Children's Home, Residential special school run by Rowden House School Limited in Herefordshire

Unique reference number SC035625 Inspector Andrew Hewston Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Registered manager Margaret Kim Ames Date of last inspection 14/01/2014 2 of 12 Inspection date 09/10/2014

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

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Overall effectiveness

The home ensures that young people develop from the point that they are admitted. Highly individualised placement planning and a knowledgeable staff team help to make sure that the complex needs of the young people are thoroughly considered and responded to. This is also completed through close involvement with parents and other health professionals. This leads to some outstanding outcomes for young people.

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Overall effectiveness

Young people are consulted about aspects of their care and are encouraged to be involved in a wide range of decision making relating to the home, although there is some variation in young people's meetings. Activities are fully promoted and young people enjoy differing experiences both within the school and externally at both specialist provisions and within the local community.

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Overall effectiveness

Young people's safety is consistently monitored. All staff have a high awareness of the need to follow both safeguarding procedures and the detailed risk assessments relating to the young people's care. Appropriate systems are in place to allow complaints relating to all aspects of young people's care to be raised and responded to, although there is a need for an advocate to be in place to further support young people. 3 of 12 Young people's behaviour management planning is well known by the staff. There is a low level of interventions and an expectation that diffusion and distraction is best for all. Some aspects of behaviour management recording needs development to ensure it is fully completed in a timely manner.

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Overall effectiveness

The home is led by a strong management team that fully support the large staff team. The Registered Manager has an extremely high awareness of each young person and the plans in place for them. A development plan highlights the strengths within the home and how these can be further built on to move forwards with care practices. Necessary developments in regulations and national minimum standards relate to recording issues and do not affect the welfare or outcomes of young people. 4 of 12

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Information about this children’s home

This service is a privately registered children's home that also provides education on site for up to 30 young people with special educational needs. The service comprises of seven separate residential homes.

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Inspection date Inspection type Inspection judgement

14/01/2014 Interim good progress 20/06/2013 Full outstanding 21/02/2013 Interim good progress 25/10/2012 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

17B (2001) ensure that within 24 hours of the use of any measure of control, discipline or restraint in a children’s home, a written record is made in a volume kept for the purpose, including the effectiveness and any consequences of the use of the measure (Regulation 17B (3)(f)) 27/12/2014

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s): 5 of 12  ensure children have access to independent advice and support from adults who they can contact directly and in private about problems or concerns, which is appropriate to their age and understanding. Children know their rights to advocacy and how to access an advocate (NMS 1.5)  ensures all staff’s work is consistent with these Regulations and NMS, the home’s policies and procedures, regarding young people's meetings across the site (NMS 21.3) 6 of 12

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Outcomes for children and young people outstanding

Young people are able to make considerable progress while being at the home. This is due to well trained and experienced staff having an exceptionally high awareness of the differing needs of the young people and how to respond to these. One social worker stated that, 'the placement has been amazing and totally changed her life.' Young people make positive attachments with members of the staff team that are important to them, one parent stated that their child has a, 'brilliant relationship with staff, they are able to really bring out the best in him because they know him so well.'

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Outcomes for children and young people outstanding

Young people develop with their awareness of being healthy and looking after themselves. Strong support systems are in place to ensure all aspects of the young people's health is examined and responded to. The close working relationship between health professionals across the school and care environments helps with the development of the young people. One young person has made significant improvements with their posture through the involvement of the occupational therapist, also benefitting from having a sensory assessment and is now enjoying a sensory diet.

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Outcomes for children and young people outstanding

Young people make strong progress in school. There is a high attendance rate and staff persistently promote young people's involvement in school activities to enhance their achievements. Information is regularly shared between care and education, including a new system of key worker meetings across these two areas. This allows staff to work with the young people consistently and effectively.

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Outcomes for children and young people outstanding

Young people are involved with well thought through consultations about their home and activities that they would like to be involved with. This contributes to the organisation of the home, developing a varied programme of experiences. Young people enjoy a range of activities within the community and are routinely involved with using transport to develop their awareness of their local environment. Records of a recent holiday to Tenby show that young people thoroughly enjoyed the trip and the experiences that this brought. A parent stated that their child 'had a wonderful time when they went away.'

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Outcomes for children and young people outstanding

Young people benefit from contact arrangements that ensure their families are a constant part of their lives despite not living at home. The use of technologies such as skype is used well and enable young people to stay in touch with siblings and parents. Parents state that the level of communication they receive from the home is exceptionally high and are able to discuss reports, telephone discussions and photographs that keep them up to date.

