Children's home run by The National Autistic Society in Islington

Inspection report for children’s home - monitoring visit: SC032154 1 SC032154

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National Autistic Society (The)

Inspected under the social care common inspection framework

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Information about this children’s home

This home is part of a charitable trust. It provides care for up to eight children who may have autism spectrum disorder. Children may have other associated difficulties, such as sensory impairment and/or physical disabilities. At the time of this inspection, two children were living in the home.

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Information about this children’s home

The home is divided into two houses, with a communal hub and garden. This registered children’s home is also part of a specialist school that provides education on site.

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Information about this children’s home

The manager registered with Ofsted in August 2022.

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This monitoring visit

This children’s home was judged inadequate at the full inspection on 8 and 9 November 2022. Inspectors found significant breaches in regulations relating to the safety and protection of children, the leadership and management of the home, restraint and the deprivation of liberty, behaviour management policies and records, and the notification of serious events. As a result of that inspection, Ofsted issued a notice restricting accommodation and issued five compliance notices under regulations 12, 13, 20, 35 and 40.

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This monitoring visit

On 19 December 2022, Ofsted carried out a monitoring visit to review the notice restricting accommodation. The inspector concluded from that monitoring visit that the provider is adhering to the notice restricting accommodation. However, the restriction notice remained in place because the compliance notices were not scheduled to be reviewed at the time of the visit.

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This monitoring visit

The purpose of this monitoring visit was to review the five compliance notices and the notice restricting accommodation. Since the last full inspection, no children have Inspection report for children’s home - monitoring visit: SC032154 2 moved in to this home. This monitoring visit included the review of documents and discussions with the manager, responsible individual, staff and the children living in the home. The inspectors concluded from this monitoring visit that five steps set in the compliance notice with regards to regulation 20 and 35 were not met. These notices have been reissued as a result of this inspection.

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This monitoring visit

There are still significant gaps in staff knowledge around lawful physical restraint practice. Managers and staff have yet to improve their understanding of the new restrictive practice policy. In particular, the guidance around ‘unplanned responses’, which is the term applied when staff use restraint techniques that are not taught as part of the physical restraint methods permitted in the home. In addition, staff have not had refresher training around the organisation’s physical restraint methodology. Inspectors were not assured that the staff had the necessary skills and competency to confidently practice in line with the children’s homes regulations. This is detrimental to the safety and protection of children.

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This monitoring visit

Children’s individual behaviour support plans record that restraint holds are permitted. However, staff are provided with inadequate guidance about specific restraint holds that are permissible and appropriate for individual children, based on their needs. This could lead to unsafe practice and harm to children.

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This monitoring visit

At the last inspection, the organisation had failed to identify that staff practice had compromised the welfare and protection of children. During this monitoring visit, the inspectors were not assured that organisational procedures had developed. This is with specific reference to the creation and implementation of quality assurance measures of the organisation’s physical restraint methodology, and restraint practice within the children’s homes regulations.

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This monitoring visit

There have been no physical restraints of children since the last inspection. The manager has oversight of all incidents to ensure that practice is safe and that the views of the children and staff are heard and acted on. Children who are involved in these incidents, including those who have limited verbal communication, have had the opportunity to take part in a structured session with a manager or independent staff member. This gives the children a chance to share their views and feelings and look at strategies to prevent further incidents.

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This monitoring visit

There are improvements to the manager’s monitoring of the home. The manager’s oversight of incident recordings in the electronic integrated safeguarding system enables shortfalls in staff practice to be identified quickly and responded to. The manager has implemented staff questionnaires and compiled case studies to gather insight into the staff’s skills and competencies. Shortfalls in staff practice have been identified and steps implemented to address the concerns.

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This monitoring visit

Organisational procedures had previously prevented the registered manager’s oversight. Organisational changes now mean that the registered manager has autonomy over decision-making about care practices for children in the home. There Inspection report for children’s home - monitoring visit: SC032154 3 is an improved understanding of the children’s homes regulations, and this is reflected in newly created policies and procedures.

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This monitoring visit

The manager has informed Ofsted of significant incidents; there has been one since the last inspection. Ofsted has had the necessary oversight to ensure that appropriate action has been taken by the manager to maintain the safety and well- being of the children.

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This monitoring visit

The manager has sourced guidance from health professionals to ensure that her staff seek necessary medical assistance for children. This improved guidance helps staff to consistently ensure that children get the correct medical support when required.

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This monitoring visit

Staff are equipped to respond to ligature incidents. Staff have received training to improve their understanding and response to ligature incidents. Careful consideration has been given to internal procedures for managing ligature risks. This includes providing a safe environment for children. The manager has developed a ligature risk assessment to provide information and guidance for staff on how to manage and reduce children’s emerging ligature risks.

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This monitoring visit

The children’s risk assessments have been developed. This implemented change creates an effective system for the manager, with the staff, to review and ensure that the children’s risk assessments are current and effective. The manager will continue to review the content and format of this newly created record to ensure accuracy and efficiency in staff practice.

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Recent inspection history

Inspection date Inspection type Inspection judgement 08/11/2022 Full Inadequate 22/03/2022 Full Outstanding 21/01/2020 Full Outstanding 08/01/2019 Full Outstanding Inspection report for children’s home - monitoring visit: SC032154 4

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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 is that children receive care from staff who—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice. (Regulation 6 (1)(a) (2)(b)(ii)(ix)) 1 January 2023

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Requirement Due date

*Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (2)) 29 January 2023

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Requirement Due date

*The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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Requirement Due date

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—

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure; 29 January 2023 Inspection report for children’s home - monitoring visit: SC032154 5 a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; and

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Requirement Due date

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”)—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

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 (2) (3)(a)(iv)(v)(viii)(b)(i)(c))

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Requirement Due date

The independent person must produce a report about a visit (“the independent person’s report”) which sets out, in particular, the independent person’s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children’s well-being.

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Requirement Due date

The independent person must provide a copy of the independent person’s report to—

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Requirement Due date

HMCI. (Regulation 44 (4)(a)(b) (7)(a)) 1 January 2023

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

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 (2)(a)(b)(c) (5)) 1 January 2023 Inspection report for children’s home - monitoring visit: SC032154 6 *These requirements are subject to a compliance notice.

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Recommendations

 The registered persons should ensure that the children’s home provides a nurturing and supportive environment that meets the needs of the children. The children’s bedrooms must be clean, and any sign of bodily fluids cleaned. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 15, paragraph 3.9)

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Recommendations

 The registered person should ensure that staff can access appropriate facilities and resources to support their training needs, and should understand the key role they play in the training and development of staff in the home. In particular, all staff should have up-to-date food hygiene training, and the senior team receive relevant risk assessment training. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 53, paragraph 10.11)

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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.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: SC032154 7

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Children’s home details

Registered provider: National Autistic Society (The)

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Children’s home details

Registered provider address: 393 City Road, London EC1V 1NG

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Inspectors

Jennifer Fenlon, Social Care Inspector Gemma McDonnell, Social Care Inspector Inspection report for children’s home - monitoring visit: SC032154 8 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.

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Inspectors

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Inspectors

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Inspectors

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