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

Inspection report children’s home: SC026910 1 SC026910 Registered provider: Cambian Autism Services Limited

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

 The children’s home is owned by a private national organisation and is registered for up to 68 children.  The service operates as a residential special school that also provides accommodation for 52 weeks of the year. As a result, it is registered as a children’s home.  The home provides care across 11 houses, for children who have autism spectrum disorders and/or learning disabilities.  The manager has been registered with Ofsted since December 2015.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

p.1

requires improvement to be good

The effectiveness of leaders and managers inadequate

p.1

requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

p.1

requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

p.1

requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: SC026910 2

p.1

Inspection date Inspection type Inspection judgement

07/03/2018 Interim Sustained effectiveness 11/07/2017 Full Good 31/01/2017 Interim Declined in effectiveness 19/07/2016 Full Requires improvement Inspection report children’s home: SC026910 3

p.2

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.3

Requirement Due date

6: The quality and purpose of care standard

p.3

Requirement Due date

The quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. In particular, the standard in paragraph (1) requires the registered person to– ensure that staff–  provide to children living in the home the physical necessities they need in order to live there comfortably;  ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. (Regulation 6(1)(a)(b), (2)(b)(vii)(c)(i)) 31/1/2019

p.3

Requirement Due date

The health and well-being standard is that– The health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being; and children are helped to lead healthy lifestyles. In particular, the standard in paragraph (1) requires the registered person to ensure that–  each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10(1)(2)(c)).

p.3

Requirement Due date

In particular, ensure that children who may require medical treatment are provided with this treatment promptly. 31/12/2018

p.3

Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on mutual respect and trust; an understanding about acceptable 31/12/2018 Inspection report children’s home: SC026910 4 behaviour; and positive responses to other children and adults. In particular, the standard in paragraph (1) requires the registered person to ensure that staff–  meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans. (Regulation 11(1)(a)(b)(c), (2)(a)(i))

p.3

Requirement Due date

In particular, ensure that children’s behaviour management plans clearly identify effective working strategies and provide staff with clear guidance. In addition, where the strategy is for staff to withdraw from a child, staff must take sufficient action to ensure the child is protected. 12: The protection of children standard

p.4

Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure that staff–  have the skills to identify and act upon signs that a child is at risk of harm;  understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;  take effective action whenever there is a serious concern about a child’s welfare; and  are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12(1), (2)(a)(iii)(v)(vi)(vii))

p.4

Requirement Due date

In addition, safeguarding records need to be comprehensive and contain information about all activities related to the safeguarding event, and include minutes of meetings and guidance given by the designated officer. 31/12/2018

p.4

Requirement Due date

13: The leadership and management standard

p.4

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– helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to–  ensure that staff have the experience, qualifications and skills to meet the needs of each child;  ensure that the home has sufficient staff to provide care for each child;  ensure that the home’s workforce provides continuity of 31/12/2018 Inspection report children’s home: SC026910 5 care to each child;  use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b), (2)(c)(d)(e)(h)) 25: Fire precautions

p.4

Requirement Due date

After consultation with the fire and rescue authority, the registered person must take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home. (Regulation 25(1)(a))

p.5

Requirement Due date

In particular, ensure that fire doors are not wedged open, and that they are checked regularly to ensure that they are working correctly and are in good condition. 31/12/2018

p.5

Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(b))

p.5

Requirement Due date

In particular, ensure that supervision records are of a good quality, reflect the discussion that took place and record any required actions to be completed. In addition, supervision records must link to any disciplinary actions. 31/1/2019

p.5

Requirement Due date

The registered person must establish a procedure for considering complaints made by or on behalf of children. The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39(1)(3))

p.5

Requirement Due date

In particular, ensure that complaint records include the views of the complainant about the outcome of the investigation. 31/1/2019

p.5

Recommendations

 When a child returns to the home after being missing from care or away from the home without permission, the responsible local authority must provide an opportunity for the child to have an independent return home interview. Homes should take account of information provided by such interviews when assessing risks and putting arrangements in place to protect each child. (‘Guide to the children’s homes regulations including the quality standards’, page 45, paragraph Inspection report children’s home: SC026910 6 9.30) In particular, ensure that leaders and managers escalate concerns to senior leaders in local authorities when they are not providing return home interviews.  Records of restraint must be kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge.

p.5

Recommendations

The review should provide the opportunity for amending practice to ensure it meets the needs of each child. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)

p.6

improvement to be good

Not all children live in an environment that is well maintained, warm, nurturing welcoming and homely. At the time of the inspection, a minority of bedrooms had curtains or blinds missing. Some bathrooms and toilets lacked soap and towels, which does not promote good hygiene. In addition, some of the houses were unclean. In contrast, other houses were well furnished and provided children with a good, homely experience. Keypad locks remain in use in many of the houses. The purpose and use of these locks requires further review. Not all children receive care and support from staff who they know well and who are sufficiently trained to meet that child’s needs. This is due to staff vacancies, large numbers of new staff and the ongoing use of agency staff. Regular staff have built positive relationships with the children. Staff were observed to treat children with dignity, respect and patience. Staff spoke proudly of the children and celebrate their

