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 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. The manager registered with Ofsted in November 2018. An education inspection took place in January 2020 and the school was judged as outstanding.

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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 outstanding

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outstanding

The effectiveness of leaders and managers outstanding

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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

Date of last inspection: 22 January 2019 Overall judgement at last inspection: Outstanding Enforcement action since last inspection: None Inspection report children’s home: SC066897 2

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Inspection date Inspection type Inspection judgement

22/01/2019 Full Outstanding 21/06/2017 Full Outstanding 03/01/2017 Interim Sustained effectiveness 13/09/2016 Full Good Inspection report children’s home: SC066897 3

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outstanding

Children make wonderful progress in this home, accomplishing things that were once thought impossible. Examples are:  Enjoying eating fruit and meat from a starting point of liquids only for many years.  Participating in activities for the first time such as swimming, going to the zoo or a theme park, from a starting point of hiding away and being socially isolated.  Doing work experience in the local community from a starting point of being unable to tolerate groups.  Significant improvements in personal care from a starting point of needing medical intervention to meet basic needs. A parent said, ‘My child has made absolutely amazing progress. I think the staff are angels at the home.’ Another parent said, ‘My child absolutely loves every moment at the home and is entirely thriving.’ A third parent said, ‘I am blessed to have my child there, we all fell in love with the home, it is like a family.’ A social worker said,

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outstanding

‘[name of child] has made amazing improvements and his communication has improved significantly.’ Another professional said, ‘I am always impressed with the exceptional level of collaboration and consistency of approach to ensure that each child makes the absolute best progress in independence and living skills.’ Children can explore the delightful world around them, confident that staff will keep them safe. Children enjoy new experiences and experiment with activities that they have never tried before. The results are extraordinary. Children enjoy climbing in a safe environment rather than putting themselves at risk, they enjoy watering plants in a local mainstream school, they make friends and enjoy birthday parties and shopping in the local community. The progress from starting points of social isolation, self-injurious behaviour and violence cannot be overstated. There are other positive consequences. Brothers and sisters now talk of being able to enjoy each

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outstanding

other, hug each other and get to know each other’s friends. Parents talk of being able to take their child for a walk or to the shop for the first time. Children enjoy nurturing and affectionate relationships with staff. The staff enjoy each child’s individual personality and character. They see the child’s ability and not disability, creating opportunities for each child to explore the world and find out their own interests. For example, children enjoy yoga, flamenco dancing and the ‘boogie monster band’. Staff use video modelling, where staff act out different scenarios for children, so that children can reflect on various situations. Children learn how they can conduct themselves appropriately in circumstances that they have historically found difficult. This means that children can relish in their newly found activities. Children make exceptional progress in their diet. Staff encourage them to play with,

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outstanding

touch and smell food without any pressure to consume it. Children are inquisitive Inspection report children’s home: SC066897 4 and go on to taste and enjoy food without any pressure from adults. Children can eat a balanced diet for the first time. It was noted that one child was able to enjoy having a packed lunch on a picnic from a starting point of not being able to tolerate any food. Children now enjoy cooking and baking. The addition of the ‘Let’s eat’ café has been another initiative that has helped children improve their diet, enjoy their food and develop their social skills. Children love staying in this home. They enjoy personalising their rooms, often with the help of their families. Staff go to great lengths to make sure the children’s rooms are of a high standard, for example searching relentlessly to find patterns for cushioning to match bedroom curtains. Children live in an environment that is

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outstanding

commensurate with their needs. Staff plan for children coming to live in the home exceptionally well. They are committed to providing a move into the home in such a way that children don’t just tolerate a move into the home, but flourish in the transition. Right from the referral stage, staff immerse themselves in getting to know the child and the family to plan the intricate details of an event that a child with autistic spectrum disorder finds extremely challenging. The multidisciplinary team does not cut corners. For example, staff follow the same comprehensive procedures for a day student transferring to residential as they would for a new child coming to the provision for the first time.

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outstanding

Safeguarding is embedded in the culture of this home. All staff are aware of their responsibilities. They are alert to anything that might indicate a child is at risk. They are not afraid to question each other’s practice and are not defensive when their own practice is challenged. This makes for a healthy and accountable environment where safeguarding comes first. A senior leader takes responsibility for any safeguarding issues. She is confident in this role and not complacent. She has a slick and precise system in place to manage any allegations. She welcomes independent scrutiny such as from local authority safeguarding audits, using these to reflect on and improve practice. She ensures that incidents are reviewed and that there is learning for future practice. Staff seek explanations for changes in behaviour. For example, one child was found to have an ear infection that explained a spike in challenging behaviour.

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outstanding

Staff demonstrate their skill in managing children who may put themselves at risk, for example through self-injurious behaviour. Staff use distraction and de-escalation techniques, for example changing a planned event at short notice, such as a meal time, to minimise distress and anxiety and prevent self-harm. The registered manager ensures that individual risk assessments inform staff of the control measures to keep children safe. Staff are not risk averse. They give children the freedom to take measured risk in accordance with each child’s age and cognitive ability. This is evident in practice with staff not feeling the need to be constantly Inspection report children’s home: SC066897 5 next to a child; rather, they give the child freedom to explore the world. This means that children are becoming empowered to understand risk and make safe choices. Children make excellent progress in relation to their health. They can undertake

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outstanding

routine procedures that once had to be performed under a general anaesthetic. Competent staff use their skills to prepare children such as using social stories for a blood test. Children who once found this terrifying can watch while a health professional takes their blood for testing. Children now have their immunisations, with a scheduled timetable to catch up on any routine vaccinations, that have been missed over the years prior to coming to the home. Staff adopt a comprehensive approach to e-safety without being risk averse. Key staff keep an oversight using software while children are taught to keep themselves safe online. Children can enjoy websites and games of their choice while keeping themselves safe. Recruitment practice is thorough. The registered manager has taken ownership of this, as recommended at the last inspection. He satisfies himself that safeguarding recruitment procedures are adopted in every case.

