Children's home run by Progress Care and Education Limited in Hammersmith and Fulham

Inspection report children’s home: SC044224 1 SC044224 Registered provider: Progress Care and Education 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

This home offers care and accommodation, for up to four young people, of both genders, who have severe learning disabilities compounded by significant challenging behaviours, autistic spectrum disorder and complex medical conditions.

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Information about this children’s home

It is part of a wider private organisation that offers transition from this home to adult residential provision, and which is registered with the Care Quality Commission.

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Information about this children’s home

The organisation also runs an independent 38-week school. It is co-educational and caters for pupils and students from the ages of seven- to 19-years-old.

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Information about this children’s home

Inspection dates: 17 to 20 November 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 requires improvement to be 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: SC044224 2

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Key findings from this inspection

 Children and young people are genuinely treated and respected as individuals in their own right, which makes them feel loved and valued.  Good staffing ratios ensure that children and young people benefit from highly individualised care. Staff show a keen interest in their daily lives and children and young people clearly enjoy spending individual quality time with them.  Admissions to this home are sensitively managed. It is a gradual process, at the child’s and family’s pace. This means that they settle quickly and start to build trusting relationships with the staff.  All the young people are benefiting from regular and positive family contact, which promotes their unique backgrounds and identities.  Young people enjoy taking part in a wide range of age- and ability-appropriate, stimulating and constructive activities.  A key strength of this home is the effective partnership working with a wide range

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Key findings from this inspection

of specialists to meet the young people’s unique, highly complex and diverse needs.  Young people particularly benefit from the clear and consistent routines and boundaries in place at this home and respond well to the emphasis on positive reinforcement of good behaviours and effort.

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Key findings from this inspection

 Staff have the confidence and competence to empower extremely vulnerable young people to access community activities and to take appropriate risks in their development into adulthood.

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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 main shortfall arising from this inspection is the fact that the registered manager and her staff team are not consistently benefiting from formal individual supervision sessions at the frequency prescribed by the company’s own policies.  The manager’s last six-monthly review report on the quality of care provided in the home did not include the views of staff as is legally required. This is particularly pertinent as this inspection period has seen a high turnover of staff, low morale and some dissatisfaction about the direction of the service.  Independent monthly visits have not been unannounced since December 2016, which potentially compromises a robust process of external scrutiny. In addition, the reports do not consistently demonstrate that young people are seen and that care practice is observed. Inspection report children’s home: SC044224 3

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Inspection date Inspection type Inspection judgement

29/03/2017 Interim Improved effectiveness 16/12/2016 Full Good 23/03/2016 Interim Improved effectiveness 06/10/2015 Full Requires improvement Inspection report children’s home: SC044224 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 registered person must ensure that all employees receive practice-based supervision, by a person with appropriate experience, at least every six weeks. This is the frequency prescribed by their own policies. (Regulation 33(4)(b)) 31/12/2017

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Requirement Due date

The six-monthly quality of care reviews by the registered person must provide for ascertaining and considering the opinions of staff. (Regulation 45(5)) 28/01/2018

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Requirement Due date

44: Independent person: visits and reports

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Requirement Due date

The independent monthly visits to the home should be unannounced and must ensure consultations with young people and/or observation of care practice. (Regulation 44(2)(a)(3)) 31/12/2017

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Overall experiences and progress of children and young people: good

Many of the young people have lived in this home for a considerable amount of time. They are happy and settled. High staffing ratios mean that young people are afforded quality time with staff members of their choice. Staff have a keen interest in young people’s daily lives and their achievements. This means that the young people are genuinely treated and respected as individuals in their own right, which makes them feel loved and valued. Inspection report children’s home: SC044224 5 Through the effective use of a range of communication aids, young people can make positive choices in respect of their day-to-day care. This includes the staff members supporting them on each shift, and food and activity preferences. One young person said, ‘I have social stories about different things in my life to help me understand them.’

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Overall experiences and progress of children and young people: good

Staff devised a gradual transition plan for one young person moving into the home. The process included staff visiting him in the family home and at his previous school to observe his routines. Staff also provided opportunities for him to visit the home prior to him moving in full-time. This enabled him to start to feel comfortable around the other young people and staff. Throughout this period, staff were particularly sensitive to his parents’ feelings of intense loss.

