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

Inspection report children‟s home: SC482414 1 SC482414 Registered provider: The Daughters of the Cross of Liege

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

St Elizabeth‟s School and Children‟s Homes is registered to provide accommodation for 58 children who have special educational needs and/or disabilities. Children attend St Elizabeth‟s School, which is on the same site. It caters for pupils aged five to 19 years old, irrespective of gender, who have complex medical needs, autistic spectrum disorders, epilepsy and associated learning difficulties.

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Information about this children’s home

St Elizabeth‟s is managed by an organisation founded by the Daughters of the Cross of Liege. The school shares the campus of St Elizabeth‟s centre with a specialist college for students aged 19 to 25 years and a care home for adults who have learning difficulties and disabilities.

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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

Overall judgement at last inspection: Improved effectiveness

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Enforcement action since last inspection:

None Inspection report children‟s home: SC482414 2

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Key findings from this inspection

 The staff understand the individual needs of the children, and support them to progress.  The staff understand the importance of contact for children and families, and support this to happen. There is a flat on site where parents can stay with their child when they visit.  The staff understand the importance of smooth transitions both into and out of the home for the parents and the children.  The staff challenge unwanted behaviours in ways that support the children to understand.  The staff understand the importance of celebrating the children‟s achievements, and have thought of meaningful and creative ideas in which to do this.  The children‟s parents comment that they feel their children are safe living in the home, and they can call any time to speak to the staff.  The children are able to access a wide variety of therapists in the home who work closely together to create a wraparound service to support the children.

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Key findings from this inspection

 The children are involved in choosing the decor and furnishings for their individual houses. The bedrooms are personalised and parents can be involved in decorating their child‟s bedroom.  There is a wide variety of activities both in the houses and in the community, and staff support the children to attend clubs.

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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

 Children now receive lunchtime medication in school rather than coming back to the house. However, no risk assessment for the transporting of medication has been completed.  Impact risk assessments have not been completed before a child is admitted into the home to ensure that risks have been identified and the mix of children has been considered.  Not all the staff achieve their required qualifications within the required timescale, and some refresher training is out of date.  When completing records, the staff need to ensure that they include relevant information and that they make the records clear.  The staff do not sit and eat with the children in order to teach them positive, sociable interactions during meal times.  Some areas in the houses need attention to ensure that the children‟s environment is of a good standard. Inspection report children‟s home: SC482414 3

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Inspection date Inspection type Inspection judgement

08/03/2017 Interim Improved effectiveness 26/07/2016 Full Good 23/02/2016 Interim Declined in effectiveness 18/08/2015 Full Good Inspection report children‟s home: SC482414 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

The quality and purpose of care standard is that children receive care from staff who understand the children‟s home overall aims and the outcomes it seeks to achieve for children.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that the premises used for the purpose of the home are designed and furnished so as to meets the needs of each child. (Regulation 6(1)(a)(2)(c )(i))

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Requirement Due date

This is with regard to the lean-to outside two of the houses, the cleaning of the cookers and bringing two of the house bathrooms up to the same standard as the rest of the home. 10/01/2018

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that promotes their welfare. (Regulation 13(1)(b))

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Requirement Due date

In particular, ensure that records in regard to risk assessments and allegations are clear and that there is sufficient time for handover for staff to ensure arrangements in place to promote children‟s welfare. 15/12/2017

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Requirement Due date

The registered person must make arrangements for the handling and recording of medicines in the children‟s home. (Regulation 23(1)) 15/12/12017

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Requirement Due date

For the purposes of paragraph (3)(b), 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 level 3 Diploma”) or a qualification which the registered person considers to be equivalent to the level Diploma. (Regulation 32(4)(a)(b)) This includes agency staff. 10/01/2018

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Requirement Due date

The registered person must ensure that all employees receive practice related supervision by a person with appropriate 15/12/2017 Inspection report children‟s home: SC482414 5 experience. (Regulation 33(4)(b))

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes the description of the measure and its duration and details of any steps used or steps taken to avoid the need to use the measure (Regulation 35(3)(a)(iv)(v)) 15/12/2107

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Recommendations

 Ensure that, where appropriate, children are involved in choosing and preparing meals and opportunities for children and adults to sit and eat together are promoted. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraph 3.7)

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Recommendations

 Ensure staff are familiar with the home‟s policies on record keeping and understand the importance of careful, objective and clear recording. Care plans, evidencing response to children‟s views, clearer recording, some is illegible. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.4)

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Recommendations

 Ensure that staff can access appropriate facilities and resources to support their training needs. („Guide to the children‟s homes regulations including the quality standards‟, page 53, paragraph 10.11) This is with particular regard to ensuring all staff have their refresher MAPA training and identity (cultural) awareness training.

