Children's home run by Nestlings Care BC Limited in Trafford

Inspection report children’s home: SC473473 1 SC473473 Registered provider: Nestlings Care Limited, company number 07252721 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 accommodate three young people who have a mental disorder. The home is privately owned. The home is a specialist residential care service, working in partnership with young people and all relevant agencies.

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Information about this children’s home

The home provides 24-hour support by consultant psychiatrist and registered mental health nurses, providing a level of comprehensive care as written in the home’s statement of purpose.

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Information about this children’s home

The home is also registered with the Care Quality Commission (CQC). A report on how the home meets the fundamental standards of quality and safety is available from the CQC.

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Information about this children’s home

Inspection dates: 27 to 28 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

Overall judgement at last inspection: sustained effectiveness

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Enforcement action since last inspection:

None. Inspection report children’s home: SC473473 2

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Key findings from this inspection

 Young people appear happy and comfortable at their home. The progress that they make from when they first moved into the home is significant. Young people continue to make good progress while living at the home.  Young people receive care from staff who understand their specific needs, and the staff and young people themselves have very positive relationships with each other. The young people experience warm and affectionate relationships with the staff.  Young people are confident in sharing their wishes and feelings about the care that they receive, the activities that they do and the food that they eat.  Young people take part in a good variety of activities. Staff support them to plan holidays and activities.  Staff prioritise young people’s health needs and education. This supports the young people to access local services to meet their physical health needs and to continue their learning.  In-house therapy services provide young people with prompt access to specialist

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Key findings from this inspection

emotional support when they need it.  Staff work collaboratively with internal and external professionals, and young people’s care plans reflect the joined-up approach.  The staff and young people have a positive regard for each other. This supports the young people to build on their emotional resilience. This approach has significantly reduced self-harm incidents in which young people place themselves and others at risk.  Young people have lived at this home for a long period of time. They have benefited from the stability that it has provided for them and from good staff support. Young people have been prepared well by staff to move on to the next phase of their lives.  The young people’s safety and well-being are at the centre of the staff’s practice. Young people have significantly reduced harmful risk-taking behaviours. They are supported to manage their own safety effectively.  The home is managed well. The leadership team is experienced and the new

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Key findings from this inspection

staff are within timescales to complete their relevant qualification.  The staff team is led by an experienced registered manager who has aspirations and a detailed knowledge of every aspect of the home’s operation. She is committed to achieving high standards of care for the young people.

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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 independent person must make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the young Inspection report children’s home: SC473473 3 people in the home’s care.  The decoration and fixtures of the home are in need of attention, so that the young people have a homely environment.

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Inspection date Inspection type Inspection judgement

22/03/2017 Interim Sustained effectiveness 31/10/2016 Full Good 07/03/2016 Interim Declined in effectiveness 28/10/2015 Full Good Inspection report children’s home: SC473473 4

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Statutory requirements

This section sets out the actions that the registered person 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 must comply within the given timescales.

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Requirement Due date

44: Independent person: visits and reports

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Requirement Due date

The independent person should interview in private the children, their parents, relatives and persons working at the home. The independent person must produce a report about a visit which sets out, in particular, the independent person’s opinion as to whether children are effectively safeguarded and the conduct of the home promotes children’s well-being. The report may recommend actions that the registered person may take in relation to the home and timescales within which the registered person must consider whether or not to take those actions. (Regulation 44(a), (4)(a)(b), (5)) 05/01/2018

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Requirement Due date

6: The quality and purpose of care standard

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Requirement Due date

Ensure that the premises used for the purposes of the home are designed and furnished so as to— (i) meet the needs of each child. (Regulation 6(2)(c)(i))

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Requirement Due date

This is in relation to the decor and carpets of the home. 28/02/2018

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Overall experiences and progress of children and young people: good

Young people’s overall day-to-day experience of living at the home is positive, and they are making good progress. The registered manager and staff work in partnership with the young people’s placing authorities and their families. These relationships enable staff to provide personalised care that supports and reflects young people’s many and often complex needs. Young people who have lived at the home for a period of time and those who have recently arrived at the home have developed sound, warm and affectionate relationships with the staff, and all of the young people are engaging in their plans.

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Overall experiences and progress of children and young people: good

The voice of young people is sought by staff, who work closely with young people. Staff Inspection report children’s home: SC473473 5 have frequent, purposeful conversations with young people, who talk to staff about their wishes, feelings and aspirations and the highs and lows of each day. Young people are encouraged to personalise their bedrooms and living spaces. They choose their weekly menus and activities. Staff have routine arrangements in place for formal key-work sessions, with clear aims and objectives to educate young people about social issues and the wider world in which they live. These key-worker sessions are recorded as one-to- one conversations and show the progress that the young people are making.

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Overall experiences and progress of children and young people: good

Young people have good-quality day-to-day experiences and agree their daily and weekly education and activity planners. The home has its own activity coordinator to support the young people through this process. Collectively, the young people told the inspector that they like living at this home, and all said that they feel well cared for and that the home’s atmosphere is very happy and calm. Individually, the young people commented:

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Overall experiences and progress of children and young people: good

 ‘I really like my home. I get to do lots of happy things which I love and the staff are the best ever.’

