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

Unique reference number SC065261 Inspection date 07/10/2010 Inspector Clare Davies Type of inspection Key

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Date of last inspection 03/03/2010 Website: www.ofsted.gov.uk

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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 Crispins, 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.

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About this inspection

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 outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

This school provides care and accommodation for up to 60 students 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 students 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 nine living groups, this includes one off-site in a neighbouring village. Four living groups providing 38 week termly boarding are located within the main building of the school. There are four living groups located separately in the school grounds providing up to 52 week care.

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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

The overall quality rating is outstanding.

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Summary

This is an overview of what the inspector found during the inspection.

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Summary

This inspection assessed this service against all the key national minimum standards for children's homes. The school received 2 days notice. An integrated inspection of the education and welfare took place at the same time. The inspection of the organisation's independent school is reported on individually. The report is published on the Ofsted website.

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Summary

This is an outstanding service for young people with autism. The staff work collaboratively across teams using their skills and professionalism to deliver high quality care whilst maintaining the primary focus as the needs of the students. This school provides a supportive caring environment enabling students to develop socially and emotionally. Such development leads to an increase in self-esteem enabling positive relationships to be formed.

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Summary

A strong line management structure and training opportunities ensure staff feel supported in their work. Through self evaluation the senior management team strive to challenge themselves and their provision in order to exceed the national minimum standards.

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Improvements since the last inspection

One recommendation was made at the last inspection in the outcome area of organisation, this relates to the number of staff who have achieved the National Vocational Qualification (NVQ) at level 3. The number of staff with this qualification has increased since the last inspection but remains lower than 80% therefore this recommendation is repeated.

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Helping children to be healthy

This school delivers outstanding health care to its students, providing a holistic approach to their physical and emotional well-being. The catering provided from the main school kitchen is of a very good quality, most meals are made from fresh ingredients providing nutritious and tasty food. The menus are analysed by a nutritionist and recent changes have included the replacement of squash with diluted fruit juice and less puddings with more fruit and yoghurts available. Some students expressed their disappointment at not having a pudding everyday, a survey is underway to ensure the most popular ones are served when pudding is on the menu.

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Helping children to be healthy

For some students with autism, eating a varied diet can be difficult. Staff encourage students to try new foods step by step and their patience and persistence pay dividends as the students extend their range of food choice and eat many things for the first time. This progress develops student confidence and their social skills. The living groups have kitchens that provide opportunities for some students to prepare and cook a snack or meal with staff support. This school has achieved the Healthy Schools Award and satisfactory visits from the environmental health department.

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Helping children to be healthy

Students are provided with guidance, advice and support on health and personal care issues through the classroom and the residential setting. Daily support is given with personal hygiene and self-care skills. Many students benefit from visual prompts, using a series of symbols showing them their schedule of events. Care staff spend time with students following a workbook on 'growing up'. This promotes awareness of the students own body image and differences in other people. Students are taught language and actions that are socially acceptable and the need to safeguard themselves and others.

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Helping children to be healthy

Individual needs are identified as part of the admission process to ensure the school can suitably meet them. The multi-disciplinary team, based at the school, can provide psychology, psychiatry, speech and language therapy, occupational therapy, music therapy and medical support from the school nurse. The collaborative approach ensures that students receive a comprehensive package of care, not only to meet their needs but to strive for progress and personal development. The school nurse co-ordinates the medical care and delivers training to all staff in the administration of medication and some particular skills required to meet individual medical needs. The nurse has developed sound systems for monitoring medication, parental consent to medical treatment, all student appointments and staff training. This ensures that training can be updated annually and student appointments can be tracked easily. There is an excellent multi-professional approach to the healthcare of

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Helping children to be healthy

students by the staff on site, visiting health professionals and use of community resources such as opticians, dentists and the health centre. Older students are encouraged to use the community resources where possible to develop their life skills and independence.

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Protecting children from harm or neglect and helping them stay safe

The utmost importance is given to the safety and well-being of students, staff and visitors. This responsibility is accepted by all staff regardless of their role within the school and is incorporated into high quality care practices. Sound policies support staff in delivering intimate personal care safely and with respect for the privacy and dignity of the students in their care.

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Protecting children from harm or neglect and helping them stay safe

The records of a small number of complaints received demonstrate how the management of the school accept any criticism by way of taking action to improve. Parents, placing authorities and the community are informed how to access the complaints procedure through the website. Any complaints are swiftly dealt with and documented. In contrast the school invite their visitors to complete a survey about their experience to try and identify any areas of their service that could be improved. Each living group has a display, using words and symbols, directing students who to contact if they have a complaint. Students are encouraged to communicate with the staff who know them well or an independent visitor. Contact details for external agencies such as Childline and Ofsted are provided.

