Children's Home run by The Together Trust in Bolton

Inspection report children's home: SC057718 1 SC057718 Registered provider: The Together Trust

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Full inspection Inspected under the social care common inspection framework

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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 who have emotional and/or behavioural difficulties, physical disabilities and learning disabilities.

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Information about this children's home

Inspection dates: 20 April 2017 and 02 May 2017

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected outstanding

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

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

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outstanding

Overall judgement at last inspection: Improved effectiveness

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Key findings from this inspection

This children's home is outstanding because Inspection report children's home: SC057718 2  A totally dedicated manager and staff team are fully committed to providing a warm, caring environment that is a home in its truest sense.  Aspirations for young people are high, with staff advocating strongly on their behalf to ensure that their rights are preserved and their outcomes maximised.  A stable, experienced and well-trained staff team know well, recognise and understand the feelings and everyday needs of young people who cannot always communicate easily how they feel.  Young people experience a full and fulfilling lifestyle, with disability not recognised as a barrier to integration into community life.  The home develops strong relationships with parents, carers and other professionals, creating inclusive working partnerships which reflect the team- centred approach taken by the home.  Excellent monitoring by the manager and deputy manager enables them to

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Key findings from this inspection

work proactively in recognising areas where continued improvements can be made.

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Key findings from this inspection

The children's home's areas for development

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Key findings from this inspection

 Following discussions with the inspector, the home is in the process of further developing the quality of recording linked to medication, making it more robust to external and historical scrutiny.

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Inspection date Inspection type Inspection judgement

05/01/2017 Interim Improved effectiveness 02/08/2016 Full Outstanding 04/02/2016 Interim Declined in effectiveness 12/05/2015 Full Outstanding Inspection report children's home: SC057718 3

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Overall experiences and progress of children and young people: outstanding

This is a home in its truest sense. A stable, long-serving, knowledgeable and well-trained staff group provides a high, consistent standard of care. Alongside the strong bonds and relationships built up with young people and their families is a real commitment towards ensuring that their needs are met. More than one staff member, when discussing the young people in their care, said, `We treat these children as though they were our own.’

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Overall experiences and progress of children and young people: outstanding

Family members and other professionals agree. For example, a family member said, `He is the most precious thing we have. We would not entrust his care to anyone else. Staff can read him like a book, they understand his moods, when he is distressed, what he needs. They can anticipate his needs so well.’ A professional who visits the home regularly said, `I have absolutely no concerns about the level of care provided by the home.’ Another stated, `If this is not the best, then it is one of the best services I have ever worked with.’

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Overall experiences and progress of children and young people: outstanding

The progress that young people make in all areas of their lives is both steady and consistent. When measured against their starting point following admission to the home, it’s outstanding. For example, one young person on admission had no desire for socialisation, preferring to be isolated from others, and was aggressive if challenged. Staff are delighted that he recently agreed to join the other young people for an uneventful trip to the coast and was able to sit in a restaurant and enjoy a meal in unfamiliar surroundings. This is a significant development.

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Overall experiences and progress of children and young people: outstanding

Another young person who on admission had no boundaries, no social skills and was described at that time as being ‘feral’, has transformed into a warm and loving person who enjoys the company of others and has developed a wicked sense of humour. A third young person, who suffered from serious mental health issues on arrival at the home and was self-harming badly, has grown into a fine young man who enjoys going to college and has re-established strong, warm relationships with his family, who he has regular contact with.

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Overall experiences and progress of children and young people: outstanding

Young people make outstanding progress because they develop strong, caring and trusting relationships with a staff team that provides stability and consistency through a team-centred approach. As well as the child, families are well supported and encouraged to continue to play an active role in their child’s life and future. A social worker recognised this as an area of strength, commenting, `Staff work really well with family members and have won them over.’ A parent said, `It’s a fantastic place. Everyone is happy to see you when you walk in.’

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Overall experiences and progress of children and young people: outstanding

The progress that young people make can be tracked and evidenced in the comprehensive planning documentation, coping strategies, assessments of individual risk and reports prepared monthly for social workers and families. More detailed reports are prepared for reviews. Diaries and skills books, coupled with lots of photographic evidence, give insight into the quality of life being experienced by young people. It is a Inspection report children's home: SC057718 4 quality of life that is enhanced by living in an inclusive, non-judgemental environment that promotes consultation, choice and celebrates personal achievement.

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Overall experiences and progress of children and young people: outstanding

Each young person is in full-time education at different schools and colleges within the locality. Attendance levels are exceptional, and any absences are due to illness. Continual progress can be tracked in various educational reports. Staff are prepared to put in considerable effort to ensure that a young person’s educational needs are best met. For example, the most suitable college placement identified for one young person is some distance from the home and does not include daily transport. Staff take it upon themselves to transport the young person to and from college daily. This is a reflection of the staff’s personal commitment to securing the best possible educational outcome for this particular young person.

