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 home is run by a local authority and 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 comprises five individual houses where children live in small groups. At the time of this inspection, one of the houses was temporarily closed. The service accommodates children for short breaks and for placements of 38 weeks of the year. At the time of this inspection, 33 children were living in the home.

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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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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected and their welfare is not promoted or safeguarded.

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inadequate

Date of last inspection: 12 December 2023

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inadequate

Overall judgement at last inspection: requires improvement to be good

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inadequate

Enforcement action since last inspection: A compliance notice under regulation 23 was issued on 15 May 2024. This was in relation to the administration of medications. This notice was reviewed at this inspection and deemed unmet. Therefore, the notice has been reissued. Inspection report for children’s home: SC470513 2

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Inspection date Inspection type Inspection judgement

12/12/2023 Full Requires improvement to be good 20/06/2023 Full Good 13/09/2022 Full Good 19/01/2022 Interim Improved effectiveness Inspection report for children’s home: SC470513 3

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Overall experiences and progress of children and young people: inadequate

The service is inadequate primarily due to the failure of leaders and managers to identify and address serious shortfalls in safeguarding practice and meet a compliance notice in relation to the administration of medication. This compliance notice has been reissued.

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Overall experiences and progress of children and young people: inadequate

At times, there are insufficient experienced staff on duty to provide good standards of care. In some instances, this means that children are unable to access the community and take part in activities. On one occasion, during this inspection, a new member of staff without sufficient training or experience was left working alone with a child.

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Overall experiences and progress of children and young people: inadequate

Some children have a positive experience of care and benefit from excellent relationships with staff who know them well and care for them with skill and compassion. However, at times, staff lack clear direction and support to ensure that they are engaging purposefully with children to help them make progress and reach their potential. In some instances, staff appeared to be supervising rather than interacting with children.

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Overall experiences and progress of children and young people: inadequate

Staff support children to access healthcare and treatment when required. Children are supported well in relation to their oral hygiene and health appointments. However, healthcare plans for children with medical conditions are not always clear in relation to emergency protocols. Plans to support children with epilepsy are not fully informed or approved by specialist health professionals.

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Overall experiences and progress of children and young people: inadequate

Many children enjoy their time in the home. They make friends, have fun and engage in a range of activities on site and in the local community. However, there are times when there are insufficient staff to take children out on activities. This reduces children’s opportunities to learn and engage with the outside world.

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Overall experiences and progress of children and young people: inadequate

Staff use a variety of methods, such as social stories, to communicate with children to help them understand situations and to cope with events and routines. However, these methods are not used consistently to help children to reflect and share their experience following incidents that involve physical intervention.

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Overall experiences and progress of children and young people: inadequate

Parents and social workers have mixed views about the quality of care provided to children. Most are positive and say that the children are well cared for by staff and make progress. Some are less positive and are concerned that the provider does not always inform them of issues or communicate effectively with them with regards to incidents or concerns.

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Overall experiences and progress of children and young people: inadequate

Children make good progress in relation to their engagement in, and enjoyment of, education. There are examples of children making excellent progress, improving their confidence and their ability to communicate and socialise. Inspection report for children’s home: SC470513 4

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How well children and young people are helped and protected: inadequate

There are significant flaws in the way that medication is managed and administered. The provider has taken some recent steps to try and improve this. However, there have been further errors in administering medication, and recording systems are not yet reliable. This creates the risk of children not getting medication as prescribed. In one instance, the dose of medication on a child’s records was incorrect. In another instance, a child did not have creams for a skin condition administered as prescribed. At times, staff are unclear about what circumstances ‘when required’ medication should be given to children. The system for recording any missed doses of medication is ineffective as is the system for stock control. In addition, there are insufficient staff trained to administer first aid. Given the complex health needs of some of the children, these shortfalls place children at risk of harm.

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How well children and young people are helped and protected: inadequate

The systems in place for managing allegations and concerns are ineffective. For example, the provider was unclear as to what action to take when deciding if staff can continue to be at work pending the outcome of investigations. In other examples, the provider failed to thoroughly investigate concerns. They did not consider the full implications and potential risks to children in response to situations where allegations were made and did not explore or implement any learning. This means that vulnerable children are not protected from potential harm.

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How well children and young people are helped and protected: inadequate

There is a high use of agency staff in the home. The information that the provider receives from the agency is insufficient. Consequently, the provider cannot be sure that agency staff are suitably experienced and vetted.

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How well children and young people are helped and protected: inadequate

All permanent staff undergo checks to ensure that they are suitable to work with vulnerable children. However, the provider relies on information provided by an external company to confirm that staff have a clear Disclosure and Barring Service certificate and does not request to see a copy.

