Children's Home run by Aspris Children’s Services Limited in Hampshire

Unique reference number SC408655 Inspection date 02/11/2010 Inspector Christopher Garrett Type of inspection Key

p.1

Date of last inspection 20/05/2010 Website: www.ofsted.gov.uk

p.1

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.

p.2

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

p.2

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.

p.3

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.

p.3

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

p.3

Brief description of the service

This children's home is for six young people aged between 11 and 17 years. The home is run by a national organisation, providing a range of services, including education. The home provides care and accommodation for young people with a diagnoses of autism and associated syndromes who have social, emotional and behavioural difficulties. The young people may attend the provider's school nearby. The seven bedroom dormer-bungalow is situated in a private housing estate in a rural location, close to both a village and a town centre with easy access to local shops and leisure facilities.

p.4

Summary

The overall quality rating is satisfactory.

p.4

Summary

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

p.4

Summary

The purpose of this visit was to conduct a unannounced key inspection of the home. During the inspection all of the key national minimum standards for children's homes were inspected. The overall standard of care for the young people at the home is satisfactory. The outcome groups relating to being healthy, staying safe, making a positive contribution and organisation are assessed as satisfactory The outcome groups for enjoying and achieving and economic well-being are assessed as assessed as good.

p.4

Summary

This is the first inspection that the home has received since it was registered in May 2010. The manager has been proactive in implementing systems, procedures and practices to meet the needs and provide care for the young people. A number of these have yet to become fully established and embedded within the practices within the home. The staff are focused on getting the home fully operational and meeting the national minimum standards. However, they do not always evidence the work that they do. The young people benefit from being cared for by a number of staff who have experience of working with young people with autism. The young people's individual traits and preferences are fully accommodated. The young people present as being comfortable and settled within the home. The young people indicate that they are able to approach staff if they have any concerns or issues. Recommendation have been made to address the shortfall in staying safe, making a positive

p.4

Summary

contribution and organisation. Two actions are made regarding the some aspects of the management of the young people's behaviour and maintenance of fire doors. At the time of the inspection five young people are living at the home .

p.4

Improvements since the last inspection

This is the first inspection of the home following registration. No recommendations or action were made at that time.

p.4

Helping children to be healthy

Staff have an understanding of nutrition and encourage the young people to eat healthily. One of the young people said, 'we have lots of fruit and vegetables even carrots' and another said,' chocolate and snacks are limited’. The young people are involved in the planning of menus and help with the food shopping and in the preparation of some meals. Menu planning takes into consideration special dietary requirements and individual preferences. A four-week rolling menu offers some variety but is occasionally repetitive. The young people are encouraged to try different foods. However, staff are very sensitive to the needs of those young people with autistic spectrum disorders who have particular issues about their food. These are accommodated and this reduces the stress and anxiety that mealtimes can present for these young people. Records are not kept of all of the meals being provided by the home.

p.5

Helping children to be healthy

Health care plans have been implemented and contain details of known medical conditions, allergies and on going medical conditions. However, details of the young people's medical history including childhood illnesses and immunisations are not complete. Consequently staff are not aware if there are any outstanding medical matters that need to be addressed. The young people have been registered with local health services and are supported and encouraged to attend any appointments. Arrangements are made for young people to access to a specialised services provided by their school, which include speech and occupational therapy. The young people have access to the school's Personal Social and Health Education (PSHE) programme which provides them with information and advice on health and social issues. Parents and stakeholders comment positively on the attention given to the health of the young people. One explained that prior to admission that a young

p.5

Helping children to be healthy

person had looked pale and underweight but was now at the correct weight and has a 'healthy glow.'

p.5

Helping children to be healthy

The young people's health needs are generally met and their welfare safeguarded by the home's medical procedures and practice. Medical consent is obtained for medical interventions including the administration of medication and first aid. However, the home does not have the consent to authorise emergency medical treatment for all of the young people. Care staff are trained in the administration of medicines and in first aid which ensures that the young people have access to a suitably qualified person at all times. Clear records are in place for the administration of prescribed and non-prescribed medication. There is minor shortfall regarding the lack of a stock control system for the medication held by the home. However, this does not directly impact on the safety of the young people as all medication is kept secure and cannot be accessed by them.