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Protecting children from harm or neglect and helping them stay safe

All staff are trained on what to do if they are concerned that student may be harmed or at risk of being harmed. Clear policies and procedures provide guidance. The provider has updated these documents to include reference to new legislation such as the Safeguarding Vulnerable Groups Act 2006. The school has good links with the local authority safeguarding teams for children and adults as some students are over the age of 18 years. With their diagnosis of autistic spectrum disorder, some students have little or no verbal communication and use alternative methods including the use of picture symbols and basic signing. For some students communication is limited to physical actions and facial expressions. Consequently they are unable to easily indicate when they have an issue or a concern. Staff are adept at interpreting the different means of communication. This allows them to take appropriate action when a student is feeling uncomfortable or unhappy.

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Protecting children from harm or neglect and helping them stay safe

Bullying and being absent without authority are not issues for these students. They receive appropriate support and are provided with high levels of supervision. The school's anti-bullying and harassment policy is entitled, 'safe to learn'. There is a safe and secure environment which ensures that the students are unable to leave without the staff's knowledge and involvement. A student reported, 'I feel confident and safe'. Behavioural risk assessments identify those students who require higher levels of supervision when on trips away from the school. Staff are fully conversant with the procedures to follow if a student should go missing.

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Protecting children from harm or neglect and helping them stay safe

To support students with their behaviour management a support plan is produced by the psychologists in collaboration with staff who work closely with each student. Daily records are made, describing incidents of positive interaction and any unusual or challenging behaviour. This information is collated towards the ongoing assessment of the students' needs. In-depth analysis of behaviour is undertaken by the psychologists, this information can inform any changes required to the behaviour support plans. With the commitment of all staff following the behaviour support plan, students receive a consistent response and are able to diminish some of their behaviour that may have a negative impact on themselves or others. Progress has meant for some students that they can now go shopping in the community or eat out in a restaurant, enhancing their social experiences. Staff are provided with training on the use of positive handling techniques, including the use of de-escalation and

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Protecting children from harm or neglect and helping them stay safe

distraction techniques and the use of restraint. The behaviour support plans provide guidance on agreed strategies and on the physical interventions that can be used. Bound record books ensure that all the key information is recorded and such records are monitored by the senior management team.

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Protecting children from harm or neglect and helping them stay safe

The impact of student behaviour is monitored closely. The senior management team have developed a robust system of recording accidents ensuring that the reports are cross referenced against the suitability of behaviour support plans and risk assessments. This demonstrates a strong commitment to the health and safety of students and staff. There are sound systems in place to maintain safety across the site and individual living groups, these include the necessary checks on electrical equipment and general safety within the home environment. There is good monitoring of fire safety with students taking part in regular evacuation drills. This ensures that they know what to do in the event of a fire or other emergency. The environment and activities are all subject to thorough risk assessment. Individual student risk assessment identify their likely response to an emergency evacuation and how to support those who may find this distressing.

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Protecting children from harm or neglect and helping them stay safe

The organisation has a robust recruitment policy, completing checks to ensure that all staff are properly vetted before they start work. Visitors to the home are also checked and escorted around. These processes help protect students from unauthorised individuals gaining access.

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Helping children achieve well and enjoy what they do

The individual support available to each student is outstanding. Staff understand students and their behaviours exceptionally well and are very knowledgeable of their individual needs and the implications this has for their care. Collaborative working across the staff teams and disciplines maintains the needs of each student as the focus of their work. Students have their own folder of therapeutic programmes that accompanies them between school and the residential setting. This ensures that all staff can support the students with their tailor made therapies in a consistent manner therefore contributing to progress. Therapists produce clear programmes for staff and students to understand including photographs of physical exercises and the correct use of equipment. Staff report that they are able to access sensory resources for students' personal use and there are sensory and therapy rooms that are suitably

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Helping children achieve well and enjoy what they do

A pen portrait has been produced for each student detailing their likes and dislikes, method of communication, cultural and dietary needs, medical needs and other information important for any staff member to know before supporting them. These are excellent documents with use of colour, symbols and a photograph of the student. Staff have ready access to software to translate information into symbols. There are lots of laminated symbols and sequence of events, known as social stories, located around each living group and classroom. The nurse has copies of social stories to explain events such as a blood test or going to hospital. Students had been prepared for the inspectors visit through social stories. Life books are produced collating photographs and listing favourite things, important people and significant events.

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Helping children achieve well and enjoy what they do

The residential provision supports the educational progress of students. The excellent communication between staff teams provides a cohesive and consistent approach to students and their learning. The activity programme promotes the 24 hour curriculum. A comprehensive document details listed activities, matching them to the national minimum standards and the Eco school project. For example, a shopping trip involves student choice, leisure interest, socially acceptable behaviour and life skills in handling money. This activity supports the Eco project by learning where the food comes from, transportation and food miles, choosing local products and taking a re-usable shopping bag. This excellent document supports staff in ensuring every activity has a purpose to contribute to the students' learning and their personal development.

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Helping children achieve well and enjoy what they do

Many opportunities are provided for activities and outings that the students clearly enjoy. School transport ensures that there are trips into the wider community, taking advantage of the school's coastal location. On site there are lots of resources and facilities including secure space to play outside in the school grounds. This school delivers as stated in its mission 'to enable each and every one of our students to reach their full potential however it is defined by them or for them'.