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Overall experiences and progress of children and young people: outstanding

Staff work closely with the various educational staff they deal with. Communication levels are high, and the strong working partnerships created ensure that young people’s educational needs are fully supported in the home and that a consistency of care is retained. A headteacher from one of the schools commented, `I have excellent relationships with staff at [name of home] and high levels of communication. It doesn’t matter which staff you speak with, you get a full and detailed view and insight into the area being discussed. The strategies used by staff are spot on and based on staff knowing and understanding the young person. Staff are well trained, calm, and efficient and communicate well.’ She concluded her views by saying, `The home has a high standard of care. It’s well organised and managed, with a comfortable, homely feel to it when I visit. I deal with a number of children’s homes, this one is the best.’

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Overall experiences and progress of children and young people: outstanding

The arrangements made to promote young people’s health continue to be 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 and paediatric services, are brought in when required. Young people and staff are also supported by a range of specialist services provided by the trust that operates the home. For example, a clinical psychologist makes regular visits to the home.

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Overall experiences and progress of children and young people: outstanding

The home has access to, and the ability to bring in, specialist training for staff as various medical needs surface. For example, specialist epilepsy training took place during the inspection, to concentrate on the needs of a young person who is currently suffering from having seizures. These actions ensure that the skills of staff are enhanced and refreshed constantly so that they can meet the ever-changing medical and psychological needs of the young people in their care.

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Overall experiences and progress of children and young people: outstanding

Following a revision of the home’s policy, the procedures for storing, administering and recording medication are viewed as an area of improvement. This is due to improved monitoring coupled with additional training, consistent audit and the ongoing assessment of staff.

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Overall experiences and progress of children and young people: outstanding

The promotion of fitness and good health is an area championed by staff. All young people are active, and they enjoy being active. Group and individual activities encourage Inspection report children's home: SC057718 5 and promote fitness. For example, current popular activities are trampolining and walking. Generous staffing levels allow for individual needs and interests to be followed. For example, one young person regularly enjoys making use of trains and buses.

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Overall experiences and progress of children and young people: outstanding

Consultation with a group of young people who have very limited or no verbal communication continues to be an area of real strength. Excellent levels of communication exist between staff and young people, with both parties being able to fully understand the other. As a result, young people get to make daily choices that makes each day unique to them, for example in choosing clothes to wear, what to eat, what activity they wish to do. This is a home where consultation with young people is woven consistently into daily life, with young people constantly being encouraged to make choices and decisions. This helps them as they move towards greater independence and to take on some responsibility for themselves.

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Overall experiences and progress of children and young people: outstanding

Contact arrangements, although complex, at times are strong. For example, family members spoken with during the inspection confirmed that they are always made welcome. A parent described a thoughtful gesture by staff, which shows the impact that staff have made. She explained how on Mother’s Day she was presented with a large canvas picture. The picture was from an original photograph taken by staff of both her children together. This has turned into a prized possession.

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Overall experiences and progress of children and young people: outstanding

Guides to the home are provided in various formats that young people can understand. They contain pictures and information about the home that is presented in a child- friendly manner. They include information such as how to complain, along with contact details of external agencies.

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Overall experiences and progress of children and young people: outstanding

Developing the independence skills, confidence and self-esteem of a highly dependent group on admission continues to be a real strength of the home. Young people are encouraged to develop new skills that will enhance their independence. For example, one young person who has some communication difficulties has learned how to use the self-service facilities in supermarkets. This has reduced his anxiety and improved his shopping skills, as well as creating more opportunities for him to make choices.

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Overall experiences and progress of children and young people: outstanding

Transition from the home is handled well by staff. Recently, a young person moved in a planned way into a semi-independent living situation, with tenancy of his own home. Staff at the home worked with the new support staff to ensure that the young person’s needs are recognised, understood and can be met. This concluded many months of planning, consultation and work which ensured a smooth transition for the young person concerned, greatly reducing his stress levels.

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Overall experiences and progress of children and young people: outstanding

Young people benefit from living in an environment that takes account of their needs, with plenty of space which allows them some privacy. For example, certain lights that a young person needs to be switched on at certain times remain on. Bedrooms are single occupancy. They are equipped and personalised to suit the needs, taste and sensory tolerance of the occupant. Young people were observed as being relaxed and at ease in their surroundings, demonstrating ownership as they moved around the building. Inspection report children's home: SC057718 6

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How well children and young people are helped and protected: outstanding

Vulnerable young people are being kept safe at all times. Young people demonstrate that they feel safe with their movement and actions around the home and by their willingness to explore new experiences with staff. Their reluctance to move from their comfort zone diminishes, and this has the benefit of stretching their personal boundaries, which can be limited due to their autism. Parents and other professionals confirmed during discussions with the inspector that they were confident that young people are safe.

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How well children and young people are helped and protected: outstanding

Although safeguarding procedures have not been tested since the previous inspection, appropriate procedures are in place and staff understand their roles and responsibilities in keeping young people safe. Training is refreshed regularly. The home has the will and ability to act quickly on suggestions made to improve practice. For example, on the first day of inspection, the inspector suggested that the home should consider implementing ‘Prevent’ and radicalisation training for staff. When the second visit took place, all but one of the staff had completed the government-sponsored training.

