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 14/05/2014 2 of 11 Inspection date 26/06/2014

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Previous inspection inadequate Enforcement action since last inspection There has been no enforcement action since the last inspection.

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Overall effectiveness adequate

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

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Overall effectiveness

Young people are making good progress across their areas of development as they live in a supportive, caring and nurturing environment. Young people enjoy positive, trusting relationships with staff. The home is making a difference to young people’s lives and provides them with the tools and opportunities to achieve positive outcomes. This is echoed by social workers who say the young people are 'happy, settled and are making very good progress in the short time they have been here.’

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Overall effectiveness

Young people are encouraged to enjoy a full range of social opportunities and activities and broaden their experiences by trying new things. Securing young people's views are central to everything the home does and is a key strength of the provision. Staff use effective communication and their awareness of each young person’s personalities to assist them to express their views, feel settled and confident, and reduce any feelings of anxiety and frustration.

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Overall effectiveness

Staff are committed and have a very good understanding of each young person's specific and complex needs. Care planning is comprehensive and is highly personalised although there are some shortfalls within some documentation. Staff have high, but realistic, aspirations for young people and work effectively to promote their growth, social and emotional development. Consequently, young people feel 3 of 11 safe and are much more able to handle difficult and challenging situations.

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Overall effectiveness

The Registered Manager, staff and organisation have taken positive, effective steps to address the statutory requirements and most of the recommendations raised at the last inspection. A range of new documentation has been implemented which now needs to be fully embedded in practice. The home is warm welcoming and homely. Young people are very pleased with the new décor in their bedrooms which they chose. Monitoring of the home has improved and means the Registered Manager is more able to identify any shortfalls and take action to address these. 4 of 11

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Information about this children’s home

The home is owned by a national organisation. It offers accommodation for seven 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. Some young people attend during the holidays and at weekends. Young people who access this service can be aged between 5 and 19 years.

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Inspection date Inspection type Inspection judgement

14/05/2014 Full inadequate 25/03/2014 Interim satisfactory progress 16/04/2013 Full adequate 14/01/2013 Interim good progress

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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 staff engaged from the commencement of the new NMS (in April 2011 hold the level 3 Children and Young Peoples workforce Diploma which must include mandatory social care units of be working towards this within 6 month of employment (NMS 18.5)  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 reference 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 5 of 11 appropriate (NMS 16.3)  enhance further the monitoring systems to ensure information is consistently recorded in all records such as health care pathway plans, all about me books to prevent any discrepancies, risk assessments are in place for the building works and consider the use of the word absconding in documentation (NMS 22.1)

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Recommendations

 enhance further the support provided to young people to minimise the risk that they will go missing in particular all young people's missing from care risk assessments are sufficiently detailed with regards to where they may and any medical attention or support they may require. (NMS 5.1) 6 of 11

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Outcomes for children and young people good

Young people feel emotionally secure, confident and settled in their time away from their family. Social workers are very positive about the service the home provides, and confirm that young people enjoy improved outcomes. For example, young people enhance their communication skills and others adopt regular routines for independent personal care. Developing independence and skills for life is a strength of the provision. Young people learn valuable independence skills, such as cooking or keeping themselves occupied.

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Outcomes for children and young people good

Young people continue to develop an understanding of their own health care needs. For example, some choose to receive their medication in their bedroom as they are of an age where by they do not want others to see what they are doing. This is effectively supported by staff and maintains young people's privacy and dignity.

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Outcomes for children and young people good

Young people enjoy a wide range of healthy meals and snacks all freshly prepared by staff. Some young people help staff prepare their meals but are quite clear on what they do and do not like. Some young people are undertaking more physical active such as going swimming on a weekly basis and undertaking one form of fitness a day.

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Outcomes for children and young people good

Young people's attendance at school is good. They are always up and ready for school due to the clear individualised support systems in place. This means they are able to arrive at school happy, settled and ready to take part in the day’s activities. As a result young people continue to make good progress in school.

