Children's home run by London Borough of Hammersmith & Fulham in Hammersmith and Fulham

Inspection report children’s home: SC443337 1 SC443337 Registered provider: London Borough of Hammersmith & Fulham

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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 local authority children’s home is registered to provide care for up to seven children who have learning disabilities and/or physical disabilities. The home provides a mix of short-break placements, shared care placements and permanent placements.

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Information about this children’s home

Inspection dates: 19 to 20 September 2017

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

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

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good

Date of last inspection: 6 December 2016

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good

Overall judgement at last inspection: Sustained effectiveness

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Key findings from this inspection

 The staff team is committed to delivering a high standard of individualised care.  There is a strong partnership between parents and the whole staff team. Inspection report children’s home: SC443337 2  Considerable thought and personalised planning occurs for young people who are either joining or leaving the home.  Staff understand young people’s needs and wishes and know the most effective ways to minimise any negative behaviour.  Restraint is only used in this home when absolutely necessary, and at the lowest possible level.  There is an effective and experienced management team in place that is supported well by the independent visitor’s careful monitoring.  External professional colleagues have effective working relationships with the home.  Staff morale is good and staff feel appropriately supported by their management team.  Review documentation is structured well and highly visual.

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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

 Care planning systems for young people in permanent placements do not adequately reflect the home’s responsibilities for the young people’s care.  Staff are not initially assessed or rechecked for their competence in delivering medication.  Communication with young people about day-to-day life in the home could be improved.  The statement of purpose does not accurately reflect the current legal framework in which the home operates.

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Inspection date Inspection type Inspection judgement

06/12/2016 Interim Sustained effectiveness 20/07/2016 Full Good 14/12/2015 Interim Sustained effectiveness 27/08/2015 Full Good Inspection report children’s home: SC443337 3

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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

Medicines Ensure that there are robust arrangements for the safe administration of medicines in the children’s home. (Regulation 23(1)) This particularly relates to ensuring that all staff are assessed to ensure their competency to administer medication. 22/11/2017

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Requirement Due date

The care planning standard Ensure that children receive effectively planned care in the children’s home. (Regulation 14(1)(a)) This particularly relates to those young people who live permanently in the home. 22/11/2017

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Recommendations

 Ensure that due regard is paid to the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’ (‘Guide to the children’s homes regulations including the quality standards’, page 5, paragraph 1.8). This particularly relates to outdated legal and guidance references made in the statement of purpose.  Ensure that children have opportunities to communicate their views, wishes, and feelings on all possible aspects of their daily care (‘Guide to the children’s homes regulations including the quality standards’, page 22, paragraph 4.6). This particularly relates to young people knowing which staff are on duty, and being able to express their opinions on possible activity choices.

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Overall experiences and progress of children and young people: good

This home is a home that is in transition. It still has some short-break placements, but is increasingly offering shared-care placements and a small number of permanent placements. These changes reflect the local authority’s commitment to maintaining Inspection report children’s home: SC443337 4 young people who have highly complex behaviour issues locally. These young people present significant behavioural challenges to the staff team. However, the staff team is committed to continuing to offer the high standard of individualised care that young people on short breaks receive. Having young people who live permanently in the home means that staff now have some increased responsibilities put on them. For example, staff are now much more involved in meeting some young people’s routine healthcare needs. Because of the complexities involved, this can mean arranging sedation, social stories and for several

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Overall experiences and progress of children and young people: good

staff having to be in attendance for certain appointments. These situations have been dealt with well. In addition, staff are now responsible for meeting the leisure and educational needs of young people who live permanently in the home. Again, this requires careful planning and significant staff investment as some young people have a low tolerance threshold for others. Staff have responded well to these different expectations of their role, but the formal systems underpinning young people’s care have not been updated sufficiently. Care planning, risk assessment and goal progress are monitored and reviewed on the same forms, and to the same frequency and detail, whether a young person comes for short breaks or permanently lives in the home. This results in insufficient, individualised scrutiny of the care of young people whose permanent home is the children’s home. Parents are very positive about the home. Several parents positively referred to the

