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

Inspection report for children’s home - monitoring visit: SC361167 1 SC361167 Registered provider: Options Autism (5) Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

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

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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 home offers specialised education and care for up to eight children.

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Information about this children’s home

A new manager was appointed in December 2021 and has yet to apply to register with Ofsted. She is suitably experienced and is working towards the level 5 qualification in management.

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This monitoring visit

On 1 February 2022, Ofsted carried out a monitoring visit at this home. That monitoring visit was made to review the progress managers and staff had made in meeting the steps outlined in the compliance notice raised in relation to medication shortfalls. In addition, inspectors reviewed progress made by the provider in addressing requirements identified at the full inspection in relation to the protection of children, enjoyment and achievement, leadership and management, staff supervision and safer recruitment practice. The report will be available on Ofsted’s website.

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This monitoring visit

At the monitoring visit on 1 February 2022, investigations were ongoing into separate concerns relating to children’s safety and staff conduct. This monitoring visit was undertaken in response to concerning information arising out of one of these investigations in relation to unexplained injuries to a child. Additional investigations have commenced since 1 February 2022. Inspection report for children’s home - monitoring visit: SC361167 2 Seven children lived at the home at the time of the monitoring visit. One child has recently moved out.

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This monitoring visit

Inspectors found that two other children had unexplained injuries and bruises logged in their daily record. Managers were unaware of these injuries because they do not routinely read the children’s daily records and staff had not alerted them to any issues. In both cases, there were no records which may have accounted for the cause of these injuries. This poor recording and reporting of injuries to children, coupled with a lack of management oversight, leaves children at risk of harm.

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This monitoring visit

There are serious concerns around the alleged behaviour and conduct of some staff. Investigations are underway and managers have taken some swift action in response to the concerns raised. However, managers have not taken all appropriate action to safeguard children while these concerns are investigated. This means that children are at continued risk of harm when serious concerns are identified.

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This monitoring visit

Senior managers have undertaken spot checks at the home in response to the safeguarding concerns raised and while investigations are ongoing. These unannounced visits have highlighted concerns such as a door being left unlocked which could have compromised children’s safety, night staff appearing sleepy and the logs for children during the night being written in advance. This raises concerns about the legitimacy of recording and the integrity of staff. However, managers had not taken additional steps to safeguard children in light of these findings. They did take action during the monitoring visit so that additional safeguards are in place to protect children while they make the necessary changes to staff practice.

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This monitoring visit

When children display self-injurious behaviour, such as banging their head, staff do not record the level and frequency of this behaviour. A self-injury plan for a child who does bang their head is out of date because it refers to staff needing to seek an immediate assessment by the on-site nurse. However, there is no longer a nurse employed to work at the home. Staff do not always seek medical advice from an alternative health professional. This is not safe practice and has the potential to compromise the child’s health and well-being.

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This monitoring visit

Ineffective monitoring systems do not enable managers to understand and respond effectively to issues arising in the home. If an incident does not involve physical intervention, managers do not review the incident record promptly. Inspectors found one incident involving physical intervention, which had not been recorded as such and so had not been reviewed. As a result, potential concerns remain unknown and unaddressed.

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This monitoring visit

Managers and staff do not monitor children’s daily routines, and so they do not ensure that children drink and eat enough. Daily records show some children do not have enough to drink. Other children miss meals. Managers were unaware of this until it was raised by the inspectors, and so are not considering the implications this could have on children’s health, well-being and behaviour. Inspection report for children’s home - monitoring visit: SC361167 3 The responsible individual has failed to effectively oversee a sustained period of compliance with the regulations. She told inspectors that they were considering a request for a child who had previously lived at the home to return. This shows a lack of regard and understanding of the position the home is in regarding staff sufficiency, safeguarding concerns and other shortfalls in the quality of care that children receive.

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This monitoring visit

Agency staff who have worked in a children’s home for over two years do not have the required qualification set out in regulation. In addition, there is not enough staff to care for children to support their morning routines in line with the level of support set out in their plans. Managers could not provide a clear, evidence-based reason for this. As a result, it is not clear that children receive the level of support they need when they get up each day. Managers reported that school staff support children’s morning routines. However, staff rotas did not show this. These shortfalls do not promote children’s well-being and do not ensure that there are records that can be relied on if needed.

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This monitoring visit

Inspectors observed positive relationships between children and staff. Some children were accessing community activities and others were making good use of play equipment in the garden. A parent and professionals spoken to as part of this visit were positive about the care that children receive.

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This monitoring visit

As a result of this visit, Ofsted issued a notice of restriction of accommodation. This means that, as children leave, no new children can be admitted. Seven new requirements have been raised, including two that are subject to compliance notices. In addition, requirements raised at the previous monitoring visit have not been reviewed at this inspection and so are restated, pending review at a future inspection. Inspection report for children’s home - monitoring visit: SC361167 4

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Recent inspection history

Inspection date Inspection type Inspection judgement 26/10/2021 Full Requires improvement to be good 04/08/2021 Full Inadequate 22/10/2019 Full Good 27/06/2018 Full Good Inspection report for children’s home - monitoring visit: SC361167 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 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

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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)(iii)(b))

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Requirement Due date

Specifically, to ensure that all children are supported to access the community, and that plans are progressed and implemented without delay.

