Children's Home run by Options Autism (5) Limited in Shropshire

Inspection report for children’s home - monitoring visit: SC361167 1 SC361167

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Options Autism (5) Limited

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This setting is an independent residential special school which is registered as a children’s home. It is owned and operated by a private company.

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Information about this children’s home

The home provides care for children and young people with autism spectrum disorder and who may also have additional medical and/or complex needs.

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Information about this children’s home

The service offers specialised education, care and accommodation for up to 22 children, which includes up to three children and young people under short-break arrangements. Some young people stay until they have completed their education at age 19 years.

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Information about this children’s home

The registered manager resigned on 30 November 2020. The deputy manager is in day-to-day charge of the home and is in the process of registering with Ofsted.

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This monitoring visit

On 4 and 5 August 2021, we carried out a full inspection at this home. Following this inspection, the home was suspended due to serious and widespread failings that compromised children’s safety. Senior managers from the organisation informed Ofsted that they had put measures in place to safeguard children and invited Ofsted to reconsider the need for the service to be suspended. As a result, Ofsted returned to the setting to review work undertaken and consider whether the suspension notice could be lifted.

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This monitoring visit

Serious shortfalls in medication management were identified at the full inspection. At this visit, further shortfalls were found in relation to medication management. The protocol for administering medication to children to manage incidents of aggression is not clear and neither is the protocol for administering medication to children covertly. A compliance notice has been issued to address the shortfalls in practice and protocols that compromise children’s health and well-being. Inspection report for children’s home - monitoring visit: SC361167 2 Since the full inspection, interim measures have been implemented to improve the arrangements for the administration and management of medication. A qualified nurse is now administering medication to children in the absence of trained staff. Plans are underway for this to continue until sufficient staff are trained and competent to manage medication arrangements safely, and protocols are reviewed

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This monitoring visit

During the visit, inspectors raised concerns about a child who was reported to be unwell after banging his head during incidents over recent days. There was no medical intervention to assess any injury or harm to his head that may have impacted on how he was feeling and behaving, and no recorded evidence that this had been considered. This was addressed during the visit, and a new head injury protocol has been devised and implemented.

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This monitoring visit

Some urgent action has been taken to remedy the dangers associated with children climbing garden and perimeter fences. This includes anti-climb measures and additional staff to be available to try and prevent children from putting themselves at risk. These measures reduce the risks to children while a full assessment of the need for and use of the fencing is undertaken.

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This monitoring visit

The home environment is now clean. In addition, work has commenced to address the recommendations raised in the fire risk assessment.

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This monitoring visit

Enough staff are working at the home to care for a reduced number of children. However, some children are not cared for by suitably trained staff who are able to meet their specific needs. Managers undertook work to address this during the visit. As a result, staff rosters have been amended to ensure that appropriately trained staff are caring for those children with particular needs. Senior managers will keep staffing arrangements under review to ensure that this is maintained.

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This monitoring visit

The use of restrictive physical intervention for children is not conducted safely. For example, one child is known to take himself to the floor during incidents and bang his head. Staff have used methods which they have not received training for to restrain the child on the floor. This increases the likelihood of children suffering injuries during a restraint. The use of ground restraint techniques has not been risk assessed to the individual needs of children and agreed by all relevant parties. In addition, restraint incident records lack detail and do not include the information set out in regulation.

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This monitoring visit

Senior managers told the inspectors that, at the current time, they cannot safely care for the number of children the home is registered for. Some measures have been introduced to reduce risk and improve children’s safety and welfare. Following this visit, another manager from within the organisation has been appointed to oversee and drive forward improvement. Inspection report for children’s home - monitoring visit: SC361167 3 As a result of this visit, the suspension has been lifted and an urgent condition has been imposed on the home’s registration to reduce the number of children who can reside at the home to five. Two additional requirements have been raised under regulations 10 and 35. The remaining requirements were raised at the full inspection. Four compliance notices have been issued in response to shortfalls identified during this visit and on the full inspection. These are in relation to

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Recent inspection history

Inspection date Inspection type Inspection judgement 04/08/2021 Full Inadequate 22/10/2019 Full Good 27/06/2018 Full Good 14/11/2017 Full Good Inspection report for children’s home - monitoring visit: SC361167 4

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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 children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

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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

ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare;

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Requirement Due date

help each child to express views, wishes and feelings. (Regulation 7 (1)(c) (2)(a)(i)(ii))

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Requirement Due date

This specifically relates to the registered person ensuring that staff gain children’s views and wishes. 17 September

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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

make a positive contribution to the home and the wider community; and 17 September Inspection report for children’s home - monitoring visit: SC361167 5 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)(iii)(b))

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Requirement Due date

This specifically relates to the registered person ensuring that staff provide opportunities for children to access the community.

