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

Inspection report for children’s home: SC361167 1 SC361167 Registered provider: Options Autism (5) Limited Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This service provides care for children who have autism spectrum disorder. The children may also have additional medical and/or complex needs.

p.1

Information about this children’s home

This setting is an independent residential special school registered as a children’s home. It is owned and operated by a private company. The service offers specialised education and care for up to five children at present. Some young people stay until they have completed their education at the age of 19 years.

p.1

Information about this children’s home

The provider has recently appointed a new manager who will need to apply to register with Ofsted.

p.1

Information about this children’s home

Due to COVID-19, at the request of the Secretary of State, we suspended all routine inspections of social care providers carried out under the social care common inspection framework (SCCIF) on 17 March 2020.We returned to routine SCCIF inspections on 12 April 2021.

p.1

Information about this children’s home

We undertook a monitoring visit on 4 February 2021, a full inspection on 4 and 5 August 2021, and further monitoring visits on 9 and 18 August and 1 September 2021. These reports are published on the Ofsted website.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

requires improvement to be good

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

p.1

requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

p.1

requires improvement to be good

The children’s 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 Inspection report for children’s home: SC361167 2 welfare not being safeguarded or promoted. As a result of this visit, one compliance notice has been issued.

p.1

requires improvement to be good

Overall judgement at last inspection: inadequate

p.2

Enforcement action since last inspection:

At the full inspection on 4 and 5 August 2021, the home was suspended due to serious and widespread failings that compromised children’s safety. Senior managers from the organisation communicated with Ofsted that they had put measures in place to safeguard children and invited Ofsted to reconsider the need to suspend the service. On 9 August 2021, Ofsted returned to the setting to review works undertaken. As a result of this visit, Ofsted lifted the suspension notice and imposed a condition on the home’s registration to reduce the number of children from 22 to five. Four compliance notices were raised following this monitoring visit. On 1 September 2021, Ofsted returned to the setting to review work undertaken to meet the four compliance notices. As a result of this visit, inspectors found that the four compliance notices had not been met and so these were issued again. An additional compliance notice was also raised.

p.2

Enforcement action since last inspection:

Inspection report for children’s home: SC361167 3

p.3

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: SC361167 4

p.3

improvement to be good

Five children lived at the home at the time of the inspection. The five children live in three separate buildings, all in the same grounds. No new children have moved in and no children have moved on since the monitoring visit on 1 September 2021.

p.4

improvement to be good

Staff support each child to use their preferred communication system, be it picture exchange, pictorial daily planners, symbols or visual sequencing cards. Training has enabled staff to do this better, and this positive change benefits children and how they interact with those caring for them and their peers.

p.4

improvement to be good

Some children have good-quality social stories to explain key events in their life, for example the recent changes in the home and the work being undertaken to improve their home environment. This work will continue as staff prepare children to move into refurbished bedrooms.

p.4

improvement to be good

More work needs to be done to embed the improved communication practices and use them consistently each day. For example, when inspectors observed medication being administered to a child, staff did not use visual cues to explain to the child what was expected.

p.4

improvement to be good

All children engage in a range of activities in the home, and some children enjoy community activities now that restrictions relating to the COVID-19 pandemic have lifted. One child goes swimming twice a week and three children have enjoyed a trip to the safari park. However, two children rarely leave the grounds other than to go for a walk with staff. Plans to support these children to engage in the community have been slow to progress. For example, there were unnecessary delays in sourcing consent to use a specialist harness that would enable a child to travel and enjoy community activities safely. Another child lives and is educated separately to his peers. Although there is a plan to increase opportunities to socialise with a peer that the child gets along with, there was little evidence that this had been implemented. These delays and the lack of oversight in progressing agreed plans have negatively

p.4

improvement to be good

affected some children’s experiences and development.

