Children's home run by Northamptonshire County Council in West Northamptonshire

Outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the home contribute to significantly improved outcomes for children and young people who need help, protection and care.

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The children’s home’s provision is outstanding because:

 Children in this home have autism spectrum disorders and learning disabilities. They experience outstanding care from highly skilled staff and are making exceptional progress from their starting points.  The home provides a structured environment that is carefully monitored and maintained to ensure that it is safe. Children have reduced anxieties and increased confidence due to a combination of the carefully controlled levels of stimulation in the home environment and nurturing, consistent relationships with carers.  Children are able to participate in activities and outings as a result of responding to clear routines and schedules implemented by staff. There are reduced challenging behaviours and improved quality of contact with families.  The manager is proactive in pathway planning, working with adult services and continuing care services. The manager is very thorough in assessing referrals for the home, ensuring that all information is shared.

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The children’s home’s provision is outstanding because:

As a result, children and young people experience positive transitions into and moving on from the home.  The manager is an experienced, passionate leader. She has implemented developments in the home that have improved outcomes for children, improved consultation with children, and enhanced staff skills and knowledge.  Staff, parents and professionals report that children with complex needs have made significant progress and their care plans have been progressed in a timely way, as a result of being cared for in this home.  There is one recommendation: to review and strengthen some recording practices.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation:  The registered person should actively seek independent scrutiny of the home and make best use of information from independent and internal monitoring (including under regulations 44 and 45) to ensure continuous improvement. (‘Guide to the children’s homes regulations including the quality standards’, page 55, paragraph 10.24)

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Information about this children’s home

This local authority home is registered to provide residential placements for up to six children and young people under the category of learning disabilities. The children and young people each have autistic spectrum disorders in conjunction with a moderate or severe learning disability.

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Recent inspection history

Inspection date Inspection type Inspection judgement 04/03/2016 Interim Improved effectiveness 09/07/2015 Full Good 03/03/2015 Interim Improved effectiveness 02/10/2014 Full Adequate

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Outstanding

Children in this home experience outstanding care from skilled, committed staff and are making exceptional progress from their starting points. Staff understand and meet children’s individual needs well. Care is always constructive and aspirational. Staff provide a calm, nurturing approach, which children respond to positively. Staff know each child’s preferred method of communication and provide care using concise instructions. Children receive consistent care in a structured environment with predictable routines. This is supported by the use of schedules and the Picture Exchange Communication System ( PECS). Staff are trained and skilled in using these systems. The inspector observed that staff respond to children’s needs, personalities and moods, and children who can be highly anxious are comfortable in staff care. The home provides a low arousal environment that is carefully monitored and maintained to ensure that it is safe. All children have en suite bedrooms to assist

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Outstanding

with personal care needs. Rooms are personalised, depending on the needs and preferences of children. Children have improved their self-care skills due to the support and guidance provided by staff. Staff ensure that children are involved in their care and that they have choices. For example, choosing menus and choosing clothes when they go shopping. Staff evaluate children’s preferences all the time, such as after an activity. Some children have not been able to go shopping or take part in activities in the past because they could not tolerate the environment. The care they are receiving has helped to regulate some of their behaviours and reduce anxieties. Staff contribute very effectively to multi-agency meetings. This includes assessment and observations. They ensure that children’s views and wishes, and their likes and dislikes in reflected in decision making. A member of staff said: ‘We want children to leave here having had a positive

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Outstanding

impact on their behaviours and having supported them to make progress. We want them to be emotionally stable and able to enjoy their next stage, whether that is returning home or to a permanent care placement.’ One child was very preoccupied with food when he first moved into the home. He was very noisy and excited before and during mealtimes, and his behaviour had an impact on his peers and on outings and activities. He has a very clear, detailed daily routine and schedule. His behaviour has changed: he is able to wait for his meal, he remains calm, he is able to join in at mealtimes, setting the table and clearing away. This makes mealtimes more enjoyable for him and means that he is able to participate in outings in the community without becoming over-excited when he sees food. Another child had a very limited diet when he moved in. Now he will try a range of foods, which has improved his health and well-being. He is less anxious about food

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Outstanding

and mealtimes. He has responded well to clear routines and schedules. This means that he can enjoy visiting cafes during outings and during contact with family. All children are encouraged to have a varied diet and to take part in a range of physical activities. Children have been swimming, horse-riding and to the snowdome. For some children, these are the first occasions they have experienced such activities. Staff are keeping children safe while supporting and managing the inherent risks of children taking part in new activities. A social worker said: ‘The environment at Arnold House and the care the staff provide really work for this child. He enjoys the sensory room and the art room, and these are set out in such a way as to limit stimulation, which is a good thing for him. Staff have worked with the family as well and this has improved the quality of contact. He has made significant progress.’ Staff visit schools, with a minimum of one visit per term, to discuss progress and