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Overall experiences and progress of children and young people: good

Staff ensure that all the young people enjoy positive family contact and that families are actively involved in the care planning process, when their views about their child’s care are listened to and respected. Recent comments from parents include, ‘I am made to feel welcome every time I visit and I can approach any of the staff. I am kept informed of my son’s progress and the monthly report they send to me is really helpful’, ‘I have total faith in all the staff’, and ‘The staff have an excellent relationship with my son and he continues to receive a high level of care.’

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Overall experiences and progress of children and young people: good

One social worker said, ‘My young person takes part in a wide variety of activities. I am impressed with the enthusiasm of the team to ensure that he is an active member of the community and reaches his full potential.’ Individual photograph albums demonstrate that all the young people benefit from daily, stimulating and constructive leisure activities, which are specifically planned to meet their diverse interests. Current examples include wildlife, cars and watching and reviewing films. Young people have also recently enjoyed making dens together, canoeing, rock-climbing and cycling. One social worker particularly highlighted the care and tenderness that the staff have put into making the young people’s photo albums.’

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Overall experiences and progress of children and young people: good

For the last 12 months, one young person has been attending a local specialist youth club once a week and has made and sustained friendships. He has also recently taken his treasured cars to show them, which staff describe as ‘a huge breakthrough’.

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Overall experiences and progress of children and young people: good

There are good arrangements in place to promote healthy lifestyles. All the young people benefit from regular physical exercise. For example, one young person goes swimming at least three times a week, as this is currently his favourite activity.

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Overall experiences and progress of children and young people: good

Improved diets have also seen a demonstrable reduction in challenging behaviours. On admission, one young person was still drinking from a bottle and had a high quantity of sugary drinks that had affected his teeth. With much patience and perseverance by the staff in supporting him to improve his oral hygiene, he now has healthy teeth and gums. Similarly, this same persistence and dedication have also ensured that there has been an improvement with toileting routines. Also, one young person can now comfortably go to have his hair cut at the local barber, which is marked progress that his mum is particularly pleased about. Inspection report children’s home: SC044224 6 One young person, who was recently admitted, came with a limited diet. This is already improving. He also loves the new opportunities for lots of physical exercise, including trampolining, swimming and drama. He goes for a walk in the fresh air every day before

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Overall experiences and progress of children and young people: good

school as this improves his energy levels. This helps him to calm and prepare for the day ahead effectively.

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Overall experiences and progress of children and young people: good

One young person said, ‘Staff take me to school and help me with my schoolwork.’ All the young people attend the company’s school, which provides bespoke programmes that best meet each child’s unique learning and behavioural needs. It is located a short bus ride away and attendance is excellent. Staff ensure that young people are challenged appropriately in school to reach their full potential. As a direct consequence, one young person is now positively engaging in small group sessions, which is significant progress. One social worker said, ‘My young person is very settled and engaged. I am very impressed with all aspects of his care and education and the way both settings work together.’

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Overall experiences and progress of children and young people: good

A key strength of this home is the effective partnership working established with a wide range of specialists to meet the young people’s unique, diverse and highly complex needs. Feedback from stakeholders is consistently positive about the quality of care provided in this home and the progress that the young people are making. Recent comments from stakeholders include:  ‘My young person appears to be thriving in this placement and he is clearly making progress with his independence skills.’  ‘There has been a reduction in his challenging behaviours at this home and he continues to become more independent.’  ‘The staff are very committed to this young person in respect of his care and his education, and incidents have reduced.’  ‘The staff could not be more helpful and I am really impressed with the progress this young person has made in such a short period of time and the detail in the monthly reports I receive.’

