Children's Home run by Step-A-Side Company Limited in Gloucestershire

Unique reference number SC030650 Inspector Heather Chaplin Type of inspection Full Provision subtype Children's home

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Registered person Step-a-Side Company Limited Registered person address 29 Market Place COLEFORD Gloucestershire GL16 8AA Responsible individual Rachel Emma Carwardine Registered manager Matthew James Underhill Date of last inspection 08/01/2014 2 of 12 Inspection date 23/09/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness good

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

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Overall effectiveness

This home has been rated good, because it helps young people with diverse individual needs to achieve positive outcomes in every area of their lives. Because of the high quality care provided, all young people have made substantial progress from their starting points. Young people spoken to enjoy being at the home; they behave well and say that they get along with their peers.

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Overall effectiveness

Young people’s care planning is highly individual and tailored to their personal circumstances. Some young people have complex medical needs and are cared for by their own team of specially-trained staff from a domiciliary care agency run by the same company. This enables parents with major caring responsibilities to have much-needed periods of respite. It also helps disabled young people to live within their own families in the community.

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Overall effectiveness

Parents and professionals are full of praise about the quality of care provided. They are very pleased with their children's progress. For example, some parents say that 'the home has worked wonders' for their child. One parent commented that it is ‘the best place he has ever been’.

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Overall effectiveness

Staff manage young people's wide-ranging needs very well through sound and respectful relationships. Consequently, young people feel safe and are safe within 3 of 12 the home and say they can speak to anyone about any worries or complaints. Young people are fully consulted about every aspect of their care. Parents' and professionals' views are regularly sought to inform day-to-day care.

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Overall effectiveness

Staff are well trained in child protection, including preventing and responding to sexual exploitation. Young people do not currently go missing from this home but if this were to happen in future, there are effective protocols in place to help protect them from harm. Staff set boundaries that are clear and understandable for young people. The manager monitors strategies and behaviour to make sure that young people are rewarded appropriately. When occasional tensions arise in the group, staff and the manager work together swiftly to address this, long before it escalates into bullying. Physical intervention to manage challenging behaviour is rare. All recorded incidents relate to one young person.

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Overall effectiveness

The home is managed and led by a skilled and qualified Registered Manager. He has been registered for this setting since April 2012, but has many years of experience in care and management prior to his present registration. The manager constantly strives for further improvement. For example, although there were no requirements or recommendations made at the last inspection, he has implemented a number of positive developments and has clear ambitions for the future.

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Overall effectiveness

There are three regulatory shortfalls but none has any direct impact on residents' welfare or safety. Two of the requirements made have arisen partly because the service has an unusually complex remit. Specifically, the home cares for one young person with learning disabilities, who receives regular respite care under Section 17 of the Children Act 1989, whereas the three long-term residents are looked-after children. The differences in the young people's legal status and ability to give informed consent have led to some misunderstandings on the home's part about their care planning responsibilities. This means that one care-planning document and the home's statement of purpose require updating to ensure accuracy. The statement of purpose has recently been reviewed to meet the amended Children's Home Regulations but requires some minor alterations to reflect accurately what the home has to offer. The third requirement relates to fire precautions. The home

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Overall effectiveness

provides a safe environment for young people but, since the last inspection, there have been some gaps in weekly fire alarm tests. The manager has addressed this by delegation and there is already an improvement in frequency of alarm tests. 4 of 12

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Information about this children’s home

This children's home is run by a small, locally-based private company, which also operates another children's home in the area. The company also provides domiciliary care services for young people and homes for disabled adults, which are separately regulated and inspected by the Care Quality Commission.

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Information about this children’s home

The children's home currently provides long-term and respite care for a maximum of five young people, who may have emotional and behavioural difficulties and/or learning disabilities.

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Inspection date Inspection type Inspection judgement

08/01/2014 Interim good progress 15/08/2013 Full good 12/03/2013 Interim good progress 04/12/2012 Full good

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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

4 (2001) compile in relation to the children's home a written statement (the statement of purpose) which shall consist of a statement as to the matters listed in Schedule 1. In particular, ensure that the statement of purpose accurately describes the services on offer in the home, staff qualifications and contains the correct address for Ofsted (Regulation 4 (6)) 30/11/2014 5 of 12 (2001) ensure that where a child who is not looked after by a local authority is placed in a private children's home other than by a voluntary organisation, prepare a placement plan is prepared for that child in accordance with Regulations 4 and 5 of the 2011 Regulations, and keep under review and revise the placement plan as necessary (Regulation 12 (1A) and (2)) 30/11/2014

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Reg. Requirement Due date

(2001) take adequate precautions against the risk of fire, including the provision of suitable fire equipment. In particular, ensure that the fire alarms are tested at least once a week in line with the home's own procedures and fire and rescue service recommendations. (Regulation 32 (1) (a)) 30/11/2014 6 of 12

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Outcomes for children and young people good

Children and young people have made very good progress in developing emotional stability, self-confidence and resilience. They have all remained in placement for a substantial period of time. The overall picture for these children is one of sustained improvement. For example, some young people are learning important life skills, while others are acquiring the ability to relate appropriately to others. Young people who have had traumatic experiences in early childhood are now learning how to respond to caring adults. This helps them to develop secure attachments that ultimately may have a lasting impact on their lives.

