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

Unique reference number SC446957 Inspector Michele Hargan 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 John Joseph Phillipson Registered manager Deborah Fleetham Date of last inspection 27/03/2014 2 of 11 Inspection date 12/12/2014

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Previous inspection good progress Enforcement action since last inspection None taken

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Overall effectiveness good

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

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Overall effectiveness

Outcomes for young people are good. Staff relate to each young person as an individual within their own right. This shapes the care and support they provide helping young people maximise their potential. A social worker said: ‘Since moving into the home this child has come on leaps and bounds with his self-care skills and life skills. Staff ensure consistency for young people between home and school and their attendance is excellent. A head teacher said: ‘It’s an outstanding home’. Relationships between the staff and young people’s families are also excellent promoting good quality contact.

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Overall effectiveness

Staff provide a quality of care to young people which is outstanding. They are exceptionally effective at ensuring young people have additional support and any aids necessary to improve the quality of their lives Staff are extremely adept at reading young people’s behaviour. Staff routinely enable young people to express their choices, views, wishes and feelings using picture exchange communication symbols. Staff also use ‘indicators of wellbeing’ to gauge young people’s levels of comfort following any distress. Young people are understood by staff building their trust and confidence.

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Overall effectiveness

Staff are good at keeping young people safe and young people’s behaviour shows that they feel safely cared for by staff. Young people’s vulnerabilities such as 3 of 11 potentially self- injurious behaviours are well understood and sensitively responded to.’ Staff know young people well and this helps them to reduce young people’s distressed behaviours promoting feelings of safety and security.

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Overall effectiveness

The Registered Manager is highly effective at leading staff and running the home. Managerial tasks are approached on the basis of being opportunities to improve the service. Young people benefit from living in a home where their needs are at the forefront of managerial practice ‘The manager is very proactive at making sure that young people get what they need,’ a health professional said. Registered Manager reports required by legislation have recently been amended, aimed at effectively demonstrating ongoing improvement in the quality of care. There is one requirement made which relates to the statement of purpose. This requires additional information to reflect what staff do in practice to enable and support young people to enjoy, achieve. Also to make clear the support for young people to take part in sporting activities and how the linguistic and culture needs of young people are met. 4 of 11

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Information about this children’s home

This children's home provides care and accommodation for children with a learning disability and autism. The home is operated by a private provider.

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Inspection date Inspection type Inspection judgement

27/03/2014 Interim good progress 13/12/2013 Full good 04/10/2012 Full adequate

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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

4 (2001) ensure the statement of purpose shall consist of matters listed in Schedule 1. In particular the arrangements for enabling children to enjoy and achieve, including how the children's home promotes their participation in cultural recreation and sporting activities. Also the arrangements for supporting the cultural, linguistic and religious needs of children. (Regulation 4 (1) Schedule 1 (3) (4)) 31/01/2015 5 of 11

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Outcomes for children and young people good

Staff develop young people’s emotional resilience and sense of security by establishing effective routines through partnership working with parents and professionals. Young people’s transitions into and leaving the home, their daily transitions to school and stays with family are managed with consistent effectiveness by staff. A parent said their child is: ‘A lot calmer…because he is attached to the staff.’ This means young people’s sense of security about their life at the home is maintained. Young people’s confidence in their own abilities is considerably improved considering where they started from.

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Outcomes for children and young people good

Young people’s independent living skills significantly improve because they learn how to do more for themselves. Staff are competent at ensuring young people’s specialist dietary requirements which are crucial to their health and wellbeing are met. Staff use a consistent approach enabling young people to improve their self- care skills and transfer this learning to other settings. Staff said, ‘He can ask to use the toilet at school now as well.’ A health care professional said about a strength of the staff team, 'they are persistent.' This approach enables young people to overcome longstanding difficulties and achieve development milestones.

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Outcomes for children and young people good

Going to school is an important part of a young person’s routine in their life at the home and their achievements are treated with importance by staff. Staff make sure they know how young people are doing at school. A parent said about staff’s involvement with school: ‘They are always there on his parents evening and annual review and always phoning up’. Young people achieve meaningful progress with their education and daily living skills. They also focus on how best to work with education staff to maximise young people’s educational outcomes. A head teacher said about the attitude of staff: ‘Anything that comes up I know I will get good support, good joint working. The medical and emotional care young people get is second to none.’ This approach promotes confidence by young people and their families in the ability of the care team to work effectively with schools to achieve the best outcomes for young people.

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Outcomes for children and young people good

Young people’s lives are enriched because staff enable them to take part in activities that are meaningful. Staff embrace opportunities to enable young people to usefully contribute to their home and wider community. Staff said about involving young people in a charity event: ‘We collected for a Cancer charity and we invited everyone along for a coffee and a cake.’ And about an in house activity: ‘We had young people’s favourite Christmas songs on not to loud and young people were holding each other’s hands and dancing it was lovely to see.’

