Children's Home, Residential special school run by Options Autism (1) Limited in North Lincolnshire

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:

 Some inconsistencies in the delivery of individualised care plans have been to the detriment of some young people’s quality of care, privacy and dignity.

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because:

 The absence of a clear and robust recording and tracking systems impedes an effective measurement of young people’s progress and outcomes from their starting points.

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because:

 Internal management monitoring reports lack a full evaluation of the quality of care at the home. This makes it unclear how the manager forms an opinion that that the practices are consistently good, safe and complies with legislation.

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because:

 Not all complaint outcomes are clear in all cases and the lessons learned are not explicit. This does not show how practice improvements are prioritised and resolved.

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because:

 Agency staff’s recruitment credentials have not been personally checked by the Registered Manager to ensure their suitability to care for young people at the home. The increased use of agency staff over the summer holidays creates uncertainty in young people’s lives.

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because:

 Not all young people’s records provide a coherent account of their journeys or include the fundamental details in recognition of needs arising from their culture and identity.

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because:

 Staff supervision does not include reflective practice or inform about the needs of the young people assigned to their care. This does not do justice to the hard work they do to meet the young people’s high and complex needs and ensure that that practice improvements are made.

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because:

 Improvements made with respect to eliminating all medication errors are yet to have a positive impact.

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The children's home strengths

 Leadership and management are well integrated, aspirational, visible and approachable. Improvements made so far are building on the foundations for further development. This has significantly improved staff morale and promotes good team spirit and some child focussed staff practices.

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The children's home strengths

 Good staff induction, training and development promote a skilled workforce that has capacity to meet young people’s needs.

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The children's home strengths

 Relationships between staff and young people are a major strength and contribute to good safeguarding.

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The children's home strengths

 Good educational, health and leisure outcomes improve young people’s experiences.

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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

(2) In order to meet the quality of care standard the registered person must:

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Requirement Due date

(i) understand and apply the home’s statement of purpose;

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Requirement Due date

(ii) protect and promote each child’s welfare;

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Requirement Due date

(iii) treat each child with dignity and respect;

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Requirement Due date

(iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background 30/11/2015

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Requirement Due date

13. The leadership and management standard

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Requirement Due date

(2) In order to meet the leadership and management standard the registered person must:

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Requirement Due date

(f) 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;

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Requirement Due date

(g) demonstrate that practice in the home is informed and improved by taking into account and acting on-

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Requirement Due date

(ii) feedback on the experiences of children, including complaints received; and

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Requirement Due date

(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 30/11/2015 The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines into the children’s home (Regulation 23(1)) 30/11/2015

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. In particular, check agency staff’s recruitment credentials with agencies prior to them working at the home (Regulation 32(1)) 30/11/2015

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Requirement Due date

The registered manager must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (3)) 30/11/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice, which allows them to reflect on their practice and the needs of the children assigned to their care.(The Guide to the Quality Standards page 61 paragraph 13.2)

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Recommendations

 Staff should be familiar with the home's policies on record keeping and understand the importance of careful, objective, and clear recording. (The Guide to Quality Standards, page 62, paragraph 14.4). Specifically, that each young person's progress, including behaviour risk reduction are fully evaluated and recorded.

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Information about this children's home

This privately owned children’s home is registered to provide care, accommodation and education for children. The home offers a specialised service to 26 children and young people with autism.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

11/03/2015 Interim Sustained effectiveness

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requires improvement

Most young people benefit from the good quality relationships with the staff who show genuine care and affection towards them. A social worker said, ‘The staff have an amazing relationship with (young person).’ Young people’s individual personalities and communication needs are understood and respected by staff who all have something positive to say about them. Their support and encouragement enables young people to feel safe and make good progress. A social worker said, ‘He’s a different boy.’ A parent said that staff ‘Go above and beyond’ their duties and ‘Overall, they have been brilliant. They know what he’s like.’ However, some inconsistencies in the delivery of individualised care planning and proactive management oversight have not met good expectations. For example, a young person’s dignity and privacy has not been respectfully treated because their care plan was not adhered to. This does not comply with the homes Statement of

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requires improvement

Purpose. It states, ‘Children’s individual support plans clearly show how the child likes to be cared for and how their privacy and dignity should be respected when providing what can be very intimate care for some young people who live within the home.’ Similarly, the absence of care planning information in relation to young people’s identity, cultural and diversity needs is not satisfactorily identified and evaluated. This is not congruent with the Statement of Purpose that states, ‘We embrace racial and cultural individuality, and celebrate its diversity’ and ‘A key part of our assessment procedure is the determination of religious, ethnic, cultural and/or dietary background and requirements.’ This requires improvement so that every young person, without exception has a good experience of life at the home irrespective of their needs and the length of their stay. All young people enjoy 100% or close to this attendance level in school and

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requires improvement

external education provisions. Positively, their overall education progress is good. Some young people are studying towards awards that help them to reach their personal goals. Strong relationships between the home and schools promote consistency, keeps everyone informed about their progress, encouraging them to achieve to the best of their ability.

