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

Unique reference number SC043994 Inspection date 14/11/2012 Inspector Emeline Evans / Jennie Christopher Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 14/03/2012 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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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 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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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be adequate .

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Overall effectiveness

Young people are supported by a stable and experienced staff team. The Registered Manager and staff are committed to improving outcomes for young people. Staff are child-centred in their approach and consistently concerned with the welfare of the young people. Young people are clearly settled and comfortable in their environment and it is apparent they benefit from caring members of staff who know them well. One parent commented, ‘my son is a happy and contented child, who has been given an opportunity to develop in a supportive and caring environment.’ A young person also stated, ‘staff are good and they are a team.’

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Overall effectiveness

Staff support young people in making significant progress across many aspects of their lives. Achievements have been seen in young people’s behaviours, their social interactions and the development of their independence skills. Staff use different ways to gain the views of the young people and enable them to make a choice and therefore influence the running of the home.

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Overall effectiveness

Safety is central to all aspects of care planning and staffing arrangements. Young people comment that they feel safe and parents reiterate this. Young people live in a secure environment. However, an area for improvement is to seek advice from the local fire and rescue service with regard to fire protection measures.

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Overall effectiveness

A number of shortfalls have been identified and requirements and recommendations have been made. The majority of the shortfalls relate to records and ensuring they comply with regulations. The Regulation 33 monitoring visits require some attention to ensure they fully form an opinion of the standard of care provided by the home. The manager is aware of the home's weaknesses 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) update the Statement of Purpose to ensure that it includes all of the criteria required by regulation (Regulation 4(1), Schedule 1) 28/12/2012

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Reg. Requirement Due date

17B (2001) ensure a volume is kept for the purpose of recording any measures of discipline and this written record meets the Regulations (Regulation 17b (3)(a-i)) 28/12/2012

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Reg. Requirement Due date

(2001) obtain for all staff, before they start work at the home, all the information set out in Schedule 2 (Regulation 26)(3)(d)) 28/12/2012

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Reg. Requirement Due date

(2001) take adequate precautions against the risk of fire, including the provision of suitable fire equipment; and provide adequate means of escape (Regulation 32 (1)(a)(b)) 28/12/2012

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Reg. Requirement Due date

(2001) ensure the visits take place frequently and the person carrying out the visits shall interview with their consent and in private, children accommodated there, their parents and persons working at the home as appears necessary in order to form an opinion of the standard of care provided by the home. (Regulation 33 (3)((4)(a)) 28/12/2012

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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 medicines which are kept in the home are stored safely (NMS 6.13)  ensure all areas of the home are comfortable and homely and avoidable hazards are removed (NMS 10.3)  obtain further checks as are considered appropriate for staff, who have lived outside of the United Kingdom, before they start work to establish their suitability to work with children (NMS 16.3(f))  ensure training is kept up-to-date to allow staff to be aware of practice and professional developments (NMS 18.1)  submit the updated child protection procedures to the Local Safeguarding Children's Board for consideration (NMS 20.4)  ensure all records are consistently clear and of a high quality. (NMS 22)

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Outcomes for children and young people

Outcomes for children and young people are good .

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Outcomes for children and young people

Young people benefit from individualised support, which helps them grow in confidence and promotes all aspects of their individual identity. Young people make measurable progress in many aspects of their lives. Staff and parents recognise the achievements young people have made and are able to give numerous examples of how young people have developed as a result of their placement in the service. Young people’s confidence and self-esteem are developing well because of the child- focused care provided by a staff team who successfully maximise the potential of each young person. Young people have made progress in their behaviour, communication skills and social interaction. Young people are now able to sit at the table and accept and respond to peer interaction. One parent commented, 'we have seen exceptional improvement in behaviour, daily living skills and general well-being.’ Another commented, ‘my daughter has moved on.’

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Outcomes for children and young people

Staff fully support young people’s education and young people have excellent attendance at the on-site school. Young people have access to a range of extra- curricular activities; these provide young people with additional learning opportunities. This results in their progression and allows a consistent approach across the school and residential services.

