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

Unique reference number SC408655 Inspection date 06/10/2011 Inspector Bridgette Lowe Type of inspection Full Provision subtype Children's home

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Date of last inspection 02/11/2010 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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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 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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The inspection judgements and what they mean

Outstanding : a service that significantly exceeds minimum requirements Good : a service that exceeds minimum requirements Satisfactory : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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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 diagnosis of autism and associated syndromes who have social, emotional and behavioural difficulties. The young people may attend the provider's school nearby.

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Overall effectiveness

The overall effectiveness is judged to be satisfactory .

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Overall effectiveness

Young people benefit from living in a home that delivers a satisfactory level of personalised care and support to them. Good attention is given to planning and transitioning of young people into the home and on leaving. This contributes to young people being settled in their home. Young people have achieved satisfactory outcomes since joining the home through education and leisure activities. Young people are achieving independent living skills through support from staff; however, it is unclear as to what extent they have progressed since joining the home. Caring and committed staff ensure that young people receive continuity of care that aims to meet their specific needs. Good relationships exist between staff and young people. This provides young people with caring staff that understand their needs and challenging and complex behaviours.

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Overall effectiveness

Effective safeguarding measures ensure young people's welfare is promoted. Young people live in a generally safe and secure environment. Young people are supported in a large, spacious homely environment. The management of the home is satisfactory. However, a number of shortfalls have been highlighted in the report and requirements and recommendations made to address these. The majority of these relate to records and the home further promoting positive outcomes for young people. The manager is aware of the home’s shortfalls and is committed to further improve outcomes for young people.

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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 person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) produce a children's guide in a form appropriate to the age, understanding and communication needs of the children 04/11/2011 accommodated in the home (Regulation 4 (4))

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Reg. Requirement Due date

(2001) revise the Statement of Purpose and children’s guide to ensure the correct address and telephone number of Ofsted are present (Regulation 5 (a)) 28/10/2011

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Reg. Requirement Due date

17A (2001) ensure that any punishment does not involve the deprivation of food and behaviour plans clearly demonstrate this (Regulation 17 (2) (b)) 28/10/2011

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Reg. Requirement Due date

17B (2001) ensure the written record of any measure of control restraint or discipline maintained meets the regulations (Regulation 17 B (3(b) (c) (f) (g) (4 (b)) 28/10/2011

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Reg. Requirement Due date

(2001) ensure that each child is enabled so far as practicable to observe any requirement, specifically to diet, of the religious persuasion to which he belongs (Regulation 19 (c)) 28/10/2011

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Reg. Requirement Due date

(2001) ensure children's case records include the information, documents and records specified in Schedule 3 relating to that child and is kept up to date, legible, with each written entry being signed and dated by the author (Regulation 28 (a) (b) (c) (Schedule 3)) 04/11/2011

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Reg. Requirement Due date

(2001) ensure the person carrying out the visits shall interview with their consent and in private, children accommodated there and their parents as appears necessary in order to form an opinion of the standard of care provided in the home. (Regulation 33 (4) (a)) 04/11/2011

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Recommendations

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

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Recommendations

 ensure young people's physical health is promoted further, specifically in relation to providing a nutritious and balanced diet (NMS 6.1)  ensure all children communicate their views on all aspects of their care and support; this specifically relates to non-verbal young people being supported and consistently encouraged to use their communication systems (NMS 1.2)  contribute to each young person's care plan and pathway plan to include details of all support young people need to develop their independence and preparation for adulthood (NMS 12.1 and 12.2)  ensure recruitment records detail the level of Criminal Record Bureau disclosure and the outcome of the check (NMS 16.3. b.)  ensure restrictions in place to safeguard young people are only used where agreed with placing authorities and parents. This relates specifically to the locking of the front door, kitchen cabinets and young people's toy cupboard at

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Recommendations

night (NMS 10.4)  ensure areas within and outside the home are made safe. This relates to young people's bedroom doors and the side access gate being able to close properly and the garden den area being repaired (NMS 10.2)  ensure young people's physical health is promoted and appropriate consent for medical treatment is obtained (NMS 6.5)  ensure where physical restraint techniques are used staff are trained in the use of the restraint technique and only use the home's agreed techniques. This specifically relates to agreed techniques being clearly outlined in young people's behaviour risk assessments. (NMS 3.15)

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Outcomes for children and young people

Outcomes for children and young people are satisfactory .

