Children's home run by Autism Initiatives (UK) in Sefton

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:

 Young people make measurable progress within all areas of their lives. Parents and professionals said that young people have made exceptional, fantastic and brilliant progress here. This has meant that young people have been able to have overnight stays at home, access activities in the local community and learn new social and personal skills.

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The children's home provision is outstanding because:

 The home has been innovative in seeking and then expressing young people‟s views in order to demonstrate their progress. For example, staff have completed PowerPoint presentations that capture young people‟s individual journeys using photographs. However, in contrast to this, the home has a lot of paperwork about young people‟s care that is not always used effectively to inform their care plans.

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The children's home provision is outstanding because:

 Young people have excellent attendance at school and achieve in line with their peers. There is very good communication between the home and the school setting. This ensures that young people receive consistency of care.

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The children's home provision is outstanding because:

 Young people‟s health has significantly improved. The staff are vigilant in observing and taking swift action to address any health need that may arise. This has led to young people losing weight, maintaining weight and choosing healthy snacks.

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The children's home provision is outstanding because:

 The home has worked closely with parents to replicate a shared care approach. Parents are involved in developing the strategies and routines within the care home, so they can then implement them in their own homes. This ensures that young people receive continuity of care.

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The children's home provision is outstanding because:

 The ethos, supervision and practice of members of staff within the home keep young people safe. After a period of time in this home, young people‟s negative behaviours and incidents significantly reduce because staff members implement carefully thought out strategies, routines and boundaries. This equips young people with the coping skills to experience new things and has meant that several young people are able to confidently access their local community. When incidents arise that require holding a young person, staff are able to do this safely. However, records of restraints do not give all the information required by the Children‟s Homes Regulations 2015.

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The children's home provision is outstanding because:

 The manager is dynamic and consistently demonstrates that she has the young people at the centre of the service. She uses her development plan and the quality of care monitoring extremely well to address any shortfalls or developments through consultation with others. She has challenged local authorities when their service has not been robust, and she ensures that excellent arrangements are in place when young people move into adult services. However, the independent visitor‟s report is not robust. The manager has already raised this with her so that she can improve and move the service forward.

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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 within the given timescales.

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure. (Regulation 35 (3)(a)(iv)(v)(vii)(viii)) 14/02/2017

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Requirement Due date

The independent person must produce a report about a visit which sets out, in particular, the independent person‟s opinion as to whether children are effectively safeguarded and the conduct of the home promotes children‟s well-being. This also includes evaluating the quality of the records in the home. (Regulation 44 (4)(a)(b)) 14/02/2017

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Requirement Due date

In order to meet the care planning standard the registered person must ensure:

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Requirement Due date

(1)(a) that children receive effectively planned care in or through the children's home. This is specifically in relation to showing their progress within their records and any action that staff need to take to secure positive outcomes. 14/02/2017

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Information about this children's home

The home is registered to care for up to eight young people with a learning disability. All young people considered for placement experience autistic spectrum disorder with associated communication and sensory impairment and a possible learning disability. The home is owned by a national organisation. Young people who access this service access the organisation's school.

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Recent inspection history

Inspection date Inspection type Inspection judgement 16/03/2016 Interim Improved effectiveness 09/12/2015 Full Outstanding 11/02/2015 Interim Improved effectiveness 16/07/2014 Full Good

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Outstanding

This is a specialised service that provides care to young people with autism spectrum disorder. The young people have different forms of communication. Some have basic language and others communicate in pictorial form, use Makaton or communicate with noises. They all have difficulty in cognitive reasoning. The staff team understands each young person‟s unique way of communicating. A parent said, „She is making excellent progress in expressing herself.‟ As a result, young people are able to influence and make choices around their care.

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Outstanding

Referrals to the home are robustly scrutinised. The manager completes a compatibility assessment to ensure that the home can meet each young person‟s individual needs. An excellent plan is put in place for their transition into the home. Their transition into the home can sometimes be a lengthy process. This is because staff visit young people in their current care provision, education setting and at their own home, to get to know them and build relationships. This process also includes young people visiting this home on several occasions, with their parents. As a result, the home has been able to carefully consider details such as what personal items within a young person‟s home, for example sensory cushions, they can replicate to help them settle in. A parent said, „I did not want my son to come into care but this home took it slowly and included me in every step. This alleviated my worries and I still feel that I am central to his care.‟ This shows that young

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Outstanding

people come to this home in a planned way that is sensitive to young people and their parents‟ and carers‟ needs, which means that they settle well.

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Outstanding

The home has all the necessary local authority documentation for each young person and it is supported by further paperwork used by the home‟s staff. For example, young people have an „All about me‟ document. This is completed with them, their parents and a range of professionals. This means that young people‟s care is informed by people who know them well, so that very specific individual likes and needs are understood.

