Children's home run by Meadows Care Limited in Rochdale

Inspection report children‟s home: SC063054 1 SC063054 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

This is one of a number of children‟s homes operated by a private company. The home is registered to provide care and accommodation for one child or young person who has emotional and/or behavioural difficulties and/or learning disabilities.

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Information about this children’s home

If required, children and young people can access the organisation‟s school and therapy department.

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Information about this children’s home

Inspection dates: 13 to 14 December 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 good

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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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Enforcement action since last inspection:

None. Inspection report children‟s home: SC063054 2

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Key findings from this inspection

This children‟s home is outstanding because:

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Key findings from this inspection

 The experience of living at this home has had a significant impact on the young person‟s life. This is because the manager and staff are consistent in the delivery of a highly child-focused and multi-agency approach to care planning and service delivery.

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Key findings from this inspection

 Care practice is underpinned by reciprocal and meaningful attachments between the young person and staff. This has contributed to the young person developing a strong sense of security that is enabling her to accept support from the highly motivated and caring staff team.

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Key findings from this inspection

 Links with partnership agencies are strong. Feedback from professionals is highly complimentary about all aspects of the home, where the manager is a tenacious advocate in ensuring that the young person‟s best interests are always given priority.

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Key findings from this inspection

 Well-integrated therapeutic support promotes emotional growth, stability and well-being.

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Key findings from this inspection

 The young person‟s safety is consistently promoted through a range of professionally informed and well-thought-out risk management strategies that are designed to safely manage the young person‟s complex behaviours, risks and vulnerabilities. These strategies have been effective in reducing a number of concerning behaviours.

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Key findings from this inspection

 The young person‟s views and opinions are routinely sought and considered as part of the day-to-day running of the home and decision-making about her care.

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Key findings from this inspection

 The manager provides good leadership for a small team of dedicated staff who are passionate about their work with the young person. Staff are aspirational for the young person and take a parent-like approach to supporting and facilitating her development and achieving positive outcomes.

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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 been sufficiently proactive in ensuring that the placing authority provides up-to-date information in relation to children-looked-after minutes and the deprivation of liberty order. Consequently, the young person‟s case records are incomplete. Inspection report children‟s home: SC063054 3

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Inspection date Inspection type Inspection judgement

16/03/2017 Interim Improved effectiveness 05/07/2016 Full Good 25/01/2016 Interim Improved effectiveness 20/07/2015 Full Requires improvement Inspection report children‟s home: SC063054 4

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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 must maintain records (“case records”) for each child which are kept up to date. (Regulation 36(1)(b)) 17/01/2018

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Recommendations

 Where the placing authority does not provide the input and services needed to meet a child‟s needs during their time in the home, the home must challenge them to meet the child‟s needs. („Guide to the children‟s homes regulations including the quality standards‟, page 12, paragraph 2.8). This is with particular reference to acquiring all outstanding case records.

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Overall experiences and progress of children and young people: outstanding

The young person has been living at this home for over two years and clearly regards this as her home. She has benefited significantly from the highly personalised and child- focused package of support she has received in this solo placement. The manager and staff have an insightful understanding of the young person‟s complex and unique needs. They have been tenacious in their efforts to ensure that all those involved in her care are doing their utmost to support her progress and development. This has resulted in the young person making significant progress in many aspects of her life, relative to her starting point and specific needs. Her readiness to return to a group-living home, which is currently being planned, is testament to this.

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Overall experiences and progress of children and young people: outstanding

A major factor in the young person‟s success is the stability and sense of security she feels. This has come as a result of the strong, parent-like attachments she has with staff who care a great deal for her. An independent reviewing officer said: „I am really impressed and this has been a really successful placement. I can‟t speak highly enough of the staff. The biggest impact on [name] is the staff team itself. [Name] is not easy but they are committed and have stuck with her. They are genuinely interested in her achieving good outcomes and constantly push to ensure [name] has positive experiences.‟ Inspection report children‟s home: SC063054 5 The young person‟s views, opinions, likes and dislikes are integral to the day-to-day running of the home. Staff are genuinely interested in what the young person has to say, and take every opportunity to engage her in family-like discussions. She is involved

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Overall experiences and progress of children and young people: outstanding

in making decisions, such as planning meals and activities and choosing the décor of the home. Staff enable the young person to share her views about her care, and make sure that these are fully represented and considered as part of the care planning process. This ensures that her best interests are at the heart of all decisions made. Staff have made arrangements for the young person to have an independent visitor, although she chooses not to access this service currently.

