Children's Home, Residential special school run by The National Autistic Society in Barnsley

Inspection report for children’s home: SC032154 1 SC032154 Registered provider: National Autistic Society (The) Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is part of a charitable trust. It is registered to provide care for up to eight children who may have autism spectrum disorder. Children may have other associated difficulties, such as sensory impairment and/or physical disabilities. At the time of this inspection, two children were living in the home.

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Information about this children’s home

The home is divided into two houses, with a communal hub and garden. This registered children’s home is also part of a specialist school that provides education on site.

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Information about this children’s home

The manager registered with Ofsted in August 2022.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: outstanding

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inadequate

Enforcement action since last inspection: none Inspection report for children’s home: SC032154 2

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Inspection date Inspection type Inspection judgement

22/03/2022 Full Outstanding 21/01/2020 Full Outstanding 08/01/2019 Full Outstanding 18/01/2018 Full Outstanding Inspection report for children’s home: SC032154 3

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inadequate

Since the last inspection, there have been significant shortfalls in the safety and protection of children and the leadership and management of the home. These shortfalls placed children at risk of serious harm. As a result of this inspection, Ofsted has issued a notice restricting accommodation and five compliance notices .

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inadequate

There are currently two children living in the home. These children have lived in this home for a number of years. Staff know and understand these two children well and are able to meet their needs and keep them safe. However, since the last inspection, other children have been admitted to and discharged from the home. As a result, the two children who have lived in this home for a long time have experienced an unsettled and chaotic period as the needs and presenting behaviours of some of the other children have changed significantly over recent months.

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inadequate

Staff have not had the skills and ability to meet the needs of all of the children who have lived in the home since the last inspection, or to help them with their behaviours. Some children have been affected by the behavioural responses of other children. Children have been threatened and intimidated by other children and their access to areas of their home restricted. Children’s toys have been broken or damaged and an aquatic pet has been killed.

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inadequate

There is no effective procedural guidance to aid staff in their decision-making about when they should seek medical guidance following an incident. Children who may have sustained injuries, due to ligaturing or the insertion of foreign objects into their bodies, have not been medically assessed. The risk around injury had not been recognised.

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inadequate

Children are helped to maintain and rebuild their relationships with their families. Plans are implemented to help children to understand and accept their family’s involvement in their lives. However, significant incidents involving children and staff that have occurred in the home have disrupted other children’s family time.

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inadequate

There is a focus on improving children’s quality of life by developing their independence. Children are being taught how to carry out daily living tasks. As children reach adulthood, most experience a planned move into a suitable adult provision. Recently, some children experienced an abrupt end to their placement because staff were unable to meet their complex needs and keep them safe. These children’s complexities had increased after their admission to the home. The two children currently living at the home do not present with behavioural responses that are outside the staff’s capabilities. Inspection report for children’s home: SC032154 4 Most of the children attend the on-site school and each child has an individualised plan to support their learning needs. One child’s plan to start education on site was not achieved during their placement due to the child’s presenting behaviours and reported mental ill health.

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inadequate

The manager has involved children in the decoration of the home. Damage caused by other children to the home has been addressed. However, the children’s bedrooms and en suites require routine cleaning, to ensure that they are maintained to an acceptable standard.

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inadequate

Children need help with their personal care. Intimate care is delivered sensitively by staff, and staff provide children with the opportunity to take control of this element of their care when possible. Levels of staff supervision and assistance are sensitive to each child’s ability and need for privacy.

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inadequate

Children are involved in choosing new community experiences. Children have enjoyed a trip to Blackpool and to the theatre. Sometimes, children have not had a choice about going out with staff because leaving the home has been necessary to prevent children from being harmed by other children.

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How well children and young people are helped and protected: inadequate

The failure of leaders and managers to ensure that staff had the skills to meet the specific needs of one child meant that staff neglected the child and placed them at risk of significant harm. The child ligatured with a blind cord while staff had placed themselves behind a locked door, protecting themselves instead of the child.

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How well children and young people are helped and protected: inadequate

Staff are not equipped to respond to ligature incidents. Staff are untrained and it was reported to inspectors that some staff have said that they are unwilling to complete ligature training. The manager has failed to ensure that the child’s risk assessments are routinely reviewed and updated, particularly when there has been an escalation of an identified risk. The inspectors found that the children’s risk assessments do not provide staff with the necessary guidance for them to help children who are in crisis and at risk of ligaturing.

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How well children and young people are helped and protected: inadequate

There has been a significant increase in the number of physical restraints since the last inspection. The management oversight of such incidents is insufficient to ensure that practice is safe and that the views of the children and staff are heard and acted on. The staff’s recording of these restraints is poor; there are also a number of gaps in the records, including, but not limited to, whether staff monitor a child’s breathing during a ground hold restraint.

