Children's home run by Autonomy Plus Limited

Inspection report children’s home: 2618477 1 Registered provider: Autonomy Plus Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This children’s home provides care for one child with complex care needs. The provider operates one other children’s home and social care services for adults. The experienced manager has been in post since this home was registered in November 2020.

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Information about this children’s home

Due to COVID-19 (coronavirus), at the request of the Secretary of State, we suspended all routine inspections of social care providers on 17 March 2020.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: Not previously inspected

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requires improvement to be good

Overall judgement at last inspection: Not applicable

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requires improvement to be good

Enforcement action since last inspection: Not applicable Inspection report children’s home: 2618477 2

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improvement to be good

Careful consideration of the facilities and layout of this bespoke home provide a much-improved environment compared to the child’s previous clinical setting. A large number of health and social care professionals are involved in the care planning along with essential consultation with parents. Regular meetings are held virtually and, more recently, discussions have occurred with specialist services on how to introduce their direct involvement.

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improvement to be good

Planning of this home occurred months before the child moved in. A specialist team of agency staff continue to support the child, having developed relationships with him in the previous setting. This agency team assisted with the move to this home, providing some consistency of care. Agency staff work with the manager and staff team of the home. Together, they ensure that the child is at the centre of their practice as they strive for the best care and outcomes for him.

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improvement to be good

The manager and staff of the home have developed some positive relationships with the child. However, these relationships can be fractured following incidents that have caused the child to become upset. It can take some time to slowly rebuild relationships. The manager and staff members are persistent in their attempts to repair their relationships, often after being injured. They are patient and creative in their approach to the child. Through understanding autism, the staff team respect the child’s pace of processing information and relationship building.

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improvement to be good

Choice of activity is led by the child. He enjoys going for a drive to familiar places and listening to music. This home is situated close to the child’s family, enabling increased opportunities to spend time together at the home and in the local area. Time spent with his family can broaden his interests, such as walking, cooking and looking at the computer together. Staff’s attempts to engage the child in a wide range of activities have not been successful. Leaders and managers have not introduced a routine of activity time into the care plan. This is a missed opportunity to promote learning in the absence of any formal education. Based on current care plan needs the child is not ready yet to access education, hence the need for structured activities to develop the skills to engage in their learning.

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improvement to be good

Deprivation of liberty, which includes restrictive practice, is currently deemed necessary to keep this child safe. These restrictions are subject to a court order, ensuring that they are carefully considered and reviewed. High staffing ratios are required, with the aim of reducing numbers as the child settles and develops positive relationships. Inspection report children’s home: 2618477 3 In the three months that the child has lived here, the manager and staff team are learning how to best support him and keep him safe. At times of distress, this has involved physical intervention and, when considered necessary, the use of ground hold restraint. This high level of restraint has been agreed through legal proceedings and is therefore subject to regular review and multi-agency oversight.

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improvement to be good

A very comprehensive behaviour support plan guides the staff team on how to avoid such restrictive measures where possible. Records confirm that restraint is used appropriately and avoided where possible. Staff employ their skills and training to reduce the child’s anxiety and attempt to distract him with breathing exercises and change of person or setting. Records of incidents are comprehensive and shared with parents and professionals.

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improvement to be good

Staff are suitably trained in the administration of medication. The child and adolescent mental health services regularly review the medication to support the child and reduce his anxieties.

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good

The registered manager is very experienced and suitably qualified. Parents and professionals report that the manager ensures good levels of communication with them. Staff report that they are very well supported by the manager and through their training and supervision. The manager is clear on her role to ensure that the child is safe, protected and that his views and wishes are established.

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good

Shortfalls are noted in the monitoring of records. The manager lacks full oversight of the discussions with all staff after an incident. An informal discussion is usually held by the manager with an agency member of staff, relying on a formal debrief to occur within the agency. Leaders and managers do not have a process for maintaining records in the home to confirm that a manager within the agency has spoken to their member of staff about their use of restraint. The manager communicates frequently with the manager of the agency to ensure that important information is shared. However, the use of email and telephone calls are not sufficient. Such discussions on the line management of staff should be formalised into written records to ensure that the manager has clear oversight of the supervision of all the staff in the home.

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good

The analysis of behaviour, accidents and injuries to identify patterns or trends requires improvement to fully inform what changes may be needed to support restraint reduction. To date, monthly reports have a narrative and graphs to show frequency of incidents and the level of intervention required. The electronic system used to record and analyse the incidents lacks the sophistication to produce reports and therefore manual extraction of the data has the potential for error, as noted on inspection. Inspection report children’s home: 2618477 4 The local community has raised several complaints about the increase in noise and parked cars in their residential area. Leaders and managers have responded to the complaints appropriately and continue to try and build positive relationships with the neighbours. Inspection report children’s home: 2618477 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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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so.

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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

promote opportunities for each child to learn informally. (Regulation 8 (1) (2)(a)(v)) 30 June 2021

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Requirement Due date

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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Requirement Due date

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

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Requirement Due date

develop the child’s interests and hobbies;

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Requirement Due date

participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and

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Requirement Due date

make a positive contribution to the home and the wider community; and

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Requirement Due date

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)) 31 May 2021

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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— 31 May 2021 Inspection report children’s home: 2618477 6 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

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(h))

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Requirement Due date

This relates to the need for detailed analysis of the use of physical intervention, restraint and any injuries as a result of using such measures of control. In addition, the manager should formalise a system to monitor the supervision of agency staff.

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Requirement Due date

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—

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Requirement Due date

details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; 31 May 2021 Inspection report children’s home: 2618477 7 within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within five 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)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(iv))

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Requirement Due date

This specifically relates to the provider establishing a formal process for maintaining records in the home when an ‘authorised person’ has spoken to a member of staff about their use of restraint.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, 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: 2618477 8

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Children’s home details

Registered provider: Autonomy Plus Limited

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Children’s home details

Registered provider address: 67 Roundpond, Melksham, Wiltshire SN12 8EB

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Inspector

Clare Davies, Social Care Inspector Inspection report children’s home: 2618477 9 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 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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