Children's home run by The Daughters of the Cross of Liege in Kensington and Chelsea

children and young people since the most recent full inspection

This home was judged Good at the full inspection. At this interim inspection Ofsted judge that it has Declined in effectiveness .

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children and young people since the most recent full inspection

At the last inspection five requirements and one recommendation were set. The manager has addressed the majority, but not all of these requirements and recommendations. They now ensure that all staff receive training in child sexual exploitation. This further enhances staff awareness of their pivotal role. In addition all staff have undertaken first aid training in reflection of the very complex needs of the young people. Staff supervision arrangements have improved, all staff now receive regular planned one to one supervision. The various buildings in use which make up the home are suitably maintained, clean and spacious. The young people benefit from an environment which is suitably adapted and equipped to meet their needs. The quality of accommodation varies between houses and there is a redecoration program in place for standardisation. Frosted screening has been placed on internal bedroom door windows providing improved privacy for young people.

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children and young people since the most recent full inspection

Fire safety arrangements are now robust, with significant improvements since the last inspection. All fire doors have been checked and repaired to ensure their integrity. Furthermore, door closures linked to the fire alarm have been installed throughout. This allows effective observation and freedom of movement whilst continuing to maintain safety. Each young person now has an easily accessible individualised personal emergency evacuation plan which guides staff in their particular support needs in the event of an emergency.

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children and young people since the most recent full inspection

The home now holds a central admission record for all young people which meets regulatory requirements. The manager, is exploring ways in which this can be held to provide more clearly accessible information. Security arrangements have been improved and all visitors are now required to produce evidence of identity before having access to the home. Staff are successful in effectively assessing and managing risk and as a result there have been no missing from care incidents. Risk assessments are now undertaken in relation to any potential risks posed by young adults with disabilities living in the home. This enables staff to reflect upon and give full consideration to any areas of potential concern, such as, boundaries for watching age related films.

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children and young people since the most recent full inspection

Physical restraint is used only by suitably trained staff when young people present a risk to themselves or others. Suitable management overview ensures all actions taken are appropriate and proportionate and there is a focus on understanding causes and triggers for behaviour. Records of restraint, however, on occasion do not evidence the young person's views have been sought. The majority of young people are making progress from their starting points in relation to their education, health, communication, mobility and self-care skills. Some young people are making great progress in their self-regulation which is building their confidence and self-esteem. They say they ‘feel calmer’ and are proud of their progress. Most young people moving on from the service do so in a positive planned transition at the end of their school career. However, there has been one placement breakdown since the last inspection. Whilst there was multi-disciplinary

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children and young people since the most recent full inspection

review within the organisation and good strategies employed, it became clear the young person’s needs could not be safely met at the home. The parents do not feel they or the placing authority, were kept informed of the escalating concerns which impacted on the ability to plan for the young person’s future. There have been three complaints about the home which have been appropriately investigated and responded to. Placing authorities have confidence in the staff to keep the vulnerable young people safe. They, however, as do some parents, raise concern about the effectiveness of communication to promote good partnership working. They highlight particular changes in need or presenting behaviours which have not been effectively communicated either to parents or placing authorities. This has on occasion meant parents are not aware of changes in medication, behaviour, levels of risk or why a young person has sustained scratches.

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children and young people since the most recent full inspection

There have been eight occasions since the last inspection, where medication errors have occurred. In each case staff have immediately sought the guidance of medical professionals. The manager has investigated each case and taken steps to reduce risk. However, the systems are not yet sufficiently robust, as despite this, further errors have occurred which have placed particular young people at risk. For example, some young people have not received the correct anticonvulsant medication, which may have significant impact on their epilepsy management. The manager is well aware of the potential risks to young people where medication is not appropriately managed. As a result, further training in relation to medication management is planned and the clinical team are reviewing medication arrangements.

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children and young people since the most recent full inspection

Developing children’s communication skills and methods of promoting inclusion permeate through the service. There are a wealth of communication tools, such as, symbol minutes of young people’s meetings and social stories used to help young people understand key information and life events. One placing social worker described how they have been ‘really impressed’ with the therapy and sensitive support provided for a child experiencing bereavement.

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children and young people since the most recent full inspection

Families and social workers consistently praise individual staff commitment, patience and caring nature. Young people clearly build very positive relationships with the staff who are important to them. For example, some talked about how they like the staff with whom they can have fun. Another ran up to staff on return from home hugging them and saying ‘I’ve really missed you, I love you.’

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children and young people since the most recent full inspection

Young people say ‘I love it here’ one said: ‘I’d say it’s really good sometimes and brilliant others.’ They describe the friendships they have made and the wide range of activities as key to their happiness. One said: ‘We do lots of fun things like bowling, scouts, other clubs and horse-riding’. One parent rated the service as ‘brilliant’ describing how their child says: ‘He calls is his second home and says I’m home. He gets so excited to see his friends and teachers and staff.’ This young person likes it so much he will sometimes ask ‘can I stay’ rather than go home for the weekend. The manager has ensured the vast majority of requirements set at the last inspection have been met. They are committed to providing consistently high quality individualised care to all the young people, however, on occasion these aspirations have fallen somewhat short for some young people and their families. Some families refer to a change in structure and service delivery having had an

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children and young people since the most recent full inspection

adverse effect on the quality of care provided and undermining their confidence. The manager has not always been fully aware of the shortfalls in order to address them and actions taken have not always had sufficient impact to secure improvement.

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Information about this children's home

St Elizabeth's School and Children's Home is registered to provide accommodation for 58 children with special educational needs and/or disabilities. Children attend St Elizabeth's School on the same site. It caters for mixed pupils aged 5 to 19 years old with complex medical needs, autism, epilepsy and associated learning difficulties. St. Elizabeth's is managed by an organisation founded by The Daughters of the Cross of Liege. The school shares the campus of St Elizabeth's Centre with a specialist college for students aged 19 to 25 years and a care home for adults with learning difficulties and disabilities. A variety of clinical support services operate from the central site and are registered with the Care Quality Commission.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard with particular reference to communication with parents and partner agencies and monitoring of the service the registered person must ensure that they enable, inspire and lead a culture in relation to the children’s home that demonstrates they:

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Requirement Due date

(2) (f) 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. 11/04/2016

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. In particular; the registered person must ensure that medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed; and a record is kept of the administration of medicine to each child. (Regulation 23(1)(2)(b)(c)) 23/03/2016

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Requirement Due date

The registered person must ensure that 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 (3)(c)) 11/04/2016

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Provide a homely, domestic environment. In particular; ensure that the quality of décor and lighting in the home are of good quality throughout. (The Guide to the Quality Standards, page 15 paragraph 3.9)

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Recommendations

 The registered person should actively seek independent scrutiny of the home and make best use of information from independent and internal monitoring (including under regulations 44 and 45) to ensure continuous improvement. (The Guide to the Quality Standards, page 55 paragraph 10.24)

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What the inspection judgements mean

At the interim inspection we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the Inspection of children's homes: framework for inspection.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

This 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 Children's Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, 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,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

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

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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