Children's Home, Residential special school run by Options Autism (1) Limited in North Lincolnshire

Unique reference number SC066565 Inspector Jacqueline Malcolm Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Registered person New Options Limited Registered person address Turnpike Gate House Alcester Heath ALCESTER Warwickshire B49 5JG Responsible individual Graham Baker Registered manager POST VACANT / Joanne Carter Date of last inspection 18/03/2014 2 of 13 Inspection date 11/12/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness adequate

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

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Overall effectiveness

There have been some significant changes in the leadership and management of the home since the interim inspection in March 2014. This includes changes to senior managers who have left the home and school. The Registered Manager left the home in September 2014 to take up another management post. A newly appointed manager recently took up her post and their application to register with Ofsted is at its final stages. The manager is qualified and has significant management experience in a similar childcare provision. She has a good understanding of the homes strengths and weaknesses. Her insight into the homes performance is enhanced by the completion of an internal provider led audit that was carried out in August 2014. The audit identifies a significant number of management and practice deficiencies and in recognition of the serious need to improve; an action plan has been implemented.

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Overall effectiveness

Young people are cared for by a resilient, competent and motivated staff team that provide stability and positive life experiences. Most young people have made good progress. However, their placement plans vary in quality and do not provide a comprehensive account of how young people are to be cared for. The plans do not identify young people’s ethnicity or show how their needs arising from their heritage will be met. This does not promote and celebrate young people’s unique diversity and differences. 3 of 13 Despite this issue, the impact on young people’s safety and welfare has not been jeopardised. Young people are safe and well cared for. This view is supported by parents and professional stakeholders who mostly speak highly about the services delivered to young people. A parent said, ‘the school has an excellent ethos around child welfare and safety. There are some outstanding members of staff who bring

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Overall effectiveness

energy, dedication and professionalism to the care of the children and work hard to extend their range of experiences.’

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Overall effectiveness

The shortfalls identified relate to having due regard to young people’s ethnicity; recruitment records; Regulation 33 and 34 reports; behaviour management measures; staff supervision; the development plan and young people’s records. These shortfalls do not impact on young people’s safety and welfare, but have the potential if not promptly addressed, to hinder their outcomes. 4 of 13

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Information about this children’s home

This privately owned children’s home is registered to provide care, accommodation and education for children. The home offers a specialised service to 26 children and young people with autism.

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Inspection date Inspection type Inspection judgement

18/03/2014 Interim good progress 04/07/2013 Full good 13/11/2012 Interim good progress 25/04/2012 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

(2001) promote and make proper provision for the safeguarding and welfare of children accommodated there; and make proper provision for the care, education, supervision and, where appropriate, treatment, of children accommodated there. Specifically review restrictive behaviour management practices in the home and comply with young people’s behaviour management plans (Regulation 11 (1) (a) (b)) 30/01/2015

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Reg. Requirement Due date

(2001) make suitable arrangements to ensure that the home is conducted with due regard to the sex, religious persuasion, racial origin, and cultural and 30/01/2015 5 of 13 linguistic background and any disability of children accommodated there. This specifically relates to the promotion of young people’s heritage and cultural needs (Regulation 11(2) (b))

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Reg. Requirement Due date

(2001) where a person has previously worked in a position whose duties involved work with children or vulnerable adults, ensure so far as reasonably practicable verification of the reason why the employment or position ended (Schedule 2 (4)) 30/01/2015

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Reg. Requirement Due date

(2001) supply to HMCI a report in respect of any review conducted by him for the purposes of paragraph (1), and make a copy of the report available on request to placing authorities where the placing authority is not the parent of a child accommodated in the home (Regulation 34 (2)) 30/01/2015

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Reg. Requirement Due date

(2001) ensure the independent person interviews with their consent and in private, such of the children accommodated there, their parents, relatives and persons working at the home in order to form an opinion as to whether children accommodated are effectively safeguarded and the conduct of the home promotes their wellbeing (Regulation 33 (8) (a) & (b)) 30/01/2015

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Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate training, supervision and appraisal; specifically demonstrate that all staff are regularly supervised. (Regulation 27(4) (a)) 30/01/2015

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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 that the written development plan for the future of the home; specifically incorporate the homes internal action plan (NMS 15.2)  ensure there is a system in place to monitor the quality and adequacy of record keeping and take prompt action when needed. (NMS 22) 6 of 13

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Outcomes for children and young people good

Young people are very well settled and stable in their placements at this home. This provides them with the firm foundations to make good, steady progress from their starting points. Overall, young people are happy and enjoy good, engaging relationships with staff who protect their dignity and treat them with respect. This enables young people to feel safe and secure in their environment and develop in confidence. A social worker for several young people placed at the home said, ‘all appear happy in placement and have made progress with behaviour, and anxieties appear to be reduced’. Parents said that the progress made by their child was in ‘leaps and bounds’ and ‘they’ve worked really hard to get his confidence back.’

