Children's Home run by Autism Initiatives (UK) in Sefton

Unique reference number SC425985 Inspector Chris Scully Type of inspection Full Provision subtype Children's home

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Registered person Autism Initiatives (UK) Registered person address Autism Initiatives 7 Chesterfield Road Liverpool Merseyside L23 9XL Responsible individual Katharine Silver Registered manager Helen Jane Guy Date of last inspection 16/04/2013 2 of 12 Inspection date 14/05/2014

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Previous inspection adequate Enforcement action since last inspection none

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Overall effectiveness inadequate

Outcomes for children and young people adequate Quality of care adequate Keeping children and young people safe adequate Leadership and management inadequate

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Overall effectiveness

Young people enjoy spending time here. Parents say their children are safe and feel safe here. They comment upon the positive interactions between staff and young people and the levels of support the families received from the service. Young people views and wishes are carefully considered and acted upon.

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Overall effectiveness

The homes Statement of Purpose provides insight into the care and support provided to young people. Young people are cared for by a committed team of staff which comprises of homes staff, school staff and bank workers from within the organisation. This means young people are cared for by people who they know.

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Overall effectiveness

The homes own placement plans detail the individualised care provided to young people. However the home does not have copies of the placing authority’s placement plans, short break plans and minutes from review meetings. In some instances the basis for each placement needs to be more explicitly set out Consequently some aspects of young people's care is not fully supported.

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Overall effectiveness

The home has taken some action to address the shortfalls from the previous inspection. However, they have failed to take sufficient action in relation to the monitoring of the home. This has led to significant shortfalls with regards to the maintenance of the home and the recording and monitoring of physical 3 of 12 interventions, both of which have been reissued at this inspection.

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Overall effectiveness

There are important shortfalls within young people's records such as key worker records, health care plans and risk assessments: including missing from care risk assessments. Staff files do not contain all the required information. These issues have had a detrimental effect upon the organisation of the home and its ability to demonstrate a capacity for sustained improvement. 4 of 12

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Information about this children’s home

The home is owned by a national organisation. It offers accommodation for seven children and young people who experience autistic spectrum disorder and a possible learning disability. Young people who access the service attend the organisation's school.

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Information about this children’s home

Placements in the home are generally provided during term time, with accommodation being provided on weekdays. Periods of short-break care are agreed on an individual basis. Children and young people who access this service can be aged between 5 and 19 years.

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Inspection date Inspection type Inspection judgement

16/04/2013 Full adequate 14/01/2013 Interim good progress 10/05/2012 Full adequate 06/12/2011 Full satisfactory

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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

12A (2001) ensure in the case of a child who is looked after by a local authority that the registered person co- operates with the young person’s placing authority in agreeing and signing the plan for the child in accordance with the provisions in regulation 9 or, as the case may be, regulation 47C(2), of the Care 06/06/2014 5 of 12 Planning, Placement and Case review (England) Regulations (2011). (Regulation 12A (1))

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Reg. Requirement Due date

(2001) ensure when a child who is not looked after by a local authority is placed in a private children's home, that the registered person must prepare a placement plan for that child in accordance with regulations 4 and 5 of the 2011 Regulations (Regulation 12 (1) (a)) 06/06/2014

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Reg. Requirement Due date

17B (2001) ensure the registered person keeps under review and where appropriate revises the behaviour management policy: notify Ofsted of any revision within 28 days (Regulation 17B (2)) 06/06/2014

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline a written record is made in a volume kept for the purpose; in particular a description of the measure used and the name of the person using the measure (Regulation 17B (3) (c) (e)) 06/06/2014

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Reg. Requirement Due date

(2001) ensure the registered persons shall not employ a person, specifically bank staff, to work at the children's home unless that person is fit to work at a children's home (Regulation 26 (1) (a)) 06/06/2014

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Reg. Requirement Due date

(2001) ensure that the registered person ensures that all persons employed receive appropriate training and supervision; in particular training on behaviour management, autism and young people's communication systems (Regulation 27 (4) (a)) 06/06/2014

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Reg. Requirement Due date

(2001) ensure all parts of the children's home used by children are of sound construction and kept in good structural repair externally and internally; are kept clean, reasonably decorated and maintained (Regulation 31 (2)(d) (e)) 06/06/2014

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Reg. Requirement Due date

(2001) ensure that there is a system for monitoring the matters set out in Schedule 6 at appropriate intervals at least once in every 3 months; in particular the evaluation and analysis of the records. (Regulation 34 (1) (a)) 06/06/2014

