Children's Home, Residential special school run by Cambian Autism Services Limited in Dorset

SC065261 Unique reference number 29 July 2009 Inspection date Clare Davies Inspector Key Type of Inspection

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26 February 2009 Date of last 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 10 Inspection Report: SC065261

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Brief description of the service

The school provides care and accommodation for up to 57 children and young people with Autistic Spectrum Disorder between the ages of nine and 19 years. It operates as a residential special school which also provides accommodation for a number of children requiring 52 weeks boarding and is therefore registered as a Children's Home.

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Brief description of the service

Students are accommodated in eight on site living units and one off site in a neighbouring village. Four living units providing 38 week care are located within the main building and the remaining four living units providing 52 week care are located in the school grounds.

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Brief description of the service

The school is set in sufficient grounds to support outside activities and close proximity to the town ensuring that the school is integrated into the community. The provider has additional registered services for children and young adults with autism.

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Summary

This inspection was announced with short notice being given. The inspection focused on all key National Minimum Standards and recommendations made at the previous inspection were also followed up.

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Summary

The school provides outstanding outcomes for students. There is a strong commitment to training for staff and to ensuring that students have access to education, care and support with life skills. Care staff and teaching staff work well together for the benefit of the students. To complement this holistic approach there are therapists and health professionals that make up a multi-disciplinary team.

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Summary

The welfare and safety of students is paramount and all staff work extremely well together to ensure that students and adults are safe. There is an individual approach to each student and comprehensive documentation to support their placement. The staff demonstrate a strong commitment to providing a quality care experience for the students. The positive interaction between staff and students is indicative of the staff skills, experience and understanding of complex needs associated with Autistic Spectrum Disorders. Each student is valued and recognised for their contribution to the school community.

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Summary

Local authorities who have placed students at this provision report high levels of satisfaction with the placements. One social worker reported, 'Communication is prompt, appropriate, frequent and contributions and comments are welcomed in planning and problem solving. There is a robust system of review and sharing of problems and exchange of ideas both internally and externally.' The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

Two recommendations relating to records under the outcome Staying Safe were made at the last inspection. One concerned the need to record details of the behaviour that requires the need for physical restraint and the other involved recording clearly when staff receive training in fire safety. The school has taken appropriate steps to address these recommendations and 4 of 10 Inspection Report: SC065261 improve the quality of care for the students. The one recommendation made at this inspection relates to staff qualifications and the need for over 80% care staff to have achieved NVQ level 3, the school are working well towards this target.

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Helping children to be healthy

The provision is outstanding. The school enlists the skills of a nutritionist to ensure that the menus reflect a healthy diet. The food is of a good quality and served in each living unit providing a social setting like a family. In some living units the staff and students prepare and cook their own meals to incorporate life skills. Staff respond to individual dietary needs whilst encouraging students to extend their food selection when only eating from a limited range due to their autism. Some students are supported in growing some vegetables and salad to enjoy the food that they have produced. This school has achieved the Healthy Schools Award.

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Helping children to be healthy

Health and medical needs are identified as part of the admission process as each student is assessed by the multi-disciplinary team. This team can provide speech and language therapy, behavioural therapy, music therapy, occupational therapy, psychology and psychiatry. The therapists work with students on site and most are based full time at the school and therefore available to be integrated into the whole staff team. Therapist work alongside care and teaching staff devising programmes of therapy to support students. The therapists attend regular review meetings for each student and are able to respond to a crisis by observing behaviour and providing guidance on how to manage and support such complex needs. Students are encouraged to lead healthy lifestyles with a good diet, physical exercise and good personal hygiene. Personal, social and health education is delivered in the classrooms, in the living units and on an individual

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Helping children to be healthy

level. Students are provided with information on relationships and sexual health. A selected group of students have been involved in a workshop looking at social skills including relationships and differences between people. A social worker reported that the school has supported a student by increasing the level of physical activity and encouraging a healthy diet that has resulted in a welcome weight loss.