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Overall experiences and progress of children and young people: outstanding

Partnership working has been highly effective in promoting education attendance and progress. The manager and staff recognise the importance of education. They work collaboratively with teaching staff to ensure that the right level of encouragement and support is provided. They are good at recognising potential barriers to participation and are proactive in their efforts to overcome these. This has contributed to the young person making very good progress in terms of her learning and behaviour. A headteacher said: „Staff have always supported education and emphasised its importance. They have high expectations of [name‟s] behaviour and have been really supportive of us in the management of this. This joint approach has changed things for the better. They want her to progress and do their best to give her the opportunities she needs. They could not have been more supportive and always want her to do well. She has travelled a great deal both in terms of education and her home life.‟

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Overall experiences and progress of children and young people: outstanding

Staff ensure that the young person‟s health needs are monitored and consistently met. They provide the necessary support to ensure that she can attend routine appointments and access specialist healthcare professionals such as paediatricians and the in-house therapy team. The work undertaken by the organisation‟s art therapist, in conjunction with the staff team, has been particularly beneficial in improving the young person‟s emotional well-being. This work has enabled staff to gain a comprehensive understanding of the young person‟s unique and often challenging and concerning behaviours, risks and vulnerabilities. They have worked closely with the therapist to develop and implement well-thought-out strategies of support, and these have been effective in managing and reducing many behaviours and risks. The therapist said: „The team are very committed to caring for and supporting [name]. Staff are much attuned to [name‟s] needs and show compassion and empathy when faced

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Overall experiences and progress of children and young people: outstanding

with her challenging behaviour. [Name] has made significant progress, in particular over the spring and summer.‟

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Overall experiences and progress of children and young people: outstanding

She went on to say: „[Name] will always ask questions and her team are brilliant at offering conversational opportunities for learning.‟

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Overall experiences and progress of children and young people: outstanding

Staff recognise the importance of family relationships and provide good support in ensuring that these can be maintained when it is appropriate to do so. They are working hard to help the young person understand past relationships and have been successful Inspection report children‟s home: SC063054 6 in helping her to re-establish contact with key family members. The independent reviewing officer said: „Particularly positive is the work around introducing contact with mum. This has happened as a result of using life story work to help [name]. As part of this they have really considered mum‟s needs, working around these and providing her with the required support.‟

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Overall experiences and progress of children and young people: outstanding

Staff enjoy spending time with the young person and provide her with lots of opportunities to enjoy fun and purposeful activities with them. However, they are mindful that she needs to spend time with young people of her own age and have made good use of clubs, such as guides, to facilitate this. Given her vulnerabilities, it is a credit to the young person and the efforts of staff that the need for direct support while at guides has reduced significantly. Staff are aware of the need to build on this and reduce further the reliance on staff support, in order to increase the young person‟s levels of independence, and well-thought-out plans are in place to promote this.

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

The young person is happy and safe in this home. The manager and staff have a thorough understanding of their safeguarding responsibilities and are fully committed to, and highly effective in promoting, the young person‟s safety and well-being. There have been no safeguarding concerns, complaints or allegations since the last inspection, and links with external safeguarding agencies and professionals are in place, should there be any in the future.

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

There have been no incidents of the young person going missing from home since the last inspection. This is primarily down to high levels of supervision and engagement in positive activities, but is also an indicator of how settled she is. Staff do not lose sight of the need to balance the management of risk against the need to take age-appropriate risks. They are proactive in their efforts to educate the young person and raise her awareness of risks in the community, such as stranger danger and road safety.

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

Managing risk and keeping the young person safe are integral to care planning and day- to-day practice. All staff have a comprehensive understanding of the young person‟s behaviours, risks and vulnerabilities, and give the management of these the utmost priority. Staff are well trained, and benefit from the input of qualified therapists who provide advice, guidance and support in the management of risk-taking behaviours such as self-harm, aggression and sexualised behaviour. Staff implement well-thought-out risk management strategies which are clearly having a positive impact on reducing these types of behaviour.

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

Staff act as positive role models for the young person, and encourage her to behave in a sociably acceptable manner. They provide her with positive praise and recognition and give subtle reminders about expectations, to keep her focused and on task. Unacceptable behaviour is challenged in a parent-like manner that encourages the young person to develop a concept of right and wrong, and consider how her actions impact on others. Over time the young person has developed better empathy and understanding, Inspection report children‟s home: SC063054 7 which is indicative in her tendency to now apologise without prompting from staff.