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Outstanding

Young people are making measurable and significant progress at this home. A parent said, „He has come a long way and is improving every day.‟ Another said, „The progress she has made is fantastic.‟ This was endorsed by all professionals spoken to as part of this inspection. One social worker said, „This young person is one of my success stories.‟ Another said, „He has made massive progress here.‟ The home has tried to demonstrate young people‟s progress and has lots of paperwork in place. However, it has not used all of this additional information to inform its care plan in each area. For example, young people‟s health plans do not always include details of additional health appointments, medical letters and assessments. This is not currently impacting on the care that young people receive but it does not clearly help young people to understand their progress or their journey through care.

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Outstanding

The home has spent considerable time discussing how young people‟s views, wishes and feelings can be meaningfully expressed in their documents and within the home. The manager said, „We did not just want to do something that may be considered as tokenistic. Not just put a happy smiley face next to comments or it be a staff‟s opinion.‟ As a result, staff have created individual PowerPoint presentations with each young person that show how choices and preferences have been captured and which show the progress that young people are making. For example, one young person was not sure about going horse riding. A presentation was created that included a picture of him watching other young people. Then one of him stroking a horse and then one of him riding a horse. This was set to background music that the young person chose. This represented his individual tastes in a format that he was able to understand and relate to. His

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Outstanding

social worker said, „I cried when I watched it. It is a fantastic story and shows how much he has progressed here.‟

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Outstanding

All the young people see their parents on a planned weekly basis. This includes going home for the weekend. One young person has built up his contact with a parent from day visits, supported by staff, to overnight stays. This has been made possible because staff have worked closely with the young person‟s parent to replicate the strategies and routines used by staff so that there is a continuity and consistency in approach that is beneficial to the young person. The young person‟s parent said, „In the beginning it was very difficult to have him home but now it is a pleasure to be with him.‟ A parent of another young person said, „He is always ready when we go to pick him up. Staff give us a clear account of his week and this helps us plan his weekend. More importantly, he is just as happy to return to the home. He waves us off and bounds up the steps with a smile on his face.‟ This means that young people receive excellent support to maintain, repair and improve

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Outstanding

significant relationships with people who are important to them.

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Outstanding

Young people are involved in a wide range of activities in and out of the home. They enjoy going swimming and horse riding on a weekly basis. Some young people like going for walks, going to the park and going out for meals. The home also has a sensory room, a quiet room and a craft room that young people enjoy using recreationally. A parent said, „It is amazing, they have got him to try different things.‟ Another said, „He did not have any friends but he does here. He can now have a quality of life within society.‟ In addition to this, young people are very much part of their local community and they have recently raised funds for some exercise machines for their garden. This entailed having a book sale, garden party and quiz night.

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Outstanding

Young people‟s health is robustly monitored and they routinely see a range of health professionals to monitor their conditions and health care needs. All members of staff are trained in administering medication, storing it correctly and they all have a first aid qualification. This means that young people receive their medication safely and are able to get emergency treatment if necessary. There are several outstanding areas of practice in how the home improves young people‟s health. For example, in preparing young people for semi-independence, and in particular to be able to self-administer medication safely, the home has been innovative in its approach. The young people have alarms set up on their personal electronic devices so that when they go off they know to ask for their medication.

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Outstanding

Another young person has lost five stone in weight due to a carefully planned healthy eating plan that they have been supported to follow. For one young person, gaining weight has been an issue because their medication supresses their appetite. The home has worked closely with a dietician to address this and, as a result, the young person‟s weight is within an acceptable range. The home continues to monitor this closely. Other young people have learned to choose healthier snacks. When the manager noticed that some young people were gaining weight, she monitored what they were eating at the home and while they were at school. She found that young people were having a late-afternoon snack at school and then one in the home before tea. She consulted with the young people and they were able to choose healthier options. This has worked really well. One young person now shops for his own snacks and buys fruit. He cuts his fruit up and puts it

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Outstanding

in a plastic bag to take to school with him. As a result of the steps taken, all the young people are eating much better and are healthier.

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Outstanding

The home has also devised a hospital support plan. This tells hospital staff about young people‟s conditions and the best possible way to care for them. For example, whether bright lights affect their sensory perception or how to soothe them should they become anxious. This enables young people to receive treatment in an environment that is less likely to be distressing for them. The staff also record how each young person responds when attending appointments. They make notes on the young people‟s interactions and behaviour so that any impact can inform the next visit. For example, arranging later appointments so that the waiting area is not busy.