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Outcomes for children and young people good

None of the children and young people in this home misuse alcohol or drugs or go missing. They feel safe and are safe in this home.

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Outcomes for children and young people good

Young people receiving respite care enjoy exciting activities such as dry slope skiing, which would be difficult for them to access from outside the service. They also benefit from informal contact and friendship with young people who live in the home full time. Respite care directly supports families and helps to keep disabled young people living in the community. The importance and value of this is immeasurable.

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Outcomes for children and young people good

All the permanently-placed young people have experienced significant improvements in their health. For example, one young person has now understands the need for dental hygiene and has improved this to the point where they now can wear the braces prescribed for them. This will, in turn, have a positive effect on their self esteem. Another young person has made good progress in managing previous weight gain and is now growing at an appropriate rate. A young person who has significant emotional difficulties now has greatly increased their ability to relate to others positively and to empathise. This will help them in future relationships and will increase their chances of leading a productive and happy life.

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Outcomes for children and young people good

Children are very effectively consulted to help them participate in the running of their home. They contribute to house meetings, complete surveys and are spoken to on a daily basis by their keyworkers and other staff, to seek their views. This helps children and young people to exercise choice in their daily lives.

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Outcomes for children and young people good

Young people attend school regularly and benefit from a good education. They say that they enjoy school and value their learning. Consequently, they are doing well and have been able to achieve their educational targets. Those who sometimes struggle with school have, in spite of this, been able to increase their attendance. This facilitates learning and improves young people's chances of obtaining further training or employment when they leave school.

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Outcomes for children and young people good

None of the young people currently living in the home are ready for independence. 7 of 12 Because most have significant learning disabilities, most of the children are likely to need continuing support as they move into young adulthood. Some previous residents have enjoyed organised work experience which helps to prepare them for employment.

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Quality of care good

Young people enjoy excellent relationships with staff. Professionals say that improving outcomes for children is a priority for staff at the home. One professional commented that there is a ‘caring and homely atmosphere, with staff who have appropriately parental relationships with the young people.’

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Quality of care good

Staff promote clear boundaries to help young people understand how they should behave. For example, any young people not attending school may not engage in activities of their choice when they should be working. This helps to instil discipline and structure into their lives, which will become increasingly important for their future life chances.

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Quality of care good

Consultation is very effective in this home. The manager has recently surveyed all young people, parents and professionals to seek their views about the service. Young people participate in regular meetings and individual key worker sessions to share their views about their care. They understand how to raise any concerns. The only complaint received since the last inspection was from a young person. This complaint has been addressed positively.

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Quality of care good

All four children have placement plans in place. Three of these plans are detailed and contain all the information required to help staff understand and meet children's needs. The placement plan for one young person receiving respite care has been drawn up by domiciliary care staff who are not based at the home and it does not contain sufficient detail to meet the Children's Homes Regulations. For example, there is a lack of clarity in the plan and risk assessment about the young person's legal status, mental capacity, the procedures for his life-preserving medication administration and the consents required for any changes to procedures.

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Quality of care good

The home works very effectively with all parents to develop effective partnerships and promote high quality care for young people. The manager and staff are fully aware of sensitive issues for parents of children with disabilities. Parents confirm that the home cares for children very well. They regard the service as a lifeline. Positive contact is promoted, which helps young people to retain their sense of identity within their families.

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Quality of care good

Young people's healthcare needs are exceptionally well managed. For example, staff support them very sensitively with their diets, sexual health, appropriate sexual behaviour and personal hygiene. The home provides a bespoke psychological service which is highly adaptable and flexible. For example, one psychologist present during 8 of 12 the inspection was collecting a young person from school to facilitate conversation with them. The psychology service reviews all the home's therapeutic behavioural support plans and is closely involved in updating young people's risk assessments. Because of the exceptionally good psychological service which this home offers, they take on children with very challenging behaviour. Staff and managers then receive high quality training from the psychology service to support them with managing each child’s unique needs.

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Quality of care good

Arrangements for dealing with medication are safe and effective. One young person is presenting some new challenges for staff in terms of medicines administration. The medicines received are essential to his health and wellbeing and potentially life saving, but staff sometimes find it difficult to persuade him to take them. The home is working well with parents and the commissioning authority to ensure that his best interests are met.

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Quality of care good

The home supports young people's education exceptionally well. For example, one young person has recently been excluded, but the home is working with the school to ensure that educational work is completed and to help resolve behaviour management issues.

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Keeping children and young people safe good

The home provides a safe environment where there are clear behavioural boundaries combined with a warm, nurturing approach which helps young people feel secure. Serious incidents in the home are very rare but when they occur, staff manage these effectively. They understand each young person’s vulnerabilities and respond to their changing needs accordingly.

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Keeping children and young people safe good

There have been no incidents of young people going missing since an incident in February 2014. This involved a resident who has since left the home. There is a joint protocol with the police which, combined with individual risk management plans for each young person, helps to ensure children’s safety.