p.5

Protecting children from harm or neglect and helping them stay safe

Care staff demonstrate respect for the young people’s privacy and ensure that personal information is confidentially managed. There is a clear expectation for all staff to knock on bedroom doors before entering. The arrangement for the delivery of personal care is recorded with the young people's files and ensures that this is provided sensitively and in private. Staff are deployed in a manner which ensures that whilst all of the young people receive a high level of supervision that this is not delivered in an oppressive or invasive manner. The young people can have private time on their own if they wish. Arrangements are made for the young people to be able receive phone calls in private. The young people's records are kept safe and secure.

p.6

Protecting children from harm or neglect and helping them stay safe

The home has implemented systems for the young people to raise concerns or issues. These arrangements include the opportunity to make contact with adults independent of the home. Some of the young people have limited or no verbal communication skills. However, there is a clear expectation and understanding that all of the young people are able to communicate in some manner. The young people indicate that are adults within the home that they are happy to approach if they have any concerns. The home has a system for responding to formal complaints. However, the few issues raised with the home have been effectively dealt with in an informal manner.

p.6

Protecting children from harm or neglect and helping them stay safe

The home takes positive steps to ensure that the young people are protected from abuse and that its care staff have the knowledge, understanding and skills required to respond to child protection concerns. The Registered Manager takes the lead responsibility in responding to child protection incidents. Care staff are aware of who to contact within the organisation if the manager is not available. Child protection training is provided to all staff as part of their induction programme and this is routinely refreshed and updated. All staff demonstrate a good understanding of the procedures in place and their role and responsibilities in responding to actual or potential incidents of abuse.

p.6

Protecting children from harm or neglect and helping them stay safe

There is a clear message that bullying in any form is not acceptable or tolerated within the home. The young people indicate that bullying is not an issue for them within the home. Staff understand that some behaviour displayed by the young people can have an upsetting ands unsettling effect on the rest of the group. High levels of supervision and the deployment of staff ensure that these occasions are promptly dealt with. The young people’s awareness of bullying is raised through their school's PSHE programme.

p.6

Protecting children from harm or neglect and helping them stay safe

Young people leaving the safety of the residential provision and/or the supervision of the staff is not a current issue in the home. Individual behavioural risk assessments are undertaken to identify those young people who are at risk of trying to leave the supervision of staff. Strategies include an increase in the staffing ratios when a potential or actual risk is identified. Staff have access to information and guidance on the appropriate steps to take if a young person were to go missing.

p.6

Protecting children from harm or neglect and helping them stay safe

The home provides care for young people with autistic spectrum disorders and related social and behavioural difficulties. The home's management of behaviour is focused on encouraging, recognising and rewarding appropriate behaviour. The young people feel that the rules in the home are fair. The young people have some understanding of the consequences when rules are broken or their behaviour is not acceptable. However, staff are fully aware that some of young people are unable to take full responsibility for some aspects of their behaviour and may have little understanding of how their behaviour impacts on others. The young people can display a range of difficult and anti-social behaviour. Staff are trained and develop the skills and knowledge that help them to understand, manage and respond to the young people's behaviour. All staff are training in the use of positive handling techniques which includes the use of de-escalation techniques and the use of

p.7

Protecting children from harm or neglect and helping them stay safe

restraint. Records suggest that there is a limited use of sanctions and for need to use restraint. However, there is evidence of inconsistencies and delays in recording and a lack of clarity about the threshold for recording some positive handling intervention. Sanctions are not routinely evaluated for their effectiveness. The sanctions book is not secure.

p.7

Protecting children from harm or neglect and helping them stay safe

The homes make use of a calm room to provide safe space for young people who are displaying behaviours that pose danger for themselves to others. Staff are provided guidance on the circumstances that the room can be used and how it is supervised monitored. Separate records are kept of its use. These show that the room has on two occasions been used for reasons not covered by the guidance.

p.7

Protecting children from harm or neglect and helping them stay safe

The home takes steps that generally ensures that young people, and staff and visitors are safe from the risk of fire and other hazards. Systems are in place for the regular checking and servicing of fire safety and detection equipment. Detailed records of fire safety activity, including practise evacuations, are kept. A fire risk assessment has been undertaken and recommendations have been acted upon. However, the failure to maintain all fire doors in good working condition poses a potential risk to the young people and staff within the home.

