Children's Home, Residential special school run by Cambian Autism Services Limited in Dorset

Inspection report children’s home: SC065261 1 SC065261 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

Cambian is a national, private organisation. Care and accommodation is provided for up to 60 children and young people at this residential special school. The team provides care for children and young people who have autistic spectrum disorders and/or learning disabilities. Some children and young people live at the service for 52 weeks of the year. Therefore, it is registered as a children’s home. The accommodation is on the main school site except for one home, which is located a short drive away.

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Overall experiences and progress of

children and young people, taking into account

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Inadequate

How well children and young people are helped and protected Inadequate

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Inadequate

The effectiveness of leaders and managers Inadequate

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Inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded, and the care and experiences of children and young people are poor and they are not making progress.

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Inadequate

Date of last inspection: 1 February 2017

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Inadequate

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC065261 2

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Key findings from this inspection

This children’s home is inadequate because:

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Key findings from this inspection

 Staff fail to follow the child protection procedure and take action to always keep children and young people safe. Leaders and managers do not consistently record the outcome to child protection concerns or feed information about the outcome back to the staff who are caring for the children. Records about child protection concerns are not always well maintained.  Despite changes in the senior leadership team, the leadership and management of the provision has not been effective. Leaders and managers are failing to sustain the improvements they had made in the past 12 months. The home was judged to require improvement at the full inspections in 2015 and 2016. Insufficient action has been taken to address the weaknesses identified in previous inspections.  Some children’s day-to-day experiences are poor. Leaders and managers fail to provide children and young people with accommodation that is homely or that

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Key findings from this inspection

helps them to participate in the daily life of the home and to develop their independence. Not all children and young people have good-quality activities and opportunities.  Leaders and managers fail to engage all families in their child’s care. Families and those with parental responsibility are not routinely provided with detailed information about incidents that their children have been involved in. The arrangements for families to visit their children at school are poor. Complaints and concerns families make on behalf of their child are not dealt with effectively.  Behaviour support plans require improvement as the information about strategies staff can use to manage high-risk behaviours are generic. Staff are not consistently following these strategies. Records about the day-to-day progress children and young people make towards meeting their individual targets are poor.  Leaders and managers do not provide staff with good opportunities to learn

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Key findings from this inspection

from each other and share practice. Meetings across both teams no longer take place and not all staff are receiving regular supervision from their managers.  The recruitment processes for new staff are weak. It is not evident how leaders and managers decide that new staff are suitable when there are gaps in their employment history and references are weak. Inspection report children’s home: SC065261 3 The children’s home’s strengths:  The direct relationships between care staff and children and young people were observed to be good. Care staff speak positively about the children in their care and are knowledgeable about their individual needs.  The home that is separate to the school site provides children and young people with a welcoming and homely environment. Children and young people who live in this house have good opportunities and experiences.  Children and young people are helped to give their views and share their feelings

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Key findings from this inspection

about incidents. The speech and language therapy team has devised incident ‘de- brief’ packs to help this process.  The therapy provision is strong. Children and young people have good access to specialist therapeutic interventions such as occupational therapy, speech and language therapy, and clinical psychology.

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Inspection date Inspection type Inspection judgement

01/02/2017 Interim Sustained effectiveness 14/06/2016 Full Requires improvement 16/03/2016 Interim Improved effectiveness 21/07/2015 Full Requires improvement Inspection report children’s home: SC065261 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

5: Engaging the wider system In meeting the quality standards, the registered person must, and must ensure that staff— (d) seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. In particular, improve the arrangements in place when parents visit their child; enabling, when possible, for them to visit and spend time with their child in their home as well as using the facilities in the school. 15/09/2017

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Requirement Due date

6: The quality and purpose of care standard The quality and purpose of care standard is that children receive care from staff who— In particular, the standard in paragraph (1) requires the registered person to— (b) ensure that staff— (i) understand and apply the home’s statement of purpose; (ii) protect and promote each child’s welfare; (iv) provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; (vi) help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult; (vii) provide to children living in the home the physical necessities they need in order to live there comfortably; (viii) provide to children personal items that are appropriate for their age and understanding; and 15/09/2017 Inspection report children’s home: SC065261 5 (ix) make decisions about the day-to-day arrangements for each