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Outcomes for children and young people good

Staff help to promote young people’s sense of identity and place within their families 6 of 11 of origin because they treat these relationships with the upmost respect. A parent said of staff: ‘They do a brilliant job, I can approach them, I can talk to them, in fact I can talk to them like I would my own mother.' The approach of staff helps reduce the likelihood of any confusion by young people about the roles and responsibilities of those involved in caring for them.

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Outcomes for children and young people good

Developing and improving young people’s independent living skills are routinely supported by staff leading to improvement. Staff start preparing young people for the transition to adult services well in advance so that they are as ready for this as possible. A senior member of staff said about this. ‘We have already started and are aiming for the young person to be ready by about the end of the academic year’. Young people are given sufficient time to build relationships with staff within these newer settings helping young people settle more readily.

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Quality of care outstanding

Staff relationships with young people are meaningful and young people clearly enjoy being with staff. A parent said: ‘My child is unable to verbalize this but I can see by his reactions and mood around staff he is very comfortable and happy.’ Another parent reported: ‘My child is non-verbal but has excellent relationships and rapport with staff’. This means staff rarely need to physically intervene physically in response to young people’s behaviour. Maintaining harmonious relationships between young people and staff promotes a calm atmosphere that helps allay young people’s anxieties.

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Quality of care outstanding

Staff seek young people’s views on a range of matters including the running of the home. A parent said about the approaches staff use: ‘Young people are difficult to communicate with at times so they are inventive in their approaches.’ For example one staff member said: ‘The young person chose the colours and I know they are what they wanted because I switched them round and they still chose the same colour’. Young people’s emotional development and individual identities are enhanced. As staff encourage young people to express themselves and respond to their views.

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Quality of care outstanding

Staff respect young people’s rights to express their dissatisfaction and anticipate that this will be primarily communicated through behaviour. For example young people can change their minds at meal times and opt in and out of activities depending on how they feel. Staff take responsibility for ensuring that young people, their families and advocates receive information about how to raise any concerns. A parent said: ‘I have not had any complaints to raise however I am confident that I would feel comfortable to do so if necessary and that my concerns would be taken seriously and dealt with properly.’ Young people’s views and feelings influence the running of the home because staff are proactive in discerning whether or not young people are happy with their choices. 7 of 11 Staff exceed expectations of their role because young people’s safety and wellbeing is of overriding importance to them. A parent complimented the actions of staff who

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Quality of care outstanding

remained at hospital with their child, ‘staff stayed overnight didn’t get any sleep and remained with him until he was returned to the home at four pm the following day.’ Also ‘he has been at the home since it opened and the care he has received has been fantastic.’ Staff said, ‘I had to stay with him overnight in hospital because I thought that’s just what you do’. A health professional said about staff who also stayed with another young person in hospital. ‘The hospital staff were very pleased with the input from the staff team’. This approach means young people get effective help and support because staff are able to advocate on their behalf.

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Quality of care outstanding

Staff consult young people their families and other professionals about sensitive matters and try to overcome any obstacles that can compromise young people’s interests. A social worker said: ‘Every effort is made to accommodate their needs and to facilitate necessary examinations, which can be very challenging for children with autism.’ Staff are resourceful in securing additional aids for young people, including specialist head wear helping to minimise the physical effects of distressing behaviour. Staff make sure the care they provide optimises young people’s health and wellbeing.

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Quality of care outstanding

Staff are resourceful and creative about ensuring young people take part in a wide range of activities that are meaningful and fun. A social worker said about staff’s care of young people: ‘Plans are built around them and their individual needs, likes, dislikes and abilities.’ A senior member of staff said about one child: ‘He went on holiday by himself just with staff we thought that was better for him and it was’. A health professional said about staff creativity aimed at helping young people change difficult behaviours. ‘They are willing to try anything, a lot of ideas they come up with I share with other homes’. This approach promotes young people’s physical and emotional development.

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Quality of care outstanding

Staff hold good quality information about the backgrounds of young people which identify their individual cultural needs within a group setting.’ ‘The young person is from the local area and so are their family,’ staff said reflecting on the heritage of a young person. Young people’s diverse levels of needs due to their varying ages, stages of development and levels of disability are all reflected within the direct care they receive. This means young people’s individuality is preserved.

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Quality of care outstanding

The home is situated within a quiet residential setting close to all amenities and young people’s schools are within easy reach of the home. Externally the building is well maintained and does not stand out from others in the area. Internally the setting is comfortable, homely, and warm. There are some minor works to a bedroom that were being attended to and the downstairs toilet needs freshening up and again this is being progressed. Measures to ensure security of the home and additional safeguards are in keeping with usual domestic arrangements. Risk assessments are in place regarding this and carried out with the agreement of parents and placing authorities. 8 of 11

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Keeping children and young people safe good

Staff know young people well enough to discern when it is necessary to proactively intervene and when it is safe enough to provide support that is less intrusive. Staff ensure young people are safe and young people communicate through their behaviour that they feel safe. Staff said about the level of supervision young people receive, ‘You have them with you all the time and we risk assess.’ Staff also said about using different approaches, ‘sometimes you can pacify a young person and other times you can’t.’ Staff respond flexibly to young people depending on their needs at the time reducing the likelihood of any escalating behaviours.

