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

Inspection report children’s home: SC458070 1 SC458070 Registered provider: Cambian Autism Services Ltd Interim inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This national private organisation provides care and accommodation for children and young people who have autistic spectrum disorders and/or learning disabilities. The service operates as a residential special school and provides accommodation for a number of children throughout the year. Accommodation is provided in four houses for up to 40 children. The houses are located in the same grounds as the school.

p.1

Information about this children’s home

Judgement at last inspection: requires improvement to be good

p.1

Information about this children’s home

Date of last inspection: 18 and 19 April 2017

p.1

Information about this children’s home

Enforcement action since last inspection: None

p.1

and young people since the most recent full inspection

This home was judged requires improvement to be good at the last full inspection. At this interim inspection, Ofsted judges that it has declined in effectiveness.

p.1

and young people since the most recent full inspection

Leaders and managers have failed to improve the service in order to provide all children with the care that they need. Some children living in this home are not meeting their full potential and some have negative experiences.

p.1

and young people since the most recent full inspection

The inspection history of the service is poor. Leaders and managers fail to sustain improvement, and shortfalls identified at this inspection are a repeat of weaknesses that were identified at a number of previous inspections. Prior to this inspection, the home was judged an inadequate service on four occasions. Leaders and managers have failed to sustain the gains made at the most recent full inspection, and some practices have declined. Inspection report children’s home: SC458070 2 Safeguarding processes are not always followed. On one occasion, staff failed to report a child protection concern to the designated safeguarding lead, putting the child at further risk. On another occasion, a social worker was not informed about a serious allegation against a member of staff that was reported to the child’s parents and designated officer.

p.1

and young people since the most recent full inspection

A repetitive pattern of neglectful practice has developed. Similar child protection concerns reoccur. These include children being left unattended and substantiated concerns about the way that some staff interact with children. Leaders and managers have investigated these concerns, but have failed to take effective action to improve the culture in the home to ensure that these incidents do not continue to happen.

p.2

and young people since the most recent full inspection

When the designated safeguarding lead coordinates child protection concerns and referrals, these are usually handled well, with in-depth internal investigations into poor practice. Investigations completed by other senior members of staff do not demonstrate the same rigour despite them receiving management investigation training. At times, leaders and managers have not taken the necessary action immediately to address poor practice because they are waiting to complete internal investigations. An example of this relates leaders and managers failing to provide staff with immediate direction and support when they failed to seek urgent medical attention for a child following an incident.

p.2

and young people since the most recent full inspection

Leaders and managers do not provide all staff with regular, good-quality supervision. One child protection concern raised in supervision did not prompt a referral to the designated safeguarding lead. Staff supervision predominantly fails to challenge poor practice and provide staff with the support and guidance that they require to improve the care that children receive. The failings related to staff supervision have been a repeated weakness. Leaders and managers have failed to improve in this area despite providing managers in a supervisory role further training and development. In addition, despite initiating a plan in October 2016 to provide staff with an annual assessment of their performance, appraisals have not yet taken place.

p.2

and young people since the most recent full inspection

The quality of the accommodation that children live in is not consistently acceptable. In some of the houses there is an improvement, particularly in some children’s bedrooms and living areas. These are homely and welcoming. However, there remain significant concerns about the overall quality of the other houses. In one house, the quality of the children’s bedrooms was extremely poor. One bedroom was very unclean with stains on the walls and bathroom door. The house manager failed to recognise this.

p.2

and young people since the most recent full inspection

Some rooms that children use as quiet or sensory/relaxation rooms have locks on the outside. The door cannot be unlocked from the inside. In one house, the former office has been made in to a snug for children. This room is unsuitable for children. A gap between an electrical socket and the wall is a hazard and the room is not a welcoming space, the walls were covered in pin holes from former office displays and the fairy lights were broken.

p.2

and young people since the most recent full inspection

Some staff are not ensuring that the privacy and dignity of children are always Inspection report children’s home: SC458070 3 respected. One child’s audio monitor was left on while the child was in their bedroom getting dressed for school. The audio output of this activity could be heard in the communal corridor. An area used for office work looks directly into one of the houses. In addition, not all children have access to a working telephone to make calls in private.

p.2

and young people since the most recent full inspection

Some kitchens areas are not as homely as they could be. This is due to health and safety documentation and signage being displayed on the walls. Despite the signage, in two of the houses some staff fail to follow health and safety legislation consistently in relation to food hygiene.

p.3

and young people since the most recent full inspection

Some staff demonstrated a poor understanding of children’s needs. In one house, staff failed to use children’s communication aids such as the picture exchange communication system (PECS), symbols and objects of reference. The mealtime observed in this home lacked organisation. Although sufficient staff are on duty to help children at mealtimes, there is a lack of attention provided to each child, leading to incidents such as children grabbing food. Furthermore, staff did not meet these children’s basic care needs, such as helping them to wipe their nose or organising hand washing before eating. These are repetitive shortfalls.

p.3

and young people since the most recent full inspection

All of the children’s care plans, epilepsy plans and behaviour support plans that were examined at this inspection were not up to date, and they did not contain all the relevant information about children’s needs. For example, increasing concerns about self-harm, suicide and mental health needs are not detailed clearly in a child’s plans. In addition, two epilepsy plans fail to provide information about triggers to seizures, signs and symptoms and how the children might present during a seizure. Staff have been unable to support some children with their behaviour. As a result, the police attended the home and a child was handcuffed for a short period of time.