p.7

Protecting children from harm or neglect and helping them stay safe

The home has implemented a process for risk assessing the activities and trips accessed by the young people. The assessments provide details what action can be taken to reduce or eliminate any element of risk. Consideration is given in regards how young people's autism may impact on their participation in an activity or trip. These arrangements help to ensure the safety of the vulnerable young people. With the exception of matters identified within this report, the physical environment is well maintained and no other significant actual or potential health and safety hazards were identified during the tour of the premises or grounds.

p.7

Protecting children from harm or neglect and helping them stay safe

The home is owned and run by a private organisation and follows its recruitment and vetting procedures. These are robust and cover all of the requirements of the national minimum standards. Criminal Record Bureau (CRB) checks at an enhanced level are completed before staff take up their employment. The organisation has a process for updating CRB checks every three years. The recruitment and vetting procedures are contributory factor to the safeguarding of the young people and help to ensure that they are not cared by staff who are actual or potential abusers.

p.7

Helping children achieve well and enjoy what they do

Arrangements have been implemented and established which ensure that the young people receive individual support when a need is identified. The young people have access to health and welfare services, which include advocacy, occupational and speech and language therapy, arranged through the organisation's school. The young have an allocated key worker whose responsibilities include taking a special interest in their key child, liaising with parents, school, external social and health care agencies and contributing to statutory reviews. Young people are given advise on how they can contact adults why are independent of the home. Most of the young people have an advocate who is able to raise concerns and issues with the home and other agencies and services involved in caring for the young person. Staff receive training in the use of different communication systems enabling them to communicate with the young people who do not use verbal communication.

p.8

Helping children achieve well and enjoy what they do

Staff are proactive in promoting the value and education and ensure that daily attendance at school is a routine part of life in the home. There is a clear expectation that young people will routinely attend school. All of young people are currently attend one of the organisation's registered residential special schools as day pupils. Some staff from the home are timetabled to work in the school providing additional classroom support. Staff comment positively on this arrangement stating that it gives them insight and understanding into the young people's education programme and progress and helps to ensue consistency in behaviour management. Two-way communication systems are established between the school and the home which provides updates on progress and on issues that may impact on the young people's moods and behaviour.

p.8

Helping children make a positive contribution

Initial care plans are in place for each of the young people. These identify the current needs for the young people and sets out how these are to be met. The manager advises that this is an aspect of the service that is still being developed. Systems are in place for the young people’s progress and their placements to be reviewed. However, only one young person has been due for and had a review during the period that the home has been operating.

p.8

Helping children make a positive contribution

Staff are fully aware of the importance for the young people to be able to maintain contact with their family/carers friends and significant others. Contact arrangements are agreed with the placing authority and are recorded in the young people's care plan. The young people have access to a cordless phone which enables them to receive calls in private. There are ample spaces in the home for the young people to meet their visitors in private. Parents and stakeholders comment positively on the communication that they have with the home. One parent explains that, 'we are very happy with the level of involvement and communication which is making us feel closer to our son and more in control'

p.8

Helping children make a positive contribution

The Registered Manager is fully aware of the anxiety and stress that young people can experience when confronted with changes to their routines. Positive and imaginative steps are taken to ensure that a young person's transition into the home is managed in a sensitive manner. Consultation takes place with parents /carers and agencies involved with the young people. If needed a gradual introduction to the home is undertaken. This provides the opportunity for the young people to become familiar with environment, the staff and have some understanding of how the home operates.

p.9

Helping children make a positive contribution

All of the young people are routinely given the opportunity to made choices. Some take an active part in the decision making process about some aspects of the day-to- day operation of the home. The young people can attend formal meetings, which are recorded, during which their views are sought on issue which are important to them. There is evidence that the young people have influenced changes within the home and are routinely consulted about matters including activities and trips. Two of the young people find the meetings difficult to manage and do not routinely attends these. It is not clear how they are made aware of any discussions and decisions that have taken place or how their views are being sought.

p.9

Achieving economic wellbeing

There is a strong emphasis within the home on the young people acquiring and developing a range of life skills to prepare them in their transition to adulthood. The young people are provided with the opportunity to acquire skills in housekeeping, cooking, gardening maintenance and in money management. Pathway plans have not been implemented for those young people who may move on from the home during the next twelve months.

