Children's Home, Residential special school run by Aspris Children’s Services Limited in Staffordshire

Unique reference number SC391860 Inspector Denise Jolly Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Registered person Priory Education Services Ltd Registered person address 5th Floor 80 Hammersmith Road London W14 8UD Responsible individual Helen Sharpe Registered manager Laura Sheridan Rider Date of last inspection 20/03/2014 2 of 12 Inspection date 19/11/2014

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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 adequate Leadership and management good

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Overall effectiveness

The children's home is making a measureable difference to the lives of young people with autism and complex needs. Staff use their enthusiasm and knowledge of specialist child care practice to provide personalised, well-planned and effectively reviewed care. Professionals involved in the lives of young people say staff help young people overcome their difficulties to achieve their individual potential. They help young people to identify and use strategies that enable their lives to improve.

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Overall effectiveness

Young people are safe and happy in the home. Staff demonstrate in-depth knowledge and understanding of the risks young people face and always take positive action to ensure risks are minimised and safely managed. They introduce and reinforce appropriate boundaries with young people. Staff work creatively to ensure young people have many opportunities to experience successful social and community interaction. Young people enjoy warm, open and trusting relationships with staff. This means they feel confident in the support available to them, readily ask for help, and respond well to praise and encouragement given for their achievements.

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Overall effectiveness

Knowledgeable staff readily communicate their vision for an improving service and work in effective partnership with all stakeholders to achieve this. The qualified and experienced Registered Manager places a clear emphasis on maximising improved 3 of 12 outcomes for young people. Managers have a thorough understanding of the strengths and weaknesses of the home and monitoring takes account of the views of all stakeholders. They are keen to address shortfalls and develop the service they provide in partnership with professionals and young people. Requirements to improve the service relate to shortfalls found in restraint records and a minority of pre-employment records. Some recommendations relate to minor omissions in care plans, and to ensure monitoring identifies all shortfalls in records. Shortfalls have not affected the welfare of young people, or the consistent progress they make. 4 of 12

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Information about this children’s home

This home is part of a residential special school which is operated by a large private care organisation. The two adjacent houses are registered to accommodate 14 children and young people with learning disabilities. The school is registered with the Department for Education and has a specialism in autism. Half the young people are currently over the age of 18 and will leave the home as they finish their education at the school.

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Inspection date Inspection type Inspection judgement

20/03/2014 Interim good progress 16/01/2014 Full adequate 27/02/2013 Interim good progress 28/11/2012 Full outstanding

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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 any restraint, the written record includes a description of any injury to the child or any other person, and any medical treatment administered (Regulation 17B (3)(g)) 19/12/2014

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of any restraint, the written record includes confirmation that the authorised person has spoken to the child and the staff involved in the restraint about the restraint. (Regulation 17B (3)(h)) 19/12/2014 5 of 12 (2001) ensure that the registered person shall not employ a person to work at the children's home unless he is of integrity and good character (Regulation 26 (3) (a)) 19/12/2014

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Reg. Requirement Due date

(2001) ensure that the registered person shall not employ a person to work at the children's home unless full and satisfactory information is available in relation to him in respect of each of the matters specified in Schedule 2 (Regulation 26 (3) (d)) 19/12/2014

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure the manager regularly monitors all records kept by the home, particularly employment records and restraint records, so that they take immediate action to address any issues raised by the monitoring (NMS 21.2)  ensure that the minutes of reviews are available in order that the requirements of each Placement Plan are implemented in the day-to-day care of that child. (NMS 25.2) 6 of 12

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Outcomes for children and young people outstanding

Young people enjoy living in the home. Young people with autism develop an understanding of their starting point and the steps they need to take in order to progress. They receive consistent and intuitive support from staff to help them overcome any difficulties in relationships. Parents praise the home and say, 'the home supports him very well and we are happy with his progress,’ and, 'school and staff support is second to none.’ This means parents feel confident about the care and support provided by staff. This helps young people to maintain attachments to important adults and experience continuity of knowledge and understanding of their background.