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Helping children to be healthy

Medication is safely stored and administered by trained staff. Staff are required to undergo a written test and observe practice before being considered competent to administer medication; this ensures that medication is administered correctly. There is a robust system of monitoring as residential staff regularly check the medication and records, this is further checked by a member of the senior management team or the nurse. The school has recently recruited a nurse after the post was vacant for a short time. The nurse oversees the medical care of the students, she liaises with the doctor who visits every week and other health professionals in the community. Parental consent is obtained for the administration of medication, first aid and other treatments as required for individual students. Protocols are in place for students with particular medical needs such as those who suffer from epilepsy. The health and medical welfare

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Helping children to be healthy

of students is monitored closely to ensure that the correct support is being provided. Observations of any changes in students' wellbeing are noted and discussed to consider any changes required to medication or therapeutic input.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The welfare and safety of students is paramount and all staff from each department work together extremely well to ensure that the students and adults are safe. A whole school approach 5 of 10 Inspection Report: SC065261 is adopted in providing a secure environment, identifying risks and providing consistency to support students with autism. Staff balance their levels of supervision with the need to promote and respect students' privacy. Policies on intimate care provide guidance to staff to support best practice.

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Protecting children from harm or neglect and helping them stay safe

There is a formal complaints procedure, use of symbols and pictures for students and a leaflet provided in the parents pack prior to admission. The school takes a positive approach to any complaint viewing it as an opportunity to improve their practice. Complaints are rare but when they do occur an independent person is appointed to investigate, ensuring a thorough and transparent process. There is a strong commitment to ensuring all staff are aware of the child protection procedures and their responsibilities to protect and report any concerns, this is explained during their induction and refreshed with training annually. The local authority report that the school respond appropriately to report any concern and seek advice. With some students over 18 years old the school liaises with the safeguarding teams for children and young adults. To ensure that there is always a senior member of staff available 24 hours a day with a higher

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Protecting children from harm or neglect and helping them stay safe

level of training in safeguarding, all the senior management team have been trained to respond as the designated person, this is a demonstration of the school's commitment to safeguarding.

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Protecting children from harm or neglect and helping them stay safe

Students are encouraged to consider other people and the impact their behaviour may have. This can involve social skills and personal behaviour and look at any bullying exhibited. The complexities of autism mean that some students are unable to comprehend the impact of their behaviour on others and the staff are skilled in managing this and developing behaviour support plans. High staffing ratios reduce bullying behaviour and avoid students wandering out of sight. Policies and procedures are in place if a student should be reported as missing, coded internal and external doors assist in keeping students safe and on school premises.

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Protecting children from harm or neglect and helping them stay safe

There are some comprehensive documents such as risk assessments and behaviour support programmes to promote positive behaviour. Each student has a log book to record any behaviour exhibited that is unusual or challenging. Every week, the psychology team analyse these records and produce graphs and reports to help explain any changes and provide guidance as to how best respond to and manage such behaviour. This approach brings together care and teaching staff with the therapeutic input to provide a consistent response to the students. A formal multi-disciplinary review takes place every six weeks for each student where their needs are considered under the Every Child Matters outcomes. The use of any physical intervention is thoroughly recorded and considered in the analysis of behaviour. The school has recently obtained a computer programme that will further assist with in-depth analysis, it has yet to be

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Protecting children from harm or neglect and helping them stay safe