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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 if a young people is missing from the home and their whereabout are not known the homes procedures are compatible with and have regard to Runaway and Missing from home and Care (RMFHC) protocols in particular th 6 of 12 young people's risk assessments are sufficiently detailed and clarify the degree of risk when a young people goes missing (NMS 5.6)  ensure the home has a record of recruitment and vetting checks which have been carried out on those working (including volunteers) including, identity checks, DBS checks, conformation of their qualification, at least two references one from a previous employer, confirm the right to work in the UK and if they have lived outside of the UK further checks are undertaken as deemed appropriate (NMS 16.3)  ensure there is a system in place to monitor the quality and adequacy of record keeping and take action where needed in particular health care plans, medication

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Recommendations

records, key worker records, risk assessments and all records are clearly signed and dated. (NMS 22.1) 7 of 12

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Outcomes for children and young people adequate

Young people benefit from individualised support, which helps them to grow in confidence. They are developing positive and realistic views of themselves. As a result they settle in well, feel confident and secure in their time away from their family. They are becoming more communicative and sociable. Young people are able to empathise with others. For example, asking their friends 'what's up’, when they can see they are sad or distressed.

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Outcomes for children and young people adequate

Young people are developing an understanding of their own health care needs in relation to their personal care needs. Young people are choosing healthier dietary options and are taking an interest in menu planning within the home. This means they are trying new foods and extending their dietary repertoire. Meal times are relaxed social occasions. Social worker's say there have been significant improvements in this area for some young people who have recently starting eating out at restaurants with staff.

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Outcomes for children and young people adequate

Young people are involved with an extensive range of health care professionals to support their on-going health care needs: including their emotional, psychological and physical health. Consequently, they are able to progress at their own pace within a safe and supportive environment.

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Outcomes for children and young people adequate

Young people's attendance at school is very good. All young people attend the organisations school. Developing independence is a strength of the provision. Staff use innovative ways in which to support young people's independence and enhance their self-esteem such as having 'silly time' at appropriate times to enable young people to engage in school activities. Young people are encouraged to develop independence, dependent upon their age and stage of development. This means they are more able to make choices and cultivate new skills, such as helping prepare meals.

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Outcomes for children and young people adequate

Young people have strong links with their families. They are able to sustain positive relationships with them through appropriate levels of contact during their stay. Young people are enjoy a variety of stimulating activities and new experiences in the home and out in the community that otherwise may not be available to them, including: using cycling; visiting theme parks; attending youth clubs; activity centres; going to the cinema, and going out for meals. They love going out and are more confident in taking part in activities in the community.

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Quality of care adequate

8 of 12 Young people have strong, trusting relationships with staff because they are treated as individuals with very specific and diverse needs. Young people obviously enjoy spending time with staff and are keen for specific staff to go with them on certain activities such as cycling. Parents say the staff are always helpful, caring and friendly. They comment that nothing is too much trouble for them as they have a good understanding of each young person and their complex and diverse needs.

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Quality of care adequate

Young people are carefully consulted and are able to make choices within their daily routines. Staff use their relationships with young people to listen to them and use some communication aids to help young people have a say in what is happening around them. Staff effectively take into consideration each young person’s needs and interests when planning activities. This means young people get to take part in an good range of meaningful and fun activities.

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Quality of care adequate

Staff understand the care needs and support individual young people require on a daily basis. The homes own placement plans are detailed and demonstrate the uniqueness of each young person. These plans incorporate young people's individual needs, backgrounds, cultures, ethnicity and reflect the personality of each young person. However, the plans are not regularly updated. Consequently conflicting information is held within various records which does not provide sufficiently clear information about young person’s actual day to day care needs. There is no placing authority placement plans, short breaks plans or minutes of review meetings available for a number of young people. This means that some aspects of their care are not adequately identified. Social worker's state that staff attend all meetings in relation to young people and are skilled at adapting their plans to meet the ever changing needs of the young people. However, it was apparent that the home did

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Quality of care adequate

not have a sufficiently clear understanding about on what basis placements were made: specifically whether individual placements constituted a short break arrangement for children in need or whether for some they fulfilled the criteria for being looked after.

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Quality of care adequate

Overall young people live in a healthy environment which promotes their physical health and emotional well-being. They are registered with the appropriate health care professionals and staff's have a good understanding of each young person’s needs, for example, the medication they are taking and the reasons for this. Health care plans and medical information are generally well documented However, some records are not always updated. This means some contain conflicting information. Also on occasion there is a lack of information regarding specific medical conditions. This may mean young people do not always get the care they need in a timely fashion.

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Quality of care adequate

Young people live in large family home within a residential area. The communal areas of the home are generally warm, welcoming environments which meet the needs of the young people resident. Some young people’s bedrooms are personalised and reflect their individual tastes and interests. However, there are numerous maintenance issues within the home and garden that have not been addressed, for example, overhanging branches, the sand pit, moss on the pathways, holes in 9 of 12 bedroom walls, rusty wire grills on doors and damaged furniture. These issues limit young people's comfort and detract from the homely environment that staff are striving to create.