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Overall experiences and progress of children and young people: good

All the young people have commenced a more formal preparation for independence programme, which is age- and ability-appropriate. Individual targets are in place. These are frequently reviewed and revised so that young people continue to develop. Should additional support be required these are then incorporated into their individualised school timetables. Notable progress includes: two young people regularly going food shopping and cooking their own meals with staff assistance; one young person eating independently with weighted cutlery; one young person is now in a good routine of making his own bed before school every weekday and loves going shopping to choose his own toiletries; and another young person can now clean his own teeth, dress with support and is a talented baker. One young person said, ‘I have a life-skills list in my bedroom to help me remember to keep my room clean and when to put away laundry

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Overall experiences and progress of children and young people: good

Detailed target review sheets closely monitor progress and ‘wow’ sheets record achievements. Recent examples include, ‘being kind and helpful to staff’, ‘making cupcakes’, ‘enjoying the first day at a new school’ and ‘raspberry picking’. Inspection report children’s home: SC044224 7

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

The four young people living at this home feel safe and secure in the knowledge that the home is now full, so there will be no more changes and they can stay until they have finished their education. One parent said, ‘This home is perfect, I would not change a thing. Seeing the smile on my child’s face makes me secure.’

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

Comments from young people include:  ‘All the staff spend time with me all of the time.’  ‘The staff always try to keep me calm and happy.’  ‘I have never been hurt or bullied at this home.’

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

This home has not had any missing from home incidents and no cause to search a young person’s bedroom.

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

Young people particularly benefit from the clear and consistent routines and boundaries in place at this home. Sanctions are not used because young people respond well to the strong emphasis on positive reinforcement of good behaviours and effort. Consequently, serious incidents have declined. One young person is revelling in being the oldest and this has had a positive effect on his behaviours because he wants to be a good role model.

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

One member of staff said, ‘There has been a massive reduction in challenging behaviours in the last two years, and in the number of restraints.’ As an example, previously one young person was restrained at least twice a day. To his credit, he has made great strides in understanding and managing his emotions. Consequently, incidents of challenging behaviours, often resulting in a restraint, have significantly reduced. He will now remove himself from a situation and spends some quiet time in his bedroom until he feels calmer. Furthermore, he is consistently earning the maximum monies for good behaviour and effort. Initially, he struggled to earn the minimal amounts. An analysis of patterns and trends show a slight increase in restraints in March, however this was identified at a time when there had been a turnover of staff. There were also three restraints in September when a new young person was admitted.

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

Detailed and individualised behaviour management plans and positive handling plans are in place and are regularly reviewed. The plans include proactive and reactive strategies. A recent development is the implementation of a new monitoring form. This form records the mood and behaviours of non-verbal young people following a restraint. This ensures that any action taken is safe and proportionate at all times.

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

Staff have the confidence and competence to empower extremely vulnerable young people to access community activities and to take appropriate risks in their development into adulthood. One young person is now frequently experiencing travelling by train. He recently became agitated when a train was late so he went into an empty waiting room. This is extremely good progress from his starting point. Initially he was described as ‘a Inspection report children’s home: SC044224 8 whirlwind’ who needed two staff to hold his hands at all times in public, as he had no sense of danger.

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

All the required external safety certificates are in place and internal checks are undertaken at the required frequencies to ensure a safe environment for young people, staff and visitors.

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

Since the last inspection, the home has a brand new, fully equipped sensory room and dining room extension. This provides young people with a choice of communal rooms that they take full advantage of. The significant building work did cause some anxieties, which were managed well by the staff.

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

Currently the main lounge is devoid of wallpaper and pictures, so it looks bare and has lost its homely ambience. This is an interim arrangement while one young person settles. Damage around the home has already decreased in frequency and severity.

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

All young people’s bedrooms are now being redecorated and refurnished. One young person has chosen freestanding cupboards, which is testament to the fact that he no longer causes damage.

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

Staff files include all the required information to demonstrate a robust recruitment and selection process, to ensure a safe and competent workforce.

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The effectiveness of leaders and managers: requires improvement to be good

This home was judged to have ‘improved in effectiveness’ at the last interim inspection on 29 March 2017 and no shortfalls were found. However, since then the home has experienced a relatively high staff turnover, which does unsettle the young people. In response, the manager ensured that there was at least one ‘favoured’ member of staff on duty who knew the young people. Recruitment of a full staff team, specifically with the skills and experience to work with the newest admission, is ongoing.

