Children's home run by The Cambian Group in Hammersmith and Fulham

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.

p.2

The children’s home provision requires improvement because:

 An exceptionally high turnover of staff has significantly impacted on the ability of the home to deliver good-quality, consistent care for children.  Risk assessments are not effectively known and acted upon by all staff in order to minimise risk.  Medication arrangements in the home require improvement in order to ensure that children’s medical needs are met and medication is dispensed by suitably competent staff. Staff do not apply a consistent approach in their response to children’s use of e-cigarettes.  Records maintained fail to provide evidence that recruitment practices are in line with best practice.  Records on occasion lack of detail or accuracy, which means that the support provided is not effectively evidenced or it is not possible to clearly identify which staff were on shift at any given time.

p.3

The children’s home strengths

 Children have made progress in relation to their education, health, personal care, behaviour and social skills.  Staff provide individualised, child-focused care and children feel consulted on all aspects of their life.  The children are very positive about their experience of living at the home and always feel well supported and safeguarded.  Professionals and children’s families have absolute confidence that their child’s individual needs are well met by caring and nurturing staff.  Staff work well in partnership with other agencies.  Staff benefit from good-quality induction, training and supervision arrangements.  The manager and responsible individual are aware of the shortfalls and have in place suitable plans to improve the quality of service and care children receive.

p.3

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 within the given timescales.

p.4

Requirement Due date

12: The protection of children standard:

p.4

Requirement Due date

In order to meet the protection of children standard the registered person must ensure that children are protected from harm and are enabled to keep themselves safe and ensure— (a) that staff— (i) 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;

p.4

Requirement Due date

in particular, ensure that staff are aware of the individual risk assessments for each child and that protocols in place post ‘missing from care’ incidents to ensure that children effectively safeguarded. 15/08/2016

p.4

Requirement Due date

13. The leadership and management standard:

p.4

Requirement Due date

In order to meet the leadership and management standard the registered person must; 2 (e) ensure that the home’s workforce provides continuity of care to each child; (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. 29/08/2016

p.4

Requirement Due date

The registered person must compile in relation to the children’s home a statement (‘the statement of purpose’) which covers the matters listed in Schedule 1.

p.4

Requirement Due date

In particular: ensure that the statement of purpose is accurate and sufficiently detailed, including all points listed in Schedule 1. (Regulation 16 (1)(3)(a)) 26/09/2016 The registered person must keep in relation to a children’s home the records specified in Schedule 4.

p.4

Requirement Due date

In particular: a copy of the staff duty roster of persons working at the home, and a record of the actual rosters worked. (Regulation 37(2)(a)) 15/08/2016

p.5

Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation(s):  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. Records must be kept of the administration of all medication, which includes occasions when prescribed medication is refused. Regulation 23 requires the registered person to ensure that they make suitable arrangements to manage, administer and dispose of any medication. These are fundamentally the same sorts of arrangements as a good parent would make but are subject to additional safeguards. In particular: ensure that children have suitable access to emergency pain relief and staff only administer medication when their competency to do so has been assessed. (‘Guide to the Children’s Homes Regulations including the quality standards’,

p.5

Recommendations

page 35, paragraph 7.15)  The registered person should ensure that, in line with their individual health plans and the ethos of the home, children are offered advice, support and guidance on health and well-being to enhance, and supplement, that provided by their school through Personal, Social and Health Education (PSHE). Staff should have the relevant skills and knowledge to be able to help children understand, and where necessary work, to change negative behaviours in key areas of health and well-being such as, but not limited to, nutrition and healthy diet, exercise, mental health, sexual relationships, sexual health, contraception and use of legal highs, drugs, alcohol and tobacco. In particular: ensure that there is a clear, consistently applied approach to the use of e-cigarettes in the house and effective cessation support. (Guide to the Children’s Homes Regulations including the quality standards, page 35, paragraph 7.18)

