Children's Home, Residential special school run by Cambian Autism Services Limited in Dorset

Requires Improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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because:

 The use of high-risk restraints (ground holds) and restrictions in the physical environment (door holds) continue to be used. The senior management team is challenging this practice but change is not fully embedded. At times staff have used restraint and holds that they are not taught to use and that do not protect young people’s wellbeing. Senior managers have challenged these practices but they have not considered sharing them with the LADO (Local Authority Designated Officer).

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because:

 Internal care plans do not provide staff with enough guidance on how they should ensure young people who live in the home full time are supported to build strong attachments with carers.

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because:

 The accommodation available to young people ranges from good to poor. Three residences are not as well maintained or presented and do not provide young people who live in them with a welcoming and homely place. There is a notable imbalance of quality in the residences.

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The children's home strengths

 The staff team understanding of the young people’s communication needs and methods is a strength of the service.

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The children's home strengths

 The new leaders and managers at the home have an understanding of the strengths and areas for improvement and have begun to address these. They are committed to improving the service and are driving the staff team towards this. They have also challenged the homes organisation on some decisions they have made. They are a child centred team.

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The children's home strengths

 There has been an improvement in the culture of the home since the appointment of the new leaders and managers.

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The children's home strengths

 Young people and the staff team benefit from having access to an onsite therapy team. This team has input into the development of all the young people’s plans.

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The children's home strengths

 Relationship between the staff team and the young people are good. Staff have a good understanding of young people individual behaviours.

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The children's home strengths

 The staff work well with external professional and parents both of whom complimented the staff on their commitment to the young people.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

6: The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard the registered person must ensure that staff

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Requirement Due date

(2) (b)(iv) provide personalised care that meets each child's needs, as recorded in the child's relevant plans; provide to children living in the home the physical necessities they need in order to live there comfortably; (c)(i)ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. 30/11/2015

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Requirement Due date

In order to meet the positive relationship standard the registered person must ensure that staff

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Requirement Due date

(a)(i) meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans. 31/10/2015

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Requirement Due date

13 :The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard the registered person must ensure that staff

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Requirement Due date

(2)(c) have the experience, qualifications and skills to meet the needs of each Child. Particularly in relation to the any member of staff involved in the restraint of a young person must be trained 30/11/2015 in the homes chosen method of restraint.

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Requirement Due date

In order to meet the leadership and management standard the registered person must ensure

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Requirement Due date

(2)(e) that the home’s workforce provides continuity of care to each child; understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home. In particular the number of staff providing care young people with attachment issues.

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Requirement Due date

The registered person must ensure that children can access all appropriate areas of the children’s home’s premises; and any limitation placed on a child’s privacy or access to any area of the home’s premises is intended to safeguard each child accommodated in the home; is necessary and proportionate; is kept under review and, if necessary, revised; and allows children as much freedom as is possible when balanced against the need to protect them and keep them safe. (Regulation 21 (b), (c(I, ii, iii, iv)) 31/10/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Ensure where the placing authority or another relevant person does not provide the input and services needed to meet a child’s needs during their time in the home or in preparation for leaving the home, the home must challenge them to meet the child’s needs Staff should act as champions for their children, expecting nothing less than a good parent would. The registered person should consider the use of an independent advocate if the child’s needs are not being met.(The Guide to the Quality Standards, page 12, paragraph 2.8)

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Information about this children's home

This national private organisation provides care and accommodation for up to 60 students with autistic spectrum disorder and learning difficulties. It operates as a residential special school which also provides accommodation for a number of students requiring 52 weeks boarding and is therefore registered as a children’s home.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

12/01/2015 CH - Interim Improved effectiveness

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Requires Improvement

The accommodation in which young people live varies across the nine houses. Two of the houses are clinical in appearance and poorly furnished; they are also, were tired, worn and unwelcoming. Some young people’s rooms had no curtains or blinds on the windows and some bathrooms were locked. In contrast the accommodation across the rest of the houses was comfortable, inviting and well furnished.

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Requires Improvement

Unacceptable blanket practices such as the use of plastic cutlery in the dining room and the locking of cupboards and doors continues. There is improvement in relation to the locking of doors and some young people have their own keys as part of a plan to help them to develop independent living skills.

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Requires Improvement

Placement and care plans do not consistently describe how staff will care for young people. They lack detail on how young people will be nurtured or how their developmental needs will be met. Some of these young people have very little family contact. Their plans lack consistent detail on how the staff will address the issues of attachment and family relationships. Young people’s individual plans do have targets but these are mainly education focused. They would benefit from additional targets around social development

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Requires Improvement

Staff have good relationships with the young people. Young people and their parents were very positive about the staff team and their commitment. There are always enough staff on duty but there can be a lack of consistent staffing. This appears to be particularly evident for the young people that are on 2 to 1 staffing. An additional concern is that some of these young people have attachment issues and having a number of different staff caring for them does not support them well.

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Requires Improvement

Staff communicate and consult effectively with children using a range of communication methods. The school council members were able to give a number of examples of ideas to put forward by young people and implemented by the staff team. Most notable recently is the school prom. One council member heard about his sibling’s school having a prom so took this idea to the school council. The prom took place and was a resounding success. Young people proudly showed the photographs and videos of this event. Young people are encouraged and supported to attend a very good range of purposeful and fun activities both on the school grounds and in the local community. Young people said staff frequently ask them for their ideas on activities and will try and arrange for these to happen. During the inspection a group were going to see a ballet.

