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

Inspection report children’s home: SC066897 1 SC066897 Registered provider: Cambian Autism 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 registered to provide care and accommodation, in six houses, for up to 31 children who have learning disabilities and/or sensory impairment. The home forms part of a residential school specialising in care, education and therapy for children who have autism spectrum disorder and associated behaviours. A public limited company owns the home. Specific support is provided to assist children in developing their communication, social and independence skills, and self-managing their behaviour. There is a multi- disciplinary approach to care provided to children, with support available from a range of professionals.

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Information about this children’s home

The manager registered with Ofsted in November 2018.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected good

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outstanding

The effectiveness of leaders and managers good

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Overall judgement at last inspection: outstanding

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outstanding

Enforcement action since last inspection: none Inspection report children’s home: SC066897 2

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Inspection date Inspection type Inspection judgement

21/06/2017 Full Outstanding 03/01/2017 Interim Sustained effectiveness 13/09/2016 Full Good 16/12/2015 Interim Sustained effectiveness Inspection report children’s home: SC066897 3

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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 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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to— use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(h)) 31/03/2019

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Recommendations

 As set out in regulations 31-33, the registered person is responsible for maintaining good employment practice. They must ensure that recruitment, supervision and performance management of staff safeguards children and minimises potential risks to them. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1)

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Overall experiences and progress of children and young people: outstanding

Children make excellent progress in multiple areas of their lives because of living in this home. Examples include accessing a healthy diet, building confidence and self-esteem, progressing so that they can stay overnight in their family home, reducing serious self- injurious behaviour, and accessing full-time education. Staff support children to discover their special talents in areas such as music, art and sport. Other progress to the extent that they can write their own social stories. A parent said, ‘My child has absolutely flourished. The care side has been the key to his success.’ Another parent said, ‘I feel like they have woken my child’s brain up.’ Inspection report children’s home: SC066897 4 Care, education and therapy staff work in a holistic way. There is a ‘link’ lead staff member who works closely with the other professionals to continuously develop consistency across the waking day. He shares the plans across the houses to ensure that

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Overall experiences and progress of children and young people: outstanding

all staff understand each child’s objectives and targets. This means that learning takes place throughout the day. Children make excellent progress with their education, often from a starting point of being excluded from their previous school.

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Overall experiences and progress of children and young people: outstanding

Staff use information communication technology extensively to capture achievement and enable children to develop independent communication. A professional said, ‘All staff know each young person’s ‘noises’ and know what the young person is saying from the noise and its intensity.’ A parent said, ‘They do fantastic work with my child’s care, well- being and education.’

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Overall experiences and progress of children and young people: outstanding

Staff have made substantial improvements to the environment. Children enjoy the new playground area with its sensory equipment, as well as the relaxation room. They have contributed to creating an allotment, planting over 400 plants to create a hedge around the allotment and a coppice. A national charity recognised the work that was done and presented the home with an award. Maintenance staff removed some internal gates, giving children the freedom to move across the site as they choose.

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Overall experiences and progress of children and young people: outstanding

Children enjoy a diverse range of interactions in the community. They can work in local shops or talk to local church members. Staff teach such adults how to interact and communicate with the children. Children enjoy a vast range of other activities such as a football club, cycling and visits to a sculpture park.

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Overall experiences and progress of children and young people: outstanding

Children enjoy the presence of the home’s therapy dog. Some participate in a desensitisation programme while others simply enjoy the company of the ‘family’ dog. The presence of an undemanding and calm animal assists children in regulating their own emotions.

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Overall experiences and progress of children and young people: outstanding

Children benefit from the staff ambition to see them develop into the best they can be. For example, staff demonstrate a commitment to ensuring that children obtain nationally recognised awards for their achievements. The number of awards that children have obtained is impressive. Senior leaders have enrolled a second assessor in response to this success.

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Overall experiences and progress of children and young people: outstanding

Staff support young people to become ready for employment. They use their own expertise and that of employment specialists to nurture aspirations and expand the horizons of young people. Young people can engage in work experiences once thought impossible. For example, young people with social integration difficulties were able to work in a shop. Another young person was able to assemble a marine engine.

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Overall experiences and progress of children and young people: outstanding

Staff worked with children to improve the food on offer. The result is a cafe/diner where children not only enjoy a healthier menu but are also supported to socialise with each other in a relaxed environment. Children who struggle with food choice can join the ‘food explorers club’ where they can try new things and extend their diet. Staff and children celebrated the removal of the deep fat fryer from the kitchen. Inspection report children’s home: SC066897 5 Staff ensure that children are in good health. They follow diligently the protocols such as the administration of emergency medication in the event of a seizure. They keep excellent records to hand over to health professionals who, in one case, commented about the high quality of information given to them.

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

Senior staff have been successful in embedding the adopted behaviour management strategy. Staff have focused on restraint reduction. They support children to manage their own behaviour. The behaviour support team ensures that staff reflect on practice, identifying the triggers and preventing recurrence. The staff team now uses visual debriefs with children who have communication difficulties. This has been a positive initiative, with some children engaging in this work for the first time. There has been a significant reduction in the number of incidents requiring physical intervention. A parent said, ‘I appreciate all they have done for my son. He is a different child.’

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

Staff are alert to any changes in behaviour. They are skilled in identifying when something is troubling a child, and seek the advice of other professionals if necessary. Staff advocate for the children to ensure that they get the best possible interventions and outcomes.