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Requirement Due date

child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice; (c) ensure that the premises used for the purposes of the home are designed and furnished so as to— (i) meet the needs of each child; and (ii) enable each child to participate in the daily life of the home. In particular, ensure that the care provided promotes the welfare of children and young people and provides them with opportunities to learn and develop. Ensure that records detail the needs of children and evidence the progress they make against their targets. Ensure that children and young people have suitable, clean and homely accommodation to live in. 7: The children’s views, wishes and feelings standard 7.—(1) The children’s views, wishes and feelings standard is that children receive care from staff who— (e) ensure that the views of each relevant person are taken into account, so far as reasonably practicable, before making a

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Requirement Due date

decision about the care or welfare of a child. In particular, ensure that the views of parents are sought when making decisions about the care of their children. 15/09/2017

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Requirement Due date

9. The enjoyment and achievement standard 9.—(1) The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff help each child to— (i) develop the child’s interests and hobbies; (ii) participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and (iii) make a positive contribution to the home and the wider community; and (b) that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. In particular, ensure that there are sufficient staff to enable all children to access activities in the community. 15/09/2017 Inspection report children’s home: SC065261 6

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Requirement Due date

12: The protection of children standard 12.—(1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (iii) have the skills to identify and act on signs that a child is at risk of harm; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is a serious concern about a child’s welfare; and (vii) are familiar with, and act in accordance with, the home’s child protection policies. In particular, ensure that the child protection policy is followed when there is an unknown cause for bruises and injuries sustained by children. Ensure that child protection concerns are reported and communicated effectively to the relevant designated

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Requirement Due date

officers, social workers and parents when appropriate. 28/07/2017

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Requirement Due date

13: The leadership and management standard The leadership and management standard 13.—(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— (2) In particular, the standard in paragraph (1) requires the registered person to— (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; (b) ensure that staff work as a team where appropriate; (d) ensure that the home has sufficient staff to provide care for 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; (g) demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

(i) research and developments in relation to the ways in which 15/09/2017 Inspection report children’s home: SC065261 7 the needs of children are best met; and (ii) feedback on the experiences of children, including complaints received; and (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. In particular, ensure the home has effective, stable and consistent leaders and managers. Ensure that monitoring systems to review the quality of care are effective. Implement a development plan that will improve the children’s experiences. Build positive relationships with parents, manage and learn from complaints. 20: Restraint and deprivation of liberty Restraint in relation to a child is only permitted for the purpose of preventing— injury to any person (including the child); serious damage to the property of any person (including the child); or Restraint in relation to a child must be necessary and

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Requirement Due date

proportionate. In particular, consider any restriction imposed as a restraint and that these restrictions are communicated explicitly to local authorities in relation to deprivation of liberty. Including the use of locks on external doors preventing access into the home and access to gardens. Reduce and seek to remove the use of unnecessary environmental restrictions that include but are not limited to locking kitchens, locking away children and young people’s belongings and locking away items to enable children and young people to develop independence in the bathroom. (Regulation 20 (1)(a)(b)(2)) 15/09/2017

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Requirement Due date

32: Fitness of workers 32.—(1) The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. (3) The requirements are that— (b) the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; (d) full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. In particular, ensure that satisfactory recruitment checks are undertaken prior to employing staff to work in the home; this includes staff employed by an agency as well as permanent staff. 28/07/2017 Inspection report children’s home: SC065261 8 (Regulation 32 (3)(b)(d)) 33: Employment of staff The registered person must ensure that all employees: receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b) 15/09/2017

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Requirement Due date

39: Complaints and representation 39.—(1) Subject to paragraph (6), the registered person must establish a procedure for considering complaints made by or on behalf of children. The registered person must ensure that no child is subject to any reprisal for making a complaint or representation. (Regulation 39 (4)) 15/09/2017

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Overall experiences and progress of children and young people: inadequate

There are widespread weaknesses. As a result, children and young people are not always kept safe and do not always have good opportunities and experiences. The quality of the on-site accommodation provided for children and young people varies considerably. Some houses are well maintained and have fixtures and fittings typically seen in family homes. Others do not. Overall, bathrooms are of poor quality and do not provide children and young people with a pleasant space in which to bathe. A number of on-site houses have no toilet paper, sink/bath plugs, towels and hand soap. Staff remove these items from the bathrooms and lock them away. Staff say that this is because a small number of young people may use these items to flood the rooms. As a result, all young people are affected and have to ask staff for these items before they can use the bathroom. The staff team lacks ambition in terms of helping young people to develop

