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

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 The staff know and understand the individual needs of the young people and are committed to working with them.  There is a wide variety of activities both in the home and community, and staff encourage and support young people to attend clubs.  Staff challenge young people’s negative behaviours in a way that each young person can comprehend and they discuss these in key-work sessions.  There are individual comprehensive placement plans in place, to which staff and the multi-disciplinary team have input. These support staff in working with the young people.  Staff understand the importance of contact for young people and their families, and they support this. There is a flat on site where family members can stay if they live some distance from the home.  The young people are involved in choosing the decor for their houses, and are encouraged and supported to personalise their bedrooms. Parents can

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The children's home provision is good because:

also be involved in decorating the young person’s bedroom.  Staff receive training from the St. Elizabeth’s psychological services (STEPS) to support and enhance their knowledge of the young people’s needs.  Young people are supported to build and maintain positive friendships, and the houses have barbecues to which young people can invite their friends.  Staff understand the importance of recognising and celebrating the young people’s achievements.  All health and safety checks are completed. However, the systems for monitoring these are not always clear about which recommendations have been completed.  Staff compete the relevant paperwork after an incident, but, at times, it can be difficult to differentiate between staff and young people.  Young people do not always have the opportunity to sign or comment regarding their care, for example, about key-work sessions, sanctions or after an incident. This results in staff not being clear whether young people

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The children's home provision is good because:

understand or agree with decisions made.

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Statutory requirements

This section sets out the actions that must be taken so that the registered persons 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 persons must comply within 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, the registered person must:

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Requirement Due date

(2) (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 1/10/16

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Requirement Due date

7: The children’s wishes and feelings standard

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Requirement Due date

In order to meet the children’s wishes and feelings standard, the registered person must:

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Requirement Due date

(1)(c) take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare in their lives. 1/10/16

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Requirement Due date

The registered person must ensure that within 24 hours of the use of measure, control, discipline or restraint in relation to a child in the home, a record is made which includes the name of the person who used the measure (‘the user’), and of any other person present when the measure was used. (Regulation 35(3)(a)(vi) 1/10/16

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  For children’s homes to be nurturing and supportive environments that meets the needs of the children, they will, in most cases be homely, domestic environment. This is in particular regard to ensuring that all accommodation is of the same standard.(‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)  Staff should be familiar with the home’s policies on record-keeping and understand the importance of careful, objective, and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including

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Recommendations

the quality standards’, page 62, paragraph 14.4)

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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 pupils, aged five to 19 years old, irrespective of gender, with complex medical needs, autism, epilepsy and associated learning difficulties.

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Information about this children's home

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

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Good

The young people have developed good relationships with an enthusiastic and dedicated staff team that knows them well and understands their individual needs and abilities. A young person commented, ‘The staff here are really good. I would give them eight or nine out of ten.’ A parent commented, ‘My son is non-verbal, but when we talk about the home he always smiles and gets excited. He loves being there and the staff really know him.’ The young people have made good progress living in the homes. All young people attend the school on site and have excellent attendance. Communication between the houses and school is good, and conversations are recorded to ensure that information is shared. A parent commented, ‘Staff in the home are always up to date with how he is doing at school.’ Another commented, ‘My son had missed a lot of school before moving here’. With the support of staff both in the home and

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Good

school, he has made excellent progress.’ The young people have individualised placement plans, which support staff working with them in all aspects of their lives. These plans outline young people’s diagnosis, communication, personal care needs and strategies for working with them. This ensures that young people are treated with dignity and respect while staff care for their day-to-day needs. Young people have made good progress with their heath. There are not only good working relationships within the home but with also with external agencies. Health professionals come to the home rather than young people travelling to appointments, which is distressing for some. This ensures that their heath needs are met. Staff in the home work closely with the homes psychological services (STEPS) and the medical team to ensure that all young people’s health needs are assessed and reviewed. This has led to some young people having a significant reduction in their

