Children's Home run by The Together Trust in Bolton

Outstanding

The children's home provides highly effective services that consistently exceed the standards of good. The actions of the home contribute to significantly improved outcomes for children and young people who need help, protection and care.

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The children's home provision is outstanding because:

 An inspirational manager, fully supported by her staff team, is dedicated to providing the highest standard of care in an establishment that can truly be called a home.  Aspirations for young people are high, and disability is not used as an excuse to stop young people living and enjoying full and fulfilling lifestyles.  Young people live in an inclusive, non-judgemental environment that promotes choice and consultation and celebrates achievement.  Based on their starting points, young people make significant progress in all areas of their lives, as they move towards adulthood and greater independence.  A real strength is the quality of the working relationships developed with other professional agencies and young people’s families. Working in partnership with them underpins the working practices of the home.  Staff are skilled and have the training in, and knowledge and understanding about, the causes of challenging behaviour. Treating the cause allows those

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The children's home provision is outstanding because:

behaviours to subside.  The strong, trusting relationships formed between staff, young people and their families are the foundation for the way in which the home functions.  Young people feel safe and are kept safe. Challenging, disruptive and unsafe behaviours reduce significantly, as they settle into the home.  Young people benefit from being looked after by a child-centred, fully committed staff team that works with a team-centred approach to provide them with a high level of consistency of care.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:

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Recommendations

 Ensure that the details of how a young person can contact external agencies are kept updated at all times. (‘Guide to the children's homes regulations including the quality standards’, page 24, section 4.22)

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Information about this children's home

The children's home is one of a number of homes operated by a charitable trust. It is registered to provide care and accommodation for up to five young people with emotional and/or behavioural difficulties, physical disabilities and learning disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

04/02/2016 Interim Declined in effectiveness

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Recent inspection history

21/01/2015 Interim Sustained effectiveness

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Outstanding

This is a children’s home that is truly a home. Young people live in a warm, caring environment where their individual needs are recognised and met. Challenges and disruption are worked through calmly and decrease as strong relationships and trust form between young people and staff. Standards of care over recent years have remained consistently high. As a result, young people make significant progress socially, emotionally and educationally. Based on their starting points, progress is outstanding. For example, a parent described a dark, unhappy place littered with self-injurious behaviour, prior to their son’s admission to this home. At that time, he was described as `not functioning, only accessing life.’ He has changed into a young person enjoying life and is making achievements in all areas that maximise his potential. The parent summed this up when saying, `They have changed his and our lives for the better. He is

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Outstanding

receiving outstanding care that recognises and meets his complex needs. I feel he is totally safe in the home.’ Another parent told the inspector, `He has made fantastic progress. He is now talking, he is more confident and he is achieving so much, like his recent award. He loves the activities and he is becoming more independent. The parent of another young person reported that, `staff have put things in place which keeps him safe. He always looks smart and well presented. He has changed so much in a year. He is eating better. He is not as hyper.’ Parents’ views about the home are supported by professionals who work directly with the home. For example, a social worker described a young person’s progress as follows: `The change in him has been fantastic since his placement. His communication and levels of behaviour are amazing compared to where they were when he was first admitted. For example, he can now go into a shop or café and

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Outstanding

order things like a drink: something thought impossible at one time.’ An independent reviewing officer also observed, `He has made massive progress since he was first admitted.’ Progress can be measured and evidenced in the comprehensive planning documentation, coping strategies, assessments of individual risk and reports prepared for reviews. Plans are detailed, individualised and of high quality. They are reviewed and updated regularly through rigorous monitoring. This keeps them current. When read collectively, they give an excellent insight into the journey being undertaken by young people as they progress through the home. Extra detailed information about progress can be found in the monthly reports sent out to parents and social workers and in the skills books recently introduced, which chart progress, success and personal achievement. The educational arrangements for each young person are excellent. They are all in

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Outstanding

full-time education at different schools within the locality. Attendance levels are exceptional, with only the odd day missed due to illness. Written documents and reports from schools, supported in views expressed by staff, parents and young people’s social workers, show that, based on their abilities, outstanding educational progress is being made. For example, a teaching assistant from a school attended by a young person said, `He is making excellent progress. He is tolerating people much better, so much so we have got him onto the summer play scheme, which is a significant step forward.’ The arrangements made to promote young people’s health are excellent. Young people’s everyday health needs are addressed appropriately through community- based services that are well established and work well with the home. More specialist support, such as mental health services, is brought in when required. Young people and staff are also supported by a range of specialist services

