Children's Home run by North East Autism Society in Durham

Unique reference number SC458754 Inspector Mark Broomhead Type of inspection Full Provision subtype Children's home

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Registered person North East Autism Society Registered person address Units 15 & 16 Lumley Court Drum Industrial Estate; Birtley CHESTER LE STREET County Durham DH2 1AN Responsible individual Brian Stoker

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Registered manager

Date of last inspection 24/09/2014 2 of 10 Inspection date 25/11/2014

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Registered manager

Previous inspection inadequate Enforcement action since last inspection none

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Overall effectiveness adequate

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

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Overall effectiveness

Young people’s safety at the home has improved since the last inspection. Staffing levels have increased which allows for closer supervision of young people to reduce the risk of incidents. This has not reduced the incidents between children and young people completely and the home has taken steps to manage that behaviour. However, the way in which the behaviour has been managed has not been consistent and has not been recognised by the Registered Manager as being inappropriate.

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Overall effectiveness

Outcomes in relation to leadership and management are mixed. Previous requirements and recommendations, with exception of one that continues until February 2015, have been met. This demonstrates progress however, there are some elements of leadership and management which remain a concern and requirements have been raised to reflect this. Together with the home’s development plan, this will improve the care provided to young people in the home and provide for a more consistent level of staffing. The registered persons have given an undertaking that the home will be effectively resourced which will allow for recruitment to continue and for a new manager to focus on managing the home and improving care practice. The new manager is undertaking a full review of care plans and staffing. 3 of 10 Outcomes for children and young people, and quality of care remain positive though improvements are required in some areas. Children and young people are

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Overall effectiveness

progressing, educational attainment continues to improve and health care needs are met. Social workers report that the young people’s care is promoted by staff and that parents have commented on improved behaviours of young people as a result of being at the home.

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Overall effectiveness

Management of some behaviours was inconsistent and had resulted in restriction of liberty of some children and young people. This was not recognised by the Registered Manager as being inappropriate.

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Overall effectiveness

As a result of this inspection Ofsted has made three requirements, one continuing from the previous inspection, and three recommendations. 4 of 10

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Information about this children’s home

The home is owned and operated by a charitable organisation. It is registered to provide care and accommodation for up to nine young people with learning disabilities.

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Inspection date Inspection type Inspection judgement

24/09/2014 Full inadequate 13/03/2014 Interim good progress 31/07/2013 Full good 15/05/2013 Full inadequate

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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

9 (2001) ensure that the registered provider and the registered manager shall, carry on or manage the home (as the case may be) with sufficient care, competence and skill. In particular, that information required for care of young people is accurately shared with staff and managers. 30/12/2014

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Reg. Requirement Due date

(2001) promote and make proper provision for the safeguarding and welfare of children accommodated there. In particular, that risk assessments are personalised to deal with individual concerns. Assessments need to identify severity and likelihood. 30/12/2014 5 of 10

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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

 children receive personalised care that promotes all aspects of their individual identify and are each treated as an individual rather than a member of a group. In particular, that staff are aware of day to day arrangements for individualised care. (NMS 2.1)  no children’s home restricts the liberty of any child as a matter of routine or provides any form of secure accommodation unless that home is an approved secure children’s home. (NMS 3.19)  staff are trained in appropriate safe-care practice, including skills to care for children who have been abused. For providers who offer placements to disabled children, this includes training specifically on issues affecting disabled children. In particular, that physical contact between staff members and young people is managed appropriately. (NMS 4.6) 6 of 10

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Outcomes for children and young people adequate

Children and young people are now more settled and receive more consistent care. This provides children and young people with stability and emotional security. Children and young people were observed being happy and relaxed during their stay. Deployment of staff has improved and now ensures that there is a spread of experienced staff across both floors. This contributes to improvements in the level of care provided to children and young people. Children and young people previously had difficult transitions after returning from home visits however, it was clear that this has significantly improved.

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Outcomes for children and young people adequate

Children and young people have made positive progress in their development. In some cases, progress from their starting points has been higher than expected. Children and young people are encouraged to make contributions to their daily routines. Because of their direct input, transition between the home and the school is more effective and causes less anxiety. One member of staff described the transition as ‘dramatically improved’.

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Outcomes for children and young people adequate

The health of children and young people continues to improve or is maintained. The home has worked with the school to introduce methods of administering medication in a way that is less stressful for them. As a result, children and young people are taking appropriate medications when previously they would refuse. In addition, the home has worked with social workers to reduce anxieties, for example the use of ‘magic gloves’. Children and young people benefit from having direct access to specialists employed by the provider and to external health care that have specialisms in working with autism. Children and young people are provided with a good diet and exercise; this keeps them healthy.

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Outcomes for children and young people adequate

Children and young people have good attendance in full-time education. In addition to verbal and written correspondence, a communication book is used to share information between the school and the home. The use of the book easily and quickly promotes continuity of care for children and young people and keeps school staff up- to-date with care issues. This means that children and young people benefit from good, consistent care between school and the home. Children and young people are able to engage in their education as a result of the home encouraging them in activities which reduces incidents that lead to disruptive behaviour. One teacher said ‘They now spend less time enabling the young person to access to communicate to a level where they can engage in learning.’ Children and young people develop self-care skills which will help them progress to independence for later life.

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Quality of care adequate

7 of 10 Children and young people enjoy positives relationships with staff and each other. Social workers spoken to during the inspection reported that the home provides a relaxing atmosphere which has resulted in a reduction of behaviours and physical interventions.