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The effectiveness of leaders and managers: requires improvement to be good

The manager is suitably qualified and experienced. She leads by example and provides clear direction to the staff. She has also established good partnership working with families and professionals to safeguard all the young people and promote their welfare. Furthermore, she has a clear and accurate insight into the many strengths of this home, and the areas for continued development. For example, since the last inspection the manager has introduced an escalation policy to try to improve the timeliness of receiving review minutes from the placing authorities. To date, this has been effective in three out of the four cases.

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The effectiveness of leaders and managers: requires improvement to be good

The manager ensures that all young people receive highly individualised care and can clearly demonstrate the very good progress they are all making from their individual starting points. One member of staff said, ‘I have worked here for five years and have seen a lot of positive changes. The young people are progressing brilliantly. The team members work well together and are very supportive of each other. We can put forward ideas and they are listened to. We have a full handover at the start of each shift and a Inspection report children’s home: SC044224 9 debrief at the end to consider what we did well and what we could have done differently.’

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The effectiveness of leaders and managers: requires improvement to be good

The manager has only received one professional supervision session during this eight- month period despite being without a deputy for the last two months. This has also had a negative impact on the frequency of formal individual supervision she can provide to her team. The independent visitor has identified this as a shortfall on two occasions at a time when it was highlighted that staff morale was low.

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The effectiveness of leaders and managers: requires improvement to be good

Shortfalls in staffing have meant that staff have taken on additional shifts. Although agency staff have been used they know the young people well and this has not had an impact on the consistent level of care. Because young people benefit from high staffing ratios at all times, there is inevitably a large staff team working at this home. Since September, the manager has extended the period between supervision sessions from six to eight weeks, but has still not been able to achieve this. Moreover, records show that some staff had not received six-weekly supervision prior to September. The main concern is that no distinction is made between the frequency of supervision for qualified and experienced staff and those new to the role. This is despite them working with highly complex, vulnerable and challenging young people. To address this, the provider is restructuring the team and currently recruiting for a deputy and two assistants who

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The effectiveness of leaders and managers: requires improvement to be good

will all have supervisory responsibilities.

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The effectiveness of leaders and managers: requires improvement to be good

Timely annual appraisals have taken place. Staff also benefit from access to a good range of relevant training courses to meet the specific needs of the young people, organisational expectations and their own interests and personal development. Two thirds of the current staff team are suitably qualified for their respective roles.

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The effectiveness of leaders and managers: requires improvement to be good

The manager’s last six-monthly review report on the quality of care provided in the home is a detailed and evaluative document, which was completed and sent to Ofsted in a timely manner. It is informed and enriched by the views of parents and placing authorities but does not include staff views. This shortfall is particularly pertinent because staff responses to the Ofsted survey suggest some dissatisfaction from staff with respect to the lack of consultation opportunities. Some staff members also felt that complaints would not be taken seriously.

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The effectiveness of leaders and managers: requires improvement to be good

The monthly independent monitoring visits have all been announced since the last inspection in March this year. The last unannounced visit was in December 2016. This potentially compromises a robust process. Despite this, the reports do not demonstrate that the visits always take place when young people are at home, so care practice is not consistently observed.

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The effectiveness of leaders and managers: requires improvement to be good

The internal and external monitoring processes in place ensure that all the required documentation is generally very well maintained.

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The effectiveness of leaders and managers: requires improvement to be good

The statement of purpose is reviewed and revised as necessary. This ensures that it is always accurate and reflects the current aims, policies, practices and staffing of the home. Ofsted is notified of any significant events in a timely manner. These notifications Inspection report children’s home: SC044224 10 are detailed, to demonstrate that appropriate action is taken in consultation with other relevant agencies to safeguard and protect young people and staff. Furthermore, clear strategies are put in place to try to prevent a re-occurrence.

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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: SC044224 11

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Children’s home details

Registered provider address: 5th Floor, 80 Hammersmith Road, London W14 8UD

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Inspector

Lynn O’Driscoll, social care inspector Inspection report children’s home: SC044224 12 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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Inspector

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