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Outcomes for children and young people outstanding

Young people pursue active and healthy lifestyles. They exercise in ways that they enjoy and acquire new skills along the way. For example, young people learn to roller blade, and others have improved their football skills. All young people enjoy getting out in the fresh air. A planned programme of activity provides young people with choices. Their routines are sufficiently robust for young people to predict the pattern of events. This enables young people to practise being flexible within the smaller details of each evening, such as making choices about going on bikes or for a walk. They develop routines that help them to understand the importance of personal care and, when necessary, taking medicine to improve their health.

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Outcomes for children and young people outstanding

Young people regularly participate in activities in the community. They use local shops and swimming pools, and attend community hairdressers and local health services. They are extremely well supported by staff who utilise their considerable skill in identifying and solving potential problems. For example, when young people take items without paying for them, they create clear schedules for shopping routines, to enable young people to understand the small steps towards making a purchase. If young people suffer setbacks in their ability to access the community, staff effectively rebuild their confidence and support them to try again.

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Outcomes for children and young people outstanding

Young people live in a setting that is rich in communication opportunities. Young people are learning to respond to and follow prompts such as word or picture schedules to help them to remember the correct order for some routines. Some use communication systems such as sign language, or electronic programmes, to make choices about the things they would like to do. This helps them to share their views with staff, and then experience validation of their wishes and preferences. As a result, young people demonstrate confidence in their environment and in the staff that support them. This enables young people to take control of many aspects of their day. Their increased confidence enables them to accept and interact with visitors to their home. One young person was very pleased to show the inspector what skills he had in making his tea. Another young person used sign language to talk to the inspector about the things she liked to do. This improves their emotional wellbeing,

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Outcomes for children and young people outstanding

7 of 12 and fosters a sense of self-worth.

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Outcomes for children and young people outstanding

Young people demonstrate many emerging and acquired skills that improve their ability to be successful young adults. They are supported to think about what is coming next after the activity they are completing. This enables them to complete many daily living tasks with increasing independence and reduced anxiety and stress. According to their abilities and needs, young people participate in shopping, cooking and cleaning tasks that provide them with a sense of achievement in daily life. They learn to occupy themselves for suitable intervals with activities that help them to enjoy time on their own, such as bouncing on the trampoline or listening to music. This is important for young people with autism as it helps them to independently identify and reduce their levels of anxiety.

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Outcomes for children and young people outstanding

Staff support young people very well to manage their feelings regarding past trauma or the impact of sensory overload or anxiety on their behaviour. As the young people trust the staff, they accept alternative activities and diversions offered to them by staff to help them to regain composure. Other professionals such as paediatricians support young people to improve their physical and emotional health.

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Outcomes for children and young people outstanding

All young people enjoy the routine imposed by school attendance. They benefit from the range of skills and development opportunities that they experience Staff have a good understanding of young people’s educational goals and targets and encourage them to show them what they have learnt on their return to the home from school. This helps them to take continual steps towards achieving a greater understanding of the world and their place in it.

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Quality of care good

Staff provide very good care to ensure young people enjoy their time at the home. Relationships appear to be well established. Young people express confidence and contentment by their settled behaviour and the progress they make. Parents, social workers and other professional visitors are complimentary about the positive impact the service has on the lives of young people. Staff use observation of young people and reflective practice to ensure that the service adapts to support their unique needs. Beautifully decorated photograph and achievement books capture the daily and special experiences of young people. The images reflect that young people and staff enjoy each other’s company and engage in many exciting activities together.

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Quality of care good

Staff see young people in a realistic light, and recognise their strengths and development needs. This means young people progress, supported by encouraging staff who are proud of their achievements. Staff help them to find activities they can enjoy safely. For example, they gradually introduce young people to practise skills in choosing and preparing food safely or to participate in simple baking activities. Some young people enjoy being read stories or join in with interactive songs and stories. This gives them a chance to improve their communication skills by engaging in 8 of 12 shared attention activities. Young people clearly enjoy the adult attention while learning how to accept relationships that are more sociable. This improves their awareness of a range of constructive and developmental activities while becoming more independent.

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Quality of care good

Staff place young people’s well-being at the centre of their practice. Key workers prepare and regularly review care plans to ensure that they receive appropriate support to meet their needs. Parents and social workers agree the plan at regular intervals so that all changes important to the young person are incorporated. For example, staff reduce support to young people in their morning routine as they acquire skills in toileting or dressing, or adapt a tooth brushing routine to enable greater independence in the task. In a minority of files, minutes of the last placing authority review of the care plan are missing. This means that there is a lack of confirmation about any actions the home must take to support the placement plan. Key workers discuss the plans in staff meetings and daily handovers. This ensures staff continually update their knowledge and understanding of the impact of the plans on the welfare and development of young people.

