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

Inspection report for children‟s home - monitoring visit: SC043994 1 SC043994

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MacIntyre Care

Monitoring visit 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 children who have autism spectrum disorder and/or severe learning disabilities. Children who attend the school live in its children’s home. The home provides 40 placements in seven houses.

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Information about this children’s home

The home has not had a registered manager since 26 July 2018. A new manager was appointed in May 2019 but has yet to register with Ofsted.

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This monitoring visit

This monitoring visit was carried out following the inadequate judgement made at the full inspection on 16 July 2019. Following the full inspection a suspension notice and five compliance notices were served. The suspension notice was lifted on 23 July 2019. A notice restricting accommodation was served on 23 July 2019. A further monitoring visit took place on 16 August 2019. The notice restricting accommodation was subsequently removed on 19 August 2019.

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This monitoring visit

The purpose of this monitoring visit was to check that the provider had met the compliance notices, which had due dates of 25 August 2019. The responsible individual and head of care were present during this monitoring visit and met with the inspectors. At the time of this inspection, there were 14 children living at the home.

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A compliance notice was served under regulation 12 (1)(2)(a)(i)

The steps in the compliance notice required the provider to review the children’s risk assessments. At the full inspection, it was found that risks for children with complex, harmful and potentially life-threatening behaviours were poorly assessed. Consequently, assessments lacked clear guidance or strategies for staff to follow to Inspection report for children‟s home - monitoring visit: SC043994 2 reduce risks.

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A compliance notice was served under regulation 12 (1)(2)(a)(i)

Since the full inspection in July 2019, staff have reviewed children’s risk assessments. For children with the most complex and critical risks, assessments are now clear and provide staff with strategies to reduce risk. However, some risk assessments remained unchanged. Examples were found where staff had signed assessments in February 2019, with leaders and managers signing the same documents in August 2019. Furthermore, some contained irrelevant statements for children who had lived at the home for several months; for example, ‘This child is new, and we will learn more about them.’ It was not possible to ascertain if these documents had been sufficiently reviewed or updated.

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A compliance notice was served under regulation 12 (1)(2)(a)(i)

Positive behaviour plans have been updated. They now include current, relevant information about the children. Where children have specific behaviours that increase certain risks, such as the risk of electrical harm, specific protocols are now in place. They provide staff with guidance and strategies to follow should the behaviours arise. Leaders and managers have signed these updated documents. However, not all staff had signed them at the time of the inspection. It was not possible to ascertain if the staff had read and understood the revised documents.

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A compliance notice was served under regulation 12 (1)(2)(a)(i)

The steps also required the responsible individual, placing authorities, parents and carers to agree the risk assessments. This process has begun, although it is not yet fully embedded.

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A compliance notice was served under regulation 12 (1)(2)(d)

At the full inspection, inspectors found children’s bedrooms to be unkempt and, in some instances, not sufficiently cleaned. Furthermore, numerous areas of the houses were in a poor state of repair, with ineffectual maintenance plans in place. The steps in the compliance notice required the provider to ensure that the houses were free from avoidable hazards, suitably cleaned and well maintained.

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A compliance notice was served under regulation 12 (1)(2)(d)

The steps also required the provider to undertake a review and produce a report of all areas of the children’s home. A report has been produced, and many areas have been significantly improved. Children’s bedrooms are now clean. Urgent maintenance has taken place to ensure that unsafe flooring, loose wires, dirty bathrooms and cluttered rooms have been rectified.

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A compliance notice was served under regulation 12 (1)(2)(d)

The swimming pool handrail has been fixed. The pool has also been deep cleaned. It now provides children with a clean and safe facility.

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A compliance notice was served under regulation 12 (1)(2)(d)

The management of control of substances hazardous to health (COSHH) has improved. Safety data sheets are in place for each material, and inspectors observed that staff were being compliant with this guidance.