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Good

epilepsy and some have not had a seizure for some considerable time. One parent commented, ‘His progression has been amazing. He was having up to 20 seizures a day. After nine months, he is seizure free due to the onsite medical team getting his medication right. He is now able to participate in so much more and is having new experiences.’ The young people have comprehensive healthcare plans, which are devised by the nursing staff who complete the first assessment when they arrive at the home. The needs of the young person are assessed and the nursing staff can refer directly to the multi-disciplinary team based at the home. The team works closely with the staff and is able to look at how they can support young people with any health needs. One young person was reluctant to engage in strengthening her leg muscles. Staff knew that she loved Thomas the Tank Engine so, by devising a game in which she had to lift her legs to let Thomas through, they enabled her to

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Good

complete her exercise in a way that was fun. This shows that staff use their initiative when working with the young people. Young people’s achievements are celebrated through ‘simply the best’ certificates, reward charts, learning challenges and house newsletters. All young people in one house have reached their targets to make their own bed in the morning and for welcoming a new person into the house. There is an abundance of beautiful pictures of celebrations of birthdays, trips out to see horses and sea life and one young person’s favourite trip to Southend. Sanctions for young people are fair and proportionate and are evaluated by the manager, but young people do not always comment on or sign these to say that they agree or understand the sanction. Staff spend quality time with the young people. There are large grounds where staff and young people can ride bikes, play football or go for a walk. They can also

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Good

access the sensory rooms in the school. Because the inspection took place during the school holidays, young people were spending time with staff. One young person was going on a picnic in the grounds. Another had come back from a walk and, the following day, a group was attending the hydro pool. The young people have the opportunity to attend activities in the community, which support them to enhance their social and independence skills, and to have inclusion with their peers. Staff understand the importance of contact with parents and siblings. Young people can use Skype, the house phones or email to stay in touch with parents, and parents can contact the home at any time. A parent commented, ‘I can call the home 24 hours a day. I phoned in the early hours once to speak to night staff as there was a thunderstorm, and I know how frightened he gets. They were able to check on him and reassure me. It’s things like that that are important to me.’

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Good

The young people have regular house meetings in which they are able to discuss things about the house, menus and activities. A representative from each house attends the school council. These are discussed in house meetings, and young people can give the representative items for the agenda. This gives all young people the opportunity to have their ideas or concerns raised. This is then fed back at the next house meeting. Young people have regular key-work sessions. These vary in quality and recording. A member of staff, using picture exchange communication systems (PECS) to communicate, recorded what PECS were used and what the young person pointed to. This gave a good insight into the conversation between the young person and staff member. Others are not informative and do not indicate the young person’s thoughts or feelings. Not all young people are given the opportunity to comment or to sign these to say that they are in agreement with the staff.

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Good

The houses are decorated to a good standard and have their own individuality. Corridors are bright and welcoming, and skylights have been added to let in light that is more natural. Young people’s bedrooms are personalised and they were proud to show them. Each bedroom reflected the individuality of the young person. Some parents have been involved in decorating their child’s bedroom, and there are photos of family members, pets and other things that are important to the young person. Staff commented that these are important especially for the non- verbal young people, as they can point to photos if they wish to talk about or contact family. Young people and staff take a pride in their environment, which is kept clean and tidy. Chilton House is currently not being used, and the maintenance team is currently in the house brightening it up to ensure that it is to the same standard as the other houses. Higley House, which is not in use but is included in the provision for the 58

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Good

The young people are safe. They have individualised and high levels of supervision by a knowledgeable staff team that understands each young person’s individual needs. Linked with this is a multi-disciplinary team that works closely with staff and informs robust risk assessments and plans, which are regularly reviewed and updated. Parents speak positively about young people feeling safe. A parent commented, ‘I never have to worry about him being safe. I have seen how staff deal with young people with challenging behaviours, and I don’t feel he is at risk. They also teach him to learn how to keep himself safe.’ Parents speak very positively about young people being safe and said that they can contact staff at any time if they are concerned. The young people have detailed behaviour management plans in place and discussions with staff demonstrated that they have extensive knowledge of the young people’s individual behaviours. This is further supported with joined-up