The school site and living units are well maintained with regular monitoring by the maintenance team. Some students are able to join the maintenance team for some work experience and they clearly enjoy this activity. Environmental and fire risk assessments are in place and regularly reviewed. Records show that fire drills and evacuations occur at different times of the day and night to ensure staff and students know how to respond. The fire safety systems are tested weekly by the maintenance team and a contractor undertakes routine servicing of equipment and appliances. Fire safety training is delivered to all staff as part of the induction programme. Robust recruitment procedures are adopted and managed by trained key people ensuring checks have been completed before permitting new staff to care for students. Staff accompany visitors whilst on site who are required to sign in at reception and get issued with a visitors badge.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Individual support is available from a variety of sources within the school to meet the complex needs associated with Autistic Spectrum Disorders. Care staff, teaching staff and the therapy team work together to provide the best package of care, tailored to the individual. Students benefit from this whole school team approach and are encouraged to develop their self confidence and life skills towards greater independence. This could lead to shopping and cooking a meal or a small but significant step towards independence such as selecting ones own clothes to wear. Each student is encouraged to reach their potential and enjoy the same rights and opportunities afforded other young people. The recording systems and six week review meetings recognise progress and achievement. Staff are proactive in seeking guidance and support from external professionals for the benefit of the students. Communication difficulties are addressed

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Helping children achieve well and enjoy what they do

through the use of symbols, Picture Exchange Communication System, schedules, signing and computerised communication aids. Staff are suitably trained is these methods of communication and have the software available to be able to produce information for students in a format that they can understand.

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Helping children achieve well and enjoy what they do

Outstanding efforts are made to integrate the students into their local community from using shops, cafes and leisure facilities to undertaking supervised newspaper deliveries and regular trips to the recycling centre with the collection of waste from their living units. Some students are members of community youth groups and local churches. Life books are collated for each student with photographs of events and outings, and certificates of achievement. Social workers reported positively on the service that this school offers, 'I was very impressed with the way they take seriously the fact that every child/young person is an individual and therefore trying to come up with what would work best for a particular student'. Another social worker reported that parents appreciate being sent photographs of their child taking part in activities in the community. On site the school has some good resources for students to enjoy such as

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Helping children achieve well and enjoy what they do

playgrounds, a sensory room, a sports hall and a collection of games and DVDs.

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Helping children achieve well and enjoy what they do

Education is viewed as an integrated part of the students' development. There is an emphasis on the 24 hour curriculum and projects such as ECO school support this. The residential experience provides the opportunity for the students to develop personal and social skills that help them with their independence and self-esteem. There are four handover points throughout the school day where teaching and care staff can share aspects of the students day. Some of the care staff work in the classroom providing support and classroom staff cover staff shortages in the residential provision. These arrangements and the good communication between the education and care teams contribute to the consistency and continuity of care and the effective management of the students.

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Helping children make a positive contribution

The provision is outstanding. Upon arrival at this school the multi-disciplinary team undertake assessments to identify how the student's needs can be met. From these assessments a placement plan is produced, these documents are of a very good standard clearly setting out how the home will meet the assessed needs and the key responsibilities of those involved. The plan addresses any areas that arise out of a student's ethnicity, race, disability, sexuality, faith or belief. The necessary up to date Looked After Children documentation is on file and the structured six weekly reviewing process 7 of 10 Inspection Report: SC065261 continually assesses student's changing needs and ensures positive outcomes are achievable. There is detailed information about involvement and the purpose and outcome of work carried out, including the purpose of an activity and what benefit it will have for the student. This

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Helping children make a positive contribution

thorough assessment process is welcomed by placing authorities, a social worker reported that they were impressed by the way this service received a young person into their school ensuring that the right assessments are done therefore allowing the young person to receive the right support.

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Helping children make a positive contribution

Statutory review meetings occur in addition to the six weekly meetings. Creative approaches are used to engage students in the review process with use of PowerPoint presentations, videos, photographs and life books. Contact arrangements with family and friends are encouraged and supported where appropriate. The recent introduction of a webcam has improved the communication for some students and their families where verbal communication is limited. Students are supported in using the telephone and email to keep in touch.

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Helping children make a positive contribution

At the start of a placement visits are arranged to have a planned introduction and photographs of key people and places are made available. A comprehensive parent pack consists of a file of information about the service including photographs of the senior management team and introductory letters from the doctor, psychiatrist, consultant paediatrician and the independent visitors. As students prepare to leave, transition planning is implemented in plenty of time at the students' pace to help them understand the process of leaving and moving on. The occasion is marked with a special meal or outing according to the student's wishes. Staff are involved with these moves and support students with visits and photographs to ease the transition.

