Over the Wall

Residential holiday scheme for disabled children inspection

Name Over the Wall Inspection date 23/08/2016 Unique reference number 1027093 Registered provider Over The Wall

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Registered provider address

Langstone Technology Park, Havant, Hampshire PO9 1SA

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Registered provider address

Responsible individual Kevin Mathieson Registered manager Mark Dwyer Inspector Elaine Cray Inspection date 23/08/2016 Previous inspection judgement This is the holiday scheme’s first inspection.

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Outstanding

The residential holiday scheme provides highly effective services that consistently exceed the standards of good. The actions of the scheme, including provision of care, contribute to significantly improved outcomes for children and young people who need help, protection and care.

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outstanding because:

 There are excellent and inspirational opportunities for children and young people with complex medical needs to grow in confidence and self-belief.  Parents’ comments include, ‘It is a safe place to be without their illnesses dominating their lives. Somewhere they can just be a kid and have some fun’, and, ‘My son comes home a different child. I am flabbergasted.’  Children and young people are inspired by their experiences. They can better manage their illnesses, return year after year and are often inspired to become volunteers.  Relationships between children, young people and staff are extremely positive and enable individuals to blossom and shine. A parent said, ‘There is such a sense of tolerance and empathy. Not judgemental and they promote such a sense of equality. The team creates a little bit of magic.’  Consultation is strong and meaningful and empowers children and young people.  Children and young people receive excellent care due a team of

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outstanding because:

professionally trained and extremely motivated staff and volunteers. The recruitment manager said, ‘They are our super heroes.’  Exceptionally well-organised medical care gives a firm and essential foundation to the safeguarding of children and young people. They can have fun, make friends and enjoy an extensive range of activities, due to excellent management of their health and medical conditions. Parents’ comments include, ‘My child feels safe and feels accepted because the staff and volunteers have such a deep understanding of being unwell.’  Leadership is directive and supportive. Roles and responsibilities are consistently reinforced and monitored. The respectful, reciprocal and levelling rapport between support staff, team leaders, the medical team and volunteers creates an enabling environment where staff and campers prosper.  Leaders and volunteers are ambitious in their constant drive for

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outstanding because:

improvement. Research and practice in therapeutic recreation and behaviour empowerment are exceptional strengths and worthy of dissemination to other services.

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Statutory requirements

This section sets out the actions that must be taken so that the registered person/s meets the Care Standards Act 2000, Residential Holiday Schemes for Disabled Children (England) Regulations 2014 and the ‘National minimum standards for residential holiday schemes for disabled children 2013’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The registered provider must supply a copy of the report required to be made under paragraph (4)(c) to HMCI. (Regulation 29(5) (a)) 31/10/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation:

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Recommendations

 Ensure that information about individual children is recorded clearly and in a way which will be helpful to the child when they access their files now or in the future. This is with particular regard to dating discussions and subsequent updates with parents on children’s records. (NMS 15.5)

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children

This holiday scheme caters for up to 60 children and young people with chronic illness.

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Outstanding

Children, young people and parents have extremely positive views of the holiday scheme. Children’s and young people’s comments include, ‘Feel so good about myself.’ A parent said, ‘I do not hand over my children lightly but I know I can trust them. I have extraordinary trust in them.’ The activity-based holiday promotes a combination of feel-good factors and education for children and young people. The sense of achievement from trying new activities, such as canoeing, archery and climbing, boosts confidence. The activities enable children and young people to have more self-belief in their capabilities and to feel that they are not restricted by their illnesses. Sporting, dancing and musical activities enable young people to stretch their physical and creative boundaries. Discovery activities, such as finding Paddy the kidnapped bear, include using finger printing and testing theories and present scientific and research opportunities.

