Children's Home, Residential special school run by Wandsworth Borough Council in Wandsworth

Assurance inspection report for children’s home: SC470513 1 SC470513

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Registered provider: Wandsworth Borough Council

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Inspected under the social care common inspection framework

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Information about this children’s home

This is a local authority-run service that provides care for up to 56 children with autism spectrum disorder, learning disabilities and associated conditions. The home is on the same site as the organisation’s school and is comprised of separate individual houses so that children live in small groups. It accommodates children for short breaks and for placements of 38 weeks of the year. There were 40 children living in the home at the time of this inspection.

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Information about this children’s home

There has been no registered manager since 31 August 2023.

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Information about this children’s home

The inspectors only inspected the social care provision at this setting.

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Information about this children’s home

Enforcement action since last inspection: none

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Information about this inspection

At this inspection, the inspectors evaluated:

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Information about this inspection

 the care of children  the safety of children  the effectiveness of leaders and managers. Inspectors have looked closely at the experiences and progress of children, using the social care common inspection framework. This assurance 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’. Assurance inspection report for children’s home: SC470513 2

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Outcome from the inspection

We identified the following serious and widespread concerns in relation to the care or protection of children at this assurance inspection.  The significant concerns relate primarily to a lack of management oversight in key areas of practice regarding behaviour management, including the use of physical interventions, and, in one example, concerns that the standards of care for a child are poor.  In addition, some staff have left, and high levels of staff sickness have re- sulted in staff feeling overstretched.  In some instances, there have been insufficient staff to provide children with the support that they need to have a positive experience of care and make progress.

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Findings from the inspection

As a result of these concerns, Ofsted has issued a restriction of accommodation notice. This prevents further children from being admitted to the home.

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Findings from the inspection

The systems in place to ensure oversight of behaviour management and safe practice in relation to the use of physical intervention are ineffective and potentially place children at risk of harm. Managers’ reviews of incidents do not provide sufficient scrutiny to ensure that learning from incidents takes place and that holds are appropriate and safe. The behaviour management team provides detailed assessments and plans but these are not informed by children’s views and do not translate into practice.

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Findings from the inspection

Children’s views and experiences following incidents of physical intervention are not sought. In one incident, a child became unresponsive during a restraint and was taken to hospital. There was no evidence that staff had caused harm to the child, but this incident was not investigated and had not been noticed by the behaviour management team. The child’s behaviour support plan was not updated in response to this incident and the manager of the home in which the child lives was unaware that this incident had occurred.

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Findings from the inspection

In another example, a child who needs staff to physically intervene to prevent self- injurious behaviours recently needed hospital admission and treatment due to injuries that occurred. He has been subject to prolonged periods of physical intervention to prevent injury but there is no clear guidance to staff as to when to seek urgent medical support in response to injuries that may be sustained. The medication prescribed to help this child to stabilise his anxieties has not been administered in accordance with the prescribed doses. Assurance inspection report for children’s home: SC470513 3 Managers do notify Ofsted when serious incidents occur. However, in some instances, these are not notified without delay as required by regulations.

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Findings from the inspection

One social worker raised concerns with inspectors that a child’s room was bare and unhygienic. She reported that these concerns were often addressed when raised, but that standards declined between her unannounced visits. The parent of this child raised concerns that, despite funding being in place to provide two-to-one support for her child, these staff were not available to support her to access the community with her child when she visits. She also raised concerns that she was not allowed into the home to see his bedroom.

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Findings from the inspection

Additional concerns were raised in relation to the care of this child. Staff do not follow his care plan and provide pads when he goes to bed. His television had recently been installed in a tamper-proof box but there was no remote control and it could not be used. Watching television is part of his night-time routine but there was no apparent urgency to make sure that he could use it. However, the social worker and parent did feel that the child was safe and they had noted a recent improvement in responsiveness and more open communication from one of the newly appointed managers in the home.

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Findings from the inspection

Some of the houses are coping better than others with the pressures on staffing. Some house managers commented that they are working extremely hard to reduce any impact on the children and that children still access the community, take part in activities and receive good care. Managers were consistent in reporting that they felt that resources were stretched, and they were at their limit in terms of sustaining best practice. One manager reported that this was having an impact on her ability to keep on top of record-keeping and administrative tasks.

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Findings from the inspection

Most staff are working above and beyond in difficult circumstances to provide good care. They are resilient and genuinely care about the children. Feedback from parents and social workers was positive in terms of the interactions between staff and children.

