Children's Home run by Aspris New Education Services Limited in Lancashire

Unique reference number SC412971 Inspection date 06/06/2013 Inspector Gillian Walters Type of inspection Full Provision subtype Children's home

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Date of last inspection 25/03/2013 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 children's home is operated by a private organisation. The home provides residential and respite care and accommodation for up to four young people with learning disabilities.

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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 making positive progress in this home and are benefiting from arrangements that, for some, support shared care with their family and, for others, provide short-term respite break placements. Young people benefit from the home’s commitment to working in partnership with parents and professionals to ensure their needs are appropriately identified and suitably addressed. One parent commented of the home and staff, ‘Super quality of care, they try to meet her needs completely.’

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Overall effectiveness

Young people’s individual complex needs and requirements are well documented and understood by the staff that care for them. Effective planning and good knowledge of young people’s needs ensures that they receive appropriate care that enables them to achieve positive outcomes in all key areas of their development.

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Overall effectiveness

Young people enjoy living in a nurturing environment where they feel safe and secure. Young people are positively supported by staff who are patient and attentive to their needs.

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Overall effectiveness

The home is currently without a permanent manager following the resignation of the home’s Registered Manager who has now left her post. The provider is aware that the absence of a permanent manager is having a negative impact on the home’s ability to make sustained improvements and to provide consistently high standards of care and practice. The provider has made acceptable temporary arrangements to provide management support to staff and to ensure the smooth running of the home until a new manager can be appointed. As a result of this inspection a number of issues have been identified as requiring action. They include the: appointment of a manager; management oversight of records completed by staff; arrangements for the administration of medication; identification of current health and safety risks within the home; recording of complaints; completion of care plans; notification of significant events to Ofsted and

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Overall effectiveness

placing authorities. A further two recommendations for improvement are also made to address staffing levels on specific shifts and the supervision arrangements for new staff.

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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 where the registered provider appoints a person to manage the children’s home, he shall forthwith give notice to Ofsted of the name of the person so appointed and the date on which the appointment is to take effect (Regulation 7(2)(a)(b)) 29/07/2013

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Reg. Requirement Due date

17B (2001) ensure that within 24hours of the use of any measure of control, restraint or discipline that a written record is made in a volume kept for the purpose that includes the effectiveness and any consequence of the measure. This specifically relates to management oversight of the effectiveness of any intervention (Regulation 17B(3)(f) 29/07/2013

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Reg. Requirement Due date

(2001) ensure that any medicine which is prescribed for a child is administered as prescribed, to the child for whom it is prescribed and that the written record of the administration of any medicine is kept accurate and up to date (Regulation 21(2)(b)(c)) 29/07/2013

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Reg. Requirement Due date

(2001) ensure that all parts of the home to which children have access are so far as reasonably practicable free from hazards to their health and safety. This relates specifically to reviewing and updating the health and safety risk assessment (Regulation 23(a)) 29/07/2013

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Reg. Requirement Due date

(2001) ensure that a written record is made of any complaint, the action taken in response, and the outcome of the investigation. This relates specifically to maintaining and being able to produce a comprehensive record of events (Regulation 24(5)) 29/07/2013

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Reg. Requirement Due date

(2001) maintain in respect of each child who is accommodated in the home a record in permanent form which is signed and dated by the author of each written entry. This relates specifically to care plans being appropriately signed and dated (Regulation 28 (1)(c) 29/07/2013 (2001) ensure that all significant events are notified to Ofsted and the relevant placing authority without delay in accordance with the relevant schedule. (Regulation 30(1)) 29/07/2013

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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 the overall number, competence and deployment of staff, both as a staff group and on individual shifts, can fulfil the home's Statement of Purpose and meet the individual needs of all children resident in the home. This relates specifically to early evening shifts when only one young person is being cared for within the home (NMS 17.1)  ensure staff have access to support and advice, and are provided with regular supervision by appropriately qualified and experienced staff. This relates specifically to new employees receiving more frequent supervision in accordance with the home’s policy. (NMS 19.4)

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Outcomes for children and young people

Outcomes for young people are adequate .

