Children's Home run by Cambian Childcare Limited in Nottingham

Unique reference number SC457500 Inspection date 19/09/2013 Inspector Catherine Honey Type of inspection Full Provision subtype Children's home

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Date of last inspection 27/02/2013 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Brief description of the service

The home is registered to accommodate up to six children with emotional and/or behavioural difficulties. The home is operated by a large private organisation.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be inadequate .

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Overall effectiveness

This home was re-registered with Ofsted under a new provider organisation in February 2013. The Registered Manager of this home left on 30 August 2013. Since then an interim manager has been overseeing the home while a permanent appointment to the manager's position is sought. However, there is no application in progress with Ofsted to register a manager for this home. The acting manager has been proactive in identifying areas of weakness and concern and has put plans in place to improve the home. However, the impact of these changes has yet to take effect.

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Overall effectiveness

Overall management of the home has not been effective and changes in staffing have led to inconsistencies, resulting in shortfalls in a number of areas. Namely: young people are living in an environment which has been damaged and not maintained sufficiently; they are taking part in external activities where the assessment of risk is not sufficient; they do not have access to a telephone without reference to staff; the home is not secure from unauthorised access, although this was rectified during the inspection; fire safety arrangements are not always adhered to; appropriate care and supervision have not always been provided for young people; concerns from professionals are not always recorded or acted on sufficiently; the home’s Statement of Purpose does not reflect the age range the home intends to meet, and updated information has not been sent to the regulator; internal doors within the home are occasionally locked, meaning young people do not have free

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Overall effectiveness

access around their own home; records of restraint have not always been recorded in a volume fit for the purpose; staff do not always work effectively with young people to develop their understanding of difference and diversity; and young people’s wishes are not always followed in relation to developing their independence. However, following recruitment, the home is now fully staffed. Staff are caring in their approach and are enthusiastic about improving standards in the home. Some young people have made some progress and all young people have education placements. Feedback from professionals and families contacted is mixed, with some giving very positive opinions and others identifying shortfalls and areas for improvement in practice.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that all parts of the children’s home used by children are reasonably maintained. This is in relation to the home and garden (Regulation 31(2) (e)) 18/10/2013

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Reg. Requirement Due date

(2001) ensure the children’s home is conducted so as to make proper provision for the care and supervision of children accommodated there (Regulation 11 (1) (b)) 18/10/2013

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Reg. Requirement Due date

(2001) ensure children accommodated in the home are provided at all reasonable times with access to a telephone on which to make and receive telephone calls in private which they may use without reference to persons working in the home (Regulation 15 (4) (a)) 18/10/2013

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Reg. Requirement Due date

(2001) ensure that all parts of the children’s home used by children are secure from unauthorised access (Regulation 31 (2) (b)) 18/10/2013

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Reg. Requirement Due date

(2001) ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 are complied with, with particular regard to ensuring that fire doors are able to prevent the spread of fire (Regulation 32 (1A) (b)) 18/10/2013

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Reg. Requirement Due date

(2001) ensure that a written record is made of any complaint, the action taken in response, and the outcome of the investigation (Regulation 24 (5)) 18/10/2013

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Reg. Requirement Due date

(2001) compile in relation to the children’s home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of a statement as to the matters listed in Schedule 1, with particular regard to the age-range of children the home intends to accommodate (Regulation 4 (1)) 18/10/2013

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Reg. Requirement Due date

(2001) keep under review and, where appropriate, revise the statement of purpose and the children’s guide and notify the HMCI of any such revision within 28 days (Regulation 5 (a) (b)) 18/10/2013

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Reg. Requirement Due date

(2001) ensure any activities in which children participate are so far as reasonably practicable free from avoidable risks. (Regulation 23 18/10/2013 (b))

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure physical restrictions on normal movement within or from the home are not used unless this is necessary to safeguard children and promote their welfare and development (NMS 10.4)  ensure any measure of control, discipline or restraint is recorded in a volume kept for this purpose. This is in relation to records being made in formats that cannot be tampered with after the event (Volume 5, statutory guidance, paragraph 2.91)  ensure staff support children’s social and emotional development, with particular regard to supporting young people to understand equality and diversity (NMS 2.2)  ensure children’s views, wishes and feelings are acted upon, in the day to day running of the home and important decisions or changes in the child’s life, unless this is contrary to their interests. This is in relation to preparation for independence. (NMS 1.1)

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Outcomes for children and young people

Outcomes for young people are inadequate .

