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

Unique reference number SC065261 Inspection date 14/10/2013 Inspector Maureen Hamer Type of inspection Full Provision subtype Residential special school (>295 days/year)

p.1

Date of last inspection 13/03/2013 Website: www.ofsted.gov.uk

p.1

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.

p.2

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.

p.3

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

p.3

Overall effectiveness

The overall effectiveness is judged to be good .

p.3

Overall effectiveness

Young people are making good progress. Positive relationships with staff are contributing to an increase in young people’s self-confidence and to a reduction in their anxiety and challenging behaviour.

p.3

Overall effectiveness

Young people have complex learning and communication difficulties. Staff are good at developing and implementing a range of individualised communication methods to improve communication with young people. Information is available to enable young people to access independent helplines; however, they do not have access to independent advocacy. In addition the children’s guide does not include contact details for the children’s commissioner.

p.3

Overall effectiveness

The home’s practice is to complete body maps on young people on a regular basis. However, this is not included in young people’s care plans or risk assessments.

p.3

Overall effectiveness

The setting has been successful in recruiting a high number of new staff. However, on one occasion, on one of two references the documentary evidence was not available to review. In addition line managers were found on one occasion to not have followed the home’s safeguarding procedures. During inspection senior managers took immediate action to address this shortfall.

p.3

Overall effectiveness

Quality assurance monitoring is in place and undertaken on a regular basis. However, the information submitted for outside scrutiny to HMCI is not comprehensive. In addition the independent visitor does not show how feedback from young people, parents and placing authorities is gained to inform their reports on the home. A good development plan is in place and the home has the capacity to improve.

p.3

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.

p.4

Reg. Requirement Due date

(2001) implement the written policy which sets out the procedure to be followed in the event of any allegation of abuse or neglect (Regulation 16 (1)(b)) 13/01/2014

p.4

Reg. Requirement Due date

(2001) ensure that the person carrying out the monthly visit to the home interviews, with their consent and in private, such of the children accommodated there, their parents, relatives and persons working at the home as appears necessary in order to form an opinion of the standard of care provided in the home (Regulation 33 (4)(a)) 13/01/2014

p.4

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.4

Recommendations

 ensure that children have access to independent advice and support from adults who they can contact directly and in private about problems or concerns, which is appropriate to their age and understanding. Children know their rights to advocacy and how to access an advocate, and how to contact the Children's Rights Director (NMS 1.5)  ensure children receive personalised care that promotes all aspects of their individual identity and are each treated as an individual; in particular with reference to the arrangements for making body map charts (NMS 2.1)  include in a record of the recruitment and vetting checks which have been carried out on those working for the children's home at least two references, preferably one from a current employer and, where possible, a statement from each referee as to their opinion of the person's suitability to work with children (NMS 16.3)  regularly monitor in line with regulations, all records kept by the home to ensure

p.4

Recommendations

compliance with the home's policies, to identify any concerns about specific incidents and to identify patterns and trends. (NMS 21.2)

p.4

Outcomes for children and young people

Young people form positive relationships with peers and staff. This is helping to promote self-esteem and supporting good progress in other areas of their life.

p.5

Outcomes for children and young people

Young people have good access to universal health services to ensure that they receive necessary care and support; this also normalises their lives. Good support from specialist services such as mental health services provides effective support and treatment to young people to promote their emotional well-being.

p.5

Outcomes for children and young people

The setting’s nurse provides on-site support to young people. This promotes young people’s well-being. Staff successfully encourage young people to choose a healthy diet such as fruit options rather than sugary and fatty foodstuffs; this has helped to improve young people's health.

p.5

Outcomes for children and young people

Young people are engaged in a range of positive activities that help them to develop social skills and have fun. For example, participating in a local football team and using local leisure facilities; this broadens their life experiences and promotes their engagement in the local community.