p.3

and young people since the most recent full inspection

Leaders and managers monitor incidents of physical restraint, however the quality of this monitoring is inconsistent. Analysis, learning and action points are not always clear. Some staff are not always supported following incidents of physical restraint, discussions with staff about restraints are not always held in a timely manner. Those conducted by the designated safeguarding lead are detailed and identify learning points for staff.

p.3

and young people since the most recent full inspection

Leaders and managers employ agency staff to assist in covering the current staff vacancies. There are currently twenty-five vacant posts. The use of agency staff can at times reduce children’s access to activities in the community, due to agency staff not being able to drive or work alone with some children. On occasions, house managers fail to deploy the agency staff effectively in order to ensure that children’s activities are not curtailed. Improvements have been made to the quality of the induction process for new staff. In addition, established staff have the opportunity to refresh their basic skills as and when necessary.

p.3

and young people since the most recent full inspection

A permanent senior leadership team is now in place, including a recently appointed principal who recognises the scale of improvements required. A new manager has also been appointed to lead the care provision. He has not yet submitted an application to register with Ofsted. The current registered manager remains in post to support this Inspection report children’s home: SC458070 4 transition.

p.3

and young people since the most recent full inspection

There are examples of some children making progress, which contribute to them having some positive experiences in the home. Some staff build positive relationships with children and support them to learn new skills. One child has started to use a knife and fork. For some children the frequency of incidents and restraint reduce. For one child there is a significant reduction in the use of pro re nata (PRN) medication for one child.

p.4

Inspection date Inspection type Inspection judgement

18/04/2017 Full Requires improvement to be good 11/01/2017 Full Inadequate 20/09/2016 Full Inadequate 20/06/2016 Full Inadequate

p.4

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.

p.4

Requirement Due date

6: The quality and purpose of care standard

p.4

Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

p.4

Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

p.4

Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

p.4

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.4

Requirement Due date

understand and apply the home’s statement of purpose;

p.4

Requirement Due date

ensure that staff— 31 January 2018 Inspection report children’s home: SC458070 5 understand and apply the home’s statement of purpose;

p.4

Requirement Due date

protect and promote each child’s welfare;

p.5

Requirement Due date

treat each child with dignity and respect;

p.5

Requirement Due date

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

p.5

Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably;

p.5

Requirement Due date

provide to children personal items that are appropriate for their age and understanding; and

p.5

Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to— meet the needs of each child; and

p.5

Requirement Due date

enable each child to participate in the daily life of the home.

p.5

Requirement Due date

(Regulation 6 (1)(a)(b)(2)(b)(i)(ii)(iv)(vii)(viii)(c)(i)(ii)

p.5

Requirement Due date

The health and well-being standard is that—

p.5

Requirement Due date

the health and well-being needs of children are met.

p.5

Requirement Due date

12: The protection of children standard *

p.5

Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

p.5

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

p.5

Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm; 31 January 2018 Inspection report children’s home: SC458070 6 understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

p.5

Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

p.6

Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

p.6

Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm;

p.6

Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health.

p.6

Requirement Due date

(Regulation 12 (1)(2)(a)(iii)(iv)(v)(vi)(b)(d) 13: The leadership and management standard *

p.6

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—

p.6

Requirement Due date

helps children aspire to fulfil their potential; and

p.6

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.6

Requirement Due date

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

p.6

Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

p.6

Requirement Due date

ensure that the home’s workforce provides continuity of care to each child;

p.6

Requirement Due date

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home;

p.6

Requirement Due date

use monitoring and review systems to make continuous 31 January 2018 Inspection report children’s home: SC458070 7 improvements in the quality of care provided in the home.

p.6

Requirement Due date

(Regulation 13 (1)(a)(b)(2()(a)(c)(e)(f)(h))

p.7

Requirement Due date

20: Restraint and deprivation of liberty

p.7

Requirement Due date

(1) Restraint in relation to a child is only permitted for the purpose of preventing—

p.7

Requirement Due date

(a) injury to any person (including the child); or

p.7

Requirement Due date

(b) serious damage to the property of any person (including the child); or

p.7

Requirement Due date

(2) Restraint in relation to a child must be necessary and proportionate. 31 January 2018

p.7

Requirement Due date

22: Contact and access to communications

p.7

Requirement Due date

(3) Subject to paragraph (5), the registered person must ensure that children are provided at all reasonable times with access to the following facilities which they may use without reference to persons working in the home—

p.7

Requirement Due date

(a) a telephone on which to make and receive telephone calls in private; and 31 January 2018

p.7

Requirement Due date

(4) The registered person must ensure that all employees—

p.7

Requirement Due date

(c) receive practice-related supervision by a person with appropriate experience; and

p.7

Requirement Due date

(d) have their performance and fitness to perform their roles appraised at least once every year. 31 January 2018

p.7

Requirement Due date

* These requirements are subject to a compliance notice.

p.7

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 Inspection report children’s home: SC458070 8 making for the children and young people whom it is trying to help, protect and look after.

p.7

Information about this inspection

This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

p.8

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’.

p.8

Children’s home details

Provision sub-type: Residential special school

p.8

Children’s home details

Registered provider: Cambian Autism Services Ltd

p.8

Children’s home details

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

p.8

Inspectors

Nicola Lownds, social care inspector Paula Lahey, regulatory inspection manager Inspection report children’s home: SC458070 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.

p.8

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.9

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.9

Inspectors

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

p.9