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

This inspection Sustained Effectiveness

This home was judged Requires improvement at the full inspection. At this interim inspection Ofsted judge that it has sustained effectiveness.

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This inspection Sustained Effectiveness

Inspectors were aware during this inspection that a serious incident that occurred at the setting is under investigation by the appropriate authorities. While Ofsted does not have the power to investigate incidents of this kind, actions taken by the setting in response to the incident were considered alongside the other evidence available at the time of the inspection to inform inspectors‟ judgements.

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This inspection Sustained Effectiveness

Since the last full inspection the home has addressed or begun to address all the requirements and recommendations made. Progress has been made in supporting staff to develop the skills and knowledge they need to care for the young people more effectively. For example, training is being delivered by the nurse, to ensure that staff are clear about actions to take when young people suffer seizures. However, not all risk assessments covered all eventualities. For example, risks from metal taps to young people who may experience a seizure in the bath tub were not assessed Some of the guidance about action to take if a young person suffers a seizure in the bath was vague. This means that staff who are new or who do not know the young people well do not have clear written guidance to base their practice on. It was noted in discussions with some staff that the risk assessments and guidance did not reflect the actual good practice of these staff.

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This inspection Sustained Effectiveness

The risk assessments and arrangements for transporting medicines across the site that were developed at the last inspection have bedded in well and this ensures that medicines are secure at all times. There was a shortfall found in relation to the instructions about the use of a young person‟s PRN medicine. While there was clear guidance for staff about when to administer the medicine there was no information about what the maximum dose should be. Young people‟s privacy is better assured because holes that were in some bedroom doors have been filled and all young people‟s bedrooms have window coverings. There are arrangements for ensuring that maintenance issues are addressed and in the main this is achieved although some matters take time to address.

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This inspection Sustained Effectiveness

Interactions between staff and young people were positive and staff were very reassuring towards the young people. Staff were attentive to their needs and calm in their interactions. They showed they have good knowledge about young people‟s needs and preferences. Some excellent work was noted in relation to consulting with young people and ensuring their wishes are met. For example, some have worked with staff to choose their menu for the week using books or the internet. They have then been supported to make a shopping list of ingredients and shop for them. Young people really enjoyed this and the activity taught them useful skills.

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This inspection Sustained Effectiveness

There have been improvements in the arrangements for how missing episodes are prevented and dealt with. This has been achieved by making some changes to the environment, for example the perimeters of some houses have been made more secure. In the event of a young person being missing clear guidance and a well thought out strategies have been developed. Records are made of incidents that involve a young person‟s whereabouts being unknown but there was a shortfall noted; a record did not detail how long the young person was out of sight of staff for.

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This inspection Sustained Effectiveness

There has been further significant progress in monitoring and reducing instances of the use of seclusion. There has been joint work carried out with the behavioural team and external behavioural professionals and this has led to far more effective means of behaviour management. Behaviour management plans are highly individualised and in some instances strategies developed for one young person have been able to be successfully used to support other young people.

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This inspection Sustained Effectiveness

When young people move on from the home staff are exceptionally good at ensuring that their needs, especially those in relation to their communication style, are known and understood by the new provider. This means they are able to make their views clearly understood in their new home and undoubtedly helps them settle in well.

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This inspection Sustained Effectiveness

The fire officer has been consulted with, as required following the last inspection, and some fire doors have been replaced. There are some outstanding matters from the fire officer‟s recent visit such as replacing glass panels in some fire doors. Additionally, during this inspection, it was noted that the effectiveness of fire protection provisions in some houses were impacted, for example, in one house, a door did not shut flush following a new carpet having been fitted. While there has been some work on revising young people‟s individual evacuation plans it was noted that neither the plan nor the house risk assessment for a young person who refused to evacuate the building had been updated. Additionally some evacuation plans lacked clarity; language such as „support‟ and „reassurance‟ are used with no detail about what this might mean for individual young people.

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This inspection Sustained Effectiveness

Progress has been made in relation to addressing and reducing risks relating to legionella and asbestos. Legionella testing and risk assessments have been carried out as have investigations into the use of asbestos in the construction of the building; it is thought unlikely that asbestos was used. There has been training for staff in the use of the safeguarding procedures and staff are aware that they need to report concerns without delay. However, some staff‟s awareness of the immediate action they should take if they witness a young person being harmed remains underdeveloped. Additionally, some did not have a clear understanding about the roles and responsibilities local authorities have in safeguarding children.