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Outstanding

achievements and any emerging concerns or changes to behaviour. It is helpful for staff to observe children in school to ensure that there is a consistency of approach and to support the achievement of reaching targets in the home and in school. A school representative said: ‘This child is highly anxious, with limited verbal communication. It is of paramount importance that school and home communicate effectively. We share information about behaviour management, routines, and developments so that we are providing consistent care. We have seen a huge improvement in how this child is responding to school and home.’ All children have up-to-date education and health care plans and personal education plans. They have a combination of attainment targets, life-skill targets and behaviour targets. These targets inform children’s goals within the home. Staff encourage and facilitate children to achieve targets as part of their daily routines.

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Outstanding

As a result, there has been progress in children’s achievements in school and at home. Children’s health has improved. In many cases there have been exceptional improvements from their starting points. Children have a range of preventative health appointments and are referred to specialist services as appropriate. Children have responded to predictable routines and to the environment. There is reduced use of medication for a range of conditions. Children’s sleeping habits and eating habits have improved. They are less anxious, with reduced aggressive behaviours, and improved emotional well-being. Children are supported to develop good self-care skills, such as brushing their teeth, and as a result have improved dental health . Part of the daily routines is helping in the home, such as setting the table and filling the washing machine. Staff encourage and reinforce positive behaviours. Reduced challenging behaviours and development of confidence means that

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Outstanding

children can experience more activities. Children have enjoyed going on a train, on a ride in an open-topped bus and overnight holiday breaks. A parent said: ‘I can’t believe the change in my son. The use of schedules and PECS, the relationships he has built with familiar staff, have helped to calm his behaviour. He can enjoy many more experiences now. I have every confidence in the manager and the staff. The manager is very knowledgeable, very responsive. I respect her opinions.’ The managers are proactive in pathway planning, working with adult services and continuing care services. They support families and children to visit resources and support and prepare children and young people for transition. There is an effective use of social stories, including photographs of staff, to support children moving on from the home and to support children moving into the home. One child has returned home, with plans in place to support care at home. This is

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Outstanding

significant progress for the family. Another young person has moved to a new placement successfully. Staff supported this transition: they visited the placement with the young person, and shared relevant information with carers. The provider visited the home and was able to see what worked for the young person at Arnold House. She has settled well in her new placement. A parent said: ‘I could not have wished for a better home for my daughter to be assessed. I have only good things to say about the home and the staff, not only were they amazing with my daughter, they were patient with me and the family, always reassuring us and being positive about my daughter. The manager was able to assess what would best suit her needs and was quick to get the ball rolling so there would not be a delay. The manager also ensured that some of my daughter’s favourite staff helped settle her in her new placement. The manager and her team

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Outstanding

very quickly understood my daughter. I can never thank them enough for how they have helped us.’ The manager and the staff have proactively progressed care plans and supported children and young people to move on. This home has a track record of improving children’s outcomes. Some young people had experienced family relationships breaking down, periods of not being in school and chaotic care arrangements prior to moving into Arnold House. The care they have received has resulted in improved family contact, stabilised behaviours and improved emotional well-being. Some have moved on to long term placements, some have returned home and some have moved to providers of supported accommodation for young adults. In all cases, staff have supported and facilitated the transitions so that children and young people are enabled to settle. The manager is very thorough in assessing referrals to the home. This includes

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Outstanding

ensuring that all information is shared and that there is an assessment of the viability of matching of needs and tolerances with current residents. There is a multi-agency information sharing meeting. Staff visit schools, respite placements and the family home to gather information. The transition takes place from school to children’s home rather than from family home. This attention to detail means that children experience carefully planned calm transitions, which are essential for highly anxious children and children who struggle with change. As a result, staff are able to support children to adjust and settle and parents have been prepared for the transition, so that good quality contact takes place.

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Outstanding

Staff and managers provide a highly structured environment, in which care of children’s needs is well documented, to inform daily practice. The use of schedules means that children know what is happening next throughout the day and evening. This means that they are less anxious and usually manage transitions from school to home and between activities very well. Children are never unattended; staff are interacting, observing and monitoring throughout the day. All staff have portable schedules for each child to support communication and behaviour management. In this way, staff sensitively respond to changing moods or any signs of distress. They intervene immediately to support children and meet their needs. There are up-to-date body maps for each child, so staff can monitor and respond to any new marks, which may be from self-harming behaviours. Some children have self-harming behaviours as a trait of autism, they can be highly anxious and

