Hulton House

Updated 3 April 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service under the service under the Care Act 2014.

This comprehensive inspection took place on 13 February 2019 and was unannounced which meant the provider did not know we would be visiting the service. The inspection team consisted of one Inspector from the Care Quality Commission Children’s Services Inspection Team.

Prior to the inspection visit we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR) on 19 October 2018. The PIR is a form that asks the registered provider for some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts and notifications that had been sent to us. A notification is information about important events that the provider is required to send us by law. Those that had been submitted by this service prompted us to examine, during inspection, the provider’s arrangements for managing risks to the safety of the young people living there.

At the time of this inspection one young person was receiving in-patient treatment in hospital. During our visit we spoke with one of the two young people who were living at Sonning Drive and their parents. We also spoke with the registered manager and several staff, including the clinical services manager, the psychologist, a mental health nurse and a key worker. Additionally, we spoke with a social worker and an independent reviewing officer visiting the service during our inspection as well as contacting the independent advocate for the young person. The comments of everyone we spoke to have been considered in this report.

We reviewed care files for both young people living at the home, and looked at three staff files and training records. We examined the records in relation to the administration of medicines as well as information about the management of the service and the provider’s processes for assuring quality.

Updated 3 April 2019

We carried out an unannounced inspection on 13 February 2019. This was the home’s first inspection following registration with the Care Quality Commmission in May 2018 .

The published date on this report is the date that the report was republished due to changes that needed to be made. There are no changes to the narrative of the report which still reflects CQCs findings at the time of inspection.

Sonning Drive, part of Nestlings Care Limited, is a children’s home in the North West of England that provides specialist treatment and care for up to two children and young people aged between 10 and 18 years with complex needs and mental ill-health who are looked after by the local authority. The provider is registered with the CQC to provide treatment of disease, disorder or injury and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The children’s home is also registered with, and inspected by OFSTED as it provides accommodation for up to two children and young people under the age of 18 who are in care.

The home is a modern detached four bedroom property with private garden in a residential area of Bolton. The ground floor comprises of lounge/dining area, kitchen with dining facilities, cloakroom with toilet and wash basin. On the first floor are two large bedrooms, one of which offers en-suite facilities, and a further two bedrooms which provide space for the staff bedroom and office. There is also a modern bathroom, that is accessed via the main landing. All rooms are tastefully furnished to a high standard, providing television point and computer access points with WIFI available throughout the home.

The provider’s vision of ‘safety, empowerment and independence achieved by opportunity and choice’ was shared and implemented by all staff and evident in all the provider’s processes and policies. Young people’s characteristics, personality and their wishes and feelings were demonstrated throughout all records that related to them and staff knew each young person well.

The service used person-centred approaches to assessing and meeting the needs of young people who live there. There is a strong focus on co-production and on developing the skills of the young people living there to enable them to transition to independent adult life.

All staff at the home were dedicated to providing a very high standard of care. They strived for

excellence through consultation, they were passionate and dedicated to the young people they were supporting in assisting them to achieve goals and aspirations. The provider's visions and values were understood and shared across the team, and they were fully supportive of development plans. The culture of the service was open and transparent.

Partner agencies also spoke highly of the home; they told us they were very impressed with care provided and the wrap around support for the young people’s mental health.

Young people who display behaviour that challenged were supported to manage their anxieties and stressors through positive behaviour support plans. These were co-produced with young people and provided staff with clear guidance on how to support the young people in the least intrusive way.

Risk assessments and management plans were co-produced. Risks included clear guidance to ensure staff were able to help the young people experience safe care and support.

Staff had a good understanding of systems in place to manage medicines, safeguarding matters and behaviours that are challenging to others. People's medicines are managed so that they receive them safely.

There is sufficient staff available to ensure people's wellbeing, safety and security is protected. A robust recruitment and selection process was in place to ensure that prospective new staff had the right skills and are suitable to work with people living in the home.

Staff were compassionate, kind and caring and developed good relationships with the young people using the service. People were comfortable in the presence of staff. Relatives and partner agencies confirmed the staff were caring and looked after people very well.

Staff worked proactively with the young people to promote their life skills to enable them to transition to independent life as an adult. Staff encouraged and supported the young people to make their own safe choices about every aspect of their daily lives such as what to eat and which activities to take part in.

Young people were supported to make choices about their personal living space. Both young people had been encouraged to design and decorate their own rooms to reflect their personalities and interests and had been helped with their preferred choice and budgeting skills for decorating materials.

Leaders and staff had a strong, shared duty of candour. This was evident in the open and transparent culture of reporting, investigating, learning and improving from incidents.