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Outcomes for children and young people outstanding

Young people's needs are of a high priority within transition arrangements both into and from the home. This ensures that changes to their living arrangements are 7 of 12 positive experiences and they develop from them. Young people that are moving from the home have developed in their skills for self- help, with parents stating that their children has developed in communication skills, washing skills and looking after their rooms. For some parents these improvements had made a significant difference to the lives of both the young people and their families.

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Quality of care good

Young people have good relationships with the staff team. Young people are seen to be comfortable with a range of adults, having differing staff that they communicate successfully with. Young people's views are sought throughout the different home areas to varying success, with some homes not being as well run and recorded as others. Some young people's meetings are highly effective showing considered responses from young people and these help to develop the way that that area works.

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Quality of care good

Young people are cared for well and their individual needs are met because placement plans are clear, precise and regularly updated. This is in line with young people's development to ensure they receive the most up to date quality care. Staff know and understand the individual needs of young people because information is collected and shared well within the team and between external professionals. This helps young people to continue to have their complex needs met and improved. For example one young person is now able to brush his teeth using hand over hand support. This significant improvement has occurred as a direct result of careful planning and target setting to recognise the starting point of young people and the slow steps required for improvement.

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Quality of care good

A robust complaints system is used at the home, with all concerns being well recorded and responded to. Information relating to who young people and their families can complain to is available within the home and literature relating to the care provided. Information is also clear within differing communication systems including picture exchange systems and through Makaton. This ensures that information is as accessible as possible for the young people. Not all of the young people have advocates, this reduces the number of individuals that young people can raise concerns with if they have a concern.

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Quality of care good

Staff are proactive, sensitive and skilled in managing the complex health and behavioural needs of young people. The home provides an environment that fully supports the complex heath needs of young people. Young people access services routinely such as dentist, GP’s and opticians. Health medicals are undertaken annually to ensure they continue to be provided with the best health care support needed. Medication is administered by trained staff and regularly monitored to ensure young people are safeguarded. Medication errors have occurred and have been reported and rectified immediately. Actions have been taken to re-evaluate the procedure to safeguard against the same incident re-occurring. Good joint working 8 of 12 with external partners such as the speech and language therapist, occupational therapist and psychologist ensures that young people continue to thrive. Their well- being is effectively promoted and improvement has been seen as a result of

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Quality of care good

Strong links between education and care ensure that young people receive a consistent level of care and that information is shared daily between the two areas. Young people achieve within school and develop an awareness of their abilities and how these can improve. The staff team are diligent in supporting the young people both within the school and care areas, challenging barriers to learning that the young people experience.

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Quality of care good

Young people experience a wide range of activities both within the school and externally. Activities are planned well within each of the home areas and these are also examined within young people's meetings. Staff are able to discuss the activities that individual young people find the most interactive, ranging from being with animals to staying in for a pamper evening. There is a high awareness within the staff team that young people respond positively to differing experiences and seek out the most appropriate for each of them. This ensures that the residential care is a developmental experience.

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Quality of care good

Each of the residential home areas is kept clean and free from damage. Where repairs are necessary these are completed swiftly and with as limited disruption to the young people as possible. Successful refurbishment of one home area has been completed since the last inspection, with all aspects of the provision being designed around the complex needs and behaviours of the young people. This ensures that the building is both safe and comfortable. Young people are involved in the decoration of their own rooms and the home areas, through choosing colours of the walls to deciding on soft furnishings. This promotes young people's choice and aids their ability to settle into the home.

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Keeping children and young people safe good

There are robust and rigorous safeguarding policies and procedures in place. These are underpinned by a safeguarding team which deal specifically with any safeguarding issues that arise. All staff are aware of the safeguarding measures in place and there is an allocated safeguarding champion within each home. Staff are aware of their roles and responsibilities within safeguarding and who to contact within the provision should they have a concern. Safeguarding is consistently on the team meeting agenda ensuring that it remains at the forefront of the care that is delivered to the children and young people. Information regarding external safeguarding agencies is not consistently known and accessible to staff. This could have an impact on the safety of young people if not used correctly.

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Keeping children and young people safe good

Missing from Care protocols are in place and have been shared with the local Policing 9 of 12 Team and Looked After Designated Officer (LADO). The provision has good relationships with the local Police and LADO. Any allegations or concerns are been investigated swiftly and thoroughly. Further actions that have arisen from the investigations are implemented; this allows the home to consistently develop in its safeguarding practices

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Keeping children and young people safe good

Effective behaviour management strategies are in place for the children and young people, with an emphasis on diffusion of situations. Physical intervention is used only when necessary and this ethos is universal within the staff teams. Positive behaviours are promoted and staff are aware of the need for the children and young people to be redirected in certain situations. Behaviour management assessments are thorough and shared with the education team to ensure a consistent level of care. Behaviour management records are not fully completed , with some lacking information relating to effectiveness and some not being signed off in a timely manner. These are recording errors and have not had a negative effect on the care of the young people.