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

Staff are very calm and caring in their approach to managing challenging behaviour, and the young person responds positively to this. Staff are able to recognise and respond to changes in behaviour, and make every effort to avoid physical restraint. When restraint is used it is always as a last resort, and is done in a sensitive and caring manner. Indeed, it is testament to the staff‟s unconditional care for the young person that incidents of crisis, which have included attacks on staff, rarely result in staff taking actual hold of the young person. This is because staff understand the motivational factors of her behaviour and make excellent use of strategies such as breakaway techniques, distraction and planned ignoring. All incidents are followed up with meaningful discussions which encourage the young person to reflect, and find alternative ways of managing her behaviour. The effectiveness of this approach is evident in how incidents

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

of challenging behaviour have decreased in frequency, but more significantly in their levels of severity. An independent reviewing officer said: „This is not merely a job for staff. Despite [name‟s] behaviour and challenge staff remain interested in her and stick with it. The manager, staff and therapist all know her really well and are constantly looking for ways to support her. When an approach doesn‟t work staff will work with the therapist and find an alternative approach.‟

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

Safer recruitment practice is followed to ensure that only those suitable to work with this vulnerable young person do so. Two staff have been appointed since the last inspection. Both have been subject to careful vetting and are in the process of completing a suitable induction and probation pathway.

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The effectiveness of leaders and managers: good

The home is run by an experienced and now suitably qualified registered manager who has been in post since March 2015. He is also registered for a second home within the company, and successfully divides his time between the two. Plans are in place to resign the registration of this home, which is due to close in March 2018. As part of this process the young person will move to the manager‟s other home as part of a needs-sensitive transition plan. At appropriate times the manager will consult with the young person and those in his other home, to ensure that they are well prepared and supported through this period of change.

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The effectiveness of leaders and managers: good

The manager is dedicated to meeting the young person‟s needs. He provides good leadership and is fully committed to promoting quality care that places the needs of the young person at the heart of care practice. He is routinely involved in all aspects of care planning and is a strong advocate for the young person. He makes sure the young person‟s needs are understood and that external networks of support are in place for her. Professionals confirm that the manager is proactive in promoting a multi-agency approach to care planning, which is based on the principles of assessment, monitoring and review. He is persistent in his efforts to ensure that all aspects of the young person‟s needs are being met, and that all those involved are working to a plan that is in the best interest of the young person. A health professional said: Inspection report children‟s home: SC063054 8 „The manager has been a strong advocate for [name‟s] needs and it was through

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The effectiveness of leaders and managers: good

his hard work that issues have been escalated ensuring [name] got the right assessments.‟

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The effectiveness of leaders and managers: good

Talking about the same subject, an independent reviewing officer said: „The manager and staff have been tenacious in challenging health organisations, making sure that [name‟s] needs are not compromised.‟

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The effectiveness of leaders and managers: good

The young person benefits from two-to-one support from a competent and well- established staff team whose members each have a comprehensive understanding of her needs. In order to maintain continuity of care, four of the current team will move with the young person to her new home early next year. Staff demonstrate a genuine warmth and affection towards this young person and are extremely proud of all that she has achieved, and how they have contributed to this. One member of staff, who had returned to working at the home after leaving, attributed her decision for returning to missing the sense of satisfaction she got from seeing this young person improve.

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The effectiveness of leaders and managers: good

Staff hold the manager in high regard and confirm that he provides them with clear direction and high levels of support, including purposeful supervision that focuses on improving practice. Opportunities for staff to maintain and improve their skills and knowledge are readily available to them. Mandatory training, such as first aid, safeguarding and the use of restraint, are kept up to date to ensure that practice is current. Staff have also completed a range of training that is specific to the needs of this young person. This training is continually assessed, and where necessary revisited, to ensure that staff have the right knowledge and skills to respond to the young person‟s known and emerging needs. In addition to the manager, only two of the seven staff have a level 3 qualification. Arrangements are in place to ensure that the remaining team members acquire this qualification within legislative timescales.

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The effectiveness of leaders and managers: good

The manager has a good understanding of what the home does well. He makes good use of a range of quality assurance processes to ensure that all aspects of the home‟s performance and the young person‟s progress are routinely monitored, evaluated and evidenced. When areas for improvement are identified the manager is generally quick to address these in most instances. For example, suitable action has been taken to address the two requirements from the interim inspection in March 2017, although one had been raised previously at the full inspection in July 2016. Consequently, staff rotas now detail clearly when temporary staff have worked in the home to cover shortfalls, and records pertaining to changes to prescribed medication now include written confirmation from the prescribing practitioner.

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The effectiveness of leaders and managers: good

Overall, the young person‟s case records and other written documentation are of a good standard. They provide a comprehensive insight into the young person‟s history, current needs and future plans. A range of professionals contribute to these records, which promotes a collaborative approach to all aspects of care planning. The manager is generally good at acquiring information from the placing authority, and when necessary has presented professional challenge. This is with the exception of the children-looked- after review minutes from July 2017 and the most recent information relating to the Inspection report children‟s home: SC063054 9 deprivation of liberty order, neither of which are currently on file. The absence of these documents has not had any direct impact on the safety of care. This is because of the constant dialogue between the home and the placing social worker, and because risk management is already high on the staff‟s agenda.

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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.

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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: SC063054 10

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Children’s home details

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

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Inspector(s)

Paul Scott, social care inspector Inspection report children‟s home: SC063054 11 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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