p.6

improvement to be good

achievements and progress. Medication systems have improved. Leaders and managers had identified this as an area of concern and have since taken action to address this. Children’s healthcare needs are generally met. The exception to this relates to a specific incident whereby there was a delay in medical attention being sought once a member of staff had raised a potential concern about the needs of a child. Medical attention was obtained, and the child did not suffer adverse effects. Children take part in a range of age-appropriate activities on-site and in the local community. Children enjoy these activities, have fun and expand their experiences and interests. Staff manage activities well. Some children attend a youth group in the community, which helps them to develop their social skills and self-confidence and to make friends outside the home. The home is well resourced. The large team of therapists provides good support to

p.6

improvement to be good

children and staff. Links with external support agencies are appropriate and accessed as required. Children’s plans are individualised and contain targets. These documents are being reviewed and developed to provide more detailed evidence of the progress children are making. Inspection report children’s home: SC026910 7 Staff have begun to develop more opportunities for children to express their views and opinions and to make choices. This will help children to provide feedback on the care they receive, more fully express their views after incidents and, where possible, have more input into their plans.

p.6

improvement to be good

The management of safeguarding concerns requires improvement. On some occasions, there are weaknesses in the swift recognition and response to some safeguarding matters. Records do not consistently show the discussions and meetings that managers have with the designated officer, or the actions that they have taken in response to these discussions. Leaders and managers have identified this weakness in their reflective management meetings, which has led to improvements starting to be made. In the main, behaviour support plans are informative. However, effective behaviour support strategies are not always clearly defined in these documents. Where it has been decided that staff should withdraw from children during an incident, it is not always clear in the records the action staff should take to maintain visual contact with the child and ensure their safety. The use of restraint is reducing. However, the duration of restraints and the actual

p.7

improvement to be good

management of children’s behaviour is not scrutinised effectively. Some incident and restraint records lack important details and are not always complete. Monitoring and evaluation of these records require improvement. Children going missing from the home is rare. However, when this has happened a return home interview has not been carried out by the placing authority. Leaders and managers have not challenged this omission effectively. The management of fire safety requires improvement. Audits of fire safety equipment are ineffective as they have failed to identify issues found with fire doors during this inspection. Inspectors found fire doors that were wedged open and others that did not close properly. Staff do understand the risks and vulnerabilities of the children they care for. They work with the children to help them to develop their understanding of risk. This work includes children using a ‘streetwise safety centre’ to develop skills in identifying risk, and where

p.7

improvement to be good

and how to seek help. In addition, staff are aware of the risk some of the children they care for may present to other children and take effective action to keep children safe. An example of this is work on online safety and its appropriate use.

p.7

The effectiveness of leaders and managers: inadequate

High numbers of staffing vacancies continue. Currently, there are 13 day-staff and 13 night-staff vacancies. Despite many recruitment activities taking place, the recruitment and retention of good-quality staff remains an ongoing issue for leaders and managers. The homes use a variety of strategies, including the use of leaders and managers, permanent staff, bank workers and agency staff to cover the vacancies. Leaders and managers try to use the same agency staff to provide some consistency for children, but this is not always possible. Inspection report children’s home: SC026910 8 Staffing levels in the houses are not consistently in line with the commissioned staffing ratios agreed with the placing authorities. In addition, there are occasions when staff on duty in one house are all staff still in their probationary period. Leaders and managers have agreed to this decision but have not completed a risk assessment to demonstrate

p.7

The effectiveness of leaders and managers: inadequate

that the provision is safe. Staff are not consistently receiving good-quality regular supervision to enable them to reflect on and improve their practice. Records of supervision sessions vary in quality. These records do not consistently reflect the discussions held or clarify the support and directions given to staff subject to disciplinary actions. Staff interviewed said that the support they received was variable, especially when seeking support from some on-call managers. All staff spoken to praised the registered manager for the support she provides. The sufficiency of staff trained to administer medication requires improvement. There is not always a trained member of staff in each house. This leads to staff being called to support from other houses, and applies specifically to the two off-site houses. This lack of provision in the off-site houses could result in a delay to children receiving medication.

p.8

The effectiveness of leaders and managers: inadequate

Monitoring and oversight by leaders and managers are ineffective. This has led to failures in identifying indicators regarding potential safeguarding concerns, which, in turn, has led to a delay in responding to these concerns. Complaints are responded to quickly and investigated thoroughly. However, complaint records require improvement. These documents do not consistently record the complainant’s view of the outcome of the investigations. The staff have built strong, effective relationships with external agencies. This promotes information sharing and cohesive working. Since the previous inspection, most of the leadership team has changed. The leadership team has identified several of the shortfalls found at this inspection, but not all. The team has developed action plans which include the revision of management roles, introducing an electronic recording system and improving how the progress of children is

p.8

The effectiveness of leaders and managers: inadequate

evidenced. These new systems will slowly be introduced and embedded into practice. The new leadership team is demonstrating a determination to make improvements.

p.8

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.

p.8

Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out Inspection report children’s home: SC026910 9 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: SC026910 10

p.8

Children’s home details

Provision sub-type: Residential special school

p.10

Children’s home details

Registered provider: Cambian Autism Services Limited

p.10

Children’s home details

Registered provider address: Cambian, Waterfront, Hammersmith Embankment, Chancellors Road, London W6 9RU

p.10

Inspectors

Wendy Anderson, social care inspector Sharron Escott, social care inspector Inspection report children’s home: SC026910 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.

p.10

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 http://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.11

Inspectors

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

p.11

Inspectors

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

p.11