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

Inspection report children’s home: SC458070 1 SC458070 Registered provider: Cambian Autism Services Ltd

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This national private organisation provides care and accommodation for children and young people who have autistic spectrum disorder and learning disabilities. It operates as a residential special school that provides accommodation for students requiring 52 weeks’ boarding. It is therefore registered as a children’s home for 40 children. Accommodation is provided in four houses, all on the same grounds as the school.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

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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requires improvement to be good

Date of last inspection: 11 January 2017

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requires improvement to be good

Overall judgement at last inspection: Inadequate

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Enforcement action since last inspection

Two compliance notices were issued following the previous inspection. These related to regulation 12 and regulation 13. A monitoring visit took place on 22 February 2017. The visit determined that the compliance notices were met. Inspection report children’s home: SC458070 2

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Key findings from this inspection

This children’s home requires improvement to be good because

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Key findings from this inspection

 Members of the senior leadership team have been deployed specifically to drive improvements. This team is providing strong leadership, but its members cannot provide long-term stability as their posts are interim and they will not form part of the future leadership and management team.

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Key findings from this inspection

 There continue to be significant shortfalls in the quality of the accommodation. These shortfalls have an impact on the day-to-day experiences of the children. Some of the houses were unclean. Shortfalls identified at previous inspections have not been addressed. These include the homeliness and quality of furnishings, overuse of signage, large green wire fencing enclosing individual garden spaces and institutional practices of locking some kitchen doors.

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Key findings from this inspection

 Children’s records are not yet good. Emergency healthcare plans do not provide sufficient detail for the staff team about the child’s particular medical need and the support that they will require from staff. Incident records are not reliably maintained; at times, the original version is amended without a secure system in place to show the amendments.

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Key findings from this inspection

 Staffing arrangements do not provide children with consistent care. The handover time for day to night staff occurs in the early evening, which is an important time for children’s activities, medication and bedtime routines. Leaders and managers identify this as a key time when incidents occur.

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Key findings from this inspection

 The supervision arrangements for staff are not effective or regular enough. When there is a cause for concern about staff practice, leaders and managers do not routinely discuss this with staff in supervision.

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Key findings from this inspection

 Staff care for children with dignity and respect. They now show a greater understanding of children’s needs. Communication with children is now stronger; staff use alternative communication methods with increasing confidence. The therapy team spends time in the houses role modelling skills and supporting staff to follow children’s routines and visual schedules.

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Key findings from this inspection

 Leadership is strong. Leaders and managers are challenging poor practice and changing the ethos and culture to improve the lives of children. Leaders and managers have effective monitoring systems that demonstrate a good understanding of where improvements are required. There is a robust development plan. Inspection report children’s home: SC458070 3

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Inspection date Inspection type Inspection judgement

11/01/2017 Full Inadequate 20/09/2016 Full Inadequate 20/06/2016 Full Inadequate 26/01/2016 Interim Improved effectiveness Inspection report children’s home: SC458070 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to 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 person(s) must comply within the given timescales.

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Requirement Due date

6: The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard, the registered person must ensure:

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Requirement Due date

3 (c)(i) that the premises used for the purpose of the home are designed and furnished so as to meet the needs of each child

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Requirement Due date

In particular, ensure that the homes are clean and hygienic, ensuring that all staff understand their roles and responsibilities in the cleaning routine.

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Requirement Due date

Upgrade the homes’ environment to make them more homely, taking into account the views of young people about the quality of their furniture and outdoor play equipment.

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Requirement Due date

Ensure that children have access to toys and play equipment that meets their needs, particularly specialist sensory equipment. 31/05/2017

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Requirement Due date

In order to meet the health and well-being standard, the registered person must ensure:

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Requirement Due date

1 (a) the health and well-being needs of children are met

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Requirement Due date

In particular, that healthcare plans for emergency treatment for children with a specific health needs such as epilepsy provide clear information to the staff about the risks to the child and actions to take to meet that health need. 31/05/2017

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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 ensure they inspire and lead a culture that: 31/05/2017 Inspection report children’s home: SC458070 5 2 (a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

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Requirement Due date

(e) ensures that the home’s workforce provides continuity of care to each child

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Requirement Due date

In particular, ensure that the registered provider employs leaders and managers that will provide stability to the senior team and take effective action to continue to drive forward improvements.

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Requirement Due date

In particular, to provide children with consistency of care in the evenings, reviewing the impact that the staff handover has on children that takes place at 7pm from day to night staff and take effective action to improve this for children. 33: Employment of staff

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Requirement Due date

The registered persons must ensure that all employees:

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Requirement Due date

receive practice-related supervision by a person with appropriate experience;

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Requirement Due date

In particular, that leaders and managers provide staff with regular supervision that monitors staff performance, challenges poor practice and sets targets, goals and actions that both support staff and improve the experiences of children.

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which:

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Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

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Requirement Due date

are signed and dated by the author of each entry.

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Requirement Due date

In particular, ensure that the system that leaders and managers use to monitor behaviour records shows effective monitoring while maintaining the original documents written by staff.

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Requirement Due date

(Regulation 36 (1)(a)(b)(c)) 31/05/2017 Inspection report children’s home: SC458070 6

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Recommendations

 Ensure that staff continually and actively assess the risks to each child and the arrangements in place to protect them. In particular, ensure that actions to review personal emergency evacuation plans following children failing to evacuate the building during a fire drill are carried out immediately. (‘Guide to the children’s homes regulations including the quality standards’, paragraph 9.5, page 42)

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improvement to be good

In parts, the quality of accommodation is poor. Not all bedrooms and living spaces are routinely well cared for or clean. There is a lack of clarity among the staff team about responsibilities for cleaning duties.

