Children's Home run by Cambian Childcare Limited in Bedford

Unique reference number SC476251 Inspector Clive Lucas Type of inspection Full Provision subtype Children's home

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Registered person Advanced Childcare Limited Registered person address Pinnacle House 2 Oakwood Square, Cheadle Royal Business Park CHEADLE Cheshire SK8 3SB Responsible individual Victor Takadiwa Registered manager Arlene Winsome Taylor Date of last inspection N/A 2 of 10 Inspection date 18/06/2014

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Previous inspection N/A Enforcement action since last inspection none

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Overall effectiveness adequate

Outcomes for children and young people adequate Quality of care adequate Keeping children and young people safe adequate Leadership and management adequate

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Overall effectiveness

This home was re-registered under a new organisation on 22 February 2014. Since that time Ofsted have had one compliance case for the home. This was due to concerns coming from notifications, relating to behaviour management and risk prevention. The responsible individual was asked to look into the concerns and provide a response. The inspection was brought forwards to follow up on these concerns and assess the responsible individual's response. This is the first inspection since re-registration, so there are no requirements or recommendations to follow up.

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Overall effectiveness

At the time of the inspection there were no young people living in the home. It is closed for a period of up to eight weeks to allow for staff training. Two young people had ended their placements in a way that was not in line with their plans and a third had moved to another home in the organisation while this home was closed. The moves have not been ideal for the young people, causing them disruption. However there has been a recognition of the need to make changes in order to successfully meet young people's needs and robust action has been taken by the organisation. This is current work and at this stage it is not possible to assess how effective these actions will be.

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Overall effectiveness

The home has provided some good outcomes such as in the encouragement of young people's leisure interests, supporting their contact and consulting with young 3 of 10 people. Shortfalls have been identified in areas such as the assessment of new placements and providing staff appropriate and timely training. These have had a negative impact on young people. It is the organisation's pro-active response to these areas that has led to the overall effectiveness judgement of adequate. Further shortfalls were identified relating to some records, maintenance of emergency lights and the Statement of Purpose. 4 of 10

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Information about this children’s home

This service is privately owned. It is registered to provide care and accommodation for four children with emotional and behavioural difficulties.

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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 there is at all times, having regard to the size of the children’s home, the statement of purpose, and the number and needs of the children accommodated there and the need to safeguard and promote the health and welfare of the children accommodated in the home, a sufficient number of suitably qualified, competent and experienced persons working at the children’s home (Regulation 25(1)) 08/08/2014

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Reg. Requirement Due date

(2001) ensure that the children’s home is conducted so as to promote and make proper provision for the safeguarding and welfare of children accommodated there. This relates to having an effective process for assessing new placements and ensuring that information is identified in relation to any areas of risk (Regulation 11(1)(a)) 25/07/2014

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Reg. Requirement Due date

(2001) ensure that a written record is kept of the administration of any medicine to any child (Regulation 21(2)(c)) 25/07/2014

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Reg. Requirement Due date

17B (2001) ensure that the matters prohibited under Regulations shall not be used as disciplinary measures on children accommodated in a children’s 25/07/2014 5 of 10 home, specifically the imposition of any financial penalty, other than a requirement for the payment of a reasonable sum (which may be by instalments) by way of reparation (Regulation 17(2)(g))

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Reg. Requirement Due date

(2001) ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 are complied with in respect of the home, this relates to addressing concerns about fire safety equipment in a timely way (Regulation 32(1A)(b)) 25/07/2014

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Reg. Requirement Due date

4 (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, specifically details of any therapy provided. (Regulation 4(1)) 25/07/2014

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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 that children are supported during the transition to their new placeme (NMS 11.8) 6 of 10

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Outcomes for children and young people adequate

There are times when young people living at the home do make progress and achieve improved outcomes. However, this is not consistent and there have been times when placements have ended in ways that were not in line with young people's plans. This has a detrimental effect on the young people, but the organisation is currently taking action to address this. There have been times when young people's experience of the ending of placements has been less positive than it could have been due to a lack of sensitivity in relation to process and information sharing.

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Outcomes for children and young people adequate

Overall, young people do have their health needs met, however in some cases this is limited by the degree to which the young people will engage with staff and health agencies. They are encouraged to do so, but the ending of placements has limited the time for this to be achieved. Young people are registered with health services such as dentists, G.P.s and opticians and this does help to meet their health needs. There is a school, run by the organisation on the same site as the home. Young people show improved attendance at school while living at the home. Getting into a routine of school attendance will help young people to maintain their involvement and improve their chances of success in education.

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Outcomes for children and young people adequate

Young people are able to have contact with their families where this is in line with their overall care plans and in their interests. They are supported in this by staff. They are consulted while living in the home and have opportunities to raise any issues of concerns. This helps them to learn about co-operation and negotiation as well as providing safeguards as they can raise any issues around their care that they are not happy with.

