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

Requires improvement

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

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The children's home provision requires improvement because:

 The living arrangements for one young person were unsuitable. The accommodation did not provide the young person with the physical necessities that they needed in order to live there comfortably. The sleeping space did not respect privacy and provide dignity. Leaders and managers took action during the inspection to start to resolve this situation.

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The children's home provision requires improvement because:

 Referrals to external safeguarding professionals are not consistent with the expectations of the child protection policy. The senior management team did not report to external partners a small number of concerns that they deemed as of minimal risk. In addition, notifiable safeguarding events are not always sent to Ofsted.

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The children's home provision requires improvement because:

 The recruitment of staff requires improvement. One employee does not have a reference from their most recent employer. Leaders and managers do not have oversight of employment checks on agency staff.

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The children's home provision requires improvement because:

 Some staff do not receive regular and effective supervision or appraisal. Some staff have long periods between supervisions, reducing the opportunity for reflection and support. Annual appraisals do not take place consistently for all staff.

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The children's home provision requires improvement because:

 There is not a consistent team of staff to care for the children and young people. A significant number of vacancies means that some young people are being supported by a range of different staff. This approach does not provide for continuity of care. Leaders and managers are working to resolve this situation.

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The children's home strengths

 A vast amount of progress has been made since the previous full inspection. The environment has become more homely, and bedrooms are personalised in consultation with children and young people. A review of the restrictions facilitates an increased freedom for children and young people in their home.

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The children's home strengths

 The approach to behaviour management has seen the number of physical interventions decrease. Monitoring of incidents is robust, and the senior management team has systems that identify learning and reflection. Staff engage children and young people in debriefings which clearly identify their views and emotions following an incident.

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The children's home strengths

 Inspectors observed staff caring for children and young people in a warm and nurturing manner. Staff are attentive to the emotional needs of children and young people, using hugs and physical affection appropriately.

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The children's home strengths

 Leaders and managers have a clear development plan in place. The senior leadership team is driven, and is passionate about providing a positive experience to children and young people.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meets the Care Standards Act 2000, Children's Homes (England) Regulations 2015 and ‘Guide to the children's homes regulations including the quality standards’. The registered person(s) must comply with the given timescales.

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Requirement Due date

6: The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard, the registered person must— (2)(b) ensure that staff— (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; (vii) provide to children living in the home the physical necessities they need in order to live there comfortably; (viii) provide to children personal items that are appropriate for their age and understanding;

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Requirement Due date

In particular, to ensure that children and young people have their own bedroom and personal items to promote dignity and respect, and that children and young people have access to kitchen facilities and the physical day-to-day necessities that one would expect in a home. 29 July 2016

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Requirement Due date

In order to meet the protection of children standard the registered person must ensure— 2(a) that staff— (vi) take effective action whenever there is a serious concern about a child’s welfare;

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Requirement Due date

In particular, that all safeguarding concerns where a child or young person may be at risk are referred to the appropriate agencies. 29 July 2016

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard— (1) the registered person enables, inspires and leads a culture that— 29 July 2016 (a) helps children aspire to fulfil their potential; (2) the registered person must— (e) ensure that the home’s workforce provides continuity of care to each child;

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Requirement Due date

In particular, that leaders and managers recognise the needs of children and young people and act on their behalf to provide them with a comfortable home, and that leaders and managers continue to reduce the number of staff vacancies, and the number of different staff providing direct care to children and young people.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

The requirements are that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2 (Regulation 32(3)(d)). 29 July 2016

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Requirement Due date

(4) The registered person must ensure that all employees— (b) receive practice-related supervision by a person with appropriate experience; and (c) have their performance and fitness to perform their roles appraised at least once every year (Regulation 33(4)(b)(c)). 29 July 2016

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Requirement Due date

(4) The registered person must notify HMCI and each other person without delay if— (c) there is an allegation of abuse against the home or a person working there; (e) there is any other incident relating to a child which the registered person considers to be serious (Regulation 40(4)(c)(e)). 29 July 2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation(s):  Continue to improve the home to provide a welcoming and nurturing environment, paying particular attention to the restrictions that remain as well as the general fabric of the home (‘Guide to the children's homes regulations including the quality standards’, page 15, paragraph 3.9).

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Information about this children's home

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

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

16 March 2016 Interim Improved effectiveness

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Recent inspection history

12 January 2015 Interim Improved effectiveness

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Requires improvement

In an isolated instance one young person did not have suitable living accommodation at the home. At the start of the inspection there was no plan in place to improve the accommodation area in which the young person was choosing to reside. The sensory room, used by all children and young people in the school, acted as a bedroom during the evening hours. The young person had no personal space to relax in for their sole use. The room is not a private space, as there are glass panels in the door which remained uncovered. Leaders and managers started to address these shortfalls during the inspection and personalised a living space to meet this young person’s needs.