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Overall experiences and progress of children and young people: good

The children make good progress living in the home. The staff understand the importance of the children having the opportunity to progress and develop in all aspects of their lives. They work proactively with the children, parents, social workers and other services to achieve this. A parent commented, „He has been there just over a year and so far he has made enormous progress. Before he couldn‟t stand and now he is whizzing around. He‟s come on leaps and bounds.‟

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Overall experiences and progress of children and young people: good

The staff understand the importance of setting individualised, realistic and achievable targets that are meaningful and support the children to progress. Each house has a different incentive board, and interactive schemes have been devised with the positive behaviour support practitioner in conjunction with the children. One child has a bus and uses this to pick up passengers as part of his reward system. Other houses have visual Inspection report children‟s home: SC482414 6 charts, such as a football chart where they score goals and „drive to success‟ where they move a car around a track to monitor progress. These are very visual and unique, and the schemes enable the children to gain self-identity and promote further progress.

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Overall experiences and progress of children and young people: good

The staff realise the importance of maintaining contact with parents and other family members who are important to the children. The parents spoke about being able to contact their children by telephone or video-calling them every night. There is a flat on site where parents can stay over with their child while still having the support from the staff if needed. This understanding enables the children to maintain positive relationships with their families.

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Overall experiences and progress of children and young people: good

The staff want the children to be able to have new experiences. During the summer holidays, six of the children went to a specially adapted caravan for a week and during half-term some are going on a barge for five days. Prior to going, the staff will be having lessons so that they will be able to drive the boat with the children helping.

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Overall experiences and progress of children and young people: good

The staff work closely with the education provision on site, and communication is good. The staff work across both the school and home, which supports the children. A parent commented, „Before coming here he was not really attending school, about 25%. Now he attends every day. I have attended two assemblies, one where he read out a poem he had written.‟ The staff and school work closely together to support children‟s education.

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Overall experiences and progress of children and young people: good

The staff support the children with developing independence according to their age, understanding and ability. The children are encouraged to keep their rooms tidy and some help the staff with chores around the house. The children learn to take pride in their environment.

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Overall experiences and progress of children and young people: good

For some children who struggle with the day-to-day routine, the staff have completed their individual routine in pictures and symbols. Picture exchange communication system is used with some children for them to express preferances. This shows that the staff have thought about the needs of the child using the appropriate communication.

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Overall experiences and progress of children and young people: good

The staff support the children‟s health needs and work with all health professionals involved in the children‟s care. For those children who have complex needs, there are clear health plans devised by specialists and therapists that are incorporated into the child‟s placement plan. A number of parents commented that having multi agencies on one site has benefited their children. For those children who struggle with attending appointments, staff complete a social story with them. A parent commented, „Before coming here, he was tube-fed, he now eats. His speech was slurred, and that has improved along with his balance.‟ This practice ensures that all of the children‟s health needs are being met and the children are progressing.

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Overall experiences and progress of children and young people: good

The staff manage transitions into and out of the home well. The staff understand the effect that a new child moving into the group can have, and inform the children during house meetings. Parents commented that transitions can be difficult for them and their children, but feedback is positive. A parent said, „I was really impressed. I knew when I Inspection report children‟s home: SC482414 7 saw it that it was the right place for my son. It‟s his home.‟ Another said, „He struggles with all transitions but they are very child-centred around my son and think about his needs.‟ However, the staff do not complete a written impact risk for a child moving into the home taking into account their needs along with those of the other children in the house. Consequently, children may be placed in a group where they will have a negative impact on an already-settled group, and any potential risks may have not been recorded.