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Outcomes for children and young people

Young people enjoy positive relationships with staff that are understanding and supportive of their complex needs. Young people benefit from the patience and emotional warmth they are shown. This enables them to feel safe and cared for thus reducing their experience of anxiety associated with autistic spectrum disorder. Young people are suitably supported to make sense of their environment and develop their communication skills to reduce the isolation and frustration that exists as result of their disability. Young people are treated with appropriate affection and respect that enables their development of trust and a positive self-esteem.

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Outcomes for children and young people

Young people benefit from the continuity of the home’s staff supporting them in school and the knowledge that staff acquire in that setting. Young people enjoy a smoother experience of transition from home to school each day that facilitates their learning. Young people are enabled to continue to develop their learning in the home environment as staff have the knowledge to replicate communication and learning techniques used in school. As a result young people are developing greater confidence in their ability to communicate and express their wishes.

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Outcomes for children and young people

Young people benefit from the co-ordinated efforts of the home, their parents and professionals in identifying and addressing their varied and complex health care needs. The home supports regular assessment and review of young people’s health care needs ensuring that good physical, emotional and psychological health is maintained. Young people benefit from spending time in their local community, such as going out with staff on walks, swimming and visiting local shops. One independent reviewing officer commented of a young person, ‘she is achieving positive outcomes in relation to the range of experiences she is enabled to undertake at this home including accessing activities within the community.’ However, a parent commented 'I occasionally feel that there is insufficient staff available, especially on a weekend. My son may be taken for a drive out but unless there is 2:1 staffing he doesn’t take part

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Outcomes for children and young people

Young people benefit from the frequent contact the home maintains with young people’s parents, ensuring that information is appropriately shared; this promotes continuity of care for each young person. One parent said, ‘Staff keep me well informed, communication is pretty good.’ For some young people, home visits are supported by staff, ensuring that the experience remains positive for young people while providing parents with some additional assistance. As a result, those young people are able to enjoy visits and overnight stays with family, sustaining relationships with those that are most important to them.

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Quality of care

Young people share positive and constructive relationships with staff that are nurturing and patient in their approach. This enables young people to feel safe and cared for. Young people benefit from living in a home that is well maintained and provides a comfortable and safe environment. It has been suitably adapted to meet their needs without losing its homeliness. For example, bedrooms are plainly decorated so as to provide a calm and relaxing environment to avoid over stimulation for those with hypersensitivity, while communal areas have pictures and some more homely touches.

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Quality of care

Young people enjoy spending time in different communal areas of the home. Some enjoy the playroom with a range of toys and books that provide sensory stimulation and fun. Others enjoy the ‘quiet’ lounge to watch films or work out puzzles. Young people also have access to a sensory room that is equipped with specialist sensory equipment. The garden is also equipped with play equipment such as bicycles and a trampoline. This means that young people can enjoy their own space and spend time with dedicated staff engaged in the activities that most interest them. Young people enjoy outings and other activities provided away from the home, such as swimming, safe play and visits to parks and other places of interest. This provides young people with positive opportunities to explore their environment and socialise with their peers.

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Quality of care

Young people are supported to develop their communication skills using a range of techniques and resources such as sign, objects and picture exchange. This encourages and promotes them to make daily living choices consistent with their age and ability. Young people have recently been allocated individual keyworkers from the staff team with the intention of improving opportunities for direct communication with young people about their care and other issues that are important to them. The home has implemented additional guidance to staff to ensure that they fully understand their role and can make progress in actively seeking the views, wishes and feelings of young people.