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Good

multi-disciplinary working with therapists and the psychology team. Staff also attend individualised workshops, which support them to understand the young people’s diagnoses, childhoods and behaviours, and this has had a good impact on young people’s experiences. However, systems currently lack differentiation between school and the home, making it difficult to see the respective impact of the school and the home. Due to the high levels of staffing, young people have not gone missing. Each house has an emergency response bag, which would be taken by staff if a child did leave the building unaccompanied. All houses have a map of the local area, which is colour coded to enable clear instructions and information to be shared among staff. This ensures that, if young people do go missing, staff are able to be proactive in looking for them. Staff use physical intervention as a last resort and are up to date with the training

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Good

required. A parent commented, ‘My son can be challenging at times and staff have had to hold him. I am always informed and I know this is used as a last resort and [is] not unreasonable. Staff will try to de-escalate situations first.’ Staff complete relevant forms, but, at times, it is unclear which staff have been involved, as full names are not always used, and this could cause some confusion if an investigation had to take place. The young people know how to complain and feel listened to. One young person commented, ‘If I was sad or unhappy about something I would tell my key worker. If she wasn’t around, I could talk to any staff and they will help me.’ There are PECS for non-verbal young people to communicate to staff if they are worried or upset. However, on occasions young people have raised concerns, such as, ‘I don’t like it when staff grab me’. On another occasion, a young person was facetiming

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Good

his mother and he informed her in the presence of staff that another young person had grabbed him. Inspectors could not find evidence that these incidents had been robustly investigated. On other occasions, it is clear that staff have followed procedures to safeguard young people. Recording systems are confusing and disjointed, making it difficult to link incidents from start to finish when recording. All medication is stored and recorded appropriately. Due to some medication errors, the manager has implemented a new system. Two staff complete the medication round and check labels, dates of expiry and medication count every time they administer. They also wear red tabards, which informs everyone that they are in the process of a drugs round and should not be disturbed. Staff report that this protocol is working well and has minimised the risk of errors.

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Requires improvement

The home was re-registered in September 2015. The manager has been in post as head of care at the setting for 10 years (as part of the previous registration) and has the relevant qualifications and experience to manage the homes. There were three requirements and two recommendations from the last inspection. The three requirements have been met. One recommendation regarding the environment has been repeated and the second recommendation, due to not being met, is now a requirement. Staff receive regular supervision and those spoken to say that they find it supportive and that it gives them the opportunity to reflect on practice and their development. There is a robust induction programme in place. New staff commented that they found shadowing more experienced staff and fortnightly supervision supportive, and this gives them opportunities to ask questions and to have time to get to know the young people.

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Requires improvement

Each house has a staff meeting once a fortnight. These are used to discuss the young people and care practice, and to plan activities. Staff commented that they find this useful, to ensure that they are working consistently and to share ideas. A deputy commented that they have started to have senior meetings, which have been supportive, and which help with communication across the houses. Recruitment is robust, and all checks are verified before staff can start to work in the home. There is an informative induction in place for new staff, to support them throughout their probation period. Staff know the strengths of the home and are proud of the achievements that the young people make. They feel supported by the manager and say that she is approachable and knows the young people well. Due to the large amount of paperwork that is required, it is difficult to identify how patterns and trends are identified and monitored. A new system is coming into

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Requires improvement

place in September, which will support leaders and managers in being able to monitor young people more effectively, but, for this inspection, there is a shortfall. Following an incident, staff complete the relevant paperwork, but it is hard to differentiate between staff and young people. Records can sometimes be unclear and it can be difficult to distinguish between fact and opinion. This will potentially result in recordings being difficult to understand if young people access their records in later life. Health and safety checks are up to date, but the system of maintaining and monitoring these records results in it not always being clear whether recommendations have been sufficiently actioned. Monitoring does not highlight shortfalls in recording systems.

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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 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 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 that 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 that 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 whom 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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