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Outstanding

Children and young people develop creative flair and a great sense of team spirit as they create displays to decorate their cabins. Themes include fairies, unicorns and Hawaii. The younger girls take delight in building a fairy grotto with trees that display all their aims and reflections for each day. Volunteers dressed as fairies create fun and magic. Children are astonished when they find magic fairy dust on their beds. These wonderful experiences enable children and young people to divert their attention from their medical conditions and to go on an endless journey of adventure. Most importantly, children and young people have a succession of opportunities to socialise and embrace the teamwork spirit that is so integral to the holiday scheme. Children make new friends and have an immense sense of acceptance and empathy. Children and young people receive outstanding care due an effective health and

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Outstanding

care planning framework. High levels of respect for the privacy and confidentiality of children and young people mean that information is only shared as required. For example, only medical staff have access to medical information. Volunteers have ‘hot sheets’ for each child and young person. Children and young people can relax as they are confident that volunteers can meet their day-to-day care needs regarding diet, personal hygiene and appropriate response to seizures. This clear demarcation of responsibilities frees up social interaction with the volunteers. Having fun, joining activities and developing excellent team spirit are the key focus for volunteers, children and young people. They know that their medical needs are safe in the hands of the medical team. Individuality shines through as children and young people are not defined by their illnesses or conditions. Calling the medical centre the ‘beach hut’ and doctors and nurses with

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Outstanding

face paints and in fancy dress, again, de-medicalises the holiday experience. Children and young people experience a strong sense of empowerment and self- determination. They have opportunities to highlight their experiences each day. Self-reflection at nightly ‘cabin chats’ enables children, young people and staff to internalise the positivity. Consistent use of the scheme’s mantra, ‘Spot it, Describe it, Praise it – celebrate success no matter how big or small’, ensures that everyone feels better about themselves and improves skills when they are interacting with others. Discovery boxes, displays and collecting ‘brilliance beads’ enable children and young people to capture their development and highlight their qualities. They are able to talk about, self-reflect and receive feedback about achievements. Taking home their own individual discovery box provides a keepsake to enable them to explore and continue all the positive experiences they have from the holiday. The

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Outstanding

box includes a contact list of friends, which helps combat some of the isolation that children and young people feel when managing chronic illness. The location of the holiday scheme is excellent. Accommodation is well maintained and good for small-group living. Wooden cabins provide small-group living where children and young people can make friends and get to know each. The activities centre provides a range of activity sites, including water sports, climbing, archery, sports’ hall and large rooms for indoor activities. The large communal dining room is a central hub for all the campers to come together to socialise and eat meals. The environment is able to meet the needs of children and young people who have physical disabilities. Mealtimes are a key part of the holiday. Children and young people enjoy a range of meals. Monitoring of catering arrangements is exceptional and promotes good health and safeguarding from any allergic reactions. Mealtimes also offer

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Outstanding

opportunities for all the groups to get together. Singing, chanting and setting different group challenges feed into a wonderful sense of camaraderie, fun and social interaction. Children and young people settle, and parents are quickly reassured, due to excellent admission and transition procedures. Robust and rigorous procedures, with integral involvement of the medical staff, ensure safe and smooth transition of children and young people to the holiday scheme. Staff are creative in helping children and young people to manage their homesickness, which is closely monitored with close liaison between staff and parents. A variety of techniques is used to divert campers from missing their families. The range of fun activities and close friendships normally address homesickness. However, leaders and volunteers place the child’s welfare in paramount importance, and children can be collected by parents if the holiday

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Outstanding

negatively impacts on their emotional well-being. Leaders and volunteers show great insight into the behavioural and communication needs of all children and young people. The positive ethos of encouragement, participation and celebration runs through the core of staff and volunteer practice. Strong boundaries and promoting positive options lead young people to make improvements in their behaviours and attitudes towards others. This helps to build their self-esteem and the quality of their relationships both on the holiday and when they return home. A parent confirmed that children have ‘a happy, positive experience and come back with this positivity which lasts quite a long [time].’ Recent developments in the behaviour empowerment policy further improve the already strong focus on positive behaviour management. Role modelling, mentoring and positive choices help to build the confidence and self-esteem of

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Outstanding

children, young people, volunteers and staff. The use of positive language and engagement always makes sure that there is a positive choice for children and young people. They learn to value themselves and others. The focus on positive role modelling and mentoring feeds into excellent outcomes for the older young people. Young people who have visited for previous holidays take on more responsibility mentoring the younger campers. They grow in confidence and develop leadership skills that are relevant to going onto higher education and employment. All children and young people feel positive about themselves because staff and volunteers are keen to focus on ‘positive competition’. They do not focus on winners and losers and they encourage cross-team interactions. Curbing but maintaining a competitive edge means that everyone tries to do better, look out for each other and reach their goals. Everyone is a winner.

