Children's Home, Residential special school run by Hesley Services Limited in Doncaster

inspection

Compliance notices were issued as a result of the last interim inspection and monitoring inspections undertaken with regard to the following regulations:

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inspection

Regulation 20 -this specifically relates to all the staff being aware of the medical conditions and prescribed medication for young people in their care, including emergency medication. All surveillance monitors being in good working order to aid close supervision where required.

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inspection

Regulation 33 -this specifically relates to the need for the provider to ensure that all employees undertake continuing professional development and receive practice related supervision by a person with appropriate experience.

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inspection

These compliance notices have been checked at monitoring inspections undertaken on the 28/04/15 and 04/06/15 and have been met.

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Requires improvement

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

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The children's home provision is requires improvement because:

 Positive changes to improve care practices and education attendance are not yet embedded to provide all young people with consistently good care throughout the service.  The medication for all young people has not been clearly recorded as given or discarded to ensure this aspect of their health needs are being fully met.  Communication aids are not routinely being used for all young people in line with their communication and language guides.  Young people have limited opportunities to access social and leisure activities that require transportation, particularly at weekends.  Not all areas within particular houses are kept adequately clean to provide all young people with a homely and hygienic environment suitable to meet their needs.  The progress of young people is not clearly evaluated within support plans and other relating care documentation.  Transition plans for young people do not always set out the plans in full,

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The children's home provision is requires improvement because:

including introductions, visits and timescales to achieve the planned move. New placements are not always identified in a timely manner to assist in a positive move for young people.

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The children's home strengths

 The management team understand the strengths and weaknesses of the service. Monitoring systems have been improved to provide a robust critical eye on where the service must improve further.  Young people are safer due to the adjustments made to care practice and the improved support provided to the staff.  Young people have established positive relationships with the staff who care for them.  Changes have been made to recruitment process and staff vacancies have been filled. This along with an enhanced induction training packages, sets out clear expectations of staff values and the standard of care to be provided to meet young people diverse needs.  Young people are benefitting from being cared for consistently by more stable staff teams.  There are aspirations to provide the best care and experience to young people. This is being disseminated from the senior management team to the rest of the workforce. This work has commenced and will take time to come

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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

Medicines 23.—(1) The registered person must make arrangements for the handling, recording, safe keeping, safe administration and disposal of medicines received into the children's home. (2) In particular the registered person must ensure that— (c) a record is kept of the administration of medicine to each child. In particular, that clear records are kept of any discarded medication and the home's policy and procedures are followed by staff in full. 28/10/2015

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Requirement Due date

The care planning standard 14.—(1) The care planning standard is that children— (a) receive effectively planned care in or through the children's home; and (c) that each child's relevant plans are followed. In particular, that language and communication plans and aids are implemented as required. 28/11/2015

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Requirement Due date

The care planning standard 14.—(1) The care planning standard is that children— (a) receive effectively planned care in or through the children's home; and (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (iii) plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child's placing authority. In particular that transition plans clearly detail and identify future services in good time prior to the young persons planned moving date; and the detail of how the transition of the move will occur and take place with set timescales. 28/11/2015

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Requirement Due date

The quality and purpose of care standard 6.—(1) The quality and purpose of care standard is that children 28/10/2015 receive care from staff who— (a) understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; (b) use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. (2) In particular, the standard in paragraph (1) requires the registered person to— (b) ensure that staff— (vii) provide to children living in the home the physical necessities they need in order to live there comfortably. In particular, that all environments are kept clean and hygienic.

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Requirement Due date

The enjoyment and achievement standard 9.—(1) The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff help each child to— (i) develop the child's interests and hobbies; (ii) participate in activities that the child enjoys and which meet and expand the child's interests and preferences; and (iii) make a positive contribution to the home and the wider community; and (b) that each child has access to a range of activities that enable the child to pursue the child's interests and hobbies. In particular that there are sufficient resources to ensure these can be provided throughout the week and the weekend. 28/12/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Staff should be familiar with the homes policies on record keeping and understand the importance of careful, objective and clear recordings. (The Guide to the Quality Standards, page 62, paragraph 14.4) In particular, that each young person’s progress is evaluated and recorded.

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Information about this children's home

This provision is a residential special school owned by a private organisation. The school offers accommodation for up to 40 children and young people between the ages of 8 years and 19 years. Children and young people have severe learning difficulties and complex needs, including autism. The residential accommodation is registered and inspected as a children's home by Ofsted.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

02/03/2015 Interim Declined in effectiveness

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requires improvement

All young people’s day-to-day experiences at the home have started to improve after a period of decline. Strong relationships between young people and particular staff are evident, young people want to engage and be with the staff looking after them.

