Children's Home, Residential special school run by MacIntyre Care in Buckinghamshire

SC043994 Unique reference number 10 June 2009 Inspection date Paula Eaton Inspector Key Type of Inspection

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 9 Inspection Report: SC043994

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Brief description of the service

This service is a residential special school for young people with severe learning disabilities and is run by a large independent organisation. The school accommodates up to 40 secondary school age young people of either sex, usually on a 52 week placement basis. Due to the length of the young people's stay at the school it is required to be registered and regulated as a children's home under the Care Standards Act 2000.

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Brief description of the service

The school is located in a small village. Although there are limited resources available close to the school, the school has access to a range of vehicles for transporting young people.

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Brief description of the service

The accommodation is provided in seven separate houses on the edge of the school site and each young person has their own bedroom. Each house has an office, kitchen, lounge/dining area and activity room as well as outdoor space for young people. There are also sufficient numbers of suitable bathroom facilities for young people.

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Summary

This was an announced inspection that was carried out jointly with the education inspectorate and a separate report outlining the key findings regarding the education provision at the service is available. All key National Minimum Standards were assessed and all outcome areas were examined during this inspection.

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Summary

The service has good systems in place for assessing and meeting the needs of the young people accommodated. Robust systems are in place for promoting and protecting the welfare of young people and staff ratios are high to meet the needs of young people. Robust policies and procedures are in place and there is a good programme of core training in place that supports staff to meet the needs of young people.

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Summary

Young people benefit from professional health care support and the service has an inclusive approach that involves parents and young people in the decision making process with regard to the care young people receive.

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Summary

Staff do not always adhere to procedural guidance and are sometimes reluctant to engage in training to support their professional development. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

There were no actions set at the last inspection for improvements to be made.

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Helping children to be healthy

The provision is good. Nutritious meals are provided for young people taking account of their individual needs and preferences. Young people also benefit from the produce of local farm shops and local butchers who make deliveries to the service. Staff take time to allow young people to choose what they 4 of 9 Inspection Report: SC043994 want to eat and support them to be as independent as possible during mealtimes. Young people are also provided with appropriate snacks and drinks and fresh fruit is available in the houses.

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Helping children to be healthy

Systems for assessing, addressing and monitoring the health needs of young people are good. The service has recently appointed a school nurse who has carried out health assessments for all young people. All young people are registered with a General Practitioner and have appropriate dental check ups and eye tests and records are maintained for any appointments that are made. The service has access to contracted healthcare professionals to meet the complex health needs of young people. An Occupational Therapist and Physiotherapist support the school and a psychologist is based at the school two days a week. Staff receive training to support them in meeting specific health needs such as managing epilepsy and continence issues.

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Helping children to be healthy

Procedures for managing the storage, administration and disposal of medication are sound. Medication is safely stored and medication records are kept up to date. Staff receive training on medication awareness and there are clear medication policies and procedures in place. Individual guidelines are in place for each young person regarding the most effective way to administer medication to meet their needs. Staff also receive first aid training.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The privacy and dignity of young people is respected and comprehensive guidelines are in place for supporting young people with personal care and moving and handling. Appropriate confidentiality policies and procedures are also in place, although, not all documentation gives clear guidance with regards to accessing third party information. Records are stored securely within the service.

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Protecting children from harm or neglect and helping them stay safe

There are satisfactory complaints policies and procedures in place including a complaints procedure produced in a suitable format for young people using pictures and symbols. The procedure is prominently displayed where young people can see it. There are low levels of complaints received about the service and records show that any concerns raised are dealt with appropriately and promptly. Staff sometimes act as advocates for young people and raise concerns on their behalf and these concerns are recorded along with the action taken and outcome.