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Outcomes for children and young people

Since joining the home young people have made satisfactory progress in relation to their disability in all areas of their lives. Parents and staff comment that young people have grown in confidence and ability since living at the home. Young people's cultural and religious needs are generally well met with young people being supported to attend church and take part in daily prayers and worship. Comments from parents include: 'my child is free to move around as he desires and he is treated as an individual, he does not have to participate in activities he does not enjoy.' However one parent commented: 'my child is fine, although as he gets older he becomes less independent, but he is there for learning and his behaviour.' Young people were seen enjoying a range of activities and opportunities on offer and are obviously happy and settled in their environment.

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Outcomes for children and young people

All young people attend the local residential special school that is run by the same organisation. The school ensures each young person has an education programme that is tailored to their individual needs. Attendance is very good and staff from the home also support young people with transitioning to and from school and also during the school day. This allows young people to be more relaxed at stressful transition times and maintain good attendance levels. Young people commented that they 'like school.'

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Outcomes for children and young people

There is a focus on developing young people's independent living skills that has resulted in young people learning skills, such as shopping, self-help skills, cooking and home management skills, such as washing and cleaning. However, it is unclear what skills are being worked on with young people to improve their independence and exactly how much they have achieved since joining the home. This has the potential for inconsistency amongst the staff team and less opportunities for young people to achieve positive outcomes and improved skills in independence. Records held do not accurately reflect the outcomes for young people since joining the home or detail independence or pathway plans. This potentially impacts on staff being able to successfully transition young people to independence or adult life.

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Outcomes for children and young people

Generally most young people are empowered to make choices through a range of communication systems, about their daily activities, enabling them to feel more in control of their lives. However, staff commented that they do not always use the communication systems in place as they prefer to talk to young people. This has the potential to reduce the opportunities for non-verbal young people to make choices about their lives. Young people also benefit from accessing the community with support from well-trained staff. Young people access the local leisure facilities, shops restaurants and parks. This has resulted in young people having more opportunities and improved quality of life.

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Outcomes for children and young people

Young people benefit from staff that ensure their daily medical health needs are met. Young people whom are on regular medication receive appropriate care and medication when needed. Young people have learnt to access appointments, such as doctors and dentist’s appointments, with less anxiety. This results in successful treatment being given and a reduction of calming medication that is needed to be administered. Young people's health needs are further enhanced by appropriately- trained and qualified staff. Consent for emergency medical intervention and therapies are gained, however, these consents relate to consent at the school and not at the home. In addition, it is unclear if young people are receiving a consistently-balanced nutritious diet that meets their physical needs. Records demonstrate that on occasion young people have eaten the same meal twice in one day on more than one occasion during the same week. Records also show a lack of fruit and vegetables

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Outcomes for children and young people

being consumed or within the menu. Some young people, due to their disability, choose to self-restrict their eating. Staff commented that they felt more could be done to improve healthy eating. Young people with restricted diets due to health needs have these met very well. However, there is less attention given to young people with religious dietary restrictions, resulting in young people eating forbidden foods as dictated by their religion. This does not meet young people’s dietary, religious and cultural needs.

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Outcomes for children and young people

Young people benefit from regular contact with their families. Young people are positively encouraged to phone home regularly. At the time of inspection the phone for use by young people was in the computer room which on occasion could be locked, restricting access and independent use of the phone. This was rectified on inspection, with the phone being placed in the young people's lounge for independent use. Young people confirmed they used the phone and kept in contact with family members.

