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 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 children. The children have severe learning disabilities, autism spectrum disorder and complex medical conditions. It is part of a wider private organisation that offers transition from this home to adult residential provision, and this 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.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

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

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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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.

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requires improvement to be good

Date of last inspection: 30 October 2018

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requires improvement to be good

Overall judgement at last inspection: requires improvement to be good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: SC044224 2

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Inspection date Inspection type Inspection judgement

30/10/2018 Full Requires improvement to be good 17/11/2017 Full Good 29/03/2017 Interim Improved effectiveness 16/12/2016 Full Good Inspection report children‟s home: SC044224 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 quality and purpose of care standard

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to 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 enable each child to participate in the daily life of the home. (Regulation 6(2)(c)(i)(ii)) 11/07/2019

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Requirement Due date

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

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff–

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Requirement Due date

assess whether each child is at risk of harm, taking into account information in the child‟s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; and

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm. (Regulation 12(1), (2)(a)(i)(iii))

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Requirement Due date

In particular, seek immediate medical advice when required and reviewing plans and assessments after incidents of restraint to inform future practice and identify any changes or further training needed. 11/07/2019

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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–

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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 11/07/2019 Inspection report children‟s home: SC044224 4 quality of care provided in the home (Regulation 13(1) (a), (2)(f)) Children‟s case records

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Requirement Due date

The registered person must maintain records (“case records”) for each child which are kept up to date and are signed and dated by the author of each entry. (Regulation 36(1)(b)(c)) 11/07/2019

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children‟s home. The registered person must maintain in the home the records in Schedule 4; ensure that the records are kept up to date; and retain the records for at least 15 years from the date of the last entry. (Regulation 37(1), (2)(a)(b)(c))

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Requirement Due date

In particular, maintain the admissions and discharge register as set out in schedule 4. 11/07/2019

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Recommendations

 Administration of medicines. Medicines must be administered in line with a medically approved protocol. („Guide to the children‟s homes regulations including the quality standards‟, page 35, paragraph 7.15) Inspection report children‟s home: SC044224 5

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improvement to be good

Progress for children is mixed, with children doing well in some areas and not progressing so well in others. Similarly, experiences are varied, with children living through some poor day-to-day events but also enjoying some positive experiences.

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improvement to be good

Managers have identified that the changing needs for one child can no longer be met while living in this home. The child remains in placement, despite his notice period having expired. There is no current plan for his transition. One child told the inspectors that he did not like living at the home because the other young people were too noisy. He said that he would like to go on a holiday to get some „peace and quiet‟. Damage caused by this child has impacted on the environment for other children, consequently there are a number of repairs and improvements required to the home. One child‟s plan states that „X finds sleep very difficult‟. Despite a sleep hygiene plan and work with the child and adolescent mental health services (CAMHS) to address this issue, the specialist blinds identified to help the child to sleep have not yet been fitted.

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improvement to be good

Staff have developed positive and caring relationships with children. Inspectors observed staff responding to children‟s needs and using their knowledge and skills to support children with their routines.

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improvement to be good

Children enjoy activities and are encouraged to attend a range of activities that they enjoy. Staff are proactive and resourceful to ensure that children can engage in these activities despite their complex needs.

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improvement to be good

Contact with family is promoted where possible. One parent said that she is kept up to date with her child‟s progress and that staff share important information with her.

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improvement to be good

One child has been supported to move on to adult services. Managers ensured that a positive transition was achieved through multi-agency communication and planning. This included staff at the new placement and clear plans about how to support the child to develop new relationships and share information.

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improvement to be good

Staff failed to fully safeguard a child during a recent incident involving the mis- administration of medication, because they did not seek immediate medical advice. Moreover, a member of staff continued to administer further medication and did not alert a manager until they arrived on duty. The manager then acted immediately to seek medical advice.

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improvement to be good

There was a further incident where a child inserted objects into their body. Although the child had complained of being sore, medical advice was not sought until the next day, Inspection report children‟s home: SC044224 6 even though staff knew the child was in discomfort. Staff failed to safeguard the child despite the child sharing discomfort.

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improvement to be good

Restraint practice is not always in line with children‟s plans. One restraint included the use of floor restraint. This was not in line with the plans for that child. The records are unclear on why it was necessary to use this hold. Furthermore, staff had not been trained in ground holds. On top of these shortfalls, management oversight neither analysed the use of restraint nor ensured that the plans were updated to reflect that this hold might be necessary.

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improvement to be good

Risk assessment ratings and strategies for staff are not always clear, and they conflict with other plans. For example, although one child‟s plan identifies an area of high-risk behaviour, no control measures have been recorded. Despite this, staff are using appropriate strategies and their positive relationships with children to de-escalate behaviours effectively.

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improvement to be good

Staff are resilient, despite the very challenging behaviours of children. Staff are subject to violence from children, yet they continue to respond with understanding and sensitivity. Staff say that, following serious incidents at the home, they feel that they are supported by managers. Managers also promote and facilitate learning and reflection sessions with staff to promote improvement in care practice.

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improvement to be good

Records are often incomplete. They lack clarity and do not help the learning by staff or children. When the registered manager is absent, there is little monitoring of incidents.

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

A qualified and experienced registered manager is now in place. He is supported by an enthusiastic and committed deputy manager. They are aware of the home‟s weaknesses, are responsive to advice and are keen to drive improvements

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

Staff speak positively about working in the home. They say that they are well supported by the management team and benefit from regular supervision. Staffing has improved since the last inspection and there is now a stable staff team in place. One social worker informed the inspectors that one child‟s confidence had improved as a result of building relationships with staff. However, despite a more stable staff team, a number of staff remain unqualified.

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

External monitoring is good. The independent visitor provides an account of progress and identifies any shortfalls in the home and the actions needed. However, the monitoring and oversight by managers have not identified some inaccuracies and conflicting information in plans and assessments. Records do not benefit from robust management analysis and response. For example, one incident record states that physical intervention was not used due to the lack of trained staff. This had not been addressed by management comments. In some cases, children have now achieved the targets set for them for a number of months. Despite this, the targets have not been reviewed by managers. Furthermore, inspectors found a number of signatures missing Inspection report children‟s home: SC044224 7 from case records. Inspection report children‟s home: SC044224 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 difference 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 9

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Children’s home details

Registered provider: Progress Care and Education Limited

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Children’s home details

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

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Inspectors

Jessica Forshaw, social care inspector Charlie Bamber, social care inspector Inspection report children‟s home: SC044224 10 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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