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

Inspection report children’s home: SC055780 1 SC055780 Registered provider: Autism Initiatives (UK) Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately run children’s home can accommodate up to eight young people who have autism.

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Information about this children’s home

Inspection dates: 14 to 15 November 2017

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Overall experiences and progress of

children and young people, taking into account

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Good

How well children and young people are helped and protected Good

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Good

The effectiveness of leaders and managers Good

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Good

The children’s home provides effective services that meet the requirements for good.

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Good

Overall judgement at last inspection: Improved effectiveness

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Good

Enforcement action since last inspection: None

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Key findings from this inspection

 Young people are making good progress in their school, health, social development and independence.  The staff team is working closely with healthcare professionals to review and monitor young people’s medication. Inspection report children’s home: SC055780 2  The staff team has close working partnerships with a variety of professionals. This means that young people receive individualised care.  Members of staff know and celebrate each young person’s uniqueness. As a result, each young person’s preferred communication style is well known and understood, which means that young people can express their views and opinions in the knowledge that they are heard.  The manager uses research articles well. This means that the staff team’s practice is underpinned and informed by new developments.  The registered manager is very experienced and qualified. There is a long- standing core group of staff. This means that a staff team that knows them well

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Key findings from this inspection

cares for young people.  Parents and professionals are extremely complimentary about the care that young people receive at this home.

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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

 Risk assessments are variable. Some risk assessments lack clarity on the strategies implemented and the action that members of staff need to take, if an incident was to occur. Further to this, some members of staff have not read and signed the risk assessments. This does not ensure consistency when caring for young people.  There are transition plans for moving in and out of the home. However, the limited information does not allow the registered manager to reflect on the experiences of young people and to adapt plans to account for any lessons learned that could inform future transitions. In addition to this, the home’s current location risk assessment was not taken into account when considering the new referral.  Some visitors have not signed out of the home. This does not ensure that everyone is safeguarded effectively.  Regulation reports are not evaluative. Therefore, they have not identified some

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Key findings from this inspection

of the shortfalls raised in this report.

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Inspection date Inspection type Inspection judgement

29/03/2017 Interim Improved effectiveness 14/12/2016 Full Outstanding 16/03/2016 Interim Improved effectiveness 09/12/2015 Full Outstanding Inspection report children’s home: SC055780 3

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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, 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 protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure that staff— assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. (Regulation 12 (1) and (2)(a)(i)) This is in relation to ensuring that agreed strategies and actions are identified to give continuity of care to young people. 31/01/2018

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Recommendations

 Ensure that the independent person makes a rigorous and impartial assessment of the home’s arrangements (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5). This is specifically in relation to evaluating the quality of the records maintained by the home.  Ensure that case records are signed and dated by the author of each entry (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.3). This includes ensuring that the manager and staff have signed essential documentation.  Ensure that there are procedures in place for welcoming and introducing each child to the home, as well as support for children to move from the home effectively (‘Guide to the children’s homes regulations including the quality standards’, page 57, paragraphs 11.7 and 11.9). This is specifically in relation to identifying whether the steps outlined in their transition plans were completed,

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Recommendations

whether the moves were successful and whether any lessons were learned to inform future practice.  The registered person should review the appropriateness and suitability of the location and premises of the home at least once a year (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.1). In particular, the registered person must ensure that they consider the location Inspection report children’s home: SC055780 4 review when completing impact risk assessments on new admissions to the home.  The registered person should build a strong safeguarding culture in the home (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.8). This is specifically in relation to ensuring that all visitors sign out of the home.

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Overall experiences and progress of children and young people: good

This home provides good-quality care to young people who have autism. All of the young people have different communication skills and different thought processes. For example, some young people can communicate verbally and others use different pictorial aids, or a combination of the two. To assist visitors to the home, the manager has introduced a small laminated card that provides useful information on each young person’s communication preferences, their daily routine and things not to do. For example, if one young person says ‘go’, then this means that they are becoming anxious. Due to this excellent system, the inspector was able to communicate and spend time with the young people.

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Overall experiences and progress of children and young people: good

Young people said or indicated that they were happy and safe, and that members of staff were ‘great’. One young person gave a thumbs up and one young person said, ‘I love it here.’ A parent said, ‘He is doing so well and does not want to leave. The care he receives is exceptional.’ A professional said, ‘He is a different child. He is happy, engages well and there has been a reduction in his anxiety levels.’ As a result, the young people are making significant progress in all areas of their lives.