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Outstanding

this is exacerbated by changes to routines. There is detailed policy and guidance for self-harming behaviours. There are behaviour observation charts, which inform behaviour management plans and risk assessments. Plans are regularly reviewed and evaluated so that they are responsive to changing behaviours and risks. Staff have had training and there is very clear guidance in the use of low-level interventions, if they need to prevent a child harming themselves or others. There are a low number of incidents given the complex needs and sometimes challenging behaviours of the children. Social workers and parents report that they believe children feel safe and are safer due to the care they receive and because of the environment. The manager is very aware of the additional vulnerabilities of children who have a disability due to limited communication, level of understanding and personal care needs. Staff have a good understanding of allegations of harm against staff. There are

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Outstanding

checks and balances in place to support staff to safeguard children. They have safeguarding training, supervision and development opportunities. Staff inductions cover safeguarding children policies and procedures in detail. The managers are confident in liaising with the designated officer, and are clear about safeguarding responsibilities and accountability. There are no missing incidents. However, staff are familiar with the guidance. In staff meetings and supervision the missing procedures are covered. For example, there are safeguarding quizzes and ‘missing’ practice drills. When staff go out with children they take relevant essential information about each child. The home is well maintained, there were no signs of damage and the gardens are a safe environment. Staff practice regarding the dispensing and recording of medication is excellent. Staff are skilled and experienced. There is a well-equipped medication room, which

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Outstanding

provides a controlled environment for accurate recording. The manager says: ‘Our children are some of the most vulnerable in society. Safeguarding them is our priority.’

p.10

Good

Senior staff and managers have had training in supervision skills. They recently received training on the use of a reflective supervision tool and this has been introduced into staff supervision. The records reviewed demonstrated that it added value to the discussion about practice and performance. Staff receive regular, high quality supervision. The manager is aware of a duty of care to staff. For some children’s behaviours, staff may need to wear discreet protective clothing, such as sleeves/caps to prevent injuries from children. They are trained in low-level interventions and in recording incidents and accidents. All incidents are reviewed by managers and debriefs take place with staff. The manager and staff report that they are very positive about the care they deliver and morale is good. The management team knows the strengths of the service, and it is skilled at motivating and supporting staff. All of the staff are

p.10

Good

aspirational for the children, supporting them to reach their potential and develop life skills. The manager liaises with an advocacy group for children who have a disability, and has enhanced independent advocacy for children in the home. She has also met with the manager of the independent reviewing officers (IROs). As a result, IROs involved in children’s plans visit the home and meet with the children prior to any planning meetings. The manager has informed the development of consultation materials for children looked after who have a disability, ensuring that they are inclusive and tailored to all children’s needs. Consultation incorporates observation of behaviours, as well as direct communication. This demonstrates that the manager is enhancing the representation of children’s views and wishes. The manager is part of a group which has developed and delivers safeguarding training for the children’s residential sector within the local authority. This means

p.11

Good

that she has a very good understanding of the safeguarding needs of children and is up to date with research and evidence-based practice. This training has been well received by staff. She has also developed and delivered workshops for parents of children with autism spectrum disorders. She has a good understanding of the impact on families of children’s behaviours, including the impact on brothers and sisters. As a result, parents are better informed and feel supported. Parenting capacity assessments have been developed by the manager for home staff to undertake. They are completed when the care plan is to assess for a return home for a child. They include the use of interactive video guidance to enhance parents’ confidence. These assessments contribute to the social work assessments. Such developments demonstrate that the manager is innovative and tenacious in improving outcomes for children and advocating on behalf of children. The

p.11

Good

manager is clear about the role and functions of the home and ensures that care plans are being progressed in a timely way. This means that children move to the most appropriate placement, at the right time, following assessment at Arnold House. As a result of a review of the staffing needs of the home (recommended by the registered manager) there has been a small increase in staffing. The impact of this is that there are more opportunities for outings and activities for children, individually and in groups. The home’s practice is underpinned by a good understanding of equality and diversity, and staff promote inclusive practice. Plans for children are informed by children’s heritage and identities. The manager is resilient and will constructively challenge colleagues, if necessary. There have been no complaints from professionals or families about the service. There are a range of monitoring and quality-assurance mechanisms in place. The

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Good

independent visitor provides monthly reports and the manager responds to recommendations. There is self-evaluation in supervisions and team evaluation on development days. Recommendations are included in the development plan. This inspection found a limited number of inconsistencies in children’s records. These included conflicting guidance in a ‘missing from home plan’ and in one risk assessment. They were rectified during the inspection. It is recommended that as part of the home’s internal quality assurance, recording practices are reviewed and strengthened. There has been no impact on the welfare and safety of children.

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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 children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children’s home is not yet delivering good protection, help and care for children and young people. A children’s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children’s home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the Children’s

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Information about this inspection

Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. the guidance ‘Raising concerns and making complaints about Ofsted’, which is available from Ofsted’s website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after 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

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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