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

Inspection report for children’s home - monitoring visit: SC482294 1 SC482294

p.1

Cambian Asperger Syndrome Services Limited

Monitoring visit Inspected under the social care common inspection framework

p.1

Information about this children’s home

The home is currently registered to care for up to 42 children who have learning disabilities. Children are accommodated across nine houses on the site. The home is privately owned by a large organisation, which specialises in providing education and care. All the children access the school, which is located on the site. Care is provided to children with a diagnosis of an autism spectrum disorder. There has been no registered manager in post since 24 April 2019.

p.1

This monitoring visit

This monitoring visit was undertaken as a result of concerns raised to Ofsted. The purpose of the visit was to assess the home’s adherence to the regulations in relation to its admission procedures, the provision of therapy, the management of staffing levels, medication prescribing and children’s ability to discuss incidents, including restraints.

p.1

This monitoring visit

Two days’ notice was given for the visit as it coincided with a three-day education inspection. This visit took place on day three of the education inspection.

p.1

This monitoring visit

Inspectors spoke to children, managers and senior leaders and examined key documents. Inspectors also communicated with the lead education inspector.

p.1

This monitoring visit

Since the last inspection, an additional manager has started, making two managers who work together across the children’s home. Their registration with Ofsted is being processed. Both were present during this monitoring visit.

p.1

This monitoring visit

Leaders and managers have looked at and reviewed many aspects of the school’s and home’s procedures and practices since the last inspection, including the areas identified in the two requirements made. Leaders present an accurate view of where they are in implementing the changes needed, and of the challenges they face. As this visit evidenced, some changes are not yet fully embedded and require further Inspection report for children’s home - monitoring visit: SC482294 2 work.

p.1

This monitoring visit

Changes have unsettled some of the children and staff. Leaders and managers need to ensure that they communicate more effectively about the changes taking place. There are a number of ways in which children can voice their views and opinions and many do. However, during this visit, some children asked to speak with the inspectors and raised concerns about the care they have received. Records show that managers do act when they know about children’s views and suggestions and address their requests in a timely manner. However, managers need to make sure that all of the children feel nurtured and cared for, and that they talk to the staff about how they are feeling regarding the changes.

p.2

This monitoring visit

Leaders have taken action to review the school’s admission procedures, in particular their assessment processes of children with mental health needs. The leaders acknowledge this is an area that requires development to ensure that children are correctly placed and that the staff can meet their needs. In addition, the managers are working to develop partnerships with local health services to ensure that primary health teams are fully informed and involved in decision-making. This includes the local general practitioner. This is not yet fully embedded in practice.

p.2

This monitoring visit

At times when children’s behaviours significantly escalate, the managers reassess to ensure that the staff team can continue to meet their needs. There is a much- improved understanding of this vital reassessment process. Staffing issues have hindered the managers in being able to suitably staff all houses. To manage this, managers and leaders have taken the decision to close one home until more staff are recruited. There is an active recruitment programme in place, however staffing levels remain a concern for the management team. Leaders confirmed that they have put a cap on the number of admissions, especially children with high needs, until such time as staffing levels and experience improve. Leaders acknowledge that some staff have struggled with the self-harming behaviours that they have had to manage, and staff skills and expertise is an area that needs to continually be a focus in the training provided.

p.2

This monitoring visit

A planned change of care staff not working in the school provision, effective from September 2019, has provided clearer boundaries between the school and residential time. This has resulted in the staff devoting all of their time in the support and care of the children in their home.

p.2

This monitoring visit

The therapy provision has seen changes. New staff have continued to provide therapeutic support and advice. Individual education, health and care plans (EHC plans) identify the therapy needed. However, one local authority’s EHC plan was poor in quality and in the information supplied. This needs to be challenged by the managers.

p.2

This monitoring visit

Improvements to the quality assurance processes have been a focus for the managers, in particular those relating to medication procedures. Newly implemented systems allow for improved oversight, monitoring and evaluations. This has yet to be Inspection report for children’s home - monitoring visit: SC482294 3 fully embedded. All medication errors are taken seriously and managed well. Prescribing issues are being discussed with local medical practitioners and hospitals to establish joint working agreements.

p.2

This monitoring visit

The use of physical intervention is recorded in accordance with regulations. However, it was noted that the person speaking to the children about the intervention was, in most records viewed, the same person who carried out the restraint. The managers said this is usually due to the child having a good relationship with that member of staff. However, this does not provide the independence required.

p.3

This monitoring visit

This is a service going through a period of change. Leaders say that they are acutely aware of the need for these changes and their impact on the children and staff in the short term.

p.3

Recent inspection history

Inspection date Inspection type Inspection judgement 03/07/2019 Full Good 20/02/2019 Full Good 04/10/2017 Full Good 07/12/2016 Interim Sustained effectiveness Inspection report for children’s home - monitoring visit: SC482294 4

p.3

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.4

Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who— take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. (Regulation 7 (1)(c))

p.4

Requirement Due date

In particular, ensure better communication with the children so that they feel cared for and are informed of the changes taking place. 20/12/2019

p.4

Requirement Due date

In meeting the quality standards, the registered person must, and must ensure that staff— seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5 (d))

p.4

Requirement Due date

In particular, further develop working partnerships with local health services to ensure that primary health teams are fully informed and involved in decision-making, when appropriate. 20/12/2019

p.4

Requirement Due date

The care planning standard is that children— are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14 (2)(a))

p.4

Requirement Due date

In particular, ensure that leaders continue to take action to review the school’s admission procedures, in particular its assessment processes for children with mental health needs, to ensure that children are correctly placed and that the staff can meet their continuing needs. 20/12/2019

p.4

Requirement Due date

The quality and purpose of care standard is that children receive care from staff who— understand the home’s overall aims and the outcomes it seeks to achieve for children. (Regulation 6 (1)(a))

p.4

Requirement Due date

In particular, ensure that better communication takes place with 20/12/2019 Inspection report for children’s home - monitoring visit: SC482294 5 the staff so that they can better understand the challenges that the home faces and the changes taking place.

p.4

Recommendations

 Any child who has been restrained should be given the opportunity to express their feelings about their experience of the restraint as soon as is practicable, ideally within 24 hours of the restraint incident, taking the age of the child and the circumstances of the restraint into account. In some cases children may need longer to work through their feelings, so a record that the child has talked about their feelings should be made no longer than 5 days after the incident of restraint (Regulation 35 (3)(c)). Children should be encouraged to add their views and comments to the record of restraint. Children should be offered the opportunity to access advocacy support to help them with this (Regulation 7 (2)(b)(iii)). (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.60) In particular, review the practice relating to who conducts debriefs following restraints.

p.5

Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

p.5

Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: SC482294 6

p.5

Children’s home details

Provision sub-type: Residential special school

p.6

Children’s home details

Registered provider: Cambian Asperger Syndrome Services Limited

p.6

Children’s home details

Registered provider address: Metropolitan House, 3 Darkes Road, Potters Bar EN6 1AG

p.6

Inspectors

Liz Driver, social care inspector Daniel Healy, social care inspector Inspection report for children’s home - monitoring visit: SC482294 7 to 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.6

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.7

Inspectors

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

p.7

Inspectors

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

p.7