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Outstanding

The young people attend a specialist school. They all have an education, health and care (EHC) plan document in place. This is used to replicate the service given to young people within the home and school. This means that young people receive a consistent approach. The headteacher said that she had a very close relationship with the home. The headteacher has face-to-face contact with staff on a daily basis. The manager attends multi-disciplinary team meetings to discuss additional support for young people who may be causing a concern, as well as internal reviews in which progress is discussed. All the young people have excellent attendance. The headteacher said that over the last academic year their attendance was 98.76% compared to day pupils at 88.40%. She stated, „When I analyse progress data annually, young people who have a “residential aspect to their care” are compared as a cohort to those without and are found to be

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Outstanding

performing equally well.‟ She continued, „I have full confidence in the manager and her team. From my observations and direct work with them I find them to be committed to providing the best possible outcomes they can for the young people they support.‟

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Outstanding

Young people are prepared for semi-independence through good support plans. These plans cover areas such as personal care, basic skills, shopping and cooking. For example, one young person can keep his room clean, strips his own bed, puts his things in the washing machine and can set it to the right wash cycle. Most of the young people will move to an adult service provision when they are ready to move on. Therefore, transition plans start early because the right provision needs to be identified. Parents say that they and their children are central to these discussions. The manager ensures that the views and wishes of young people are heard. She is prepared to formally challenge local authority decisions should shefeel it necessary and that it is in the best interests of young people. This has included seeking independent advocacy and legal representation to secure young people‟s rights.

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Outstanding

Most young people are supported and supervised by two staff. One young person‟s support has recently been reduced to one staff member due to the excellent progress that they have made.

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Outstanding

Parents, social workers and other professionals spoken to said that the support that young people receive is excellent and that this keeps them safe. They also commented on how members of staff help young people recognise when things are unsafe, such as road safety, strangers, being suitably dressed and their behaviour in the community. One parent said, „It is now a pleasure to take him out.‟ A social worker said, „The work that this home has done with him and his mother has allowed him to be safe in the community. I saw them out the other day together and I could not believe it.‟

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Outstanding

Excellent behaviour management plans and risk assessments help young people to be safe. Strategies for reducing unacceptable behaviour, or areas of concern, are discussed in multi-disciplinary meetings. They are then further discussed in staff meetings. This ensures that a consistent approach is given to young people and this reduces their anxieties. A social worker said, „She [a parent] has been able to mirror the structure and boundaries within the home. She can now manage his behaviour and use the same soothing techniques to reduce his anxieties. This means that they have a great time together.‟ Another young person who was non- verbal when he came to this home has now learned a few words. When he wanted people to move away, he used to hit them. He now says „go‟, and members of staff know that this is their cue to give him some space. Another young person‟s incidents spiked and the manager was successful in identifying the trends and

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Outstanding

patterns for this. She noticed that they were on a certain Wednesday and coincided with the end of term on a Tuesday. This was his way of expressing that he was unhappy that his routine had changed. Therefore, the manager was working closely with the school in preparing him for the Christmas break.

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Outstanding

Young people have received lots of positive rewards for their improving behaviour. One young person chose a Little Mix CD. Another chose new posters for his room. At the end of the school year, young people attended their prom, chose new outfits and were taken to their prom in a vintage car. This was a celebration of their hard work, progress and attendance at school.

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Outstanding

When young people have difficulty expressing themselves, they often resort to hitting out or damaging property. On some of these occasions, they are held for their own or others‟ safety. All staff are trained in how to hold young people safely, and this is refreshed annually. The home currently uses an online recording system that is also used by the young people‟s school. Although this ensures that teachers know what has happened and enables the home to use the information in a statistical way to show increase or decrease of incidents, it does not follow the Children‟s Homes Regulations 2015. For example: it lacks information around medical treatment and what has been administered; the techniques are not explained, as it says „see support plan‟, and the effectiveness of the intervention is not clear. This is not currently impacting on the excellent outcomes but has the potential to do so.

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Outstanding

Young people have not been reported missing from this home. Members of staff fully demonstrated their roles and responsibilities in this area, if an incident was to occur. This is further supported by an excellent risk assessment that tells the staff team clearly what action to take. This helps to safeguard young people.

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Outstanding

All safeguarding incidents are formally addressed through several procedures and protocols within the home. Any allegation against a member of staff is reported to the designated safeguarding officer of the local authority. On their advice, external and internal investigations take place. Due to these robust practices other concerns have been highlighted. For instance, although one incident was deemed „no further action‟, the manager noticed that one member of staff did not report the incident for several days. This led to a separate internal investigation. The result of this was that the member of staff was supported with further training and a higher level of supervision for a period of time to ensure that they understand their roles and responsibilities and follow the home‟s procedure for reporting concerns.

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Outstanding

Young people live in a safe environment. The home has a maintenance person who attends to all small repairs swiftly. In addition to this, he also advises the home on how young people can have additional things, in a safe way. For example, for the Christmas period, the home has a nativity scene that moves and makes sounds. He has put up a protective screen so that young people can enjoy this, but not harm themselves or break it. One young person said, „I love it‟ (whilst clapping her hands excitedly). In addition to this, the young people have a range of sensory, exercise and fun apparatus in their garden. These have been secured and are on a soft textured ground. Young people have also requested a sunken trampoline. The manager has secured the funding and is working with a company to ensure that this can be safely installed. All domestic appliances and utilities are regularly serviced. All the young people have an individual evacuation plan. This is specific to

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Outstanding

the support that they would require if they needed to evacuate the building quickly.

