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

Inspection report children’s home: SC473473 1 SC473473 Registered provider: Nestlings 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 accommodate three young people who have a mental disorder. The home is privately owned. The home provides specialist care and treatment for young people aged between 10 and 18 years old. The team is made up of an experienced manager, registered mental health nurses, residential support workers, clinical psychologist, occupational therapist and a consultant child and adolescent psychiatrist. 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: 26 to 27 September 2018

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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 November 2017

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good

Overall judgement at last inspection: Good

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good

Enforcement action since last inspection: None Inspection report children’s home: SC473473 2

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Inspection date Inspection type Inspection judgement

27/11/2017 Full Good 22/03/2017 Interim Sustained effectiveness 31/10/2016 Full Good 07/03/2016 Interim Declined in effectiveness Inspection report children’s home: SC473473 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 must maintain records ("case records") for each child which include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated and the author of each entry. (Regulation 36(1)(a)(b)(c) Schedule 3) In particular, ensure that detailed records are kept of when a child goes missing from home. These records should include the date and circumstances of all incidents, including any information relating to the child’s whereabouts during the period of absence. 30/11/2018

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Recommendations

 The registered person must specify the procedures to be followed and the roles and responsibilities of staff when a child is missing from care or away from the home without permission and how staff should support the child on return to the home. (‘Guide to the children’s home regulations including the quality standards’, page 45, paragraph 9.28)  All staff must have their performance and fitness to carry out their role formally appraised at least once annually. This appraisal should take into account, where reasonable and practical, the views of other professionals who have worked with the staff member over the year and children in the home’s care. (‘Guide to the children’s home regulations including the quality standards’, page 61, paragraph 13.5)

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Overall experiences and progress of children and young people: good

Young people who live in this home receive good care and support, which is closely tailored to their individual needs. The quality of care enhances their progress and life experiences. Feedback from young people themselves is positive. Comments included: ‘This is a good place for me, because I feel relaxed here.’ Another young person said: Inspection report children’s home: SC473473 4 ‘I’d give this home 8 out of 10. This is because I like most of the adults here. They talk to me and help me out with stuff.’ The manager and staff have a good understanding of the young people’s complex and unique needs. They have been tenacious in their efforts to ensure that all those involved in care planning are doing their utmost to support young people’s progress and development. Because of this, young people are making significant progress in many aspects of their life, relative to their starting points and specific needs.

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Overall experiences and progress of children and young people: good

Most of the young people have a history of poor educational outcomes. However, through effective support and intervention, the arrangements for their educational needs have improved. For example, one young person is achieving 100% attendance, and another who recently left the home is accessing university. Young people’s views, opinions, likes and dislikes are integral to the day-to-day running of the home. They are actively involved in making decisions such as planning activities and choosing the décor of the home. Staff also support young people to share their views about the care that they receive and make sure these are fully represented and considered as part of the care planning process. Staff are ambitious for young people and provide them with ongoing encouragement to engage in meaningful activities. They recognise and nurture young people’s talents and ensure that their day-to-day experiences enhance their opportunities to build skills and

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Overall experiences and progress of children and young people: good

confidence. Young people receive intensive support from the in-house multidisciplinary mental health team. Specialist support and training is also provided to staff. This ensures that young people receive effective care which is responsive to their needs. Young people’s all-round independence skills continue to develop. This includes accomplishing practical tasks such as cooking and doing basic household tasks. These are important aspects of learning to cope with transition and adulthood. With respect to young people who have more complex needs, these small improvements represent big steps in terms of their emotional literacy, self-determination and independence. Transitions into the home are effectively planned. New admissions are carefully matched to young people already in the home, who are also consulted about any new young person identified as a potential placement match. Young people visit the home and are

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Overall experiences and progress of children and young people: good

introduced to the other young people prior to their move. This is a very positive, well- thought-through transition process. The home is furnished and decorated to a good standard and feels welcoming and homely. The issues identified at the last inspection have now been addressed. The necessary maintenance work has been completed and new carpets have been fitted throughout.

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

Observations throughout the inspection indicate that young people feel a strong sense of belonging at the home. This is a place where they feel accepted, nurtured and safe. Inspection report children’s home: SC473473 5 Effective safeguarding practice contributes to young people’s sense of safety and well- being. Risk management elements of care planning are very carefully considered for each young person. There is clear identification of the risks, potential triggers for risk- taking behaviours and strategies to minimise or manage risks. The core staff team is skilled in recognising and responding to young people’s behaviours. They maintain a high level of vigilance throughout the day and night to ensure young people’s safety. Challenging behaviour is addressed in a supportive way, and staff encourage discussion after incidents to help young people reflect and learn. Some young people have unique ways of expressing their worries and concerns, and staff have developed specific

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

techniques to manage this and to help each young person express their emotions safely. Staff can easily access the organisation’s clinical department and, through discussion in weekly meetings, they are able to build a greater understanding of the young people’s psychological needs and associated behaviour. Restraint is used appropriately to keep the young people and staff safe. Records show that interventions are often guided holds to prevent young people from harming themselves. Staff complete work with the young people to support their development of self-regulation, and the registered manager supports staff to debrief about the use of restraint. Staff have effective plans in place should a young person go missing, although not all staff demonstrate a thorough understanding of what action to take should a young person leave the home unauthorised. In addition, missing from home records lack clarity

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

in relation to what action has been taken, where the young person was located and the circumstances of their return home. This makes it difficult for the manager to monitor practice and gain an accurate picture of the event. All staff receive safeguarding training at the start of their employment, as well as regular updates and refresher training on an ongoing basis.

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The effectiveness of leaders and managers: good

The home has a new manager in post who has recently applied to be registered by Ofsted. She is motivated to provide young people with good-quality care and help them to achieve the best possible outcomes. The manager communicates this clearly to the staff team and expects a high standard of care to be delivered to young people. Achieving consistency of staffing has been a challenge. This is because of staff leaving and other factors that have resulted in staff absence. That said, the manager has ensured that the young people have continued to be cared for by a small core team of experienced and competent staff who know them well. The use of agency staff has also been necessary. However, this has been kept to a minimum to avoid any unnecessary disruption to the young people. There is an extensive training programme in place. Staff receive regular training in a variety of areas and are trained regularly by the clinical psychologist allocated to the

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The effectiveness of leaders and managers: good

home. Training is often individualised and specific to young people and their individual Inspection report children’s home: SC473473 6 therapy and care needs. This ensures that the right support is delivered to each young person. Staff say that they benefit from regular supervision and informal discussions. The manager is visible in the home on a daily basis and is heavily involved in the delivery of day-to-day care to the young people. Staff appraisals and professional development plans are completed annually. However, these do not consider the views of young people, families or professionals. This is a missed opportunity to undertake a more holistic review of professional practice and this would assist the manager in identifying development needs within the team. Young people’s case records are well maintained. Records are sufficiently detailed and well written and are presented in a way that is helpful to young people both now and in

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The effectiveness of leaders and managers: good

the future. Regular monitoring of the home, both externally and internally, is sufficient. Monthly visits by an external visitor are undertaken to ensure independent scrutiny of the quality of care provided. Any shortfalls identified as part of this process are routinely addressed to ensure that the home is operating appropriately and meeting young people’s needs.

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The effectiveness of leaders and managers: good

The requirements made at the last inspection have been addressed. This demonstrates that effective action is taken when shortfalls are identified.

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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: SC473473 7

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Children’s home details

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

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Children’s home details

Responsible individual: Anthony Thompson

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Inspector

Ceri Evans, social care inspector Inspection report children’s home: SC473473 8 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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