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Outcomes for children and young people good

Young people's complex and life threatening health needs are effectively attended to through their prompt access to health services. This improves their quality of life and prolongs their ability to maintain relatively independent lives. All young people are registered with primary health care professionals, including specialist clinical psychologists and occupational health services delivered by the in-house clinical team. Young people who require specific treatments are supported to attend hospital appointments. This promotes their health and wellbeing.

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Outcomes for children and young people good

Young people benefit from consuming healthy well-balanced, home cooked meals both in their flats and at the on-site ‘bistro’. Some young people have started to work out at the gym and others have lost weight through healthy eating plans that have helped to control their health conditions. Other physical activities include young people making good use of the on-site sport facilities, such as the swimming pool, indoor and outdoor trampolines, and sports hall. These activities improve young people’s fitness levels and enhance their self-esteem, which makes them feel good.

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Outcomes for children and young people good

Young people have exceptionally good school attendance at the on-site school. The positive and unrelenting commitment from the school and home environments promotes young people’s learning and social development. This improves their educational outcomes. Young people’s progress is closely monitored by the school and information is shared by them, either by face to face communication with the home’s staff or through home-school books. This enables any issues to be quickly resolved and also promotes consistency for young people between the home and school, minimising any disruptions that may otherwise impact on their behaviour. A parent said, ‘my child has hit the programme targets and achieved more with the schools learning establishment, can't praise them enough.’

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Outcomes for children and young people good

Young people’s access to their chosen afterschool and leisure activities provide them with hours of stimulation and enjoyment both at home and away. This includes the support they receive to visit a range of community facilities, such as bowling, walks in the country, meals out, trips to the seaside and activity holidays. Young people have 7 of 13 access to a range of home based activities, such as toys, books, television, iPads and are involved in seasonal celebrations, such as Halloween. This ensures they always have something fun and interesting to occupy their free time. In addition, young people’s involvement in community activities promotes their social inclusion, confidence and ability to integrate. For example, young people’s contribution to making a lantern for the Christmas parade and selling their home grown produce at the local market improves young people’s confidence in their abilities. In order to

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Outcomes for children and young people good

capture young people’s experiences staff and young people have recently been issued with cameras, which will form a visual memory of young people’s lives at the home.

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Outcomes for children and young people good

Young people’s important and valuable contact with family and significant people in their lives helps them to maintain firm attachments with their kin. Young people’s sense of identity, belonging and consistency is endorsed by these positive relationships. The flexibility and support afforded to young people and their families enables them to engage in their contact either at the home or away from the home. A parent said, ‘support for us to take our child out for a day is excellent.’

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Outcomes for children and young people good

Young people’s plans and the expectations for their independence skills are individual and realistic in relation to their developmental needs. Consequently they make good choices, such as how they want their rooms to be decorated and laid out, involving themselves in their personal care routines and helping to tidy their living space. Young people’s confidence is enhanced when they are given every opportunity to do more for themselves. Young people who are reaching the age for transition to adult services are protected by well-co-ordinated plans that ensure they move into appropriate placements that can meet their needs. The support is recognised by parents who, in one example, took a group of staff out for a meal to celebrate their child’s 18th birthday and express their gratitude for the difference they have made to their child’s life.

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Quality of care adequate

Overall, young people receive an adequate quality of care. This is principally due to deficiencies in the quality and content of a number of young people’s individual placement plans. Although it is acknowledged that all of the plans have been overhauled in recognition of the required improvements; this has not been done in a timely manner or quality controlled to ensure they are of a consistently high standard. The current plans do not consistently and coherently represent how young people’s care is to be delivered. This does not sufficiently reflect the good care, support and protection that are afforded to the young people throughout their care journey at this home. Young people’s needs arising from their disability are promoted in their plans, but their needs arising from their ethnic origin are not recognised, irrespective of the young person’s heritage. This does not promote or recognise young people’s diversity and support staff to attend to their specific requirements

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Quality of care adequate

arising from their heritage. 8 of 13 Despite this, young people enjoy positive relationships with staff who place them at the centre of their practice. Young people are helped to form and maintain friendships with their peers in a nurturing environment that enables most young people to flourish. A social worker said, ‘my young person has positively thrived in their care over the last year. They have developed her social skills significantly and her ability to manage change and difference.’ Daily staff handovers enable all staff to keep up to date with young people’s progress and their changing behaviours are discussed and debated with professionals from the clinical team. This helps staff to understand changes in individual young people’s behaviours and discuss possible strategies to manage their behaviours in more consistent and effective ways.

