Children's home run by London Borough of Hammersmith & Fulham in Hammersmith and Fulham

Inspection report children‟s home: SC443337 1 SC443337 Registered provider: London Borough of Hammersmith & Fulham

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This local authority children‟s home provides care for up to seven young people. The home‟s statement of purpose states that it provides care for young people who have learning disabilities and/or physical disabilities. The home provides a mix of permanent placements, shared care placements and some short-break placements. The home‟s statement of purpose states that the home can provide care in a flexible manner either as a full-time or shared care arrangement, promoting contact with family and maintaining local community links. The registered manager has been in post since 2012.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers requires improvement to be good

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inadequate

There are serious failures that mean young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: Good

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inadequate

Enforcement action since last inspection: None Inspection report children‟s home: SC443337 2

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Inspection date Inspection type Inspection judgement

09/07/2018 Full Good 19/09/2017 Full Good 06/12/2016 Interim Sustained effectiveness 20/07/2016 Full Good Inspection report children‟s home: SC443337 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 registered person must complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months. In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating— the quality of care provided for children; the feedback and opinions of children about the children‟s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review (“the quality of care review report”). The registered person must— supply to HMCI a copy of the quality of care review report

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Requirement Due date

within 28 days of the date on which the quality of care review is completed; and make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home. The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1)(2)(a)(b)(c)(3)(4)(a)(b)(5)) 30/09/2019

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay— If there is any other incident relating to a child which the 30/09/2019 Inspection report children‟s home: SC443337 4 registered person considers to be serious. (Regulation 40(4)(e)) The registered person must ensure that— within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— the name of the child; details of the child‟s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and

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Requirement Due date

any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(iv)) 30/09/2019

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Requirement Due date

The registered person must— maintain in the home the records in Schedule 4; (Regulation 37 (1)(2)(a)) In particular, leaders and managers must maintain a register of children. 30/09/2019

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children‟s safety. The registered person may only— employ an individual to work at the children‟s home; or if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that 30/09/2019 Inspection report children‟s home: SC443337 5 individual to work at the home, if the individual satisfies the requirements in paragraph (3). The requirements are that— the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; For the purposes of paragraph (3)(b), an individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained— the Level 3 Diploma for Residential Childcare (England) (“the

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Requirement Due date

Level 3 Diploma”); or a qualification which the registered person considers to be equivalent to the Level 3 Diploma. (Regulation 32(1)(2)(a)(b)(3)(b)(4)(a)(b)) The registered person must ensure that all employees— undertake appropriate continuing professional development; receive practice-related supervision by a person with appropriate experience; and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(a)(b)) 30/09/2019

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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. 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, furnished and maintained so as to protect each child from avoidable hazards to the child‟s health. (Regulation 12 (1)(2)(d)) 30/09/2019

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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. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— 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; 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 30/09/2019 Inspection report children‟s home: SC443337 6 are familiar with, and act in accordance with, the home‟s child protection policies. (Regulation 12(1)(2)(a)(i)(v)(vi)(vii)) In particular, leaders and managers must ensure that the home‟s child protection policies are followed and children‟s risk

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Requirement Due date

assessments are kept up to date The registered person must maintain records (“case records”) for each child which— include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry (Regulation 36 (1)(a)(b)(c)). In particular, leaders and managers must record the statutory provision (if any) under which the child is provided with accommodation and keep a copy of any EHC plan or statement of educational needs in relation to the child. In particular, leaders and managers must ensure consistency of practice in reviewing and updating children‟s risk assessments. 30/09/2019

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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— 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 the home‟s workforce provides continuity of care to each child. (Regulation 13(1)(a)(b)(2)(e)) In particular, when staff are unable to attend team meetings, a record is kept stating that staff have read the team meeting notes. 30/09/2019

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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. („Guide to the children‟s homes regulations including the quality standards‟, page 19, paragraph 3.9) In particular, ensure that repairs are quickly undertaken.  Each home must have clear arrangements in place to maintain effective management when the manager is absent, off duty or on leave. („Guide to the children‟s homes regulations including the quality standards‟, page 54, paragraph Inspection report children‟s home: SC443337 7 10.20) In particular, ensure that the person left in charge has access to all necessary documentation.