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Outstanding

provided by the trust that operates the home. The home has overhauled its policy and procedures for storing, administering and recording medication. This is due to errors found during the previous inspection. New facilities, coupled with staff training and more intensive monitoring and auditing, mean that the systems in place to deal with medication are now operating well. Consultation with a group of young people, some with no verbal communication, is an area of real strength. Communication levels between staff and young people are high, with both parties being able to fully understand the other. Young people make choices in their daily interaction with staff. However, the arrangements for consulting formally on a weekly basis through young people’s meetings are outstanding. For example, young people meet as a group with a planned agenda. Their views on issues such as bullying, whether they are happy or sad, along with their choices

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Outstanding

of activities and food, are recorded separately. Aids such as pictures and photographs have been put together to help young people with their choices. The thought, planning, recording and implementation of the meetings are deemed to be outstanding practice, giving every young person a voice. It also gives them a feeling that their views and opinions matter as well as a feeling of ownership regarding the way in which the home operates. Staff are conscious of promoting fitness and good health. Individualised activity programmes promote fitness as well as enjoyment. All young people are active, which is something they enjoy. Staffing levels and the transport facilities available allow for individual needs and interests to be followed. For example, after building up tolerance levels of groups over a number of years, one young person successfully negotiated being involved in a community-based play scheme. Diet

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Outstanding

and food intake are closely monitored. One young person was observed helping himself to grapes out of the fridge as a snack, whereas another eating an unhealthier snack was allowed to do so only in moderation. Contact arrangements, some of which are complex, are facilitated by the home flexibly. For example, many parents reported that they can visit at any time without having to make prior arrangements or an appointment. This gives them some sense of security. A number spoke about staff going that extra mile to support and facilitate contact, such as staff using their own time to support medical appointments and going with parents to school parents’ evenings. The extra commitment that staff are prepared to give is much appreciated by parents. Young people have access to a number of different guides to the home, which appear in different formats. Guides contain the information required and are child friendly in their presentation. Contact details for external agencies and helplines

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Outstanding

are included, but the details for some were found to be out of date. This matter was rectified by the second day of the inspection. Developing the independence skills, confidence and self-esteem of a highly dependent group on admission is a strength of the home. Staff demonstrate outstanding knowledge and understanding of each young person. Work starts early to develop and encourage greater independence, by introducing new skills and encouraging young people to develop them, for example developing speech, improving tolerance levels of young people in social situations and undertaking basic household tasks. This programme towards greater independence gives young people confidence, ambition and the skills to enjoy full participation in the facilities in the local community and, eventually, to live as independently as possible. Young people benefit from living in an environment that takes account of their

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Outstanding

needs, with plenty of space, which allows them some privacy. They are relaxed and at ease in their surroundings. Bedrooms are all single occupancy and personalised to suit the taste of the occupant. The overall state of repair and the quality of decor, furnishings, fixtures and equipment are high. Since the previous full inspection, young people have benefitted from having a new conservatory built to the rear of the home, following the home’s receipt of a generous donation.

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Outstanding

All young people indicated that they feel safe in the home, a view very much supported by their parents and social workers. Although not tested since the previous inspection, safeguarding procedures that have proved previously to be robust are in place. A well-trained and experienced staff team understands fully its roles and responsibilities in keeping young people safe. The manager maintains excellent relationships with those external agencies charged with keeping young people safe. The home accommodates a number of young people with the potential to go missing, making them highly vulnerable should they do so. It is to everyone’s credit that no young people have been missing since the last full inspection. This reflects the excellent work by staff, which ensures that young people remain safe, along with the levels of progress that young people make. The manager maintains the contact details of the local police officer responsible for

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Outstanding

missing children. All young people have suitable assessments of risk, along with description cards that can be put to use immediately should they go missing. Protocols for staff to follow are in place. This is a reflection of one of the proactive responses adopted by the home that keeps very vulnerable young people safe. Young people live in an environment where they feel safe and they respond positively by developing strong and trusting relationships with staff and their peers. They operate within clearly defined boundaries and established routines that are individual to them and which they are comfortable with. This adds to their feelings of security. The way in which the home manages behaviour management, which includes sanctions, rewards, restrictive practices and dealing with self-harm and bullying, is outstanding. The home works without the use of sanctions, and only with rewards. Incidents of self-harm and physical intervention have significantly reduced to the