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Outcomes for children and young people

Young people are engaged in an array of community-based activities. Young people enjoy taking part in these activities; these opportunities mean that young people’s experiences of social interaction are further enhanced. There are a range of facilities on site to allow for participation in activities including outdoor space and sensory rooms. This enhances the sensory development of the young people.

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Outcomes for children and young people

Young people receive the care and encouragement they need to develop independence skills. Young people are supported to develop skills such as personal self-care and daily living skills. Young people are developing well in this area and this is contributing to enhancing their self-esteem. These achievements are enabling young people to develop new skills in preparation for the transition to adult life. The home has recently implemented a document called ‘living my young life’. This is very comprehensive, and focuses on achievements and skills to be developed with the young people. This form of person-centred planning will inform the transition process to adult placements. Some young people have recently moved on to semi- independent living. The service is proactive in planning for the young people’s futures and ensuring young people are equipped with the necessary skills for this to be a success.

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Quality of care

The relationships between the staff team and young people are a real strength of the service. Young people benefit from good supportive relationships from a staff team that is enthusiastic and committed. Staff are responsive towards young people’s needs and understand when young people are upset; this results in alleviating unnecessary stress and anxiety for the young people. Young people hold a positive regard for the staff team and one young person commented, ‘staff are very good.’ This is equally ratified by young people’s parents and comments from parents include, ‘I cannot fault the care’ and ‘the staff are great, they do their best.’

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Quality of care

Young people use a range of communication methods including pictures and schedules. Staff are consistent in the use of these aids and adapt and personalise these methods according to the young people’s level of understanding. Young people are supported to make choices in many aspects of their care including the choice of staff they work with, the activities they take part in and the meals they eat. Young people are encouraged to express their views and feelings in the running of the home. This results in young people feeling their views are actively sought and acted upon.

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Quality of care

Staff will advocate and make complaints on behalf of the young people. This demonstrates that staff listen to and respond to any concerns young people may have and action is taken to address these. The home is proactive in responding to matters raised by parents and this shows the service’s commitment to act upon comments in order to improve the quality of care.

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Quality of care

Young people’s needs are central in all aspects of their care planning. Detailed and comprehensive placement plans are developed. Placement plans take into account the complex needs of the young people including their health, cultural and behavioural needs. These plans are individualised and enable staff to support young people and understand the possible reasons for negative behaviours. Staff are familiar with young people’s placement plans and these are used fluidly across the shifts. This practice ensures consistency in the quality of care is achieved. When possible young people’s views are sought, by link workers, about their placement plans. This is achieved by observing ways in which young people express their likes or dislikes or by young people indicating preferred routines.

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Quality of care

Staff work closely with a range of professionals on-site to support the young people’s health and emotional needs. Staff work very closely with these on-site professionals to communicate and respond appropriately to any concerns. This ensures continuity of care is achieved. One professional explained, ‘staff are brilliant in ensuring they communicate and this enables us to work together for the young people.’

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Quality of care

Healthy lifestyles are promoted and young people are encouraged to make healthy choices in relation to the food they eat and the exercise they take. The service has a cook in each house who ensures individual cultural and dietary needs and personal preferences are well catered for. One young person commented, ‘the food is really good.’ Staff support the young people to make choices at meal times and this is assisting in developing their independence skills.

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Quality of care

A structured programme is in place for the administration of medication. Some young people now have their medication stored in cabinets in their rooms. This practice allows more independence and privacy when taking medication. However, some cabinets are not sufficiently secure.

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Quality of care

There are presently eight separate houses providing accommodation across the site. One house is providing temporary accommodation for young people who find it difficult to live in a group situation. Each house is comfortable and young people’s personal space is furnished and personalised according to their needs and preferences. The temporary accommodation was previously used as accommodation for parents and has been adapted. However, there are still a number of hazards, and the house is showing signs of wear and tear, which distracts from a homely environment.

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Safeguarding children and young people

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

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Safeguarding children and young people

The routines and structures in place for individual young people support them in feeling safe and comfortable in their surroundings. Staff interpret young people’s behaviours very well and are therefore able to act upon instances when young people are worried or upset. This means young people are able to achieve in their personal development as they feel safe.