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Overall experiences and progress of children and young people: inadequate

Leaders and managers have failed to safeguard young people in the home. An agency member of staff physically harmed a young person. The registered manager did not take immediate safeguarding action and the member of staff continued to work in the home, presenting possible further risks to the young people. Leaders and managers have failed to implement plans to minimise risks to young people in the home. As a result, on three separate occasions one young person has physically injured himself. One injury was significant enough to require urgent medical attention in hospital. Despite these concerns, young people make progress from their starting points. Young people‟s goals include increased engagement in group activities and improved social and communication skills. However, staff do not consistently review these goals. As a result, some goals become out of date, which potentially limits the young people‟s

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Overall experiences and progress of children and young people: inadequate

development. Where possible, young people receive encouragement to develop their independence skills. Young people are helped to manage their personal care and take their washing to the laundry room. Staff also support the young people to develop confidence in using public transport. A parent said, „The staff have been working patiently, calmly and consistently to improve [X‟s] independence.‟ Staff care and support the young people, focusing on their individual needs. They understand the young people‟s individual communication styles and listen, observe and act on young people‟s body language, eye gaze or picture exchange systems. This helps to ensure that the young people can make choices and that their care is dynamic and responsive to their changing needs. Staff work in partnership with schools and other professionals to help to ensure consistency in the young people‟s care. With detailed planning and meticulous visiting

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Overall experiences and progress of children and young people: inadequate

arrangements, staff helped a young person move and settle into foster care. Staff also invited a parent to the home to demonstrate cooking her son‟s favourite meal. The large home offers young people many accessible communal areas. The play areas, garden, sensory rooms and computers are all popular. However, two radiators need minor repairs. A range of community activities enhance young people‟s experiences, including visits to a specialist disability cycling centre. Staff create social stories to help young people to prepare for unfamiliar experiences which may unsettle them. Social stories provide young people with accessible and helpful picture stories which help to reassure them about events such as a visit to the dentist or when they first arrive at the home. Inspection report children‟s home: SC443337 8

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

Young people‟s risk assessments are not up to date. One young person‟s challenging behaviour has resulted in accidental physical injuries to himself. Strategies to minimise the avoidable hazard and the risks presented by the young person are ineffective and the registered manager has not carried out the recommended actions to help to minimise the risks. On one occasion, a member of staff physically harmed a young person. The registered manager did not follow the home‟s child protection procedures after the incident. As a result, young people in the home continued to be at risk of physical harm. The registered provider has now taken robust action to address this serious shortfall in practice. The registered manager was not in day-to-day charge of the home at the time of the inspection. The home is reducing its short-break service provision and moving towards a long-term residential service. Team meeting minutes recorded that incidents of a physical nature

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

are happening more often as the young people who now use the service have more challenging behaviour. Since the last inspection, incidents of physical restraint have significantly increased. During the inspection, it was not possible to confirm that all the staff have a suitable level 3 qualification and there was no verifiable record that all staff have received appropriate physical restraint training. This means that some staff may not have the necessary skills and knowledge to support the young people appropriately in the home. Not all significant incidents in the home are reported to Ofsted. After instances of physical restraint, there is no record that the young people and staff are offered the opportunity to talk about their feelings. This limits the registered manager‟s opportunity to review and monitor restraint patterns in the home. Young people‟s files are incomplete and inconsistently maintained. Case records do not

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

meet regulatory requirements. Education, health and care plans are missing and there is no record of the statutory provision under which young people are accommodated in the home. The home does not maintain a register of children who use the service.

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

Several regulatory shortfalls were identified at this inspection. During the inspection, managers acknowledged the issues and now have plans in place to improve the service. A specialist trainer has recently visited the home to provide the staff team with support and advice to help manage the young people‟s increasingly challenging behaviours. Personal counselling support has been made available to the staff team. However, staff have reported feeling anxious, stressed and vulnerable when dealing with young people‟s increasingly challenging behaviours. It is not clear who is responsible for the supervision of agency staff and it was not possible to ascertain if all employed staff had had an annual appraisal. This means that leaders and managers do not provide Inspection report children‟s home: SC443337 9 regular formal support and advice to the staff to help to manage any challenges in the home. Staff say that the leaders and managers are slow to respond to requests for support.

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

Due to the large size of the home, staff say that they sometimes feel vulnerable when they are caring for the young people in the more distant parts of the home. Staff have asked for improved communication equipment in the home so that additional staff support can be quickly called on if required. The head of service agreed during the inspection to purchase staff „walkie talkies‟ to assist with in-house communication, and leaders and managers have recently increased the staffing levels at night to help to support staff if young people are unsettled. Weekly staff team meetings alongside detailed shift planning and handover discussions enable staff to plan appropriately to meet the needs of the young people. However, actions arising from the team meetings are not followed up, and there is no record of staff reading the team meeting minutes if they have not been able to attend. During the inspection, the registered manager was absent, with the head of service and

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

deputy manager having overall responsibility for the running of the home. The registered manager has not completed an updated quality of care review, and the deputy manager could not access some of the home‟s records that are required to be kept for inspection purposes. Despite the home‟s shortfalls, parents and professionals report positive working relationships with the staff. Staff attend young people‟s multi-professional meetings and contribute to the reviews and placement plans. Professionals praise the staff‟s successful joint working relationships and child-centred practice.

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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‟. Inspection report children‟s home: SC443337 10

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Children’s home details

Registered provider address: Town Hall, King Street, London W6 9JU

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Inspector

Victoria Jones, social care inspector Inspection report children‟s home: SC443337 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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