Children's home run by Cambian Autism Services Limited in Hammersmith and Fulham

inspection

A compliance notice was issued following the previous inspection. This inspection identified the compliance notice has been met.

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Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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because:

 Systems introduced by the manager to meet the compliance notice and previous requirements are yet to embed. The manager has not reviewed the effectiveness of these changes as they continue to implement them to improve care to young people.  The manager highlights shortfalls in the supervision of staff. Staff are not supervised frequently as stated in the supervision policy. This includes staff whose performance is under monitoring following concerns about the care they provide.  The quality of the environment is under constant review to make it more homely. The manager prioritises key issues such as the removal of locks. Some houses need further development to bring them up to a consistently good standard.  Care plans do not explicitly detail how young people are supported to progress. Basic information is included in information about young people however there is no clear emphasis on what care staff do to support this. There is no evidence that

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because:

young people are consulted with about their aspirations.

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The children's home strengths

 The responsible persons and their staff show a passion and commitment to improving care for young people in this home.  Staff show excellent communication skills when caring for young people. Communication systems are individual to each young person and use a range of methods. Young people use these systems to make choices and their feelings known.  Young people form positive relationships with staff caring for them. Staff understand the needs of young people they are caring for well. Staff are respectful of young people’s request for privacy.

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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

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. 33 (4)(b) 02/03/2016

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  'Ensure the environment is homely and domestic rather than giving an 'institutional' impression. Paying particular attention to blinds in bathrooms, soap and paper towel dispensers, signage and television cabinets’ (Guide to the Children's Homes Regulations including the quality standards paragraph 3.9, page 15).

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Recommendations

 'Ensure the registered person reviews care plans to further develop a culture of high aspiration for children, specifically that targets and progress are explicitly recorded' (Guide to the Children's Homes Regulations including the quality standards paragraph 10.4, page 52).

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Information about this children's home

Care is provided in 11 homes, nine are within the grounds of a special school, two homes are situated in the local community. Care is provided to a maximum of 68 children and young people with autistic spectrum disorder and learning difficulties. Packages of care are provided for 38 and 52 week long term placements. The home is managed and owned by a private company.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

03/12/2014 CH - Interim sustained effectiveness

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Recent inspection history

11/03/2014 CH - Interim Satisfactory Progress

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Recent inspection history

19/03/2013 CH - Interim Satisfactory Progress

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Requires improvement

Systems introduced by the manager to improve the day to day experiences of young people in the home are in their early stages of implementation. The manager identifies time is needed to embed these before she starts to review their effectiveness and impact on young people. The quality of the environment must improve to make it a homelier place for young people to live. For example, some windows in bathrooms do not have blinds. Recognition is given that new soft furnishings and pictures have improved the presentation of the homes. Overuse of signage in homes, soap dispensers and paper towel holders amplify an institutional feel that managers wish to remove. Young people are not actively included in setting their own targets. Aspirations of young people do not come across as a priority in their written plans. It is unclear how staff measure and evidence progress. This is a shortfall in systems as young

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Requires improvement

people do make progress. A parent said ‘he is now toilet trained and speaking more’. Since the previous inspection, the responsible persons have made huge strides to improve the care young people receive. A review of restrictions in the home is proving to be a success. Locks are disabled on all internal communal doors enabling young people to move freely around their home. Young people now have access to kitchen cupboards and wardrobes. A member of staff said ‘young people now go to the kitchen and make a drink or snack, they choose their clothes from their wardrobe and move independently around the home’. Social stories and talking mats aid staff to communicate the changes taking place and seek young people’s views on them. Some young people chose to have a lock on their bedroom door for privacy. In addition all bathrooms and toilets have a lock that young people can use if they wish. Staff no longer wear uniforms and their presentation has improved. The use of an

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Requires improvement

internal radio system has diminished and isolated for emergency use only. These sensory differences make a positive change in the atmosphere of the homes. Staff are skilled in communicating with young people. Methods include objects of reference, schedules, talking mats, social stories and applications on tablets. These communication techniques give young people choice, an understanding of their day and expectations for them. Staff recognise the value of communication, one member of staff said ‘the tablet is his voice; it must be charged 24/7’. Inspectors observed quality and respectful connections between staff and young people. Staff are kind to young people and show warmth in their care towards them. Positive relationships develop and young people seek staff to support them with their needs. Young peoples have their health needs met well. All have access to general health services such as a doctor and dentist. Individual health care protocols for epilepsy

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Requires improvement

provide clear direction about the support young people require. A school nurse is on hand to monitor the health of young people and provide additional training to staff. A parent said ‘extra staff have been supporting my daughter very well during a recent health concern’.

