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

Unique reference number SC043994 Inspection date 02/05/2013 Inspector Peter Harrell / Wendy Anderson Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 26/02/2013 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 good .

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Overall effectiveness

Young people benefit from living in an environment which is suitably resourced, well managed and which delivers a high level of personalised care and support. Staff focus on developing young people’s communication skills, enabling them to have a wider understanding of their world around them. As a consequence, young people experience strong individual growth and progress during their time at the home. Individualised attention is given to planning and transitioning young people into the home, as well as leaving and moving on to adult service provisions. This contributes to young people settling well.

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Overall effectiveness

Young people achieve excellent outcomes through education, a range of leisure activities and through staff working closely and collaboratively with behaviour support advisors. Young people benefit greatly from being cared for by committed, nurturing and highly motivated staff who all aim to meet their specific needs. Young people enjoy living at the home and spending time with staff. Staff ensure that all the young people are active and have opportunities to mix in the community. A parent commented, ‘the way my son is cared for is much like what happens in a family; it is not an institution.’

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Overall effectiveness

A young person stated, ‘I like the staff; I like lots of the things I do.’ A social worker said 'they (the staff) are fantastic, there is very thorough care.’

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Overall effectiveness

Conversely, there are several shortfalls resulting in requirements and recommendations. These relate to safer recruitment, storage, handling and dispensing of medication; signing and dating records; updating missing persons protocols; checking visitors and ensuring that there is a robust process for recording complaints. The Registered Manager is aware of these areas for improvement and is committed to further improve outcomes for the young people and provide a high quality service.

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Overall effectiveness

Members of staff are provided with regular supervision, team meetings and regular and relevant training opportunities; these provide them with the appropriate skills to support young people and to meet the objectives contained in their individual care plans.

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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) ensure that there are suitable arrangements for the handling, safekeeping, safe administration and disposal of any medicines received into the children's home, in particular; there should be no secondary dispensing of medication and medicines should be kept in a container with attached instructions provided by the pharmacist (Regulation 21(1)) 01/07/2013

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Reg. Requirement Due date

(2001) ensure that a written record is made of any complaint or representation, the action taken in response and the outcome of any investigation. In addition, record any learning points and whether the matter was resolved to the complainant’s satisfaction. (Regulation 24 (5)) 01/07/2013

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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 unchecked visitors are adequately supervised when on the home's premises. In particular, ensure that an record of visitors, including parents, is maintained (NMS 4.8)  if a child is absent from the home and is missing, ensure the home's procedures are compatible with and have regard to current Runaway and Missing from Home (RMFHC) protocols and procedures maintained and managed by the police or the local authority (NMS 5.6)  ensure the children's home has a record of the recruitment and vetting checks which include: the outcome of CRB Disclosures and checks to confirm the right to work in the UK (NMS 16.3 (b) (e))  make sure that entries in records are legible and signed and dated. (NMS 22.4).

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Outcomes for children and young people

Outcomes for young people are outstanding .

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Outcomes for children and young people

Young people receive an excellent level of care in a welcoming, secure and nurturing environment. This supports young people to reach their full potential and promotes their independence.

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Outcomes for children and young people

Young people are healthy and enjoy healthy lifestyles. They benefit from being cared for in accordance with their particular needs. Each young person has a detailed and individualised plan of care which includes all key areas and clearly details their routines. In all young people’s records, relevant documentation is written in the first person. This is excellent practice. Any specific needs arising from cultural heritage or disability are clearly identified.

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Outcomes for children and young people

Young people are fully consulted, which helps them to participate in day-to-day and longer term decisions. As a result, young people experience significant individual growth and live in a highly stable home.

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Outcomes for children and young people

Young people have experienced substantial growth in relation to personal care, social interaction, independence skills and managing their anger and behaviour, all of which has a very positive impact on their lives.

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Outcomes for children and young people

Young people enjoy taking part in a broad range of activities both in the home and the wider community. These activities result in meaningful opportunities for social interaction away from the home environment. Sensory development is a key part of young people's progress and there is a range of facilities in the home, including outdoor spaces and sensory rooms, to facilitate this.

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Outcomes for children and young people

Young people are supported very well to progress to adult services through a highly detailed skills development scheme entitled ‘living my young life’. This scheme has been very successful in preparing young people for this transition.

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Outcomes for children and young people

Young people are supported in making great educational progress and developing their communication skills. Staff actively support young people’s education and young people have excellent attendance at the connected school. There is also a broad range of out-of-school and holiday activities. This demonstrates a 'joined up' level of care which results in further progression across both the residential and educational services.

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Outcomes for children and young people

Children and young people benefit from regular meetings with their families. Contact is actively encouraged, sensitively supported and regularly maintained. Parents say that their sons and daughters are very well cared for by a highly committed staff team. One parent commented: 'Staff at Macintyre are like a second family to me, I can't praise enough the care they provide, it is a really good place and they should be rewarded for what they do.’

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Quality of care

The children’s home consists of eight houses which provide comfortable and spacious accommodation for young people, with separate gardens in each house. Young people live in a safe environment where a great deal of care has been taken to meet their specific requirements. Each young person has their own bedroom which they can personalise according to their wishes. One house provides accommodation for young people with a high level of support, who find it difficult to live in a group situation. There are plans to develop this house into two separate living areas. The property and grounds have been sufficiently maintained and there is an on-going programme for redecoration and repair.