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How well children and young people are helped and protected: inadequate

Staff generally manage behavioural incidents well. Practice is underpinned by well- informed assessments that help staff understand how to support individual children through periods of crisis. In some instances, the use of physical intervention is required to keep children safe. These incidents are clearly recorded, and staff make all reasonable efforts to manage these incidents without the use of restraint. However, as mentioned earlier in this report, staff do not talk to children following these incidents to understand their experiences.

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The effectiveness of leaders and managers: inadequate

The lack of effective leadership and oversight has impacted on the safety of children and the quality of care that they receive.

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The effectiveness of leaders and managers: inadequate

Leaders have failed to work effectively in partnership with parents and placing authorities to address concerns. They have also been unable to deliver sufficient improvements in relation to the administration of medication. Inspection report for children’s home: SC470513 5 There is currently no registered manager for this home. There is an acting manager, who provides support to the individual house managers. The responsible individual has a lead role across the school and residential provision.

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The effectiveness of leaders and managers: inadequate

There are no clear lines of communication, accountability or decision-making in relation to safeguarding. In some instances, investigations into allegations have been led by the Human Resources department and lacked focus on safeguarding children. No consideration was given to wider learning to reduce the risk of incidents happening again. These shortfalls create an environment where children could be mistreated.

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The effectiveness of leaders and managers: inadequate

There are not always enough suitably qualified or experienced staff. There are frequent changes to the planned staffing arrangements, and staff rotas are not updated to reflect these changes. Consequently, there is not an accurate record of who has been on shift. This makes it difficult for managers to monitor staffing levels. In addition, plans for children are not always clear in relation to their supervision needs. For example, where it is identified that a child needs a one-to-one staffing ratio, it is not clear what this means in practice for each child. This means that managers cannot be satisfied that staff are deployed in the right way.

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The effectiveness of leaders and managers: inadequate

Some monitoring and review systems are poor. They do not support leaders to identify weaknesses or make improvements in the quality of care provided in the home. The designated safeguarding lead is unable to access the system where behavioural incidents and physical interventions are recorded. When there are incidents between children, there is no system that clearly identifies if these incidents are deemed to have been bullying. Consequently, managers are not able to look for patterns or identify trends.

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The effectiveness of leaders and managers: inadequate

The managers of the individual homes are motivated and committed to providing good- quality care for children. They have good oversight of some day-to-day matters and report concerns to senior leaders and managers. However, senior leaders do not always respond appropriately. 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 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 receive advice, services and support in relation to their health and well-being.

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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

achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

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Requirement Due date

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding. (Regulation 10 (1)(a)(b) (2)(a)(i)(ii))

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Requirement Due date

In particular, ensure that health guidance to staff remains reviewed, updated and informed by health professionals so that staff fully understand how to respond to the health needs of all children. 12 July 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.

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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

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; 12 July 2024 Inspection report for children’s home: SC470513 7 are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(v)(vii)(b))

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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

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(h)) 12 July 2024

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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

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child. (Regulation 13 (1)(a)(b) (2)(c)(d)) 12 July 2024

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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

medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to 12 July 2024 Inspection report for children’s home: SC470513 8 them;

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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; and

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Requirement Due date

a record is kept of the administration of medicine to each child.

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Requirement Due date

Paragraph (2) does not apply to medicine which—

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Requirement Due date

is stored by the child for whom it is provided in such a way that other persons are prevented from using it; and

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Requirement Due date

may be safely self-administered by that child. (Regulation 23 (1) (2)(a)(b)(c) (3)(a)(b))

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Requirement Due date

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans;

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Requirement Due date

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 (a)(d)) 12 July 2024

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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

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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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

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background. (Regulation 6 (1)(a)(b) (2)(iv)) 12 July 2024 Inspection report for children’s home: SC470513 9 In particular, ensure that all staff engage with each child in a way that is purposeful and focused on engaging them to make progress.

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Requirement Due date

at all times, at least one person on duty at the home has a suitable first aid qualification. (Regulation 31 (2)(a)) 12 July 2024

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home; or

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Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

the individual is of integrity and good character;

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform;

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (2)(a)(b) (3)(a)(b)(d)) 12 July 2024

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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 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 12 July 2024 Inspection report for children’s home: SC470513 10 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.

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Requirement Due date

Paragraph (3) does not apply in relation to restraint that is planned or provided for as a matter of routine in the child’s EHC plan or statement of special educational needs. (Regulation 35 (2) (3)(b)(i)(ii)(c) (4))

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1) (2)(a)(b))

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Requirement Due date

In particular, ensure that accurate records of staff rotas are kept. 12 July 2024

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Requirement Due date

* These requirements are subject to a compliance notice.

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Recommendation

 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)

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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 11

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Children’s home details

Provision sub-type: Residential special school

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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 Sara Stoker, Social Care Inspector Rebecca Fisher, Social Care Inspector Inspection report for children’s home: SC470513 12 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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