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Quality of care adequate

Young people’s wishes and feelings are valued and respected by the staff team. Their wishes are effectively communicated in their chosen communication method, such as the Picture Exchange Communication System (PECS) that staff understand and are responsive to. Young people are regularly consulted about their home environment and their leisure choices are listened to and acted on. Staff are strong advocates for young people, fighting their corner so that their voice is represented and any complaints raised by them are represented and resolved.

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Quality of care adequate

Effective communication between the home, parents and professional stakeholders promote an effective ‘Team Around the Child’ method of practice. This enables young people to benefit from prompt access to a range of health services to help meet their holistic needs. For example, interventions from the in-house clinical team support young people with their behavioural, emotional and psychological health needs. A social worker said, ‘I feel that (name of home) have had to be proactive in employing their own clinical team as it has proved exceptionally difficult if not impossible to secure support from local Child and Adolescent Mental Health Services(CAMHS).’ Health support from the local hospital ensures that young people with serious and complex health conditions are regularly treated. The home has been able to challenge the appropriate authorities and seek a resolution in relation to their concerns about the impact of young people’s health conditions on their safety and

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Quality of care adequate

welfare. Similarly a stronger communication between the home and school environments is developing more cohesive and consistent work practices. These interventions improve young people’s life chances.

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Quality of care adequate

Young people live in purpose-built accommodation that is divided into well-equipped flats and include semi-independence and short breaks accommodation. A number of the flats have been redecorated, which has taken into account young people’s preferences and has freshened up the environment. Young people have their own rooms that reflect their individual personalities and needs and provide them with a private and comfortable space. The location of the home allows for good access to local facilities, which enables young people’s positive integration into community life. 9 of 13

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Keeping children and young people safe adequate

Young people’s safety and welfare is taken seriously and is promoted by the home. There are no current safeguarding concerns or issues in relation to allegations against staff. However, staff awareness about the whistleblowing policy supports them to challenge unsafe practices should this be detected or is witnessed by them. Parents and professional stakeholders consider young people to be safely cared for by staff who understand their vulnerabilities. A parent said that that their child is ‘definitely safe and secure’ living at the home and ‘the school has an excellent ethos around child welfare and safety.’

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Keeping children and young people safe adequate

Generally good recruitment and selection practices and the chaperoning of visitors around the home protect young people from unsuitable people who may pose a risk to them. However, not all recruitment files verify the reason why previous employment ended. Similarly not all records in relation to disclosure and barring checks make explicitly clear that no successful applicant starts working with young people until clearance has been received. This does not promote a transparent process that demonstrates safe recruitment practices are consistently followed.

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Keeping children and young people safe adequate

High staffing levels provide appropriate levels of supervision and support ensuring that young people get the protection they need. This safeguards young people from various forms of significant harm associated with abuse, bullying, child sexual exploitation and missing from care incidents. These issues do not currently feature at this home; however, systems are in place should such concerns arise.

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Keeping children and young people safe adequate

The behaviour management policy is under review to ensure it underpins the agreed practice and is compatible with the school policy. Young people’s behaviour is generally well managed and they are supported to self-regulate their behaviours. Some young people’s behaviour is risky and includes self-harming behaviour that could be life threatening if not promptly addressed. This is dealt with effectively by staff that have appropriate behaviour management training. However, some behaviour management plans and risk assessments are not consistently applied. For example, some habitual behaviour that young people display is not followed in synergy with their behaviour management strategies. This does not promote young people’s well-being or effectively change behaviours that the strategies deliberately seek to minimise.

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Keeping children and young people safe adequate

Some behaviour management strategies promote restrictive and institutional practice. This is in the form of locking bedroom furniture in several young people’s rooms, which prevents them from freely obtaining their personal belongings. The fundamental reason behind this practice was to address some challenging behaviours. This practice has not been reviewed since it was implemented several years ago. This inhibits young people's opportunities to develop other coping mechanisms and their independence as they mature. The provider is reviewing this practice. 10 of 13 The numbers of restraints and physical interventions have significantly reduced. This is due to the positive learning in the staff team about what they need to record. Although restraint records are monitored; the expectation for staff to sign the records in a timely manner is not met. This does not make staff accountable for their involvement in these incidents.