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Requirement Due date

Progress against this requirement was not reviewed at this inspection and has been restated. 20 March 2022

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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; and

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Requirement Due date

children are helped to lead healthy lifestyles.

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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 staff help each child to— 11 March 2022 Inspection report for children’s home - monitoring visit: SC361167 6 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. (Regulation 10 (1)(a)(b)(c) (2)(a)(i)(ii))

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Requirement Due date

This specifically relates to ensuring that children are appropriately hydrated and are accessing appropriate meals.

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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 necessary, make arrangements to reduce the risk of any harm to the child;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare;

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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. (Regulation 12 (1) (2)(a)(i)(iii)(v)(vi)(b))

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Requirement Due date

In particular, to ensure that staffing levels in the morning are reviewed and amended as necessary, and that concerns about staff practice during the night are addressed. In addition, that the registered person takes prompt and effective action to report, record and respond to any concerns. 11 March 2022 Inspection report for children’s home - monitoring visit: SC361167 7 *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

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home;

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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)(f)(h))

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Requirement Due date

In particular, that children receive the staffing levels as outlined in the placing agreement with local authorities. If there are exceptional circumstances when this cannot be achieved, this must be carefully reviewed to understand the impact of this and that there is clear communication with the relevant children’s placing authorities. Also, that managers’ monitoring systems scrutinise records of children to identify any weaknesses in recording and reporting. 11 March 2022

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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

ensure that the home has sufficient staff to provide care for each child. (Regulation 13 (1)(a)(b) (2)(c)(d)) 11 March 2022 Inspection report for children’s home - monitoring visit: SC361167 8 In particular, ensure that there are sufficient staff with the skills to meet the needs of each child.

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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 statement in paragraph (1) requires the registered person to ensure—

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Requirement Due date

manage and review the placement of each child in the home; and

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Requirement Due date

that each child’s relevant plans are followed. (Regulation 14 (1)(a )(2)(b)(ii)(c))

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Requirement Due date

In particular, ensure that there is a clear understanding about what any additional support is for, and that this is clearly documented in children’s plans, followed and reviewed.

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Requirement Due date

Progress against this requirement was not reviewed at this inspection and has been restated. 1 March 2022

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Requirement Due date

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)) 11 March 2022

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Requirement Due date

The registered provider must appoint a person to manage the children’s home if—

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Requirement Due date

there is no registered manager in respect of the home; and

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Requirement Due date

is not, or does not intend to be, in day-to-day charge of the home. (Regulation 27 (1)(a)(b)(i)(iii)) 11 March 2022 Inspection report for children’s home - monitoring visit: SC361167 9 Specifically, ensuring that the appointed manager applies to register with Ofsted without delay.

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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))

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Requirement Due date

In particular, that agency staff working at the home hold an appropriate qualification within two years of commencing employment in a care role in a children’s home. 20 March 2022 Inspection report for children’s home - monitoring visit: SC361167 10 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.

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Requirement Due date

This requirement was raised at the last inspection and is repeated.

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Requirement Due date

Progress against this requirement was not reviewed at this inspection and has been restated. 20 March 2022

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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

The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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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; 11 March 2022 Inspection report for children’s home - monitoring visit: SC361167 11 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;

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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")—

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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) (2) (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii) (b)(i)(ii)(c))

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Requirement Due date

In particular, ensure that incidents involving physical intervention are recorded as such and that managers review all incident records promptly and effectively.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date; and

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Requirement Due date

retain records for at least 15 years from the date of the last entry. (Regulation 37 (2)(a)(b)(c))

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Requirement Due date

In particular, ensure that clear records are maintained about when and where staff work at the home. 20 March 2022

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Requirement Due date

*These requirements are subject to a compliance notice. Inspection report for children’s home - monitoring visit: SC361167 12

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Recommendations

 The registered person should ensure that prescribed medicines are only administered to the individual for whom they are prescribed. Medicines must be administered in line with a medically approved protocol. Specifically, that MAR records reflect when medication should not be taken alongside other medication as outlined in advice notes. (‘Guide to the Children’s Homes Regulations, including the quality standards,’ page 35 paragraph 7.15)  The registered person should ensure that staff are familiar with the home’s policies on record keeping and understand the importance of careful, objective, and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child.(‘Guide to the Children’s Homes Regulations, including the quality standards,’ page 62 paragraph 14.4)

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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 13

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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

James Tallis, Social Care Inspector Jackie Line, Social Care Inspector Inspection report for children’s home - monitoring visit: SC361167 14 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

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