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Outcomes for children and young people good

Young people enjoy a wide variety of fun activities and new experiences in the home and out in the community that otherwise may not be available to them, including going to the park, attending youth clubs, activity centres, the cinema, going for bike rides, swimming and out for meals. They are able to follow their interests and hobbies. Young people enjoy the company of staff and happily tell visitors that they are going to 'take over the world!' with staff. The young people's achievement files are much improved and now tell the real 'story' of the young people’s experiences, activities and friendships within the home.

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Outcomes for children and young people good

Young people are in regular contact with family members and other people who are important to them. Parents and carers are able to contact the home at any time during their child's stay to talk to them or staff to see how they are. Parents feel reassured that the young people are well looked after and say that they could not rest if they thought their child was unhappy. Young people are really eager to come here and parents comment that they have to hide their bags so that they do not become too excited before they leave home. 7 of 11

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Quality of care good

Staff provide good care to ensure young people enjoy their time at the home. Relationships are well established; young people express confidence and contentment by their settled behaviour and the progress they make. Parents, social workers and independent visitors are complimentary about the positive impact the service has on the lives of young people. Young people enjoy spending time with other young people in the home, for example, going out on activities with them and celebrating special events.

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Quality of care good

Consultation with young people is a strength of the provision. Staff are keen to secure the views of young people and see this as an intrinsic to the care and support provided. This means young people have a voice, are listened to and their wishes and feelings are acted upon where possible. Young people have recently been consulted on the décor for their bedrooms and are extremely pleased with the results. Staff said, one young people bounced up and down on their bed in delight when seeing their new room painted in their favourite colour and adorned with their choice of cartoon characters. Others are choosing to spend more time in their room reading. One young person said, 'I liked my room but I like it better now.'

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Quality of care good

The home has improved upon how they plan young people's care. All young people now have a placement plan from their placing authority from which the homes individualised care plans are created. This means nothing is missed and care plans are specifically tailored to meet each young person’s diverse needs. Social workers state the communication between them and the home is good and staff are skilled at adapting young people's plans to meet their ever-changing needs.

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Quality of care good

Staff plan effectively to meet the health care needs of young people. However, the use of three documents to record health care needs means on occasion they contain conflicting information. For example, one identifies a young person has hay fever while others do not mention this. This means that some aspects of their care are not adequately identified.

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Quality of care good

Staff have improved the recording of medication as each record is more specific with regards to where medication such as cream are to be applied and how much. Health promotion is promoted well. Staff use innovative ideas to encourage young people to take part in exercise such as linking this to token reward schemes to enable young people to purchase new games. Some young people like to come up with their own ideas such as 'modern exercise' whereby they link this to their games consoles or tablets. As a result young people are engaging more in keeping themselves fit and healthy.

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Quality of care good

Staff have consistently high aspirations for young people's education. They work in partnership with the organisations school to ensure they consistently deliver the 8 of 11 same message to young people. For example, using the same communication programme to support their thinking; choices; motivations; expectation; sensory differences, learning and cognition; access to the community; transitions and behaviour. Consequently, young people have increased confidence in their own abilities and self-esteem.

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Quality of care good

Young people live in large family home in a residential area. The home has recently undertaken a refurbishment programme with regards to young people's bedrooms, gardens and communal areas with some work currently ongoing. This has significantly improved the environment in which young people live and has been well received. Improved maintenance systems within the home means the response to carrying out repairs is more effective and ultimately young people are cared for in a safe and secure environment. The garden is now free from obstacles, such as the overhanging branches and moss on the pathways. Also plans are in their infancy for the development of a sensory area for young people within the garden.

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Keeping children and young people safe adequate

Staff understand their responsibility to protect young people and are well trained in child protection. They are able to take effective action should they have concerns about young people’s welfare. Young people’s individual plans identify any risks they may face and outline effective strategies to ensure their welfare is promoted and protected. The plans for young people’s safety are consistently put into practice and fully address their needs and circumstances.

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Keeping children and young people safe adequate

Staff are very knowledgeable about young people’s particular vulnerabilities relating to their level of understanding and disability. They identify that young people can become easily distracted by their own interests and motivation when outdoors and may be inclined to wander off. Similarly they recognise that some young people are getting better at crossing the road but need to be reminded to look both ways. This means staff are able to balance the need for protection with enabling young people to take reasonable risks as part of their growth and development. Young people are always suitably supervised and any activities in the community are carefully planned to reduce the risks to personal safety.