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Keeping children and young people safe adequate

Young people’s individual needs and characteristics are protected by the checks undertaken in their home environment. For example, fire safety checks and the servicing of gas and electric appliances safeguards young people against the risk of fire and faulty equipment.

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Leadership and management adequate

Since the last interim inspection in March 2014, the previous Registered Manager who was registered with Ofsted in September 2013 ended her employment on 3 September 2014. The departure of other senior managers from this home and other parts of the service has adversely impacted on leadership and management oversight.

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Leadership and management adequate

In response to this concern, a new senior management team has been put in place and they are effectively working together to implement a consistent and seamless approach to young people’s care, education and therapeutic support. A new head of service commenced his role at the home in July 2014. His previous involvement with the home as a Registered Manager provides some familiarity with the systems. An internal and comprehensive review of the service in August 2014 detected a number of management and practice deficiencies and raised a significant number of development areas, which resulted in a detailed action plan. These findings present serious questions about the leadership and management of the home in previous months, although there are no known concerns about young people’s safety and welfare. A management consultant has been appointed to review and establish more integrated management systems within the home and is working with the staff team

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Leadership and management adequate

to embed practices in a manner which makes the team accountable to their roles and responsibilities. An additional appointment of a quality assurance manager in October 2014 supports the home’s improvement agenda. Although this is an ongoing and a time limited process, it is clear that the provider has taken matters very seriously and has put in place robust measures to improve service delivery. However, the action plan is not integrated into the home’s development plan to ensure a clear measurement of the impact of the improvements.

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Leadership and management adequate

A manager has been appointed to manage the home and she commenced her role on 8 December 2014. An application for her registration is lodged with Ofsted and a fit person interview is imminent. The manager has 13 years’ experience as a Registered Manager of a similar type of residential service for children and young people with a range of needs associated with severe and profound learning disabilities, physical disabilities, sensory impairment and complex healthcare needs. The manager is 11 of 13 appropriately qualified to competently carry out this role. Her involvement in the home’s action plan ensures that she can take ownership of the issues and with senior management support, drive forward improvement so that young people are provided with a strong quality of care that sustains their holistic development needs and good progress.

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Leadership and management adequate

The manager is ably supported by a sufficient number of stable and motivated core staff who are familiar and fond of the young people and show care, patience and respect towards them. New staff to the team and internally promoted staff are inducted into their role. The deputy and leadership management roles underpin a well-supported and resilient staff team who are supportive to each other and contribute to young people’s good outcomes.

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Leadership and management adequate

Young people are cared for by a skilled and competent staff team who have attained an appropriate childcare qualification at level 3 and above. Staff who do not have this qualification are working towards one, providing a fully qualified work force for the future. Staff have good training opportunities, including mandatory training and regular refresher training sessions on issues such as safeguarding, first aid and fire training. Bespoke training helps staff to meet young people’s needs arising from their autism and health conditions, such as epilepsy. This enhances the staff team’s individual knowledge and skills. The frequency of staff supervision has been identified as an area for improvement. Not all staff members’ supervision records evidence that all staff are regularly supervised.

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Leadership and management adequate

There were no requirements or recommendations raised at the last inspection.

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Leadership and management adequate

The most recent internal monitoring has not been received by HMCI, Ofsted. This impedes Ofsted from reviewing young people’s progress and detecting any issues of concern, outside of the inspection cycle. Good external scrutiny performed by an independent visitor provides a ‘critical friend’ approach to improvement, highlighting the strengths and weakness of the home without fear or favour. Although there is clear evidence of the visitor’s interactions with young people, no parents have been consulted during these visits. This omission has also limited the visitor from forming an opinion as to whether children are effectively safeguarded and confirming that the conduct of the home promotes the wellbeing of young people accommodated.

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Leadership and management adequate

Young people’s records are not in consistently good order, which makes their progress difficult to evaluate. Although this concern is recognised as an area for improvement and is being addressed by the provider; it is not happening with sufficient speed. This does not ensure consistently good quality records that accurately support the positive practice that most parents and professional stakeholders speak highly about and value.

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Leadership and management adequate

The statement of purpose is a comprehensive document that informs parents and stakeholders about the services that young people can expect to receive. It has been recently updated to reflect the changes to the management of the home. Parents and 12 of 13 professional stakeholders are happy with the services delivered to young people and confirm that communication with the home has improved. A social worker said, ‘my manager meets with the senior team there on a regular basis and any concerns are addressed during these meetings.’ A parent said, ‘regular daily diary and telephone calls are followed up by regular arranged meetings excellent communications and feedback.’ 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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