Children's Home run by Meadows Care Limited in Rochdale

Inspection report children’s home: SC390577 1 SC390577 Registered provider: Meadows Care Ltd

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

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Overall experiences and progress of

children and young people, taking into account

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Requires improvement to be good

How well children and young people are helped and protected Requires improvement to be good

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Requires improvement to be good

The effectiveness of leaders and managers Requires improvement to be good

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Requires improvement to be good

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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Requires improvement to be good

Date of last inspection: 11 January 2017

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Requires improvement to be good

Overall judgement at last inspection: Sustained effectiveness

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Requires improvement to be good

Enforcement action since last inspection: None

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Key findings from this inspection

This children’s home requires improvement to be good because Inspection report children’s home: SC390577 2  Staff do not consistently follow risk assessments. This has placed young people at risk of harm.  The registered manager has not always ensured that risk assessments accurately reflect the current management of risks.  Staff do not consistently respond promptly when faced with safeguarding concerns.  Some young people disengage from education. Staff do not effectively implement their education plans.  Staff do not ensure that young people’s health improves, and, in particular, that young people brush their teeth.  The registered manager’s monitoring of the care provided does not identify the ineffectiveness of reward systems or the lack of progress in key areas of young people’s progress.  The registered manager does not robustly review case records to ensure that they reflect an accurate picture of young people’s lives or review whether

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Key findings from this inspection

maintenance work is completed in a timely manner.

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Key findings from this inspection

 Staff develop positive relationships with young people. They are interested in young people and have a detailed understanding of their histories and behaviour.  Staff work effectively with therapists to provide therapeutic care in line with the home’s statement of purpose. This allows staff to manage young people’s behaviour in an individualised way.  Staff develop positive relationships with professional stakeholders and families.  Staff understand how to respond when young people are missing or absent from the home. They are proactive in looking for young people and in coordinating their response with the police and young people’s families.  Some young people make progress in managing their self-regulation.  The registered manager is proactive in addressing shortfalls. She has the capacity to take the necessary action to improve outcomes for young people.

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Inspection date Inspection type Inspection judgement

11/01/2017 Interim Sustained effectiveness 18/05/2016 Full Requires improvement 06/01/2016 Interim Sustained effectiveness 13/05/2015 Full Good Inspection report children’s home: SC390577 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In order to meet the protection of children standard, the registered provider must ensure that

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Requirement Due date

staff assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. In particular, they must ensure that risk assessments are accurate and up to date. (Regulation 12(1) and (2)(a)(i)) 30/06/2017

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In order to meet the protection of children standard, the registered provider must ensure that

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Requirement Due date

staff understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12(1) and (2)(a)(v)) 30/06/2017

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In order to meet the protection of children standard, the registered provider must ensure that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. In particular, they must ensure that staff follow risk assessments. (Regulation 12(1) and (2)(b)) 30/06/2017 Inspection report children’s home: SC390577 4 The leadership and management standard

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that (a) helps children aspire to fulfil their potential and (b) promotes their welfare.

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Requirement Due date

In order to meet the leadership and management standard, the registered person must ensure that the registered person

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Requirement Due date

uses monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1) and (2)(h)) 30/06/2017

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Requirement Due date

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

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Requirement Due date

staff help each child to achieve the child’s education and training targets, as recorded in the child’s relevant plans. (Regulation 8(1) and (2)(a)(i)) 30/06/2017

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Recommendations

 Staff should be familiar with the home’s policies on record-keeping and understand the importance of careful, objective, and clear recording. Information about the child must always be recorded in a way that will be helpful to the child. This is with particular reference to the setting and reviewing of achievable targets, which demonstrate how children are supported to achieve their targets. (‘Guide to the children’s homes regulations including the quality standards’, April 2015, page 62, paragraph 14.4)  Children’s homes staff should encourage children to take a proactive role in looking after their day-to-day health and well-being. Where children have specific health needs or conditions, they should be supported to manage these, subject to their age and understanding. In particular, they should ensure that young people brush their teeth and use specific toothpaste to improve their oral hygiene.