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Outcomes for children and young people

Some young people have achieved positive outcomes since they started living in the home. For those young people, achievements relate particularly to educational attainment and decrease in drug use. A social worker said, 'My young person is very positive about his life at the moment.' However, inconsistencies in the care and supervision of young people mean that outcomes have been adversely affected and have lessened the progress made for other young people.

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Outcomes for children and young people

All young people are enrolled in education or further education. Some young people, who have previously struggled with school attendance, started new education placements at the start of the term and are achieving well. Others have achieved qualifications. However, others are struggling with their behaviour at school and their attendance has been affected by this.

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Outcomes for children and young people

Some young people have struggled to develop a positive self-view and improve their emotional resilience. Young people have shown difficult behaviour, found it hard to form positive and respectful relationships with staff and have not valued their environment. Opportunities for the development of positive relationships have been affected by the instability of the staff group, meaning young people have not received consistency of care. However, staff do spend quality time with young people, undertaking key working or planned placement sessions. This means young people have opportunities to respond positively to advice and guidance.

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Outcomes for children and young people

Young people benefit from a balanced diet and take part in deciding the weekly menu. At times they help with the food shopping and cooking. Young people also engage in physical activity such as swimming or playing football in the garden. Most young people enjoy good health, although some smoke. Some young people have decreased their drug use during their placement, meaning they have taken responsibility for their health, and their health outcomes have improved.

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Outcomes for children and young people

Young people are not always provided with effective opportunities to increase their independence. Where it has been recognised that young people are ready to move to a more semi-independent provision within the home’s environment, this has not been provided, despite young people and professionals believing this was happening imminently. This missed opportunity means young people are not being enabled to reach their full potential. However, young people are given opportunities within the home to become more independent, for example, by doing their own laundry and managing their own food budgets.

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Outcomes for children and young people

Young people benefit from contact with their friends and families. During contact, where appropriate, parents are encouraged to spend time with young people in the home or engaging in activities in the community. Parents speak positively of the support they receive from staff while visiting the home. One young person has a part-time job and others enjoy attending a gym which means they are taking an active part in their community.

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Quality of care

Staff demonstrate a caring and upbeat manner. They want young people to do well and to be able to have positive opportunities and outcomes. Staff recognise that in the past few months they have not successfully achieved this, and changes to the staff team have not helped provide consistent care and boundaries for young people.

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Quality of care

Generally, staff have established and maintained good relationships with young people’s schools and are proactive in supporting young people to attend. A teacher stated, 'Staff at the home are very good at communicating and regularly share information.' Young people are appropriately supported when they feel ill or are injured. Young people have opportunities to attend health appointments and have contact with more specialist services, such as a child psychologist. However, it is difficult to see how suggestions and strategies that specialists have discussed with staff have been implemented in practice. Staff are trained to administer medication and medication is safely administered.

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Quality of care

Young people benefit from a staff group who have an understanding and sensitive approach to their individual needs. However, young people’s awareness of equality and diversity issues is not always fully supported by staff. For example, young people’s use of derogatory language towards certain groups in society is not always challenged, although this is identified as an area of focus in care planning documentation. Although staff and young people have occasional key work sessions about people’s differences, it is difficult to see how young people are learning about gender, disability, sexual orientation, ethnicity, religious belief, language or faith.

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Quality of care

Young people have access to different activities to suit their interests. This has included go-karting, swimming and bike riding. Young people also enjoy being able to see their friends and maintain links with their local communities. Furnishings in the home have experienced damage recently, mainly through young people's poor behaviour. Although replacements, such as a new dining room table, have been sought, not all maintenance is completed quickly. Young people's bedroom doors have been marked with graffiti and kick marks, there are paint marks on the stairs carpet, and there is a broken toilet window. In addition, towel rails are broken in the bathrooms young people use. The home benefits from an extensive garden, however, it is not well maintained and there is a broken set of swings at the bottom of the garden. This does not help young people respect and value their environment or encourage a sense of belonging.

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Quality of care

Young people feel able to make a complaint, and where complaints have been made they have been dealt with in accordance with the home’s policy. The majority of complaints are followed up effectively, and practice has improved as a result of lessons learnt. For example, one young person complained about the administration of pocket money and there was a subsequent change to the system. Young people’s complaints are sensitively followed up with them, directly and by letter. However, complaints made by professionals are not always followed up with the same rigour. Where professionals, such as independent reviewing officers, have raised serious concerns about the home, this is not always treated as a complaint or followed up sufficiently.