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outstanding

Children live in a warm and comfortable environment that is clean and well maintained. Care staff have effective systems to report any maintenance issues that are addressed quickly. There is a rolling refurbishment programme of improvement, such as replacing some bathrooms.

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The effectiveness of leaders and managers: outstanding

This home is led by an exceptional team across the board. Their professionalism, skills, diligence and commitment to meet each child’s individual needs are unquestionably of an extraordinary standard. The multidisciplinary team works collaboratively with excellent communication across the disciplines to ensure that children have the necessary routine, structure and consistency. Consequently, children are not distressed and are able to enjoy their lives. Likewise, the care staff team is exceptional. It is innovative and creative in its approach, always forward thinking about developing each child to reach their full potential. Leaders and managers highly value the team. Care staff’s skill, persistence and dedication does not go unnoticed. An example is staff working until the early hours on Christmas morning to create a magical environment for the children to enjoy. The senior leaders recognised this as going above and beyond the call of

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The effectiveness of leaders and managers: outstanding

duty. A member of staff said, ‘I feel valued by my line manager.’ Another staff member said, ‘I love the difference we make to the children, this is a career opportunity and not a job.’ It is worthy to note that education staff and care staff are indistinguishable in their approach to support children. Care staff learn how to support each child in education and education staff learn how to support each child in their care needs. Care and education staff work in each other’s environments, understanding and valuing the contribution that each professional brings to improve the life of each Inspection report children’s home: SC066897 6 child academically and socially. All professionals contribute to all of the children’s goals. This is a home that is always reflecting on how best to meet the needs of children. Senior leaders have created a culture that is responsive to the immediate and ongoing needs of children. For example, strategies discussed and agreed at review

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The effectiveness of leaders and managers: outstanding

meetings are implemented within hours of such a meeting. A parent spoke in the most positive terms about the registered manager, who has given her assurance that her child can return to the home no matter what time of the day or night, given her own personal circumstances. Senior leaders have created some additional roles since the last inspection that have been hugely successful. Care managers provide additional support to house managers and a well-being practitioner provides additional support to children and staff. Senior leaders value their staff and the contribution that they bring. As well as support provided through formal processes such as supervision, senior leaders listen to staff and deliberately question them as to how their job can be improved. Simple ideas, such as ensuring that the minibus is of a high standard before being handed over and improving seating in the staff room, have given a very clear message to

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The effectiveness of leaders and managers: outstanding

staff about their value. Consequently, morale is high, staff are loyal to the setting and all work together harmoniously. This is beneficial to the children. Senior leaders recognise that they have work to do with staffing numbers. They will not compromise on their decision to only recruit high-calibre, competent and skilled individuals. They have clear plans in place to look at alternative ways of recruitment such as social media campaigns. They have been resourceful in managing staff shortages through the deliberate choice of agency staff on long-term fixed contracts, bank staff and staff overtime. They ensure that staff are deployed across the homes so that there is the correct balance in each team to meet each child’s needs. Agency staff have the same training, supervision, support and guidance as permanent employees. This is exceptional practice. Agency staff stay for long periods, which is in the best interest of the children.

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The effectiveness of leaders and managers: outstanding

Senior leaders and staff advocate for children, challenging other professionals when necessary, to ensure that each child’s best interests are at the centre of practice. The nurse has developed key relationships with other health professionals to ensure that there is a prompt response to any child in need of healthcare. Staff are not deterred by any child who has complex health needs and have comprehensive safety plans in place, so that each child can engage fully in the life in the home. One parent said, ‘I am overwhelmed by the speed and efficiency in which my child’s health needs get met.’ The strong relationship with a local university continues. Undergraduates from the local university participate in the induction as part of their university degree. The home’s psychologist, occupational therapist and speech and language therapist provide education and training in the local university. Senior leaders are working

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The effectiveness of leaders and managers: outstanding

with the university on innovative research projects on autistic spectrum disorder. Key staff also work with other settings to grow and develop nurturing practices, consider professional development and provide reflective support to colleagues. Inspection report children’s home: SC066897 7 An independent visitor acts as a critical friend offering professional guidance and challenge that senior leaders welcome. The registered manager provides a comprehensive six-monthly reflective report to Ofsted with clear actions for the next period. Senior leaders have developed key performance indicators that give them an accurate picture of how well the whole service is performing. They ensure that no stone goes unturned to consider how to drive forward improvement so that children continue to excel in this home. The previous requirement to improve practice in monitoring and improving medication errors is met in full.

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The effectiveness of leaders and managers: outstanding

No further requirements or recommendations are made at this inspection. 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, 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: SC066897 9

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Children’s home details

Provision sub-type: Residential special school

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

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Children’s home details

Responsible individual: Katherine Landells

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Inspectors

Keith Riley, Social Care Inspector (Lead) Sophie Wood, Regional Inspection Manager Kelly Marchmont, Social Care Inspector Inspection report children’s home: SC066897 10 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 children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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