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 registered for up to 68 children who have autism spectrum disorders and/or learning disabilities. 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. The home is owned by a private national organisation.

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 requires improvement to be good

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

Date of last inspection: 22 October 2018

p.1

requires improvement to be good

Overall judgement at last inspection: requires improvement to be good

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

22/10/2018 Full Requires improvement to be good 07/03/2018 Interim Sustained effectiveness 11/07/2017 Full Good 31/01/2017 Interim Declined in effectiveness 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

13: The leadership and management standard

p.3

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.

p.3

Requirement Due date

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 care to each child. (Regulation 13(1)(a)(b), (2)(c)(d)(e)(h)) 30/09/2019

p.3

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.3

Requirement Due date

In particular, ensure that all staff, including agency staff, have taken part in a fire evacuation. 19/07/2019

p.3

Requirement Due date

The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 31(1))

p.3

Requirement Due date

In particular, leaders and managers must ensure that all agency 31/08/2019 Inspection report children’s home: SC026910 4 staff have the relevant experience to work in the home, that they receive a good-quality induction and regular supervision, and that they receive essential training prior to caring for children. Leaders and managers are required to maintain training records of agency staff. 33: Employment of staff

p.3

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.4

Requirement Due date

In particular, ensure that supervision sessions include a review of incidents, restraints and any disciplinary actions that the member of staff has been involved in. In addition, ensure that supervision records are of good quality, reflect the discussion held and document actions to be completed. 31/07/2019

p.4

Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene etc.); however, in doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)

p.4

Recommendations

In particular, continue the ongoing refurbishment programme.

p.4

Recommendations

 Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective, and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)

p.4

Recommendations

 The registered person should only accept placements for children where they are satisfied that the home can respond effectively to the child’s assessed needs as recorded in the child’s relevant plans and where they have fully considered the impact that the placement will have on the existing group of children. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.4)

p.4

Recommendations

In particular, improve children’s matching risk assessments for individual houses Inspection report children’s home: SC026910 5 to include up-to-date information on the risks that each child may present to others.

p.4

improvement to be good

Insufficient staffing affects all areas of the provision and results in a lack of consistency of care provided for individual children. There are currently 34 staff vacancies. Staff including teachers, administration staff, and leaders and managers are working additional hours to cover some of these vacancies. The remaining vacancies are covered by agency staff. An insufficient permanent workforce means that children are regularly exposed to different adults caring for them, which could hinder strong attachments.

p.5

improvement to be good

Children are making progress at the home, with some children making good progress. Examples of this progress include improvements in children being able to communicate more effectively, increased confidence and children’s levels of anxiety reducing. This is confirmed by feedback from parents. Families recognise this progress and can celebrate this with their children by receiving photographs and certificates of children’s experiences and attainments. One parent is pleased that they are now able to take their child into their local community to have a hairdressing and/or doctor’s appointment without the child becoming anxious. Staff recognise the small steps that children make and are creative in building on these steps. However, they do not always comprehensively record the progress that children make and their achievements.

p.5

improvement to be good

Children develop independence skills. Where possible, children learn how to plan, shop and cook for themselves and others and do their own washing. Children are proud of these achievements. Staff support children in making choices. This involves staff working closely with the therapy team, which provides resources and training for staff.

p.5

improvement to be good

Care staff provide good support to children and work collaboratively with health professionals to ensure that children’s healthcare needs are met. During a visit by one of the local doctors, a potentially life-threatening condition was identified, and immediate action was taken to address it. On another occasion, staff worked with a child and their doctor over a nine-week period to prepare the child to have a blood test. Successfully preparing for the test was a positive achievement for the child.