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Outstanding

level that there have been no such incidents since the last inspection. Bullying is not a live issue. The group gets on well, although young people can be solitary within a group due to their conditions. An example of why the home is outstanding in its behaviour management links to the working practices adopted. Based on training, advice and research-informed practice, staff have the confidence, ability, understanding and training to treat extreme behaviour, such as serious self-injurious behaviour. They do so by identifying the cause of the behaviour rather than just the behaviour itself. By doing so, behaviour is moderated and goes away, rather than returning in another form because the root cause has not been addressed. This is something the staff are extremely skilled at. Staff retention, overall, is excellent. The home had a period of six months during which replacing some staff who had moved on took time, due to finding and

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Outstanding

employing staff with the correct attributes to work in the home. It is to the credit of staff that any shortages were covered by themselves, rather than by agency or temporary staff who had no knowledge of the young people. Bringing in temporary staff could have seriously disturbed the consistency of care that the young people receive. Young people benefit from this consistency, with the main group of staff being experienced and stable, having worked together over a period of years. Recruitment practice and clearance procedures are thorough and meet with regulatory requirement and current guidance. Longer-serving staff are re-checked every three years, which ensures that young people are only looked after by staff who have been suitably recruited and cleared. Young people are living in a non-punitive, safe environment where their needs are identified and met. Detailed risk assessments are reviewed and updated regularly.

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Outstanding

Risk is identified in and around the whole campus, as well as in the community and for activities. This helps to keep staff, young people and visitors safe. Appropriate service contracts are in place, to ensure that safety equipment is well maintained, which adds to the levels of safety in the home.

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Outstanding

An experienced and suitably qualified registered manager works as part of a senior staff team. Her leadership qualities are showcased by her leading from the front and spreading her ambition, dedication and child-centred approach through the whole staff team. There are high expectations of staff performance and high standards set. The manager is supported well by a staff team that buys into the culture, ethos and working practices developed in the home over the years. The team members work together cohesively, which demonstrates the team-centred approach that is so beneficial to young people in relation to the consistency of care that they receive. Aspirations for young people are high, and disability is not an excuse to stop young people attaining their potentials. Their outcomes improve as they journey through the home, helped by the high expectations that staff have, coupled with their ability and willingness to advocate strongly on behalf of young people.

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Outstanding

Communication levels among staff are excellent, which is demonstrated during staff handover meetings. These daily meetings prepare staff for their shifts and allow them to prepare well, for example in the way in which staff are deployed around the home. Morale is high, and staff report that they feel well supported by senior staff. The formal programme of supervision, which is taking place with consistency along with annual appraisal, supports this view. These levels of support and supervision allow for professional development to take place and help staff to understand better the implications of their actions and working practices. This gives them a greater appreciation of their own responsibilities. The home has a high investment in staff training. There is an expectation that staff will participate fully in the core staff training programme that is in place, which is monitored closely. This means that longer-serving staff refresh skills, such as

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Outstanding

safeguarding, first aid, physical intervention and others, regularly. This ensures that skills remain current to meet the needs of the young people in their care. New staff are quickly introduced into the training programme as part of their induction. Specialist training is brought in when any shortfall is recognised. This can often link to the changing needs of young people. Training linked to autism and sleep clinic training are recent examples. During the inspection, staff met with a visiting psychologist to look at ways of improving how a young person is being managed and to develop a more informed understanding of his complex needs. This reflects the excellent proactive approach taken by the home, along with a recognition that improvement is a continuous process. The monitoring of the home, both internal and external, is excellent. Both are challenging and evaluative, leading to self-assessment and ultimately to

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Outstanding

improvements in practice. This gives managers a clear understanding of the home’s strengths and areas that require development, which are reflected in the home’s development plans. The home has an excellent record of compliance. The three requirements made at the previous inspection have been fully addressed. This has led to improvements in the security of the home, a complete reorganisation of the way in which medication is dealt with, improvements to the fabric of the building and obtaining written permission from social workers for the use of a basic alarm system located on the landing. This is a home that strives for continuous improvement. A number of new improvements and developments have been achieved since the last full inspection. They include the introduction of skills books for young people, bought-in specialist training such as that on autism and sleep clinic training, a new conservatory,

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Outstanding

complete revision of the medication policy, procedures and practice, work undertaken with staff to improve report writing and a greater sensory input for staff. Vulnerable young people, often in crises when first admitted, live in a home where equality is promoted strongly. Young people settle and make exceptional progress in all areas of their lives, helped by the dedication of a skilled and highly motivated staff team. The relative of a young person summed this up when talking to the inspector by saying, `The care and dedication of the staff is unbelievable. They have given us our young man back. His progress has been exceptional.’

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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 that 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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