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Recommendations

(‘Guide to the children’s homes regulations including the quality standards’, April 2015, page 34, paragraph 7.10)  Staff should seek to meet the child’s basic needs in the way that a good parent would, recognising that many children in residential care have experienced environments where these needs have not been consistently met. Doing so is an important aspect of demonstrating that the staff care for the child and value them as an individual. In particular, they should address maintenance issues promptly. (‘Guide to the children’s homes regulations including the quality standards’, April 2015, page 15, paragraph 3.7) Inspection report children’s home: SC390577 5

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improvement to be good

Since the last inspection, one young person has left the home and another has joined the home. The young person left the home due to an increase in risk-taking behaviours, including self-harm and aggression between the young people. The registered manager planned her transition successfully to another home within the organisation, as she recognised the negative impact of living together on both young people.

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improvement to be good

The new young person who joined the home did so in a planned way, with consultation between young people’s social workers and a gradual transition into the home. The registered manager completed an impact risk assessment, which identified that the young people’s needs would not adversely impact on each other and that the existing young person’s good engagement with school would provide positive modelling. Since the new young person has joined the home, he has not engaged well with staff. This is despite the fact that he has known some staff for over 18 months from his previous placement in a sister home, and several of his core staff team moved with him. He is frequently absent from the home for days at a time. Although staff know where he is and encourage him to return, he remains absent and his basic needs are unmet. For example, he contacts staff and asks them to bring him food because he is hungry. He is

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improvement to be good

also missing school, because he is absent, at a crucial point in his education when he is due to take assessments towards functional skills awards.

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improvement to be good

Staff do not consistently follow risk assessments. There are numerous incidents when this occurs. For example, some staff allow young people to access the staff office where they take keys, money and a bank card and they take young people to see family members when risk assessments expressly state that they should not. Young people require consistent boundaries to feel secure, and staff do not promote their welfare when they provide inconsistent boundaries.

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improvement to be good

Some young people attend and engage well with education, following a dip at the point of the new young person joining the home. They are rightly proud of their achievements and one told me: ‘I’m pleased with how I have improved at school. I bought my teachers some flowers with my pocket money to thank them.’ Staff understand the need to promote family contact when that is in the interests of the young person; this promotes young people’s sense of identity.

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improvement to be good

Staff endeavour to promote young people’s health, with mixed results. Some young people engage well with therapeutic services to support their emotional needs. Staff persevere to ensure that young people attend the general practitioner (GP) and dentist as necessary, but young people refuse to take the treatment provided, which does not promote their health. Staff understand how to obtain young people’s wishes and feelings. They try to encourage them to achieve their personalised goals. This is mainly ineffective, and there are many weeks when young people do not achieve their targets. Inspection report children’s home: SC390577 6 For example, one young person has special toothpaste to improve his oral hygiene. However, he has not brushed his teeth at all for over four weeks.

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improvement to be good

Young people engage with the wider community infrequently. Occasionally, they go to the local arcades, to a farm or on a trip to Blackpool, but they do not regularly engage with clubs or hobbies. Staff offer young people opportunities, but they do not feel able to engage with them. Young people appear to have positive relationships with staff. They encourage young people to be involved in making choices on a day-to-day basis and in choosing how to decorate their bedrooms. There are a number of outstanding maintenance issues, which do not show young people that staff value them. For example, doors and doorframes remain unpainted for months.

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improvement to be good

Staff have a detailed understanding of young people’s histories and needs. They work effectively with therapists to provide individualised therapeutic care. The in-house therapist provides training in attachment, to support staff’s understanding of young people’s behaviour. She recognises the impact of their care: ‘The team [has] a good understanding of the therapeutic needs of the young people. They are able to be reflective looking at the attachment needs of the young people and the impact of the work on their own emotional state in terms of tuning in to self as well as the young people.’ This supports some young people to develop improved emotional resilience so that they are able to live with others. One young person said to me: ‘I have been well. I have moved to a dual (from a solo) placement. It is good.’ This represents significant progress from the starting point of this young person.

