Children's Home, Residential special school run by Wandsworth Borough Council in Wandsworth

Unique reference number SC470513 Inspector Sophie Wood Type of inspection Full Provision subtype Children's home

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Registered manager Jane Helen Bonner / Deborah Jane Tomlinson Date of last inspection 03/12/2014 2 of 12 Inspection date 13/01/2015

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Previous inspection inadequate Enforcement action since last inspection none

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Overall effectiveness good

Outcomes for children and young people good Quality of care good Keeping children and young people safe adequate Leadership and management good

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Overall effectiveness

In December 2014, the home was judged inadequate at its first full inspection following its change of status from a residential special school to a children's home. Shortfalls with regards to staff recruitment, staff supervision processes and monitoring arrangements resulted in one compliance notice and two requirements being set. This second visit explores all of the areas of a full inspection although a rigorous focus is placed upon the previous shortfalls.

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Overall effectiveness

Young people are benefitting from highly personalised, well-planned care. Their unique and frequently challenging needs are valued, respected and very well understood. Hence, young people make good, and in many instances, excellent progress from their starting points.

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Overall effectiveness

Despite numerous communication difficulties, young people in this home learn to develop a strong and influential voice. Staff read their behaviours and find creative ways to ensure their opinions are known and effectively communicated. Young people feel valued and this is routinely demonstrated through their behaviours towards the staff team. Loving and caring relationships are nurtured. These are appropriately balanced with clear behavioural expectations which teach young people about living successfully within a wider society. 3 of 12 Senior managers have embraced the findings of the previous inspection. A well- planned, targeted action plan is being systematically delivered with appropriate speed and efficiency. Progress is swift yet diligent. Improvements towards recruitment practices result in a safer environment. All staff are now receiving improved supervision arrangements and this impacts positively upon the quality of

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Overall effectiveness

the care provided for the young people. Monitoring systems are more focused; they are driving improvements.

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Overall effectiveness

Senior managers understand the need for continuing review and evaluation of these changes. Clear reviewing timescales are in place. They also understand the remaining areas, requiring further development. One example is the current recording format with regards to the use of physical restraint, for which a requirement is made. 4 of 12

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Information about this children’s home

This service is a residential special school, registered as a children's home to care for up to 52 children on a weekly, termly or 52 week basis. It is operated by a local authority. The home is registered to accommodate children with a learning disability, including those on the autistic spectrum and with communication and interaction difficulties.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children’s home, a written record is made in a volume kept for the purpose of which shall include; the effectiveness and any consequences of the use of the measure and details of any methods used to avoid the need to use that measure (Regulations 17B (3f and 4b)) 20/03/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s): 5 of 12  ensure that all people working in or for the children’s home are interviewed as part of the selection process and have references checked to assess suitability before taking on responsibilities; make telephone enquiries as well as obtaining written references. (National Minimum Standards 16.1) 6 of 12

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Outcomes for children and young people good

Young people are thriving within a stimulating and nurturing environment. They make good or excellent progress across all areas of their social, behavioural and educational development. Young people learn to understand their surroundings and experiences and this is a significant achievement for many who cannot understand the wider world. Structured routines, combined with highly individualised care planning builds their confidence, understanding and trust.

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Outcomes for children and young people good

Young people usually enjoy good general health. They benefit from physically active lifestyles combined with healthy nutritious diets. Those with additional support needs concerning their lifestyle choices, such as issues with food and meal times, receive consistent and thoughtful help. Some young people are not fully able to make safe choices and decisions about their health and well-being. In such circumstances, they receive the help, support and guidance they require. Young people are assured that their best interests are effectively promoted. Staff patiently help young people to overcome their issues and anxieties. As a result, young people make very good progress in their emotional well-being. Phobias and fears are very well understood by staff; these are factored into their daily living opportunities, subtly and sensitively. Young people learn to become more tolerant of their surroundings and many begin to

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Outcomes for children and young people good

widen their desire to interact with others.

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Outcomes for children and young people good

This factor is especially beneficial in strengthening their personal relationships, particularly with their own family members. Comments from parents include, 'my child has come on so much' and 'there were many things we couldn't do as a family before but we can now.' Positive outcomes for such young people are having a tremendous impact upon their own families.

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Outcomes for children and young people good

Young people learn to refine their preferred communication methods which frequently manifest as extremes of behaviour. Over time, individually tailored communication methods reduce their frustration at being misunderstood. Young people are learning to effectively communicate and this has enriched their relationships with staff and their peers.