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How well children and young people are helped and protected: outstanding

It is to the credit of everyone that no young people have gone missing from the home, despite the risk that they might. Generous staffing numbers, coupled with excellent organisation and deployment of staff, contribute significantly to this statistic. This is an example of the success that the home has in keeping its young people safe from harm. Despite this, each young person have suitable ‘assessments of risk’ and description cards that can be put to use immediately should they go missing. Staff have access to the necessary contact details if required.

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How well children and young people are helped and protected: outstanding

The management of behaviour is outstanding, and the home takes a complete non- punitive approach to bad behaviour. This means that the home works only with rewards and that sanctions are not imposed. Staff have a full understanding of why each young person behaves in a certain way and can equate behaviour with training and advice received, based on theoretical input.

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How well children and young people are helped and protected: outstanding

Staff receive regular advice from a visiting clinical psychologist. The benefit of this and from other visiting professionals is reflected in the behaviour management records for incidents such as physical intervention, serious incidents and self-harming episodes, which in this home are now almost non-existent. Although they can each be solitary at times, the group of young people get on well, and this is reflected with the increase of more joint activities being arranged. Bullying in the home is not a current issue.

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How well children and young people are helped and protected: outstanding

Staff retention overall is excellent, with young people benefiting from the consistency of the staff group and of care received. No new staff have been recruited since the previous inspection and any staff shortage, for example through sickness, is covered by regular staff. The home purposely does not use agency staff.

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How well children and young people are helped and protected: outstanding

Young people are living in a non-punitive, safe and caring environment in which their Inspection report children's home: SC057718 7 needs are identified and met. Detailed risk assessments are reviewed and updated regularly. Risks in and around the home, and in the wider community, are updated regularly. 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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The effectiveness of leaders and managers: outstanding

The home is very well managed by an experienced and deeply committed manager who leads by example. This has earned her the full respect of the staff team. Her aspirations for young people are high. The expectations for staff are the same, with high standards demanded and expected.

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The effectiveness of leaders and managers: outstanding

The whole organisation and management of the home is totally child-focused. This is achieved by the willingness of staff to buy into the ethos, culture and working practices developed in the home over the years. Young people’s needs are put first, and staff are prepared to work extra or flexibly so that those needs can be met. For example, during the recent hospitalisation of a young person, staff maintained a presence throughout the two-day hospital stay, supporting both the family who were in attendance and the young person concerned.

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The effectiveness of leaders and managers: outstanding

Staff and the management team work together cohesively, demonstrating a team- centred approach that is so beneficial to young people regarding the consistency of care that they receive. The morale of staff is high, and warmth that abounds throughout the home, which creates a happy and positive environment for young people.

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The effectiveness of leaders and managers: outstanding

Staff feel well supported by senior staff. The formal programme of supervision and appraisal takes place consistently. Informal support is part of the culture developed in the home. Communication levels between staff are high, which underpins the overall levels of support being received by staff.

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The effectiveness of leaders and managers: outstanding

The core staff-training programme is closely monitored by senior staff who are aware of any shortfall. Monthly team meetings are also utilised for training purposes, which can be linked directly to the current needs of young people. For example, at the last meeting, a specialist in epilepsy delivered a session that was tailored to reflect the current needs of young people. Putting theoretical models alongside the current practical needs of young people gives staff a greater insight into their specific condition and how best to manage it. This results in risk assessments and management strategies being reviewed and updated, which gives staff a greater understanding of young people’s needs.

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The effectiveness of leaders and managers: outstanding

The monitoring of the home, both internally and externally, is of a consistently high standard. Records are monitored regularly by senior staff who inject meaningful evaluation and comment. The manager is adept at taking on the external observations, linking them with her own views and evaluation of the home and then translating them into development plans. These plans identify strengths and areas for improvement.

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The effectiveness of leaders and managers: outstanding

The home has an excellent record of compliance. The one recommendation made at the Inspection report children's home: SC057718 8 previous inspection has been fully addressed, leading to an improvement in consistency regarding the overall management of medication. A number of new improvements and developments have been achieved since the last full inspection. For example, they include the development of a hospital passport for each young person and improvement to records which makes them more robust to external and historical scrutiny.

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The effectiveness of leaders and managers: outstanding

This is a home for children in its truest sense. Its whole operation centres on the needs of young people. All staff are child-centred in their thinking and in the way they act. An independent reviewing officer spoken with during the inspection described the home as `an excellent, unique service’. A parent summed up her feelings by saying, `The staff are extremely well trained, well supervised and maintain very high standards of care. The consistency of care they give to my son is vital for his development and the trust he shows in the staff.’

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the 'Social care common inspection framework', this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children's Homes (England) Regulations 2015 and the 'Guide to the children's homes regulations including the quality standards'. Inspection report children's home: SC057718 9

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Children's home details

Registered provider address: The Together Trust Centre, Schools Hill, Cheadle, Cheshire SK8 1JE

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Inspector(s)

Graham Robinson, social care inspector Inspection report children's home: SC057718 10 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children's services, and inspects services for looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

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