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Requirement Due date

*The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being.

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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

achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

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Requirement Due date

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding;

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Requirement Due date

understand and develop skills to promote the child’s well- being. (Regulation 10 (1)(a)(b) (2)(a)(i)(ii)(iv))

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Requirement Due date

In particular, ensure that: all children’s health needs are understood and issues are acted on; arrangements for administering and managing medication are improved, including reviewing protocols for administering medication ‘when required’ and administering medication covertly. 31 August 2021

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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

assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if 31 August 2021 Inspection report for children’s home - monitoring visit: SC361167 6 necessary, make arrangements to reduce the risk of any harm to the child;

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Requirement Due date

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;

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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)(a)(i)(b)(d))

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Requirement Due date

This specifically relates to the registered person ensuring that the home and grounds are maintained to protect each child from avoidable hazards to their health and safety.

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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—

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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 have the experience, qualifications and skills to meet the needs of each child;

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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)(c)(h))

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Requirement Due date

This specifically relates to the registered person ensuring that the quality of care provided to children is monitored. 31 August 2021

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home.

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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 each child’s relevant plans are followed. (Regulation 14 (1)(a) (2)(c)) 17 September Inspection report for children’s home - monitoring visit: SC361167 7 This specifically relates to the registered person ensuring that staff follow children’s care plans and keep them up to date.

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Requirement Due date

The registered person must compile in relation to the children’s home a statement ("the statement of purpose") which covers the matters listed in Schedule 1.

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Requirement Due date

keep the statement of purpose under review and, where appropriate, revise it; and

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Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (1) (3)(a)(b))

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Requirement Due date

This specifically relates to the registered person ensuring that the statement of purpose is kept up to date. 17 September

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them. (Regulation 23 (1) (2)(a))

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Requirement Due date

This specifically relates to the registered person ensuring that staff follow the home’s procedures and are suitably trained to administer medication. 17 September

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must—

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Requirement Due date

take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home.

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Requirement Due date

If the Regulatory Reform (Fire Safety) Order 2005(a) applies to the home—

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Requirement Due date

the registered person must ensure that the requirements of that Order and any regulations made under it, except for 17 September Inspection report for children’s home - monitoring visit: SC361167 8 article 23 (duties of employees), are complied with in respect of the home. (Regulation 25 (1)(a) (2)(b))

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Requirement Due date

This specifically relates to the registered person ensuring that the Regulatory Reform (Fire Safety) Order 2005(a) is complied with.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home; or

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Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform.

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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—

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Requirement Due date

the Level 3 Diploma for Residential Childcare (England) (‘the Level 3 Diploma’); or

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Requirement Due date

a qualification which the registered person considers to be equivalent to the Level 3 Diploma.

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Requirement Due date

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

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Requirement Due date

in the case of an individual who was working in a care role in a home on 1st April 2014, 1st April 2016. (Regulation 32 (1) (2)(a)(b) (3)(b) (4)(a)(b) (5)(a)(b)) 17 September Inspection report for children’s home - monitoring visit: SC361167 9 This specifically relates to the registered person ensuring that staff are suitably qualified, skilled and experienced.

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(b)(c))

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Requirement Due date

This specifically relates to the registered person ensuring that staff receive regular supervision and an annual appraisal. 17 September

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Requirement Due date

*The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home; and

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Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home.

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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

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 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 August 2021 Inspection report for children’s home - monitoring visit: SC361167 10 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 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 (1)(a)(b) (3)(a)(iii)(iv)(v)(vii)(viii)(b)(i)(ii)(c))

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Requirement Due date

In particular, ensure that: incidents of restraint are recorded in line with regulation; managers review and evaluate incidents of restraint effectively; children are spoken to after an incident by someone who was not involved in it. In addition, review the use of ground restraint techniques and ensure that these are agreed by relevant parties, individually risk assessed and that staff are trained to use these restraint techniques.

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Requirement Due date

*These requirements are subject to a compliance notice.

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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: SC361167 11

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Options Autism (5) Limited

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Children’s home details

Registered provider address: Atria, Spa Road, Bolton BL1 4AG

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Inspectors

Jackie Line, Social Care Inspector James Tallis, Social Care Inspector Inspection report for children’s home - monitoring visit: SC361167 12 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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Inspectors

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Inspectors

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Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

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