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Keeping children and young people safe adequate

Young people are safeguarded because staff have a sound knowledge and understanding of the home’s child protection and safeguarding procedures. This means that if staff have any concerns about a young person’s safety or well-being they are able to take effective action. Staff are knowledgeable about young people’s particular vulnerabilities relating to their level of understanding and disability. Staff balance the need for protection with enabling young people to take reasonable risks as part of their growth and development. For example, young people are always suitably supervised and activities in the community are carefully planned.

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Keeping children and young people safe adequate

Young people do not go missing. Staff are aware of the homes missing from care procedure and are acutely aware of the associated risks for each young person. Missing from care risk assessments are in place: however, they do not always clarify the level of risk for each young person and places where they may go or how to approach the young person. This impacts on staff's ability to provide clear support to young people and the agencies involved in searching for them.

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Keeping children and young people safe adequate

Young people’s behaviour is generally safe. Staff support young people appropriately should their behaviour deteriorates as a results of their anxieties or limited communication skills. They do not experience bullying or harassment. Staff carefully consider the needs of young people so that they get on well together during their short stays. Staff have a good understanding of the times and factors that contribute to young people becoming upset. This includes working well with school and parents to develop behaviour management strategies that reduce young people's anxieties and frustrations; for example, using computer tablets, going for walks and spending time alone.

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Keeping children and young people safe adequate

Sanctions are never used and physical interventions are rare. However on some occasions 'hands on' interventions are not always recorded within 24 hours and do not contain clear information about the hold. This is compounded as the behaviour management policy is not clear on what constitutes a physical intervention. This is being addressed through the creation of a new policy; however, this has not been ratified by the organisation.

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Keeping children and young people safe adequate

Staff carry out regular health and safety checks, including hot water temperatures, annual checks on electrical and gas safety, and fire drills to ensure young people know what to do in case of an emergency. There are good systems in place that are consistently followed to check and monitor visitors to the home. This helps ensure young people are protected. 10 of 12

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Leadership and management inadequate

The home is lead and managed by a qualified and experienced Registered Manager. The manager works a number of childcare shifts each week. Together with staff they demonstrate a commitment to delivering good childcare practice tailored to the diverse, personal needs of the young people. This is reflected in the positive comments from parents and social worker's.

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Leadership and management inadequate

However, insufficient information is available to fully judge the impact the service has in supporting young people’s progress while staying at the home. This is due to shortfalls in monitoring of the conduct of the home. The current arrangements for monitoring does not effectively identify weaknesses in record keeping, such as insufficient detail in young people's care plans; key worker records and young people’s individual risk assessments.

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Leadership and management inadequate

Similarly, monitoring has not identified omissions in staff files, for example, a lack of information pertaining to their recruitment checks and supervision for in particular bank staff. For some staff who work in other parts of the organisation, no information was made available in relation to their employment and recruitment. Consequently the home is unable to satisfactorily demonstrate the robustness of the recruitment and selection process of the organisation.

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Leadership and management inadequate

The Registered Manager does not fully evaluate staff training needs. Consequently, some staff have not had behaviour management training for some time. Supplementary training on autism and young people's communication systems has also not been fully addressed. This impacts upon staff's ability to fully understand communication systems young people use in order to enable them to communicate successfully.

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Leadership and management inadequate

Monitoring by the independent person has identified some shortfalls in records and the maintenance of the home. However, the home has failed to address the maintenance issues and these have been outstanding for some time. The home does not have an up-to-date development plan which clearly outlines the development opportunities for the next 12 months. As result the home cannot demonstrate its capacity for sustained improvement.

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Leadership and management inadequate

The Statement of Purpose provides insight in to the organisation of the setting. This is appropriately shared with parents, and placing authorities.

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Leadership and management inadequate

The home has taken appropriate action to address one of the recommendations from the last inspection to raise the awareness of staff to use only agreed physical holds and interventions. The home has taken some action to revise the behaviour policy, but this has not yet been implemented. The issues surrounding monitoring of the home have not been addressed and as a result have been reissued at this inspection. 11 of 12 Insufficient action has been taken to ensure the home is appropriately maintained: consequently a requirement has been made to improve the interior and exterior of the home.

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Leadership and management inadequate

Young people are looked after by a committed and caring team of staff. Adequate staffing ratios mean young people have sufficient support to engage in activities of their choice and have their needs met during their stay. Education staff and the organisations bank staff provide support to maintain staffing ratios. This means young people receive care from people who are known to them. Website: www.ofsted.gov.uk

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Leadership and management inadequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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