Children's Home run by Plus One South West Ltd in Somerset

Unique reference number SC467115 Inspector Sharron Escott Type of inspection Full Provision subtype Children's home

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Registered person Plus One (South West) Ltd Registered person address Plus One Ltd The Mount 21 High Street WELLINGTON Somerset TA21 8QT Responsible individual Lou El Gilany Registered manager Brian Harold Solman Date of last inspection 17/07/2014 2 of 11 Inspection date 11/09/2014

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Previous inspection inadequate Enforcement action since last inspection none

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Overall effectiveness adequate

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

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Overall effectiveness

The home provides an adequate quality of care, which meets young people’s identified needs. The previous inspection, conducted eight weeks ago, found the service to be inadequate in all areas. Ten requirements and three recommendations were made. A major factor in this assessment was in the home providing placements for young people in an emergency whose specific needs were not being fully met as a result of the staff team not having the required skills and experience to meet their needs.

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Overall effectiveness

Since the last inspection, one young person has moved placement. Two weeks before the present inspection, a number of serious incidents requiring medical intervention have taken place. The manager and staff team have responded to and managed these incidents appropriately. As a result, young people are receiving the health care support they need and supporting agencies are being accessed.

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Overall effectiveness

The views of one young person were obtained during the inspection who said they enjoyed living at the home and wouldn’t want to live anywhere else. They said they felt safe and enjoyed spending time with some staff members. Education arrangements have not progressed, despite the placing social workers wish for the young person to remain in placement at the home, the local authority are considering two alternative placements as a result home's inadequate inspection 3 of 11 findings. It is far too soon after the inadequate inspection to be confident that improved outcomes in terms of personal development and safety can be sustained. For this reason, the rating for outcomes is adequate.

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Overall effectiveness

The home’s manager has acted promptly to address the shortfalls identified at the last inspection. A staff member stated that the recent training courses attended has positively benefited their practice, knowledge and awareness. Specific training around understanding and dealing with Autism and Asperger’s syndrome has been identified and is planned to start for manager and staff. The Registered Manager has been pro-active and assertive in improving the services provided by the home and stated that ‘the inspection process had been instrumental in helping the service to improve’. These developments have led to the rating for leadership and management to progress to adequate and this is reflected in the overall judgement.

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Overall effectiveness

The home has done well to address six out of the ten requirements from the last inspection, in a relatively short timeframe. Those not fully met are a result of this short time frame, availability of specialist training and limited opportunity to address other shortfalls such as robustly assessing the compatibility and needs of new placements. Completing all specialists training and providing formal education. There are improvements in behaviour management which focuses individual’s positive behaviour rather than unwanted behaviour. Sanctions which were previously ineffective have not been imposed. 4 of 11

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Information about this children’s home

The home, which is operated by a locally-based private company, provides care and accommodation for up to two young people who may have emotional or behavioural difficulties.

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Information about this children’s home

The provider also operates other homes in this area and education can be arranged using other private care organisations which provide small specialist schools.

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Inspection date Inspection type Inspection judgement

17/07/2014 Full inadequate 12/11/2013 Full adequate

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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

(2001) ensure that the children’s home is conducted so far as to promote and make proper provision for the welfare of children accommodated there. Specifically, ensure that emergency referrals do not impact on young people already placed at the home (Regulation 11 (1) (a)) 26/12/2014

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Reg. Requirement Due date

(2001) ensure that the routine of the home is organised so as to further young people's participation in education, including regular attendance at school and particularly ensuring that reasons why a young person is not attending school are robustly 31/10/2014 5 of 11 addressed without delay (Regulation 18 (1)(b)

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Reg. Requirement Due date

(2001) ensure that there is at all times, having regard to the size of the children’s home, the statement of purpose and the number and needs of the children accommodated there; and the need to safeguard and promote the health and welfare of the children; a sufficient number of suitably, qualified, competent and experienced persons working at the home (Regulation 25 (1) (a) & (b)) 28/11/2014

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Reg. Requirement Due date

(2001) ensure the report reviewing the quality of care details the information as set out in Schedule 6 and shall provide systems for consultation with children, their parents and placing authorities. (Regulation 34(1);Regulation 34(3)) 28/11/2014 6 of 11

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Outcomes for children and young people adequate

Outcomes achieved by young people in this setting continue to be variable. This is as a result of the placing authority who have yet to agree the long term care plan for the young person. The young person has been informed that there are two alternative options being considered in addition to remaining at the home. The young person stated that their preferred option is to remain at the home and they have researched local educational provisions to attend. The lack of decision making is significantly contributed to the young person emotional wellbeing who has experiencing heightened anxiety resulting in an increase of incidents requiring medical intervention.

