Children's Home run by North East Autism Society in Sunderland

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 provision is outstanding because:

 Children and young people make exceptional progress within the limitations imposed by their disabilities. The staff use their knowledge of theory, and undertake additional research where necessary, to ensure that they provide a high quality of individualised care and support.  Staff are zealous in upholding each child’s and young person’s rights and ensuring that their dignity is promoted at all times. Relationships between children, young people and staff are excellent. A variety of stimulating activities provides enjoyment and enhances self-esteem.  The staff focus on enabling the children and young people to be as independent as possible, and help them to feel included in wider society.  The home provides an outstandingly safe environment for the children and young people. The skill of staff in understanding how each child and young person communicates their feelings is a significant factor in this success.

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The children’s home provision is outstanding because:

 Staff work closely in partnership with families and social workers. They take advantage of the expertise of other professionals to enhance the quality of care provided.  The leadership of the home is extremely effective. Managers have high expectations of staff, who are themselves highly motivated to put the interests of the children and young people first. Two recommendations have been made in relation to minor shortfalls.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  When establishing the home, the registered person must ensure that it is suitably located so that children are effectively safeguarded and can access services to meet needs identified in their relevant plans (see Regulation 12 (2)(c)). Under Regulation 46, the registered person should review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home's location and strategies for managing these. ('Guide to the children's homes regulations including the quality standards', page 64, paragraph 15.1)  The registered person is responsible for ensuring that all staff consistently follow the home's policies and procedures for the benefit of the children in the home's

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Recommendations

care. Everyone working at the home must understand their roles and responsibilities and what they are authorised to decide on their own initiative. There should be clear lines of accountability. Each home must have clear arrangements in place to maintain effective management when the manager is absent, off duty or on leave. ('Guide to the children's homes regulations including the quality standards', page 54, paragraph 10.20)

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Information about this children’s home

The home provides accommodation for up to four children who have learning disabilities. It is operated by a charity.

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Recent inspection history

Inspection date Inspection type Inspection judgement 11/03/2015 Interim Improved effectiveness 12/12/2014 Full Good 27/03/2014 Interim Good progress 13/12/2013 Full Good

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Outstanding

The staff provide an outstanding quality of care to the children. The number of staff on duty at any one time ensures that each child receives an appropriate level of support. Care plans are extremely detailed, setting out each child’s needs and how to meet them. They are underpinned by theory. For example, how autism impacts on the child’s relationship with the outside world and how they perceive it. These plans include information about how each child communicates, and how they indicate their state of well-being through their presentation and behaviour. This enables the staff to respond instantly if a child is showing signs of discomfort or distress, even if they are unable to express this in words. Plans also demonstrate the importance that the staff attach to promoting each child’s individuality, reinforcing their identity, and acknowledging their changing needs. For example, in the emergence of sexuality as children pass through puberty and adolescence.

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Outstanding

The close attention that the staff pay to the children pays dividends in terms of the progress that the children make. Children develop significantly in all areas of their lives. For example, the children who were not able to sit at the table to eat, or use cutlery, now do so with confidence. They become more self-reliant in toileting and bathing, enhancing their privacy and dignity. With the encouragement of staff, the children take responsibility for tasks such as clearing their plates from the table, or taking their laundry downstairs to be washed. When they come in from school, the children hang their own coats up. One child goes shopping with staff for groceries. He has his own shopping list (in picture symbol format), chooses the items from the shelf and puts them in the trolley. A social worker said, ‘The child has made impressive progress since he moved here. His sleep has improved massively, he is

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Outstanding

eating a wide variety of food, he will sit at the table to eat his dinner and he has developed strong attachments to staff members.’

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Outstanding

The children clearly relish the time that they spend with the staff. There is lots of warm, physical contact, demonstrating their affection for the staff and the trust that they place in them. The staff share activities and games with the children, reading and singing to them. This provides stimulation and fun, and helps to develop children’s social skills. The staff realise the importance of taking the children out as often as possible. Activities include trips to the beach, cinema, pub meals, trampolining, horse riding and going to local Premier League football games. This level of engagement with the outside world ensures that children are not socially isolated, and prepares them more effectively for their lives as adults. A social worker said, ‘The child is never in, they are always out and about, there are regular activity clubs and they go on holidays. Socially, they are much calmer, more settled and tolerant. They are more engaging with people, and less challenging.