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Overall experiences and progress of children and young people: inadequate

their skills and to have access to all the usual facilities normally found in a bathroom. This weakness has been identified at previous inspections. Some kitchens remain locked. One home has limited food in the cupboards, and some children and young people cannot have access to the gardens without the permission of staff. Staff still carry walkie-talkie radios and large bunches of keys. None of these practices are conducive to a family environment and do not provide children and young people with opportunities to participate in the daily life of the home, or to develop skills to help them become self-reliant. These weaknesses have been identified at previous inspections and insufficient action has been taken to identify alternative ways to support the children and young people. Some families agree with these findings and raised concerns with the inspectors. One family member said, ‘I feel my child is contained and it

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Overall experiences and progress of children and young people: inadequate

is like a young offenders’ unit. The children are locked in everywhere.’ Another family member said, ‘I think my child has become institutionalised. There is no plan for Inspection report children’s home: SC065261 9 adulthood.’ Not all children and young people have good-quality activities and opportunities. For some children and young people, activities are repetitive and uninspiring. In addition, their access to the local community is limited. Some parents raised concerns with the inspectors about the lack of activities for their children. Comments include: ‘My child watches DVDs in their bedroom, plays on the Kindle, occasionally goes for a walk and prepares vegetables for the Sunday dinner – these are not exciting activities for a 14- year-old’; ‘My child’s world has got smaller. My child spends most of the time in their bedroom and rarely goes out’; ‘My child does three things: ICT, sports hall and

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Overall experiences and progress of children and young people: inadequate

playground. His life is getting narrower and narrower.’ The lack of good-quality activities is particularly evident for the children and young people who have the most complex needs. Leaders and managers have recognised this weakness and have recently appointed a member of staff to take responsibility for activities. However, this role is new and the impact is yet be determined. The arrangements for families when they visit their children at home are poor. Some families told inspectors that they cannot spend time with their child in their homes or in their child’s room. They have to meet their child in reception to either take them out or use the family contact room at the home. This contact room is not conducive to a homely environment. As a result of these rules, poor use is made of the grounds and facilities, which families could benefit from utilising. Each child and young person has targets for their development set and shared between

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Overall experiences and progress of children and young people: inadequate

the education and care teams. Care staff are not consistently recording the progress that children and young people make towards achieving these targets. Staff can explain the progress that children and young people are making, and some parents agree with this feedback, but not all. Some families told the inspectors that, in the past year, their child has not made progress and their opportunities and experiences have decreased. The monitoring by leaders and managers does not identify this weakness. Records used to detail the needs of children and young people require improvement. For one young person new to the home, staff have conflicting information about the care plan and their legal status. This leaves unanswered questions about who has parental responsibility and consent. Leaders and managers have a plan in place to improve placement plans. The direct care given by staff to children and young people is warm and nurturing, and

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Overall experiences and progress of children and young people: inadequate

this is a strength of the home. Staff told an inspector, ‘There are issues with senior management, but we will not let that impact on the care we provide to the children.’ Children and young people develop positive relationships with the staff. The new staff rota provides improved consistency of care so that children have the same staff caring for them throughout the day. One young person describes how the staff ‘do her hair all pretty in the morning and paint her nails’. Children and young people have access to an on-site therapy team that includes occupational therapy, speech and language therapy and clinical psychology. Parents speak highly of this resource and the positive impact it has on the children and young people. There is a passionate and dedicated member of staff who is responsible for supporting Inspection report children’s home: SC065261 10 young people and their families with moving on from the home. This support includes

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Overall experiences and progress of children and young people: inadequate

considering options of moving back home with family, into further education colleges, or independent or supported living accommodation. The member of staff has a good system to track the young person over time, review their progress and evaluate how successful the move was for them.

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

Staff do not always follow the child protection policy. Records detail injuries and bruises on children and young people with an unknown cause. Action is not always taken to ensure that these concerns are reported to the designated safeguarding lead, or to external safeguarding agencies. As a result, children and young people are not protected. Leaders and managers have not ensured that the system to track child protection concerns, and follow them through to the final outcome, is clear and well documented. Leaders and managers do not consistently record all the actions they claim to have taken to protect children and young people. Staff who report child protection concerns do not get feedback from leaders and managers about the outcome of these concerns. In addition, they are not given information about the actions needed to protect children and young people. A social worker and parent reported concerns to the inspectors about the lack of

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

information they received about child protection concerns. This includes allegations that a child made about staff. One parent said that the child informed him of the child protection concern; the information did not come directly from leaders and managers. The staff team frequently use physical restraint to protect children from harm, or from harming others. Staff have appropriate training to use these restraint methods. The number of restraints is continuing to reduce year on year. Some of the restraints include holds on the ground. These occur when a child or young person pulls staff to the floor and does not release the grip immediately. The use of seclusion to manage a child’s behaviour in an emergency ceased in December 2016. The quality of leaders’ and managers’ monitoring of incidents and restraints, since the last full inspection, has declined. Reports lack the rigour and in-depth reflection that the senior leadership team