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Overall experiences and progress of children and young people: good

‘strong partnership’ between them and the home. Parents recognise that staff have warm relationships with young people and will go out of their way to promote the young people’s welfare. For example, staff will start their shift early or go home later because a young person has a particular appointment. As a parent said, ‘The staff know my child well and have a good relationship with my child.’ Professional colleagues reinforce these positive views, saying that, ‘They understand their young people and meet their needs really well.’ The home has recently initiated a very good example of involving young people who have communication difficulties in the recruitment of staff. One young person showed candidates around, and all were able to look at the visual ‘All about Me’ booklet that candidates prepared. Young people are also encouraged to express their views on their individual preferences, for example choosing which drink to have. However, on a day-to-

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Overall experiences and progress of children and young people: good

day level, the overall routines of the home are not explicitly geared towards young people’s perspectives. For example, some young people like to know who is looking after them that day, but they do not have a visual display to check this. Each young person has at least one personalised goal to reach, and these are displayed in the home to remind everyone. Where possible, these are linked with school goals and some young people make significant progress. For example, some young people have improved communication skills, and others now follow less restrictive diets. These successes help young people to be as independent as possible and can boost their self- esteem. The home has a good range of activity options on site, and has a comprehensive programme for the school holidays on offer. Young people have opportunities to attend drumming workshops, yoga, or cookery. Once the activity is over, they can relive the

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Overall experiences and progress of children and young people: good

memory by looking at the photos on display. These imaginative activities extend young Inspection report children’s home: SC443337 5 people’s range of experiences, and offer them valuable sensory and life experiences which they may not otherwise be able to experience at home or in other settings. Transition work is a strength of this home. Local managers carefully consider new admissions, and focus on equipping the staff group in advance to care effectively for the proposed young person. Young people who leave the home can take with them photographs of their time there, and they have special farewell parties. Staff will work hard at ensuring that the new placement is as familiar as possible for the young person. Staff are adept at putting together social stories with photos of the new placement. Once the young person is happy with this stage, staff will visit with them and introduce the young person to new staff. This all helps to promote positive endings and minimise

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

Staff are vigilant about the safety of young people. This is noted by parents who do not have concerns about their child’s safety when they are at the home. One parent said, ‘The staff notice every mark on him, and they notice when he is tired and so on. It is a very caring environment.’ This confidence is shared by local authority and education professionals, who note that staff are persistent in following up unexplained marks on young people. They do not have any safeguarding concerns about the home. Appropriate staff ratios and a secure campus help keep young people safe from harm when they are outside the home. There have not been any occasions of young people going missing from the home. Inside the home, thoroughly executed health and safety checks help keep young people safe from environmental harm. Food hygiene is given a high priority and has recently received the highest accolade from environmental health

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

inspectors. The overall environment of the home is warm, homely and comfortable. Medication shortfalls are rare in this home. However, there has recently been a serious medication error and, in addition, paperwork relating to medication is not always accurate. The error was appropriately dealt with by the registered manager, and the young person concerned was not harmed in any way. There have been some improvements in practice as a result. However, staff competency in understanding medication administration is still not either initially assessed or routinely checked. This means that, in this area, young people’s safety is insufficiently promoted. Staff have appropriate safeguarding knowledge, and are clear about what to do if they have a concern about a young person. Several staff have recently attended safeguarding training, and they are enthusiastic about practising their new learning. This helps keep

