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

SC043994 Unique reference number 26 April 2010 Inspection date Paula Eaton Inspector Key Type of Inspection

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28 January 2010 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 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 unannounced inspection that covered all outcome areas and all key national minimum standards.

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Summary

The service has good systems in place for assessing and meeting the needs of young people. Particular strengths of the service include behaviour management and the systems in place to meet the health needs of young people. Young people and staff benefit from the input of a variety of healthcare professionals and a sound multi-disciplinary approach to meeting the needs of young people.

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Summary

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. Comprehensive 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

The environment is maintained to a good standard. 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 was one action set at the last inspection that required the provider to ensure that regular fire drills were taking place. This has been met.

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Helping children to be healthy

The provision is good. Young people benefit from nutritious meals made from ingredients sourced from local farm shops and butchers where possible. Individual dietary needs are clearly identified and included on the menus provided where appropriate and young people are encouraged to make choices about what they would like to eat. Mealtimes are sociable, lively occasions and those young people who require staff support are helped in a sensitive manner, the use of appropriate 4 of 9 Inspection Report: SC043994 equipment helps to enable young people to remain as independent as possible. Cultural and religious dietary requirements are clearly recorded and considered during meal preparation.

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Helping children to be healthy

Sound systems are in place for assessing and meeting the health needs of young people. All young people have a health action plan and clear records are maintained for any appointments attended and any treatment received. The school nurse is actively involved in supporting staff to meet the health needs of young people and facilitates training and runs clinics within the school. The school also benefits from the services of a consultant Psychiatrist, Physiotherapist, Occupational Therapist and a Psychologist.

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Helping children to be healthy

Robust systems are in place for the safe storage, administration and disposal of medication. Staff receive medication awareness training and are observed administering medication before they are permitted to do so alone. There are clear medication policies and procedures in place and there are individual guidelines in place for each young person with regard to what medication they take, the reason for this and how it should be administered. All staff 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 and records are stored securely to prevent unauthorised access.

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Protecting children from harm or neglect and helping them stay safe

There are very few complaints made about the service. Any complaints that are made are responded to promptly and effectively. The complaints procedure is produced in a suitable format for young people. The Registered Manager of the service is the designated safeguarding officer for the school. All staff receive initial child protection training as part of their induction and are then also expected to attend safeguarding training provided by the local authority. There are good safeguarding policies and procedures in place. The Registered Manager maintains a central log of any safeguarding issues and monitors the progress of any investigation that is taking place.

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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 closely monitored. Bullying is uncommon within the service and any difficulties that occur between young people are usually as a result of challenging behaviour and not as a result of bullying. Staffing levels are high and young people are supervised at all times which also limits opportunities for bullying. 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. Risk assessments are completed for individuals where there is a potential risk of a young person absconding and measures are put in place to minimise this risk.

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Protecting children from harm or neglect and helping them stay safe

A behaviour specialist team work with staff to develop, monitor and review individual behaviour support plans for each young person. Each plan contains comprehensive guidance for staff on how to manage the behaviour of young people and also how to recognise and avoid triggers 5 of 9 Inspection Report: SC043994 for difficult behaviour. This approach ensures consistency between school and residential staff, leads to fewer incidents and provides secure boundaries for young people. Physical intervention is only used when necessary to protect the young person or others from harm. Appropriate records are maintained for any physical interventions used and all staff receive regular training on behaviour management including physical intervention to ensure they are able to safely respond to difficult behaviour.

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Protecting children from harm or neglect and helping them stay safe

Good systems are in place to ensure the health and safety of young people and staff. Regular health and safety checks take place in each of the residential houses and there are clear health and safety policies and procedures in place. There are also detailed individual fire risk assessments in place for young people outlining any issues with regard to evacuation and fire drills are taking place on a regular basis. However, the times of fire drills are not currently being recorded and therefore it is not possible to tell if they are taking place at different times of the day as expected.

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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 the young people who use the service. All required checks take place prior to a new employee commencing work within the service. Employee records are kept in good order.

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Helping children achieve well and enjoy what they do

The provision is good. Staff strive to meet the individual needs of young people. Comprehensive care plans and guidance for staff ensure that young people are treated as individuals and supported to develop in their own way and at their own pace. Each young person has a key worker who is responsible for ensuring their needs are met. Specialist support is also arranged for those young people who require it and the cultural and religious needs of young people are considered. For example, Halal produce is provided for young people of the Muslim faith. Individual risk assessments are in place for each young person and daily records are also maintained for individual young people.

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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 and continuity of the 24 hour curriculum between school and the residential houses works well. Regular reviews of the young people's educational needs take place.

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Helping children achieve well and enjoy what they do

Young people benefit from a wide range of activities tailored to meet their individual needs. In house, young people have access to activities such as arts and crafts, trampolines, sensory activities and cooking. Staff also support young people to engage in activities out in the community such as swimming, bowling, the cinema and one young person has been supported to attend a circus school. The school also supports young people to go on holiday. A recent camping trip had taken place and three young people were going on a four day trip to Center Parcs on the day of the inspection.

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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 6 of 9 Inspection Report: SC043994 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. Multi-disciplinary meetings also take place on a regular basis to ensure that care plans are reviewed and updated as young people's needs change.

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Helping children make a positive contribution

Review meetings take place 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. Parents are also actively involved in this process and supported to contribute. For example, on the day of the inspection a parent who was unable to attend a review meeting for her child as she was abroad was supported to participate by using a speakerphone service.

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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 one young person was being supported by two members of staff to travel abroad and visit his Mother the day after the inspection.

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Helping children make a positive contribution

Good systems are in place for supporting young people to move into and 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. 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

The environment is maintained to a good standard and any maintenance issues are responded to promptly. Furnishings in the residential accommodation are of a good quality and young people are encouraged to personalise their rooms. However, due to the nature of the disability of some young people some rooms have limited personal effects in them. 7 of 9 Inspection Report: SC043994

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Organisation

The organisation is good. The service has a Statement of Purpose in place that contains all of the required information and is updated at regular intervals. There is also a young people's guide in place that is produced in a suitable format and contains information about what to expect from the service as well as key information about complaints and safeguarding issues.

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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. Religious and cultural needs are also taken into consideration.

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Organisation

Staffing levels are high to ensure that there is sufficient staff cover to meet the complex needs of young people. Additional staffing is sometimes provided to facilitate activities and appointments the young people may have. Staff are competent and benefit from a comprehensive two week induction programme that covers areas of mandatory training and guidance about working with young people as well as covering key policies and procedures. There is an appropriate handover period between shifts and a good line management structure in place.

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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. All staff have access to the central training programme and can therefore request to be included on a training course arranged. The school training database provides an excellent training monitoring tool that highlights training due to expire and any training attended or required. The service has also introduced some e-learning that is accessible to all staff.

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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. Regular health and safety audits also take place.

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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.

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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): • record the time that fire drills take place to evidence that they are taking place at different times of the day (NMS 26) 9 of 9 Inspection Report: SC043994

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