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Outcomes for children and young people adequate

Since the last inspection the home has not considered or accepted new placements. The manager is very confident and clear that a full and robust assessment would be considered and completed prior to a placement being offered. As a result, opportunities to evaluate the home's reviewed procedures on admissions, suitability and compatibility of young people could not be established.

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Outcomes for children and young people adequate

Young people's views are regularly sought and considered to ensure they enjoy a varied and healthy diet. The storage of fresh food has improved ensuring all cooked and uncooked foods are stored correctly reducing the risk of young people eating or accessing contaminated food.

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Outcomes for children and young people adequate

Recent incidents have resulted in staff seeking the support, advice and assistance from a range of health care professional. Their actions and support has positively benefited the young people to ensure that their health care needs are met and they are provided with emotional and nurturing support. Young people attend regular appointments health appointments with their General Practitioner, Dentist and Optician. This ensures young people’s specific health care needs are responded to and monitored. Good working relationships with supporting health care agencies are maintained; as a result, young people are receiving the treatment and advice they need and require.

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Outcomes for children and young people adequate

A placing social worker commented, ' the manager and staff team have built a positive relationship with the young person, they manage and respond to her behaviour and needs well. Significant incidents have reduced and the recent events is not a result of the home's management but because the young person is experiencing high levels of anxiety in relation to her long term care plan. Communication is good and I am really pleased with the service provided.’

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Outcomes for children and young people adequate

Young people are encouraged to participate in a variety of activities and enjoy living in a location that is calm and tranquil. The senior leaders are considering a young person’s request to have a rabbit. The young person said, 'I have achieved all my 7 of 11 targets, this has enabled me to save money to buy a cage, rabbit, food and bedding. I believe having a pet of my own will help me when I am feeling unsettled and anxious. I understand that my behaviour needs to be good because it may affect the rabbit.'

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Quality of care adequate

Since the last inspection one young person has moved from the home leaving one young person in placement. Despite having a vacancy the home has chosen not to offer a placement until an appropriate match has been identified. This demonstrates that the home will not accept a new placement until they have robustly considered and assessed the impact of individuals placed together given their presenting behaviours and needs.

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Quality of care adequate

All young people have an up-to-date local authority care and placement plans which is regularly reviewed and effectively followed by the home. In addition, individuals also have care plans and risk assessments that have been developed by the home. These inform staff members how to meet the changing daily living needs of young people. Targets identified are meaningful and achievable; those set are agreed in consultation with the young people. In addition, the manager and team have reviewed and modified their behaviour management approach. This includes the introduction of a new intervention technique and a greater emphasis on recognising and rewarding young people's positive behaviour. This has reduced the need to impose sanctions for unwanted behaviour. Young people are encouraged to recognise and celebrate their achievements which in turn have helped individuals to develop their self-view, confidence and resilience.

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Quality of care adequate

The education arrangements for young people are adequate. The home continues to promote vocational learning by ensuring day trips out enable continual learning opportunities. However, formal educational arrangements have not been identified and secured. Discussion with the placing social worker concluded that the as a result of the home's last inspection judgement the long term plan for the young person to remain in placement has not been secured. The social worker confirmed that the local authority and young persons preferred option is for the placement to continue and for a local educational service to be identified and secured. This means the young person has not received formal education since being placed at the home. Their academic needs are not being met or developed which will restrict their opportunities in the future.

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Quality of care adequate

The storage and management of medication has been reviewed. All controlled medication is now stored safely and securely. The core staff team are up-to-date with basic mandatory training in first aid and the administration of medication.

