Children's Home, Residential special school run by MacIntyre Care in Buckinghamshire

Unique reference number SC043994 Inspector Emeline Evans Type of inspection Interim Provision subtype Residential special school (>295 days/year)

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Registered person MacIntyre Care Registered person address MacIntyre Care 602 South Seventh Street Milton Keynes Buckinghamshire MK9 2JA Responsible individual Brenda Maria Mullen Registered manager Catherine Warren Date of last inspection 09/07/2014 2 of 7 Inspection date 01/12/2014

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Previous inspection adequate Enforcement action since last inspection none

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This inspection

This home was judged adequate at the last full inspection. At this interim inspection Ofsted judge that it has declined in effectiveness .

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This inspection

Progress for children and young people has been mixed. There is a lack of consistency in record keeping across the seven houses which hampers leaders and managers from properly evaluating the progress made or the factors which have hindered this. At the last full inspection, a new manager had recently been appointed and she has since been registered with Ofsted. The senior management team has been restructured and managers are still identifying and redeveloping practice and processes.

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This inspection

The use of seclusion has continued since the last inspection, although there is no evidence that seclusion as a practice has any therapeutic value to the person exposed to it. There is insufficient detailed information recorded about incidents to either justify or significantly help analyse the, and their frequency is not reducing. Information is available but not always shared with all relevant people. Records seen were not an accurate indication of the number of seclusions implemented. Discussions with staff indicated they are unclear if seclusion can or cannot be used within the children’s home. Senior managers have begun to monitor processes and the decision making which has led to the over-use of seclusion. However, this is not sufficiently robust and it fails to provide a comprehensive picture of what has and is presently happening in the children’s home. Incidents of seclusion noted through regulation 33 visits and during the course of the inspection have not been included

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This inspection

in this management oversight. Managers were not aware of all of the incidents which had taken place. It was not clear if the exchange of information between the behaviour management team, staff and senior managers is complete. Staff have not yet got the confidence to reliably use other, less restrictive, interventions. This is at the centre of the decline since the last inspection.

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This inspection

Records of physical intervention are completed in bound log books within each house. These entries are not very detailed and do not clearly cross reference to 3 of 7 incident records, which are in place. This does not allow patterns, trends and triggers for behaviours to be fully identified and understood. Some young people’s placement plans have been updated but not all. In one instance medication changes had not been updated and other placement plans had not been reviewed within planned timescales.

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This inspection

Four children and young people have come to live in the children’s home since the last inspection. There have also been internal transitions between the houses. An impact risk assessment format has been developed by managers for completion prior to young people’s placements. These are also used for internal transitions between houses on site. However, they have not been completed in all cases and an evaluation of the young person’s compatibility with the current group of young people or the wider suitability of the placement is not evident. This fails to demonstrate how admission and transition decisions are made, taking into account the unique needs of young people who could be placed and those already living in the home. There is information in place for young people who have lived or who are living in the children’s home but this does not contain all the required information about young people in the form of a register.

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This inspection

Since the last inspection, there has been a focus on recruiting to the vacant positions within the children’s home. This has resulted in an increase in permanent staff employed; and to cover remaining vacancies the number of directly employed bank staff has been increased. This ensures consistency for the young people and a decrease in the use of agency staff. This has led to an improved understanding and implementation within the staff team of the home’s ethos and approach to caring for young people. Records available and discussions with staff indicated not all staff have completed training in restrictive practice. The system in place for ensuring the frequency and quality of supervision and appraisal has improved. However, a number of staff are still not receiving regular formal supervision. As a result, staff are not being adequately supported to reflect on and improve their professional practice. Staff undertake a detailed induction to provide them with the competencies

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This inspection

required to meet the complex needs of the young people. However, needs to be more clearly aligned to the Children’s Workforce Development Council’s induction standards and to explicitly include the legal context for children’s homes. There has been a delay in staff completing the induction package and undertaking the Children’s and Young People Workforce Diploma level 3 qualification.

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This inspection

There are presently seven separate houses providing accommodation across the site. Each house is personalised according to the young people’s needs and preferences. There is a maintenance plan in operation and a kitchen is in the process of being replaced. This has resulted in some areas being well decorated and maintained. There are still many areas within the individual houses that require attention. This needs to address: mould in bathrooms; holes in bedroom doors; fire doors not closing adequately; and bedroom windows without curtains or frosting to protect privacy. A small number of young people require close supervision for health reasons such as epilepsy. Electronic devices are used to ensure these supervision 4 of 7 levels are maintained. These devices are no longer in view for others to see and now afford young people their privacy. However, consent for their use has not been obtained by placing authorities in all cases.

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This inspection

Management oversight has been hampered by poor recording systems. This has not enabled patterns and trends to be fully evaluated in order to improve the quality of care provided. The internal monitoring visits undertaken under Regulation 34 of the Children’s Homes Regulations are not currently being sent to Ofsted. There were six requirements and four recommendations made at the last full inspection. Four requirements and two recommendations have not been fully met and are raised again in this report. 5 of 7

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Information about this children’s home

This service is a residential special school registered as a children's home for young people with severe learning disabilities and is run by a large independent organisation. The school accommodates up to 40 young people in eight separate houses, usually on a 52 week placement basis. Due to the length of the young people's stay at the school it is required to be registered and regulated as a children's home under the Care Standards Act 2000.

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Inspection date Inspection type Inspection judgement

09/07/2014 Full adequate 11/09/2013 Interim satisfactory progress 02/05/2013 Full good 26/02/2013 Interim good progress

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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

17A (2001) ensure any measure of restraint may only be used on a child accommodated in a children's home as listed in Regulations and then only where no alternative method of preventing the event specified in Regulations is available: specifically reduce the number of seclusions used (Regulation 17A(1)(a)(b)(c) 31/01/2015

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Reg. Requirement Due date

(2001) ensure the children's home is conducted so as to promote and make proper provision for the safeguarding and welfare of children accommodated there: specifically complete thorough impact risk assessments prior to admitting 31/01/2015 6 of 7 a child or moving them within houses on the site (Regulation 11(1)(a))

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Reg. Requirement Due date

(2001) obtain consent from the children's placing authorities for the use of electronic monitoring devices (Regulation 22 (1)(a)) 31/01/2015

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate training on the use of restrictive practices (Regulation 27 4(a)(b)) 28/02/2015

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Reg. Requirement Due date

(2001) ensure a record in the form of a register showing in respect of each child accommodated detailing all the information in schedule 4(1) is in place and is reviewed (Regulation 29(1)) 31/01/2015

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Reg. Requirement Due date

(2001) ensure all parts of the children's home used by children are kept clean and reasonably decorated and maintained (Regulation 31(2)(e) 28/03/2015

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Reg. Requirement Due date

(2001) implement an effective system to monitor the matters set out in Schedule 6 to improve the quality of care provided; ensure this system provides for consultation with children, their parents and placing authorities; and that any report made under this regulation is supplied to Ofsted. (Regulation 34 (1)(a)(b)(2) and (3)) 31/01/2015

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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 are able to meet children's individual needs as set out in placement plans by having updated plans available to staff (NMS 2.3)  ensure the induction package currently in use meets he Children's Workforce Development Council’s induction standards (NMS 18.3)  ensure existing care staff are working towards the Children and Young People's Workforce Diploma and induction standards within required timescales (NMS 18.5)  ensure that there is a system in place to monitor the quality and adequacy of record keeping (particularly physical intervention records) and take action when needed. (NMS 22.1) Website: www.ofsted.gov.uk

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Recommendations

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What inspection judgements mean

At the interim inspections we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the Inspection of children’s homes: framework for inspection.

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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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