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requires improvement

The recent improvement and changes to care practice and education attendance are yet to be embedded securely into practice for all young people to make sustained progress.

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requires improvement

Shortfalls have been found in the recording of the administration of medication for some young people. For example, it is not clear when medication has been discarded or given in some instances. Not all medication has been signed for as given for particular young people. Staff have not always followed the services policy and procedure for recording medication. While this area is being monitored by managers, errors have still been made, which could have a negative impact on the health of some young people.

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requires improvement

Young people have clear communication language guides and support aides, including PECS symbols, now and next cards and identified motivators. In the main these are being consistently used in school. However, this is not the case for all young people in their homes. Some young people experience other constraints to their communication, such as information not being displayed in appropriate formats within their homes. This could further hinder the young people’s development and the consolidation of their communication skills. It could also lead to individuals experiencing frustration and show declining behaviours due to them not feeling understood.

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requires improvement

Young people have mixed opportunities to experience and attend social and leisure activities. Consultation with young people is being promoted by the advocacy service and within the school council where they are actively involved and make decisions about social activities. Young people have enjoyed an array of activities programmed for them to participate in during the summer holiday period. Some young people regularly visit parks to play, visit their families, go for walks, shopping, go swimming or take part in rebound therapy. There are fluctuations and limitations when leisure pursuits require car or minibus transportation, particular at weekends. This reduces the enjoyment of social and new experiences which enhance their lives further. Care and support plans provide staff with clear guidance on how to care for young people consistently. However, the records do not routinely demonstrate the young

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requires improvement

peoples’ achievements and progress. The transition plans for some young people do not always detail the specifics for their introduction to their new home and scheduled of visits. This does not assist families and young people to have a view of the changes ahead. Neither does it aid young people to adjust and settle positively when moving into new services.

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requires improvement

A number of young people’s daily life experiences have been improved by the decoration of their living environments. Young people have been positively involved and have made choices about colour schemes and wallpaper for their homes. However, not all of the houses are consistently kept to a high standard of cleanliness. Areas found to be unsatisfactory included; some wall and floor surfaces, a medication storage area, a fridge and outside bins were overflowing. This does not ensure all young people live in a suitably hygienic environment at all times.

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requires improvement

Young people benefit overall from their health needs being met. They are well supported to attend health appointments and health issues are actively pursued. Healthy and balanced diets are promoted. Staff demonstrate a clear understanding of young people’s health needs. This is further enhanced with access to specialist clinical professionals. This supports young people’s continued good health.

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requires improvement

The majority of young people benefit immensely from having regular contact with their families. Parents confirm that they have regular phone contact, come to visit their children and some young people have home visits and overnight stays. This ensures young people sustain and maintain secure relationships with family members and others who are important to them. A parent said ‘The staff keep me well informed and I am made welcome on my visits to see my son.’

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good

Young people’s safety is given priority. Staff clearly understand the risks that can pose potential threats to young people’s vulnerabilities and they know how to protect them.

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good

All young people profit from having a more stable staff team, with identified core staff teams to care for them and clearer support plan routines. This assists young people to be more secure in knowing their daily routines and boundaries. This has built stronger trusting relationships with their carer’s. As a result, young people are less anxious and present more settled behaviour. In turn, there has been a reduction in the number of physical holds undertaken to protect the young person from hurting themselves or others.

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good

Staff are aware of the risks and behaviour strategies to use to support each individual young people in their care. These are in line with clear support and behaviour plans, risk assessments, all of which in the main have been reviewed regularly.

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good

Young people’s safety and behaviour is being monitored closely. When young people go into crisis this triggers a multi-disciplinary team of staff including clinic support staff to meet. This team collate and analyse events and review support strategies for the individual young person. This provides a more immediate response to ensure the young person’s anxieties are supported and their behaviour returns to a settled position in a shorter time frame to allow them to enjoy their daily life.

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good

Two parents commented that ‘Our son, has a consistent team of staff caring for him, they know him very well. We visit most weekends and know he is safe, settled and well for cared for. This is very reassuring.’

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good

Staff state that they have received suitable training to assist them to keep young people safe. This includes safeguarding, health and safety, first aid, emergency medication administration and behaviour management. Staff demonstrated a good awareness of the action to take to safeguard and protect young people. Safeguarding referrals have been made to the LADO as required. Prompt investigations have been conducted and appropriate action taken to address the deficits identified. In recent months the number of safeguarding referrals has reduced.

