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

Inspection report for children’s home: SC470513 1 SC470513 Registered provider: Wandsworth Borough Council Full inspection 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 40 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 37 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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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: good

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Enforcement action since last inspection:

A restriction of accommodation order was issued on 24 October 2023. This has now been lifted. Inspection report for children’s home: SC470513 2

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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 Inspection report for children’s home: SC470513 3

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improvement to be good

The service is judged as requires improvement because significant health issues for some children are not clearly identified in the home’s care plans. In addition, an investigation into a matter of concern was not completed in a timely manner and the management oversight of behaviour management incidents lacks rigour.

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improvement to be good

The provider has made some improvements since the last inspection in October 2023, when serious and widespread concerns were identified. Although some aspects of care practice are not yet good, effective action has been taken in response to those concerns. As a result, the restriction of accommodation notice that was imposed on 24 October 2023 has been lifted. This means that the provider is permitted to admit new children to the home.

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improvement to be good

The quality of care provided in the houses is inconsistent. Most children have a positive experience, receive good care and make good progress. However, for some children, aspects of their care risk compromising their privacy. There are no clear plans in place to ensure that staff who provide personal care to children undertake this in a way that balances the need to promote privacy and independence. The quality of the showering facilities in one of the houses is very poor.

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improvement to be good

Insufficient attention is paid to children’s personal belongings. Some parents reported that their children’s clothes were often mixed up and that they returned home for the weekend with other children’s clothes. One parent commented that they felt compelled to buy cheap clothes as they frequently got lost and had to be replaced.

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improvement to be good

Children take part a wide range of activities and frequently access the community to have fun and to learn skills for independence. Some children access an arts project in the community, and this enables them to meet new friends and explore interests. Parents report that the activities and friendships that their children enjoy are a strength of the service. Several parents commented that their children have gained confidence and that they are more able to take part in family outings and holidays as a result.

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improvement to be good

Children get good support to attend medical appointments. For example, where children have significant anxieties about visiting the dentist, staff have been able to support them to receive dental treatment. Staff work closely with parents to ensure that children have regular appointments to review their health needs. As a result, several children have been supported to reduce medications in response to improvements in their well being and behaviours.

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improvement to be good

Children’s views are sought and used to inform service development. Since the last inspection, practice has improved to ensure that staff talk with children to explore Inspection report for children’s home: SC470513 4 their feelings and address issues when there is conflict or challenging behaviours between peers.

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improvement to be good

Children attend and engage well in education. Several children who previously struggled to attend school now do so, and several parents commented that their children are now thriving in school and enjoying education.

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improvement to be good

Care staff and school staff communicate well in terms of day-to-day matters. However, in one example, an assessment and intervention identified in school to support a child who was at some risk of swallowing inedible objects was not understood or employed by residential staff. This was resolved during the inspection.

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improvement to be good

Some children have limited ability to communicate verbally and are not easily able to let staff know how they are feeling. Staff are attentive to children’s needs and most staff know the children well. However, important information in relation to the health needs for some children is not recorded in a way that is easily accessible to staff. This means that some staff, particularly new or temporary staff, may not have all of the information they need to be alert to, and respond to, children’s needs. This is a shortfall that was identified at the last inspection and has not been corrected.

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improvement to be good

Staff have positive relationships with children and generally manage behaviour incidents well. There has been a recent reduction in behaviour management incidents for some children. This is due to staff having clearer direction in terms of how to respond. For example, for one child, his behaviours have improved because staff have worked effectively with him to involve him in decisions and to make more choices.

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improvement to be good

Staff sometimes use physical interventions to manage situations where children are at risk of harm. The management oversight of behaviour incidents has improved since the last inspection. However, there is still insufficient scrutiny of some incidents to ensure that all interventions are necessary and proportionate. In addition, there is inconsistent practice in relation to ensuring that staff and children are spoken to after incidents where physical interventions are used. Incident records do not demonstrate that any learning is used to inform future practice.

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improvement to be good

Some children are prescribed medication to help them to calm in times of crisis. These medications are not frequently used, and staff have clear guidance as to the circumstances in which these medications can be administered. However, there is no system in place to record the circumstances in which they are given, and no management oversight of the administration or effectiveness of these medications to ensure that they are being given as prescribed and that they are helpful to children.

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improvement to be good

There are good systems in place to ensure that both low level and more serious concerns are identified, reported and acted on. The designated safeguarding leads in the school and home work effectively in partnership with relevant agencies in Inspection report for children’s home: SC470513 5 response to concerns. However, in one example, there was an avoidable delay in completing an investigation into how a serious safeguarding incident occurred.

