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

Inspection report children’s home: SC446957 1 SC446957 Registered provider: North East Autism Society

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately operated home provides care and accommodation for up to four children and young people who have a learning disability. The home specialises in looking after children and young people who have an autistic spectrum disorder.

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Information about this children’s home

Inspection dates: 20 to 21 September 2017

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected good

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outstanding

The effectiveness of leaders and managers good

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outstanding

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

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outstanding

Overall judgement at last inspection: improved effectiveness

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Enforcement action since last inspection:

none Inspection report children’s home: SC446957 2

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Key findings from this inspection

This children’s home is outstanding because:

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Key findings from this inspection

 The children and young people are significantly progressing and achieving, both from their starting point and since the last inspection. They are reaching their full potential. Living at this children’s home contributes towards the children and young people exceeding expectations.  Relationships between the children and young people are very positive. They have formed close bonds with the staff, and good contact arrangements ensure that they are able to maintain links with their families and other people who are important to them.  Educational outcomes are considerable. Dynamic partnership working between the staff at the home and schoolteachers is reaping positive results. All the children and young people are healthy and happy. Activities are a strength, which ensures that children and young people make the most of their leisure time.  The children and young people are safe and they feel emotionally secure. Their

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Key findings from this inspection

day-to-day experiences are fulfilling. Involvement within the local community is very good, and the children’s and young people’s rights and diversity are fully respected.  Excellent partnership working with other agencies and professionals provides all the children and young people with holistic care that meets their needs. The registered manager and the staff actively advocate on behalf of the children and young people.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 The staff duty rotas do not include all the required details in line with regulation.  Storing a number of wheelie bins, including a clinical waste bin, in the front driveway makes the home look different from all the other houses in the street.  The recording of restraints is inconsistent, and at times mediocre.  There is no workforce plan in place.  The monitoring of the home has failed to analyse a high turnover of staff.  Not all transition plans for young people moving into adulthood are completed. Inspection report children’s home: SC446957 3

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Inspection date Inspection type Inspection judgement

28/03/2017 Interim Improved effectiveness 13/12/2016 Full Outstanding 08/03/2016 Interim Improved effectiveness 26/01/2016 Full Good Inspection report children’s home: SC446957 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, the 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 maintain in the home the records in Schedule 4. (Regulation 37(2)(a))

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Requirement Due date

In particular, ensure that the staff duty rosters include the full names of the staff; their designation; and who was in charge of the children’s home in the absence of the registered manager. 31/10/2017

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Recommendations

 Ensure that the children’s home is homely and has a domestic environment. (‘Guide to the children’s home’s regulations including the quality standards’, page 15, paragraph 3.9)

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Recommendations

In particular, make improvements to the exterior of the home to either move the large bins that are stored on the drive or disguise them so that the children’s home looks the same as the other houses in the street.

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Recommendations

 Ensure that the records of restraint are documented clearly to enable the registered persons and the staff to review the use of control and restraint effectively. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

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Recommendations

In particular, ensure that the written description of each restraint makes it clear what led to a restraint being carried out, what actions were taken to prevent a restraint, and the rationale for implementing a restraint. Additionally, ensure that the records stipulate that medical attention has been sought if a child or young person has sustained an injury during a restraint.

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Recommendations

 Ensure that there is a workforce plan, which can fulfil the workforce related requirements of regulation 16. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)

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Recommendations

In particular, ensure that the workforce plan details the processes and agreed timescales for staff to achieve induction, probation and any core training Inspection report children’s home: SC446957 5 (such as safeguarding, health and safety, mandatory qualifications, and a level 3 childcare qualification).

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Recommendations

 Ensure that the registered persons, and the independent visitor, monitor and review the patterns and trends of turnover of staff to understand and, where possible, address any negative trends. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.19)

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Recommendations

 Ensure that the registered person, and where appropriate key workers, work with the placing authority to ensure that each young person’s transition is planned and that the transition plans set out how the young people are prepared for leaving the children’s home. (‘Guide to the children’s homes regulations including the quality standards’, page 57, paragraph 11.9)

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Overall experiences and progress of children and young people: outstanding

The children and young people receive exceptional levels of care and support that meet their needs. Individualised care is evident, which positively affects the children’s and young people’s outstanding outcomes. Their day-to-day experiences are meaningful and productive, which enhances their lives. All the children and young people have progressed from their starting point, and they continue to thrive and flourish.