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Overall experiences and progress of children and young people: good

 ‘I can now look after myself, I enjoy cooking for others and staff are always there to help me. I don’t know what I would do without them.’

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Overall experiences and progress of children and young people: good

 ‘I have settled here, the staff are very kind and caring. The wi-fi can be slow, but there are lots of other things to do if I get bored.’

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Overall experiences and progress of children and young people: good

The home is decorated and maintained to an acceptable standard, but plans are in place to improve the decor and furnishings of the home. All young people have double bedrooms that are decorated and furnished in line with their individual choices. The cleanliness of bathrooms was identified at the last inspection in March 2017, as at that time the bathrooms were reported not to be clean. The young people’s bathrooms and en suite facilities were clean and tidy during this inspection.

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Overall experiences and progress of children and young people: good

The registered manager and staff are dedicated to the individual and group needs of the young people. All of the young people are encouraged to lead an active and healthy lifestyle. Staff have supported the young people to change their diets and enjoy regular exercise, and clear health benefits are enjoyed by the young people. Young people enjoy a good variety of activities, both inside and outside the home, including clubs and local leisure facilities. The young people enjoyed a summer holiday abroad. If young people lose interest in their hobbies, the staff encourage them to find new interests. This means that young people enjoy a wide range of exciting opportunities that support their self- worth and build their self-confidence.

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Overall experiences and progress of children and young people: good

Young people are making progress in their education. All of the young people have excellent educational attendance, which is a significant achievement for those young people who previously missed out on education. The communication between staff and their education colleagues is extremely effective and ensures that young people receive consistent support to enable them to reach their potential. Young people’s education is enhanced outside of learning environment, and some enjoy drama, while others are Inspection report children’s home: SC473473 6 supported to learn about and care for their pets. One young person who has moved on from the home now attends university, and another young person living at the home has an ambition to go to university.

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Overall experiences and progress of children and young people: good

Young people are encouraged to develop their independence skills at a pace that suits their individual age, needs and abilities. Small steps have achievable goals, such as making and changing bedding, keeping their bedroom tidy and personal presentation and hygiene. Other young people design creative menus, cook for staff and themselves, and take more responsibility for budgeting. These opportunities enable the young people to take on appropriate levels of responsibility to develop their life skills for the future. Careful planning leads to the young people’s smooth transition when moving on from the home. Likewise, partnership working with the local clinical commissioning group prepares young people, often from hospital admissions, to have a planned introduction to the home.

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Overall experiences and progress of children and young people: good

The staff know and understand how the young people’s life experiences have affected their behaviour and emotional well-being. Care planning for young people focuses on minimising the negative impact that past experiences have had on their overall well- being. Young people’s specific needs are identified and met immediately at the home. This is achieved by having a clinical governance team working at the home. Registered mental health nurses, occupational therapists, clinical psychologists and a consultant child and adolescent psychiatrist support the young people and provide guidance for the staff. These arrangements significantly reduce the need for referral to external professionals.

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Overall experiences and progress of children and young people: good

One social worker commented, ‘They (staff) know my young person inside out and provide them with every resource to meet their specific needs. The staff are professional and the home has everything in house. I am really impressed, as it is not often you see these services on site. This really does benefit the young people living there.’

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

All of the young people told the inspector that they feel safe at the home. Risk assessments for individual young people are clear and regularly reviewed, and they incorporate strategies which the staff understand and follow. There are good reporting procedures in place for young people who go missing from care. Staff keep in contact with young people and work closely with other professionals to safeguard young people. There have been three incidents of missing from home since the last inspection, involving one young person. Records show that the young person has received an independent return home interview on each occasion. This enables staff to have a better understanding of why the young person left the company of the staff and to put in place stringent measures to prevent it from happening again.

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

All staff have completed their training in safeguarding and demonstrate their knowledge well about the action that they might take, when given scenarios that the young people may place themselves in. The management team has reported one safeguarding concern since the last inspection. On this occasion, appropriate reporting to the local designated Inspection report children’s home: SC473473 7 officer, police and the young person’s social worker took place. Comprehensive records are in place to detail the actions taken by the management team to protect the young person and to provide support to the staff member. All required notifications about young people’s safety are referred to the relevant professionals and organisations, and inter-agency working to protect the young people is strong.

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

Nurturing and supportive relationships between the young people and the staff ensure that the young people trust the staff and feel able to share their concerns. When young people have raised complaints, the staff have been responsive and taken swift action to address the concern. Records show that all complaints have been resolved to the young people’s satisfaction.

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

Staff work consistently together and they manage the young people’s behaviour exceptionally well. Behaviour management is effective and, although physical interventions have taken place, the records show that these are more of a hands-on guide to prevent young people from harming themselves or others. Young people understand the expectations of living at the home, and these are reinforced by an agreed rewards system which the young people respond to well. As a result, young people’s negative behaviour is rare and the home is settled. A registered mental health nurse working at the home is qualified to provide behaviour management and physical intervention training to the staff.