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improvement to be good

The registered manager and staff identify risks associated with young people’s behaviour and needs. They update risk assessments. However, these are not always clear as to what current action is required to minimise the risk. For example, risk assessments regarding allegations state that waking staff will be in place at night. However, this is no longer the case. Risk assessments clearly state that young people should always be supervised when they are with other young people. However, staff do not consistently follow this risk assessment and they have allowed young people to be alone in their bedrooms with friends, whom they subsequently allege have inappropriately touched them. This does not safeguard young people or promote their welfare.

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improvement to be good

The registered manager safely recruits new staff. There have been a number of changes to the core staff team, which have in part been to meet young people’s needs as they have moved with them from another home within the company. There have been 34 different staff members working in the home in the last four months. This does not promote stability or consistency for young people.

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improvement to be good

Staff understand what to do when young people are missing or absent from the home. They maintain contact with young people as far as possible and with their families and friends. Staff go and look for young people in familiar places and try to encourage them to return home. They share concerns with placing authorities about where young people Inspection report children’s home: SC390577 7 spend their time, but this is not robustly managed by the placing authorities, and young people continue to be absent from the home for days at a time. For example, in the last month, one young person has been absent for 18 nights. The registered manager has escalated this with the placing authority and is aware of the need for further multi- disciplinary strategy meetings to review the young person’s plan. Staff have positive relationships with the local police. They maintain regular contact with them so that they

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improvement to be good

know each young person living in the home. The police attend strategy meetings and provide information to help to safeguard young people.

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improvement to be good

Staff encourage young people to take age-appropriate risks and to develop their skills in independent living so that they are prepared for adult life. Young people make some progress with these skills. However, safeguarding concerns mean that young people are no longer able to have money to spend. Staff’s detailed knowledge of them enables most staff to use de-escalation techniques effectively. As a result, staff need to use physical intervention infrequently. This reflects some young people’s improved emotional resilience and self-regulation.

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improvement to be good

Staff do not always follow safeguarding procedures. For example, staff do not understand the need for robust action when they injure young people during an incident. As a result, on one occasion, staff did not inform the placing authority for 14 hours. This does not allow the placing authority to take immediate action to support the young person or to instigate child protection procedures, if necessary. The registered manager does, however, understand the role of the designated officer and ensures that she refers all concerns regarding staff’s behaviour to her. She also notifies Ofsted in a timely manner, so that the regulator is able to monitor trends and patterns of incidents in the home.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has been in post for a few months and has completed the registration process with Ofsted this month. Thus, she is now the registered manager. She is suitably experienced and is currently completing the level 5 diploma in leadership and management in residential childcare. The registered manager ensures that her team has completed training which is specific to young people’s needs. She has identified where there are weaknesses in staff’s knowledge and practice and arranged training in team meetings regarding safeguarding. The registered manager takes disciplinary action appropriately to deal with staff’s shortfalls; this has been necessary on a number of occasions. Staff receive regular supervision to aid their development and improve their practice. Staff report working in a supportive environment with good levels of supervision and training.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager understands young people’s care plans and the overall progress that they are making. She works with placing authorities and education providers to address young people’s poor engagement, but this is not always effective and one young person’s education attendance has fallen to 11%. She has escalated her concerns with the placing authority to arrange an urgent review of the young person’s care plan. Inspection report children’s home: SC390577 8 The registered manager has in place systems to monitor and review the quality of care provided. She has made some progress with addressing the shortfalls identified at the last inspection. However, staff’s timely action when managing safeguarding concerns remains a shortfall. In addition, the registered manager’s monitoring is not consistently leading to improvements to the quality of care provided, for example, the content of and staff’s adherence to risk assessments, the effectiveness of reward systems to improve

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The effectiveness of leaders and managers: requires improvement to be good

young people’s outcomes or direct work sessions to improve young people’s understanding of their behaviour. However, she has the capacity to address these shortfalls.

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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 whom 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: SC390577 9

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Children’s home details

Registered provider address: Meadows Care Ltd, Egerton House, Wardle Road, Rochdale OL12 9EN

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Children’s home details

Responsible individual: Niel Shelmerdine

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Inspector

Rebecca Quested, social care inspector Inspection report children’s home: SC390577 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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