Children's Home run by The Together Trust in Stockport

Inspection report children‟s home: SC008575 1 SC008575 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

This children‟s home is run by a charitable organisation and is registered to provide care and accommodation for five young people who may have physical disabilities and/or learning disabilities and/or sensory impairment. The home provides short-term breaks.

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Information about this children’s home

Inspection dates: 29 to 30 November 2017

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children‟s home provides effective services that meet the requirements for good.

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good

Date of last inspection: 27 February 2017

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good

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection:

None Inspection report children‟s home: SC008575 2

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Key findings from this inspection

 Children and young people are well cared for in a safe, supportive and nurturing environment.  All children and young people are treated with dignity and respect. The care they receive is responsive to their needs.  The manager and staff have effective working relationships with parents, carers and placing authorities.  Observations confirm that children and young people enjoy positive relationships with all the staff.  The safety and well-being of children and young people is at the centre of staff practice.  Effective transition planning ensures minimal disruption in the lives of children and young people.  Arrangements for the administration of medication are generally sound.  The registered manager is highly motivated and effective.

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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

 The manager has not routinely reviewed the use of an audio monitoring tool to ensure that this measure is proportionate to an individual‟s needs.  Care plans, particularly for children and young people who have complex health needs, do not clearly demonstrate how these should be managed by the staff. This specifically relates to gastrostomy management.  Restraint records do not show that within five days of the use of the measure being used the child or young person was spoken to.  Improvements to some of the home‟s records are needed. For example, not all staff have signed the personal evacuation plans to show they have read and understood them.

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Inspection date Inspection type Inspection judgement

27/02/2017 Interim Sustained effectiveness 09/08/2016 Full Good 22/03/2016 Interim Not judged 17/11/2015 Full Good Inspection report children‟s home: SC008575 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 registered person may only use devices for the monitoring or surveillance of children if the monitoring or surveillance is no more intrusive than necessary, having regard to the child‟s need for privacy. (Regulation 24(1)(d)) 31/01/2018

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Requirement Due date

The registered person must ensure that within five days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35(3)) 31/01/2018

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Recommendations

 Staff should continually and actively assess the risks to each child and the arrangements in place to protect them; specifically in relation to gastrostomy management. („Guide to the children‟s home regulations including the quality standards‟, page 42, paragraph 9.5)

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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. 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. („Guide to the children‟s home regulations including the quality standards‟, page 62, paragraph 14.4)

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Overall experiences and progress of children and young people: good

Children and young people receive a good level of individualised care and support while living here or enjoying their short breaks. Staff provide a warm, nurturing environment that is child-centred. This enables children to make good progress and benefit from their stay at the home. One parent said, „They [staff] have worked wonders. He has come on leaps. He‟s learning more control and to respect his environment. Relationships with the staff are good.‟ A social worker commented, „All parents have informed me that they are very happy with the service that they receive, and that staff go out of their way to help.‟ Inspection report children‟s home: SC008575 4 One young person currently lives at the home; they engage well with those children and young people who come to stay on short breaks. Staff carefully plan children and young people‟s stays. This helps to support and build children and young people‟s friendships.

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Overall experiences and progress of children and young people: good

Children and young people accessing the service have a range of complex health needs. Care plans set out individual needs and ensure that the staff have the necessary information to meet the health needs of each child and young person. The staff team is well trained in both first aid and the safe administration of medication. Medication errors are rare. However, when they have occurred these have been addressed promptly. Investigations have taken place to ensure that lessons are learned to improve practice.

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Overall experiences and progress of children and young people: good

The home provides a nurturing and stimulating environment for children and young people who have a range of disabilities. Children and young people are able to find their way around the home with ease. The garden is well equipped with specialist play equipment that enables children and young people to relax and play.

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Overall experiences and progress of children and young people: good

Children and young people are offered a full range of activities and experiences within both the home and the community. They enjoy relaxing in the sensory space, as well as listening to music, watching television and playing computer games. The children and young people also enjoy trips out, including going shopping and visiting places of interest. During the inspection, staff were observed offering children and young people activity choices, including taking part in the music group or having time to themselves. The opportunities offered to children and young people help them to establish their own personalities and identities. A social worker commented, „Staff always ensure that the children have an enjoyable stay. Staff always try to encourage the child‟s interests and they support them to attend activities that they enjoy, such as swimming.‟

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Overall experiences and progress of children and young people: good

Interaction between young people and staff is extremely positive and supportive. Children and young people who have little or no verbal communication were observed seeking out staff for help and re-assurance. Staff are beginning to use a variety of communication methods with individual children and young people, including pictures and symbols as prompts. However, the management team recognises this requires further development in order to help the staff communicate more effectively with children and young people.