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Overall experiences and progress of children and young people: good

Staff realise that it is important to have positive endings, and plan these with children and their families. This understanding shows that the staff know the importance of the children having positive and meaningful endings.

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Overall experiences and progress of children and young people: good

The children have developed good, trusting relationships with a staff team that understands the children‟s individual needs. Good interactions were observed throughout the inspection, and the children were clearly happy and relaxed around the staff. A parent commented that a member of staff had stayed late so that their child could attend a birthday party. These relationships enable the children to develop and maintain positive interactions with adults who care for them.

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Overall experiences and progress of children and young people: good

The children have individual placement plans to support the staff working with the children. A new system is in place which incorporates all the care plans from other services working with the child. However, these have not yet been completed for each child and some information is sparse. The staff have not completed the cultural needs of the children in detail to support them looking after and identifying their diversity and cultural needs.

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Overall experiences and progress of children and young people: good

The children have begun to complete „All about me‟ placement plans. The children complete these with the staff, using photos and pictures. The plans inform the staff of the information that the children would like to know about them in order to care for them in a way which is meaningful to them.

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Overall experiences and progress of children and young people: good

The children have to plan their menu a week in advance and are given a choice of two meals. This means that if a child changes their mind, it is not always possible to have an alternative. A parent commented, „The only issue I have is that the food is delivered. It‟s not hot and could be a bit tastier and look more appetising, although staff will find him something if he hasn‟t enjoyed his meal.‟ The staff do not sit and eat with the children at meal times. For those children placed in the home for 52 weeks, this practice means that they may not get to experience the social side of sharing mealtimes with adults.

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Overall experiences and progress of children and young people: good

The home is located in a rural village and surrounded by large, well-maintained grounds. Each house has been decorated to a good standard and is individual. The children‟s bedrooms are personalised, and there are plenty of areas where the children can go if they wish to have time away from the group. However, some areas need attention. For example, there is wear and tear on some lounge carpets, a lean-to covering a walkway is in need of being cleaned and some cookers needed de-greasing. The children are involved in choosing the decor for the houses. This shows that staff see this as the children‟s home. Inspection report children‟s home: SC482414 8

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

The children spoken to communicated that they were happy in the home. One child who was asked whom she would talk to if she was sad could name two members of staff on duty. Parents spoken to commented that the staff take safeguarding seriously and that their child is safe.

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

The staff challenge unwanted behaviours and reinforce boundaries taking into account the child‟s age and level of understanding. Behaviour management plans are in place and outline all of the potential risks and how these can be reduced. These are regularly reviewed and updated by the positive behaviour support practitioner. The staff follow up any unwanted behaviours in key-work sessions, which gives the children an opportunity to look at how they can behave differently. This supports the children to look at more appropriate ways of managing behaviours.

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

There have been incidents in the home where children have had to be held to protect themselves or others. Both parents and social workers spoken to say that they are informed if their child has had to be held and they have no concerns. There have been incidents in the home where children have had to be held to protect themselves or others. Both parents and social workers spoken to say that they are informed if their child has had to be held and they have no concerns. However, the records do not always detail the length of the hold. In addition, the staff do not always complete a de-brief with the child recording that they are still in a heightened state but no evidence that they speak to the child when they are calm. This lack of evaluation and recording makes it difficult to fully monitor and evaluate the hold.

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

Sanctions are recorded and evaluated by senior staff. The children have the opportunity to comment and sign to say they have understood the reason for the sanction. They complete a „My thinking report‟ to help them understand and reflect on their behaviours. The children also have a positive consequences recorded when they have had a positive reward and are able to communicate to staff how this has made them feel. This reflection helps the children to understand both negative and positive consequences and to understand how they feel when these happen.

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

The staff have a good understanding of safeguarding. Any concerns are recorded and reported to the appropriate services. However, some of these records are illegible and could lead to important information being missed.

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

The staff have completed safeguarding training. Social workers spoken to report that the staff contact them if they have any concerns. The designated officer commented, „We have no concerns. They engage with us and are very positive. They always attend any training that we offer. There are a lot of children out of county and they make sure the social worker is aware. They always use us appropriately.‟ This transparency with social workers and the designated officer further safeguards the children.