p.5

Outcomes for children and young people

Attendance at school is good. Young people's educational progress is linked with their personal, social and communication needs to maximise their independence. A social worker made reference that previously a young person had not engaged with his peer group or at school. Now he is attending school and interacting with his peer group. He will now go out for a walk at times with his friends and access the local community with no signs of anxiety. This demonstrates the young person’s increased self-confidence.

p.5

Outcomes for children and young people

Staff provide appropriate support to enable young people to have successful contact with family members. This helps to develop and to maintain important and supportive relationships that contribute to their positive self-view.

p.5

Quality of care

The quality of care provided to young people is good. A parent stated that the home has provided very good care to their child. The parents feel more confident and able to help their child when he is anxious when they are on outings. In addition the parent stated that their child is much better able to self-manage his behaviour and has developed many life skills.

p.5

Quality of care

Young people have complex communication needs and some are not able to verbally communicate. Staff use a range of personalised and effective methods of communication to find out how young people are feeling For example, staff use sign language and pictorial exchange cards. This enables young people to express themselves, quickly reduces their anxieties, reduces episodes of challenging behaviour, and engages them positively with staff. A social worker stated: ‘the care setting meets the young person’s sensory needs very well. He goes into the lounge and mixes and is not on his own in his room; he is joining in.’ Communication systems are also used by staff with young people to enable them to make a range of individual choices for example about food choices and activities. This improves young people’s engagement in their daily living and enhances their life experiences.

p.5

Quality of care

The young people’s daily routine is described well in their care files. Young people have access to a range of activities in the community. Age appropriate activities are incorporated into young people’s transition plans and support is given to increase their independence. Staff clearly express their aspirations to integrate young people more into community based activities. This promotes young people’s positive transition to adulthood.

p.6

Quality of care

There is effective communication on a day-to-day basis between the care setting and school. This promotes continuity of care. Staff verbally, and in writing, report young people's progress to appropriate partners such as parents and social workers. Progress reports are prepared for statutory reviews and staff attend those meetings.

p.6

Quality of care

Care staff also work very closely with the on-site multi-disciplinary team. The team includes a psychologist and speech therapist who are involved in developing young people’s behaviour support strategies and communication plans. Education staff and care staff work with children and parents to develop individual education targets including social and personal hygiene objectives. Supervision of young people is good and key workers informally and formally engage young people in their care.

p.6

Quality of care

The home’s children’s guide is written in a range of formats to maximise young people’s accessibility to the information. In addition there are phone lines that young people can use to access independent help. However, children do not have access to independent advocacy and the details of the children’s rights commissioner are not included in the children’s guide. This limits children’s access to services that can ensure that young people’s rights are effectively supported.

p.6

Quality of care

Young people’s medication is safely administered. Auditing of drugs, including controlled drugs, is completed. Staff are provided with regular training to ensure that their knowledge and practice of administering medication is safe.

p.6

Safeguarding children and young people

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

p.6

Safeguarding children and young people

Young people are safe in this nurturing home environment. Staff act to promote young people’s welfare. Young people act in a positive manner that demonstrates secure attachments to staff.

p.6

Safeguarding children and young people

Individualised positive behaviour plans are in place. They identify antecedents to young people’s behaviour and triggers that result in challenging behaviour. Plans also identify actions to de-escalate negative behaviour. Staff are consistent in applying young people’s plans and this has successfully resulted in a reduction in challenging behaviour.

p.6

Safeguarding children and young people

Staff record when behaviour plans are not adhered to and reports show that on such occasions debriefs are given to staff and children. This provides the opportunity for staff to reflect on the event and to improve practice. This also provides opportunities for young people to express themselves and for staff to learn and reflect on the incident from the young person’s point of view to avoid future recurrence.

