Children's home run by Diverse Abilities Plus Limited in Bournemouth, Christchurch and Poole

Inspection report children‟s home: SC004085 1 SC004085 Registered provider: Diverse Abilities Plus Ltd

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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 short-break residential children‟s home is run by an independent charitable organisation.  The home provides a service for children who have sensory, physical and/or learning disabilities. It is registered to provide care and accommodation for up to four children at one time.  Day care for young adults aged 19–25 years is also provided on the same premises. Young adults are present only at times when there are no children in the home. The building also accommodates a domiciliary care service, which is registered with the Care Quality Commission.  The registered manager has been in post since December 2013.

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Information about this children’s home

Inspection dates: 18 to 19 September 2018

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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 requires improvement to be 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

Date of last inspection: 16 February 2018

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good

Overall judgement at last inspection: sustained effectiveness

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good

Enforcement action since last inspection: none Inspection report children‟s home: SC004085 2

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Inspection date Inspection type Inspection judgement

16/02/2018 Interim Sustained effectiveness 17/05/2017 Full Good 13/02/2017 Interim Improved effectiveness 13/10/2016 Full Requires improvement Inspection report children‟s home: SC004085 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 leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that helps children aspire to fulfil their potential and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home has sufficient staff to provide care for each child; and ensure that the home‟s workforce provides continuity of care to each child. (Regulation 13(1) and (2)(c)(d)(e)).

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Requirement Due date

This is with particular regard to ensuring that:

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Requirement Due date

 Leaders and managers continue their efforts to recruit a full permanent staff team.  All staff receive training in areas which meet individual children‟s needs, for example in autistic spectrum conditions and in behaviour management strategies.  Fire alarm tests are always completed and recorded in line with the fire and rescue service‟s recommendations.  The registered person monitors children‟s records to make sure that all staff sign and date them when they have read them. 30/11/2018

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes the name of the child; details of the child‟s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any 30/11/2018 Inspection report children‟s home: SC004085 4 other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised

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Requirement Due date

by the registered person to do so (“the authorised person”) has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35(3)(a)(b)).

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Requirement Due date

In particular, ensure that restraint records are recorded in full and maintained in a secure page-numbered book to avoid the risk of unauthorised amendment. Ensure that restraint records are complete and that they are linked to the relevant incident report.

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Recommendations

 Ensure that the use of agency staff is carefully monitored and reviewed to ensure children receive continuity of care. („Guide to the children‟s homes regulations including the quality standards‟, page 54, paragraph 10.6)  Ensure that recruitment of staff safeguards children and minimises potential risks to them. In particular, ensure that all new applicants have their references verified by telephone and that these conversations are recorded on the personnel files. („Guide to the children‟s homes regulations including the quality standards‟, page 61, paragraph 13.1)

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Overall experiences and progress of children and young people: good

The overall care for the children who receive short breaks in this home is good. Staff are attentive, sensitive and highly supportive. Some of the communication skills observed during this inspection were excellent.

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Overall experiences and progress of children and young people: good

Children and young people make good progress in the home. One child has begun to use an eye-gaze communication system when she visits the home. Another child, who is often anxious, has coped very well with his first holiday stay. Another now participates in group activities, instead of choosing to play alone.

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Overall experiences and progress of children and young people: good

The children and young people enjoy a wide range of activities and are fully consulted, as far as their communication needs permit.

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Overall experiences and progress of children and young people: good

As this is a short-breaks service, most of the children and young people live at home Inspection report children‟s home: SC004085 5 with their parents. Parents are therefore responsible for managing their children‟s education and most of their healthcare needs.

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Overall experiences and progress of children and young people: good

The children and young people have detailed healthcare plans. These provide staff with good-quality information to help support the children‟s highly complex health needs.

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Overall experiences and progress of children and young people: good

Since the interim inspection, the incidence of medication errors has continued to fall. In August 2018, there was an isolated incident when staff made a mistake while they were administering a young person‟s medication. The staff acted swiftly to reduce the risk of the young person experiencing unpleasant symptoms.

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Overall experiences and progress of children and young people: good

After this incident, the registered manager conducted a detailed investigation. As a result, staff have been observed administering medication and they now use a new colour-coded system of medicines administration recording. Staff confirm that the new system is much safer, making a recurrence highly unlikely. This incident was appropriately notified to Ofsted and updated when the investigation was complete.

