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

Inspection report children’s home: SC482294 1 SC482294 Registered provider: Cambian Asperger Syndrome Services Limited

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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 currently registered to care for 53 young people who have a learning disability. The number of places is under review following refurbishment of some of the houses. Young people are now accommodated across eight houses on the site. The home is privately owned by a large organisation which specialises in providing education and care. All young people access the school, which is located on the site. Care is provided to children and young people who have a diagnosis of autistic spectrum disorder, usually Asperger syndrome.

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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 requires improvement to be 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: 7 December 2016

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good

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection:

None Inspection report children’s home: SC482294 2

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Key findings from this inspection

 The home is in the hands of experienced and capable leaders who identify its strengths and weaknesses. They have addressed the requirements and recommendations of the previous inspection.  Staff are competent and well trained. They are motivated to provide the best possible support. They are diligent and committed, especially when faced with extreme challenging behaviours that put their own safety at risk.  Young people enjoy their time at the home. They engage in a wide range of stimulating and meaningful activities.  Young people make good progress, especially in their social interaction, independence and communication skills.  Staff are knowledgeable about autism and the specific needs of the young people in their care. Young people enjoy good relationships with staff, especially their key workers.  Staff communicate effectively with parents. There is effective joint working to provide the best possible care.

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Key findings from this inspection

 All staff work together to keep young people who are demonstrating high-risk behaviour as safe as possible.  Staff work well with external professionals, such as the child and adolescent mental health services, to discuss current needs and agree strategies.

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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

 The covert administration of medication has not been implemented with sufficient thought or checks to its effectiveness.  There is no clear rationale for the use of door alarms at night-time.  There are not currently enough staff, although this is being managed in the short term.  Fire drills have not been regular.  The safeguarding records are dispersed and not simple enough to locate and interrogate.  Children who are struggling to access education in the classroom only have their houses as an alternative.  The independent visitor reports have been over reliant on the manager’s input and should explore a wider range of sources. Inspection report children’s home: SC482294 3

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Inspection date Inspection type Inspection judgement

07/12/2016 Interim Sustained effectiveness 04/07/2016 Full Good 02/02/2016 Interim Improved effectiveness 05/10/2015 Full Requires improvement Inspection report children’s home: SC482294 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

Seek to secure the input and services required to meet each child’s needs. (Regulation 5 (b)) 05/12/2017

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Requirement Due date

Administer medicine which is prescribed for the child as prescribed to the child for whom it is prescribed. (Regulation 23 (2)(b)) 05/12/2017

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Requirement Due date

12. In order to meet the protection of children standard the registered person is required to —

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Requirement Due date

assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child and help each child to understand how to keep safe. (Regulation 12 (2) (a)(i)(ii)) 05/12/2017

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Requirement Due date

13. In order to meet the leadership and management standard the registered person is required to —

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child. (Regulation 13 (2)(d)) 05/12/2017

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Requirement Due date

Take adequate precautions against the risk of fire, and ensure by means of fire drills and practices at suitable intervals that children are aware of the procedure to be followed in case of fire. (Regulation 25 (1)(a)(d)) 05/12/2017

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Requirement Due date

12. In order to meet the protection of children standard the registered person is required to —

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Requirement Due date

ensure staff understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12 (2)(a)(v)) 05/12/2017 Inspection report children’s home: SC482294 5

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Recommendations

 Children should be in full-time education. (‘Guide to the children’s homes regulations including the quality standards’, page 28, paragraph 5.14) Specifically, create clearer boundaries between school and home if a child is unable to join a classroom.  Any individual appointed to carry out visits to the home as an independent visitor must make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the home’s care. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5)

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Overall experiences and progress of children and young people: good

Young people make good progress in this home. Young people who have social and communication difficulties learn to engage with others and make friends. They visit each other in the various houses across the school site and participate in joint activities. Staff encourage young people to develop their independence skills, such as going for a walk on their own or doing their own laundry. Young people relish the opportunity to do this and are confident that staff will show them what to do.

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Overall experiences and progress of children and young people: good

Young people engage in a wide range of meaningful and stimulating activities, such as ice-skating and indoor skydiving. They provide peer support to each other, for example if a friend is fearful of trying a new activity. Young people are able to have new experiences that at one time seemed impossible for them.

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Overall experiences and progress of children and young people: good

Young people enjoy a warm and supportive relationship with staff, especially their key worker. Staff spend time with them, take an interest in them and guide them in the right direction. One young person showed his appreciation of his key worker by buying a card and flowers from his own pocket money to say thank you. A parent said of her child’s experience, ‘His key-worker is exceptionally good.’ Key workers act on any conversation that causes concern, such as young people talking of hurting themselves. The registered manager acts on this information, adapting strategies and redeploying staff to keep young people safe.