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Keeping children and young people safe good

The relationships between young people are generally positive. Bullying is monitored and peer relationships are promoted with any concerning difficulties being quickly resolved or managed by the staff team. Social stories are utilised to promote positive peer relationships. Staff are highly aware of the needs and behaviours of the young people and these are balanced with the needs and behaviours of their fellow residents. Topics such as internet safety are promoted within the setting to support individual’s safety. The environment is warm and nurturing and staff strive to work in partnership with parents to promote the safety and well-being of the children and young people in their care.

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Keeping children and young people safe good

Recruitment information shows that the home has a robust focus on ensuring staff are safe to work with the young people. All necessary checks are completed and additional references are sought to confirm applicant’s previous experience. Young people have an involvement in the recruitment process through a group exercise. This ensures that new staff are confident with working with the challenges that some of the young people exhibit at the home.

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Keeping children and young people safe good

All necessary health and safety checks are completed on a regular basis and staff are aware of their responsibilities in this area. This ensures that both the staff and young people are safe within the home.

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Leadership and management outstanding

The home is managed by a Registered Manager that has been in position for three years and is suitably qualified and experienced. The Registered Manager is currently involved with further developing her qualification through attaining the level five certification. Since the last inspection they have spent time away from the home, working with a placing authority and also supporting the development of another children's home. This excellent experience has significantly developed their 10 of 12 awareness of the placements process and also allowed them to work with social workers supporting children with complex needs. It has also given them the additional confidence to challenge poor placing authority practice and raise expectations of the level of information that the home could receive from social workers. As a result admissions paperwork is now of a higher quality giving a greater depth of knowledge of the young people to the staff team

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Leadership and management outstanding

The staff team have responded fully to the requirements and recommendations made at the last inspection. All notifications relating to the care of the young people have been received by Ofsted and all young people now have key workers. This highlights the responsiveness of the team to effect positive change within the home.

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Leadership and management outstanding

The home has a Statement of Purpose that clearly defines the home and the care practices involved within it. It is regularly updated and clearly explains the assessment process that is on-going though young peoples admissions into the home, to ensure that they are correctly placed and the home will best meet their needs. Young people's guides are individualised to meet each admissions' individual communication needs.

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Leadership and management outstanding

Robust and highly detailed monitoring is completed using a range of individual homes managers sharing information, relating to their own areas. The Registered Manager collates and analysis differing aspects of young people's care across the residential provision. This ensures that they are fully aware of any concerns or challenges and reflects on these to further develop practices that would enhance young people's residential experience. Monitoring feeds directly into the homes development plan. This is highly detailed and challenges the staff team to strive for improvement in a wide range of areas relating to the home and improving the outcomes for the young people. External monitoring is completed through an independent body, with reports being robust and challenging to further improve the service. Where reports highlight possible developments these are responded to fully and swiftly.

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Leadership and management outstanding

Staff are fully supported through a very well organised system of supervisions and appraisals. Staff are able to discuss the merits of the supervision process with one stating how they, 'have really encouraged' them to improve their practice. A recent quality audit of supervision across site found that the vast majority found them to be very helpful and supportive, enhancing their skills and allowing them to reflect on their practice. Team meetings are completed regularly to share points relating to the home and care practice issues, further developing consistency across the home's site.

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Leadership and management outstanding

The home is well staffed and all staff are appropriately trained, with basic mandatory courses forming part of their induction to the home prior to them working directly with the young people. Further training is completed as staff progress, relating specifically to the differing needs of the young people, so enhancing the care provided. Specialist training in areas such as differing feeding techniques and information relating to complex needs are updated regularly to promote the highest standard of care to young people. The Registered Manager also uses skills 11 of 12 evaluations within the appraisal process to develop training packages for the staff team, highlighting areas where staff feel they need reviews of their practice or skills. This is an excellent way of ensuring staff are confident in working with the young people.

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Leadership and management outstanding

All significant events are swiftly reported to the necessary authorities to ensure that all parties are aware of on-going issues for the young people. Notifications are detailed and show both the incident and how these have been responded to. This creates a confidence in the ability of the home to meet the challenges that the young people may bring. Website: www.ofsted.gov.uk

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Leadership and management outstanding

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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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