p.5

improvement to be good

Since the previous inspection, a new nurse has been appointed. Seven medication errors have been reported which involved seven different children and staff. These events were reviewed, and no patterns were identified. The errors were addressed with staff and, where needed, training was provided, performance plans were put in place, and letters of concern were sent out. Leaders and managers have conducted an audit into medication errors, and effective partnership working with the local doctor has led to a new medication system. This system has been devised but has yet to be implemented. Inspection report children’s home: SC026910 6 Overall, the children’s houses are well furnished and comfortable. Children’s bedrooms are personalised. The site offers a safe space for children and a wealth of facilities for activities. However, some of the gardens are unkempt and not all children in one home have free access to their garden area as they cannot operate the mechanism required to

p.5

improvement to be good

The refurbishment programme to improve the environment has been slow due to a shortfall of staff in the maintenance team. Leaders and managers have now brought in external contractors to address this.

p.6

improvement to be good

The safety of children has the potential to be compromised due to insufficient, inconsistent staffing. On occasions, staffing levels have fallen below those required by commissioners. In one home, in 10 days before the inspection four days had insufficient staffing levels as required by commissioners, and staff were working long hours.

p.6

improvement to be good

Risk assessments vary in quality. In some houses, the children’s matching risk assessments do not include up-to-date information on the risks that each child may present to others. Risk assessments for activities are suitable.

p.6

improvement to be good

Not all staff have taken part in a fire evacuation. Failing to ensure that all staff know how to respond in the event of a fire places children at risk and is further compromised due to the current staffing shortages.

p.6

improvement to be good

Behaviour is managed effectively. Behaviour support plans are clear and provide staff with detailed working strategies. Staff have a good understanding of children’s anxieties and behavioural triggers. Incidents and the use of restraint have significantly reduced to almost half of the total seen at the previous inspection. Boundaries and expectations for children are clear and consistent. Staff keep behaviour strategies under review and find creative ways to help children. For example, a child who is finding it difficult to have his hair washed is helping staff to wash a horse’s tail before moving towards washing his own hair.

p.6

improvement to be good

The management of safeguarding concerns has improved since the last inspection. Staff demonstrate a good knowledge of safeguarding and child protection. Records of safeguarding events are clear and comprehensive. However, leaders and managers were unable to assure inspectors that all agency staff have completed safeguarding training.

p.6

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

Failing to staff the home with enough permanent staff remains an ongoing weakness. Leaders and managers have carried out a review of staffing and, as a result, they have implemented new strategies and approaches to addressing the issue. The advertisement of job opportunities and a new bonus scheme for retaining staff have had some success. However, at the time of this inspection, 34 vacancies remained. Leaders and managers Inspection report children’s home: SC026910 7 are aware that this is the main weakness in the setting, and they are continuing to find ways to make the necessary improvements.

p.6

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

The frequency and quality of staff supervision remain inconsistent. The sessions do not assist staff in reflecting on and developing their practice. Safeguarding issues and medication errors are discussed and addressed in supervision sessions. However, the same approach is not used for incidents and restraints. The registered manager has developed a tracking system for staff supervision sessions and she has highlighted this as an ongoing area for improvement. She is addressing this with staff who are responsible for providing supervision.

p.7

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

Induction training for agency staff is inconsistent, with some agency staff not receiving an induction. Leaders and managers are not assured that all agency staff have received essential training prior to caring for children. Training for agency staff is not monitored as leaders and managers do not maintain training records for them. Training for other staff is appropriate.

p.7

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

Leaders and managers have a clear understanding of the home’s strengths and areas for improvement. They are ambitious and want to improve the quality of care. Suitable plans are in place to make the necessary improvements, but these plans are either not yet implemented or not yet embedded into practice.

p.7

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

Staff have developed good working relationships with other services. They challenge local authorities effectively when they fall short of expected standards. Such shortfalls include a lack of clarity over a child’s legal status and ineffective planning regarding moves to adult care.

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 making for the children and young people whom it is trying to help, protect and look after.

p.7

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: SC026910 8

p.7

Children’s home details

Provision sub-type: Residential special school

p.8

Children’s home details

Registered provider: Cambian Autism Services Limited

p.8

Children’s home details

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

p.8

Inspectors

Wendy Anderson, social care inspector Clare Davies, social care inspector Janice Hawtin, social care inspector Inspection report children’s home: SC026910 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.

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 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.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: http://www.gov.uk/ofsted

p.9