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Outstanding

The staff are fantastic, the child has much better quality of life due to the support they get from staff.’

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Outstanding

The staff work very closely with health professionals. These include child and adolescent mental health services, speech and language therapists, occupational therapists and specialist nurses. They have collaborated with a dietician in addressing the needs of a child who came into the home with an extremely limited, unhealthy diet. He now eats a wide range of foods, sitting down at mealtimes and having much fewer snacks. Regular monitoring by the staff shows that he is steadily reducing his weight to a healthier level. For example, losing three pounds in the last month. The detailed recording made by the staff of sleeping patterns is also helpful. At one child’s last medical review, this information enabled the consultant paediatrician to reach a conclusion about their sleeping difficulties and advise appropriate action.

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Outstanding

In addition, the staff undertake their own research when they are confronted with a medical condition that they are unfamiliar with. The registered manager commissions training for the whole staff group, and signposts them to other sources of information. For example, internet videos on autism. This commitment means that the children are looked after by staff who have the highest possible level of skills and knowledge, and contributes significantly to the progress that children make.

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Outstanding

The staff are passionate about not allowing the children’s disabilities, however profound, to act as a barrier to their ability to make choices. They consult with them constantly, using different communication methods according to each child’s ability and needs. Some of the children use picture symbols to express themselves, such as what they would like to eat at mealtimes. The staff construct ‘social stories’ using these symbols to help the children understand what the plan is for the day or what will be happening on an outing. This provides the children with predictability and reduces anxiety. The staff prepared one child for his first outing to a football match in this way, and because of this he was able to cope admirably with the unfamiliar surroundings and the noise of the crowd. The staff are also able to use sign language, which is the preferred communication style for some of the young people, and are booked onto a refresher course to update their skills.

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Outstanding

The process for admission planning is exceptionally meticulous. The registered manager gathers all available information and carries out a detailed assessment of whether the home can meet the child’s needs, and whether they will be compatible with the other children. If additional resources are needed to ensure the right level of support, for example, additional staffing, they will be provided. Pre-admission visits enable the child to become familiar with their new home and the staff to glean further information about their particular needs and vulnerabilities. One child had several visits, for meals and for a ‘fun day’, and five overnight stays before he moved in permanently. This preparation proved invaluable. One lesson learned was that the child had an obsession with turning light switches on and off. As a result, the home had time to modify the switches, removing the source for this behaviour and benefiting safety in the home.

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Outstanding

The staff are highly effective in ensuring that the children are able to maintain relationships with their families. They provide significant support in this area, not only transporting the children home, but also staying for the duration of the visit when necessary. This is extremely helpful for some families, and improves the quality of contact for both the parents and the child.

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Outstanding

The number of staff on duty at any one time is determined by the needs of the children. The ratio of staff to each child is explicit in their care plan and is never reduced. As well as promoting excellent outcomes and stimulating the children’s development, this keeps the children extremely safe. For example, some children have behaviour which causes them or others harm, such as, scratching and nipping. The close attention provided by the staff reduces the risk of this to a minimum. When injuries or marks are noticed, the staff record them in great detail and carry out enquiries to find out how they happened. For example, with the school. Unexplained injuries are discussed in meetings with other professionals to determine appropriate action. This transparency and openness is key to the home’s effectiveness in safeguarding these very vulnerable children. The way in which the home promotes the rights of children is also important. A social worker said, ‘Staff

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Outstanding

include the child as far as possible in every aspect of their care, which contributes to their safety.’

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Outstanding

Each child has a comprehensive risk assessment. These are updated as necessary and reviewed at intervals. The children do not have sufficient understanding or ability to be safe outside the home without staff supervision. Consequently, the physical security of the home is robust. This necessary restriction on the children’s liberty is fully described in each child’s plan and risk assessment, and agreed with the placing authorities and their parents. It is also reviewed on a monthly basis to ensure that the measure is still relevant. Despite this, the staff ensure that the children have as much freedom as possible. For example, doors to the garden have picture symbols attached so that a child can indicate if they want to go out. Generic risk assessments of the premises are good. The registered manager’s assessment of the home’s location is also effective in evaluating any risks in the surrounding area. However, it fails to describe the opportunities and advantages, such as ready

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Outstanding

access to public transport and services such as doctors and dentists.