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Overall experiences and progress of children and young people: good

Most of the young people have been living at this home for a significant period. There has been one new admission and one young person has moved to an adult service. The transition plans for the young people only give a list of visits to the home or to a new service and for going out shopping for essential items. The plans do not say how the visit went, whether arrangements had to be rescheduled, whether there were any difficulties in executing the plan or whether there are any contingency plans if things go wrong. This does not help the manager to reflect on the experiences of young people and to adapt plans to account for any lessons learned that could inform future transitions. In addition to this, the manager did not take into account the home’s current location risk assessment when considering the new referral. Having said this, both moves have been successful.

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Overall experiences and progress of children and young people: good

The home has all the necessary local authority documentation for the young people in order to care for them well. However, the social worker, manager and members of staff have not signed some documents. For example, the manager has not signed the service summary. This does not ensure that all parties are in agreement with the plan. In contrast to this, the manager makes sure that reviews of care are completed on time and that regular meetings are scheduled if any issue becomes a concern. The staff team Inspection report children’s home: SC055780 5 keeps parents and professionals updated through regular telephone calls and reports. This is reflected in comments from parents and professionals. A professional said, ‘Communication between us is fantastic.’ A parent said, ‘The staff do not just keep me informed when things have gone wrong but when he is doing well. This gives a balanced view of how he has been.’

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Overall experiences and progress of children and young people: good

Most of the young people attend the company’s school. Young people receive individual support and a curriculum that is specifically designed to meet their individual needs. Young people have excellent attendance and they are making good progress. Educational meetings included teachers, speech therapists and healthcare professionals. The staff team works closely with these people so that any changes in routines or behaviour management for young people are shared. The headteacher said, ‘A particular strength this year has been the link between the home and the speech therapists. They have worked closely together to develop communication aids.’ This consistent and joint working was recognised and praised in a young person’s education review.

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Overall experiences and progress of children and young people: good

All of the young people are in good health. Members of staff are trained in administering medication and in first aid. This means that young people receive their medication in line with their prescription and small accidents can be treated. One young person has been struggling due to a medication change. His mother said, ‘It is at times like this that you really get to see and know the home. Staff are fantastic and I cannot thank them enough.’ A professional said, ‘They should be commended for their close links with medical services and their tenacity in ensuring that young people receive timely and appropriate support.’ Members of staff show respect, ensure privacy and provide dignity to young people who require help with their personal care. Young people are prompted and encouraged to wash, shower and take pride in their appearance. As a result, some young people need less help. Other young people enjoy having their hair done, having

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Overall experiences and progress of children and young people: good

pamper nights and buying new clothes. This helps with their independence and builds confidence and self-esteem.

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Overall experiences and progress of children and young people: good

In the summer, the young people took part in a social enterprise scheme called ‘We grow’. This was a garden project that included growing and trying new types of vegetables, taking part in nature treasure hunts and building tents in the wild. Young people brought potatoes back to the home to cook, made vegetable kebabs and grew their own strawberries. In addition to this, the young people have been involved in a local authority’s initiative in completing more exercise. It is called the ‘10 minutes shake up’. The young people have been walking to school, dancing and doing general exercises. Each young person has a book with their own ideas about how they can be more active. These projects have helped young people to be healthier. Further to this, the deputy manager has devised a new health plan format. This has assisted staff to have information around young people’s health; it clearly identifies each aspect of their

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Overall experiences and progress of children and young people: good

health and any further actions necessary to secure good health outcomes. Other professionals have asked for this format because they have found them useful. This means that the home is assisting others to improve.

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Overall experiences and progress of children and young people: good

Young people enjoy a range of activities and experiences. One young person wanted to attend a pop concert. Previously, it was thought that her anxiety levels would stop her Inspection report children’s home: SC055780 6 from being able to experience this kind of event. However, the manager identified an outdoor venue and meticulous planning meant that she was able to attend. The young person said, ‘It was brilliant. I want to do it again.’ A healthcare professional identified that one young person lacked upper body strength. The young person now goes boxing. She has received two trophies for her efforts and her fitness is improving. Other young people like to go horse riding, swimming, for walks or enjoy sensory play. This means that young people have a range of opportunities to engage in the local community. One young person has made a friend in school. Members of staff have encouraged this relationship through telephone calls and social media. They have now been out on an

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Overall experiences and progress of children and young people: good

activity together. This helps young people to make and sustain friendships.