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

Staff recognise the triggers which cause young people to engage in self-harm. They are trained, skilled and experienced in working directly with young people who self-harm, including those for whom self-harming behaviours are potentially life threatening. A staff member described his self-harm training, facilitated by one of the professionals working at the home, as ‘inspirational’. This is because the trainer used real-life examples specific to the young people living at the home, allowing the staff to reflect and learn from practice. Effective strategies, including one-to-one work to identify the cause of these behaviours, have ensured that these incidents are reducing in frequency and intensity.

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

Each young person has a comprehensive risk assessment and management plan. The management team analyses patterns and trends in individual young people’s behaviours and presentations. Each week these detailed plans are discussed at the multidisciplinary team meetings, enabling the professionals at the home to track and plan the young people’s progress or identify further areas of support for them.

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

The registered manager is experienced in safe recruitment and there are thorough recruitment processes in place. She is confident that staff understand the principles of a safe culture at the home. Recently recruited staff have been chosen specifically for their experiences in mental health, learning disabilities and autistic spectrum disorder. These arrangements successfully bring health and social care together under one roof to provide the young people with a complete wrap-around care package.

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

The home’s environment is safe. Staff regularly record their health and safety checks, and external contractors service the appliances as required by timescales. The home’s fire risk assessment and location risk assessment are clearly written. Young people have Inspection report children’s home: SC473473 8 a personal emergency evacuation plan. The home’s contingency plan details many scenarios and factors which may impact on young people and staffing. It details what is required in adverse weather conditions, as the rural location of the home makes this a possibility. These arrangements ensure that the home is safe for young people, staff and visitors.

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The effectiveness of leaders and managers: good

A new manager joined the home in July 2017. She has 19 years’ experience of working with adults and young people with mental health, autistic spectrum disorder and learning disabilities. She has been a registered manager for 12 of those years, with both the Care Quality Commission and Ofsted. She has completed her level 5 diploma in leadership and management for residential childcare. There has been a lengthy handover from the previous registered manager, who has moved as part of their career progression within this organisation. The new manager was successful at her interview with Ofsted in September 2017 for the position of the registered manager of the home.

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The effectiveness of leaders and managers: good

The registered manager is innovative in her approach and understands the home’s strengths well. She is receptive to new ideas and aspirational regarding making improvements. This ensures that the staff always meet the needs of the young people to a high standard.

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The effectiveness of leaders and managers: good

Staff feel well supported by the manager. A member of staff told the inspector, ‘Before coming here I used to work with a large childcare provider and often our approach was reactive. The manager here explains to me why I am doing things. I feel more empowered, and I am able to work alongside the young people. For example, we see them going into crisis, and manage and support them through this. It is a very different and interesting way of working.’

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The effectiveness of leaders and managers: good

The management team makes sure that staff receive regular supervision in order to assess individual competencies and enhance their skills. Staff take part in regular clinical supervisions, and this provides them with additional advice on the young people’s health and emotional needs, as well as support for their own emotions. Staff told the inspector that they feel supported in their role. New staff are experienced, and are expected to pass their probationary period and attain the required level 3 qualification in residential childcare within the timescales required by regulation.

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The effectiveness of leaders and managers: good

The objectives, as described in the statement of purpose document, are evident at the home. Staff are caring and supportive, and have a positive regard for those young people in their care and each other. The whole staff team is having a positive impact on the health and social welfare of the young people who live at the home.

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The effectiveness of leaders and managers: good

Monitoring is improved, and the management team reviews and reports on the quality of the service every six months. Staff use this report to reflect on and improve what has happened. An independent person visits regularly to check what goes on. Their reports are thorough, making useful recommendations which have helped the home to develop, particularly regarding behaviour management and health plans. However, the reports do Inspection report children’s home: SC473473 9 not specify the independent person’s opinion on whether the staff safeguard children and promote their well-being. This requirement was made at the last inspection in March 2017, and is made again at this inspection.

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The effectiveness of leaders and managers: good

The management team and staff work closely with families and other services that support the young people to provide them with a multi-agency input into their health and social care needs. The registered manager is not afraid to challenge professionals to ensure that young people receive the support and services that they are entitled to. The staff team advocates on behalf of the young people to create an environment in which they can grow and progress. All young people benefit from the support of an independent advocate. Detailed reports are presented at each young person’s statutory review. These reports contribute to clear and agreed plans for the young people’s daily lives and their futures.

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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: SC473473 10

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Children’s home details

Registered provider: Nestlings Care Limited, company number 07252721

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Children’s home details

Registered provider address: 185 Grove Lane, Hale, Altrincham, Cheshire WA15 8LU

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Children’s home details

Responsible individual: Anthony Thompson

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Children’s home details

Registered manager: Jenny Thompson-Kavanagh

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Inspector

Mark Kersh, social care inspector Inspection report children’s home: SC473473 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 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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