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:

 Insufficient progress has been made in addressing shortfalls identified at the last inspection regarding the lack of continuity of care provided by staff, and in recording restraints.  The registered manager has not ensured that full information in relation to temporary staff and agency staff is available to him and held in the home. This means that he is unable to understand how these staff can meet the child’s needs. He has not ensured that these staff are adequately prepared to work in the home, have undertaken an introduction to the home’s policies and procedures or to the child’s case files. This does promote the child’s welfare.  The registered manager has not monitored the use of restraint and ensured that it is recorded promptly. This means that staff are not given an opportunity to evaluate their use of physical intervention, and the registered manager loses opportunities to improve practice.

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The children's home provision requires improvement because:

 The registered manager has not developed an effective system to monitor, review and evaluate the quality of care provided.  Staff do not understand the progress that the child is making in engaging with education, because there is no effective recording of this or awareness of what his education plan states. Important documents, which help staff understand this, were only tracked down by the registered manager during the inspection.  The child is unable to access the internet within agreed parameters during leisure time. This is due to the lack of capacity to use the internet service within the home. This has the potential to affect his home schooling and staff’s use of the internet as well as his enjoyment and learning.  Staff do not monitor the effectiveness of interventions to encourage the child to maintain his basic hygiene. They do not record the actions that they take, and the registered manager does not review the quality of care

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The children's home provision requires improvement because:

systematically so that he is aware of these shortfalls. This means that there are significant delays in progress being made in this area.  Staff understand how to manage allegations made by the child and to respond promptly and effectively so that the child and staff are safeguarded. They do not ensure that Ofsted is notified in a timely manner, which prevents the regulator from monitoring patterns or trends and the effectiveness of the home’s response.

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The children's home strengths

 The registered manager and staff are committed to providing a nurturing and caring environment. This is evident in the positive relationships between the staff and child.  The core staff team uses its detailed knowledge to inform its behaviour management techniques. It is skilled in using de-escalation, and consequently physical intervention and serious incidents have reduced.  The child feels safe and values the positive relationships with his staff and therapist.  Staff offer a range of activities within the home and community to encourage the child to develop self-confidence and to have fun.  Staff support the child’s contact with his family when that is safe and in his best interests.  The current staff team is new. The core staff work effectively together and report good levels of support from each other and the registered manager. This provides them with emotional resilience to provide effective care.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person 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 must comply within the given timescales.

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

(2) In order to meet the leadership and management standard, the registered person must:

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Requirement Due date

(e) ensure that the home's workforce provides continuity of care to each child

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Requirement Due date

(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 30 May 2016

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Requirement Due date

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 in accordance with regulation (Regulation 35(3)(a)). 30 May 2016

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Requirement Due date

The registered person must ensure that within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’) has spoken to the user about the measure and has signed the record to confirm it is accurate (Regulation 35(b)(i)(ii)). 30 May 2016

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Requirement Due date

(2)(a) In order to meet the education standard the registered provider must ensure that:

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Requirement Due date

(i) staff help each child to achieve the child's education and training targets, as recorded in the child's relevant plans and

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Requirement Due date

(viii) staff help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as 30 May 2016 possible.

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4 and ensure that the records are kept up to date. In particular, that all case records are current, accurate and relevant and enable children's progress to be effectively monitored (Regulation 37(2)(a)(b)). 30 May 2016

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Requirement Due date

The registered provider must notify HMCI without delay if there is an allegation of abuse against the home or a person working there (Regulation 40(4)(c)). 30 May 2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  The registered person should ensure that children are offered advice, support and guidance on health and well-being, to enhance and supplement that provided by their school. Staff should have the relevant skills and knowledge to be able to help children to understand, and where necessary work to change, negative behaviours in key areas of health and well-being, with specific reference to ensuring that children maintain basic hygiene routines of bathing and brushing their teeth (‘Guide to the Children's Homes Regulations, including the quality standards’, April 2015, page 35, para 7.18).  Children should have access to a computer and the internet to support their education and learning, with specific reference to not restricting internet access to children, and to ensure that there is internet capacity for the

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Recommendations

administrative running of the home (‘Guide to the Children's Homes Regulations, including the quality standards’, April 2015, Page 29, paragraphs 5.19).  Staff should be familiar with the home’s policies on record keeping, and understand the importance of careful, objective and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child, in particular so that staff are aware of planned responses to a child’s basic care needs, such as personal care or education, and record their responses to these daily, so that progress can be evaluated (‘Guide to the Children’s Homes Regulations, including the quality standards’, April 2015, Page 62, paragraph 14.5). 