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Overall experiences and progress of children and young people: good

Young people have not made any complaints. They said or indicated that they were confident to raise a concern and that members of staff would take it seriously. An advocate who visits regularly supports most of the young people. One advocate said that the young person is given several contact numbers to help them to raise an issue if necessary. This means that young people have someone independent from the home to talk to.

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Overall experiences and progress of children and young people: good

The young people have different arrangements for seeing their parents. Some see their parents every weekend, while others see them in school holidays. These details are highlighted within their placement plans, which means that members of staff know the arrangements and can prepare young people well for these visits.

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Overall experiences and progress of children and young people: good

An outstanding area of practice is the charity events that young people are involved in. They have helped to raise money for the home by having quiz evenings and garden parties. Some young people have baked cakes to sell at these events. As a result, the young people chose a new trampoline, a swing and bike and rower outdoor exercise equipment. This shows that young people are involved in the development of their home and see the results of their hard work. They are currently working with a local boxing club for their next project. It is hoped that other charities will benefit from this event.

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Overall experiences and progress of children and young people: good

Young people live in a large home that provides plenty of space and shows the individual personalities of each young person. Young people keep certificates of achievements, trophies and photographs in their bedrooms. This gives them a sense of belonging. The home employs a cook, a maintenance person and a domestic person. This means that the home is maintained well and that members of staff can concentrate on the young people.

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

Young people said or indicated that they were happy and safe at this home. There is a lot of space and rooms in this home. Therefore, when young people are unsettled they can access different sensory or playrooms. This means that any negative behaviour does not impinge on the others at the home. All of the young people receive one-to-one or higher levels of support. They are supervised fully and know at the beginning of each shift who will be caring for them. This means that they are safe in the home, at school and in the community. Inspection report children’s home: SC055780 7 The safeguarding officer from the local authority said that this home was good at sharing information, raising concerns and following procedures. Members of staff receive regular training in protecting young people. This includes training on safeguarding, around child sexual exploitation, radicalisation and e-safety. In addition to this, staff’s

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

understanding is periodically checked about the home’s policies and procedures. Therefore, members of staff are confident in carrying out their roles and responsibilities. For example, there have been two occasions when members of staff have used the whistleblowing policy. This is because they were concerned about members of staff’s behaviour. This led to one member of staff being dismissed and one incident is currently being investigated. The safeguarding officer said, ‘The home works well alongside me to manage any allegation and they take appropriate action.’ As a result, young people are safeguarded effectively.

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

Young people have not been reported missing from this home. Good individual protocols show the young people’s vulnerabilities if they were missing. They clearly identify the level of risk, action for staff to take and who should be contacted, if an incident was to occur. This further protects young people.

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

Young people have been held for their safety or for the safety of others. The records clearly identify why the intervention was necessary, who was involved and the outcome. The manager oversees the records effectively. This means that she can identify any patterns or trends. Young people do not understand the concept of sanctions. Therefore, they are not used. However, young people are rewarded when they do well. For example, three young people entered an art competition in the county. All of them were placed in the top four awards. The home has bought them more art materials to encourage their talents and to celebrate these achievements.

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

Young people express their emotions and anxieties in different ways. This sometimes results in negative behaviours. Risk assessments are variable in quality. This is because some risk assessments do not have any agreed strategies to reduce the risk or any actions for staff to take to minimise the risk. For example, one young person has been risk assessed for his physical aggression towards others. There are no strategies to defuse the situation or divert the young person and the stipulated action for staff to take is to supervise him. The lack of strategies and actions to take does not show that staff take a consistent approach, if an incident was to occur. In contrast to this, the staff team has the ability to turn a negative behaviour into a positive one. For example, one young person liked to set off the fire alarms. Work was completed with her around safety issues and the reason for fire alarms. She was then given the responsibility to sound the

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

alarm when there are new members of staff or visitors to the home. She has taken this responsibility seriously and takes pride in doing this.

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

A stable core staff team cares for young people. There have been seven new staff since the home’s last inspection. The company follows the safer recruitment guidance. For example, it checks any gaps in employment history and it verifies references. New staff complete an induction period, complete all mandatory training and have to pass a six- month probationary period. In this time, they are supported by a named mentor and Inspection report children’s home: SC055780 8 receive additional supervision. This means, as far as possible, young people are cared for by members of staff who are supported well in their role.

