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

Unique reference number SC065261 Inspection date 13/03/2013 Inspector Paula Lahey / Michelle Oxley Type of inspection Interim Provision subtype Residential special school (>295 days/year)

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Date of last inspection 15/10/2012 Website: www.ofsted.gov.uk

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Brief description of the service

This national private organisation provides care and accommodation for up to 60 students with autistic spectrum disorder and learning difficulties. 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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The inspection judgements and what they mean

Good progress The children’s home has demonstrated continued improvement in quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the large majority of recommendations that were raised at the previous inspection. Satisfactory progress The children’s home has maintained quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the majority of recommendations that were raised at the previous inspection. Inadequate progress The children’s home has failed to address one or more requirements and/or has not met the majority of recommendations and/or the quality of care and outcomes for children and young people have declined since the last full inspection.

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Progress

Since their previous inspection the service is judged to be making satisfactory progress .

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Progress

At the full inspection in October 2012, the overall rating was judged to be adequate. The service has taken action towards addressing the six requirements and one recommendation raised and has a suitable action plan in place to embed these developments further. One requirement and two recommendations are made following this inspection.

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Progress

Action has been taken to reduce the use of restraint and restriction of liberty. The headteacher has recently joined a companywide working group to revise the overarching behaviour policy. The home intends to implement a restraint reduction plan for each young person who requires this. A priority list has been identified. As such, three plans are currently in use with a further two under development. The team are able to explain possible reasons for an increase and/or decrease in young people’s behaviour, but as yet this examination of trends and patterns is not robustly documented. Restraint reduction plans will be formally reviewed on a monthly basis and managers anticipate that this format will capture the required evidence. There is indication of a reduction in the overall use of seclusion techniques since the last inspection, with the majority lasting for less than five minutes. However, a small

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Progress

number of seclusions are longer, with records demonstrating durations of between 15 and 65 minutes. Interventions involving supine restraint have not yet significantly decreased. Records show that restraint is used to support young people who are displaying behaviour that compromises their own and other’s safety.

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Progress

Improvements have been made to ensure that restraint and incident records contain all the required information. The staff team have been provided with training in incident report writing. Senior managers now have daily oversight of all incident records. Shortfalls in detailed information or poorly recorded reports are appropriately challenged, with action taken to implement changes. Records are now maintained of debriefing young people following physical interventions. An assessment tool is now in place to determine the need for use of physical intervention when this is required for medical treatment. This protocol will ensure that the home maintains documentation of multi-agency consultation and consent. The home has not needed to implement the protocol since the last inspection. Senior managers have an action plan to implement further improvements to restraint and intervention record keeping and documentation.

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Progress

The staff team have further considered and recorded the reasons for the use of physical restrictions within the living environments. As such, team managers have now completed individual risk assessments on each young person in their care.

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Progress

The home has undertaken a review of staff supervision systems. The policy has been revised to ensure that each member of staff is provided with formal supervision a minimum of six times per year. Within their probation period, staff members are provided with monthly support including one-to-one meetings and group supervision. There has been a notable improvement in the provision of regular supervision and there is an effective system in place for managers to monitor this. This ensures that targets are suitably met and staff continue to receive the appropriate support and direction for their role.

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Progress

Management oversight of what goes on in the home has improved. The Registered Manager is now maintaining a suitable system for reviewing and improving the quality of provision. There is a clear action plan in place to address identified areas for improvement.

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Progress

Appropriate action is taken in response to complaints, concerns and significant events involving young people. There is positive partnership working with external agencies and local authorities and they are kept well informed of action taken. However, notification to Ofsted is not undertaken until the home has completed all actions. This means there is a delay in sharing information with the regulator which is not consistent with the national minimum standards.

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Progress

The home is continuing to implement actions on its development plan. Recruitment drives have been successful and a number of new staff have started work. This has meant the home no longer uses agency staff to supplement permanent positions. Regular multi-professional meetings continue to be held to review each young person’s placement and progress. Improvements to this system now include a formal assessment of young people against global targets.

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Progress

Improvements continue to be made to the living groups. New furniture has been purchased, bathrooms refurbished and areas redecorated. All these developments benefit 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

17B (2001) review and revise the behaviour management policy. In particular, ensure it reflects current guidance and regulation regarding seclusion and is implemented so as to significantly reduce the use of restraint and restriction of liberty. (Regulation 17B (2)(a)) 20/05/2013

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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 that the home regularly reviews incidents of challenging behaviour and examines trends or issues emerging from this, to enable staff to reflect and learn to inform future practice. In particular, ensure that detailed records are maintained to evidence this analysis (NMS 3.21)  ensure that there is a system in place to notify within 24 hours the person and appropriate authorities of the occurrence of significant events in accordance with Regulation 30. The system includes what to do where notifiable events arise at weekends, holidays or in the absence of the Registered Manager. (NMS 24.1)

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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 progress made by the provider since the last full inspection, identifies any further strengths, any areas for improvement and makes judgements as outlined in the Inspection of children’s homes – framework for inspection.

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