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good

Similarly, complaints made about aspects of the care of particular young people have been investigated promptly and have been taken seriously. Suitable action has been taken to address the shortfalls identified. As a result, the changes have been made to improve the care provided to young people. A parent said ‘After making a complaint about the care of my daughter, the new managers have taken over and things are very, very good. They have made a difference, they have made changes, she is doing much better, she is safe, and I’m so pleased. The managers are more accessible and return my calls quicker.’

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good

Safe recruitment practices and procedures are implemented. With all suitable staff checks undertaken, including the Disclosure and Barring Service, health and identification. References are requested and verified, along with a full and satisfactory employment history. This ensures that all staff are safe and suitable to work with young people with learning disabilities.

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good

The registered manager, senior team and care managers are vigilant in addressing poor practice. This is making a difference; staff are supported by managers who are good role models.

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good

Young people are benefitting from a new leadership team who have taken up post in the last seven months. This has brought a new approach and direction for the service and the care young people are receiving.

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good

The new manager has the relevant qualifications and has wealth of experience working with children and young people, including those with disabilities.

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good

The leadership team have swiftly assessed the service to attain a very good understanding of the strengths and weaknesses of the home. This has generated an array of change in the management arrangements and staff practice where deficits have been identified. This is having a positive impact on the safety, care and wellbeing of young people.

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good

The compliance notices issued after the last interim inspection have been met. The requirements made at the last interim and monitoring inspections have also been addressed and implemented. This demonstrates the service has a capacity to improve

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good

All the staff are aware of the medical conditions and of the prescribed medication for young people in their care, including emergency medication. All monitors are in good working order to aid close supervision of young people with medical conditions.

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good

Staff receive regular formal supervision, which is practice lead and provides them with good support. The quality of supervision has been improved with staff having a clear agenda which includes staff development and a clear child focus. A member of staff said ‘I couldn’t be better supported now.’

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good

Staff retention is an important focus of the new senior management team. This area continues to be monitored to ensure the changes made in the recruitment of staff are effective in the long term. Recruitment drives to address a large number of vacancies have been successful and the staff team’s skills have been improved further with the introduction of working mentors, clinical support staff and a practice lead. This provides young people with a more stable, sufficiently skilled and equipped care staff team that can meet their needs well.

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good

The provider has reported all serious incidents where required, to Ofsted without delay in line with the regulations. This has kept the regulator fully informed about the matters of concern to enable them to take action if required.

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good

The education attendance of young people has improved tremendously, with the vast majority of young people attending Fullerton house school. A small number of young people receive education timetables within their home with education tuition providing and supporting lessons. This ensures young people education is given importance and they continue to learn and achieve.

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good

Young people who are eighteen now have transition plans to move to adult services. Some young people have recently moved to their new homes. The senior management team have worked with placing authorities to support suitable placement moves. A young person visited his new home as part of their familiarisation with parents and staff during the inspection. This will support the young person greatly to settle and adjust to this change more easily.

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good

The manager has submitted a quality of care review report to Ofsted, which covers the areas set out in the regulations. It provides a good oversight of the operation and care service provided to young people.

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good

New staff benefit greatly from thorough induction training, which has recently been enhanced with additional areas to better equip staff to undertake their duties. This training includes values, the ethos of the home, how to care for, and safeguard young people. Staff quickly commence training in mandatory all areas. The organisation gives priority to ensure new staff complete the Level 3 Diploma qualification quickly with an aim to complete this training where possible within a 12 month period. The organisation has aspirations to have a workforce that are well trained to meet and understand the diverse needs of the young people in their care.

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good

The manager and responsible individual have worked closely with other agencies including the LADO, police and placing authorities. This has been to foster and improve partnership working and address identified shortfalls and deficits. The management team have made good progress and resolved areas of concern.

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good

The monthly monitoring undertaken by the independent visitor and been strengthened and is more robust. This visitor regularly seeks feedback from parents, social workers, staff and the young people. The visitor evaluates thoroughly how effectively young people are being safeguarded. They routinely make recommendations for improvement to the care provided. This provides an invaluable critical eye to the management team. The current monitoring systems support continued improvement of the service. Senior managers are regular visitors to all the houses to see children, young people and staff, including night time visits to monitor care practices. As a result, this has brought a stronger, secure an accurate overview of the quality of care, safety and the daily life experience of young people.

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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. procedures set out in 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

regulates and inspects to 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

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Information about this inspection

Policy Team, 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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