p.4

improvement to be good

Managers have undertaken a multi-disciplinary approach to reviewing children’s care and support plans. Key information and views have been sought from parents, placing authorities, clinicians, managers and staff who know the children. This good work has resulted in written plans that now provide a clear explanation of the child’s needs, behaviours, risks, desired outcomes and how to achieve these. Tailored plans are helping staff to provide children with more individualised care and support, but these are not yet implemented consistently. Inspection report for children’s home: SC361167 5 All the children attend education at the on-site school. Care and education staff communicate well to facilitate an effective handover of information each day. Children’s education needs and plans are reviewed and staff support children to make progress with their learning in line with their age and development.

p.4

improvement to be good

Children access health services and all their routine dental and eye checks are up to date. When needed, health professionals come to the home to undertake these checks. Staff make referrals for specialist health assessments and treatment as required. It is unclear if one child has received their annual health assessment and managers are looking into this.

p.5

improvement to be good

Managers have reviewed the restrictions in place for children that limit their freedom of movement around their home and grounds. The need for so much fencing around the grounds has been reassessed and work is underway to remove unnecessary fencing and lockable gates. In newly refurbished homes, internal doors will not be locked and children will be able to go to the toilet and their bedrooms without being reliant on staff to give them access. These improvements will help to promote children’s independence and mean that children will no longer have to live in an institutionalised environment.

p.5

improvement to be good

Management oversight of restraint incidents has continued to improve. The use of restraint is appropriate to keep children and others safe, and the number of restraint incidents is reducing. There is greater challenge of staff practice by managers to understand what happened and how to prevent the same thing from happening again. However, shortfalls remain. For example, it is still not clear if all staff involved in a restraint and those who witnessed it have been spoken to. In addition, the quality of follow-up support to children is variable. Staff are not always using children’s preferred communication systems to check on their welfare after a restraint.

p.5

improvement to be good

Staff receive training to raise their knowledge and awareness of how best to promote children’s health and safety. Staff have received training to help them to know how to respond to incidents of self-harm, including ligatures and medical emergencies such as epilepsy. Staff were able to explain to inspectors how to use this training should the need arise.

p.5

improvement to be good

Medication management is improving. Trained staff are administering medication. Medication protocols have been reviewed and recording systems for non-prescribed medication and topical treatments are in place. Despite the improvements, one child’s prescription stated a specific method of administering a medicine. However, this was not being followed. In addition, it is taking staff a long time to administer medication to the five children. As a result, some children experience delays in receiving their prescribed medication on time. Managers had not considered the impact of time delays on the next required dose of medication for children. Inspection report for children’s home: SC361167 6 Children’s risk assessments have been reviewed and updated. Most are well written and include key information. Staff have read them and implement the measures designed to protect children from harm. However, one child’s risk assessment does

p.5

improvement to be good

not contain accurate information about the nature of the risk and helpful information to manage this. While addressed during the inspection, this shortfall shows that management oversight sometimes lacks the attention to detail required.

p.6

improvement to be good

Managers ensure that allegations, concerns and complaints have been appropriately investigated. When concerns have been raised, these have been investigated by someone independent. Comprehensive reports with clear recommendations have been produced and managers are now working on implementing these recommendations.

p.6

good

Most staff receive support through individual supervision and team meetings. This provides staff with the opportunity to reflect on their practice. However, some staff are not receiving supervision regularly and all eligible staff have not had an annual appraisal. This means that some staff have not had their performance and development reviewed.

p.6

good

New staff are subject to an assessment of their suitability to work with children. This includes references and criminal records checks. However, leaders and managers have not ensured that all staff have had their employment history explored and gaps explained. This means that recruitment checks are not as thorough as they need to be and may lead to unsuitable people caring for children.

p.6

good

Staff receive mandatory and specialist training to enable them to develop the skills and knowledge they need to care for children effectively. Staff spoke confidently to inspectors about the recent training and how it had informed their practice. Most staff are qualified to level 3 in caring for children or are working towards this within timescales set out in regulation. Managers have an ambitious workforce development plan, which includes a plan to deliver autism practitioner training to all staff. They are about to embark on this training for staff which, when completed, will mean staff are qualified to diploma level.

p.6

good

Leaders and managers know the strengths and weaknesses of the service. They are moving away from crisis management that has been a feature in recent months, and working to develop and embed the positive changes being made to the quality of care provided to children. Newly implemented audit and monitoring systems have contributed to this process and this improvement work is ongoing.