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Outcomes for children and young people good

Young people’s seamless transition from home into the school day helps to maximise their learning potential. Methodical joint planning between home and school staff ensures they practise their goals and targets throughout the day and evening. Young people maximise their learning potential and this positively impacts upon their developing independence. Opportunities to practise life-skills are transferred into the wider community. 7 of 12

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Quality of care good

Some young people have little or no verbal communication. Others describe staff as 'good, my friend' and 'lovely.' The quality of their relationships with staff is frequently demonstrated through their behaviour. Examples include easy laughter in their company and actively seeking out the individual staff members they want to spend time with. Young people trust these relationships because staff actions are responsive to their needs and consistently applied.

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Quality of care good

A strong emphasis is placed upon the unique communication needs of the young people. Communication passports have been developed and these documents provide meaningful assistance, particularly when young people move onto adult services. New carers can quickly learn the very specific and individual traits and needs of the young people.

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Quality of care good

Thoughtful, well-planned care packages take young people's individual and unique needs into account. Young people are highly valued and their key workers, in particular, know them extremely well. Staff are able to speak about young people in great depth and with insight. Following the previous inspection, individual care planning files are being reviewed and updated. The previous reliance upon long- standing staff knowing the young people well is being replaced by clearer written information. This improved practice brings clarity for new staff and improved consistency for the young people.

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Quality of care good

Innovative and creative methods effectively capture the views and opinions of the young people. Their realistic and meaningful contributions at formal and informal meetings have a direct impact upon the day-to-day running of the home. Those with language and communication difficulties receive individually tailored assistance such as pictorial aids, objects of reference and the interpretation of their behaviours to ascertain their views.

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Quality of care good

Bedrooms are highly personalised and young people exercise their personal choice with regards to how to spend their free time. High staffing levels ensure they choose their own activities in accordance with their own preferences and interests. Supervision and support levels proportionately reflect needs without being oppressive. Young people enjoy the freedom of movement within the home and grounds within safe parameters.

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Quality of care good

Young people receive the guidance and support they need to maintain their usually good general health. The home enjoys a very positive relationship with the local GP surgery. Young people receive speedy appointments when these are required. If young people need to visit specialists they are well supported and the home continues to challenge and push for the right health support, for example from Child and Adolescent Mental Health Service teams. Many of the young people require medication. This is diligently monitored and staff receive external training and competency assessments for this. Young people are protected by this safe practice 8 of 12 which is further enhanced by a current review of medication storage areas.

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Quality of care good

Young people’s transition between home and school is very well managed. High staffing levels and diligent shift planning ensures young people are well prepared for the school day ahead. Excellent liaison between school and care staff ensures that young peoples' targets in relation to their educational and social needs are individually tailored, meaningful and suitably challenging. Staff across the entire provision have high aspirations for the young people.

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Keeping children and young people safe adequate

Young people are kept safe by staff that work closely with them and understand their needs. Some young people are unable to express themselves verbally. Staff fully appreciate the potential risks and vulnerabilities which arise from this. As a result, communication methods are highly individualised. Young people are given every opportunity to express themselves.

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Keeping children and young people safe adequate

All staff receive on-going safeguarding and child protection training which is underpinned by clear procedural guidance. Staff members are aware of the signs and symptoms of abuse and neglect. They take appropriate action and know who to report concerns to. Staff members have an excellent understanding of the specific and diverse needs of all of the young people. This enables them to consider wide ranging risks and to recognise all aspects of young people's behaviour. Staff ratios are very high, typically one to one. As a result, young people are well supervised throughout their day in all aspects of their care.

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Keeping children and young people safe adequate

Recruitment practices have recently been comprehensively reviewed. In many examples, retrospective checks have been made to previous employers and references have been re-evaluated. These activities have resulted in a much stronger focus substantiating the skills and suitability of employees. Human resources and recruitment practices demonstrate clear and concise measures in place which ensure no applicant can begin employment until the process is satisfactorily completed. It is acknowledged that this is an extensive and comprehensive review and completion is imminent. A recommendation is therefore made simply requiring completion of this ongoing piece of work.

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Keeping children and young people safe adequate

Senior staff members demonstrate a strong understanding of their specific safeguarding duties and responsibilities. Young people are safe because a culture of questioning, challenge and checking exists. Child protection training provision is commensurate with roles and responsibilities. Senior staff maintain their knowledge and practice by routinely attending wider agency conferences and seminars. Prompt referrals and consultations with the local safeguarding agency ensures the protection of children. This practice also includes the Local Authority Designated Officer in the event of any concerns raised about staff members. 9 of 12 Staff appreciate the impact of young people's learning disabilities and in many examples, their limited means of effective communication. They understand the associated risks and how such factors can adversely affect young peoples' ability to complain and, in some cases their understanding of their rights. Comments from staff

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Keeping children and young people safe adequate

include, 'some of our children might not even know if they are being badly treated so we must make sure that we have strong safeguards in place.' Such potential concerns are minimised by the use of advocacy services, independent visitors and an open door practice with regards to visiting family members and friends.