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

young people safe from possible harm. Staff’s good knowledge of young people’s needs and wishes helps to maintain the usually positive atmosphere that exists in the home. Staff are aware of which young people would rather be in the middle of things and which prefer to be left alone. Staff know that some young people are intolerant of each other. Staff are confident in using practical strategies to separate some young people, and then ensure that the same young people are happily occupied in different parts of the building. All staff are appropriately and routinely updated on de-escalating challenging behaviour. Inspection report children’s home: SC443337 6 They are very competent at this, particularly given that some young people are very challenging. The skills of the staff team are apparent in the commendably low numbers of restraints used. If restraint does have to be used, it is for appropriate reasons and is

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

at the lowest possible intervention to meet the young person’s need. Recruitment processes are appropriately thorough. Prospective staff are carefully vetted and assessed prior to employment, and agency staff are given a good induction. This helps promote young people’s safety in the home.

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The effectiveness of leaders and managers: good

This home is managed well by an effective, experienced and qualified registered manager. He is strongly supported by an able deputy manager, and both are ambitious for the highest standards of individualised care for their young people. Staff morale is good, and staff have considerable confidence in their local, leadership team. For example, a staff member said, ‘The manager treats everyone with respect . You can go to him with anything.’ This positive attitude towards the leadership team helps motivate staff to go that extra mile to benefit young people. External professional colleagues are also positive about the home and its management. They feel that communication about young people is good, and that staff from the home will attend relevant meetings and be appropriately prepared. One external colleague said, ‘The home has a good solid management team. It is a consistent staff team that knows the children well, and delivers good partnership working with other agencies and

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The effectiveness of leaders and managers: good

families.’ The home has successfully recruited two staff members to cover essential posts, and is now appropriately staffed with the assistance of some agency and sessional workers. There are sound workforce plans to minimise the usage of temporary staff in the home, but those that are currently used are appropriately supported which minimises any negative impact on young people. The registered manager has a highly visible presence around the home. He is actively engaged in monitoring all aspects of the home’s functioning, including health and safety checks, as well as restraint records. He knows young people well and will, on occasion, become directly involved with their care. This hands-on approach is respected by parents. One parent commented, ‘He advocates for you with the school or social worker, whatever is best for the young person.’ There is also an experienced and effective independent visitor in place, who routinely offers useful scrutiny of the care offered by

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The effectiveness of leaders and managers: good

the home. One requirement and two recommendations resulted from the last inspection. The requirement related to ensuring that appraisals were routinely held, and this has been met well. The two recommendations have also been met. This further demonstrates that effective leadership and management are in place. One of the recommendations was about training, and the second related to a senior management placement decision that placed significant strain on the home’s smooth functioning. This has now been resolved, and local authority leaders have been complimentary in their praise for the home’s ‘flexibility, adaptability and good grace in successfully taking this task on’. In addition, considerable thought was given to ensuring that this placement did not adversely affect Inspection report children’s home: SC443337 7 routine life in the home, and the management team successfully ensured that it swallowed up most of the negative impact. This meant that young people were not

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The effectiveness of leaders and managers: good

adversely affected. Supervision is routinely carried out, and staff feel supported. There are very regular team meetings and these focus strongly on discussion about young people. This means that staff have a good knowledge and understanding of all the young people in the home. Training is a major positive factor for staff. A new training programme for working with disabilities has recently begun, and staff are enthusiastic about this and very keen to participate. Later this year, the current training will be usefully supplemented by a programme of resources on working with health needs. The home’s statement of purpose is appropriate, but signposts readers with some outdated legal references. This does not help to clarify the roles and responsibilities of the home. Although there are some shortfalls in case recording, particularly in the case of those young people who live permanently in the home, review documentation for young

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The effectiveness of leaders and managers: good

people is very good. The review documents are clearly written with lots of photographs of the young person, and present a highly individualised picture. An external colleague described the review documents as ‘excellent’ and a parent commented that the wording ‘got’ her child.

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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 differences 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: SC443337 8

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Children’s home details

Registered provider address: Town Hall, King Street, London W6 9JU

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Inspector

Bridget Goddard, social care inspector Inspection report children’s home: SC443337 9 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

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Inspector

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