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Findings from the inspection

Since the last full inspection, there have been significant changes to the management and staffing in the home. This has had an impact on the safety and experience for some children with the most complex needs. When staff are diverted to meet these children’s needs, they are less able to attend to the needs of other children to enable them to make progress and have a positive experience of care.

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Findings from the inspection

Since the last inspection, several managers and care staff have been absent due to either leaving or high levels of sickness. The registered manager left, and an acting manager was appointed before he left. The acting manager was not present during this inspection.

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Findings from the inspection

Senior leaders have a clear vision and high expectations in terms of the standards of care they are seeking to achieve. They reported that they felt there was a need to create a more open and child-focused culture in the home. They face significant Assurance inspection report for children’s home: SC470513 4 challenges in the current circumstances to deliver this change and their vision has yet to translate into practice. Many of the staff are optimistic and welcome a fresh start but the reality on the ground is that they are stretched to, and at times beyond, capacity. Leaders and managers have been successful in recruiting new staff and some other applicants have been offered posts subject to checks to fill the gaps.

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Findings from the inspection

Progress in relation to the shortfalls at the last inspection has been limited and although new arrangements are in place to involve parents and seek children’s views, these have not yet had time to translate into improvements in practice. Therefore, the requirements and recommendations made at the last inspection will remain in place. Additional requirements have been made in relation to ensuring sufficient staffing, the administration of medication and the need to notify Ofsted of serious incidents without delay. Assurance inspection report for children’s home: SC470513 5

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Inspection date Inspection type Inspection judgement

20/06/2023 Full Good 13/09/2022 Full Good 19/01/2022 Interim Improved effectiveness 21/04/2021 Full Requires improvement to be good Assurance inspection report for children’s home: SC470513 6

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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, The 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 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—

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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;

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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, ensure that staff fully understand how to intervene to keep children safe. 13 November

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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

helps children aspire to fulfil their potential; and

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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

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child; 13 November Assurance inspection report for children’s home: SC470513 7 ensure that the home’s workforce provides continuity of care to each child;

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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 quality of care provided in the home. Regulation 13 (1)(a)(b) (2)(a)(b)(c)(d)(e)(f))

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children are helped to lead healthy lifestyles. (Regulation 10 (1)(a)(c))

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Requirement Due date

In particular, ensure that health guidance to staff is reviewed and updated to ensure that children’s individual health needs and any emergency interventions are explicit. 13 November

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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

helps children aspire to fulfil their potential; and

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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

demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

feedback on the experiences of children, including complaints received. (Regulation 13 (1)(a)(b) (2)(g)(ii)) 13 November

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home.

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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— 13 November Assurance inspection report for children’s home: SC470513 8 the name of the child;

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Requirement Due date

details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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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;

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Requirement Due date

the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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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;

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Requirement Due date

has signed the record to confirm it is accurate; 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 (1)(a) (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c))

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. Regulation 23 (1) (2)(b)) 13 November Assurance inspection report for children’s home: SC470513 9

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Recommendations

 The registered person should ensure that children are consulted regularly on their views about the care provided by the home, to inform and support continued improvement in the quality of care provided. Due consideration should be given to the child’s cognitive ability in the development and implementation of any consultation processes. Children should be able to see the results of their views being listened to and acted on. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 22, paragraph 4.11)  The registered person should ensure that observation, monitoring or surveillance of children does not remove reasonable privacy, and should allow as much privacy as is possible, including in dressing, washing and using the toilet. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 22, paragraph 3.36)  The registered person should ensure that procedures for dealing with allegations

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Recommendations

of bullying are in place and staff have the skills required to intervene, protect and address bullying behaviours effectively. (See regulation 34(3) on the policy for the prevention of bullying.) (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 39, paragraph 8.16)  The registered person should develop the home’s effective working relationships with each child’s parent. These working relationships will also be key to success in delivering the care planning standard (regulation 14). (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 52, paragraph 10.3) Assurance inspection report for children’s home: SC470513 10

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Wandsworth Borough Council

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Children’s home details

Registered provider address: The Town Hall, Wandsworth High Street, London SW18 2PU

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Children’s home details

Responsible individual: Penelope Doswell

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Inspectors

Lee Kirwin, Social Care Inspector Rebecca Fisher, Social Care Inspector Assurance inspection report for children’s home: SC470513 11 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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Inspectors

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