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Information about this children's home

The home is registered to provide care for two children with emotional and/or behavioural difficulties. The home forms part of a large social care company.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

16 February 2016 CH - Interim Declined in effectiveness

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Recent inspection history

30 January 2015 CH - Interim Declined in effectiveness

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Requires improvement

The quality of individualised care provided is mixed. Staff are committed to providing stability to the one child in this placement. The core staff team builds positive relationships with him through investing their time and listening to him. As a result, he develops a sense of permanence and told me, ‘I am going to stay for a year.’ This represents significant progress from his arrival.

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Requires improvement

Staff do not make effective use of records. This means that the progress that the child makes in addressing basic hygiene and education are not clear. Staff and the registered manager describe encouraging the child to engage with education. However, what steps are taken are not recorded. The child is not able to attend the company’s school provision, as it is unable to meet his needs. The child is home educated by the school staff but he refuses to engage for weeks at a time with no record of the actions taken to re-engage him or to identify a suitable alternative placement. The registered manager tracked down the personal education plan and updated education healthcare plan during the inspection. These important documents would have greatly assisted staff in their day-to-day planning of support for the child.

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Requires improvement

Staff ensure that the child is registered with universal health services and that he receives appropriate care by dentists and opticians. Staff understand that the child needs to maintain basic hygiene. They do not detail how they are trying to ensure that this occurs. This means that progress is not clear and reviewing the effectiveness of strategies is not possible to drive forward improvements in the quality of care provided. This is particularly pressing, as the child requires braces, but the orthodontist will not fit them until he is cleaning his teeth regularly. At the point of inspection, there was no record of the child having had a bath for over a month.

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Requires improvement

Staff ensure that the child is offered a range of recreational activities. He enjoys activities outside the home such as trampolining, bowling and mini-golf. He particularly enjoyed the opportunity to go to Legoland recently. He also enjoys activities in the home, such as gaming, reading and using the internet. His access to the internet has boundaries, which ensure that his use is safe and not excessive. However, limitations of usage placed on the home to access the internet mean that he is not often able to access the internet for his leisure as usage is preserved for staff use or for home teaching.

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Requires improvement

Staff support the child to have contact with his family where that is safe and in his best interests. This promotes the child’s sense of identity. When this contact is being re-introduced after a lengthy period, the registered manager challenges the placing authority to ensure that this is at the child’s pace. Staff ensure that the child is offered the services of an independent visitor and advocate so that he can have support in representing his views. Staff use key working sessions as well as day-to-day conversations to gain the child’s views. They prepare him well for important events, such as his review. As a result, he was able to attend and fully participate. This represents good progress.

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Requires improvement

The registered manager ensures that staff receive regular formal and informal supervision. Staff value this and describe improved emotional resilience as a result. This ensures that they are better able to meet the child’s needs.

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Requires improvement

The home is generally well presented, and timely requests for replacement of damaged items are made. This ensures that there is a homely feel with photos of the child on display and of his achievements.

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Good

The core staff team understands the risks associated with the child’s behaviour and works hard to develop positive relationships with him. As a result of these improved relationships and his regular therapeutic intervention, the child develops more appropriate responses to anger and is able to use sensory toys and cushions to re-direct his emotions. The core staff team is skilled in de-escalation techniques and makes good use of its knowledge of him. He becomes increasingly safe from his starting point, as there are fewer significant incidents or occasions for the need to use physical intervention.

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Good

Staff respond swiftly when there are changes to the risks presented. For example, when the child develops an interest in fire, they ensure that any sources of fire are secured and that the local fire safety officer visits him to help him understand the risks associated with fire setting.