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Requires improvement

The manager has not concluded the investigation into the cause of unknown bruising on some young people identified in body maps. Collaboration with the Local Area Designated Officer (LADO) and social workers has taken place to ensure young people are safe. Staff have good knowledge of the new procedure for reporting safeguarding concerns and have started to put it into practice.

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Requires improvement

Links with professionals such as the LADO have become stronger. The manager works together with the LADO to improve safeguarding procedures and make them more robust. These changes will make young people safer. The manager acts swiftly when they receive information about a safeguarding concern. Staff protect young people as they follow safeguarding procedures well.

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Requires improvement

The manager and therapy team have conducted a review into behaviour management strategies used in the home. Young people no longer experience door holds or single separation during incidents. Staff have attended additional training in physical intervention. This has reduced the number of unauthorised techniques significantly.

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Requires improvement

Behaviour management plans provide clear information to staff about how to support young people with their behaviour. A clear philosophy of de-escalation strategies is forming which young people respond to successfully. Debriefs with young people following a physical intervention have improved. A functional skills profile for each young person is in place to distinguish how best to consult with them. This ensures young people have their voice heard in the most effective manner.

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Requires improvement

Staff benefit from thorough debriefs following an incident. Debriefs facilitate reflection about the impact their care has on young people. This creates an avenue of learning that as a result can improve experiences young people have.

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Requires improvement

Behaviour management records provide good detail on events leading up to and during an incident. Staff have received additional training on writing records that is evidently improving. The manager’s monitoring of behaviour management records is more effective.

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Requires improvement

Risk assessments are comprehensive documents that effectively detail risks and measures in place to minimise these. Regular updates mean they evolve with young people. Risk has been assessed in relation to every young person and the lifting of restrictions, this is providing a more personalised approach.

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Requires improvement

Recruitment checks in place to safeguard young people are at an acceptable standard. The manager ensures the independent translation and verification of documents from overseas. Recruitment checks are available for the independent visitor.

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Requires improvement

All fire doors that raised a concern previously have been tested and now functioning. The manager has implemented a system to test fire doors on a more regular basis.

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Requires improvement

Supervision is not consistently monitoring practice and improving care for young people. The manager identifies the frequency of supervision as a concern. Staff whose performance is under scrutiny have not had supervision within a suitable timeframe. Staff whose performance is a concern are clear about the expectations to improve. The manager is clear about her role to safeguard young people in relation to allegations management. Formal investigations are instigated when deemed necessary. The responsible persons have been highly responsive to the findings of the previous inspection. A detailed action plan is in place to address all the shortfalls. Explicit staff meetings inform staff of the concerns; including the plan to improve young people’s experiences. Staff recognise the need for change and embrace the transformations taking place. Monitoring of care is more frequent. The senior leadership team undertake direct

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Requires improvement

observations in houses to improve the care young people receive. A member of staff said ‘I appreciate the feedback and we get to talk about it as a team’. Monitoring by the manager overall is getting better. The manager said ‘I feel much more in control now’. Fifty eight percent of care staff are unqualified. A large number of staff are registered and working towards their qualification. An action plan identifies targets dates for completion and identifies how the manager intends to support staff to meet this. Since the last inspection staff have completed a number of training courses including safeguarding, behaviour management records, de-escalation and physical intervention. The manager has a targeted training programme in place to develop staff skills. The previous registered manager resigned from her post in August 2015. The current manager received promotion from within the company and has worked at

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Requires improvement

this home for a number of years. The manager is suitability qualified for the role and is working towards a management qualification. The manager’s application to register is in progress.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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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 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

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Information about this inspection

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

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Information about this inspection

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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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