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Keeping children and young people safe good

Staff occasionally need to hold young people as a last resort for their own or another’s safety. The reasons leading to any physical intervention are carefully considered so that where possible the risk of needing to do so again is reduced. Staff also monitor the effectiveness of agreed behavioural strategies as part of a debrief again aimed at further improving practice. Staff said: ‘We try to use the positive behaviour approaches and we give young people time and space we offer drinks.’ And; ‘Sometimes we offer a young person a cool shower as they can get quite clammy and overheated when distressed.’ Young people’s challenging behaviour reduces over time as staff are able to help them work through their anxious feelings.

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Keeping children and young people safe good

Staff undergo a thorough selection and recruitment process and are subject to renewed disclosure and barring service checks to ensure their ongoing suitability to care for very vulnerable young people. Staff files for a newly appointed and longer serving member of staff were looked at on inspection showing sufficient diligence by the registered provider in appointing staff. Such rigorous recruitment practice promotes young people's safety.

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Keeping children and young people safe good

Staff know what action to take if a child were to go missing or if a child protection matter was brought to their attention. Staff said in about what they would do about any safeguarding concerns, that they would; ‘Write it down word for word and tell the young person I had to pass it on and speak to my manager and make sure the young person is safe’. There are no allegations about staff nor have there been any in the intervening period between inspections. The Registered Manager takes effective action in liaison with other professionals when a young person has any unexplained injury no matter how minor. This is aimed at establishing the cause so young people’s ongoing safety is assured.

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Leadership and management good

9 of 11 The Registered Manager is a suitably qualified and experienced individual who has been at the home since 2009 and has managed it since May 2012. There are no outstanding requirements or recommendations from the previous inspection. The Registered Manager has addressed a difficult complaint in as conciliatory manner as possible from a community resident. This has resulted in agreement that the impact of visitors to the home will be lessened by ensuring alternative parking arrangements. Written communication relating to this demonstrates effective measures have been taken by the registered provider. This approach ensures the Registered Manager fulfils both the primary responsibility to protect young people who live in the home. It also meets the Registered Managers duty of care to staff.

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Leadership and management good

The home has recently been assessed as meeting the required criteria necessary to achieve the’ investor in children award’ and a recommendation to this effect is underway. A senior member of staff said about this: ‘It is a reassurance for us that we are going in the right direction because we communicate with young people in other (non-verbal) ways.’ A social worker said: ‘The manager is very knowledgeable and always keen to discuss any issues with me as a child’s social worker and to work in partnership’. Young people live in a setting where their views are central to the care they receive.

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Leadership and management good

Registered Manager reports are detailed and demonstrate effective monitoring and improvement in the quality of care young people receive. The Registered Manager has modified these reports aimed at more readily demonstrating compliance and improvements in these areas. Reports of visits by a person independent of the home are carried out on a monthly basis and also forwarded to Ofsted as required. A concern that reports did not consider events occurring during intervening visits was brought the attention of the registered provider and has been addressed.

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Leadership and management good

Staff provide young people with care and support in keeping with the ethos of inclusivity and non- discrimination as reflected within the homes statement of purpose. A parent said when responding to being asked about any suggested improvements: 'There is nothing I would change as I feel my child’s needs are fully met’. There are some small additions required to the statement of purpose to more clearly convey what young people experience in practice. These relate to what staff do to support and enable young people to enjoy and achieve and take part in sporting activities Also what staff do to ensure young people’s cultural and linguistic needs are met. Lack of this information hinders those who are involved with placing potential children and young people.

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Leadership and management good

The Registered Manager has a comprehensive development plan in place which is child centred. This document identifies the strengths and weaknesses, of the home and the necessary actions to improve and mitigate any threats. The plan is informed by the views of parents and placing authorities citing ‘excellent feedback’ from both parties about all aspects of the home.

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Leadership and management good

Staff are sufficient in number and experience to meet the needs of young people. 10 of 11 The Registered Manager has a contingency arrangement in place as the deputy manager is on planned leave and this is working well. Staff confirm that they receive regular mandatory training and supervision to help them keep up to date with practice and maintain sufficient skills. The majority of staff hold the required level of qualification and others who do not are working towards this. The level of support to staff promotes good outcomes for young people.

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Leadership and management good

Staff contribute good quality reports to young people’s looked after reviews. Feedback from independent reviewing officers described these reports as ‘excellent.’ Young people’s records tracked during the inspection are up to date and showed young people to be making good overall progress. Young people’s files are securely stored within locked cabinets, within a locked office ensuring their right to confidentiality is upheld.

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Leadership and management good

The Registered Manager ensures Ofsted and appropriate others are notified of any significant events as required by legislation. Any such incidents are analysed for themes, or trends that may be of concern. 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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