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Quality of care good

Arrangements for dealing with medication are extremely safe and effective and staff are suitably trained. Staff help young people to adopt excellent routines for the administration of medication. To promote their dignity, and to ensure safe administration, young people individually go to the medication room in the home. Managers monitor staff practice to ensure young people are given the medication and health support they need. Young people are familiar with the routines associated with how they receive their medication and cooperate with staff. Staff discuss medication requirements with medical practitioners and parents in order to identify how best to support young people’s health needs.

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Quality of care good

Staff set clear and appropriate boundaries for young people, while recognising their individual starting points. Staff carefully match young people’s activities to their interest areas, such as trips to quiet places for those who enjoy outdoors but have difficulties with lots of children. This helps young people to access activity that is appropriate to their ability and helps them to remain calm and enjoy the experience. Parents of young people who live at the home recognise that relationships between staff and their child are strong because staff know the young people very well. Parents say that this fosters a sense of security in their child. For some this leads to a reduction in anxious outbursts.

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Quality of care good

Managers and keyworkers promote communication between the local authority, health professionals, school, families and the home to provide an effective team approach to the care and support of young people. Young people benefit from detailed and regularly reviewed plans of care that identify all actions necessary to promote their welfare and development. This includes, for example, how and when contact with families will take place and how much support staff will give to enable the contact to be successful. The school’s speech and language therapist said that staff are enthusiastic about learning a range of communication skills. This celebrates 9 of 12 and supports young people’s preferred modes of communication. As a result, young people experience successful communication and are more confident to initiate interaction with others.

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Quality of care good

Young people contribute their views and opinions in a variety of ways, specific to their unique communication style and ability. Some young people talk to staff about their needs and wishes in simple phrases and gestures, while others have their views interpreted and recorded for them by staff. Parents also provide feedback to staff about the quality of care provided. When they raise concerns, staff do their best to rectify the situation. Parents say, ‘Staff are always ready to talk to me, on the telephone, or whenever I visit.’ While it is unusual for young people to complain, staff are alert to any sign of unhappiness and work hard to improve matters. Staff help young people complete a ‘Questions I ask’ book when they request activities or equipment that is not immediately available. The Registered Manager responds to these requests by using the same picture communication system, so that young people know they are being listened to, and their requests are taken seriously. Social

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Quality of care good

workers and parents say staff are good at listening and responding to suggestions for improvement to the service, to provide consistently improving care practice.

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Keeping children and young people safe adequate

Staff work effectively with parents and the safeguarding agencies to promote young people's safety. Safe caring practices ensure that young people feel safe and are protected from harm. Parents express confidence in the ability of staff to respond effectively to young people when they demonstrate unsafe behaviour. Staff understand their responsibility to protect young people and have attended introductory training in child protection. Senior staff have developed their understanding of their responsibilities in child protection through attendance at external, multidisciplinary training opportunities. Staff talk knowledgeably about the actions they would take to respond effectively to a range of child protection scenarios.

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Keeping children and young people safe adequate

Young people’s individual plans identify the risks they may face and outline strategies to ensure staff promote and protect their welfare. Behaviour support strategies identified consistently reflect their immediate needs and circumstances. Staff are very knowledgeable about the young people’s particular vulnerabilities relating to their level of understanding and disability. This enables them to ensure young people are safe at home and in the community. Staff balance the need for protection with enabling young people to take reasonable risks as part of their growth and development. For example, staff always provide suitable levels of supervision and any activities in the community are carefully planned. Risk management plans include any additional support young people may need to travel safely, such as individual seating plans, or additional staff support. This means that young people can enjoy every day experiences while being kept safe.