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requires improvement

Young people are helped to live healthily, which improves their quality of life. They are registered with primary health care professionals which ensures their health needs are closely monitored and responded to. This includes those young people who have serious health conditions, such as diabetes and haemophilia that benefit from the prompt interventions from specialist health professionals. A healthy diet and regular exercise is proving to be effective for those young people whose weight was previously a cause for concern. Although these practices are good and promote young people’s safety and welfare, the remedies made in response to eliminating all medication errors are yet to have a positive impact. Young people are helped to fully participate in activities that they enjoy. They have fun times and sensory experiences both at the home and the community. A social worker said, ‘He gets to do loads of stuff’ and ‘They go off site a lot.’ Young people

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requires improvement

may also choose to keep themselves amused using the on-site equipment in the home, such as the IPad, watching DVD’s, using the hydro pool and swimming. Parents consulted by the Registered Manager said, ‘They are exactly what my son likes to do and enjoys them’ and ‘The ability for our son to take trips into the community within the safe caring environment’ and ‘Varied and lots of chances to go out for lots of activities.’ These golden opportunities increase young people’s confidence in their abilities. It also integrates them into community life and improves their social and developmental aspirations.

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requires improvement

A number of young people are responsive to helping themselves more and where possible are encouraged to express their self-determination and independence. For example, personalising their rooms, making choices when shopping, meal and drinks preparation, self-care and some are undertaking work experience. A social worker commented that independence is encouraged. A recent transition of a young adult into adult accommodation was considered by all involved to be well planned and made in their best interests. Young people’s wishes and feelings are sought and acted on where possible by intuitive staff, social workers and advocates. This has helped to resolve issues raised by young people when they have not been happy about an aspect of their care.

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requires improvement

Young people benefit from good contact arrangements. These are well known to staff and they facilitate these occasions with flexibility and skill enabling young people’s continued bonds with their kith and kin.

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good

Young people are safe. Their safety and welfare is championed and led by a leadership culture that drives forward the safeguarding message to the staff team. This assures no doubt about their safeguarding responsibilities. The Registered Manager has satisfied herself at this point in time that, ‘Staff are safe, the young people are safe and the environment is safe.’ Since the last inspection, young people have benefitted from newly recruited permanent staff who have gone through proper recruitment and vetting procedures. This minimises opportunities for unsuitable adults to have contact with them. New staff benefit from a good induction and shadowing opportunities alongside existing staff. This good grounding offers new staff a steadier pace of understanding about meeting the needs of young people with autism. Good risk management and staff practices are responsive to young people’s vulnerabilities and protect them from abuse and exploitation. The factors that contribute to this,

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good

such as the high staffing levels deliver a minimum of one to one care, coupled with the secure environment that prevent missing episodes. Young people are also enabled to participate in a range of enjoyable activities when at home and in the community. Good social integration is derived from these practices and enables young people to take controlled risks. This is normally delivered by staff who have a good knowledge of their needs and vulnerabilities. Most staff know the young people well enough to identify if changes in their behaviour are a cause for concern. Safeguarding training further enhances the team’s awareness of the signs and symptoms of abuse in its different forms. They know how to protect young people and promote safer environments. A member of staff said, ‘Basically, the child comes first.’ This view is shared by parents, social workers, independent visitor and the local authority designated officer (LADO), who report no safeguarding

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good

concerns. Investigations into allegations against staff are appropriately shared with the LADO and notified to professional stakeholders and the regulatory body, Ofsted. Young people’s complex and risky behaviours are well managed by staff that implement consistent behaviour management strategies. Specifically, those individuals who increasingly self-harm and present with unpredictable behaviours are protected by being ‘held’ or they are safety guided away and distracted. The independent visitor provides a good analysis of physical interventions to ensure they are transparent and safe. A social worker reported a significant reduction of behaviour related incidents of young people placed by them. Similarly, other anecdotal reports from staff provide a good impression about a range of young people overcoming some of their difficulties. However, management monitoring has missed that the behaviour management plans are not dated; neither do they

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good

show precisely the extent of progress in risk reduction. Although this bears no detriment to children and young people’s welfare, it misses an important opportunity to measure outcomes from young people’s starting points.