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Overall experiences and progress of children and young people: outstanding

A parent said: ‘This home is amazing, I cannot find fault. We have a happy family and happy [Name]. His quality of life has changed and is so much better. He gets out a lot more and he is very settled. The home has a lovely feel about it. [Name] is really well supported and very relaxed. We could not want any more for him. It is the best thing that ever happened.’

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Overall experiences and progress of children and young people: outstanding

The staff team nurtures trusting bonds with the children and young people. The members of staff are patient and kind, and they understand that some children and young people who have an autistic spectrum disorder will struggle to understand social interactions. With gentle persistence and a consistent approach, the staff guide and encourage the children and young people to gain confidence in themselves and those people who are close to them. From these interactions, positive relationships develop.

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Overall experiences and progress of children and young people: outstanding

An independent reviewing officer said: ‘Since [Name] moved into the home he has made so much progress. The manager and his key worker are great. [Name’s] social skills are so much better, and his behaviour is very much improved, which is great. I have watched [Name] with the staff at the home, and he has very good relationships there.’

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Overall experiences and progress of children and young people: outstanding

Educational outcomes are exemplary. The children and young people enjoy school and they have 100% attendance. They are meeting their educational targets and expectations, and they have positive interactions with their peers. A key driver to the children and young people achieving is excellent partnership working between the staff at the home and the staff at the school. Regular communication provides high levels of Inspection report children’s home: SC446957 6 consistency and continuity, which are vital to maintaining the children’s and young people’s routines. The staff meet regularly to share good practice and to ensure that they are all following individual care plans and management plans. This dynamic, professional approach significantly increases the children’s and young people’s successes.

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Overall experiences and progress of children and young people: outstanding

A teacher said: ‘I think this is a really good home. The communication is good and we have good partnership working. The staff fully take on board what we say, and how we work with [Name]. We have a communication book that goes between the home and the school, and we all monitor [Name’s] behaviours. We share information and meet about every six weeks. I can see [Name] has progressed since he moved to the home, and he is a lot more settled. Overall, I cannot fault them. All of the staff at the school feel that being at the home is having a very positive effect on [Name].’

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Overall experiences and progress of children and young people: outstanding

The children and young people are healthy and their healthcare needs are exceedingly well met. The registered manager oversees the children’s and young people’s health and development needs, particularly when complex healthcare needs are present. She has a very good overall knowledge of health issues specifically linked to children and young people with autistic spectrum disorder, and she has used her knowledge and experience to instigate new healthcare investigations to ensure that the children and young people receive the best care possible. This has resulted in some excellent outcomes. For example, two young people are now medication free after needing a range of medications over a prolonged period and another young person has had new treatments to help them with their diet.

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Overall experiences and progress of children and young people: outstanding

The children and young people take part in a wide range of activities that increases their socialisation and involves them in their local community. The staff are very keen to encourage the children’s and young people’s wishes and their aspirations. Group and individual activities are very much part of the home’s daily routine and all the children and young people enthusiastically participate.

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Overall experiences and progress of children and young people: outstanding

A parent said: ‘Everything is good. [Name] is much calmer since he moved to the home. It was becoming very difficult to look after him at home, but now he has plenty of supervision and he is happy. He goes on lots of activities that he loves. We could not manage this at home. This is a good place and all the staff are polite and friendly.’

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Overall experiences and progress of children and young people: outstanding

The support offered to parents and families is outstanding. The staff go over and above to consult with and involve families, which is very much appreciated and valued by parents and other family members. Support for family contact is excellent. The staff are committed to maintaining family relationships, which ensures that the children and young people continue to have strong familial bonds. The support involves practical help, including providing transport and supervising contact, and emotional support that helps parents come to terms with the difficult decisions they are faced with when they can no longer look after their children in their own home.

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Overall experiences and progress of children and young people: outstanding

An independent reviewing officer said: ‘A particular strength of the home is the support that they have given [Name’s] family. They have been very understanding with the Inspection report children’s home: SC446957 7 parents who have struggled to come to terms with [Name] coming into care.’