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Requires Improvement

Young people make good progress in their education from their starting point upon admission to the home. They live in an environment where they progress educationally. Achievements are recognised and celebrated. Young people have excellent attendance at school. Communication across the education and care provision is good which allow a shared practice approach.

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Requires Improvement

Transitions for young people are very well managed whether this be admission to the home or their move into adult services. The staff understanding this is an area which causes the young people a great deal of stress and anxiety. The process are managed at the individual young person’s pace. Young people leaving the home work throughout their stay on their life books.. This provides them with a comprehensive history of their life at the home. Young people were very proud of these books.

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Requires Improvement

Young people’s health care needs are well met. They have access to a range of medical professionals who are either directly employed by the home or who are running clinics there.

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Requires Improvement

Catering at the home is of a good standard. Young people are enabled to have input into the menus. Mealtimes are family style service however the ‘togetherness’ of these meals is reduced in some houses by staff bringing in their own meals.

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Requires Improvement

The majority of restraints are recorded correctly. However some restraint records do not clearly record all the required information. This includes a lack of evidence of outcomes and subsequent action taken to prevent reoccurrence. Some entries contain vague or emotive language. In addition some do not include information on when there has been discussion with the Local Authority Designated Officer. These omissions should have been addressed through the manager’s monitoring systems. The monitoring of these records has improved since the appointment of a new registered manager who is now identifying areas for improvement.

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Requires Improvement

Staff who have not been trained in the homes method of physical interventions, have on occasions been involved the physical restraint of young people. This unacceptable practice has been highlighted in the independent visitors report, but senior managers have failed to take action. The use of door holds has reduced considerably but is still happening. Senior managers agreed that the practice is not acceptable but to date have failed to eliminate it

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Requires Improvement

There are effective risk assessment processes which reflects the young people’s current situation and provide staff with guidance on how to manage and reduce these risks, these are implemented in practice. The therapists are involved in developing and reviewing these plans. Young people and staff benefit from having the therapy services on site as they are readily available and able to provide swift responses to requests for advice.

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Requires Improvement

The home has policies and procedures regarding safeguarding and child protection. However these are not consistently adhered to in practice as some concerns have not been shared with the LADO. Staff are particularly aware of the additional vulnerability presented by the young people they care for due to the level and the complexity of their needs. Records of safeguarding concerns are clear and contain all the required information. Leaders and managers at the home have built effective working relationships with fellow safeguarding professionals.

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Requires Improvement

There is a robust recruitment and vetting policy and procedure in place which protects young people from adults who may wish to harm them. These processes are consistently applied across all employees and staff personnel files contain comprehensive evidence of this. However when providing references for staff applying for other jobs the organisation currently only supply dates of employment and details of their role. The environment is safe for young people to live and staff to work in. Young people’s individual needs make them highly vulnerable and risks within the environment are well managed through a robust health and safety systems. Enhancing this is the locality risk assessment leaders and managers have developed with input from the Police, Local Council, young people, their parents, social workers, independent reviewing officers and the services therapy team.

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leaders and managers

Leaders and managers are effectively managing this home because there has been a notable improvement in the overall culture and ethos of the service since their appointment. Leaders and managers have demonstrated a commitment to cease using restrictive practices such as door holds by identifying and recognising that its use is not acceptable. As a management team they have improved the overall monitoring and analysis of incidents and now have a greater understanding of practices that occur in the home. The leadership team’s monitoring has identified the majority of concerns about incidents, restraint and door holds that have been found during this inspection. Together with the therapy team they have identified where practice needs to improve and have made suggestions to this effect. At times, though the response from the management and therapy teams is not firm enough to ensure that a very clear message about not using restrictive practices is

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leaders and managers

Leaders and managers have worked well to improve the morale of staff and attempt to deal effectively with the ongoing staff retention and recruitment issues. Leaders and managers have used creative approaches to recruit new staff to the home as well as increased remuneration benefits for existing staff. Staff appreciate these approaches to recognise their hard work and have confidence in the leadership team to continue in this work. However, staffing complement continues to be supported by a large number of staff working overtime and the use of bank and agency staff. Agency staff are required to be known to the home in an attempt to provide young people with consistency.

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leaders and managers

The staff team receive regular supervision on annual appraisals. The main focus for supervision session is their work with the young people and the supervision records contained evidence of staff reflecting on incidents they have been involved in. Staff interviewed said they now felt well supported by their peers and the senior management team. The staff training programme is comprehensive and includes additional training on young people specific individual needs. New staff are subject to a good induction period which they felt prepared them well for their role.

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leaders and managers

The homes statement of purpose accurately reflects the work taking place so that placing authorities, other professionals and parents are clear on what the home provides for the young people.

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leaders and managers

An independent visitor attends the home on a monthly basis. The reports they produce challenge practices at the home and raised some of the points for improvement noted in this report. Currently the independent visitor is not accessing the young people’s records. This includes their individual files as well as some central documents maintained by the school. The registered manager said this was due to lack of consents being obtained from parents and/or placing authorities despite frequent request from the home. The registered manager in his last letter requesting this information has said that if a response is not receive by a stated date then permission will be presumed to be given. This will ensure that on the independent person’s next visit they will access all the required information.

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leaders and managers

Links with home and the community are good. Young people access the local facilities and are active members of community events. This enables the young people to expand their social interaction and experiences.

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leaders and managers

Fellow professional who work with the staff are very positive about young people’s placement at the home. Those spoken too commented on the commitment of the staff team and how well they understood the young people they care for. Parents spoken too expressed similar views. They said they can see the progress their child has made. They also praised the staff for the support they not only give the young people but also the support they give to them.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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