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Overall experiences and progress of children and young people: good

Care planning and practice are personalised to meet the individual needs of each child and young person. Staff contact parents prior to their child‟s short break to ascertain if there have been any changes to their care needs. This ensures that staff have the most up-to-date information to care for each child and young person appropriately. A social worker commented, „I have found [name of home] staff to be very effective at meeting children‟s needs. They adapt their service for each child.‟

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Overall experiences and progress of children and young people: good

Education and healthcare remain the responsibility of parents or carers, with the exception of the young person living at the home. Prior to living at the home, the young person had missed a large amount of education due to ill health. The registered manager is working with education professionals to identify a suitable education Inspection report children‟s home: SC008575 5 provision, but this is proving be a challenge. In the meantime, the young person has been provided with a tutor to try to improve his outcomes in this area.

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

Children and young people are safe and feel secure because the staff promote their safety and well-being effectively. Many of the children and young people have complex health needs, which means they are fully dependent on the staff for all of their care needs. However, there is no specific risk management plan in place in relation to gastrostomy management. That said, the staff are very confident and competent with this procedure, which helps specific young people to feel comfortable and suitably nourished.

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

The registered manager reports that there have been no safeguarding concerns. Staff use additional safety measures, such as audio monitoring. Although staff gain parental consent for the use, they do not routinely review this measure to ensure that it continues to be proportionate to an individual‟s needs and protects their privacy.

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

There are no incidents of children and young people going missing from the home. Clear procedures are in place, and these are known and understood by all the staff. Excellent levels of supervision ensure that children and young people‟s safety is maintained both inside and outside the home.

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

Staff are well trained in positive behaviour management. They do not use sanctions to modify behaviour. Positive and proactive behaviour management strategies are consistently applied. Staff are skilled at recognising when a child or young person is becoming upset, and can often use re-direction or reassurance to prevent the behaviour from escalating. However, there are times when a child or young person‟s behaviour becomes a risk to themselves or others and physical intervention is necessary to prevent harm. Records do not show that within five days of the use of the measure being used that the child or young person was spoken to. Furthermore, records do not use plain language to describe the techniques used by staff when trying to defuse challenging situations; instead, they use phrases such as „used his long shin bone‟. This does not provide the reader with a clear picture of the intervention used.

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

The organisation has a robust recruitment and selection process for the employment of new staff. Staff ensure that visitors provide identification before entering the home and are suitably monitored throughout their visit. This ensures the safety of children and young people accessing the service.

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

The home is safe and regularly monitored to ensure that hazards are minimised. Staff are required to sign risk assessments to demonstrate that they have read and understood them. However, the personal evacuation plans have not been signed by all the staff. If staff are unaware of the risk management guidelines, then they cannot always follow them within their practice. Inspection report children‟s home: SC008575 6

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The effectiveness of leaders and managers: good

The home is managed by a suitably qualified and experienced manager. She brings a wealth of knowledge and experience to the role. A deputy manager supports the manager in her role. Together they show an ambitious vision and have high expectations of their staff team.

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The effectiveness of leaders and managers: good

The home is well resourced and is achieving its aims and objectives as set out in the statement of purpose. There have been some changes to the staff team since the last inspection. That said, staff combine a good range of experience and skill to provide good quality care for children and young people. Most staff have the required qualifications, while suitable plans are in place to ensure that others achieve these within the required time frame.

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The effectiveness of leaders and managers: good

Professionals and parents are very complimentary about the service and levels of communication. The management team has developed good working relationships with parents and social workers. A parent said, „They‟re a life saver. He does call this setting “home”. He gets lots of attention. Each member of staff brings a different thing.‟ A social worker commented, „Quality of engagement is very good with parents and professionals. Staff always keep in touch with social workers and they ensure that we are kept updated. Staff always attend meetings, such as child in need meetings, and they provide a comprehensive report.‟

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The effectiveness of leaders and managers: good

Monthly independent monitoring of the service evaluates effectively the care and support provided. This enables the managers to take positive action to secure any future improvements. The management team strives for continuous improvement and have a good understanding of the strengths and weaknesses of the service. The registered manager monitors the quality and impact of the service, and any shortfalls identified are addressed at the team meetings or during individual staff supervision sessions.

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The effectiveness of leaders and managers: good

The registered manager has addressed the recommendations made at the last inspection. The staff team provides consistent and nurturing care to all children and young people. Children and young people are valued and receive high-quality care and protection.

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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 differences 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. Inspection report children‟s home: SC008575 7 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

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Information about this inspection

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: SC008575 8

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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

Michelle Bacon, social care inspector Inspection report children‟s home: SC008575 9 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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