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Overall experiences and progress of children and young people: outstanding

A parent said: ‘The staff are there when you need them. They come to my home with [Name], and they will stay if they are needed. I feel like I have known them for years, they are like part of the family.’

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Overall experiences and progress of children and young people: outstanding

There are strengths and weaknesses in the transition arrangements for young people moving into adulthood. The staff support the children and young people, from an early age, to develop their independence skills, with some good and some outstanding outcomes. Additionally, the registered manager is involved in helping with practical arrangements, including looking at suitable adult placements. However, a young person who is currently in their transitional period has not had a suitable pathway plan, which should have been implemented on her 16th birthday. The impact on the young person is minimal because she will remain accommodated for another year, which will give her current social worker time to implement an adult transition care plan. A failure to ensure that young people have an agreed pathway plan potentially compromises a smooth transition into adulthood.

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Overall experiences and progress of children and young people: outstanding

A parent said: ‘[Name] is doing really well and is growing up and becoming more independent. I am anxious that [Name] will be moving out soon, and I have spoken to the social worker about this. [Name, registered manager] is supporting me. So I will see how it goes.’

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How well children and young people are helped and protected: good

The children and young people are safe, and they live in a safe environment. The staff are skilled in managing known risks, and high staffing levels ensure that the children and young people are suitably observed and supervised. Individual risk assessments are highly personalised, which is important because the children and young people are especially vulnerable. There have been no incidents of children or young people going missing, and none are at risk from sexual exploitation or radicalisation.

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How well children and young people are helped and protected: good

The staff receive regular child protection training and they know what to do if they have any safeguarding concerns. This keeps the children and young people safe. The registered manager has close links with a local advocacy service, and she actively seeks the support of an advocate if she feels that a child or young person is at risk of having their rights compromised. This highly promotes their equality and diversity. There have been no child protection referrals since the last inspection.

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How well children and young people are helped and protected: good

Behaviour is managed effectively and positively. Comprehensive behaviour management assessments are carried out by a suitable qualified person to ensure that the children and young people receive consistently high levels of support. Staff who have received behaviour management training at an advanced level support the staff in the home and they oversee the behaviour management plans to ensure that they are current and relevant. This professional approach is producing very good results. The children and young people who have previously experienced high levels of challenging behaviours, which are linked to feelings of distress because of their autistic spectrum disorder, have Inspection report children’s home: SC446957 8 significantly settled since they moved into the home. This is very good progress.

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How well children and young people are helped and protected: good

A family member said: ‘This is a really special place, it is fabulous. [Name] has gone from being an unhappy, confused and sometimes aggressive child to become a lovely young person.’

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How well children and young people are helped and protected: good

Restraints are rarely used and they are only considered as a last resort. The staff are very skilled in using de-escalation techniques to avoid a physical intervention. This reduces causing undue stress and anxiety that may arise from being physically held or restricted. Each child’s and young person’s behaviour management plan sets out de- escalation strategies that are individual to them, which increases the likelihood that their behaviour can be managed calmly, and in line with their needs and their level of understanding.

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How well children and young people are helped and protected: good

The staff complete a number of records following each restraint. Some of these are statutory documents, which are required by regulation, and some are additional records that are used by the provider to collect a range of data and statistics. Overall, the documentation provides a full picture of each event to show that each restraint was appropriate. However, the statutory records in the form of a ‘restraint log’ do not fully include the required information. A failure to include all the necessary information in the correct log potentially leaves the children and young people vulnerable should there be a future investigation into restraint practice in the home.

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How well children and young people are helped and protected: good

The children and young people live in a homely environment that meets their needs. Regular health and safety and fire safety checks reduce environmental hazards. A well- planned maintenance schedule ensures that all the utilities are safe and in good working order, and that the interior and exterior of the home are in good repair. However, there are a number of large refuse bins on the front drive of the home. This looks unsightly and it attracts attention because no other houses have their bins on display. Additionally, one of the bins, which is used to store clinical waste, is immediately noticeable because it is bright yellow; all the other bins used in the street are green. Having this bin open to public viewing compromises the children’s and young people’s privacy and dignity.

