Children's Home, Residential special school run by MacIntyre Care in Buckinghamshire

Inspection report children‘s home: SC043994 1 SC043994 Registered provider: MacIntyre Care

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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 children‘s home is a part of an independent school for autistic children and young people who have severe learning disabilities. The great majority of children and young people who attend the school live in its children‘s home. The home provides 40 placements in seven houses. The home has not had a registered manager since 26 July 2018. A new manager was appointed in May 2018 but has yet to register with Ofsted.

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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

Date of last inspection: 24 January 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: SC043994 2

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Inspection date Inspection type Inspection judgement

24/01/2018 Interim Sustained effectiveness 14/06/2017 Full Good 24/11/2016 Interim Sustained effectiveness 10/05/2016 Full Requires improvement Inspection report children‘s home: SC043994 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 care planning standard is that children— receive effectively planned care in or through the children‘s home. (Regulation 14(1)(a)(b)(2)(a)) Specifically, the registered person must ensure that children‘s written care plans are reviewed and kept up to date, in particular, where there is a major change in a child‘s needs. 01/02/2019

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Requirement Due date

For the purposes of paragraph (3)(b), an individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained— the Level 3 Diploma for Residential Childcare (England) (―the Level 3 Diploma‖); or a qualification which the registered person considers to be equivalent to the Level 3 Diploma. The relevant date is— in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home; or in the case of an individual who was working in a care role in a home on 1st April 2014, 1st April 2016. The registered person may defer the relevant date if the individual— does not work, or has not worked, in a care role in a home for a prolonged period; or works, or has worked, in a care role in a home on a part-time basis. (Regulation 32(4)(a)(b)(5)(a)(b)(6)(a)(b))

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Requirement Due date

Specifically, the registered person must ensure that children receive care from qualified staff, in line with this regulation. 01/02/2019

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Requirement Due date

The registered person must maintain records (―case records‖) for each child which— 01/02/2019 Inspection report children‘s home: SC043994 4 include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. Case records must be kept— if the child dies before attaining the age of 18, for 15 years from the date of the child‘s death; in cases not falling within sub-paragraph (a), for 75 years from the child‘s date of birth; securely in the children‘s home during the period when the child to whom the case records relate is accommodated there; and in a secure place after the child has ceased to be accommodated in the home. (Regulation 36 (1)(a)(b)(c)(2)(a)(b)(c)(d) Schedule 3.15 – information relating to care, protection or safety of the child) Specifically, the registered person must ensure that children‘s individual case records contain the date and circumstances of

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Requirement Due date

any measure of control, discipline or restraint used in relation to the child.

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Recommendations

 Children should be able to maintain and develop their cultural or religious beliefs as far as practicable and where appropriate, through participation and instruction, and by observing religious requirements including dress and diet. (‗Guide to the children‘s homes regulations including the quality standards‘, page 17, paragraph 3.22) Specifically, the registered person should ensure that the information about children‘s cultural and religious backgrounds is recorded, that staff are aware of the related needs and that the care planning is informed by those needs for each child.  The registered person should monitor and review the patterns and trends of turnover of staff, whether agency or directly employed, and be able to understand and, where possible, address any negative trends. (‗Guide to the children‘s homes regulations including the quality standards‘, page 54, paragraph 10.19) Specifically, the registered person should be effective at maintaining a more

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Recommendations

stable staff team.  The home‘s records on each child represent a significant contribution to their life history. (‗Guide to the children‘s homes regulations including the quality Inspection report children‘s home: SC043994 5 standards‘, page 62, paragraph 14.5) Specifically, the registered person should organise children‘s files in ways that promote staff‘s good understanding of children‘s histories and in ways that evidence the progress that children have made while living at this children‘s home.

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Overall experiences and progress of children and young people: good

Children and young people have positive experiences and good opportunities to make progress from their individual starting points. Parents describe their children as being happy in this home. One mother said that her son‘s move to the home was a positive and life-changing experience for him and the whole of the family. She said that the staff ‗were wonderful and incredibly compassionate‘. The home ensures that children and young people have a strong voice. Staff know and respect the views, wishes and feelings of children and young people, despite the communication differences. Staff use a social-story approach to help children and young people understand what is happening around them and enable them to participate more meaningfully in their interactions with others. Care planning is highly individualised and child centred. Children and young people are well cared for by staff who know them well and have their best interests at heart. One

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Overall experiences and progress of children and young people: good

mother talked about the service being very flexible around the needs of her son and said: ‗Nothing is too much for staff. They are really kind and sweet towards my son.‘ Children and young people receive high-quality integrated care and support. Professionals work across the therapeutic, educational and residential teams to provide care and support that consistently addresses children and young people‘s complex and wide-ranging needs. This has a positive impact on children and young people‘s overall progress and development. They have made strong progress in developing their communication and social skills. The school nurse and the therapeutic team ensure that children and young people receive the specialist health support that they need in respect of their physical and emotional health. The school nurse oversees the implementation of the individual healthcare plans and the management of medication in the home. This partnership

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Overall experiences and progress of children and young people: good

working results in healthier outcomes for the children and young people. For one young person, this resulted in a healthier diet and weight loss. The home makes a strong contribution to the school‘s waking-day curriculum and children and young people‘s educational attainment. The educational team ensures that staff in the home continue to promote children and young people‘s learning in line with their individual learning plans. One mother said that, in the 10 years of attending various educational establishments, this is the first time that her son has enjoyed learning and refers to it as fun. Inspection report children‘s home: SC043994 6 Children and young people receive excellent support to manage transitions. This includes everyday transitions, as well as very well-planned admissions to the home and when they move on. Staff maximise children and young people‘s independence skills to help them prepare for the next stage in their lives.

