Children's home run by Milton Keynes Council

Inspection report children’s home: SC383187 1 SC383187 Registered provider: Milton Keynes Council

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home was previously a residential special school registered with Ofsted as a children’s home for 24 children. There has been a change in registration since the last inspection. The service is now registered as a stand-alone children’s home, providing 52- week placements for up to four young people who have learning disabilities. The home is owned and operated by the local authority.

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Information about this children’s home

The manager was registered with Ofsted in August 2019.

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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: 18 December 2018

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good

Overall judgement at last inspection: good

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good

Enforcement action since last inspection: none Inspection report children’s home: SC383187 2

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Inspection date Inspection type Inspection judgement

18/12/2018 Full Good 04/09/2018 Full Inadequate 05/02/2018 Full Requires improvement to be good 02/03/2017 Interim Declined in effectiveness Inspection report children’s home: SC383187 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 protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (1)(2)(d))

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Requirement Due date

This especially means improving the hygiene in the dining area, tidying the garden area and removing broken items from all areas. 31/10/2019

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

ensure that staff provide to children living in the home the physical necessities they need in order to live there comfortably. (Regulation 6 (1)(a)(b)(2)(b)(vii))

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Requirement Due date

This especially means providing suitable dining areas including tables and chairs that are fit for purpose. 31/10/2019

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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 31/10/2019 Inspection report children’s home: SC383187 4 children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

ensure that staff work as a team where appropriate;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13 (1)(a)(b)(2)(b)(c))

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Recommendations

 Please see regulation 23. Care must be taken to ensure prescribed medicines are only administered to the individual for whom they are prescribed. Medicines must be administered in line with a medically approved protocol. Records must be kept of the administration of all medication, which includes occasions when prescribed medication is refused. Regulation 23 requires the registered person to ensure that they make suitable arrangements to manage, administer and dispose of any medication. These are fundamentally the same sorts of arrangements as a good parent would make but are subject to additional safeguards. Where the home has questions or concerns about a child’s medication, they should approach an expert such as a General Medical Practitioner, community pharmacist or designated nurse for looked-after children. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.15)

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Recommendations

In particular, strengthen the medication error policy.

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Overall experiences and progress of children and young people: good

Young people are making good progress in behaviour, personal care and relationships with others. They have improved health and are developing independence skills. Staff have ensured that young people have speech and language assessments, if necessary. In one case, this has resulted in the use of an electronic device for communication. Communication skills are much improved for this young person, who has been enabled to talk to a wider range of people using established methods.

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Overall experiences and progress of children and young people: good

Young people enjoy a range of activities inside and outside the home such as theme parks, train trips, bicycling and art and craft. Young people enjoy cooking and baking. Inspection report children’s home: SC383187 5 They demonstrate a good understanding of health and safety while in the kitchen.

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Overall experiences and progress of children and young people: good

Staff support young people to develop their independence, such as doing their own laundry. Some young people have a fob that enables them to have access to all areas, as staff have assessed.

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Overall experiences and progress of children and young people: good

Staff have advocated for a young person’s health needs. They challenged other professionals to ensure that the young person has the correct diagnosis and treatment. This has led to improved outcomes, both in better health and challenging behaviour significantly diminished. Staff have followed up on health appointments; for example, they have ensured that there are consents in place for a general anaesthetic, so that the necessary treatment can take place.

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Overall experiences and progress of children and young people: good

Staff demonstrate a commitment to the young people in their care, placing them at the centre of their practice. Committed staff work flexibly to meet the needs of the young people; for example, staff start work early to ensure that young people’s appointments are kept. Such practice helps the young people to feel valued and cared for.

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improvement to be good

Aspects of the risk management practice of staff need to improve to fully ensure that the safety of the young people is achieved in all aspects of their lives. There are examples where the action taken by staff to minimise risks has not been thorough. For instance, staff identified that a young person’s fingernails should be clipped due to him scratching himself. Staff did not evidence, in their written records, that they had completed this task nor how they were going to prevent the situation from happening again. In another example, staff assessed that a young person needs an additional staff member when going swimming, but the risk assessment guidance does not specify what this staff member’s responsibilities are.

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improvement to be good

Young people have developed trusting relationships with the adults around them. Young people are confident that the staff understand their idiosyncrasies and their unique methods of communication. Consequently, the staff understand the young people’s needs. Staff underpin their approach to safeguarding by working with the young people’s families and social workers in their efforts to reduce potential risks.

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improvement to be good

An independent pharmacy audit found that staff practice in handling medication is good. However, it is noted that the written procedure for dealing with a medication error lacks clarity. Although no actual errors have occurred since the last inspection, this remains an area of potential risk until the procedure is reviewed and strengthened.

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improvement to be good

Senior leaders and managers expect staff to deliver a high standard of care. They take any allegations that staff fall short of this standard extremely seriously. They follow due process and protocol, keeping the young people safe while necessary investigations take place. Someone independent of the home conducts these investigations, resulting in Inspection report children’s home: SC383187 6 clearly written, concise outcomes.

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improvement to be good

Staff support the young people well to manage their behaviour. Staff use distraction and de-escalation techniques, so they do not need to resort to physical intervention when young people are expressing themselves through their behaviour. Staff seek to understand the triggers for challenging behaviour and support the young people to manage their frustrations in other ways. Consequently, behaviour such as ripping clothes has decreased in frequency and intensity.

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improvement to be good

The physical environment is generally safe and secure and protects the young people from harm or the risk of harm. However, the kitchen, dining area and garden need improving. The change in the home’s registration has meant that the young people now use these areas more frequently. Some furniture, such as the dining tables, needs replacing. Additional cleaning is required in the kitchen and dining room. Staff need to consider how to reconfigure the art room that young people use as an alternative dining area, so that this is a suitable place for food consumption. Staff have not removed unused or broken items from all areas. The registered manager has not reinstated the soft play area in the home since the school facilities became unavailable.

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improvement to be good

School staff still provide the lunchtime meal during school holidays, with the home’s staff cooking the evening meal. These arrangements are not suitable long-term, with regard to who takes overall responsibility. During this inspection, there was one meal on the menu that was not available as staff did not have the right ingredients to prepare it.

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The effectiveness of leaders and managers: good

Senior leaders and managers have led the home through a turbulent period during which the reconfiguration and restructuring have been unsettling. Staff speak highly of the leadership team and the changes it has brought. Staff appreciate the supportive environments and their training that allows them to perform their roles to a good standard. The registered manager has a clear development plan in place to transform the home into its own unique entity, separate from the school.

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The effectiveness of leaders and managers: good

The senior leadership team made a deliberate choice to use relief and agency staff, especially through the holiday period. Leaders used agency staff who know the young people well and work in the home regularly. Although this arrangement is working, senior leaders do not always ensure that all such staff have the necessary level 3 qualification.

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The effectiveness of leaders and managers: good

Staff generally work well together as a team. However, on occasion, they have not problem-solved to make the best possible use of their collective skills, especially driving, to make sure that the young people can access the activity of their choice.

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The effectiveness of leaders and managers: good

No new young people have moved in since the last inspection, and one young person has successfully moved on. There are clear plans for permanency, with staff working with other providers to plan and support the young people to move on when the time Inspection report children’s home: SC383187 7 becomes right for them.

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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: SC383187 8

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Children’s home details

Registered provider: Milton Keynes Council

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Children’s home details

Registered provider address: Saxon Court, 502 Avebury Boulevard, Milton Keynes MK9 3HS

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Inspector

Keith Riley, social care inspector Inspection report children’s home: SC383187 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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