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Helping children make a positive contribution

Individual placement plans clearly identify a student's needs and how they will be met through the day and night. Key documents compliment the placement plan such as a risk assessment, a behaviour support plan, an education plan and therapeutic programmes. Ongoing assessment contributes to the regular update of placement plans and formal reviews occur every six weeks. This is in addition to statutory reviews to consider the statement of special education and for children looked after by local authorities. There has been development to improve the quality of reports towards these review meetings, this ensures that reporting is comprehensive and consistent in style.

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Helping children make a positive contribution

To maintain contact with family members, arrangements are known by the staff team and weekly calendars list regular telephone calls between students and their parents, and staff and parents. Some students use a webcam to communicate with their families, others gain enjoyment from simply hearing their parents' voices over the telephone. To support students who become homesick digital photograph frames provide some comfort and calendars are used as visual aids to count down when they will next see their parents. The school welcomes visits from relatives and can offer a family room with refreshments and toys. To keep parents informed about their child's placement, weekly newsletters are sent providing a summary of the week in education, residential care and any therapies used. These are very good documents enhanced with photographs of the students and their achievements of the past week.

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Helping children make a positive contribution

Attention to detail is given for any student joining the school. The move is carefully considered and planned at a pace that is commensurate with each students ability to cope with the transition. Information is given to parents and in an appropriate format for the student including photographs and social stories. To explain to the group of students that a new person is coming to join them social stories are created for them as well. Similarly when students leave school they receive support in preparing them for change.

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Helping children make a positive contribution

Consultation and involvement of students in decision making is integral to daily life at this school. Staff have a good understanding of how the students express themselves and are both patient and persistent when communicating with them. Students are encouraged to make daily choices for example with regards to food, clothing and activities. Living groups hold meetings and there is a school council. The student voice has chosen the name of the new living group, the school football team and are actively involved in the Eco project. Students are encouraged to make a positive contribution in the school and within the local community. Some students assist the maintenance and domestic teams with jobs on site and some students take part in a newspaper round.

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Achieving economic wellbeing

Independent living skills are promoted throughout the classroom and the living groups. This varies from managing personal hygiene without prompting to cooking a simple meal or attending a work placement. Living skills are documented to show what level of support each student requires and then repeated over a period of time. These records measure progress and support students in reaching for their potential. Students are supported to integrate in the local community, using leisure facilities, restaurants and shops.

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Achieving economic wellbeing

The accommodation is a mixture of purpose built properties and adapted areas of the old building. There is one house off site in a neighbouring village. Students are allocated to living groups according to their age, individual need, gender and whether they are accommodated for 38 or 52 weeks of the year. The accommodation varies in character in each living group though all provide single bedrooms, some with en-suite facilities. Communal areas are comfortable with soft furnishings. Students can personalise their bedrooms with posters and belongings, some prefer less stimulation and their room is adapted to suit their individual needs. The most recently built living group is generous in size and will provide high quality accommodation within the school grounds. Overall the quality of the accommodation is good although some locks on bathroom and toilet doors are not functioning, this could compromise the privacy of some students.

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Organisation

The promotion of equality and diversity is outstanding. To support staff in their practice they receive training and there is an ongoing evaluation of how equality and diversity can be addressed within the national minimum standards. Students are of mixed gender in living groups, supported by staff reflecting diversity through age, gender and ethnicity. Students are supported in observing their own religious and cultural needs. There is an events calendar for the whole school to celebrate a spectrum of cultural and religious events.

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Organisation

The school is organised and managed in a manner that delivers and maintains an outstanding level of care. The registered manager has the expertise, skills and knowledge to effectively manage the residential provision. The cohesion of the senior management team is a strength of the school with their determination to continually raise standards in the delivery of care and education to the students. The Statement of Purpose reflects the service and is further supported by a website and brochures. There are sufficient numbers of staff to meet the complex needs of the students throughout the day and night. A team of bank staff help provide consistency of care when there are staff shortages. There are good arrangements for on-call senior cover and access to senior management, providing advice and support when needed.

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Organisation

There is a strong commitment to staff training ensuring that professional development is continual. Staff report very positively on their training opportunities and the support they receive from their colleagues, the therapy team, their line managers and the senior management team. Staff are proud of their contribution to this service and report some of the strengths as follows; excellent opportunities for students, encouragement for students to achieve their personal best, an organisation that has a good understanding of autism, a student focussed service and a good location for interaction with the community.

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Organisation

There are sound established systems to monitor care practices and the development of the service. Through self evaluation this school strives to further improve and raise standards for the benefit of the students. Parents and placing authorities report high levels of satisfaction with the service provided.

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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):

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Recommendations

 ensure that the home provides adequate good quality domestic style facilities for those living on the premises consistent with the purpose and function of the home and is maintained in good order throughout. In particular, ensure locks on bathrooms and toilets are in working order (NMS 24.1)  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).

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