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Quality of care

The quality of the care is satisfactory .

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Quality of care

Young people enjoy positive relationships with staff that are caring and understand their needs well. Staff treat young people with respect and dignity especially at times of managing their intimate care needs. Young people commented that the staff are 'nice'. Staff support young people to develop their self-help skills and become more independent individuals. Staff have realistic aspirations for young people with efforts to ensure they reach their potential in all areas of their lives. However, it is unclear how much work is undertaken in this area, and whether pertinent areas for development are being progressed. For example, comments from staff detailed one young person needing to improve their independent dressing skills. Targets set and care plans seen did not highlight this as an area for improvement, thus potentially leading to staff not being aware of the needs of the young person and their

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Quality of care

development needs. Staff demonstrate a committed and caring approach to young people and are genuinely caring about their well-being and care. One parent commented: 'staff are caring and interested in my child; my child's key worker is brilliant.'

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Quality of care

Annual reviews and regular looked after children reviews are held at the school or within the home. On occasion some documents were not available for inspection as they were not present on young people's files. These included statement of special educational needs, personal education plans and looked after children review reports. Health information was at times difficult and confusing to understand with discrepancies in records and events communicated by staff. This lack of up-to-date and relevant information has the potential to impact on the quality of care staff afford young people as they may not be well informed of current issues or actions needing to take place. Staff expressed that they consistently request missing documents to ensure full formation is held on young people to inform care practices.

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Quality of care

Young people are encouraged to attend the weekly young people's meetings. Pictorial agendas and minutes of meetings are produced to support young people's understanding and input. It is unclear from the minutes and discussion with staff as to the benefit or outcome of these meetings for non-verbal young people and the input they have in the meetings. There are systems in place to inform young people how to complain. There have been no complaints from young people. However, it is unclear from discussion with staff whether non-verbal young people understand the complaints system or the effectiveness of the current system.

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Quality of care

Young people enjoy living in a large spacious home that meets their needs. The home is well maintained and every effort is made to keep it in very good decorative condition and homely in appearance. Young people commented: 'I like my room' and 'the garden is great!'

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Safeguarding children and young people

The service is satisfactory at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Young people live in an environment that is safe and keeps them safe from harm. Young people are protected by the use of clear risk assessments. However, on one occasion the young person’s behaviour risk assessment did not detail the agreed type of physical intervention hold that could be used as a last result. In this instance this was pertinent to inform staff as it was an advanced hold that could only be used by trained individuals. Any restrictions in place are not fully addressed in young people's risk assessment and are not agreed with placing authorities and parents. These include the locking of the front door, as this is not a normal front door and secures the building appropriately, locked kitchen cabinets to protect young people from sharp objects and toy cupboards being locked at night. However, young people are able to move freely around the home and garden having a separate entrance which is not locked and for their use.

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Safeguarding children and young people

Young people's challenging behaviour is managed well. Staff are proactive in finding supportive strategies to manage some very complex behavioural issues. Young people benefit from positive reinforcement and and supportive staff who are trained in a range of positive interventions. Physical intervention is only used as a last result to protect young people from harming themselves or others. The Registered Manager monitors behaviour logs, incidents sheets and any intervention used with young people. However staff, are expected to complete a number of records when incidents and behaviour occur. This results in duplication of records and inconsistency in accurate records being made. Some records are illegible and the bound intervention book does not meet the required regulations. This makes accurate monitoring of all incidents difficult to undertake, thus not providing a clear and consistent picture of the level of incidents of behaviour young people are

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Safeguarding children and young people

exhibiting. When advanced interventions were used on rare occasions the records did not detail clearly enough which staff were involved in the intervention. It was unclear which staff were trained to the advanced level and agreed to undertake this level of intervention. Behaviour management guidance in place for staff clearly outlines how staff support young people. However, one guideline states that if the young person becomes aggressive staff remove food and say he can have it when he is calm. It was reported that this strategy was recorded inaccurately. This record could potentially inform staff to act in an illegal manner and not safeguard the young person in question. Observations on inspection were of very happy, calm young people engaged in a range of enjoyable and positive activities. There were no incidents of challenging behaviour exhibited by young people on inspection.