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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. Most missing from care risk assessments have been updated since the last inspection. However, some are not yet sufficiently detailed with regards to where young people may go and any medical needs they may have. Although staff have a very good understanding of the risks associated with each young person this is not always reflected in the written record. This hinders 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

The revised behaviour management strategy provides clear direction for staff on the 9 of 11 preventative measures that can be used to support young people. All staff have recently undertaken behaviour management training and say they feel confident in managing any issues that may arise. Physical interventions are rarely used and are carried out as a last resort with minimal intervention.

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Keeping children and young people safe adequate

A number of new documents have been introduced to support the recording of physical interventions and the strategies implemented to minimise the occurrence of this. Positive intervention support plans clearly outline each young person’s vulnerabilities triggers, anxieties and counter measures to support them. However, it is too soon to evaluate the effectiveness of these documents in relation to the improved recording of physical interventions.

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Keeping children and young people safe adequate

Young people are protected from any hazards, by a range of detailed health and safety procedures, risk assessments and checks. The recruitment and selection of people working at the home is thorough to make sure young people are protected. The Registered Manager ensures that staff have the skills and competencies to meet the needs of individual children. There are suitable systems in place to ensure that visitors and contractors are suitably checked and supervised to protect young people.

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Leadership and management adequate

The home is 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 adequate

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 adequate

The Registered Manager and organisation has taken positive steps to address the issues raised following the inadequate judgment at the last inspection. Effective action has been taken to address the eight statutory requirements and four recommendations in relation to placement plans; behaviour management policy; recording of physical interventions; the safety and maintenance of the premises; staff records; missing from care risk assessments; some records and the monitoring of the home. The action taken in the short period of time demonstrates the homes commitment to improve outcomes for young people, and now requires time to fully embed the new systems.

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Leadership and management adequate

Monitoring of the home by the Registered Manager is more detailed and clearly outlines any shortfalls and the action taken to address this, such as minor omissions with a physical intervention record. This is due to the implementation of new recording systems. However the effectiveness of this cannot be fully evaluated as only one report has been completed since the last inspection. Copies of the managers 10 of 11 monitoring are sent to Ofsted within the prescribed timescales. Monitoring by a representative of the organisation is appropriate and identifies shortfalls within practice.

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Leadership and management adequate

Positive steps have been taken to ensure all information pertaining to staff working in the home is held in their individual staff files. However on some occasions it does not make clear as to their qualifications and experience although this is held in their main file within human resources. Also some information regarding the verification references is missing. As a result this recommendation has been reissued at this inspection. Most staff hold a recognised childcare qualification, however some who have been employed for over six months are not yet enrolled on to an appropriate course. The Registered Manager is in discussions with human resources to secure 'bolt on' training, but this has not yet been finalised.

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Leadership and management adequate

Records and documentation are appropriately maintained. Though there are some shortfalls in the recording of young people's health care needs, written risk assessments for the building works and all about me books. Also the use of the word absconding in records is not appropriate given the needs of the young people being cared for. Overall there has been an improvement in record keeping. For example, key worker reports clearly outline the discussions taken place with young people. They explain how issues within the home have been explained to them and how staff have taken their lead from parents. As result the same language has been used to explain specific issues.

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Leadership and management adequate

Staff have attended courses to learn about the support needs of children with autism, including alternative communication systems and behaviour management training. The Registered Manager provides staff including bank staff with regular and developmental supervision, to assess the impact of training on staff practice.

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Leadership and management adequate

Staff are competent, enthusiastic and caring, and work well together to promote young people’s welfare and development. The numbers of staff on duty are sufficient to meet the needs of young people in the best possible way; including the support they need for activities. Team meetings take place regularly to allow the staff team to discuss the running of the home, to look at ways to improve the service they offer, to reflect on young people’s progress and how best to support them. Website: www.ofsted.gov.uk

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Leadership and management adequate

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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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