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A compliance notice was served under regulation 12 (1)(2)(d)

The introduction of a housekeeper, and assistant housekeeper, has had a positive Inspection report for children‟s home - monitoring visit: SC043994 3 impact on the quality of the premises. Some areas have been decorated and new soft furnishings added. This has improved the look and made areas more inviting to the children. Children have made choices about the development of their bedrooms and shared areas of the houses. One child proudly showed the inspector the improvements that she had contributed to.

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A compliance notice was served under regulation 12 (1)(2)(d)

A revised system is in place to record, report and rectify maintenance issues as they arise. However, the system is yet to be fully embedded. A child’s toilet seat had remained loose for over a week. Staff absence was a contributing factor. Leaders and managers are yet to ensure that the system in place can mitigate the effects of staff absence.

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A compliance notice was served under regulation 13 (1)(a)(b)(2)(h)

The steps in the compliance notice required the provider to review the home’s monitoring and reviewing systems to ensure that they contributed to the continuous improvement to the quality of care provided.

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A compliance notice was served under regulation 13 (1)(a)(b)(2)(h)

The provider undertook a review. The initial review highlighted specific areas where processes needed to be created and improved, for example developing clear accountability for the daily and weekly checks and tasks. These identified areas from the review have been acted on in appropriate timescales. The responsible individual advised that this is an ongoing piece of work and more systems and processes will need to be added over time.

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A compliance notice was served under regulation 13 (1)(a)(b)(2)(h)

Practice and management checklists ensure that essential processes and maintenance are completed each day. This gives leaders and managers increased oversight. They also oversee maintenance requests and are meeting with the independent visitor to ensure that they are clear about their findings and can take effective action to rectify any shortfalls.

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A compliance notice was served under regulation 13 (1)(a)(b)(2)(h)

Leaders and managers have reviewed restraint records. They now have a system in place where managers have regular oversight and ensure that debriefs take place for the staff and children.

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A compliance notice was served under regulation 13 (1)(a)(b)(2)(h)

‘Team around the child meetings’ are now taking place. This ensures that the education, care and therapeutic services meet regularly to share knowledge and skills. Lead responsibility is assigned across the fields to ensure accountability for formulating, reviewing and delivering services.

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A compliance notice was served under regulation 25 (2)(b)

The steps in the compliance notice required the provider to ensure that the advice from the fire safety officer had been met. Specifically, the requirement was to repair and replace fire doors to ensure that they complied with fire and smoke protection requirements set out in the fire officer’s report. Inspection report for children‟s home - monitoring visit: SC043994 4 A tour of the premises was conducted. Fire exits were clear and fire doors largely replaced. Other areas of fire protection had been improved with the addition of a smoke detector near to appliances and fire protection around wires. The schedule of works to rectify any shortfalls with the fire doors is now complete. This work has been signed off by an authorised person.

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A compliance notice was served under regulation 25 (2)(b)

Children’s personal evacuation plans had been reviewed. Leaders and managers had direct oversight and have signed off all plans.

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A compliance notice was served under regulation 25 (2)(b)

A system of weekly and monthly checks is in place to ensure routine maintenance and a focus on fire safety. A new health and safety lead at the home has oversight and ensures that staff remain compliant with the routine checks.

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A compliance notice was served under regulation Reg 32 (1)(3)(b)

The steps in the compliance notice required the provider to ensure that individuals working in, and being recruited to work at, the home have the appropriate experience, qualification and skills for the work each individual is to perform. The provider undertook recruitment checks on the agency staff that are used. They found some shortfalls, such as gaps in employment and training certificates. The agency has now rectified the shortfalls.

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A compliance notice was served under regulation Reg 32 (1)(3)(b)

Improvements have been made to staff completing their level 3 qualification. Since the last inspection, four members of staff have submitted their coursework for approval. The remaining staff have made appropriate progress considering the timescale. Leaders and managers now receive frequent progress reports to give them clear oversight against individuals’ completion dates.

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Conclusion

The provider has taken action to meet the steps of the five compliance notices. However, not all actions are fully embedded yet. Progress against these actions will be further tested at the next inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 16/07/2019 Full Inadequate 09/10/2018 Full Good 24/01/2018 Interim Sustained effectiveness 14/06/2017 Full Good Inspection report for children‟s home - monitoring visit: SC043994 5

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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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Statutory requirements

The quality and purpose of care standard is that children receive care from staff who— understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential; ensure that the premises used for the purposes of the home are designed and furnished so as to— meet the needs of each child; and enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b)(2)(c)(i)(ii)) 22/09/2019

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Statutory requirements

The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills.