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Quality of care adequate

Staff work to build positive relationships with young people and to some degree this is successful. However, there have been periods of very disruptive behaviour which have not been conducive to building strong relationships. The home has maintained its categories of registration since it was re-registered but, within these, there has been a shift in the profiles of young people who have been accommodated in the home. Staff say that they were not provided with sufficient training to prepare them for this at the time. The organisation has since recognised the need to provide this training and ensure that staff have the skills and experience to provide suitable care for young people. This recognition is positive, but the impact of the training has yet to be seen and judged.

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Quality of care adequate

The process for assessing the suitability of new placements and assessing potential 7 of 10 risk has not worked effectively in all cases. This has resulted in information on young people not being used to address important areas. However, staff do have a good awareness of young people's recorded individual needs and plans where these are identified. The records of the administration of medicines to young people are mostly clear and accurate, but there are some instances of the running total of medicines being wrongly recorded. This had not been identified in the monitoring of records. Lack of clear records and effective monitoring reduces the safeguards to ensure that young people receive the medicines they should.

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Quality of care adequate

Young people are given information on how to make complaints. They are also involved in constructive and purposeful meetings with staff, both as a group and, for those young people who have engaged, through individual work. Consequently, young people have opportunities to express their views and voice concerns. There have not been any complaints from young people since the home was re-registered. There is not a telephone in the home that young people can use without reference to staff. This removes an option for young people who wish to raise any concerns outside of the home. Staff identify and address young people's individual needs in relation to their identity. This helps young people to find out about their culture and make decisions about to what extent they wish to observe it.

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Quality of care adequate

Young people are encouraged to participate in activities and interests that help them to develop their self-esteem and to build sound relationships with people in the community. The rural location of the home provides a range of opportunities for young people. Equally, the proximity to towns provides opportunities for young people to participate in a further a range of interests and staff support young people in this.

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Keeping children and young people safe adequate

There have been times when young people in the home were not adequately safeguarded, but the organisation and the Registered Manager implemented new processes and provided additional guidance for staff. Staff are aware of these changes and had begun to implement them before the home closed. An example of this is the approach to managing some challenging behaviour. Staff responses to this had not been sufficiently firm and the advice from on call managers was not always helpful in supporting them. However, since the new guidance was produced, staff have begun to implement it and have experienced some success in addressing some of the behaviours. Staff recognise and reward positive behaviour by young people, which helps to encourage this behaviour. Records of sanctions are kept in a bound book. On one occasion staff used a financial sanction which is prohibited under the Children's Homes Regulations 2001. This had not been identified in the monitoring of

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Keeping children and young people safe adequate

Staff follow the agreed protocols and plans when young people go missing from care. This helps to ensure a consistent response to reduce the risks to young people when 8 of 10 they are missing. There are effective responses to safeguarding allegations of concerns. The Local Authority Designated Officer reports that they have not had concerns about how the home responds to such issues. Placing authorities say that the response to missing from care has been in line with agreed plans. Over time there have been reductions in the level of risk taking behaviours for some young people, but this has not been sustained. Staff are clear about the need and the process to report any concerns that they may have about colleagues. This provides a very important safeguard for young people, as it is the staff who see the quality of care of young people on a daily basis.

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Keeping children and young people safe adequate

There are processes and procedures in place to ensure that the home provides a safe and suitable environment for young people. This includes fire safety procedures such as routine drills and equipment checks. However, while most of this system is effective at reducing the risk to young people, there have been unacceptable delays in dealing with concerns about emergency lights. This reduces the overall effectiveness of the system to keep young people safe in the home.

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Leadership and management adequate

The home was re-registered on 22 February 2014. This is the third registration for this home since November 2012. The Registered Manager has been in post since 29 July 2013, she has been manager during all three registrations. She is currently studying for a Children and Young People Services level 5 award. She has a level 4 Registered Manager’s Award in Adult services This is relevant to her management role, but does not cover areas of child care, which the more relevant Children and Young People award will. She has significant experience in social care and counselling. The majority of this is with adults, but it does include experience with children and young people.

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Leadership and management adequate

The management of the home and those in the wider organisation have identified issues within the home which they have taken action to address. This is a positive step to improve outcomes for young people, but it is in its early stages. The commitment they have shown in temporarily closing the home and providing training and opportunities for staff to gain experience in other homes is significant and shows an awareness of the strengths and weaknesses of the home.

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Leadership and management adequate

The Statement of Purpose for the home is unclear in the references to therapy and services that are provided to young people. Consequently, placing authorities are unclear exactly what services the home offers. The home provides a pleasant comfortable and domestic style environment for young people to live in. It is well maintained and furnished.

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Leadership and management adequate

Training is provided for staff, and they indicated that there has been an increase in training opportunities since the re-registration. However, as covered in the section on Quality of Care above, some training has not been provided in a timely way to 9 of 10 support staff in providing good care for young people. This is now being addressed by the organisation. Staff speak positively about the level of support and supervision that they receive. Other agencies, such as placing authorities, say that there is good communication between them and the home. This is important in providing consistent care and assessing how well young people's needs are met. Website: www.ofsted.gov.uk

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Leadership and management adequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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