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

Unique reference number SC043994 Inspection date 11/09/2013 Inspector Peter Harrell Type of inspection Interim Provision subtype Residential special school (>295 days/year)

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Date of last inspection 02/05/2013 Website: www.ofsted.gov.uk

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Brief description of the service

This service is a residential special school registered as a children's home for young people with severe learning disabilities and is run by a large independent organisation. The school accommodates up to 40 young people in eight separate houses, 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

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

The overall effectiveness of this service was judged as good at the last full inspection in 2nd May 2013.

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Progress

Since that time, the service has demonstrated improvement in their quality of care for the children and young people. The home has suitably addressed all of the requirements and two out of the four recommendations raised at the previous inspection. There is a new requirement, two repeated recommendations and one new good practice recommendation resulting from this interim inspection. Improvements need to be made to the behaviour management policy, recruitment checks, signing young people’s records, and one aspect of medication administration recording.

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Progress

Since the last inspection, there has been a strong focus on ensuring all staff are aware of the importance of suitable arrangements for handling, storing and administering medication. The Registered Manager, head of care and school nurse have updated and introduced several policies regarding the administration of medication. The most significant improvement is that there is no longer any secondary dispensing. Relevant medicines are now kept in a tamper proof container with clearly labelled instructions supplied by the pharmacist. It was observed however, that there are inconsistencies in the houses regarding double entry counting and auditing of controlled medication.

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Progress

At the last inspection, the Registered Manager identified that a more robust system for managing and monitoring complaints, would enhance the services commitment to improving the quality of care provided to young people. This has now been effectively actioned. There is a clear system and process in place to record complaints and compliments and to learn from matters raised, together with active encouragement of staff to gain the views of young people young people who do not communicate verbally.

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Progress

A new visitors’ policy is in now place for parents and carers who stay at the home overnight and for extended periods of time. Visitors to the overnight accommodation are recorded and they have access to an on call manager’s number. In addition to this and in order to ensure an evaluation of this safety measure, the new visitors policy is incorporated and reviewed in line with the children’s home operating risk assessment.

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Progress

Although there have been no incidents of a young person going missing, the service has consulted with the local police and other agencies to obtain the most up-to-date missing from home protocol. This is good practice because the young people living at the service could be in immediate danger if leaving the home unsupervised.

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Progress

At the last inspection it was brought to the services attention that where a staff member has lived outside the United Kingdom, there were no specific checks to confirm their right to work. An audit of relevant staff recruitment records commenced and at the time of this inspection, the Registered Manager confirmed that a quarter of these records had been updated. Completion of this process will ensure that there is a continuity of staff for young people together with demonstrating a more consistent and robust approach to prevent unsuitable people from being recruited to work at the home.

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Progress

Young people’s records contribute to a clear understanding of the young person’s life and progress while at the school. However not all documents are signed, this does not ensure the highest level of recording management.

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Progress

The quality of relationships between staff and young people is very strong. Staff respond well to the young people’s complex needs and will actively seek out their views. However, some aspects of the home’s behaviour management policy is not in line with current legislation and there is currently a review of their practices. For example, reference to using restriction of liberty. Although there is no evidence to demonstrate that that this is routinely carried out in practice, there has been a few occasions, in an emergency situation, where young people under 16 years of age have been secluded for several minutes. The Registered Manager and behaviour management team are aware of the need to review this practice and have already committed themselves to this process.

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Progress

The manager and staff team have young people’s well-being at the centre of their care. Staff are very supportive of each other and express strong enthusiasm and commitment about promoting positive 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

17A (2001) prepare and implement a written policy (in this regulation referred to as the "behaviour management policy") which sets out the measures of control, restraint and discipline which may be used in the children's home and the means whereby appropriate behaviour is to be promoted in the home. Specifically in relation to statutory guidance for restriction of liberty. (Regulation 17B (1)(a) and (b)) 31/12/2013

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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 all written records and numbered entries relating to the administration of medication are correctly entered and recorded (NMS 6.15)  ensure the children's home has a record of the recruitment and vetting checks which include: the outcome of DBS 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. (NMS 22.4)

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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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