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Statutory requirements

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff help each child to— develop the child’s interests and hobbies; participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and make a positive contribution to the home and the wider community; and that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1)(2)(a)(i)(ii)(iii)(b)) 22/09/2019

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Statutory requirements

The health and well-being standard is that— the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being; and children are helped to lead healthy lifestyles.

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Statutory requirements

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff help each child to— achieve the health and well-being outcomes that are 22/09/2019 Inspection report for children‟s home - monitoring visit: SC043994 6 recorded in the child’s relevant plans. (Regulation 10 (1)(a)(b)(c)(2)(a)(iii))

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Statutory requirements

Specifically, ensure that children are supported to attend all health and well-being appointments in line with their relevant plans. The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults. (Regulation 11 (1)(a)(b)(c)) 22/09/2019

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Statutory requirements

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Statutory requirements

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— help each child to understand how to keep safe; have the skills to identify and act upon signs that a child is at risk of harm; manage relationships between children to prevent them from harming each other; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action whenever there is a serious concern about a child’s welfare; and are familiar with, and act in accordance with, the home’s child protection policies; that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm; that the premises used for the purposes of the home are located so that children are effectively safeguarded; that the effectiveness of the home’s child protection policies is monitored regularly.

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Statutory requirements

(Regulation 12 (1)(2)(a)(ii)(iii)(iv)(v)(vi)(vii)(b)(c)(e)) 22/09/2019

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Statutory requirements

The care planning standard is that children— receive effectively planned care in or through the children’s home. (Regulation 14 (1)(a))

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Statutory requirements

Specifically, ensure that agreed procedures and support plans are detailed within clear care plans that are understood and followed by care staff. 22/09/2019

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Statutory requirements

The registered person must make arrangements for the 22/09/2019 Inspection report for children‟s home - monitoring visit: SC043994 7 handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23 (1)) A responsible individual must— have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated. (Regulation 26 (7)(b)) 22/09/2019

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Statutory requirements

The registered person must prepare and implement a policy which— is intended to safeguard children accommodated in the children’s home from abuse or neglect; and sets out the procedure to be followed in the event of an allegation of abuse or neglect. (Regulation 34 (1)(a)(b))

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Statutory requirements

In particular, ensure that disciplinary proceedings are carried out even when a member of staff is no longer working in the home; and that the outcomes of these proceedings are referred to the disclosure and barring service (DBS) if required. 22/09/2019

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Statutory requirements

The registered person must ensure that— within 48 hours of the use of the measure [of control, discipline or restraint], the registered person, or a person who is authorised 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)(b)(i)(ii)(c)) 22/09/2019

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Statutory requirements

Case records must be kept— securely in the children’s home during the period when the child to whom the case records relate is accommodated there. (Regulation 36 (2)(c)) 22/09/2019

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Statutory requirements

The registered person must notify HMCI and each other relevant person without delay if— there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 22/09/2019

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Statutory requirements

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating— the quality of care provided for children; 22/09/2019 Inspection report for children‟s home - monitoring visit: SC043994 8 the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Statutory requirements

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review. (Regulation 45 (2)(a)(b)(c)(3)) The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year, taking into account the requirement in regulation 12(2)(c) (the protection of children standard).

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Statutory requirements

When conducting the review, the registered person must consult, and take into account the views of, each relevant person. (Regulation 46 (1)(2)) 22/09/2019

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children‟s home - monitoring visit: 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: 602 South Seventh Street, Milton Keynes, Buckinghamshire MK9 2JA

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Inspectors

Sarah Olliver, social care inspector (lead) Daniel Healy, social care inspector Inspection report for children‟s home - monitoring visit: SC043994 10 to 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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Inspectors

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Inspectors

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Inspectors

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