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Outstanding

The home’s management of medication is exceptionally robust. The staff receive regular refresher training in the administration of medication, and the process itself follows a detailed procedure which reduces the possibility of error to a minimum.

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Outstanding

The staff maintain highly detailed behaviour management plans for each child. They set out: the child’s communication abilities and preferences; what might trigger their anxiety or aggression; what works most effectively in avoiding these situations; and the best kind of support to help the child manage when their behaviour may cause harm to themselves or others. The skill of the staff in coping with challenging behaviour is demonstrated by the low number of incidents of physical restraint, only nine occasions in the past nine months. When restraint is necessary, the staff make a comprehensive record, which is monitored by the registered manager. A feature of the record is that staff evaluate the well-being of the child after the incident. The staff’s in-depth knowledge of each child enables this to be accurate even when the child is unable to communicate verbally or by signing. A social worker said, ‘Staff are very attuned to the child’s needs, this keeps

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Outstanding

them safe, they can be really challenging but the staff are always very responsive in managing this.’

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Outstanding

The home’s safeguarding practice continues to evolve. A recent development has been the introduction of a monthly safeguarding audit carried out by a senior manager within the organisation. This provides an additional level of scrutiny to ensure that children are protected. The staff also work in partnership with other professionals to ensure safety. For example, in the case of one child who is due to spend some time with family at Christmas, the social worker said, ‘The way that the home has planned for this has been excellent, we are drawing up a joint risk assessment to ensure it goes well.’

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Outstanding

The registered manager is appropriately qualified and highly experienced. She leads the staff team with enthusiasm and whole-hearted commitment to the welfare of children. A deputy manager provides able support, but beneath this level of management there are no other senior roles. On every shift, one of the staff is identified as the shift leader, and there is a robust on-call system so that the support of a manager can be obtained round the clock. However, the lack of a supervisory structure within the wider team means that there is no contingency should one of the managers be absent. It also means that the developmental work that some of the staff undertake must be done in their own time as their rostered hours are almost exclusively in direct contact with the children.

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Outstanding

There has been little turnover within the staff team. This stability provides consistency for the children and means that the group has amassed a substantial level of knowledge and ability. The majority of the staff are suitably qualified, and follow a programme of training refreshers which keeps their skills updated. Managers provide the staff with formal supervision at regular intervals. This is focused on the needs of the children and the progress that they are making. The passion of the staff for their work is evident in their interactions with the children and their willingness to work extra hours or change their shifts when necessary. A social worker said, ‘I put the improvement in the child down to the staff knowing what they are doing, providing consistent structure and boundaries and always responding positively to the child.’

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Outstanding

The staff are effective in recording each child’s daily achievements and progress. They celebrate small steps that the children make towards their goals. For example, by producing a printed certificate of achievement for a child who has successfully had their meal at the table for the first time. Staff compile reports for meetings and looked after reviews which chart the child’s behaviour and outcomes. These include: photographs of the child clearing his own dishes from the table; out walking with staff; and playing football in the garden. Staff are always looking to innovate. The evaluation of each child’s ability in self-care skills is currently being improved. Daily records now include ‘Wow moments’, where staff make note of anything a child does which signifies improvement. For example, playing nicely with another child and taking turns.

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Outstanding

The detail within the records enables the child’s social worker and their parents to understand the progress that children make. It also means that the registered manager can make use of this information in her own regular monitoring of the home. These monitoring reports are of outstanding quality. They take account of the views of the children, social workers and their parents. In addition, they are detailed, evaluative and identify areas for improvement which are then incorporated into a robust action plan covering the following six months.

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Outstanding

The staff work collaboratively with other services to ensure that the welfare and safety of each child is at the forefront of their practice. When necessary, the manager is sufficiently assertive in challenging other professionals. For example, if an important meeting to address a child’s future is overdue. Additionally, the staff work in partnership with each child’s parents, supporting family contact and improving the relationship between the child, parents and siblings. Parents are universally appreciative of the work that the home does, one saying, ‘The home is excellent, staff are second to none, they go above and beyond, I can’t fault it.’

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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 that 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 whom 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, 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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