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requires improvement

The manager has been registered with Ofsted for six months. She has significant social care experience, including 13 years management experience with a different provider. She holds the MSc in Health and Social Care and level 4 Registered Manager’s Award. Staff are well supported and listened to by the manager and feel that their views count. The enhanced staff morale and teamwork result in staff going the ‘extra mile’ to deliver good care and protection to young people. A member of staff said that the manager, ‘Has come in, seen the problems and tried to rectify them. She listens to what you have to say’ and ‘She gives you the impression that she is here for the long-term.’ Firm and transparent leadership is strengthened by the strong partnerships that integrate social care, education and clinical expertise. Their work has created the support structures that are specific to staff member’s roles and responsibilities. Such a positive and visible management

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requires improvement

culture has evolved that staff have confidence in, due to them seeing the positive changes. A staff member said that the managers’ door ‘Is always open’ and they are ‘Always seeing improvements for the kids.’ Another said, ‘It’s all work in progress, but you can see the difference.’ Marked improvement in aspects of service delivery is good, but is undermined by gaps that have not been implemented and embedded with sufficient speed. Consequently, the shortfalls require improvement to elevate practices to the next level. For example, standardised care plans for individual young people have not yet been applied to support consistently good practice. Not all young people’s needs have been well met. Specifically, concerns are raised by about how their quality of care, privacy and dignity has been delivered. A related complaint has been investigated and the outcome will be shared with Ofsted. Good attention to

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requires improvement

the recruitment of permanent staff ensures a well-resourced service and a good talent pool of committed staff. However, the manager cannot demonstrate that she has satisfied herself that all agency staff have the right credentials to care for young people. The increased use of agency staff over the summer holidays has the potential to create uncertainty for young people. Good quality external monitoring visits emphasise the positive practices and inform the manager about the areas for improvement. The views of young people, their family and professional stakeholders are sought and their contributions influence the developments within the home. The manager takes the recommendations raised at these visits seriously and acts on them. She understands the home’s strengths and weakness and has a development plan. However, internal monitoring reports lack analysis in key areas, such as physical interventions and

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requires improvement

complaints. It is unclear how the manager forms an opinion that the measures taken are safe, suitable and complies with their policies and procedures. Similarly, complaints do not show outcomes in all cases and the lessons learned are not explicit, so it is not clear how practice improvements are prioritised and resolved. Some positive feedback from stakeholders, parents and good staff knowledge provide promising indicators that young people do make good progress resulting from living at this home. A social worker said, ‘It’s all good’ and ‘The family are pleased with (name of child) progress.’ However, the absence of a clear and robust tracking system makes it less effective for the manager to demonstrate their best evidence in relation to young people’s progress. Neither does it allow room to identify and tackle issues as indicated in recent notifications to Ofsted that raise concerns about the standards of care that some young people have experienced.

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requires improvement

Furthermore, not all young people’s records provide a coherent account of their journeys or include the fundamental details in recognition of their culture and heritage. Staff feel well supervised and they speak highly about the support they receive. The frequency of supervision is an area that the manager has identified for improvement. The quality of staff supervision is not reflective of their practice or young people they care for; so does not do justice to how they meet the young people’s high and complex needs. Training is very good. A good investment in the appointment of a well organised training co-ordinator has improved the quality of staff training and development. Manager’s and staff training covers a broad range of role specific topics from the point of induction. Staff significantly benefit from the training they receive. A staff member described the training as, ‘Brilliant’ and said, ‘If there is something you

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requires improvement

specifically want they will look into it if it suits the needs of the child.’ Regular team meetings ensure that management and practice information is filtered through the teams. This effectively keeps everyone up to date and helps to counter the issues raised by parents and professional stakeholders about the times when communication between them and the home had not been good. The two requirements made at the last inspection have been addressed. The independent monitoring reports include a clear summary confirming that children accommodated are effectively safeguarded and the conduct of the home promotes their wellbeing. The behaviour management practices have been reviewed to ensure they comply with young people’s relevant plans. The premises provide a well maintained environment for young people to live and stay. Their personalised rooms showcase their individual personalities and preferences.

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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

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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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