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Outstanding

Children and young people experience high levels of respect and self-value. Treating each other with respect is covered in the opening ceremony. Individual team agreements enable individuals to find out about each other. Clear boundaries and reinforcing the importance of respect mean that children and young people understand each other’s differences and seldom experience bullying.

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Outstanding

Children and young people experience high levels of safety, stability and security due to the excellent care-planning framework, medical support and exceptionally strong relationships with volunteers. Liaison with community agencies, such as hospitals, police and host authority safeguarding, lends to effective partnership working. Robust safeguarding procedures and staff knowledge protect children and young people. For example, all staff understand what they should do, should a child or young person go missing, and this includes liaison with the local police. Leaders show excellent insight into safeguarding needs and profiles of children and young people. This insight enables effective risk management and partnership working with families and the activities’ centre staff. There are no current safeguarding concerns at the scheme. Robust and contemporary risk management addresses both environmental and

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Outstanding

individual risk. Leaders work collaboratively with the activity centre staff to ensure that outward-bound activities are safe and meet the individual needs of children and young people. Leaders and volunteers effectively implement robust and contemporary risk management. Attention to detail promotes the consistent safety of all children and young people. For example, changes of rooms for activities receive immediate review of the existing risk assessment before the same activity can go ahead. Expert management of children’s and young people’s medical and health needs keeps them safe and reassured. Close partnership working with parents makes a key contribution to robust healthcare planning. Medical staff are qualified to carry out all nursing and medical interventions. Robust medical emergency and medication procedures give excellent protection to children and young people. This strong foundation means that children and young people can relax and enjoy

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Outstanding

their holidays. Medical and care records are consistently maintained to ensure that all children and young people receive safe and contemporary care. Some discussions with parents are not consistently dated, and this compromises the retrospective reading of children’s and young people’s records. Leaders promote and implement high levels of scrutiny to safeguard children and young people. Recruitment fully meets and goes beyond safer recruitment procedures. For example, the volunteer coordinator now renews references every three years to ensure the ongoing scrutiny of volunteers and staff who return to the scheme year after year. The volunteer coordinator commented, ‘I am always making sure I am the most up to date with safer recruitment. The more barriers I can create, the more I will keep children safe. I want people to self-select themselves out, when they realise the process is robust.’ This sums up the

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Outstanding

scheme’s excellent approach to and understanding of safeguarding. Clear expectations about integrity ensure a stringent code of conduct. The responsible individual is effective in challenging inappropriate practice. Prompt referral to regulatory agencies maintains excellent safeguarding across all levels of adults working with children and young people at the holiday scheme. Children and young people feel safe because staff and volunteers have excellent insight into their individual needs and social integration. Concerns about group dynamics and potential for bullying are dealt with swiftly. Support staff give extensive consideration to the makeup of groups and of children and young people sharing bedrooms. Should concerns continue, individual campers are challenged and clearly informed that bullying will not be tolerated. Leaving the scheme is an option for those campers who choose not to adapt their behaviours.

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Outstanding

Security and health and safety are held as high priority. Children’s and young people’s security is promoted, with scrutiny of visitors, combination locks to cabins and one-to-one staff supervision of children and young people at all times. Fire safety checks are carried out by activity centre staff and monitored by the leaders at the scheme.