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

has achieved in the past. It is not always clear what learning has taken place to prevent such an incident occurring again. Some families reported concerns to the inspectors about the lack of information given to them about incidents that their children have been involved in. Leaders and managers have recently started to provide reports containing a monthly summary of incidents to families. However, these documents do not contain all of the information required to enable those with parental responsibility to analyse the incident and understand fully what happened. The therapy team supports children and young people to communicate their views and feelings following an incident. Each child and young person has an individual ‘debrief pack’ that uses creative materials and methods to help ascertain their views. Leaders and managers also provide staff with the opportunity to reflect on their involvement in any

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

incidents and restraints. Inspection report children’s home: SC065261 11 Individualised risk assessments detail a list of behaviours children and young people may demonstrate, if they become anxious or unsettled. Behaviour support plans set out strategies to direct staff to manage these behaviours and risks. However, the information in these plans provides generic responses to a list of behaviours, rather than an individual approach to each child and young person. Staff are not routinely following these behaviour support plans when they involve sensory equipment and therapeutic strategies. The processes for the recruitment of new staff require attention. Although staff do not start work without disclosure and barring checks, it is not evident how leaders and managers decided that some new staff are suitable when there are unexplored gaps in their employment history and their references are weak. A member of staff employed by

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

an external agency has disclosed a conviction on their disclosure and barring check. However, records do not show that leaders and managers have followed this up to find out whether the conviction would make the person unsuitable to work with the children and young people.

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The effectiveness of leaders and managers: inadequate

Despite changes in the senior leadership team, the leadership and management of this home is ineffective. Leaders and managers do not understand all the weaknesses evident in this provision. Most notable are the concerns about unknown marks and injuries seen on children. These are not always reported to leaders and managers, or to external safeguarding agencies. The development plan put in place by leaders and managers to improve the quality of care has not been implemented. There is a deterioration in the progress made since the last inspection. Staff and parents raise concerns about the senior leadership team’s ability to manage the home. The new manager has been in post for two months and aims to register as the manager with Ofsted. Senior leaders in the company took decisive action to address concerns, and to tackle the closed culture that has developed. Changes to the school’s senior team took place during this inspection.

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The effectiveness of leaders and managers: inadequate

In some cases, families who make complaints or raise concerns about their child’s care are not satisfied with how these are managed. A small number of families told the inspectors that they did not feel confident to escalate their concerns for fear of reprisal. Senior leaders have set up a stakeholders’ working group to enable families and the staff team to look at ways to improve the provision together. Some families speak very positively about this group and the opportunities it brings. This view is not shared by everyone, and some families lack confidence in how it is led and managed. Not all children and young people receive sufficient staff support to enable them to join in with regular activities outside of the home. Some young people need more than one member of staff to support them. However, leaders and managers have recently removed the staffing needed to provide the required level of support. There is a lack of attention

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The effectiveness of leaders and managers: inadequate

given to the development of young people’s living accommodation. As a result, larger works, such as replacing bathrooms and toilets, and removing excessive high fencing, has not taken place. Inspection report children’s home: SC065261 12 Staff are not receiving regular supervision. This shortfall was identified at the previous inspections. This weakness is particularly notable among waking night staff and those employed on a temporary basis. Staff say that they feel supported by their direct line manager, but not by some of the senior leaders. Due to changes in staff working patterns, team meetings no longer include staff who work on opposite shifts. Staff rely on electronic handover systems. As a result, it is difficult for staff to learn from one another. The review of staff working patterns has been successful in providing children with more stability and opportunities for consistency of care. Staff now work longer shifts so that

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The effectiveness of leaders and managers: inadequate

they can provide care throughout the day. Waking night staff and temporary staff are now assigned to each individual house. This has reduced the number of different adults who care for children and young people. Additional work is still required to fill all of the staff vacancies.

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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 who 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: SC065261 13

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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: Trudie-Toni McLelland

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Inspector(s)

Nicola Lownds, social care regulatory inspector Paula Lahey, regulatory inspection manager Polly Soper, social care regulatory inspector Wendy Anderson, social care regulatory inspector Inspection report children’s home: SC065261 14 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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Inspector(s)

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Inspector(s)

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Inspector(s)

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