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

Positive relationships between staff and children and young people underpin effective safeguarding. The environment is supportive, ordered, calm and safe. Clear boundaries and daily routines help children and young people to develop a sense of safety and security, allowing them to flourish. The school‘s positive behaviour management team helps children and young people to learn how to regulate their emotions and behaviours in the school and the home. Staff have good safeguarding awareness and the ability to work in line with the individual positive behaviour and risk management plans. The good management of risks is intrinsic to the good support that staff provide to children and young people. Staff recognise early when risks are increasing and take proactive actions to minimise them. This approach to risk management is effective at ensuring the safety of children and young people and minimises the risk of serious

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

incidents. Written records of incidents demonstrate that the staff members managed them well and kept children and young people safe. Children and young people who have self-harmful behaviours receive good help. The ‗intensive interactions practice‘ approach is being used effectively to help children and young people to achieve better sensory integration, alleviate their anxiety and develop feelings of improved self-worth and confidence. In one case, a staff member distracted one young person from engaging in their self-injurious behaviour and, in turn, lifted their mood by using intensive interactions. Staff‘s positive approach to managing young people‘s behaviours of concern has had a positive impact on young people. The school‘s monitoring records show overall a steady reduction in those behaviours. However, recording practices do not allow for easy monitoring of the physical interventions carried out by the children‘s home‘s staff and do

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

not meet the requirement for keeping those records on the children and young people‘s individual files. Leaders and managers have developed close links with the local authority‘s lead safeguarding officer. They have regular discussions about safeguarding issues including the appropriateness of some physical interventions. Leaders and managers monitor staff practices and take decisive action against staff members who do not follow good safeguarding guidance consistently. All parents spoken to said that they had confidence that their children are safe at the home and the school. One mother said: ‗This is the first time in 14 years that I can relax in the knowledge that my son is safe‘ and added: ‗They turned around my child from the confused and aggressive teenager back to the loving person that he used to be.‘ Inspection report children‘s home: SC043994 7

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The effectiveness of leaders and managers: good

Leaders, managers and staff share a vision for the service that has the welfare of children and young people at its centre. Leaders and managers run the home efficiently and staff play an active role in fulfilling the home‘s statement of purpose. This children‘s home is making a positive difference to the lives of autistic children and young people who have severe disabilities. Leaders, managers and staff work in close partnership with the families of children and young people. One mother said that this was the first time that she experienced the needs of the whole family being taken into account. Leaders, managers and staff have made effective links with professionals from the young people‘s placing authorities. An independent reviewing officer highlighted how staff advocating for the voice of children and young people to be heard at the meetings as the real strength of the home. In this professional‘s view, staff went above and

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The effectiveness of leaders and managers: good

beyond their duties to secure positive outcomes for children and young people. Comprehensive monitoring processes ensure that the quality of the service and its effectiveness is maintained. The home‘s independent visitor‘s monthly monitoring reports contribute to good-quality assurance. Leaders and managers know the service well and have a realistic picture of its strengths and weaknesses. The complaints procedure focuses on learning and opportunities for improvement. Shortfalls mainly relate to staffing numbers and record-keeping. These weaknesses are already included in the home‘s improvement plan and have not had a negative impact on children and young people. There have been many changes to the permanent staff team and not all staff hold an appropriate qualification. With the help of relief and agency staff, the home has continued to provide adequate staffing levels at a minimum of one-to-one support and

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The effectiveness of leaders and managers: good

more when required. The vacancy level of permanent staff is currently a third of the overall residential staff force. Leaders and managers are recruiting new staff. The children and young people‘s files are cumbersome and do not easily provide an insight into their history, progress and outcomes. There are three separate files for each child or young person. However, important information was missing on some of the files: one young person‘s file did not have any information about her cultural or religious background, while another young person‘s care plan did not reflect his current needs following a recent diagnosis of a serious health condition. The management of change that the new manager has introduced is effectively taking the service forward. The therapeutic, educational and residential staff all said positive things about the impact of these changes on the development of more integrated working practices being in the best interest of children and young people.

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The effectiveness of leaders and managers: good

Inspection report children‘s home: SC043994 8

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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: SC043994 9

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider address: MacIntyre Care, 602 South Seventh Street, Milton Keynes, Buckinghamshire MK9 2JA

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Inspectors

Seka Graovac, social care inspector Juanita Mayers, social care inspector Kevin Whatley, regulatory inspection manager Inspection report children‘s home: SC043994 10 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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Inspectors

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Inspectors

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Inspectors

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