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The effectiveness of leaders and managers: good

The registered manager has been in post since April 2012. She has the right qualifications, skills and experience to undertake her role. Her knowledge of how having an autistic spectrum disorder affects children and young people is very good, and she actively uses this knowledge to improve the children’s and young people’s outstanding outcomes.

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The effectiveness of leaders and managers: good

The registered manager is supported by an experienced assistant manager who is committed to improving the home. Together, they form a strong management team that strive to enhance the children’s and young people’s quality of life. The managers and the staff have high aspirations for the children and young people and they consistently focus on the individuality of each child and young person. Inspection report children’s home: SC446957 9 The statement of purpose clearly sets out the home’s aims and objectives. This provides good information for parents, social workers and placing authorities who seek an appropriate placement for children and young people. The information for children and young people about how it is to live in the home is written in a variety of formats. This includes all children and young people, whatever their level of understanding and comprehension.

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The effectiveness of leaders and managers: good

The managers have a very good overview of the children and young people to ensure that their needs are met, and that they receive purposeful support. Consultation with the young people contributes towards their ongoing care and development. All the children and young people experience a level of communication difficulty, which potentially affects how they are able to share their views, wishes and aspirations. The managers and the staff endeavour to include all the children and young people within their limits and capabilities by using a wide range of communication aids. This gives the children and young people a voice in making decisions.

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The effectiveness of leaders and managers: good

There has been a significant turnover of staff in the last 12 months, which has affected continuity and consistency. A core group of experienced and qualified staff has worked flexibly to reduce the impact that staff changes have on children and young people, which are more prevalent for those who have a learning disability and an autistic spectrum disorder. The commitment that these staff have shown over this difficult period is commendable.

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The effectiveness of leaders and managers: good

A member of staff said: ‘Things are a lot better. Last Christmas we were using a lot of agency staff. This is not the case now. We are covering the shifts now without any problem. The team are great, and the young people are lovely. All the young people are doing great and they are happy, that is the main thing.’

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The effectiveness of leaders and managers: good

The registered manager and the provider have worked hard to recruit suitable staff but there have been past difficulties attracting the right people to apply for a job at the home. However, a recent recruitment drive has proved successful and new staff have commenced employment.

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The effectiveness of leaders and managers: good

The new staff are at various stages of progression from their induction to their probationary period and to attaining a full-time contract. However, there is no workforce plan that stipulates the timescales for the staff to achieve each stage of their induction, statutory training, or their ongoing professional development. Consequently, there have been some delays in the staff starting their level 3 mandatory children’s and young people’s qualification. Moreover, one member of staff has not attained their qualification within the required timescales. A lack of specific workforce planning potentially affects the home failing to meet regulation for staffing adequacy.

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The effectiveness of leaders and managers: good

All leavers receive an exit interview that is carried out by the registered manager, and the outcomes from these meetings are sent to and stored with the provider’s human resources department. There are no records available to show that the registered person, or the independent visitor, has monitored or analysed the information gained to check for any trends or patterns as to why there has been a higher than normal staff Inspection report children’s home: SC446957 10 turnover. This is a missed opportunity to gather data, which could prevent further staff from leaving the home.

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The effectiveness of leaders and managers: good

There are strengths in the home’s monitoring that drive improvement. The independent visitor has developed her skills to improve her reports, and the registered manager has a very good oversight of the home’s strengths and weaknesses. The home’s development plan is routinely reviewed to make sure that identified actions are met. However, the monitoring has failed to address some shortfalls in the staff rotas. The current rotas do not record the full names or the designation of the staff, including the registered and assistant manager; the persons in charge of the home in the absence of the manager are not identified. This lack of detail and accuracy could potentially affect future enquiries or investigations.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC446957 11

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Children’s home details

Registered provider: North East Autism Society

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Children’s home details

Registered provider address: North East Autism Society, 15 Lumley Court, Drum Industrial Estate, Chester-Le-Street, County Durham DH2 1AN

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Inspector:

Debbie White, social care inspector Inspection report children’s home: SC446957 12 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector:

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Inspector:

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Inspector:

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