p.5

Recommendations

 When a child returns to the home after being missing from care or away from the home without permission, the responsible local authority must provide an opportunity for the child to have an independent return home interview. Homes should take account of information provided by such interviews when assessing risks and putting arrangements in place to protect each child. In particular: establish a system to prompt the arrangement of a return interview after each missing from care event. (Guide to the Children’s Homes Regulations including the quality standards, page 45, paragraph 9.30)  The registered person should ensure that all incidents of control, discipline and restraint are subject to systems of regular scrutiny to ensure that their use is fair. In particular: ensure suitable overview of sanctions and their effectiveness by the manager and clarity of the actual sanction imposed. (Guide to the

p.5

Recommendations

Children’s Homes Regulations including the quality standards, page 46, paragraph 9.36)  Review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home’s location and strategies for managing these. Providers should refer to the non-statutory advice about the location assessment process. (Guide to the Children’s Homes Regulations including the quality standards, page 64, paragraph 15.1)  As set out in regulations 31–33, the registered person is responsible for maintaining good employment practice. They must ensure that recruitment, supervision and performance management of staff safeguards children and minimises potential risks to them. In particular: ensure that evidence of fitness is held for all staff. Furthermore: ensure that any induction of agency staff is

p.6

Recommendations

suitably documented to evidence the guidance given. (Guide to the Children’s Homes Regulations including the quality standards, page 61, paragraph 13.1)

p.6

Information about this children’s home

This is a privately owned and run children’s home registered for up to three children/children with emotional and behavioural difficulties.

p.7

Recent inspection history

Inspection date Inspection type Inspection judgement

p.7

Recent inspection history

15/03/2016 Interim Declined in effectiveness

p.7

Recent inspection history

18/03/2015 Interim Sustained effectiveness

p.7

Requires improvement

All of the children make some progress in the time they are placed at the home. One family member commented that a child ‘was more relaxed and calm and more mature. The self-harming stopped and the going missing really reduced.’ Families are very positive about the support their child receives; one said: ‘The guys at the home are brilliant. It’s one of the best places he’s ever been’ and another said, ’The home were fantastic. They really helped him turn it around whilst he was at the home in a short space of time.’

p.8

Requires improvement

The staff provide individualised care, which is aimed at meeting the particular needs of each child. One partner professional described the home as having ‘a good friendly atmosphere but with appropriate boundaries and nurturing staff’. The children are positive about individual staff; one said: ’Staff are alright, actually they are really nice people.’ However, there has been over the past six months a lack of continuity of staff to provide stability and consistency to the children. While the organisation has attempted to reduce the impact, such uncertainty and lack of continuity potentially has a significant impact, as children are unable to gain a sense of permanence and build trusting and secure relationships with adults working in the home.

p.8

Requires improvement

The children are involved in all day-to-day decisions about their daily lives and have confidence that staff listen to them and will respond to any issues of concern which they may raise. They are supported to maintain friendships and family relationships which are important to them, making arrangements for contact where they are placed a long way away from their family. For example, one child and their family have been able to enjoy a memorable family day out at a large theme park facilitated by staff. Families are very positive about the support their child receives; one said: ‘The home have done brilliant with him. It’s the best place he could have been, I am gutted we moved him out but at the time we felt it was the right thing as he was doing so well and appeared ready to move on.’

p.8

Requires improvement

Medication arrangements in the home require some improvement in order to comply with the statutory guidance and ensure that all staff have fully understood the medication training they have completed. For example, medication e-learning is not supplemented with an assessment of individual staff members’ competency to administer medication. Some children are not prescribed emergency pain medication, nor is there a homely remedy protocol in place, rendering staff unable to administer emergency pain relief should this be requested. The children’s health has generally improved and they benefit from improved dental care and health. Staff have provided children with suitable guidance around their personal health with some success. However, some children continue to engage in unhealthy behaviours such as smoking e-cigarettes and cannabis. There is not a consistently applied approach to the children’s use of e-cigarettes. For

p.8

Requires improvement

example, throughout the inspection a child was observed ‘vaping’ in the house unchallenged by staff, despite the manager’s assertion that this was not permitted.