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Keeping children and young people safe adequate

10 of 12 Young people do not experience bullying or harassment. They get on well together most of the time and staff effectively deal with the rare occasions when they affect each other’s stability. Staff have a very good understanding of the times and factors that contribute to young people becoming upset. This includes working with a multidisciplinary team, including education staff and parents, to create behaviour management strategies that reduce young people’s anxieties and frustrations. For example, using positive redirection or reducing unnecessary communication with them. The focus of these strategies is on praising positive behaviour and staff put them into practice effectively to support young people.

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Keeping children and young people safe adequate

Due to high levels of supervision, appropriately secure buildings and grounds, and staff knowledge of young people, young people do not go missing from the home. Managers are alert to the possibility that young people with autism may not understand the importance of staying in sight of staff. They have worked with police missing from care coordinators, to create a clear profile for each young person, should young people go missing. This is available in case of emergency, and enhances the safety of young people.

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Keeping children and young people safe adequate

The organisation employs staff by using safer recruitment processes that help prevent unsuitable adults from working in the home. References are sought, and senior managers make decisions about information that questions the integrity of any applicant. In one case, an applicant’s employment history was incomplete, and in another, the Registered Manager was not made aware of disciplinary action that was reported by a previous employer. This unusual oversight did not directly affect the welfare of young people, but it prevented the Registered Manager from having sufficient knowledge to identify any additional supervisory or professional development needs. Thorough induction assessments ensure that staff are equipped with the knowledge and skills to work safely and competently with vulnerable young people. Continuous supervision and feedback from managers underlines the importance of open, reflective and transparent practice, to help keep young people

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Keeping children and young people safe adequate

Staff use restraint to ensure the safety and welfare of all young people and they are trained in an accredited approach. When staff restrain young people, they complete clear and detailed records about the incident, to ensure that managers can analyse the records, and identify any emerging trends or patterns. Staff have thoughtful discussion about any serious incident to identify ways their practice can improve. Staff report thate they use a specific picture communication tool, to engage young people in talking about the behaviour that led to a restraint. The record of restraint does not always confirm this review has taken place, or that staff have discussed the incident with managers. Additionally, the records do not consistently identify the specific nature of minor injury sustained by young people during an incident involving restraint, although appropriate medical attention is always provided. This causes

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Keeping children and young people safe adequate

delays when independent persons assess the appropriateness of the restraint as some information is kept elsewhere. This shortfall relates to the quality of records only. It has not affected the safety or welfare of young people. 11 of 12

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Leadership and management good

An experienced and suitably qualified Registered Manager has been in post since February 2010. She has consistently provided enabling leadership to a stable, committed and competent staff team. Staff respond enthusiastically to her expectation that they will deliver continually improving care to complex and vulnerable young people. Young people benefit from a placement that fully supports their emotional, safety and learning needs, and helps them to progress in leaps and bounds. Staff recognise and celebrate the efforts of young people to improve their knowledge and understanding of the world and their interaction with it.

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Leadership and management good

The Registered Manager and provider conduct transparently recorded monitoring of the home. Occasionally, lack of oversight of employment records, and minor errors in records, are not rectified within timescales that ensure that all staff have accurate information about young people’s needs. However, highly effective staff handovers mitigate against this shortfall having an impact on the welfare of young people. Through reflective discussions and carefully planned approaches, the home continues to develop and deliver services that have proven benefit to young people. as a result of consistent and responsive consultation with all stakeholders, complaints are rare, with most areas of concern resolved at an early stage. Parents say that the home is always responsive to feedback and works hard to get the best possible outcomes for young people.

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Leadership and management good

The provider, Registered Manager and staff are aspirational about the future of the home and the lives of young people. Together, they assess and discuss the quality of care provided and identify any development need required for the home to continue to progress. Currently, they are exploring better ways to measure the progress young people make, to provide improved data that highlights the success of young people. Through highly detailed and interactive staff meetings, managers identify best practice, and ensure that all staff operate at a consistent level of performance.

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Leadership and management good

Staff benefit from regular and developmental supervision. They say that this helps them to reflect on their performance and ensures they continually improve the quality of care they provide. The Registered Manager works with the provider to identify training and development needs for the team and ensures this is reflected in the development plan for the home. Recently, the Registered Manager has embarked upon a joint project with speech and language professionals to refresh and update staff knowledge about how young people communicate. This ensures that staff continue to provide care that reflects the immediate and emerging needs of young people and keeps them up to date with legal and professional developments. 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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