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Safeguarding children and young people

Young people have comprehensive behaviour support plans in place. The staff team work closely with the psychologists, psychiatrists and behaviour support professionals to ensure a proactive approach is taken. There is detailed analysis of all incidents and physical interventions with the young people. This allows patterns and trends to be identified and strategies to be implemented.

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Safeguarding children and young people

Staff are vigilant in responding to young people’s gestures and behaviours. Early intervention and re-direction is used and staff attempt to understand how young people are feeling. Sometimes physical intervention is used to prevent situations escalating. A bound volume and incident forms are used to record physical interventions and the action taken. Some young people respond to consequences such as ‘time out.’ However, these instances of consequences are recorded along with physical interventions. This makes it confusing to monitor the use of consequences, as these entries are subsequently not fully completed. Therefore, there is a requirement for a separate volume to be completed for instances of consequences which complies with regulations.

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Safeguarding children and young people

Staff receive regular training in safeguarding and recognising particular vulnerabilities relating to young people with disabilities. As a result, staff demonstrate a good understanding of the action to take should they have a concern about a young person’s well-being. There is a comprehensive safeguarding policy and procedure which has recently been revised. This however has not been submitted to the Local Safeguarding Children’s Board for consideration. The supervision provided due to the high staffing levels minimises the risk of young people going missing. Procedures to follow when a young person is missing are known by the staff should this arise.

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Safeguarding children and young people

There is careful selection of staff working with young people in the home. However, there are gaps of employment identified in staff member’s files and full employment histories are not all documented. It is therefore not clear if gaps were explored at the time of recruitment. Where a member of staff has lived outside of the United Kingdom, enhanced Criminal Record Bureau checks are undertaken prior to staff starting work. However, further checks have not been undertaken to establish their suitability to work with children.

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Safeguarding children and young people

Generally, there are sound health and safety systems in place to minimise unnecessary risks to the young people, staff and visitors. Regular fire alarm tests and drills take place and are recorded. Young people are regularly involved in this process. This ensures young people are clear about the action to take in the event of a fire or emergency. However, across the houses a number of fire doors are propped open. This means that if there had been a fire, the doors would have to be released manually in order to provide proper protection. The house, which is providing temporary accommodation, has a locked fire exit. This is the only exit out of the building in the event of fire. Therefore, there is not an adequate means of escape for young people or visitors should a member of staff not be available. The home is therefore required to seek advice from the local fire and rescue service to ensure they comply with regulations.

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Leadership and management

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

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Leadership and management

The Registered Manager and staff team are committed to and focused on improving the quality of care provided. The management team understand the strengths of the service and know areas for development. There is a development plan in operation to clarify the future of the home with a focus on improving outcomes for young people.

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Leadership and management

A comprehensive Statement of Purpose is in place but in some areas, this lacks information. The document does not contain a description of the listening monitors which are used within the home and what benefits this means of surveillance provide for the well-being and safety of the young people. In addition, there is no information with regard to the use of consequences. The young people’s guide is informative and explains what young people can expect from the home. This guide is personalised and adapted to each young person’s level of understanding.

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Leadership and management

Monitoring visits under Regulation 33 of the Children’s Homes Regulations take place. These visits involve looking at two homes each month. Therefore, it is a number of months before a visit back to the same house takes place. During these visits, records are consistently not available for inspection. It is not evident if routine consultation with young people, parents and staff takes place during this monitoring so as to form an opinion on the quality of care provided in the house. This could mean that shortfalls in the care of young people are not being recognised or addressed.

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Leadership and management

Young people are supported by a staff team who are knowledgeable and experienced. Staffing levels are good and the staff team works together to cover gaps in rotas. Staff benefit from regular supervision and staff meetings to ensure they have the opportunity to raise any issues as they arise. Staff have undertaken a number of statutory training courses and there is a comprehensive training programme in place. This includes training specific to the needs of young people such as autism, methods of communication and epilepsy awareness. However, a number of staff have not recently attended refresher training in mandatory areas. This does not allow staff to keep up to date with practice and professional developments.

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Leadership and management

Young people’s files are stored securely and contain documents which are relevant and contribute to an understanding of the young person’s life. There is some inconsistency in the quality and adequacy of record keeping, this results in some records not being clear and comprehensive. Therefore, it is difficult to fully evaluate certain documentation.

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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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