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improvement to be good

Feedback from parents and professionals raised no concerns in relation to the safety or welfare of children, and those children who were able to express their views to inspectors reported feeling safe in the home.

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good

The provider has made all reasonable efforts to recruit a manager for the home and to support their registration. Due to unforeseen circumstances, the person employed in this role is away from work. The provider has recently employed a suitably experienced interim manager to have oversight of the day-to-day care and to develop the service.

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good

Leaders and managers have good insight into the strengths and weaknesses in the service and they have credible plans to improve practice. They are at an advanced stage of introducing systems to improve recording and to ensure better management oversight of behaviour management incidents. These systems are not yet operational or fully embedded, which means they have not had an impact on addressing the shortfalls identified at this inspection.

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good

Managers are taking appropriate action to reduce inconsistencies in the quality of care between the houses. They have introduced regular meetings between house managers to share good practice and to consult on service development. House managers now get formal supervision, which they report as being helpful. Leaders are providing clear support and direction to managers and have systems in place to address areas where care may fall short of the expected standards.

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good

House managers are providing better supervision and support to care staff. However, this is not consistent and not all staff have received supervision in line with the agreed frequencies as set out in the home’s policies.

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good

Leaders and managers have made progress in recruiting new staff and are looking at ways to improve conditions to improve retention. Staff are positive about the support that they get from managers, and report that they feel there are enough staff to meet the children’s needs. There are contingency plans and capacity to provide extra cover when this is needed to cover sickness or unexpected needs.

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good

Following a significant restructuring of the staffing deployment, leaders and managers are working together to improve consistency of care so that all houses have a core team of permanent staff, and that most agency staff are long term and are well known to the service and the children.

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good

Leaders and managers have made improvements in a number of areas, but these improvements are not embedded to ensure consistently good care practice in relation to all children. For example, practice has improved to ensure that children’s Inspection report for children’s home: SC470513 6 feelings are explored, and the impact of behaviours are considered when there are incidents between peers. However, there is not a consistent approach to doing the same following other behaviour incidents or physical interventions. This has led to some requirements from the last inspection being repeated.

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good

For some children with complex needs, support plans are much clearer since the last inspection and there have been improved outcomes for these children in terms of a reduction in behaviour incidents. However, inspectors identified plans for other children that were not clear in respect of meeting some children’s health needs and addressing behaviours of concern. The plans for these children were updated by managers and shared with their staff during the inspection. Inspection report for children’s home: SC470513 7

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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 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 remains reviewed and updated so that staff fully understand how to respond to the health needs for all children. 5 February 2024

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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—

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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

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)(b)(i)(ii)(c)) 5 February 2024

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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. 5 February 2024 Inspection report for children’s home: SC470513 8 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;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12 (1) (2)(a)(i)(iii)(vi)(vii))

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Requirement Due date

In particular, ensure that any concerns are investigated promptly.

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Recommendations

 The registered person should ensure that a record of supervision is kept for staff, including the manager. The record should provide evidence that supervision is being delivered in line with regulation 33(4)(b). (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 61, paragraph 13.3)  The registered person should ensure that staff are familiar with the home’s policies on record-keeping and understand the importance of careful, objective and clear recording (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 62, paragraph 14.4)  The registered person should ensure that children’s homes are nurturing and supportive environments that meet the needs of their children; they will, in most cases, be homely, domestic environments. Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene, etc.). However, in

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Recommendations

doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 15, paragraph 3.9)  The registered person should ensure that when considering whether restraint is warranted, staff in children’s homes need to take into account: - the age and understanding of the child; Inspection report for children’s home: SC470513 9 - the size of the child; - the relevance of any disability, health problem or medication to the behaviour in question and the action that might be taken as a result; - the relative risks of not intervening; - the child’s previously sought views on strategies that they considered might de- escalate or calm a situation, if appropriate; - the method of restraint which would be appropriate in the specific circumstances; and - the impact of the restraint on the carer’s future relationship with the child.

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Recommendations

(‘Guide to the Children’s Homes Regulations, including the quality standards’, page 49, paragraph 9.55)  The registered person should ensure that there are clear plans in relation to providing personal care to ensure that staff respect children’s privacy and support the other children living in the home to do so. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 16, paragraph 3.17)

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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 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: Wandsworth Borough Council, 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 Jane Balfe, Social Care Inspector Anne-Marie Davies, Social Care Inspector 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 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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