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Keeping children and young people safe adequate

Some young people's presenting needs may result in physical intervention being necessary. However, as staff members know the young people so well, situations are often predicted and de-escalation techniques are effective. Where physical intervention is needed, staff use the least restrictive measures and gentle guiding and redirection is typically successful. Although incidents of physical intervention are well recorded, in a small number of examples, the specific written records kept in the restraint log do not contain all the necessary information required by regulation. Staff do access this information through other systems and this shortfall has had no discernible impact on young people's welfare.

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Keeping children and young people safe adequate

Young people do not go missing from the home. High staffing levels and the use of surveillance assists with this. Policy guidance and the Statement of Purpose make the use of surveillance within communal areas explicit within placement agreements for social workers and parents to consider. The home maintains their absence and missing person guidance in accordance with local authority, placing authority and police protocols.

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Keeping children and young people safe adequate

The home is maintained to provide a safe and secure environment for young people. Effective risk assessment reduces or removes many potential risks and hazards. High staffing ratios further ensure that young people do not come to harm or place themselves in any danger. Fire safety and health and safety are effective; all staff and young people keep themselves safer by receiving regular instruction on fire evacuation drills.

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Leadership and management good

The two Registered Managers possess relevant qualifications, a wealth of knowledge and vast experience in managing staff and supporting young people with complex care needs and disabilities. Their skills and knowledge complement each other in this shared role. This provides the staff team with a wide and diverse knowledge base and leadership resources. Staff members say that they feel supported by the management team, have confidence in its leadership and feel valued.

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Leadership and management good

Staff benefit from a rich and varied programme of training. This is targeted to ensure those staff with more specialist roles within the home, such as the administration of medication or specific communication roles, develop their skills through enhanced 10 of 12 training. Mandatory courses include safeguarding, promotion of welfare, and training related to children’s specific disabilities. All new staff are inducted through formal, accredited programmes providing them with the necessary skills in the early stages of their development. Staff and managers recognise the importance of research and training and demonstrate this commitment to further their knowledge through the recent improvements and development of the training programme. Staff say they feel both challenged and supported by training. Leaders and managers have recently implemented a skills audit; the findings are being used to further enhance training in

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Leadership and management good

supervision and quality assurance practices. Young people benefit because the team, in its widest sense, is competent and knowledgeable.

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Leadership and management good

Staff feel well supported through regularly planned supervision and six monthly appraisal. They explore their own development needs and use these meetings to reflect on practice and improving young people’s outcomes. The self-confidence of staff grows through supervision and this enables them to be still more competent in their roles. One staff member commented, 'I look forward to supervision as it provides me a good opportunity to raise and discuss matters. It's good reflection.'

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Leadership and management good

Well-maintained care records are kept in a manner that provides young people with good opportunities to look back at their histories and time spent in the home. These documents are frequently reviewed in order that young people are actively encouraged to understand and take ownership of their own targets, goals and aspirations.

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Leadership and management good

No complaints have been received since the last inspection. Senior managers demonstrate transparency and a desire to continually improve by making such processes widely available and known. Although significant incidents are very rare, managers again demonstrate a strong desire to work collaboratively with external agencies, such as Ofsted by making prompt notifications.

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Leadership and management good

From its first inspection as a children's home, in December 2014, the home was issued with a compliance notice to improve its recruitment practice. Two requirements due to shortfalls concerned with staff supervision and monitoring processes were also made. Senior managers demonstrate a committed approach towards improvement. Necessary changes have resulted in significantly reduced risks and staff now receive meaningful, skill-enhancing supervision. All core areas of care practice are now subject to robust and rigorous monitoring. The home has embraced the inspection process and learnt valuable lessons.

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Leadership and management good

Independent Regulation 33 visits to the home continue to make recommendations which help to maintain and improve the quality of the care provided for the young people. On-going development plans demonstrate clear focus on the young people’s care and the services that support the improvement of their outcomes. The management philosophy and style ensures leadership is kept very close and accessible to care staff, enabling staff to influence and develop practice effectively. Staff comments include, 'our views are listened to by the management and we feel 11 of 12 that our opinions are valued.' In addition, they say, 'we can speak to any manager and we know they will listen to us.'

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Leadership and management good

Comprehensive and detailed procedures for the reviewing, monitoring and improving the quality of care are now clearly defined along with staff roles and responsibilities. A recent review of quality assurance inspections and monitoring carried out under Regulation 34 has resulted in effective oversight being undertaken of the home's performance and progress. Quality assurance monitoring results in prompt and effective action being taken to address any area of shortfall or area assessed as requiring development. Website: www.ofsted.gov.uk

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Leadership and management good

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information about this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

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