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Keeping children and young people safe good

Since the last inspection, there have been just five physical interventions. These all involved one young person who in each instance was physically aggressive. The interventions used were appropriate and effective in reducing the risk of harm to them and others. Young people and staff are spoken to after each incident and have the opportunity to express their views about what took place. This helps all parties to learn from the experience and reduces the chance of a repetition.

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Keeping children and young people safe good

The home has a strong and effective anti-bullying policy. Any issues are addressed immediately to keep young people safe and this was observed during the inspection. Young people interviewed did not think that bullying was an issue.

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Keeping children and young people safe good

Staff are recruited safely. The company’s personnel records are robust, with well- 9 of 12 organised staff files that meet regulatory requirements. This helps to ensure that young people are cared for by suitable, carefully-checked staff.

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Keeping children and young people safe good

The Registered Manager was on call during the inspection and dealt appropriately with a child protection concern relating to another service. He has good links with the local authority designated officer (LADO) and with the police, which ensures effective communication. There have been no allegations in relation to this home since the last inspection.

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Keeping children and young people safe good

The home provides a safe environment for young people. Good quality, regularly- updated risk assessments of the home, fire hazards, activities and individual young people provide clear staff strategies. The home has a location risk assessment in place to help ensure that any hazards in the area are identified and managed.

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Keeping children and young people safe good

Accident and fire safety records are generally well maintained. Regular health and safety checks ensure that all equipment in the home is serviced when required and that it works effectively.

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Keeping children and young people safe good

Fire drills have taken place at the specified intervals but prior to June 2014, fire alarm tests were not always completed on time. For example, there were 26 fire alarm tests in the 38 weeks from 1 January 2014 to the date of the inspection. In June, the manager delegated the task to a member of staff. This person has ensured that checks since that date have been completed weekly. Although this has now been addressed, a requirement has been made.

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Leadership and management good

The Registered Manager has driven a series of improvements to the home since the last inspection. For example, the staffing re-structure has resulted in improved delegation and accountability. This has freed the manager’s time to plan, manage staff and participate in looking after the children.

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Leadership and management good

The manager has also advocated hard to improve the quality of care and vision for each young person. This has been achieved by working with schools, instigating medication reviews and focusing on presenting behaviour rather than dwelling on the child's disability. Young people now have clear, achievable targets to help them to meet their long, medium and short term goals.

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Leadership and management good

The home has a detailed and ambitious development plan in place. The manager said, ‘the home feels like it is flying to me, we are working as a unit and the children are clearly benefitting.’

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Leadership and management good

The home has recently updated its statement of purpose and has placed a condensed version of this document on the company web site to make it readily accessible to commissioners and parents. There is also a children’s guide which is 10 of 12 very detailed and contains some attractive photographs of the home and garden.

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Leadership and management good

The majority of the statement of purpose is clear and accurate. The home was re- developed and extended to provide a respite care bed in 2012. This young person has their own en-suite bedroom at the home, which can be further adapted for physical disabilities if necessary. However, the home is not currently registered for this category, so the manager has been asked to remove references to physical disability from the statement of purpose. This document also contains a previous address for Ofsted and staff qualifications are not provided. A requirement has been made.

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Leadership and management good

The manager works well with his company to ensure that children and young people’s individual and group needs are met at all times. For example, he accepts only suitable admissions, which means that the present group of young people is balanced, stable and settled. The manager’s decisions are respected and since the last inspection, there have been no issues about inappropriate mixes of young people. This helps to ensure that all young people in the home receive high quality care.

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Leadership and management good

The home is very well monitored, both internally and externally, through Regulation 34 checks and monthly Regulation 33 visits. These visits are conducted by an independent person who consults with parents and children to form a view about the home. The reports are detailed and perceptive and provide a useful tool for management improvement.

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Leadership and management good

The Registered Manager said that the company is far-sighted and values his plans to improve the quality of the home. All reasonable requests for financial resources are met.

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Leadership and management good

The home is in very good condition, clean and well organised. The large, attractive garden is beautifully maintained, making a very pleasant environment for young people, visitors and staff.

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Leadership and management good

The home employs sufficient staff to enable any vacant shifts to be covered internally, avoiding the use of agency staff. This means that young people are cared for by staff who know them and understand their needs. The staff team is stable and supportive. They work well together and are motivated.

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Leadership and management good

The home’s training tracker shows that staff have all received specialist instruction in how to administer medication to a young person who has high-level medical needs. Some staff have recently attended training in responding to child sexual exploitation. Most routine training updates have been completed and a high percentage of staff have completed or are undertaking a level 3 qualification in the care of children and young people. This means that staff are qualified and skilled in caring for young people in the home. 11 of 12 Most records in the home are clear, well managed and stored securely to ensure that they are not inappropriately accessed. There are excellent relationships with other agencies.

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Leadership and management good

Ofsted has received notifications when required in the past. There have been no notifications since the last inspection. Website: www.ofsted.gov.uk

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Leadership and management good

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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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