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

The safeguarding lead sits on the local safeguarding hub and keeps abreast of best practice. She creates a regular safeguarding newsletter for staff and parents. She ensures that all staff are aware of the latest thinking in safeguarding practice. Staff demonstrate an interest in how to adopt best practice and regularly discuss the pertinent issues. Safeguarding is embedded in the culture of the home.

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

Safeguarding professionals within the setting take swift and decisive action when there are any concerns. They are persistent in their approach, challenging other agencies when required. They use video evidence to demonstrate the cognitive ability of a child to other agencies such as the police. They keep an excellent chronology of events demonstrating the decision-making process based on the evidence. They dutifully follow their responsibility to refer to other agencies, such as the disclosure and barring service, when necessary.

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

Managers adopt safer recruitment practice and only employ adults who are deemed suitable to work with children. On one occasion, the registered manager did not ensure that there was sufficient challenge of references that only confirmed employment details. Recruitment staff missed an opportunity to fully explore why an applicant left their previous employment.

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

Staff practise emergency evacuations regularly. They identify children who struggle with the transition or the noise of the alarm. They ensure that the personal emergency evacuation plans reflect the individual approach for each child to leave their house safely. Inspection report children’s home: SC066897 6

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The effectiveness of leaders and managers: good

The senior management team comprises exceptional leaders. They are dedicated to achieving the best possible outcomes for the children. They are committed to the staff team, supporting and developing them to be innovative and creative in terms of improving the quality of care. One example is the use of video modelling, where staff act out different scenarios for children. Children who have social integration challenges can reflect on various situations and how they can conduct themselves appropriately in circumstances that they have historically found difficult.

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The effectiveness of leaders and managers: good

Senior managers consult with other experts in their field to stay at the cutting edge of recent thinking and development in autism practice, for example by joining research projects with a local university. They have engaged with a musician to provide stimulation to the children in their care. Children have found this therapeutic, and some have found that music now plays a significant part of their daily lives. Staff support this interest, for example by arranging piano lessons.

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The effectiveness of leaders and managers: good

The senior management team is open to professional dialogue and challenge. There is a culture of striving for excellence. An example is the behaviour support team. Its members analyse the data, working with other professionals to revise strategies and update care plans. The formation of an ‘impact group’ brings together professionals from care, education and therapy. They add a further level of scrutiny to drive forward improvement.

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The effectiveness of leaders and managers: good

Senior managers arranged an external audit of supervisions. They agreed an action plan for improving the supervision process for staff. Staff value the new approach and the difference it makes to their emotional well-being. They appreciate the opportunity to reflect on practice led by the clinical psychologist.

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The effectiveness of leaders and managers: good

Senior staff adopt a comprehensive quality assurance cycle with clear, delegated responsibilities throughout the year, with key performance indicators to measure progress. The registered manager uses the statutory monitoring procedures to improve the quality of care. He has recognised the need to improve the cleanliness of the environment and his plans are well advanced to address this. His day-to-day management does not always consider all the potential areas to drive forward improvement. An example is not critiquing an investigation into a medication error in conjunction with the nurse.

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The effectiveness of leaders and managers: good

Staff speak highly of the registered manager and the leadership he is showing. He has organised training for middle managers in areas such as supervision, effective management and safeguarding especially for managers. He has been effective in giving house managers the autonomy to manage their ‘house base’ so that there is ownership of responsibilities and accountability. The registered manager has arranged regular training opportunities for other staff, for example on using sign language, understanding bipolar disorder and zones of regulation. He supports each manager in each house to Inspection report children’s home: SC066897 7 achieve the level 5 management qualification.

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The effectiveness of leaders and managers: good

Leaders and managers have established an excellent induction programme. It is an exemplar of best practice. Staff speak in the most positive terms about their induction. Undergraduates from the local university participate in the induction as part of their university degree. The expertise of the home’s psychologist and speech and language therapist is highly sought. They provide education and training in the local university and the wider community. Staff working in local businesses communicate with children who have social integration difficulties.

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The effectiveness of leaders and managers: good

Senior leaders have made some key decisions to maintain the quality of care. Children benefit from living in ‘home bases’ with a consistent staff team. Changes in shift patterns mean that transitions, which children on the autism spectrum often find difficult, are minimised.

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The effectiveness of leaders and managers: good

The senior leadership team has demonstrated good leadership. For example, the team invited all staff to take part in audits using tools based on the quality standards and how the home meets the standards. All completed audits were entered into a draw, with the prize of a weekend away. The resultant feedback was fed into the school development plan.

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The effectiveness of leaders and managers: good

Staff morale is high. Members of staff support and encourage each other to provide the best possible care. Staff nominate each other for the ‘making a difference award’. They demonstrate a professionalism and dedication to their work, putting children’s needs at the centre of their practice. A parent commented that the staff are ‘superb’ and the key to their child’s successful outcomes.

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The effectiveness of leaders and managers: good

Staff have done a considerable amount of work in improving the care files. Staff now store the records safely in electronic format. All staff have easy access to the most up- to-date information, as well as the archived information. Inspection report children’s home: SC066897 8

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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’.

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Children’s home details

Registered provider: Cambian Autism Services Limited

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Children’s home details

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

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Children’s home details

Responsible individual: Katherine Landells

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Inspectors

Keith Riley, lead social care inspector Sophie Wood, regional inspection manager Inspection report children’s home: SC066897 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 looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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