p.9

Requires improvement

The children engage positively in their full-time education placement, which is currently arranged on-site, with periods of weekly off-site activity. Home staff, under the guidance of the organisation’s educational staff, also offer alternative nationally recognised education courses to supplement the main educational programme. Due to the effective arrangements, children improve their school attendance and are making educational progress.

p.9

Requires improvement

The home is a spacious, rural detached house with large individually decorated bedrooms and generous living space. Responses to damages are swift and the furnishings are both homely and functional. As a result, the building provides a high-quality homely, welcoming environment for children. The large, well-kept garden includes a football pitch. The house is adjacent to a farm and the children enjoy watching the animals.

p.9

Requires improvement

One young person described their time at the home as ‘brilliant’ and ‘excellent’. They said, ‘It was all right you know, I wanted to stay for longer.’

p.9

Requires improvement

Prior to residing in the home, all children had a history of going missing from care and they have made varied improvement in relation to the frequency and length of time they go missing. The response to children who go missing from home is robust and caring. The local police liaison officer commented that, while missing from care events are too frequent, when the children are missing from care, the staff are fantastic. Staff undertake key work sessions with children to explore their reasons for going missing and to ensure their immediate welfare. However, there is not an effective system to ensure that the child has an independent return home interview after each missing from care interview, including exploration of actions which can be taken to safeguard them more effectively in the future.

p.9

Requires improvement

Each child has a personalised, regularly reviewed risk assessment and management plan. However, staff do not always understand the importance of key information in these plans and are unaware of specific guidance in place. This lack of knowledge has on occasion placed children at potential risk. For example, a group activity with another home took place without full consideration of the mix of children and, as a result, potential risks were not identified, resulting, in turn, in a potential safeguarding incident. The manager and staff were unaware of, and consequently failed to follow, room search protocols established following a previous incident. As a result, some time elapsed before finding a further missing vulnerable child in another’s room.

p.9

Requires improvement

The children feel safe, secure and well cared for. They receive supportive, caring responses from individual staff in relation to any incidents of conflict, which means they continue to feel protected. One young person said ‘I always felt safe’ and said ‘The home was excellent’.

p.10

Requires improvement

Partner professionals comment on ‘really good partnership working with the home’. One professional said the alertness of the new manager who ‘picked up the issues and started to piece the concerns together,’ in respect of one child enabled the placing authority and youth offending teams to have a much better understanding of risk. They also described how well staff manage extreme behaviour in an attempt to de-escalate situations. One said: ‘Staff don’t want to give up on the child, but balance safeguarding and they can meet the child’s needs with this.’

p.10

Requires improvement

The manager does not consistently review and monitor all behaviour incidents to enable them to contribute to meeting the ongoing and changing needs of children. For example, the recording of the reason for and sanction applied for negative behaviour is on occasion not sufficiently clear. This potentially undermines the ability for reflection to contribute to meeting the ongoing and changing needs of children.

p.10

Requires improvement

Records in the home, on occasion, do not fully evidence that vetting practices are consistently robust and in line with best practice. Systems are in place to ensure that staff do not work at the home until checks on their identity and any offending history are verified. However, records do not always demonstrate that potential health concerns are effectively identified and explored and that references have been verified. Furthermore, for some agency staff, there is no record that suitable references have been obtained.

p.10

Requires improvement

The manager ensures that good systems are in place to ensure the safety and security of the building. Judgement grade

p.10

Requires improvement

The leadership and management of the home are not yet good. The previous registered manager left in April and the pre-existing staffing difficulties continued to deepen. The acting manager, who has been in post since the previous manager left, has not yet submitted an application to Ofsted for registration and their suitability has yet to be established. They have, during their short tenure, developed a positive working relationship with staff and partner agencies and begun to introduce improvement. One partner professional commented: ‘The new manager has been great, he hit the ground running and really has tried.’ The manager and the responsible individual are aware of the weaknesses in the service and have suitable plans in place and capacity to implement these.