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

All appliances and insurance certificates are updated regularly. Members of staff, young people and visitors are taken through the fire evacuation procedure. This means that everyone knows what to do in an emergency. However, not all visitors have signed out of the home. This does not safeguard young people fully.

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The effectiveness of leaders and managers: good

The manager was registered with Ofsted in 2010. Before this, she was a head of care for a residential service. She is suitably qualified. This means that she has the experience and skills to manage this home effectively. Two deputy managers support her in her role. There is a large, stable core staff team of 22 members of staff, plus seven new members of staff. A full-time secretary has been working at the home for a number of years. All members of staff describe the manager as fair, supportive, approachable and child-focused.

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The effectiveness of leaders and managers: good

The home’s statement of purpose reflects the ethos of the home. It has all the necessary information for other services and local authorities to make an informed decision on whether the home can meet the individual needs of a young person. Professionals confirmed that they had received the statement of purpose. Parents and professionals said that the home works well with them collaboratively, and that communication from the home is excellent.

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The effectiveness of leaders and managers: good

Most of the staff team members have a suitable childcare qualification. The new members of staff have been registered on an equivalent qualification and are at varying stages of completion. A new development is that all new members of staff are assigned a senior mentor. The manager said that this gives older serving staff ownership, development opportunities and the ability to pass on their knowledge and skills. A new member of staff said, ‘It is great to be able to discuss things daily and not have to wait. This means that I am confident in my approaches with young people.’ All staff receive regular supervision and appraisals to support them in their roles. In addition to this, members of staff complete mandatory training and specific tailored training, such as autism awareness. This means that a well-qualified and supported staff team cares for young people.

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The effectiveness of leaders and managers: good

Staff are motivated to review and improve their practice. They have researched the local authorities and the government’s priorities for the year. For example, obesity is high on the agenda from both services. Therefore, they have been involved in the ‘We grow’ and ‘Ten minute shake up’ projects to encourage young people to be healthier. They have gained leaflets from the local safeguarding board that tell members of staff, young people and parents how allegations are investigated and where they can find external support. They are also using the local authorities ‘7 minute briefing’. This tool can be used to understand the difficulties in getting clear responses from young people with communication difficulties. In addition to this, they regularly explore Ofsted’s twitter account for supporting information. These practice issues are discussed in staff Inspection report children’s home: SC055780 9 meetings. This gives the staff team the opportunity to discuss how the information helps

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The effectiveness of leaders and managers: good

them to support young people and how they can incorporate them into the service. This shows that staff strive to improve the service that they give to young people.

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The effectiveness of leaders and managers: good

The manager has challenged several professionals successfully. For example, one young person’s psychiatrist retired and there was no handover to another psychiatrist. This meant that the young person’s high anxiety was not monitored effectively by a healthcare professional and this was challenged. A deputy manager attended a meeting with the placing authority to ensure that this did not happen again. As a result, an action plan was agreed that would benefit all service users. Another placing authority wanted to cease providing an independent advocate as the young person had a personal assistant. The manager challenged this because the local authority employs the personal assistant and therefore they were not independent. The local authority agreed and the advocate continues to support the young person. These practices show that the manager and staff team ensure that young people get the services that they require.

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The effectiveness of leaders and managers: good

The staff team uses innovative ways to capture the voice of the young person. A young person’s progress is recorded throughout the year and put on a DVD. The young person chooses the accompanying music that reflects their personality, as well as other content such as segments of photographs. These are shown at young people’s reviews and enables their wishes, feelings and views to be heard. The DVDs also act as a memory aid for the future. A professional said, ‘It brought me to tears. How wonderful and inventive.’

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The effectiveness of leaders and managers: good

The company has recently identified a new service to complete monthly independent visits. The reports from these visits are sent in a timely manner to Ofsted. However, the visitor has not identified that some documents are unsigned and that the risk assessments and transition plans require further information. This does not alert the manager to the shortfalls and help her to improve the service. The manager completes a six-monthly report about the service. It is detailed and she has identified areas for improvement and actions for the forthcoming months, such as the implementation of mentors for new staff. These good practices show that the home is striving to improve.

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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 and 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 Inspection report children’s home: SC055780 10 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: SC055780 11

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Autism Initiatives (UK)

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Children’s home details

Registered provider address: Sefton House, Bridle Road, Bootle, Merseyside L30 4XR

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Children’s home details

Responsible individual: Katharine Silver

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Inspector

Pam Nuckley: social care inspector Inspection report children’s home: SC055780 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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