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Requires improvement

The support that children and young people receive at the home to help them progress is inconsistent. While some parents recognise the significant milestones that their child reaches here, others do not agree with this view. In some houses, there is a lack of age-appropriate activities that help children and young people to move on into their adolescent years. Since the interim inspection, leaders and managers have introduced a new system to measure targets and progress. This is an improvement. This system is not yet good, as it has not been used to identify and evaluate tasks that assist young people to gain more independence.

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Requires improvement

In the main, the provision is now more homely and welcoming. Individual houses have been refurbished and nicely decorated, staff no longer wear uniforms, and the use of plastic crockery and cutlery is no longer customary. Environmental restrictions are still in use across the provision. Leaders and managers do undertake regular reviews of these restrictions, but further work is required to ensure that all those that are unnecessary are removed. For example, in one house a kitchen is routinely locked when not in use, as a result of the location of a staff office.

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Requires improvement

The home has introduced a research-based model to support staff to develop positive and nurturing relationships with young people. Although it is early days yet, and not all staff are trained in the practice, during the inspection inspectors observed good-quality interactions between staff and the young people.

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Requires improvement

There are same good examples of children and young people becoming part of their local community. When staffing ratios permit, staff organise activities out of the home, such as trips to the beach and skate park, local walks and fundraising events. Children and young people have the opportunity to join local groups, such as Scouts, ballet and parcour, where they can meet new friends outside of school.

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Requires improvement

Placement plans are of good quality, and clearly describe the needs of children and young people. The system to review these is effective, as it keeps up to date with the presenting needs of each child and young person.

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Requires improvement

Children and young people have good access to health services. A designated school nurse oversees their health needs. In addition, a general practitioner visits weekly to provide accessible healthcare at the children’s and young people’s home. There is good communication with specialist health consultants. Children and young people benefit from having a therapy team within the home to support their emotional needs.

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Requires improvement

Staff are skilled in various communication methods which assist children and young people to express their views. There is evidence that consultation with children and young people is starting to effect change. Opportunities to express their views about their bedrooms, activities and food are widely taken up. Staff confidently run house meetings to gather feedback about hot topics at the home.

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Requires improvement

The attention to detail and passion of the dedicated transition worker is an example of exemplary practice. The person in this role works tirelessly to coordinate transitions with young people, their families and external professionals. One parent described this service as ‘amazing’. An annual review keeps track of young people’s progress when they move on.

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Requires improvement

Leaders and managers do not consistently refer child protection concerns to external partners for scrutiny. Inspectors identified that the senior management team failed to recognise two concerns as a potential risk of harm to children and young people. Therefore, they did not report these to the local area designated officer and children’s safeguarding team.

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Requires improvement

Notifications are not always submitted to Ofsted when there has been an allegation of abuse against the home or persons working there, or any other incident that leaders and managed deem to be serious. Although referred to professionals who safeguard young people, some incidents have not been notified to Ofsted as required by regulation 40.

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Requires improvement

Despite these oversights, relationships with the local area designated officer are strong. Records show clear communication and outcomes from referrals. The scrutiny by external professionals of staff practice, in relation to safeguarding concerns, is robust and transparent. Staff understand their role in safeguarding children and young people, and follow the child protection procedure effectively.

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Requires improvement

The recruitment and vetting of new staff are not yet good. Leaders and managers rely on agency providers to undertake safer recruitment checks, and do not themselves verify that all the required checks are in place. It is not evident that agency workers pass the required ‘right to work’ checks or that the agency has obtained disclosure and barring checks (or the equivalent) for staff who have previously worked overseas. For one permanent member of staff, leaders and managers had not sought sufficient information to understand the reasons why they had left their previous employment. A previous employer reference was not obtained, and neither did leaders undertake registered body checks. These weaknesses place young people at risk.

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Requires improvement

The school nurse scrutinises errors relating to medication. An audit trail evidences that errors predominately relate to ensuring an accurate stock balance. Misadministration is rare but, when it does happen, staff recognise errors swiftly. In these events, staff ensure that children and young people receive medical treatment and are monitored. The school nurse has taken action to minimise the likeliehood of this happening in the future.. An independent pharmacist carries out regular audits, for additional scrutiny.