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Safeguarding children and young people

The service is inadequate at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Incidents of young people going absent and missing from the home are infrequent. The home appropriately implements the agreed missing from care protocol. This means that staff have clear guidance as to the steps they should take on occasions when young people are missing from care. However, on one occasion, staff did not adhere to instructions left by a manager, which led to a young person going missing for a period of time. This demonstrates that the care and supervision provided for young people are not always sufficient.

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Safeguarding children and young people

Young people enjoy engaging in all sorts of activities such as bike riding and fishing. However, activity risk assessments held in the home are not sufficiently robust and lack sufficient detail. It is not clear if there has been any assessment of risk for one young person who goes swimming regularly. As a result of this, young people are vulnerable as staff have not been provided with sufficient guidance on how to keep them safe during these activities.

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Safeguarding children and young people

When young people's behaviour becomes agitated, staff use de-escalation and distraction methods to defuse the situation. Use of physical intervention in the home is low. Details are recorded in line with regulation, and a tamper-proof book has been used to record the two most recent incidents of physical intervention. However, previous records are not held in a tamper-proof form but in loose-leaf pages. This means an important record is at risk of being lost and tampered with.

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Safeguarding children and young people

On occasion, some young people's behaviour is challenging. Records demonstrate that young people have been involved in incidents of climbing on to the roof, letting off fire extinguishers and causing damage within the home. This indicates that the care and supervision staff provide for young people have not been sufficient. The acting manager has identified this shortfall and has taken steps to increase the staff supervision of young people at times of the day which are known to be difficult, such as night-time. However, to help manage young people’s behaviour during the day, internal doors are routinely locked. This is not a positive behaviour management strategy and does not allow young people free movement around their own home.

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Safeguarding children and young people

Although some young people have personal mobile phones, not all do, meaning that they do not have access to a telephone without reference to staff. This shortfall has been previously identified and a telephone has been ordered, however it is still not installed.

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Safeguarding children and young people

Suitable checks are carried out to ensure staff are suitable to work with young people. Periodic testing of gas and electrical systems ensures that risks to young people and staff are minimised. Fire checks are completed regularly and fire equipment is suitably maintained and serviced. Regular fire drills ensure that young people know what to do in the event of a fire. However, wedging open fire doors in unoccupied rooms undermines their effectiveness and reduces the safety of young people. A fire door self-closure was also identified as being broken during the inspection, although immediate action was taken to address this shortfall.

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Safeguarding children and young people

The home is not always secure from unauthorised access. An external door was observed as having been left wide open and unattended on several occasions during the inspection. The locking mechanism on the front door to the home meant that the home could be accessed without challenge. This meant the home was at risk from potential unauthorised access. However, this was rectified during the inspection.

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Leadership and management

The leadership and management of the children's home are inadequate .

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Leadership and management

The home does not have a Registered Manager. Although there is an acting manager in post, there is not an application in progress to register a manager with Ofsted. Several changes in management have created instability within the home. The acting manager has identified key areas for immediate improvement, such as changing how staff supervise young people and responding constructively to poor behaviour. The acting manager is working together with staff to raise standards. However, the effect of these changes is still to be seen.

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Leadership and management

The home has had significant changes to its staff and management teams since its re-registration. There has been successful recruitment. However, a large proportion of the staff team are new and have not yet had time to embed and consolidate the skills they have acquired during induction in order to become an effective team. The home is now fully staffed. New staff in particular are passionate and full of ideas. They have benefited from a good training and induction process and describe feeling well supported by existing members of staff during their first few shifts at the home. However, these significant changes in staffing have created inconsistency for young people.

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Leadership and management

Professionals give mixed views of communication from the home. Some state that communication is very good, with information being passed well between staff members. Others state that communication is poor, with some important information, such as significant changes in the management of the home, not being passed on. This does not indicate that partnership working is always effective.

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Leadership and management

The home's Statement of Purpose does not reflect the age range of the young people it intends to accommodate. This means placing authorities may not be clear about the aims and objectives of the service and the mix of young people’s age ranges in the home. In addition, changes to the Statement of Purpose have not been sent to Ofsted, which limits proper oversight of the home.

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Leadership and management

There is clear reporting of significant incidents, such as safeguarding concerns, to professionals, such as social workers and Ofsted. Records demonstrate clear actions are taken following incidents, and identified areas for improvement are swiftly addressed. For example, where shortfalls have been identified in staff supervision of young people, appropriate measures have been taken to help prevent reoccurrence.

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection and the evaluation schedule for the inspection of children's homes.

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