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Safeguarding children and young people

Young people are protected from stringent health and safety measures. Routine and regular checks are undertaken on areas, such as fire alarm systems and gas and electrical systems, to promote the safety of young people and staff alike. All young people regularly practise the fire evacuation procedure and clearly understood the evacuation process. Some young people's bedroom doors do not close properly. This has the potential to put young people at risk should there be a fire. One young person commented the best thing about living at Linden House was that it was 'safe!' Currently the side entrance gate does not close properly compromising the security of the home. In addition, the shed used as a den in the garden is dirty in appearance and has some broken wooden floor slats that has the potential to harm young people.

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Safeguarding children and young people

Staff undertake mandatory child protection training as part of their induction process with regular refresher training being continually delivered within the training programme. This further protects the welfare of young people.

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Safeguarding children and young people

Comprehensive vetting and recruitment procedures are undertaken for the protection of the young people. Minor shortfalls relate to records maintained in the home. Recruitment records do not clearly demonstrate the level of Criminal Record Bureau check undertaken, although the recruitment policy states all staff are checked at an enhanced level. In addition, the records do not identify the outcome of the check undertaken.

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Safeguarding children and young people

Young people are supported by good staff ratios thus reducing the opportunity to target other young people or display bullying behaviour. Young people have benefitted from being educated about the impact of bullying behaviours and have made posters to show there is zero tolerance to bullying in Linden House.

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Leadership and management

The leadership and management of the children's home are satisfactory .

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Leadership and management

Young people benefit from a Registered Manager and staff team that are committed to improvement and reflect on constructive evaluation of the service and care they provide to young people. All aspects of care are monitored, although the Registered Manager confirmed feeling overwhelmed with the amount of work in this area to ensure she further develops staff practice and promotes outcomes for young people. The home is still relatively new in existence, being registered with Ofsted for only 18 months. The Registered Manager is aware of the shortfalls of the home and has developed a plan to make improvements. Requirements and recommendations made at the previous inspection have been acted upon satisfactorily. The senior management team at the school work closely with the Registered Manager to inform practice and improvement. Regular monitoring visits are undertaken monthly by an independent visitor to the home. Reports are produced in a timely manner and

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Leadership and management

forwarded to the Registered Manager and Ofsted. However, the monitoring visitor does not routinely consult with young people on every visit. In addition, parents or stakeholders are not interviewed as part of the visit in order for the monitoring visitor to form an opinion of the standard of care provided in the home. This could mean that shortfalls in the care of young people are not being recognised or addressed.

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Leadership and management

The home meets the aims and objectives set out in the Statement of Purpose. There is a clear focus of working in partnership with young people, parents and advocates to achieve a consistent approach to meeting the needs of young people. The Statement of Purpose does not contain the correct address and telephone contact details for Ofsted. The young people's guide is informative and comprehensive outlining what young people can expect from the home. The current young people's guide contains a range of information which is described in a colourful written and pictorial format. However, the current format is not suitable for all young people's level of understanding.

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Leadership and management

Overall, staff are equipped with the necessary skills to support young people through a thorough training programme targeted to meet the specific needs of the young people. Staff confirmed that the training available is good. Staff are able to use regular supervision to highlight their development needs and reflect on training that may be needed to enhance their working practice and skills further for the benefit of young people.

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Leadership and management

However, young people's records do not hold sufficient information to meet the regulations. Records maintained in relation to young people were not always up to date, legible and signed and dated by the author. Documents lacking on some files include personal education plan, essential information, pathway plans, statement of special education needs and looked after children review reports.

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Leadership and management

Equality and diversity practice is satisfactory .

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