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This inspection Sustained Effectiveness

Staff support is inconsistent across the setting. For example, it was noted that one new member of staff had only had one formal supervision session in the three months of their employment; this does not ensure that new staff are being effectively supported and does not allow for the formal evaluation and review of their practice through their probationary period. The training programme has been reviewed and now includes training for staff in supporting young people in the safe use of the internet.

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This inspection Sustained Effectiveness

Improvements made in the staff recruitment and retention policies have begun to have a positive impact on the stability of the care staff teams; twenty nine staff have been recruited since the last inspection. There have been fewer staff leaving and, while take up has not been good, all staff leaving are offered an exit interview. The reasons for staff leaving are being monitored to establish if there are any trends.

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This inspection Sustained Effectiveness

The arrangements for external monitoring of the home are effective in relation to considering some aspects of the care of the young people but the independent visitor does not have access to information relating to notifications of serious incidents, including safeguarding concerns. This means he is unable to carry out a rigorous assessment of the arrangements for safeguarding children.

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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

29/06/2015 CH - Full Requires improvement

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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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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

12. —(1) (a) The protection of children standard

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Requirement Due date

In order to meet the protection of children standard the registered person must, (with particular reference to epilepsy risk reduction assessments and protocols and staff‟s confidence in and awareness of the action they need to take should they have a concern about another adult,) ensure that staff:

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Requirement Due date

(i) assess whether each child is at risk of harm, taking into account information in the child‟s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; (ii) help each child to understand how to keep safe; (iii) have the skills to identify and act upon signs that a child is at risk of harm; (iv) manage relationships between children to prevent them from harming each other; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is a serious concern about a child‟s welfare; and (vii) are familiar with, and act in accordance with, the home‟s child protection policies; (b) that the home‟s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm; (c) that the premises used for the purposes of the home are

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Requirement Due date

located so that children are effectively safeguarded; (d) that 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; and (e) that the effectiveness of the home‟s child protection policies is monitored regularly. Fire precautions In order to meet the Fire safety standard; with specific reference to ensuring at all times fire protection provisions are effective and when there is information that suggests an update of an individual‟s evaluation plan and risk assessment is required this is carried out in a timely way the registered person must: 25.—(1) (a) take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children‟s home;

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Requirement Due date

Information relating to the care, protection or safety of the child

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Requirement Due date

36 (Schedule 3) In order to meet the information relating to the care, protection or safety of children standard the registered person must ensure that staff-

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Requirement Due date

14. Record the date and circumstances of all incidents where a child goes missing from the home, including any information relating to the child‟s whereabouts during the period of absence; with specific reference to the duration of the young person‟s absence.

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Requirement Due date

Monitoring and reviewing children‟s homes 44.-(1) Independent person: visits and reports In order to meet the monitoring and reviewing standard the registered person, with specific reference to ensuring that the visitor has access to all notifications and safeguarding incidents, must ensure that an independent person visits the children‟s home at least once each month. (2) When the independent person is carrying out a visit, the registered person must help the independent person— (a) if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires; and (b) to inspect the premises of the home and such of the home‟s records (except for a child‟s case records, unless the child and the child‟s placing authority consent) as the independent person requires. (3) A visit by the independent person to the home may be unannounced.

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Requirement Due date

(4) The independent person must produce a report about a visit (“the independent person‟s report”) which sets out, in particular, the independent person‟s opinion as to whether— (a) children are effectively safeguarded; and (b) the conduct of the home promotes children‟s well-being.

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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 supervision of staff practice ensures that individual adults in the home are engaged in the safeguarding culture of the home so they understand what they would need to do if they found other staff misusing or abusing their position to the detriment of the safety of a child. (Guide to the Quality Standards page 43, 9.14)

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Recommendations

 Ensure staff are clear about the duties and responsibilities of local authorities and others who deliver children‟s services with regard to safeguarding children that are set out clearly in the statutory guidance, Working together to safeguard children. (Guide to the Quality Standards page 42, 9.2)

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Recommendations

 Ensure any individual appointed to carry out visits to the home as an independent person makes a rigorous and impartial assessment of the home‟s arrangements for safeguarding and promoting the welfare of the children in the home‟s care. (Guide to the Quality Standards page 65, 15.5.)

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Recommendations

 Ensure medicines are administered in line with a medically approved protocol; with specific reference to ensuring that there is clear guidance about minimum and maximum doses for PRN medicine agreed and clearly recorded (Guide to the Quality Standards page 35, 7.15)

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Recommendations

 Ensure that all staff receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care; with specific reference to the frequency of supervision. (Guide to the Quality Standards page 46, 13.2)

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What the inspection judgements mean

At the interim inspection we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the Inspection of children's homes: framework for inspection.

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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 focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

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 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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