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

Inspection report children’s home: SC066897 1 SC066897 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

The home is registered to provide care and accommodation for up to 31 children and young people who have learning disabilities and/or sensory impairment. The home forms part of a residential school specialising in care, education and therapy for young people who have autistic spectrum disorder and associated behaviours. It is owned by a public limited company. Specific support is provided to assist young people in developing their communication, social and independence skills and the self-management of their behaviour. There is a multi-disciplinary approach to care provided to young people, with support available from a range of professionals.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected good

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC066897 2

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Key findings from this inspection

This children’s home is outstanding because

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Key findings from this inspection

 Young people are making outstanding progress while living in the home.  Staff provide an excellent quality of care to young people.  Young people’s life chances are enhanced by living in the home.  Leaders, managers and staff are innovative in their practice, striving to support young people to achieve their best.  Young people experience a wide variety of activities and experiences, which enables them to develop positive life skills.  Leaders and managers are inspirational, having high expectations and aspirations for those in their care.  They are child focused and all decisions made about the home benefit and improve the quality of life for young people.  Skilled, knowledgeable staff care for young people through exceptional relationships in a nurturing, caring way.  Relationships with others outside of the home are very positive. Staff have a positive impact on people’s attitudes towards, and understanding of, young

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Key findings from this inspection

people who have complex needs.  Leaders and managers are very clear about their strengths and weakness and have robust plans to bring about change.

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Key findings from this inspection

The children’s home’s areas for development

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Key findings from this inspection

 Safeguarding concerns and allegations were not reported swiftly as described and required in the home’s policy and procedures.  Young people had some locked drawers in the bedrooms, restricting their access to their possessions and clothing, with no clear rationale and reason for this.  Staff do not routinely record young people’s views following an incident of restraint.  There were no local authority consents for the use of surveillance devices.  Staff who have been employed for longer than two years have not all achieved the required qualification, although there has been significant improvement and development with this. Inspection report children’s home: SC066897 3

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Inspection date Inspection type Inspection judgement

03/01/2017 Interim Sustained effectiveness 13/09/2016 Full Good 16/12/2015 Interim Sustained effectiveness 21/07/2015 Full Outstanding Inspection report children’s home: SC066897 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 with the given timescales.

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Requirement Due date

Fitness of workers An individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained the level 3 Diploma for Residential Childcare (England). The relevant date is, in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home. (Regulation 32(4)(a)(5)(a)) 30/03/2018

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Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene etc.); however in doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)  Any home using CCTV or other monitoring equipment should have a written policy describing how this will support the safeguarding and well-being of those living and working in the home in accordance with regulation 24. Homes must gain consent to any monitoring or surveillance by the placing authority in writing at the time of placement. The use of CCTV is regulated by the Protection of Freedoms Act 2012 and the Surveillance Camera Code of Conduct (Home Office

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Recommendations

2013). (‘Guide to the children’s homes regulations including the quality standards’, page 16, paragraph 3.16)  Children who cannot or choose not to verbalise, have the right to have their views, wishes and feelings heard and respected in the same way as other children. There may be children whose abilities and understanding are such that regulations 7(2)(a)(iv), (b)(i) and (c) will need interpretation according to their individual circumstances in consultation with their social worker. (‘Guide to the children’s homes regulations including the quality standards’, page 24, paragraph Inspection report children’s home: SC066897 5 4.24)  Supervision of staff practice should ensure that individual adults in the home are engaged in the safeguarding culture of the home so they understand what they would need to do if they found other staff misusing or abusing their position to the detriment of the safety of a child. (‘Guide to the children’s homes regulations

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Recommendations

including the quality standards’, page 43, paragraph 9.14)  Any child who has been restrained should be given the opportunity to express their feelings about their experience of the restraint as soon as is practicable, ideally within 24 hours of the restraint incident, taking the age of the child and the circumstances of the restraint into account. In some cases, children may need longer to work through their feelings, so a record that the child has talked about their feelings should be made no longer than 5 days after the incident of restraint (regulation 35(3)(c)). Children should be encouraged to add their views and comments to the record of restraint. Children should be offered the opportunity to access an advocacy support to help them with this (regulation 7(2)(b)(iii)). (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.60)

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Overall experiences and progress of children and young people: outstanding

Young people benefit from living in this home. Staff support young people to develop essential life and social skills. Young people develop their independence and their future opportunities are enhanced as a result.