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Quality of care

Young people’s care arrangements are suitably supported by effective planning that takes account of their individual and complex care needs. Young people benefit from regular planning and review meetings. These routinely involve their parents and the range of professionals concerned with their care. This ensures that those with significant knowledge and experience of the young person are appropriately consulted and contribute to plans that will promote their care and enable them to achieve positive outcomes. However, some young people’s care plans were found to be unsigned and undated. Although such shortfalls have not had an immediate impact on the care of the young people concerned, they are significant in terms of good practice and the home’s responsibility to ensure the availability of a full and complete record in relation to all young people receiving care.

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Quality of care

Young people benefit from careful attention to their complex health needs. Their health is suitably promoted, with the home making good use of local health care services and specialist advice to ensure that acute and long-term conditions are appropriately assessed and addressed. Young people benefit from the skill and experience of staff in promoting healthy living such as good nutrition and personal and oral hygiene. Young people receiving prescribed medication are only administered with medication by staff that have been trained and are deemed competent in doing so. The home has reported one recent incident when a young person failed to receive medication as was documented. Fortunately, this had no apparent detrimental effect on the young person’s health. However, this is identified as a significant error in practice, contrary to established medication administration procedure.

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Quality of care

Young people attend a specialist school operated in the locality by the provider. Young people are supported in their education by staff from the home; staff accompany them on a daily basis and work alongside teaching staff. Young people benefit from the support of adults that are familiar to them. They are able to provide care and understanding to assist in reducing their anxieties in the school setting. This enables them a more settled environment in which to learn and offers staff a good opportunity to experience and develop their understanding of young people’s communication and learning abilities.

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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 live in an environment that is safe and designed to protect them from harm. External doors are protected by a security entry and exit keypad system ensuring that young people only leave the premises accompanied by a member of staff. All visitors are required to sign in on arrival and provide a valid reason for visiting the home. They are required to provide suitable credentials if not already known to staff. Visitors are chaperoned at all times within the home. These measures ensure that young people are not at risk from persons who may pose a risk to their safety. Parents and professionals that visit the home have confidence in staff and their ability to safeguard young people's welfare, making them feel safe. One parent said that she had ’absolutely no concerns for her daughter’s safety.’

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Safeguarding children and young people

Young people benefit from their participation in regular fire drills having successfully practiced what they would have to do in the event of a real emergency. Fire fighting equipment and utilities are regularly checked and maintained to ensure that they are in good working order and fit for purpose. Routine monitoring of the home ensures that all hazardous materials, such as cleaning fluids, are securely locked away and are not readily accessible to young people. Such actions contribute positively to protecting young people from known risks in the home. However, during this inspection it was identified that the home’s health and safety risk assessment had not been recently updated and the last action plan was incomplete. This means that the home cannot be assured that it is accurately reflecting and addressing current potential risks to young people, or that action has successfully been taken to eliminate or reduce risks.

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Safeguarding children and young people

Young people are supported on a minimum 1:1 staffing ratio and for some staffing is greater when out enjoying activities in the community. There have not been any occasions when young people have gone missing from this home. However, staff are familiar with local protocols and procedures should such an event occur. The home has prepared information concerning each young person in their care to enable young people to be quickly identified, reassured and appropriately supported by police when located.

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Safeguarding children and young people

Positive behaviour is promoted by established routines, consistent application of clear boundaries and gentle encouragement and praise. This means young people have an understanding of what is expected of them on a day-to-day basis. Sanctions are not used within this home as the young people do not have the cognitive ability to appreciate them. Staff are familiar with and regularly trained and updated in the use of positive behaviour management and physical intervention techniques. Staff are clear on the occasions when physical intervention may be used and these are consistent with current legislation and good practice. Staff maintain appropriate records of such events, detailing information as required by legislation. However, some recent records have not benefited from management oversight that would inspire confidence that good practice is being consistently applied.

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Safeguarding children and young people

Young people benefit from the home’s robust procedures and application of safer recruitment and selection practice. All staff are thoroughly checked and vetted in advance of commencing work within the home to ensure their suitability and skills and experience to work with children and young people. These measures ensure that young people are not exposed to adults that are deemed unsuitable to work with young people.