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Protecting children from harm or neglect and helping them stay safe

The Head of Care is the designated Safeguarding Officer for the service. The service continues to have a good working relationship with Buckinghamshire County Council and safeguarding policies and procedures have been reviewed and updated. Staff are required to read and sign guidance that gives clear definitions of safeguarding issues and specifically outlines expectations with regard to reporting concerns. However, there are still occasions where staff are reluctant to report concerns immediately. Staff receive regular safeguarding training and this training is included as part of the induction programme for new staff. Good systems are in place for responding to any concerns reported and comprehensive records are maintained for any investigations that take place and their outcome. The Registered Manager maintains a central log of any safeguarding issues and monitors the progress of any investigation that is taking

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Protecting children from harm or neglect and helping them stay safe

There is an appropriate anti-bullying policy in place and relationships between young people are monitored. Incidences of bullying are uncommon due to the nature of the disabilities of 5 of 9 Inspection Report: SC043994 the young people using the service and the fact that young people are closely supervised by staff at all times. Staff receive anti-bullying training.

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Protecting children from harm or neglect and helping them stay safe

Satisfactory systems are in place to minimise the likelihood of young people going missing and procedures are in place to ensure that prompt action is taken should a young person abscond. There are very few incidents of young people absconding as they are closely supervised as a result of their complex needs.

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Protecting children from harm or neglect and helping them stay safe

Individual behaviour management plans are devised to ensure a consistent and effective approach is adopted in response to difficult behaviour. These form part of individual care plans and are developed involving all staff involved in the care of the young person including a behaviour support team who advise on strategies for managing specific behaviours.

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Protecting children from harm or neglect and helping them stay safe

There are clear policies and procedures in place to guide staff, and training is provided for staff to enable safe physical intervention when a young person's behaviour poses a risk to themselves or others. Physical intervention training is provided for all staff as part of their induction programme prior to them working with young people. Sanctions are rarely imposed and if they are it is usually to diffuse a situation where a young person is exhibiting difficult behaviour and records for this are maintained in each house. Physical intervention is only used as a last resort to prevent harm. Appropriate incident records are maintained.

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Protecting children from harm or neglect and helping them stay safe

Health and safety policies and procedures are in place and available to staff. Checks relating to fire safety occur on a regular basis and separate records for these are maintained in each house. There are also detailed individual fire risk assessments in place for young people outlining any issues with regard to evacuation. Systems are in place to monitor health and safety throughout the service and identified issues are addressed promptly.

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Protecting children from harm or neglect and helping them stay safe

Robust recruitment policies and procedures are in place to safeguard young people who use the service. All required checks take place prior to a new employee commencing work within the service.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive a support package that meets the individual needs outlined in their care plans. Very specific information is recorded about their likes, dislikes and preferences as well as comprehensive information about their communication needs to support them to make choices and to help staff effectively meet their needs. Key workers support individual young people. Young people also receive specialist support where required. The cultural and religious needs of young people are also taken into consideration and comprehensive risk assessments are completed for individual young people to ensure that they are protected from harm and supported to take controlled risks that help them to develop new skills.

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Helping children achieve well and enjoy what they do

The education of the young people is a central part of the service and records contain evidence of the young people's achievements and support provided to meet their educational needs. Good systems are in place to ensure consistency of care between school and the houses, although, continuity of the 24 hour curriculum between school and the residential houses is not as strong. Regular reviews of the young people's educational needs take place. 6 of 9 Inspection Report: SC043994 A variety of activities are provided for young people outside of school hours that include arts and crafts, woodland walks, trips to the cinema, bowling, the theatre and swimming. The range of purposeful activities varies between houses in the residential setting and therefore, there are differences in the quality of activities provided for young people. The service actively encourages young people to experience new things and annual holidays are arranged. Trips

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Helping children achieve well and enjoy what they do

abroad to Greece and Spain are being arranged to support individual young people to maintain contact with their families and a holiday is planned at an outdoor pursuits centre for two groups of young people.

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Helping children make a positive contribution

The provision is good. Comprehensive needs assessments take place prior to young people moving into the service. Placement plans are then developed outlining these needs and what action staff should take to meet them. These documents are then updated as young people settle into the service and staff get to know them. Staff are aware of the needs of individual young people and there is satisfactory communication between school and the houses to ensure consistency in practice.

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Helping children make a positive contribution

Records show that young people have regular reviews as required. The service contributes to this process and produces a detailed report that includes information covering all areas of need. Key workers and senior staff contribute to the review process and young people attend their reviews where possible.