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Overall experiences and progress of children and young people: outstanding

Young people have established secure relationships with staff and seek affection and reassurance from them when they are anxious or upset. Staff provide high-quality individualised care to young people. Staff know young people well and understand their needs. Young people are happy living in the home and display a sense of belonging.

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Overall experiences and progress of children and young people: outstanding

Staff effectively use a range of techniques to communicate with young people, including sign language, schedules, ‘now and next’ prompts, social stories and symbols. Staff continually encourage young people to improve their communication skills. As a result, young people make very good progress in their ability to communicate their needs.

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Overall experiences and progress of children and young people: outstanding

Staff help young people to exercise choices, such as choosing snacks and personalising their rooms. The new ‘Let’s Eat Café’ enables young people to choose what they would like to eat at lunch time and with whom they would like to sit. However, not all children can access storage in their rooms as drawers are locked or have no handles. There is no clear rationale to explain these restrictions. An independent advocate visits the school twice a month, which helps young people to get to know her.

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Overall experiences and progress of children and young people: outstanding

Staff support young people to move between education and home settings. Effective relationships and information sharing between staff promotes consistency of approach Inspection report children’s home: SC066897 6 across settings. Home staff support young people throughout the day, providing routine and structure, which promotes young people’s ability to cope with transitions. Staff provide a seamless curriculum with all aspects of daily living utilised as meaningful learning experiences.

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Overall experiences and progress of children and young people: outstanding

Staff effectively use social stories and schedules to help young people to understand their health needs and attend medical appointments. Parents are fully involved in making decisions about their children’s health and treatment. Staff are responsive and inquisitive to changes in young people’s presentation and seek guidance when needed. They follow detailed protocols and plans to manage chronic conditions and illnesses. Young people are supported to address longstanding healthcare needs, which they have not previously been able to do.

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Overall experiences and progress of children and young people: outstanding

Staff offer young people a full programme of activities. These include gardening, arts and crafts, music, using outside space for physical activities, access to community activities, services and voluntary groups. There are weekly clubs that staff facilitate on site that young people can attend if they wish. Activities focus on preparing young people for next steps, developing their independence and life skills that enhance and promote individuals’ skills to achieve their best.

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Overall experiences and progress of children and young people: outstanding

Staff are thoughtful and thorough in making arrangements for young people to move into the home, taking into account the needs of young people moving in and those already living there. Staff carefully prepare young people to move on and involve young people in choosing where they will live.

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Overall experiences and progress of children and young people: outstanding

Staff understand the importance of young people being able to keep in touch with their families and friends. They support young people to establish, maintain and build positive relationships with family and friends. Staff go the extra mile to support young people and their families to have good-quality family experiences and relationships.

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How well children and young people are helped and protected: good

Young people feel safe and each has a trusted adult. They seek support and guidance from staff at times of high anxiety and are soothed by known adults, which enables them to become calm.

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How well children and young people are helped and protected: good

Staff know how to keep young people safe; managers have effective relationships with external safeguarding professionals. Managers and staff have used workshops to reflect on research and serious case reviews. Internal and external reporting of safeguarding concerns is effective. There was one exception to this: an internal report was delayed; managers reviewed this but did not consider all the actions they could have taken. This one incident was less robust than their usual practice.

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How well children and young people are helped and protected: good

Young people are informed about how to make a complaint. Not all young people are able to verbalise a complaint or have the ability to understand how to make a complaint. Their behaviour may be the way in which they express their concern or upset. The home’s policy does not currently reflect how staff will respond to this. However, staff are skilled in Inspection report children’s home: SC066897 7 observing and interpreting behaviour and ascertaining whether a young person is unhappy. There have been no complaints made by others outside of the home.

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How well children and young people are helped and protected: good

There have been no episodes of missing, but there is a clear protocol for staff to follow should this occur.

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How well children and young people are helped and protected: good

Staff encourage young people to develop age-appropriate skills. Staff provide education and information to develop knowledge and understanding about risks associated with using the internet. Staff educate young people about the impact of risk-taking behaviours throughout the home’s 24-hour curriculum. Staff actively encourage all young people to learn new skills and to learn from experiences and age-appropriate risk taking.

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How well children and young people are helped and protected: good

Staff work well with young people to help them to develop strategies to manage their behaviour. Staff are proactive in de-escalating challenging behaviour and, whenever possible, avoid physically intervening. When physical intervention cannot be avoided, detailed records show that it is applied in line with the young person’s behaviour management plan and for as short a period as possible. Effective arrangements are in place for incidents to be reviewed by the multi-agency strategy team. The team considers whether changes are needed in how staff work with young people to prevent further physical intervention being needed.