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Outstanding

There is a dynamic, motivated and driven manager at this home. She was registered with Ofsted in October 2010. She has a wealth of knowledge and experience in caring for young people. She has worked for the company for a number of years and has had several positions, including the head of residential services. She stepped down from this position to manage this home. She is suitably qualified and has two deputy managers who support her in this role. This means that there is a strong oversight at the home. Staff described the manager as „approachable‟, „fair‟, „supportive‟, „fights the young person‟s corner‟, and as „having young people at the heart of her practice‟.

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Outstanding

The home‟s statement of purpose reflects the ethos of the home. It clearly shows the arrangements for caring for the young people at the home. Professionals and parents confirm that they had a copy and that the home reflects what is in this statement. A parent summarised this by saying, „They do exactly what it says on the tin.‟

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Outstanding

There are over 23 members of staff at this home, with three supporting auxiliary members of staff and one administrator. Most of the staff team have a suitable qualification in childcare and others are at different stages of completing this. All staff complete a probationary period that can be extended if necessary. As part of this, all staff complete their mandatory training before being left unsupervised with young people. Staff receive additional training that reflects young people‟s needs. For example, one past resident had epilepsy. All staff received external training on epilepsy prior to him coming to the home. This means that members of staff could care for him safely. When a training need is identified, the manager quickly puts this in place. At a recent inspection of another home within the company, it was identified that the staff team required training in e-safety. The manager sourced this training and staff completed it within three weeks of the inspection. A member

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Outstanding

of staff said, „I would not have thought that this was going to be useful to us, as the young people do not access social networks or have the comprehension to understand this. How wrong I was.‟ Another said, „This training was extremely beneficial to me. A video was shown as part of the course. We all made the wrong assumptions. This really highlighted the dangers and misconceptions to me.‟ Another said, „Our world is now the centre of social media. I found this training to be one of the most useful that I have been on. I am more confident in how to protect young people.‟ This not only shows that the manager takes swift action when a shortfall is raised but that the staff team has benefited from it. This means that young people are cared for by a well-qualified and trained staff team.

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Outstanding

Several members of staff told the inspector that they are supported through excellent supervision. They said that they are given regular and ample time to discuss their practice, young people, and how they wish to develop in their career. As a result, some staff have progressed into senior and deputy manager positions, and others are looking at completing their level 4 in childcare. Further to this, they said that staff meetings are a forum to be honest, open and an arena for discussing practice. The manager uses the Regulation 44 report in the staff meetings to discuss any actions set by the independent visitor. This means that the home continues to improve.

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Outstanding

The home works with a range of professionals and parents to ensure that all the young people‟s health, education, social and personal care needs are met. This ensures that: a consistent approach is taken; that everybody knows and understands their roles and responsibilities; plans are changed and updated as and when necessary; and that young people‟s needs are holistically met. A social worker said, „The level of communication between the home and me is fantastic. Therefore, we can take immediate action if necessary.‟ Another said, „The staff are moveable in their approaches. They discuss and try new things. They are excellent at keeping me updated.‟ A parent said, „The communication is brilliant. It does not matter which staff you talk to, they are all clear on her day or if there has been any issues.‟

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Outstanding

The manager has a development plan that reflects on what the home does well and what can be further achieved. As a result, several new things have been put in place, such as PowerPoint presentations for reviews, medical alerts on young people‟s electronic devices, and consideration has been given to young people‟s requests for a trampoline in the garden. The manager informs the local authority and Ofsted if any incidents have occurred that require a formal notification. Any learning from these incidents is put into practice. For example, ensuring staff know and understand that any safeguarding concern is to be reported immediately.

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Outstanding

The quality of care in the home is monitored by an independent person. The manager has raised with the independent visitor that her reports are not robust enough to help her improve the home. For example, she has put „reviewed‟ in some boxes. This statement is not clear on whether the home has reviewed the document or whether she has reviewed it. Further to this, the independent visitor does not give an opinion as to whether young people are fully safeguarded in this home, as required by the Children‟s Homes Regulations 2015. The independent visitor attended the inspection and spoke with the inspector. She agreed that the report could be more evaluative and will address this in her future reports. This shortfall is not currently impacting on the young people because the manager uses her monthly reporting of the quality of care within the home extremely well. She takes decisive action when identifying any trends and patterns, such as the

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Outstanding

incidents around a young person‟s routine being disrupted when term time finishes mid-week. As a result, young people progress, learn, thrive and flourish at this home.

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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 that 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, 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

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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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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