Children's Home, Residential special school run by MacIntyre Care in Buckinghamshire

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 staff team have not been provided with sufficient skills to work with the complex young people currently in placement. Concerns raised by external professionals regarding staff knowledge have not been acted upon by managers.  There has been unnecessary delay in notifying the leadership team of safeguarding information, and the safeguarding procedure has not fully implemented in practice.  The school is not fully compliant with its own health and safety policy and risk assessments. This is in specific relation to legionella and asbestos risk management.  Remedial work to reduce the risk of fire has not been completed following a visit by the local fire department. Deficiencies in relation to fire safety were identified during the inspection.  The privacy of some young people is not appropriately protected. Specifically, some bedroom doors and an uncovered window.  The therapy team and residential team need a more cohesive approach to

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because:

ensure all the needs of the young people are fully incorporated into care planning.

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The children's home strengths

 Young people benefit from receiving a good standard of individualised care from a committed and child-centred team.  Monitoring and analysis of trends and behaviours enables the children’s home to develop strategies to minimise the use of restrictive practice. Records demonstrate this is successful with the number of seclusions decreasing.  Work in partnership with other professionals and support agencies has contributed to the progress made by young people in reducing behaviours.  Care planning and risk assessments are detailed and equip staff to easily understand what young people need to do to meet targets.  Staff use education to promote young people’s welfare throughout the waking day. Young people make good progress in developing social skills and independence.  There is a range of extra-curricular activities on offer to the young people which has improved social interaction and developed young people’s

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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

In order to meet the leadership and management standard the registered person is required to:

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Requirement Due date

ensure that staff have the skills, experience and qualifications to meet the needs of each child. This specifically relates to ensuring staff are aware of epilepsy protocols and staff competency is monitored. (Regulation 13 (2)(c)) 01/08/2015

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Requirement Due date

In order to meet the protection of children standard the registered person is required to ensure that staff;

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Requirement Due date

are familiar with, act in accordance with, the home’s child protection policies. (Regulation 12(2)(a)(vii)) 01/08/2015

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Requirement Due date

In order to meet the protection of children standard the registered person is required to ensure that;

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Requirement Due date

the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. This specifically relates to fulfilling legionella and asbestos risk management assessments. (Regulation 12(2)(d)) 01/08/2015

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Requirement Due date

In order to meet the privacy and access regulation the registered person must:

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Requirement Due date

ensure the privacy of children is appropriately protected. Specifically make sure the environment does not needlessly compromise their privacy. (Regulation 21(a)) 01/08/2015

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Requirement Due date

In order to meet the fire precautions regulation the registered person must:

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Requirement Due date

ensure the registered person takes adequate precautions against 01/09/2015 the risk of fire following consultation with the fire and rescue department. (Regulation 25(1)(a))

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  review and implement the risk assessment for transporting medication between the school and the residential accommodation  ensure there is an integrated approach to care planning between the therapy team and residential team  continue to evaluate and monitor the use of restrictive practice to eradicate its use  develop and implement a system for undertaking exit interviews with staff who are leaving the organisation and evaluate this information to inform practice  continue to ensure all staff working in the children’s home receive training in restrictive practice  ensure that staff have the relevant skills and experience to keep young people safe; in particular in relation to training in e-safety.

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Information about this children's home

This service is a residential special school registered as a children's home for young people with severe learning disabilities and is run by a large independent organisation. The school accommodates up to 40 young people in seven separate houses, usually on a 52 week placement basis.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

01/12/2014 CH - Interim declined in effectiveness

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Recent inspection history

11/09/2013 CH - Interim Satisfactory Progress

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requires improvement

Ongoing refurbishment of the houses has improved the environment for young people. A kitchen in one home has been extended and refitted and staff reported that it was now much more user friendly. There are photos around the homes of young people which give a homely feel and personalises each of the houses. Some of the houses have had the lounge decorated and young people have chosen the colours for their bedrooms. Some bathrooms have been refurnished and there are plans for the refurbishment of others. A bedroom window covering was missing and there were holes in some bedroom doors; these issues impact on young people’s privacy.

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requires improvement

Medication procedures are in the process of being reviewed. Medication kept in the house is securely stored. The arrangements for the transporting of medication from the store in the office to the houses were not secure. This was risk assessed during the inspection by the provider; the risk assessment needs to be implemented in practice.

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requires improvement

Not all the staff team have been provided with sufficient skills to meet the complex needs of young people currently in placement. For example, a staff member was not aware of the correct protocol to use following an epileptic seizure. Issues raised by external health professionals regarding staff’s knowledge have not been acted upon by managers.

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requires improvement

The young people have developed good relationships with staff. Staff spend quality time with them and are attentive to their needs and wishes. For example, a member of staff was brushing a young person’s hair at her request and another that wanted to play on the swings was supported with this. The young people have developed some good relationships with their peers including those from other houses. They are supported to maintain these relationships through the opportunities they have to mix with their friends from across the residential school site.

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requires improvement

Staff interact effectively with young people. For example, over lunch staff spoke with young people about what they had done at school that morning showing them they were interested in how their morning had been. The young people have the opportunity to experience a wide range of activities of their choosing, in the community and within school. They go swimming, to the cinema, bowling and to the local shop to purchase snacks. A young person, who had been bowling, was pleased that she had beaten staff; she had enjoyed the activity. The young people also access the schools facilities during the evenings, weekends and holidays. This gives them opportunities to develop and maintain positive relationships with each other and staff. A social worker commented that ‘the staff meet all x’s needs, the staff team really know x and they have been given her the opportunity to access lots of different activities’. Staff support young people to make scrap books of the

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requires improvement

activities they take part in so that they have positive memories of their time living here.