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Helping children make a positive contribution

Contact arrangements are clearly outlined in young people's case files and any restrictions on contact made clear. Staff support young people to maintain contact with their families, and parents and carers are able to visit. Young people can maintain contact with their families in various ways. Families are able to visit the service and staff facilitate visits home by transporting young people and sometimes supporting families during visits. Email updates are provided to parents regarding their child if they request this and communication also takes place via web cam for some families. The service actively supports young people to maintain contact and is supporting one particular young person to travel abroad to visit his mother.

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Helping children make a positive contribution

Good systems are in place for supporting young people to move into and move out of the service. A planned process incorporating several visits with the support of staff enables young people to become familiar with the service, staff and young people prior to them moving in. When young people are preparing to leave the service staff advocate strongly on behalf of young people to secure a suitable placement and help them to settle by escorting them on visits and providing comprehensive information to the new placement.

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Helping children make a positive contribution

Formal consultation with young people can be limited due to the nature of the young people's disabilities. However, young people's meetings do take place and minutes are recorded using recognised pictures and symbols. Staff also make every effort to encourage young people to make decisions about everyday activities such as during mealtimes. Parents are kept informed about the progress of their children and any concerns that are identified and are involved in the decision making process.

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Achieving economic wellbeing

The provision is good. 7 of 9 Inspection Report: SC043994 As a result of the complex needs of the young people who use the service it is unlikely that they will move on to live independently. However, staff work with young people at a level appropriate to their need and encourage them to be as independent as possible. This includes developing new skills and encouraging young people to express their feelings and make choices.

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Achieving economic wellbeing

Good systems are in place for maintaining the environment to a satisfactory standard. Any maintenance issues are reported and dealt with promptly. The furnishings in the houses are of a domestic style and the environment is safe and comfortable for the young people. There are telephones for young people to use if able and young people's rooms are personalised. Due to the nature of their disability some young people choose to have limited personal effects in their bedrooms.

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Organisation

The organisation is good. The Statement of Purpose accurately reflects the provision at the service and is reviewed and updated as required. It is available for parents and placing authorities when considering a placement at the service. There is also a young person's guide in place that is produced in a suitable format using symbols that includes information about the service, staying safe and how to raise concerns.

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Organisation

The promotion of equality and diversity is good. Staff strive to get to know the individual needs, likes and dislikes of young people and take action to meet these encouraging young people to make choices wherever possible. Staff recognise the individuality of the young people they support and take this into consideration when planning activities and generally when supporting them on a daily basis.

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Organisation

Although there is a system in place that encourages staff to begin their National Vocational Qualification (Level 3) following completion of their six month probation some staff are reluctant to complete this training and the levels of completion for the service are low. There is an appropriate handover period between shifts to enable staff to discuss any issues and pass on relevant information and this is also recorded. The rotas seen show that there are ample staff on duty to ensure that young people are adequately supported and young people receive one to one supervision where this is in their best interests. Staffing levels vary depending on the needs of the young people and there were sufficient staff on duty at the time of the inspection. There are also cooks and ancillary staff who support the houses.

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Organisation

A good programme of training is in place to ensure that staff complete all mandatory training as well as additional training to help them understand the needs of the young people that they support. The comprehensive induction process that has been developed includes two weeks training in core areas, such as safeguarding, physical intervention and communication. Other training available for staff includes moving and handling, medication awareness, fire safety, an introduction to physiotherapy, epilepsy awareness and continence issues.

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Organisation

The service operates within the remit of its Statement of Purpose and there are systems in place for monitoring the service as required. Regulation 33 visits to the service take place as required and the Registered Manager also monitors various aspects of the service.

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Organisation

Each child has a secure individual record of their history and progress maintained that contains all of the information outlined in Schedule 3 of the Children's Homes Regulations 2001. 8 of 9 Inspection Report: SC043994

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Statutory requirements

This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • include details regarding access to third party information in the guidance relating to access to records (NMS 9) • continue vigilance with regards to ensuring that staff adhere to safeguarding reporting procedures (NMS 17) • increase the level of staff completion of National Vocational Qualification (Level 3) (NMS 29) 9 of 9 Inspection Report: SC043994

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