Break-away

Break-away Inspection report for residential holiday schemes for disabled children

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Unique reference number 1027081 Inspection date 17/08/2015 Inspector Fiona Littlefield Type of inspection Full

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Registered person Break Registered manager Victoria Smith Responsible individual Hilary Richards Date of last inspection 24/10/2014 Inspection Report Break-away, 17/08/2015 Page 2 of 9

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated. Inspection Report Break-away, 17/08/2015 Page 3 of 9

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Brief description of the service

The residential holiday scheme for disabled children provides a holiday for up to ten young people, for two nights during school holidays or weekends. The scheme is run specifically for children and young people who may have complex needs, including learning and physical disability and related health needs. Referrals are made either through Activities Unlimited or through Suffolk County Council Children’s Services.

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The inspection judgements:

 Outstanding  Good  Requires improvement  Inadequate

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The overall experiences of children and young people

The overall experiences of children and young people is judged to be Good Young people benefit from attending the holiday scheme because they are looked after by staff who know their needs and vulnerabilities well. The Registered Manager said: ‘I want this to give them confidence to come again, to have fun and to get on well together.’ For instance, when young people arrive, staff take the time to settle them in quietly before arranging an activity, such as a walk on the beach. As a result, young people have time to take stock and get used to new surroundings. They are able to relax with staff before the break begins in earnest.

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The overall experiences of children and young people

Young people have the opportunity to participate in a range of activities, including water sports, walking, horse riding, crabbing by the beach or simply being out and having an ice cream. If the weather does not allow outside activities, imaginative and inventive games are played inside. For instance, young people were encouraged have put on an impromptu pantomime in front of an audience of other young people and staff. The performance was very funny including one member of staff allowing himself to be taken hostage for a reward.

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The overall experiences of children and young people

Staff promote a sense of fun and creativity and approach any possible limitation as a challenge to be overcome. Young people’s privacy and dignity are promoted through careful planning, an awareness of risks and a focus on enjoyment. Consequently, they gain confidence from new experiences. Inspection Report Break-away, 17/08/2015 Page 4 of 9

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The overall experiences of children and young people

Some young people prefer quiet time with an individual adult. Staff are skilled at reassuring young people and making sure that everyone is noticed and appreciated. Quiet activities include mini-spa breaks where the girls get their nails painted, while others read or play games on the computer. Settling down time at night is carefully observed so the young people remain calm and relaxed.

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The overall experiences of children and young people

Staff help young people develop relationships with one another by encouraging them to look out for each other, share a table at mealtimes and play games together. For some young people who have never slept away from home, this is striking progress and shows in their confidence and willingness to come back for another break.

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The overall experiences of children and young people

Parents of young people are complimentary about the scheme. They appreciate that staff recognise that their own needs for a break are legitimate. Staff recognise the central importance of the young person’s relationship with their families and take every opportunity to establish a relationship of trust and confidence. Families receive regular updates throughout the break to keep them informed of progress. At the end of the holiday, they also receive a summary of the young person’s activities. The mother of one young person said: ‘I know that she has had a good time because she is so relaxed and smiling.’

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendations:  ensure that all records are legible, clearly expressed, non-stigmatising and distinguish as far as possible between fact, opinion and third party information. This is with particular reference to risk assessments for young people (NMS 15.4)  ensure that there is a system in place to monitor quality and adequacy of record keeping and take action when needed. This is with particular reference to maintaining full and up to date records on young people attending the scheme. (NMS 15.1) Inspection Report Break-away, 17/08/2015 Page 5 of 9

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protected

The service is Good at helping and protecting children and young people. Staff regard the safety of young people as paramount. Young people who attend the holiday scheme have very complex behaviours and as a result, they do not understand the concept of safety themselves, so staff work intensively to protect them.

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protected

They achieve this through very careful and rigorous preparation. Following a referral to the scheme, staff visit young people and their parents at home to meet them and have a detailed discussion about the holiday. This core activity provides the basis for planning. Staff identify risks and vulnerabilities alongside learning objectives, activities that the young person enjoys and contact with family. The carer for one young person said: ‘I am confident that they can manage him. It’s very important to me as I want to access this service.’ This organised and integrated approach means that young people feel secure.

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Staff meet together as a group before the break begins to review the details of the young people and to make sure that they know and plan for their medication and dietary needs. Young people are safe because of this rigorous approach. The scheme has robust and effective systems for managing, administering and recording medication. Some young people have complex health needs and staff have detailed knowledge of a young person’s medical needs following the initial home visit. This will include contact details of their medical practitioner should further medical advice be necessary.

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Staff show a good awareness of robust safeguarding policies and procedures. They have all received training in child protection training and are confident that if a young person raised a child protection issue, that they would know how to respond appropriately. Staff have also recently been trained in anti-bullying awareness, including internet abuse, and are alert to the possible dangers for young people in their care.

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All risk assessments emphasise the need for planning ahead and constant vigilance. Incidents of young people going missing are extremely rare and for many young people this has not occurred at all. Staff have not needed to make formal contact with the local safeguarding board or the police. The Local Authority Designated Officer confirmed that there have not been any concerns raised.

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protected

Young people receive good quality care and support. Staff want them to make progress in their learning objectives, but also to enjoy themselves and are imaginative and purposeful in helping them develop independence skills. For instance, staff suggested that one young person could help with food preparation, Inspection Report Break-away, 17/08/2015 Page 6 of 9

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protected

including making drinks for visitors. He was delighted and this had a very positive effect on his self-esteem.

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Staff are skilled and empathetic in helping young people feel part of the group through activities, such as plaiting their hair or playing on the computer with them. They also help young people develop confidence in social situations by partnering them with someone else in the group. The mother of one young person said: ‘she didn’t like to leave me but they encouraged her and she has grown in self- confidence.’