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Good

The residential holiday scheme is managed by an experienced and suitably qualified registered manager. He leads an effective management team that works hand-in-hand with the responsible individual. The registered manager was absent during this inspection and the team effectively managed the scheme in his absence. The recent appointment of a residential coordinator demonstrates how the welfare of children and young people is held as the highest priority. This new appointment is already having a direct impact on delivery of the service to the children and young people. Volunteers and support staff experience a greater coordination and connectivity between volunteers, support staff, campers and parents. Developments in behaviour empowerment and developing a more child-focused database contribute to the outstanding quality of care. Children and young people receive exceptional medical support with well- organised staffing arrangements. A range of medical experience and skill sets

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Good

connect across a team of doctors and nurses. These skills are expertly allocated across the separate holiday lodges to ensure safety and good health for all children and young people. Leaders have excellent insight into the profiles of volunteers. This ensures that their professional backgrounds, qualities and skills marry across the individual teams. Volunteers often return year after year, and their experience and motivation form a strong set of team leaders to coordinate each team of campers and volunteers. Extremely skilled, talented and creative volunteers and activity coordinators support an excellent array of activities. Induction training for medical staff and general training with volunteers ensure that all staff and volunteers operate according to the scheme’s statement of purpose. Working on scenarios enables all staff to understand the child-centred and empowering ethos of the scheme. Well-organised induction, with a variety of policy and experiential training, gels

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Good

volunteers, team leaders, medical staff and support staff. Children and young people receive outstanding care from an extremely cohesive and collaborative team as they share skills and experiences with each other. Team handbooks are excellently detailed with practical checklists and easy-to-access information. Team leaders and volunteers have clear boundaries regarding their roles and responsibilities and how to promote a safe, caring and motivational environment for children and young people to enjoy. The behaviour empowerment approach impacts on care practices at the scheme. There is now a greater mingling of teams. Interaction between staff is couched in positive language and engagement. Professionals and volunteers automatically contribute to each other’s development by sharing expertise and experiences. For example, team leader and volunteer meetings always focus on ‘top tips’, celebrate achievements and ensure that feedback goes to all involved in the scheme. This

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Good

celebration includes the activity centre instructors who receive ‘beads of brilliance’ for their contributions. Complaints are well managed. Leaders’ comments such as, ‘We always have to think about what we do and that is restorative to the campers’ demonstrates how children and young people remain at the core of practice. Feedback, evaluation and development are key features of the management structure and day-to-day operation. For example, detailed incident reporting and review of ‘near misses’ provide for stringent monitoring of the holiday scheme. Any shortfalls, including administrative mistakes and potential safeguarding issues are picked up and dealt with immediately. The scheme is outstanding because leaders are committed to reviewing their own practices and driving improvement at all levels of the holiday scheme. The holiday experience empowers children and young people, and they are keen to drive the development of the scheme. They have self-belief because their views

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Good

are understood and taken into account for each activity and at the end of each day. Staff and volunteers are asked for feedback throughout and at the end of each scheme. They also receive email updates and are asked for their ideas in between holidays via their own Facebook page. The website shows the staff handbook is frequently accessed, which demonstrates how volunteers are keen to promote their own practice development. Leaders acknowledge that, while feedback is valued and clearly circulates back through development plans, internal quality assurance lacks strategy. Regular independent visits are made to each scheme and feedback given to the board, but a format for monitoring and reporting to HMCI is not yet in place.

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What the inspection judgements mean

The experiences of children 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 residential holiday schemes for disabled children: framework for inspection’.

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Information about this inspection

Inspectors have looked closely at the experiences of children attending the residential holiday scheme. Inspectors considered whether the work of the residential holiday scheme is founded on safe care and individualised support. They read case files, watched how professional staff work with children and each other, and discussed the effectiveness of care given to children. Wherever possible, they talked to children and parents. In addition, the inspectors have tried to understand what the residential holiday scheme knows about how well it is performing, how well it is doing and what difference it is making for the children. 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 Residential Holiday Schemes for Disabled Children (England) Regulations 2013’ and the national minimum standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's

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Information about this inspection

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

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Information about this inspection

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Information about this inspection

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Information about this inspection

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