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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 Provider has suitable interim arrangements in place to temporarily cover the vacancy created following the resignation and departure of the Registered Manager. The day-to-day operation of the home is shared by and delegated between the recently appointed deputy manager and a senior member of the care staff team. Management oversight of the service will be retained by a Registered Manager that already has responsibility for two other homes operated by the provider in the local area. Staff have been consulted and report satisfaction with these planned interim arrangements.

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Leadership and management

The home overall employs sufficient staff to ensure that young people have appropriate and consistent support to meet their identified needs. However, there are a few regular shifts when only one young person requires care within the home as others are with their families. It is during these shifts that staff more often than not, work alone providing for the young person’s care. Although additional support can be called upon from another of the provider’s home’s situated close by, this arrangement is not routinely available to ensure that the member of staff has adequate support to balance caring responsibilities alongside the routine tasks, such as preparing and cooking an evening meal. The acting manager had considered a possible solution in providing additional support during this critical time but had not yet implemented action on this.

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Leadership and management

All relevant staff either have or are working towards a suitable qualification in working with children and young people. Staff benefit from regular training opportunities offered by the company. The home has a comprehensive training programme in place that ensures that staff have sufficient opportunities to improve their knowledge, skills and experience and to update their learning on key issues such as safeguarding and behavioural management techniques. The majority of staff receive positive support through regular supervision arrangements. However, it was identified during this inspection that arrangements fell short for those newly employed members of staff that should have received more frequent supervision during their probationary period, in accordance with the company’s policy.

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Leadership and management

The provider is meeting the aims and objectives of the Statement of Purpose, and these are clearly understood by staff, parents and placing authorities who express satisfaction with the service provided. One independent reviewing officer commented, ‘The quality of care was considered to be good by all review members and no safeguarding concerns have been raised.’

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Leadership and management

At the last inspection on 25 March 2013 two recommendations were made. Of these, one has now been fully addressed in that young people have suitable coverings on their bedroom windows to ensure their privacy. In respect of the second recommendation, some progress has been made in developing keyworker sessions to enable young people the opportunity to express their views on their care and support. Clarity has been established concerning the keyworker role and staff have been given guidance to support them in their role. However, this is not yet fully implemented so that all young people receive regular time with dedicated staff.

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Leadership and management

The provider has suitable arrangements in place for monitoring the quality of care and activities within the home. Regular weekly and monthly audits of practice and activities have been completed by staff and the manager. The provider has appointed a compliance officer to regularly visit the home and report in accordance with Regulation 33. The quality of external monitoring and reporting has improved providing greater scrutiny of practice. The former Registered Manager also successfully completed a review of internal monitoring over a six-month period and forwarded it to Ofsted within the required timescale. As a result of these activities the provider and current management team have an improved understanding of the home’s strengths and weaknesses. The recognised priority is to have a permanent Registered Manger who can drive and sustain improvement in the home.

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Leadership and management

The home has recently received a complaint and has now effectively dealt with this matter. However, a complete and permanent record has not been made that provides a comprehensive account of the complaint to its conclusion. This is contrary to regulatory requirements. In relation to this matter, it has been identified that Ofsted were late in being notified of a significant event and did not receive a second notification that had been prepared and was available within the home. The placing authority also failed to receive notification of the event in connection with the child they had placed. This is also contrary to regulation. It hinders the placing authority’s ability to effectively monitor the young person’s placement, and denies Ofsted’s the opportunity to monitor events as they occur.

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Leadership and management

Young people’s individual records are well organised and generally well maintained apart from the shortfalls identified in relation to the validation of some young people’s care plans. Young people’s records provide an appropriate account of their life, experiences and plans for the future. Young people’s files are stored securely, ensuring their rights to confidentiality and privacy are maintained.

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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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