actions taken by staff, including the time and frequency of welfare checks. Processes are in place to ensure any emerging concerns or changes in behaviour are fully recorded in young people's risk assessments and behaviour management plans. Interim strategies are put into place until these can be formally

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Keeping children and young people safe adequate

reviewed by the manager or deputy manager. This ensures young people's known and emerging risks are effectively managed and their welfare is promoted.

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Keeping children and young people safe adequate

Staff are clear about their roles and responsibilities in keeping young people safe. This is because pertinent information about young people is shared through planned handovers, which are fully recorded. A daily diary sheet has been introduced to ensure staff share detailed information about each young person's day. This includes highlighting any specific issues or concerns. Consequently, staff have a more comprehensive picture of the events from the previous day and what action may be necessary to support and protect young people and keep them safe 7 of 10 There are effective procedures in place in the event that a young person chooses to leave the home. There have been five occasions when the young person has gone missing since the last inspection. Staff have routinely followed the young person in an attempt to keep them in sight. If this has not been possible they have followed the home’s missing from home procedures, which includes notifying the police at an

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Keeping children and young people safe adequate

agreed time. This has been necessary on two occasions. Staff will continue to make enquiries as to the young person's whereabouts, maintaining links with the police during the young person's absence. This ensures a risk led and proportionate response is taken to promoting a quick and safe return.

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Keeping children and young people safe adequate

All staff are trained in behaviour management including the use of restraint. Challenging behaviour has not been a problem since the last inspection. The young person has positively engaged with staff and has not presented any unusually challenging behaviour during their brief stay at the home. Consequently, there have been no sanctions or incidents of restraint since the last inspection.

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Keeping children and young people safe adequate

The home is a safe environment for young people to live in. This is because young people are protected by a range of health and safety procedures, risk assessments and routine maintenance and fire safety checks. Young people know how to safely evacuate the home in the event of a fire.

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Leadership and management adequate

The manager has been in post since July 2013. He is suitably experienced and is currently in the process of completing the Level 5 Diploma. He manages another home within the same company, which is in close proximity of this home. He divides his time well between the two homes and maintains a good level of oversight.

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Leadership and management adequate

Robust action has been taken in response to the serious incident that occurred in the home in June 2014. A detailed action plan has been devised and is at various stages of application. The action plan recognises where some areas in practice could be improved and identifies how these improvements can be made. For example, the organisation’s management team has been restructured. This includes the introduction of area managers who hold specific responsibility for the oversight and monitoring of their allocated homes. They undertake a range of quality assurance checks, including routine and focused inspection visits. This improved oversight and monitoring by the senior management team ensures that concerns and shortfalls are routinely identified and Registered Managers are held accountable for addressing 8 of 10 these.

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Leadership and management adequate

The provider and manager have taken suitable action to address the requirements and recommendation from the previous Ofsted inspection which was completed in September 2014. This raised a serious safeguarding concern around failure to effectively manage young people’s risk of substance misuse. Although unhappy with Ofsted’s judgements, the provider put in place an action plan in order to improve its policies. These positive actions have improved the care, support and safety of young people. However, the effectiveness of these actions cannot be measured in any great detail because of the limited time young people have been living at the home.

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Leadership and management adequate

Safeguarding systems have been improved to ensure that responses to safeguarding concerns are robust and that staff take the necessary action to promote young people's welfare. Processes in place for assessing, monitoring and managing young people's risks have also been improved to ensure risk assessments are up-to-date and suitable risk management strategies are consistently put into practice. The procedure for managing critical incidents has been improved. This provides clear and well thought out responses to the management of significant events, in particular child protection concerns. Disciplinary procedures have been amended. Whereas staff were previously taken off shift, in response to any serious incident, it is now standard protocol to suspend staff without prejudice in the event of any serious safeguarding concerns or allegations, until a thorough investigation can be completed. The lone working policy has been changed to provide clarity on staff lone working with young

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Leadership and management adequate

people. There is now a minimum expectation that staff have successfully completed and been signed out of their probationary period and received relevant training. A number of recording processes have been introduced to ensure there is an up-to- date and detailed picture of young people's lives, experiences, progress, and how they are to be supported by staff. Schedule 6 monitoring has been strengthened to ensure that the manager maintains rigorous oversight of all matters in the home, in particular any risk management or safeguarding concerns or incidents. This ensures any known or emerging concerns are recognised and effectively managed by staff.

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Leadership and management adequate

The manager shows positive learning from the issues which resulted in the inadequate judgement at the last inspection. He has clearly reflected on how practice can be improved. This includes the introduction of a number of processes that provide routine scrutiny of staff conduct, care practice and written records. For example, the manager or the deputy manager check young people’s daily diary to note any changes in behaviour or risk. They introduce strategies based on this risk and maintain oversight of staff practice. 9 of 10 A range of forums for the purpose of information sharing have been introduced throughout the organisation. For example, managers meet with senior managers on a weekly basis to update them about young people's progress and the prevalent issues in their respective homes. Case management meetings are held monthly. These involve managers and representatives from education, the therapy team and

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Leadership and management adequate

directors. The outcomes of these meetings are recorded in written action plans. There is an expectation that managers put these plans into action within agreed timescales and provide senior managers with regular updates on progress. This ensures young people's needs, risks and behaviours are known and are being effectively managed to secure good outcomes.

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Leadership and management adequate

With the exception of the manager, all staff are new to this home. They offer young people a good range of experience, age and gender and are qualified or working towards a relevant childcare qualification. Staffing levels are responsive to the changing needs of young people. Prior to the recent re-opening of the home staff have worked in other parts of the organisation. Staff confirm that they have been well supported by the manager and other colleagues in preparation for the home admitting young people. They have good access to training opportunities and the recent appointment of a training manager has further strengthened these rearrangements. A full training audit has been undertaken throughout the organisation and all staff are to be provided with comprehensive training to further develop their knowledge, skills and expertise around alcohol and substance misuse. This will enable staff to understand the prevalent issues associated with alcohol and

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Leadership and management adequate

substance misuse, better equipping them to manage risk and help young people reduce these risk taking behaviours.

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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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