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How well children and young people are helped and protected: inadequate

Some restraints on children are unlawful because staff use unplanned restrictive holds, including ground holds. Ground holds were being used despite inspectors being informed that these are not agreed by the organisation or by their awarding body. There has also been an increased use of door holds and other bespoke holds. These holds are being used on children without clear guidance being provided to staff. Inspection report for children’s home: SC032154 5 Leaders and managers have not given staff members involved in restraints the opportunity to have a proper debrief together. This does not provide an occasion for managers and staff to look at incidents in detail and to evaluate the appropriateness, effectiveness and safety of holds used. The staff do not have the opportunity to discuss how the restraint has affected them, especially when injuries have occurred.

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How well children and young people are helped and protected: inadequate

Children involved in these incidents, including those who have limited verbal communication, have not had the opportunity to take part in a proper structured session with a manager or independent staff member. This does not give the children a chance to share their views and feelings about how they were restrained.

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How well children and young people are helped and protected: inadequate

High staffing ratios ensure that children have staff supervision, and this reduces the risk of children going missing. No child has been reported as missing. The missing- from-home protocols in place direct staff to call immediately for police assistance, reflecting the vulnerability of risk for children. Nevertheless, the protocol does not provide staff with guidance about the necessary actions that they need to take to help locate a child as quickly and safely as possible.

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The effectiveness of leaders and managers: inadequate

Leaders and managers across the organisation have failed to identify that staff practice and/or a lack of suitable training have compromised the welfare, safety and protection of children. The oversight of the recordings in the integrated safeguarding system is ineffective and shortfalls in staff practice, including the skills and competency of staff, have not been identified and addressed.

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The effectiveness of leaders and managers: inadequate

The manager has not informed Ofsted of significant incidents. As a result, Ofsted has not had the necessary oversight to ensure that appropriate action has been taken by the manager to maintain the safety and well-being of the children.

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The effectiveness of leaders and managers: inadequate

The manager has been developing her monitoring of the home and produces a monthly report. However, internal and external monitoring processes lack evaluation and reflection, and have failed to highlight the shortfalls in care practices. There is a focus on national minimum standards for residential special schools, and not the required children’s homes regulations. There is delay in Ofsted receiving external monitoring reports, which means that Ofsted does not have timely insight into this home and the safety and welfare of the children.

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The effectiveness of leaders and managers: inadequate

Over the summer, a decision was made by the organisation to change the responsible individual. Ofsted has not been notified of this change.

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The effectiveness of leaders and managers: inadequate

The manager is suitably qualified for her role and is supported by a deputy manager to lead the staff team. The complex needs of the children and shortfalls in staff practice mean that the members of the management team have been pulled away from their leadership duties to provide hands-on care and support to children. This has directly removed them from their leadership and management responsibilities. Inspection report for children’s home: SC032154 6 Staff are mostly positive about the recent changes to the management team. They said that the manager values the team’s welfare and has brought improved communication. The manager has also improved communication with professionals. This was a response to concerns raised by a child’s placing authority. Inspection report for children’s home: SC032154 7

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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 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

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

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice. (Regulation 6 (1)(a) (2)(b)(ii)(ix)) 1 January 2023

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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. (Regulation 10 (1)(a))

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Requirement Due date

In particular, the registered person must ensure that children are medically assessed following incidents of restraint and self-injurious behaviour. 1 January 2023

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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 1 January 2023 Inspection report for children’s home: SC032154 8 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; and

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Requirement Due date

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

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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

*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

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

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; and

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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)(b) (2)(c)(f)(h)) 1 January 2023

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Requirement Due date

*Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (2)) 1 January 2023

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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

The registered person must ensure that— 1 January 2023 Inspection report for children’s home: SC032154 9 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

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

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; and

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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

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 (2) (3)(a)(iv)(v)(viii)(b)(i)(c))

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Requirement Due date

*The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 1 January 2023

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Requirement Due date

The independent person must produce a report about a visit (“the independent person’s report”) which sets out, in particular, the independent person’s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children’s well-being.

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Requirement Due date

The independent person must provide a copy of the independent person’s report to—

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Requirement Due date

HMCI. (Regulation 44 (4)(a)(b) (7)(a)) 1 January 2023

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating— 1 January 2023 Inspection report for children’s home: SC032154 10 the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (2)(a)(b)(c) (5))

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Requirement Due date

* These requirements are subject to a compliance notice.

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Recommendations

 The registered persons should ensure that the children’s home provides a nurturing and supportive environment that meets the children’s needs. In particular, the environment should be homely and the children’s bedrooms should be clean, and any sign of bodily fluids cleaned from the floors. (‘Guide to the Children’s Homes Regulations, including the quality standards,’ page 15, paragraph 3.9)  The registered person should ensure that staff can access appropriate facilities and resources to support their training needs. In particular, ensure that all staff have up-to-date food hygiene training and that senior staff receive relevant risk assessment training. (‘Guide to the Children’s Homes Regulations, including the quality standards,’ page 53, paragraph 10.11)

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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 for children’s home: SC032154 11

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Children’s home details

Registered provider: National Autistic Society (The)

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Children’s home details

Registered provider address: 393 City Road, London EC1V 1NG

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Inspectors

Jennifer Fenlon, Social Care Inspector (lead) Gemma McDonnell, Social Care Inspector Inspection report for children’s home: SC032154 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

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