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The manager and staff are careful that the needs of the individuals in the group are compatible and that they can get along as a group. Young people are on holiday and want to enjoy the break. They behave well generally and do not want to miss out on any activity. On occasion, their behaviour may become challenging but staff are effective in managing these situations. Individual care plans give guidance to staff as to how to respond. Staff work to reassure a young person by offering a positive choice and there is an emphasis on distraction and de- escalation. Incidents of restraint are extremely rare and effective plans are in place to manage this.

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The holiday scheme takes place in a building that offers ample room for exuberant young people to let off steam and enjoy themselves. There are comfortable areas for relaxing and watching TV and other areas where the whole group can have a meal together. The number of bedrooms is limited so that young people have to share. Staff have planned for this and on occasion they have been able to use this positively. One young person, who had been assessed as needing a room on his own, invited some others to share the room. This proved very successful and an unexpected achievement for the young person.

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protected

The gardens have extensive room for games and are near to the beach. This adds to the sense of space and freedom which young people clearly enjoyed.

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The effectiveness of leaders and managers

The effectiveness of leaders and managers is Good

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The effectiveness of leaders and managers

The Registered Manager is suitably qualified and has extensive relevant experience for this work. The majority of the staff team are qualified at NVQ Level 3 with plans for remaining staff to be enrolled on training. This reflects a high level of professional achievement in this staff group.

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The effectiveness of leaders and managers

The scheme’s statement of purpose is very clear and in line with regulation. The focus is to provide a warm stable environment for young people but recognises that families also need support. This empathetic and insightful approach is important for families and staff who work with them. Inspection Report Break-away, 17/08/2015 Page 7 of 9

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The effectiveness of leaders and managers

The Registered Manager is committed and passionate about the scheme and provides effective management for the team. They speak very highly of her drive and resilience. They work well as a team, roles and responsibilities are shared and they respect one another’s skills. There is a sense of purpose and shared responsibility with an emphasis on the need for accurate up-to-date information about the young people and constant vigilance to ensure that the young people remain safe. The staff group is consistent throughout the break so young people benefit from getting to know the same people. Staff have confidence in their ability to manage different situations. As a result, they are ambitious and encourage young people to persist with new goals including personal care or helping with domestic chores. This has a marked impression on the self-esteem of some young people.

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The effectiveness of leaders and managers

The Registered Manager and staff consistently review the service to identify strengths and possible areas for improvement. Young people are supported to feedback using a variety of tools, including visual aids while the managers and staff speak to parents, social workers and schools. One social worker said that they were successful because: it ‘really mattered to them that the young people had a good break.’

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The effectiveness of leaders and managers

The Registered Manager has regular meetings with representatives from commissioning teams to review the schemes. She has recently started to arrange a professionals meeting with social workers and schools to discuss improving the service. This thorough and enthusiastic approach has been noted by external agencies, one of whom commented: ‘they believe in adding value. Parents have often commented that young people come back being able to do something that they couldn’t before.’

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The effectiveness of leaders and managers

The Registered Manager provides a regular monthly report to senior managers in organisation. This provides feedback on recent themed breaks, comments on the how young people have made progress and comments on staff recruitment and development.

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The effectiveness of leaders and managers

Staff and managers have a very positive attitude to training and confirm that the organisation offers a comprehensive programme of training. Staff receive robust mandatory training which is regularly updated and additional specialist training is available. Staff receive regular supervision and emphasise that managerial support is always available.

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The effectiveness of leaders and managers

Young people’s records all include an up-to-date risk assessment and management plan. However these plans do not indicate who has contributed to the discussion and as a result, it is not clear how comprehensive the assessment may be. There are some gaps in recording and some incidents of misfiling of risk assessments. These do not constitute an ongoing risk to young people. However, there is a need for increased levels of managerial scrutiny of records and files to ensure that any shortfalls are addressed. The Registered Manager is aware of this and is Inspection Report Break-away, 17/08/2015 Page 8 of 9

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The effectiveness of leaders and managers

addressing this with senior manager in the organisation as a matter of urgency.

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children and young people

The effectiveness of leaders and managers is Good at working in partnership to improve outcomes for children and young people.

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children and young people

Young people, their families’ social workers and external professionals are all extremely positive about the scheme. The carer for one young person described staff as ‘brilliant’, while a professional said that they were always ‘prepared to go the extra mile’. Staff respond to young people and their families confidently and with sensitivity. The initial robust assessment meetings are crucial in establishing relationships and confidence. Parents feel that the staff know what to expect and can manage. They also appreciate that their own needs for a break are respected.

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children and young people

Commissioners are complimentary about the scheme. They visit the schemes in operation and meet with provider every six weeks to review the service. This confirms a dynamic partnership between the scheme and statutory partners.

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children and young people

The Registered Manager has not been able to agree formally the protocol for missing young people with the Police. She has made strenuous efforts to achieve this but has not been successful. This matter is being taken up as a matter of urgency by her senior managers. However this does not negatively affect the safety and well-being of young people.

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children and young people

Managers have a good awareness of local facilities and this has led to some imaginative projects. For instance, the Registered Manager has recently made contact with a local community voluntary drama and music group. The plan is to take the young people to the group where staff from the group will work with them to put on a production together. This is especially encouraging, as young people have demonstrated how they enjoy creative activities and how their confidence improves through being able to participate in new experiences. Inspection Report Break-away, 17/08/2015 Page 9 of 9

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About this inspection

The purpose of this inspection is to inform children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The 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 relevant regulations and meets the national minimum standards. The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made againstResidential holiday schemes for disabled children: The inspection framework, evaluation schedule and grade descriptors.

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