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improvement to be good

The accommodation lacks a homely feel. Feedback from children about their homes includes comments such as: ‘I don’t like the furniture.’ There are unnecessary signs displayed in the home that are not relevant to the children. At times, some of the kitchens are locked, preventing children’s access to kitchen facilities. The garden areas around the individual houses are surrounded by high wire fencing. The purpose of this fencing is not clear, as the school perimeter is safely secured with appropriate fencing. These observations have been raised at previous inspections.

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improvement to be good

Children do not have access to a good range of toys and play equipment. The houses lack specialist sensory equipment and outdoor play areas that children would benefit from; this is particularly important, as some children struggle to leave the boundaries of the school.

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improvement to be good

Leaders and managers identify that placement plans require improvement to be good. It is evident that these documents are improving, and include more information about children’s needs and how to meet them. Leaders and managers have supported staff to develop their skills in reviewing placement plans. This new approach needs time to embed before its effectiveness can be measured.

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improvement to be good

Staff are building positive relationships with the children that they care for. Some staff are new and others have moved from one house to another, so some of these relationships are in their infancy. Staff demonstrated a warm and nurturing approach towards children. They provide care that respects children’s dignity and choices.

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improvement to be good

Staff utilise communication aids such as picture exchange systems, objects of reference, schedules and social stories well. This approach is enabling children to communicate their needs and make meaningful choices. The therapy team spends time with children Inspection report children’s home: SC458070 7 and staff in their home. Members of the therapy team act as role models to staff. This supports staff members’ learning and development needs well. As a result, children are making progress.

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improvement to be good

Leaders and managers take effective action to ensure that children are protected when allegations are made. The designated person for safeguarding has a robust system in place to manage and record all concerns about poor practice and safeguarding. Appropriate referrals are made to outside agencies when a child protection concern arises.

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improvement to be good

Safeguarding training has improved, and members of the senior team are trained to a high level. House managers report that this training has been beneficial. Staff have a clear understanding about how to protect children and follow the child protection policy well. Leaders and managers scrutinise the child protection arrangements in place to ensure that children are safe. There continue to be weaknesses in staff supervision sessions, as they do not always address actions with staff as required from safeguarding investigation reports.

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improvement to be good

Leaders and managers have provided staff with additional training to develop their skills in behaviour management and de-escalation strategies. Staff are showing a better understanding of the needs of children and using de-escalation strategies more effectively to prevent incidents from escalating. There have been no allegations of abuse linked to restraint since the previous inspection.

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improvement to be good

The senior leadership team, including the therapy team, meets regularly to review and monitor incidents and restraint. Learning is then identified and fed back to the staff team. Behaviour records are becoming clearer, providing more detail about the incident and de-escalation methods used. However, when leaders and managers monitor incidents and restraints, the original record is amended, which increases the risk of information being misrepresented.

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improvement to be good

Fire drills take place regularly, but records of these are poor. It is not clear from the records which children and staff are involved in fire evacuations. Leaders and managers are slow to develop strategies to support those young people who had difficulties leaving the building during a fire practice.

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improvement to be good

Emergency healthcare plans require prompt attention. These include plans for children with conditions such as epilepsy. There is a lack of information and insufficient detail to enable staff to deliver effective care and to meet young people’s needs.

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improvement to be good

Leaders and managers are improving the recruitment process to ensure that they recruit staff following safer recruitment guidance. This includes the recruitment of staff through an agency. Leaders and managers are auditing agency recruitment records to ensure that they comply with their own recruitment policy. Inspection report children’s home: SC458070 8

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The effectiveness of leaders and managers: requires improvement to be good

The current leadership team has a passion to drive improvements. They are achieving this aim, and the ethos and culture are gradually changing to become more positive. However, the current leaders and managers do not offer long-term stability, as they have interim posts and do not form part of the future development plan for the management team. The registered provider is taking action to address this shortfall, and has a plan to recruit quality staff to senior posts. This plan is yet to come to fruition, leaving uncertainty about the future leadership of the service.

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The effectiveness of leaders and managers: requires improvement to be good

Some improvement has been made to the arrangements for supervision of staff. House managers have received supervision training and coaching from the responsible individual. Leaders and managers identify that supervision continues not to meet the children’s homes regulations and is not as regular and effective as they would like. Monitoring systems identify the areas of weakness in relation to supervision of staff. Leaders and managers are focusing on these in order to improve the overall quality of staff supervision.

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The effectiveness of leaders and managers: requires improvement to be good

Leaders and managers have closed one of the houses. This has resulted in an improvement in the quality of staffing in some of the remaining homes. The use of agency and bank staff is reducing over time. Shift patterns require attention. The current rotas have a negative impact on children due to the time that day staff leave and night staff arrive. This happens at a key time for children in the early evening, and does not provide consistency of care around evening activities, bedtimes and the administration of medications.

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The effectiveness of leaders and managers: requires improvement to be good

Staff members’ access to training has increased, which is providing them with the additional skills they need to meet the needs of the children. Leaders and managers have improved the induction process, and new staff say that they feel supported in their new roles. Agency staff also complete an induction and have access to key training, such as safeguarding and behaviour management. Inspection report children’s home: SC458070 9

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, 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’. Inspection report children’s home: SC458070 10

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Cambian Autism Services Ltd

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Children’s home details

Registered provider address: 4th Floor, Waterfront Building, Chancellor’s Road, Hammersmith Embankment, London W6 9RU

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Inspectors

Nicola Lownds, social care inspector Paula Lahey, regulatory inspection manager Wendy Anderson, social care inspector Inspection report children’s home: SC458070 11 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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