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Quality of care

Staff and managers demonstrate a clear commitment to ensuring that young people have the best outcomes possible. Relationships between the staff team and young people are an important key to achieving this. Staff respond well to the young people’s complex needs and will actively seek out their views. As a consequence, relationships are very positive and young people are effectively consulted.

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Quality of care

Young people who live at this service are most settled when routines are familiar and clear. Members of staff deliver individualised care according to each young person's particular needs. Staff will closely adhere to these routines with any variations fully explained, using communication aids to reinforce this. When young people present challenging behaviour, staff will consult with the behaviour support team who are highly skilled in ensuring a consistency of approach throughout the staff team.

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Quality of care

Staff promote the health of the young people at the home and they are supported to attend regular appointments with health professionals. Healthy lifestyles are promoted and young people are encouraged to make healthy choices in relation to exercise and food choices; for example, there is a cook in every house who helps young people meet their dietary needs.

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Quality of care

A programme is in place for medication administration. However, some out-of-date medication required disposal. Storage facilities are satisfactory but examples of medication left out within staff offices were observed. There was some secondary dispensing of medicines. Where there was potentially the risk that incorrect medication could be administered to young people action was taken to prevent this as soon as it was brought to the attention of staff and management of the service.

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Quality of care

Staff advocate for young people and respond to concerns on their behalf. The home is proactive in responding to matters raised by parents and childcare professionals connected with the service, which reveals a commitment to improvement in the service’s quality of care. Young people enjoy very positive and strong relationships with staff. Parents mentioned specific staff who are very dedicated in caring for their sons and daughters. In addition, social workers comment on the service’s ethos of openness and 'fantastic staff, very thorough care and good communication'.

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Quality of care

The staff's ability to communicate extremely well with young people who do not communicate verbally is a key strength of the service. Varying methods, such as adapted pictorial communication systems, symbols and photographs, are used to help staff and young people communicate effectively. Staff said they, ‘go at the young person’s pace'.

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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

Young people feel safe, secure and well cared for. Young people using the service have autism and challenging behaviour and will target their anger or frustrations at staff. Through close liaison with the behaviour support team, staff actively work to prevent this occurring through looking at triggers for behaviour and appropriate interventions, whilst also helping young people develop their communication skills in more socially appropriate ways.

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Safeguarding children and young people

There are a range of risk assessments which identify children and young people's vulnerabilities. Any risks regarding activities are monitored and closely documented. High staffing levels mean that young people are under constant supervision to keep them safe. Since the last inspection, there has been one incident of a young person going missing. The characteristics of the young people living at the service mean that they could be in immediate danger if leaving the home unsupervised. However, the service has not recently consulted with the local police and other agencies regarding the most up-to-date missing from home protocol. This may make young people vulnerable; for example, if there were to be any delays in reporting their absence.

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Safeguarding children and young people

Employment records show that the provider has safer recruitment procedures in place. Where a staff member has lived outside the United Kingdom, there are no specific checks to confirm their right to work. This could potentially compromise the continuity of staff for young people. All CRB checks are taken and a record of this maintained. The outcome of these checks are not recorded unless there is positive information on them.

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Safeguarding children and young people

Parents are actively and positively encouraged to stay at the home in accommodation provided for them. However, there are no clear records of their visits which occur outside school time. Whilst this shortfall may not have a direct impact on the care provided to young people, the absence of a better system for monitoring these visitors may give rise to confusion about who has been in the home.

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Safeguarding children and young people

The staff are knowledgeable about safeguarding. They receive regular training in this area which highlights particular vulnerabilities relating to young people with disabilities. The safeguarding policy and procedure is well known and has recently been revised. As a result, staff demonstrate a good understanding of the action to take should they have any concerns regarding a young person.

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Safeguarding children and young people

Health and safety systems in the home are sound. 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.

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Leadership and management

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

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Leadership and management

The staff and management team are very focused on improving the quality of care provided to all young people who use the service. Young people benefit from a Registered Manager and staff team who are committed to improvement and regularly reflect and evaluate the care provided. However, the Registered Manager identified that a more robust system for managing and monitoring complaints and reflecting on matters raised, would further enhance the services commitment to improving the quality of care provided.

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Leadership and management

Most aspects of care provision is monitored and reviewed. Regulation 33 visits take place at each of the eight houses in order to ensure that there is effective external scrutiny and challenge.

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Leadership and management

Staff demonstrate a strong commitment to working with young people. All care and support is individualised and child focused, responding to each of the young people’s complex and diverse needs. Parents and placing authorities provide highly complimentary feedback on how staff support the young people in their care.

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Leadership and management

The home meets the aims and objectives set out in the Statement of Purpose. There is a focus of working in partnership with young people, parents and advocates. This helps to achieve a consistent approach to meeting young people’s complex needs.

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Leadership and management

Managers in the home have proactively implemented previous requirements and recommendations.

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Leadership and management

Young people’s files are stored securely and contain documents which contribute to a clear understanding of the young person’s life. However not all documents are signed and dated correctly, which does not ensure the highest level of recording management.

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Leadership and management

Young people benefit from living in an environment which is well maintained and managed. Although there have been some changes, there remains a stable staff team. The manager and members of staff confirmed that they are able to access regular good quality supervision and training to highlight and address their development needs.

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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 and the evaluation schedule for the inspection of children's homes.

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