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How well children and young people are helped and protected: good

Staff follow detailed risk assessments that provide practical advice and guidance, enabling them to support young people and reduce and manage risk. Regularly reviewed plans are updated, reflecting current risks. Thorough pre-planning before activities significantly reduces risks. Staff use surveillance and monitoring systems to enable them to monitor young people who have complex health conditions. They have not gained consents for these from the young person’s placing authority.

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How well children and young people are helped and protected: good

Efficient maintenance arrangements ensure that the home is safe and that damage is swiftly repaired. The presentation and decoration of some areas of the home have improved since the previous inspection. Evidence shows that regular maintenance and monitoring checks are completed as required. The house fire drill records show regular day- and night-time drills and evacuations. Each child has a personal emergency evacuation plan. During inspection, fire doors were propped open and did not have quick door-release systems.

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How well children and young people are helped and protected: good

Safer recruitment processes are followed and thorough records detail all necessary information.

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How well children and young people are helped and protected: good

Staff are trained in medication administration procedures. Their practice is observed and assessed to ensure competency. Robust systems ensure that medication is stored securely and risk is well managed.

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The effectiveness of leaders and managers: outstanding

An efficient, appropriately qualified manager leads the home. She has addressed all recommendations and requirements from previous inspections. An effective and robust action plan covers all areas that the manager aspires to improve and includes clear actions Inspection report children’s home: SC066897 8 and desired outcomes.

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The effectiveness of leaders and managers: outstanding

Staff access a wide variety of training, which is suitable for their roles. The number of staff who have achieved the required qualification has increased, but some staff have still not completed this and have exceeded the expected timescale in which to do so. Staff are provided with effective, reflective supervision, which has a positive impact on their practice. This helps them to evaluate and improve their practice. Staff are clear about their professional responsibilities and are accountable for their practice. Managers observe and assess staff skill and ability in order to confirm their competency in aspects of their work.

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The effectiveness of leaders and managers: outstanding

Records and documents provide all the required information and detail to enable staff to meet young people’s needs. Leaders and managers have improved the records and recording systems to ensure that they are specific and avoid duplication. Staff involve young people, enabling them to contribute to their targets and objectives. They choose a target which is supplementary to academic and care targets. Staff break down targets into achievable steps for young people to achieve.

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The effectiveness of leaders and managers: outstanding

Leaders have high aspirations for young people. They influence young people’s future life chances and opportunities. They offer opportunities for young people, which others believed was never possible. Staff have supported young people and families to transfer skills across their home settings.

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The effectiveness of leaders and managers: outstanding

Managers have effective recruitment processes in place that ensure that vacancies are filled promptly. A thorough induction programme prepares new staff well to fulfil their roles. Leaders use research, observation and feedback from young people well to develop and improve practice. One example of young people’s feedback influencing services is the establishment of the ‘Let’s Eat Café’. This has successfully widened the variety of foods that young people are prepared to eat. A wide range of exceptional activities are available to young people. Staff are aspirational and inclusive and actively seek to overcome barriers to young people participating in the activities or experiences available to them.

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The effectiveness of leaders and managers: outstanding

Strong positive links with the local community benefit all. Young people access work- experience opportunities in the community and all of the local services, groups and facilities. Leaders, managers, staff and young people are changing the attitudes of those outside of the home and school. They have supported others to learn some of the basic communication systems used, promoting their ability to engage with young people when they use their services and facilities.

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The effectiveness of leaders and managers: outstanding

Leaders and managers also provide professional challenge to others when required, ensuring that the young person is central to all decisions and planning and they hold other services to account. An independent advocate has been trained in communication by the managers and has enough presence to be familiar to young people. Similarly, the independent (regulation 44) visitor has developed communication with young people and spends significant time with them.

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The effectiveness of leaders and managers: outstanding

The support, planning and preparation for transition to the children’s home are exceptional. There have been no placement breakdowns. Staff have a good understanding of young Inspection report children’s home: SC066897 9 people and commence relationships with them prior to their arriving at the home. Transitions out are equally carefully and comprehensively managed. Young people successfully move on to and settle into adult placements. This is the consequence of the well-coordinated, child- centred and multi-disciplinary approach implemented.

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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: SC066897 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, Chancellors Road, Hammersmith Embankment, London W6 9RU

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Children’s home details

Responsible individual: Katherine Landells

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Inspectors

Amanda Maxwell, social care inspector Chris Peel, social care inspector Inspection report children’s home: SC066897 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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