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Overall experiences and progress of children and young people: good

Young people have a voice in the home. As well as the good relationship with their key worker, young people access the complaints procedure or express their views through the school council. Staff listen to them and respond, for example they have purchased new scooters and arranged a bedroom move in response to recent requests.

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Overall experiences and progress of children and young people: good

Parents spoke highly of the home. They said that their children have the best possible experience and make great strides in improving behaviour. Parents value the regular conversations that they have with their child’s key worker. Parents said that staff keep Inspection report children’s home: SC482294 6 them informed and that no question or request is too much trouble. Parents reported a warm welcome when they visit the school, even if they arrive unannounced.

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Overall experiences and progress of children and young people: good

On occasion, some young people struggle to access education. Staff do their best to support their learning, for example by relocating to the home. This is not ideal. Young people on the autistic spectrum may find it difficult to separate their learning environment from their home environment and associate their home as place they go to for poor behaviour.

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Overall experiences and progress of children and young people: good

Young people are in good health. Staff ensure that their physical needs are met. They use social stories to explain why good health is essential. Some young people who had never been to an optician have now had their eyesight checked. Of particular note is the approach to mental health. Staff are acutely aware of the indicators that a young person may be struggling. They help young people to express themselves and engage with other professionals, such as the home’s clinical psychologist, to discuss how best to improve mental health.

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Overall experiences and progress of children and young people: good

Young people make good progress towards independence. They learn how to cook, do their laundry and manage money. Young people who have social interaction challenges learn to function in the wider community.

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Overall experiences and progress of children and young people: good

Young people who are new to the home spoke highly of their induction experience. They said that staff and other young people make them welcome. They settle quickly into the residential experience and make friends. They said that staff treat them respectfully and form good relationships with them. They say they are able to stay in contact with their families and do not feel lonely.

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improvement to be good

Staff are proficient in dealing with challenging incidents. Other professionals train them in de-escalation skills as well as physical intervention. Staff follow the behaviour management plans to keep everyone as safe as possible. However, some staff have been injured because of these incidents. Line managers provide good support and review risk assessments as a result. Staff use a variety of positive reward systems to promote good behaviour. They help young people to identify and express their emotions and feelings. Staff, on occasion, use physical intervention to keep young people safe. They maintain appropriate records which now meet the requirement made at the last inspection. Parents spoke positively of the approach to behaviour management. One parent said of their young person, ‘His behaviour can be challenging but the school coordinates things well. They are excellent at communicating incidents and discussing

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improvement to be good

strategies.’ A parent confirmed this, saying, ‘They could not have handled it better. They do a fantastic job. It is a team effort.’

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improvement to be good

The senior management team recognised the need to analyse incidents further. It has appointed a behaviour support lead specifically for this role. Good progress has been Inspection report children’s home: SC482294 7 made, such as identifying indicators in young people who may bite. Staff now have access to personal protective equipment in this case. Key staff, such as the clinical psychologist, are skilled at debriefing young people after an incident. They tailor the conversation at a level dependant on the communication needs of each individual. The opportunity for young people’s anxiety and subsequent challenging behaviour to decrease is maximised.

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improvement to be good

Staff use risk management plans that are of a good quality. The plans inform them of the presenting behaviours and the various strategies to use as those behaviours become more risky. Since the last inspection, staff have been particularly adept at keeping young people safe who are exhibiting high-risk behaviours. They work with parents and other professionals to discuss immediate strategies, reflect on antecedents and plan future support. They rearrange bedrooms to minimise the risk of young people using items to hurt themselves. Staff are trained in emergency interventions, such as using ligature scissors. They follow protocols to involve external professionals when required.

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improvement to be good

Bullying is not an issue in the home. Young people who struggle with social interaction make friends. They visit each other in the different houses on site. They enjoy activities together away from the home. Staff are on hand to help young people interpret and resolve any disagreements.

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improvement to be good

Staff have administered medication covertly, as requested by a parent. This has been without the advice and guidance of health professionals. Managers have not sought information on the effectiveness of the medication when mixed with a drink. Records do not evidence when staff administered medicine covertly and when they did not. It is unclear whether they have administered the full dose on every occasion.

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improvement to be good

Young people of both genders occupy some of the houses. The registered manager has some control measures in place to manage risk. However, when there are no waking night staff on duty, door sensors are not used. Key workers do some work with young people to keep themselves safe but this does not specially include night-time arrangements. For some young people assessed as at risk of sexual exploitation or sexualised behaviour, the night-time risk assessments require greater individualisation.