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Quality of care adequate

Social workers said that ‘the young person’s settling period has gone better than anticipated’, ‘incidents have lessened’ and ‘the young person is happy and settled’. Information provided by social workers confirmed that parents had also commented on positive progress of their children.

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Quality of care adequate

Children and young people are encouraged to become involved in aspects of their care. This has a positive impact on their transition between school, their home and the service.

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Quality of care adequate

Staff are aware of some risks however, on some occasions this is not robust enough nor consistent with individual care plans. For example, following an incident of a young person swallowing a small object, the risk assessment does not describe specific strategies or actions to ensure the young person’s access to small items is reduced. In addition, risk assessments include a large amount of generic risks, such as slip and falls, and maintenance of the play area which is not specific to the young person and makes the current risk assessment cumbersome and difficult to follow. Risk assessment would also benefit from showing the relationship between likelihood of a risk occurring and severity of that risk, and the measures used for calculating these risks. The home should then demonstrate what steps have been taken to reduce the risk by demonstrating the revised calculation.

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Quality of care adequate

Young people have access to support from a range of professionals including psychiatrists, speech and language therapists, an occupational therapist and an autism assessment manager.

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Quality of care adequate

Young people take part in a number of activities. These take place within the home and in the community. Young people have access to a play area and have been swimming with the staff. This promotes their physical, emotional and psychological health needs.

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Quality of care adequate

The home appropriately accommodates young people over two floors. Facilities within the home are good. The layout of the downstairs of the home has been adjusted to allow for better supervision of young people. Young people have access to apartments which are well furnished. As a result, young people can enjoy a homely atmosphere.

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Keeping children and young people safe adequate

8 of 10 Since the previous inspection there have been a number of incidents. On one occasion a young person caused injuries to another young person. Staffing at the time of the incident was sufficient however, the incident was not prevented and a result a young person was injured.

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Keeping children and young people safe adequate

Staff are aware of some of the risks to children and young people however, there are occasions when they are not robust enough. There have been incidents when a young person has been able to access small items and ingest them. This has resulted in a young person attending hospital and is currently being monitored by staff in the home.

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Keeping children and young people safe adequate

Management of some behaviour is inappropriate. On occasions, doors are locked into communal areas which restricts liberty of children and young people. This must not be used as a method of managing behaviours of young people, particularly as staffing ratios are sufficient to engage young people in an individual way. The manager took immediate action to ensure this practice ended. Physical restraints carried out in the home continues to reduce.

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Keeping children and young people safe adequate

As a result of previous enforcement activity, the home now has a number of trained investigators should any allegation be made that can be investigated internally. This reduces delays in investigating and contributes to staff feeling less anxious and properly supported during any investigation. This reduction in investigation time allows staff to return to work quickly, where appropriate, and reduces the impact on young people of staff they know being away from the home for considerable periods of time.

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Keeping children and young people safe adequate

The premises are safe. Equipment is appropriately tested. Arrangements are in place in the event of a fire.

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Keeping children and young people safe adequate

Recruitment arrangements have been improved which helps to ensure that staff employed to work at the home have appropriate checks made in a timely manner. This allows the home to identify high calibre staff and employ them in the home as soon as possible.

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Leadership and management adequate

The Registered Manager, who is suitably qualified and experienced, is shortly leaving the service. A new manager was in place at the time of inspection and is applying to become registered with Ofsted.

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Leadership and management adequate

Staffing of the home has been improved since the last inspection which has resulted in a more experienced staff team and less use of agency staff. This demonstrates progress and that motivation of staff has increased. It has allowed for increased supervision of children and young people which promotes a safer environment. However, this remains a concern and the provider must be able to demonstrate a 9 of 10 sustained improvement by recruiting a sufficient number of suitably qualified, competent and experienced staff to work permanently in the home. In addition, deployment has been reconsidered to allow for experienced staff to be on both floors, with both floors being led by a suitable member of staff. Staff rotas have been improved so that start and finish times are clear and any changes are appropriately recorded. The registered persons must take steps to ensure the new manager has the ability to dedicate enough time to the management of the home to ensure that

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Leadership and management adequate

deficiencies identified at this inspection are dealt with and that any improvements are sustained.

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Leadership and management adequate

Information provided by the managers at the home was inconsistent in relation to care for children and young people. The number of staff allocated to care for each child or young person was reported differently when speaking to different staff members. This may affect care provided to children and young people. Information in relation to the practice of locking of doors was also inconsistent which demonstrates that the communication between managers and staff in relation to the care being provided is not effective.

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Leadership and management adequate

Reports required under Regulation 34, which allow Ofsted to monitor the home, have not yet been submitted. The new format was reviewed at the monitoring visit carried out in October 2014 and will be reviewed further once submitted.

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Leadership and management adequate

Appraisals for staff are now in place and supervision takes placed regularly. Training needs are identified as part of the supervision process. A number of staff are working towards qualifications. This will improve the care provided to children and young people.

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Leadership and management adequate

Requirements and recommendations made as a result of the previous inspection have been met. Ofsted will continue to support the home to improve by regular liaison with the manager to review progress towards meeting requirements and recommendations made at this inspection. The manager confirmed that there is appropriate budget to provide for resources in the home and that action plans will make provision for the long term future of the home.

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Leadership and management adequate

The physical environment is maintained to a high standard. Improvements to the home have been identified to ensure young people do not injure themselves for example, providing padding on radiators. 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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