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Quality of care adequate

Young people live in an environment that they enjoy spending time in and are 8 of 11 pleased to call the house their temporary home. Young people have personalised their bedroom. New soft furnishings and personalisation of the home environment has contributed to the home being warm, welcoming and homely. The gardens surrounding the home are well maintained and are spacious; young people enjoy spending time in the gardens.

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Quality of care adequate

Young people views are sought informally throughout the day; in addition their views are obtained during key worker session and through the home's formal consultation survey. Views shared are considered and contribute to the home's development.

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Keeping children and young people safe adequate

The manager and staff team provide stability and continuity of care for the young people placed at the home. Shift vacancies due to leave or sickness are predominately covered by core staff. However on occasions the manager has required the support of bank staff and agency staff. Prior to working at the home the manager verifies their suitability, experience and qualifications. A summery copy of this information is held on file at the home. The home’s recruitment practice meets the requirements of the children’s homes regulations and young people are safeguarded from harm.

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Keeping children and young people safe adequate

Young people engage well in key worker sessions. Subjects discussed focus on individual’s safety, health, well-being and relationships with staff members and family. Young people are encouraged to reflect on incident and consider alternative options and behaviours. In addition, the views expressed through these sessions are considered and has promoted greater opportunities for young people to engage in age appropriate risks, this includes safe management and usage of the internet and high risk activities.

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Keeping children and young people safe adequate

Young people say they feel safe living at the home; they enjoy spending quality time with individual staff members. Young people say they are confident to access child line, Ofsted and other supporting agencies if they have a concern or a complaint. Records indicate that the home has supported and responded to issues being raised ensuring communication with social workers and agencies are well maintained.

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Keeping children and young people safe adequate

Health and safety checks are completed regularly. These include fire drills, maintenance of fire equipment and electrical checks. The manager has completed a location risk assessment which identifies risks presented within the local area.

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Keeping children and young people safe adequate

Records reviewed show that young people have not been missing from the home, and just one restrictive intervention has taken place to ensure the safety of young people. All staff members are suitably trained in de-escalation and physical intervention techniques, which are effective. No sanctions have been imposed and the central records have been reviewed to ensure that in the event of a sanction being imposed they will contain the information required to meet the regulatory 9 of 11 requirements.

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Leadership and management adequate

Since the last inspection the manager has demonstrated that the home has capacity for improvement having in a short time scale met all but four regulatory requirements set.

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Leadership and management adequate

The Statement of Purpose has been reviewed and details the services provided by a staff team who have the skills and experience required to meet the needs of young people with emotional and behavioural difficulties. At the request of Ofsted and following the outcome of the last inspection the manager was requested to submit an application for a variation to the home's registration to include providing for children with learning disabilities. This is currently being reviewed and approval will be given full consideration when the manager and staff team have completed the necessary specialist training.

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Leadership and management adequate

As a result of the home's last inspection being eight weeks ago the monitoring activity of the home has been minimal. The independent monitoring report received details the activity of the home, outcomes and area's for improvement. The manager stated all visits since the last inspection have been unannounced; however this has not been identified on the report and is an administrative error. Reports now include the views of young people, social workers and parents and include their feelings about the quality of care provided by the home.

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Leadership and management adequate

The manager has reviewed and consulted with professionals and colleagues in regard to the home's development plan. The manager confirmed that he is reviewing his current development plan to include targets to improve the quality of care provided to young people and other areas of development for the home.

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Leadership and management adequate

Young people benefit from the stability and continuity of care provided by a staff team who are experienced and are committed to develop and learn to enhance their skills and knowledge. A placing social worker said, 'I am pleased with how the team manage the young person, they do not heighten her anxiety or respond inappropriately to her presenting and at times challenging behaviour.'

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Leadership and management adequate

The team are enthused and motivated to ensure young people have a positive experience whilst living at the home. Staffing levels continue to be high and reflect the needs of young people. Staff said they enjoy working at the home and feel supported and listened to by the manager. They feel their views are considered and decisions they make are supported. Staff members benefit from receiving regular and comprehensive supervision that focuses on their practice, development and concerns. 10 of 11 The home has met six out of the ten requirements and all three of the recommendation’s raised at the last inspection. Short time scales have contributed to the requirements for referral assessment, education, Regulation 34 monitoring, and specialist training not being met and therefore these are reinstated. 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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