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Good

The child describes feeling safe in the home and knows whom to speak to if he is unhappy about anything. He said, ‘I would talk to anyone if I had a problem.’ He has made no complaints since the last inspection, although there have been allegations made about staff. Staff respond promptly and effectively to these allegations, ensuring that the child and staff member are safeguarded. Appropriate referrals are made to the placing authority and local authority designated officer. The local authority designated officer describes the relationship with the home positively, saying that there is ‘a good process in place in terms of allegations management’ and that the home is ‘highly responsive’.

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Good

There have been no incidents of missing or risks indicative of child sexual exploitation since the last inspection. Staff are clear about how to respond if necessary. They have developed a positive relationship with the local police who work in partnership with staff to avoid the unnecessary criminalisation of the child. Staff understand the risks associated with the use of the internet and appropriate safeguards are in place.

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Good

The registered manager ensures that there are appropriate risk assessments in place. Any use of monitoring and surveillance is in line with the placing authority agreement, and actions were taken immediately to remove the constant use of bedroom door monitors, when it was drawn to the registered manager’s attention during the inspection that this did not promote the child’s welfare or safeguard him. This indicates that the registered manager is able to reflect on his practice.

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Requires improvement

The manager has recently been registered by Ofsted. He has been in post since last year, and has enrolled on the appropriate level 5 leadership and management diploma for children’s residential childcare. Although new to the managerial role, he has lengthy experience of working in residential childcare. He ensures that the home operates in line with the statement of purpose to provide nurturing care. This is achieved through the use of a core staff team the members of which report good levels of support from each other and the manager, enabling them to develop emotional resilience.

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Requires improvement

At the last inspection, there were 10 regulatory requirements. Seven of these have been met. as the registered manager works in partnership with placing authorities, ensures that the child’s health needs are met, including for therapeutic intervention, and that the child has access to an advocate and independent visitor. He ensures that appropriate actions are taken to implement risk management strategies and has suitably evaluated the admissions and discharges over the last six months, ensuring that he reflects on these experiences.

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Requires improvement

Three of these requirements remain unmet, as insufficient progress has been made in addressing the following shortfalls. The registered manager has endeavoured to ensure continuity of care in terms of staffing. He has ensured that at least one member of staff from the core team is on shift in the home. However, in the month between 19 March and 18 April 2016, there were 23 different temporary members of staff who worked in the home. This does not allow for the child to receive continuity of care, or for those who care for him to have adequate knowledge of his needs.

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Requires improvement

The registered manager does not ensure that there is sufficient information about temporary staff held within the home, or that he understands how they can meet the child’s needs. For example, he does not know their qualifications or their experience, or record how they have been introduced to the home or the child’s needs.

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Requires improvement

The registered manager is still developing his approach to the monitoring of the quality of care, and there have been shortfalls, hence the delay in recording restraint and notifying Ofsted of significant events. He is responsive to the recommendations of the independent visitor who has identified gaps in the monitoring of the home. The registered manager’s monitoring and reviewing systems are not robust enough to drive forward improvements in the quality of care provided consistently.

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Requires improvement

The registered manager works in partnership with the placing authority, police and in-house education and therapists to meet the holistic needs of the child. The effectiveness of this is unclear due to the shortfalls in recording when contact has taken place.

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Requires improvement

The registered manager has a detailed understanding of the child’s needs, and works hard to prioritise his stability. He withdrew the notice, which had been served at the last inspection, and has shown, with the core staff team, a commitment to maintain the placement as a permanent one. He has not accepted any further placements to the home, recognising that, at the moment, this would not meet the needs of the current child in placement. The registered manager knows most of the progress the child makes, and understands the impact that core staff members’ positive relationships have on improving the child’s emotional self- regulation. He is robust in his challenges to the placing authority to ensure that any changes to the child’s care plan promote his welfare. For example, the registered manager encouraged the re-introduction of family contact at the child’s pace

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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 children looked after 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 that 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 whom 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

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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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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