p.7

Safeguarding children and young people

New reporting systems have been put in place to record physical interventions. Staff have been provided with effective behaviour management training. New training in behaviour management is also being implemented to support the momentum to reduce the use of physical interventions. This will improve young people’s and staff’s safety. In addition, staff have been given support in writing incident forms to ensure that there is accurate information available about the need for and use of a physical intervention. This is already showing a significant improvement in staff’s practice. Young people show increased attachment to the home and show less anxiety in their home environment. Young people’s bedrooms are personalised and show individual young people’s interests.

p.7

Safeguarding children and young people

Current risk assessments and care plans are well completed but do not show the reasons for routine body mapping of children. Parents and placing authorities are aware of the practice. The procedure is undertaken during routine care routine to promote children’s dignity and if the child objects then it is not undertaken. Verbally staff describe the reasons for this procedure being undertaken to provide early identification of physical harm to a child. However, risk assessments do not show the justification for this practice to take place.

p.7

Safeguarding children and young people

The home has a high number of new staff recruited to work with young people. Staff are selected and vetted robustly to ensure that young people are cared for by suitable adults. However, on one occasion, the verification of one of two references for one new member of staff was not documented comprehensively to show the suitability of all staff to work with children. During inspection evidence that verification of references had been gained was made available.

p.7

Safeguarding children and young people

All new staff receive safeguarding and promoting positive behaviour training during their induction to promote young people’s safety and well-being. Staff are aware of how to report concerns related to poor care provided to young people to ensure that young people are kept safe. Senior managers take robust action to address any such incidents. However, on one specific occasion, managers failed to record the actions taken following a concern. This concern did not have a detrimental effect on the outcomes for young people. Appropriate action was taken to address this at the inspection.

p.7

Safeguarding children and young people

The home has a safe environment. There are good and regular reviews of health and safety, including fire safety equipment, to ensure that the home is safe. This ensures that in the event of an emergency, young people are kept safe and are able to safely evacuate the building.

p.7

Leadership and management

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

p.8

Leadership and management

The manager is a suitably qualified and experienced.

p.8

Leadership and management

The Statement of Purpose does reflect the aims and objectives of the service. There is a good audit of quality of care that fully utilises the national minimum standards; children’s home’s regulations and the inspection framework. This enables managers to identify shortfalls and good practice in the care provided to children. The home’s development plan is comprehensive and shows a capacity for improvement.

p.8

Leadership and management

One requirement was made at the last inspection and the senior management in the home and organisation has responded positively to improving the home’s behaviour management guidance in line with good practice. Recommendations have also been met through the development of improved data tracing and evaluation of information; this informs children’s behaviour management strategies and demonstrates safe and individualised support to children is provided. In addition the home is informing HMCI of necessary notifications to ensure that appropriate independent scrutiny of issues arising takes place.

p.8

Leadership and management

The manager responds well to complaints and gains feedback from the complainant about the outcome of all investigations. The home has received many compliments and thanks from parents about the care that staff have provided to young people in the home.

p.8

Leadership and management

The home takes action to ensure that all young people have statutory reviews. Staff report on young people’s progress on a six monthly basis and the effectiveness of actions taken to improve young people’s outcomes is reviewed. There is good partnership working with partners providing support to young people in the home.

p.8

Leadership and management

The monitoring and evaluation of the quality of care is undertaken on a regular basis. This is particularly good at an individual level. However aggregation of information to show overall trends is not always reported to HMCI and this hinders independent scrutiny of the home. The views of children, parents and local authorities are gained to inform the effectiveness of the service. However, reports do not show input from young people, parents or placing authorities. The manager had completed an audit of the service and this has informed the home’s development plan. As a result the manager is aware of the strengths and weaknesses of the home and is taking action to address issues identified during the inspection.

p.8

Leadership and management

The home has been successful at recruiting new staff. There is on-going staff recruitment. Management of the home has demonstrated good leadership in effectively managing significant staff change. Staff state that they feel well supported through both one-to-one and group supervision. New members of staff are provided with a good induction programme and they feel well supported when they are with young people. The home shows good capacity to improve.

p.8

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.

p.10

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.

p.10