p.6

good

The home is suitably staffed and this has led to a reduction in the use of agency staff. This means that children are receiving care from consistent staff. When concerns arise about staff practice, managers take prompt action and follow due process. On one occasion, managers did not notify the regulator about a serious incident and the actions they had taken in response. Inspection report for children’s home: SC361167 7 The home environment is improving steadily. A programme of works is underway and ongoing. Newly refurbished rooms will be ready for some children to move into soon. These are modern and well decorated, and communal areas are more homely.

p.6

good

Four out of the five compliance notices raised at the last inspection have been met and one compliance notice is being raised again in relation to physical intervention. The condition Ofsted imposed on the home’s registration to reduce the number of children to five has been lifted. Shortly after this inspection, Ofsted granted an application by the provider to vary the number of children they can care for from five to eight. Inspection report for children’s home: SC361167 8

p.7

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.

p.8

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.

p.8

Requirement Due date

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

p.8

Requirement Due date

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

p.8

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)(iii)(b))

p.8

Requirement Due date

In particular, ensure that all children are supported to access the community, and that plans are progressed and implemented without delay. 12 January 2022

p.8

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—

p.8

Requirement Due date

helps children aspire to fulfil their potential; and

p.8

Requirement Due date

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

p.8

Requirement Due date

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; 12 January 2022 Inspection report for children’s home: SC361167 9 use monitoring and review systems to make continuous improvements in the quality of care provided in the home.(Regulation 13 (1)(a)(b) (2)(a)(h))

p.8

Requirement Due date

In particular, continue to embed new monitoring and audit systems and use these to their full effect to promote children’s progress and experiences.

p.9

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.

p.9

Requirement Due date

In particular the registered person must ensure that—

p.9

Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. (Regulation 23 (1)(2)(b))

p.9

Requirement Due date

In particular, ensure that clarification is sought from a GP about how a medication is to be administered and ensure that medication is administered to children in a timely way. 30 November

p.9

Requirement Due date

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

p.9

Requirement Due date

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

p.9

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

p.9

Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each matters in Schedule 2. (Regulation 32 (1) (2)(a)(b)(3)(d)) 12 December

p.9

Requirement Due date

The registered person must ensure that all employees—

p.9

Requirement Due date

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

p.9

Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(b)(c)) 12 January 2021 Inspection report for children’s home: SC361167 10 This specifically relates to the registered person ensuring that staff receive regular supervision and an annual appraisal.

p.9

Requirement Due date

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

p.10

Requirement Due date

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

p.10

Requirement Due date

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

p.10

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—

p.10

Requirement Due date

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

p.10

Requirement Due date

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")—

p.10

Requirement Due date

has spoken to the user about the measure; and

p.10

Requirement Due date

has signed the record to confirm it is accurate; and

p.10

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)(b)(i)(ii)(c))

p.10

Requirement Due date

In particular, ensure that incidents of restraint are recorded in line with regulation, managers review and evaluate incidents of restraint effectively, and that children and staff are spoken to after an incident by someone who was not involved in the incident. This requirement was subject to a compliance notice at the previous inspection and another compliance notice has been issued following this inspection. 12 December

p.10

Requirement Due date

* These requirements are subject to a compliance notice.

p.10

Recommendations

Inspection report for children’s home: SC361167 11  The registered person should notify Ofsted and other relevant persons if there is an incident relating to the protection, safeguarding or welfare of a child living in the home which the registered person considers to be serious (40(4)(e)). (‘Guide to the children’s homes regulations, including the quality standards,’ page 63, paragraph 14.10)

p.11

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 for children’s home: SC361167 12

p.11

Children’s home details

Provision sub-type: Residential special school

p.12

Children’s home details

Registered provider: Options Autism (5) Limited

p.12

Children’s home details

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

p.12

Inspectors

James Tallis, Social Care Inspector Jackie Line, Social Care Inspector Inspection report for children’s home: SC361167 13 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.

p.12

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.13

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.13

Inspectors

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

p.13