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

The staff keep daily records and record incidents, sanctions and positive rewards. Inspection report children‟s home: SC482414 9 However, some of these records are illegible, which makes it difficult to understand the full picture and could lead to staff not being able to follow up on concerns and ensure that they are reported appropriately.

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

The staff record when medication is brought into or taken from the home, and a complete audit is undertaken three times a day. However, the audit does not state the time the medication was received into the home and counted by staff. This makes it difficult to have a true reflection regarding the quantity of medication kept in the home, making it difficult to identify any errors. The staff take the children‟s lunchtime medication into the school. Staff report that this is less disruptive for the children. However, there is no risk assessment in place to ensure that the medication is transported between the home and school safely.

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

The staff complete risk assessments that support them to work with the children and keep them safe. However, these are not always updated following an incident. This could mean that the staff are not all working in a consistent way.

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

The children know how to complain. There is a grumble book in each of the houses that children can fill out. There are monthly visits from the advocate who spends time talking to children about their views as well as from the independent visitor who spends time with the children. The children can complain through key-work sessions and weekly house meetings. This provides the children with a wide variety of avenues to use if they wish to complain including adults who are not directly involved with the home. There have been no complaints from children since the last inspection. However, there have been three complaints from parents. The manager and senior staff have responded to these appropriately and in line with their procedures. The manager has been transparent regarding complaints and has notified Ofsted appropriately.

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The effectiveness of leaders and managers: good

The registered manager has been in post since 2014 and has over 25 years of experience working with children. She has the relevant qualifications and experience to run the home. She has a clear vision for the home and recognises the strengths and areas she would like to develop. Staff, professionals and parents spoken to hold her in high regard.

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The effectiveness of leaders and managers: good

There were two requirements and two recommendations from the last inspection, all of which have been met. Monitoring is more robust and key-workers are responsible for checking their child‟s files to ensure that the relevant information is updated. Children‟s personalised record books have been reviewed and updated to ensure that the staff sign and date logs. The staff use key-work sessions to discuss any unwanted and positive behaviours with the children to ensure that they have the opportunity to discuss and record their comments.

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The effectiveness of leaders and managers: good

The manager monitors and evaluates care practice and reports any issues to the deputy managers who inform the staff team. The independent visitor completes detailed reports Inspection report children‟s home: SC482414 10 every month, which supports the manager in the development of the home. These are discussed in staff meetings. This practice supports the staff to understand any shortfalls in care practice and work together to improve practice, which further supports the children with their outcomes and further safeguards them.

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The effectiveness of leaders and managers: good

The staff understand that communication between the parents and other professionals is important. Parents spoken to commented that the staff contact them regarding any concerns. A parent commented, „They let me know what he‟s been doing. I can call every night, and if he‟s ill they will let me know.‟

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The effectiveness of leaders and managers: good

The home is working in line with the aims and objectives set out in the home‟s statement of purpose and function. There is a comprehensive children‟s guide in place, which gives children information about the home.

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The effectiveness of leaders and managers: good

The majority of the staff are having supervision. However, this is not always consistent, which means that the staff do not have the opportunity to talk about care practice and personal development. Agency staff have no formal supervision. Some of the agency staff have been working in the home for up to three years and should have regular supervision to identify their training needs.

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The effectiveness of leaders and managers: good

The staff have a planned handover at the beginning of their shift to ensure that information is passed on and that shift plans are completed. Several of the staff commented that there is a lack of time to discuss issues from the previous shift, which could potentially lead to information being missed.

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The effectiveness of leaders and managers: good

Not all staff have not completed their mandatory training including how to restrain children safely, and diversity and culture awareness training. Some staff have not completed their level 3 diploma in residential care within the required timescale. The staff should have the relevant training to ensure that children receive care from staff who are appropriately qualified.

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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 Inspection report children‟s home: SC482414 11 children‟s homes regulations including the quality standards‟. Inspection report children‟s home: SC482414 12

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: The Daughters of the Cross of Liege

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Children’s home details

Registered provider address: St Wilfrid‟s Convent, 29 Tite Street, London SW3 4JX

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Inspectors

Trish Palmer, social care inspector Natalie Burton, social care inspector Inspection report children‟s home: SC482414 13 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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