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requires improvement

The young people all attended the school on site. Attendance is good and the young people are supported in attending by staff. Education and support staff keep each other informed about the young people through the use of home-to-school books. This makes sure that all staff are aware if a young person is having a difficult time and staff can work effectively with the young person across the day.

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requires improvement

There are clear transition plans for the young people who are looking to move on. Staff meet with parents, the therapy team and social worker to devise a ’My Way’ plan. These detail the current and likely future needs of a young person moving on to more independent living. Young people are supported to learn about budgeting because it is planned that they will now go shopping twice a week with staff. One social worked reported ‘the home has been on the ball with the young person’s transition putting his needs first. The house manager and senior staff have been instrumental in supporting the young person with the transition.’

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requires improvement

The home is in the process of developing a child-centred document to show achievements and to use them to help young people understand their life story. This covers a wide range of areas for the young person and enables staff to understand the young people’s likes and dislikes and achievements. These are in addition to the scrap books the young people make.

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requires improvement

The young people’s placement plans are clear concise and detail how to support each young person individually and how to help them develop positive relationships. These are easy to follow which enables all staff to work consistently in supporting the young person in their day-today life by giving them the continuity of care they need.

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requires improvement

The therapy team has recently been expanded with the employment of more staff to the team. They work with staff to develop and implement therapeutic learning plans to ensure there is an integrated approach when working with the young people. These plans are still new and will be expanded and continually developed to give the young people realistic individual goals. However, care staff are not all aware of the therapeutic goals because these have not been incorporated into the young people’s placement plans and risk assessments. This does not provide all staff with a clear basis on which to support young people in developing their skills in managing their behaviour more effectively.

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requires improvement

Each house on site has a separate fire risk assessment outlining the particular risks to young people. Issues have been highlighted in relation to fire safety. Some remedial work has been undertaken since the last fire officer’s inspection in January 2015. Remaining work required includes the replacement of fire doors. Some intumescent strips on the fire doors have been painted over which could result in them being ineffective in the event of a fire.

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requires improvement

There are gaps within the health and safety documentation. Staff are not following the legionella risk assessment and the management of asbestos risk and electrical safety not sufficiently robust. It was not evident as to when checks were last completed. Risk assessments highlighting areas assessed as high risk have not been implemented.

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requires improvement

The manager meets and consults with the Local Authority Designated Officer for safeguarding who reported that the home is working well with her and communication has improved. The homes safeguarding procedure was not followed by staff in one instance resulting in a delay reporting a concern to senior management within the organisation.

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requires improvement

Young people are not supported effectively to use the internet safely. One young person did not know he could talk to a member of staff if he had a concern around the internet and some staff were not clear about their responsibility in relation to this.

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requires improvement

There are effective arrangements for young people who require close supervision for example, due to epilepsy. The strategies used, such as electronic monitoring devices, are agreed by parents and other appropriate people. The home ensures that these do not impact on a young person’s right to privacy any more than is necessary to safeguard their well-being.

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requires improvement

The staff have an appropriate understanding of behavioural management. The behavioural team work with other professionals to embed positive practice approaches in behaviour management techniques. Staff were noted as using distracting techniques effectively when a young person became agitated. There are now individual plans to reduce the use of seclusion. The number of seclusions has been reduced since the last inspection. The staff have worked closely with the British Institute of Learning Disabilities to develop a comprehensive assessment to reduce the use of seclusion for one young person.

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requires improvement

Good individual risk assessments are in place for young people that cover a wide range of risks. Staff are aware of the risks and how they can be reduced and this ensures young people are protected from harm.

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requires improvement

The young people presently living in the home do not go missing. The supervision provided by high staffing levels minimises this risk. There was one reported incident which resulted in a young person walking off site, but she was supervised by staff until safely returned.

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requires improvement

The arrangements for admitting young people to the home are robust. Care is taken in ensuring the impact of a new young person on the current group of young people is fully assessed. Senior management have ensured that young people whose needs they feel unable to meet are not admitted.

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requires improvement

The home uses safer recruitment procedures which are robust; all references are verified, vetting and barring scheme checks are completed before staff are employed.

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requires improvement

The Registered manager qualified as a nurse for people with learning disabilities in 1992 she has been in her current post since July 2014. She is currently undertaking Level 5 Diploma in Leadership for Health and Social Care.

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requires improvement

The manager has not always ensured that staff follow protocols set out by the home. For example, the arrangements for infection control have not been followed by all staff.

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requires improvement

There are some staff vacancies for care staff, the home is actively recruiting to these posts. To make staff recruitment a quicker process and to avoid losing the interest of potential staff the organisation has amended its recruitment procedures. Staff who have recently left the home were not offered exit interviews and therefore it is not clear why staff have left. This means retention strategies are not comprehensive.

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requires improvement

Staff have supervision every four to six weeks and that they find these sessions supportive. Annual appraisals are completed ensuring that staff have a development plan for the following year.

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requires improvement

There is a comprehensive training plan in operation which focuses on children’s individual needs, the manager needs to continue to ensure that training continues to be rolled out and that refresher training is in place. Staff do not provide young people with specific e-safety guidance. The home also needs to ensure all staff are trained in restrictive practice.

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requires improvement

The development plan is child focused and covers how staff are to continue to develop their practice to improve outcomes for the children. The manager uses the findings of the internal and external monitoring of the home to improve practice. The house managers ensure that actions identified are addressed and that young people have a say in matters important to them such as how the living areas and bedrooms are decorated.

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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

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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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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