p.11

Requires improvement

The home has not been able to deliver the caring experience to children as set out in the statement of purpose. The primary cause for this is the significantly inconsistent staff team following an unsettled period and the departure of the previous manager. In the past four months, over 34 different members of care staff have been employed to work within the home. There is only one member of staff who has worked at the home for over 12 months, and nine staff have left since the last full inspection in December. The organisation have made arrangements to ensure that on each shift there are suitably qualified and experienced staff from other homes within the organisation to support children.

p.11

Requires improvement

Staff are individually caring and supportive. Families say ‘staff at the home are brilliant’ and that they ‘went above and beyond’. However, due to the constant staff changes in the past few months, children have not had the opportunity to establish a relationship with the children. They live in an unpredictable environment with changing personnel, which may potentially have had an impact on placement stability. Furthermore, on occasion there have been shortfalls in sharing key information regarding risk.

p.11

Requires improvement

Permanently employed staff benefit from a comprehensive two-week block of training prior to taking up their post within the home. Training is ongoing and a comprehensive training programme is available for staff development. Supervision and appraisal systems are suitably effective for those staff who are based at the home. Permanent staff report that they feel well supported by the new manager and know what their responsibilities are.

p.11

Requires improvement

The staff duty rota and signing-in book are not always accurate in recording who was on duty at a given time. While this has no impact on children, it means that records are not accurate and potentially impacts on the ability to conduct any future investigation into staffing or safeguarding matters. This is particularly concerning given the levels of staff change in the home. The statement of purpose is not an accurate document as it provides out-of-date information in respect of the home’s designated safeguarding officer and children’s rights. The manager has undertaken a review as to the appropriateness and suitability of the location and premises of the home which identifies low risks in relation to criminal activity within the community. However, there is insufficient information and evaluation of any risks and opportunities regarding health and education presented by the home’s location, particularly for children placed from

p.11

Requires improvement

out of area, and the strategies that the organisation has for addressing these.

p.12

Requires improvement

The staff work effectively in partnership with children and partner agencies, who describe the home as ‘brilliant’. Despite all the staffing changes, children, their families and partner agencies continue to refer to the home as generally providing a good or excellent service. One said about a particular young person, ‘He really improved during his time at the home, it’s the best place he’s ever been.’

p.12

Requires improvement

The current acting manager and responsible individual have addressed most of the requirements from the last inspection and have a clear awareness of the strengths and areas for development. They are working in partnership to effectively prioritise the existing children’s needs and address the current staffing shortfalls. For example, new staff have been employed subject to checks and no new placements will occur until suitable staffing is in place. The manager does have clear aspirations for the home and plans to improve the service. While a number of requirements and recommendations have been set, partner professionals, children and their families remain positive about the support they receive and there is a demonstrated commitment and capacity to improve the quality of service.

p.12

What the inspection judgements mean

The experiences and progress of children and children 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’.

p.13

What the inspection judgements mean

An outstanding children’s home provides highly effective services that contribute to significantly improved outcomes for children and children 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 children 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 children looked after 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 children. A children’s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and children being

p.13

What the inspection judgements mean

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

p.13

Information about this inspection

Inspectors have looked closely at the experiences and progress of children and children living in the children’s home. Inspectors considered the quality of work and the difference adults that make to the lives of children and children. They read case files, watched how professional staff work with children, children and each other and discussed the effectiveness of help and care given to children and children. Wherever possible, they talked to children, children 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 children 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 Homes (England) Regulations 2015 and the ‘Guide to the Children’s Homes

p.14

Information about this inspection

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 0300 123 4234, or email enquiries@ofsted.gov.uk .

p.14

Information about this inspection

achieve excellence in the care of children and children, 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, work- based 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,

p.15

Information about this inspection

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

p.15

Information about this inspection

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

p.15

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

p.15