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improvement to be good

Senior staff have reviewed the school’s fire risk assessment following a recent instruction from the Department for Education to all schools. The quality of the revision is poor. They have not identified key hazards, such as fire doors propped open and storage of combustible materials. Buildings, recently refurbished, do not have the correct documentation. Staff have not carried out fire drills at frequent intervals at various times of the day, across care and education. Senior staff took corrective action during the inspection.

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improvement to be good

The senior leadership team has appointed a designated safeguarding lead and a number of deputies. The senior leadership team members work together to address any concerns as they arise, including referral to the local authority officer designated for safeguarding. Practice is effective. External safeguarding professionals said that there is good communication and reporting with agencies. They said that the school is Inspection report children’s home: SC482294 8 responsive to guidance and advice. However, some record keeping needs improving, for example documents could not easily demonstrate which staff require safeguarding training and the number of referrals to children’s social services. The lines of delegated responsibility are unclear for such tasks. Senior leaders recognise the need to include a chronology, with times and dates, in some key documents.

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improvement to be good

Staff demonstrate a good understanding of the risks in the cyber world. E-safety is a continuous item for discussion and education. Young people understand how to keep themselves safe. They trust the staff in the home and talk with them about any issues that concern them.

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improvement to be good

Senior staff implement safer recruitment practice. They employ adults deemed to be suitable to work with children.

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The effectiveness of leaders and managers: good

The home is in the hands of an experienced and competent leadership team. The leadership team members have high expectations of themselves and others. They have their finger on the pulse and ensure that young people living in the home have a positive experience of care. The senior leadership team (SLT) is aware of the need to recruit staff. It has innovative strategies to attract and recruit people. Maintaining sufficient staffing numbers remains a challenge, especially waking night staff. The registered manager utilises agency staff and overtime to manage the current situation. However, this is not sustainable long-term.

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The effectiveness of leaders and managers: good

The SLT identifies other strengths and weaknesses of the home. For example, it recognises the need to improve security for the whole site, including the installation of new gates and fencing. This is in the long-term development plan.

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The effectiveness of leaders and managers: good

The registered manger is effective in monitoring the home. He processes the day-to-day information to make pertinent decisions, such as in staff deployment. He reviews incidents and ensures that protocols are followed. He provides the statutory six-monthly review on the quality of care to Ofsted. The SLT has recognised the need to improve the external monitoring of the home, in particular the quality of the independent visitor’s report. Currently, the report lacks full independence, for example the most recent report had an over-reliance on the registered manager’s view of the setting.

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The effectiveness of leaders and managers: good

The registered manager gathers relevant information to inform care planning documents. He ensures that placement plans are succinct and inform staff of the relevant needs and most up-to-date information. Staff show a good knowledge of the plans and apply them in practice. The registered manager is aware that plans could be shared more frequently with young people to increase their input into them.

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The effectiveness of leaders and managers: good

The registered manager is showing good leadership. He notifies relevant authorities, including Ofsted, of significant events. He takes necessary action to keep young people safe. He has addressed the requirements and recommendations from the previous Inspection report children’s home: SC482294 9 inspection. He has helped develop a culture of high expectations and aspirations for all young people living in the home.

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The effectiveness of leaders and managers: good

Staff are competent and well trained. They show a good understanding of the needs of young people on the autistic spectrum. They said that line managers support them well, for example through the supervision process. They demonstrate a comprehensive knowledge of the individual needs of the young people in their care. Staff are committed to providing the best possible care, remaining calm and professional when presented with challenging behaviour. Staff put their training to use, working as a team, to defuse situations. A parent spoke very highly of their approach. She said, ‘My son can be provocative. They are brilliant in their approach to him; they know how to de-escalate things.’

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The effectiveness of leaders and managers: good

Staff develop good relationships with parents. Parents report excellent communication. One parent said, ‘Staff are not condescending. I am an equal. We work together for the sake of my child.’

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The effectiveness of leaders and managers: good

Young people live in a warm and comfortable environment. Recent refurbishment to some buildings has been completed to a high standard. Young people personalise their rooms so that they have a sense of identity and belonging.

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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. The inspection was aligned with an inspection of education, for which a separate report is available.

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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: SC482294 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 Asperger Syndrome Services Limited

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Children’s home details

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

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Inspector(s)

Keith Riley, social care inspector Amanda Maxwell, social care inspector Inspection report children’s home: SC482294 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 looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

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