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Helping children make a positive contribution

Great emphasis is placed on the importance of listening to and encouraging the voice of students, as a group and individually. Formally there is a school council and discussion groups, informally students are regularly consulted on day to day care issues and the wider development of their placement and the school. Some of the issues the student council have been considering are; requests for activities, the forming of a school football team, students holding keys to their bedrooms and a school badge. Pictures and symbols are used to present the school council meetings to the rest of the school.

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Achieving economic wellbeing

The provision is good. Independent living skills are promoted throughout the classroom and the residential units. Parents are requested to complete a living skills audit at the beginning of each placement to provide a baseline from which staff can support students to progress from and increase their personal skills. Independent skills vary enormously from managing personal hygiene without prompting to cooking a meal. There is good integration in the local community to develop such skills.

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Achieving economic wellbeing

The living units are individual in character yet operate to the school policies and procedures providing consistency for students and staff who may work across different units. The quality of the accommodation is good with some outstanding areas such as the off site accommodation and units that have recently been refurbished. Some students have the benefit of en-suite bathrooms promoting their privacy. Bedrooms are decorated according to the students preferences, many have pictures, photographs and their personal belongings such as toys and items of special interest. There are secure outdoor play areas with access to school playground equipment. The on site maintenance team are committed to ensuring that the students have 8 of 10 Inspection Report: SC065261 a safe and homely environment. There are some challenges as students who become frustrated can cause damage to the property. Staff show a commitment and determination to find a

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Achieving economic wellbeing

solution that will withstand the frustration from the students and still look pleasant with suitable furniture and fittings.

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Organisation

The organisation is outstanding. The promotion of equality and diversity is outstanding. This school has a culture of inclusion and every student is valued for their individual contribution to the school community. A range of festivals are celebrated marking cultural and religious days, and students are supported in attending local churches. The living units cater for mixed gender students and the multi-disciplinary staff team reflects diversity through age, gender and ethnicity. Staff have received training 'Diversity means Difference' and following an audit of how equality and diversity is currently promoted, further action has been identified. This demonstrates the schools commitment to raising the standards of care delivered.

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Organisation

The Statement of Purpose reflects the service provided and is incorporated into the prospectus available through the school's website. Staff training is given a high priority and staff are supported with a two week induction, regular supervision and an annual appraisal of their work. As a result staff feel equipped to perform their duties and motivated to develop their professional skills. Just over 50% of care staff have achieved NVQ award level 3, and a further 25 staff are working towards this qualification. The school is committed to ensuring at least 80% of care staff have this qualification. There are good staffing levels in place providing 24 hour care with separate teams of night staff. The commitment and dedication from the staff is a strength of the school. Any absence of care staff is generally covered by the existing staff across the school or known bank staff, this ensures continuity of care for students. There are clear lines of

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Organisation

accountability and a duty system 24 hours a day. Members of the senior management team are on call for advice and support when needed.

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Organisation

There are sound systems in place to monitor the care of the students and the development of the service. Living units undertake their own monitoring, which is then checked by senior staff and then further checked by the Registered Manager. Two independent visitors also undertake monitoring visits and report directly to the head office. This process of monitoring promotes an open culture of the practice regularly being assessed to identify where it can be further enhanced. This school adopts a proactive approach and strives to develop and raise standards to improve the safeguarding and promotion of the welfare of students. The Registered Manager provides sound leadership to the care staff and contributes to the senior management team of the whole school led by the head. The head brings together the whole school staff team who operate effectively and show their commitment to providing an outstanding quality of

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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. 9 of 10 Inspection Report: SC065261

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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): • continue to work towards a minimum of 80% of all care staff having completed their NVQ Level 3 in care or equivalent (NMS 29.5). 10 of 10 Inspection Report: SC065261

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