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improvement to be good

The home‟s risk assessments on each individual child are clear, and provide accurate, regularly updated information to guide the staff‟s practice. Risk management in the home is generally good.

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improvement to be good

Children have good-quality, regularly updated care plans and behavioural support plans which accurately describe their needs. Staff explained that they always read and implement any updates to the children‟s care plans, risk assessments and behaviour support plans, so that they are aware of their contents. However, the staff have not been asked to sign and date these documents to show that they have read them.

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improvement to be good

The manager uses team meetings and individual supervision to explain to staff the need for consistent behavioural strategies. Generally, this dissemination of information is effective. However, there have been a very small number of incidents where staff did not follow the care plans. Staff are trained in de-escalation techniques, but a small minority have inadvertently escalated the children‟s behaviour. This is because they were not sufficiently aware of the children‟s individual needs to withdraw or modify their approach to children in distress. This is an area for professional development which has, in the inspector‟s opinion, contributed to incidents where staff have been harmed.

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improvement to be good

Restraints are only carried out as a last resort. Those that have taken place have been appropriate.

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improvement to be good

There are significant shortfalls in restraint recording. The home‟s restraint log is not securely bound or page numbered. This means that there is the potential for a record to be removed without the manager, the independent visitor or the regulator realising that this has happened. In addition, some restraint records are poorly recorded. In some Inspection report children‟s home: SC004085 6 instances, there is no evidence of a staff debrief. In addition, restraints are not always linked to incident reports, so there is no clear audit trail.

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improvement to be good

Health and safety is generally well managed. There is one isolated example from June 2018, when a single fire alarm test was either missed, or not recorded.

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improvement to be good

Staff recruitment is generally well managed. However, the company only verifies references by phone if there is a specific concern, or insufficient information. This verification should be done for every reference. Omitting to do this increases the risk that the organisation may appoint unsuitable people.

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improvement to be good

The registered manager has worked with other agencies when necessary in order to share relevant information about any safeguarding concerns.

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improvement to be good

Ofsted has received a complaint about the service‟s restraint practice. This was investigated during the inspection. The complaint was not upheld, but the investigation revealed some shortfalls in restraint recording, described above.

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The effectiveness of leaders and managers: good

The qualified, registered manager is highly experienced. She ensures that the home complies with its statement of purpose. Management monitoring is generally very good. The registered manager has a clear overview of the home and is ambitious for the children and young people.

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The effectiveness of leaders and managers: good

The manager‟s vision has resulted in a significant programme of improvements being carried out since the last full inspection. The charity which operates the children‟s home has made a substantial financial investment to improve the quality of the environment. For example, the bedrooms have been attractively decorated. There are good facilities and plenty of space for indoor and outdoor play. This provides children with lots of opportunities to express themselves, interact with others and have fun.

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The effectiveness of leaders and managers: good

The staff receive good foundation training and a thorough, well-managed induction. They report that they are well supervised and supported. However, only one member of staff has received recent training in working with children who have autistic spectrum conditions. There are four children with these needs currently accessing the service. This means that these children‟s needs are not sufficiently well understood. As described above, some of the incidents in the home could have been better managed with additional training in de-escalation techniques.

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The effectiveness of leaders and managers: good

The home is actively recruiting. There are two vacancies on the staff team. Despite good efforts, it has proved difficult to fill vacancies. The registered manager seeks to fill any gaps on the rota with existing staff or managers, or from the small pool of regular bank staff who are known to the children. Sometimes, particularly during the summer holiday period, there has been no alternative but to use agency staff. During the week of this inspection, there was one agency night-waking person on duty. Inspection report children‟s home: SC004085 7

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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 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: SC004085 8

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Children’s home details

Registered provider: Diverse Abilities Plus Ltd

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Children’s home details

Registered provider address: Barnabas Project Centre, 13–15 Manor Avenue, Poole, Dorset BH12 4LB

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Children’s home details

Responsible individual: Jonathan Seaward

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Inspector

Heather Chaplin: social care inspector Inspection report children‟s home: SC004085 9 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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