p.9

Achieving economic wellbeing

The young people live in a comfortable well-kept home that provides sufficient space to meet their needs and interests. The home is well maintained in a state of repair and decoration. The home is furnished and equipped to a good standard and makes use of domestic-style furniture to provide a homely environment. The home is clean and tidy. The young people have individual bedrooms which are well furnished and have ample storage facilities. Each room is of a good size providing a usable floor space for the young people to use when they want to play or pursue interests away from the group. The young people have the choice whether to personalise their rooms. There are ample well-equipped communal spaces that are used for a variety of activities and provides alternative areas where the young people can spend time on their own

p.9

Achieving economic wellbeing

Externally there are garden areas to the side and rear of the building which provide a good-sized space for a range of outdoor activities and interests. Space has been allocated for the young people to have their own garden areas and to build dens and play houses.

p.9

Organisation

Information on the home's purpose, values, organisation and what it sets out to do for the young people is clearly set out in its Statement of Purpose and the children's guide. The documents provide sufficient information to enable the young people, parents and other interested parties to determine the function and aims of the home.

p.10

Organisation

The home takes positive steps to ensure that the young people are cared for by competent trained staff who have the skills and knowledge to provide care for young people with diagnoses of autism and associated social, emotional and behavioural difficulties. The organisation provides an induction training package that includes child protection, behaviour management, fire awareness and an introduction to autism. This is followed up by a comprehensive training programme which includes first aid, administration of medication and food handling. Staff have access to service specific training which includes the use of communication systems. There is a clear expectation that all care still will complete a National Vocational Qualification (NVQ) at level 3 in Caring for Children and Young P\eople. The organisation allows staff to enrol on NVQ training before completing their probationary periods. All of the

p.10

Organisation

existing care team have either completed, or are or the process of undertaking, their NVQ training. Staff comment positively on their training and states that it helps them in the preparation and development if their care roles.

p.10

Organisation

There are sufficient numbers of staff to meet the current needs of young people within the home. This included the support the young people need for their activities, visits and appointments. The home and the young people benefit from having a core team of staff who have had experience of working with young people with autism. Staffing is arranged to provide consistency and continuity of care and management of the young people. The home has satisfactory arrangements in place to cover planned and unforeseen absenteeism.

p.10

Organisation

Systems have been implemented for the external and internal monitoring of the welfare of the young people and practices within the home in the home. Action is taken in response to any recommendations and/or observations made following the external monitoring visits and internal monthly checks. The home has not implemented a process for consulting with the young people, parents and placing authorities on improving the quality of care within the home. This shortfall is not currently seen to have an impact on the care being provided to the young people or on the development of the service.

p.10

Organisation

The promotion of equality and diversity is satisfactory. All of the young people are valued and respected as individuals. Individual preferences and traits are respected and accommodated. Special diets are catered for. The care team is diverse in regards to age, race and gender and meets the current needs of the young people. Staff receive training that raises their awareness of equality and diversity.

p.10

Organisation

Individual files are in place for each of the young people. Satisfactory arrangement are in place to keep these safe, secure and confidential.

p.11

Statutory Requirements

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

p.11

Std. Action Due date

22 ensure that within 24 hours of use of any measure of control, a written record is made in a volume kept for the purpose (Reg.17 (4)) 17/12/2010

p.11

Std. Action Due date

26 make adequate arrangements for the maintenance of all fire equipment (Reg. 32 (1) (c) (iv)) 19/11/2010

p.11

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s):

p.11

Recommendations

 ensure that menus offer a good variety of food and that records are kept of all of her meals provided by the home (NMS.10.4)  ensure that health plans contain details of the young people's medical history and records of immunisations (NMS.12.2)  implement a stock control system for recording and monitoring the medication held in stock within the home (NMS.13.2)  implement procedures which ensure that the young people can receive prompt emergency medical treatment if required (NMS.13.4)  review the operation and management of the calm room (NMS.22.2)  ensure that all of the young people have the opportunity to make their wishes and feelings known regarding their care and treatment within the home. (NMS.8.1)  implement systems for consulting with the young people, parents, carers and placing authority on how to improve the quality of care provided in the home. (NMS.33.1)

p.11