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Requires improvement

Clear emergency healthcare plans are in place for those children and young people who require pro re nata (PRN) medication to deal with an emergency health need, such as epilepsy. Staff receive specialist training that equips them to care for children and young people with specific emergency medication and complex health conditions.

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Requires improvement

Leaders and managers have taken effective action to improve the ways that staff support young people who display behaviour that challenges. High-risk interventions, such as ground floor-holds, are still used but are decreasing. The use of door-hold strategies are no longer commonplace, and this is a positive change in practice. The clinical psychologist and behaviour support coordinator are helping staff to find less restrictive ways to help young people when they become upset and anxious. Detailed behaviour support plans provide staff with useful information and strategies to support young people.

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Requires improvement

The strategies that staff use to help young people to express their views about restraint and incidents have improved, resulting in positive outcomes. The behaviour support coordinator is modelling good practice, and is coaching staff to gather young people’s feedback. There is good evidence of staff helping a young person to describe what happened during an incident and how it made them feel. Staff took effective action in response to the young person’s feedback.

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Requires improvement

Overall, leaders’ and managers’ monitoring of restraint and incidents, and the records pertaining to these practices, have improved. However, a small number of restraint records that were reviewed did not clearly document the specific detail of what had occurred during the incident.

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Requires improvement

Leaders and managers are becoming better at questioning the practices that take place, and they undertake serious incident reviews when high-risk strategies or unplanned interventions take place. These reviews have identified when the needs of young people can no longer be met at the home. It is evident that leaders and managers are working with external agencies to identify more suitable provision for these young people.

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Requires improvement

Risk assessments are in place for each child and young person. They are personal documents that identify their individual risks and how to manage these proportionately. Risk assessments link with the behaviour support plans. There have been no incidents of missing from home since the interim inspection.

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Requires improvement

All staff have training in safeguarding children and adults. Designated safeguarding leads are trained to the required level for that role. Training in safeguarding disabled children and young people is not currently part of the training programme.

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Requires improvement

Leaders and managers failed to meet the basic care needs of one young person. This led them to unsuitable living arrangements. Although the rationale for their decision making was to provide consistent care and to avoid further disruption their solution resulted in a lack of privacy and unnecessary disruption for this particular young person.

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Requires improvement

Managers have identified 45 current care staff vacancies across the provision, including several permanent positions. Leaders and managers have plans in place to deal with this weakness, and work hard to ensure that they meet their contractual obligation to provide a specific number of staff for each shift. This has resulted in the regular use of agency and bank staff, and permanent staff working overtime. As a consequence, a high number of different adults regularly work with young people in the houses, which does not provide for continuity of care.

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Requires improvement

The arrangements for staff to receive support through supervision and appraisal is ineffective. Supervision is not regular for the majority of the staff team. Not all staff have their performance appraised annually. These inefficiencies lessen the opportunities for reflection, learning and development.

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Requires improvement

Leaders and managers oversee a comprehensive mandatory training package for staff. There is an effective system to identify when refresher training is due. Training includes informing staff of new government departmental advice, such as the ‘Prevent’ duty. However, there is no workforce development plan in place, and leaders and managers recognise this shortfall.

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Requires improvement

The previous registered manager resigned in February 2016. A new manager was appointed immediately and has submitted an application to register with Ofsted. The new manager is suitably qualified for the role. She has substantive experience of working within the company, particularly at this home. The manager identifies the weaknesses of the home and has a clear development plan to improve it, which includes devising a ‘Prevent’ risk assessment.

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Requires improvement

Leaders and managers are passionate about the home. It is evident that they want children and young people to achieve the best outcomes in their future. Compatibility assessments now evaluate the needs of children and young people when there is an admission to the home. Leaders and managers have not previously operated with such rigour to assess all those currently residing in the home and the impact that they have on each other.

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Requires improvement

Leaders and managers deal effectively with complaints from children and young people, and their families. Records of complaints show how the views of children and young people are considered. One request from a young person to move houses was listened to, regarding their feelings, and resulted in a new ‘club night’ to give more opportunities for socialising. An advocate continues to visit the home to support children and young people with any complaints or concerns that they may have.

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Requires improvement

Leaders and managers are not afraid to challenge responses from agencies that they do not believe are in the best interests of children and young people. This is particularly significant for those young people whose needs the leaders and managers recognise they can no longer meet at the home. There are good links with external agencies that support children and young people in their care, such as local authorities, healthcare services and the local police.

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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’. 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.

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What the inspection judgements mean

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.

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What the inspection judgements mean

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.

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What the inspection judgements mean

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 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.

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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 ‘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 0300 123 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, work- based 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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