Children's Home run by Cambian Childcare Limited in Worcestershire

Unique reference number SC478134 Inspector Suzanne Young Type of inspection Full Provision subtype Children's home

p.1

Registered person Cambian Childcare Limited Registered person address Pinnacle House 2 Oakwood Square, Cheadle Royal Business Park CHEADLE Cheshire SK8 3SB Responsible individual Sharon Michelle Edney Registered manager Caroline Denise Nilsson-White Date of last inspection N/A 2 of 10 Inspection date 11/09/2014

p.1

Previous inspection N/A Enforcement action since last inspection none

p.2

Overall effectiveness inadequate

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

p.2

Overall effectiveness

This is the home's first inspection since it was registered by Ofsted in April 2014. The home has a permanent, qualified and experienced Registered Manager in place.

p.2

Overall effectiveness

The home is failing to provide an adequate level of care to young people. Staff are not successfully managing young people's behaviour or keeping them safe. Young people are admitted into the home with insufficient information to adequately inform impact assessments. Risk assessments are incomplete and fail to effectively safeguard young people. Staff are overwhelmed by managing crises in the home resulting in a high use of physical intervention. As a result, the home is not promoting positive outcomes or meeting young people's needs.

p.2

Overall effectiveness

Young people are not having their education needs met as they are not attending school, college or employment. Staff are failing to promote the health needs of young people. Young people have been administered inaccurate medication by staff and are not attending routine health appointments. Poor records mean staff have little knowledge of young people's health requirements.

p.2

Overall effectiveness

The manager's monitoring processes do not effectively review the quality of care and ensure safe practice is provided by the home. As a result, leaders and managers are unable to adequately understand the strengths and weaknesses of the home. 3 of 10 Ofsted is not being informed of significant events occurring in the home to be able to review the actions taken by the provider in response to serious incidents.

p.2

Overall effectiveness

There is an insufficient number of suitably qualified, experienced staff working in the home. The home has an inexperienced staff group with only three members of staff qualified to the required level. This has resulted in staff being unable to adequately care for some young people with very challenging behaviours. 4 of 10

p.3

Information about this children’s home

This children's home is registered to provide care and accommodation for four young people of either gender with emotional and/or behavioural difficulties. The home is one of many children's homes owned by this company.

p.4

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.

p.4

Reg. Requirement Due date

4 (2001) compile in relation to the children's home a written statement which shall consist of a statement as to the matters listed in Schedule 1 (Regulation 4 (1)) 07/11/2014

p.4

Reg. Requirement Due date

(2001) ensure the home is conducted so as to promote and make proper provision for the safeguarding and welfare of children and are not making proper provision for their care, education supervision and support of children accommodated there (Regulation 11(1)) * 07/11/2014

p.4

Reg. Requirement Due date

(2001) ensure the prompt referral to the local authority in whose area the children's home is situated of any allegation of abuse or neglect affecting any child accommodated in the children's home (Regulation 16 (2)) 07/11/2014

p.4

Reg. Requirement Due date

17B (2001) must with 24 hours of the use of any measure of control, restraint or discipline in a children's home a written record is made in a volume kept for the purpose specifying all matter in regulation (Regulation 17B (3)) 07/11/2014

p.4

Reg. Requirement Due date

(2001) shall promote the educational achievement of children accommodated in a children's home 07/11/2014 5 of 10 (Regulation 18(1))

p.4

Reg. Requirement Due date

(2001) ensure children accommodated in the home are encouraged to develop and pursue appropriate leisure interests (Regulation 18(2)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) shall promote and protect the physical, emotional and mental health of the children accommodated in the home (Regulation 20 (1)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) shall make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home ( Regulation 21 (1)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) ensure all part of the home and activities are so far as reasonably practicable free from hazards (Regulation 23 (a)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) ensure a sufficient number of suitably qualified, competent and experienced persons working at the home (Regulation 25(2)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) ensure a person is not allowed to work in the home unless full and satisfactory information is available to him in respect of each of the matters specified in Schedule 2 (Regulation 26 (3)(d)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) shall maintain in respect of each child who is accommodated a record which includes the information documents and records specified in Schedule (Regulation 28 (1)) 07/11/2014

p.5

Reg. Requirement Due date

(2001) notify without delay the persons indicated in column 2 of the table in Schedule 5 if any of the events in column 1 of the table takes place. (Regulation 30(1)). 07/11/2014

p.5

Reg. Requirement Due date

*These requirements are subject to a compliance notice

p.5

Recommendations

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

p.5

Recommendations

 ensure young peoples views, wishes and feelings are acted upon, in the day to day running of the home (NMS 1.1)  There are clear and effective procedures for monitoring and controlling the activities of the home. (NMS 21.1) 6 of 10

p.5

Outcomes for children and young people inadequate

Young people living in the home are not experiencing positive outcomes. This is because they are not having their health, education and emotional needs adequately met. Young people are not attending health appointments because staff are not effectively promoting the health of young people in their care. Staff have limited knowledge of the health requirements of young people because health plans are not in place or are incomplete. As a result, young people's welfare is compromised as they are not receiving the medical and health care they need.

p.6

Outcomes for children and young people inadequate

Young people's educational needs are also not being adequately met within the home. Management and staff have not sufficiently promoted the arrangements for young people's education in time for the start of the school term. At the time of the inspection no young people were engaged in education or employment. Young people are also not engaging in leisure activities in the wider community. This is because they are not encouraged by staff to join clubs or sporting activities in the local area. As a result, young people are not being adequately supported and enabled to resume their education and fulfil their potential.

p.6

Outcomes for children and young people inadequate

Young people are not supported to make or sustain positive attachments and develop in emotional resilience. Frequent changes in staff in the home has made it difficult for young people to form strong attachments. One young person stated, 'Staffing is chaotic, you don’t know who is on.' Young people are placed inappropriately in the home without adequate information to make informed decisions about the impact on the existing young people in the home. As a result young people have experienced placement breakdown and unnecessary moves. This impacts negatively on young people's ability to develop in emotional resilience and self-worth.

p.6

Outcomes for children and young people inadequate

Young people are not making a positive contribution to their home. Although they choose their activities and meals they do not participate in regular young people’s meetings to express their views about the running of the home.

p.6

Quality of care inadequate

The quality of care young people receive in the home is inadequate. Staff deployment has not been effectively organised which has had an effect on young people's continuity of care. As a consequence, young people are not enjoying positive and constructive relationships with staff and each other.

p.6

Quality of care inadequate

The management of behaviour between young people and towards staff is inadequate. Staff struggle to manage young people's behaviour and are 7 of 10 overwhelmed by managing crises in the home. As a result, there is a high use of physical intervention within the home. The recording of physical interventions is also inadequate and does not meet regulatory requirements. There have been occasions where young people have antagonised and assaulted each other. Staff are not effective in setting clear, consistent boundaries for young people to minimise negative behaviour and to engage positively with staff and each other.

p.6

Quality of care inadequate

The welfare of young people is not adequately promoted in the home. Young people do not have accurate and up-to-date care plans or placement plans in place. For example, one young person did not have any documentation from his placing authority, including care plan, placement plan, education plan, health plan or medical consent for 26 days following his admission. This means that staff do not have an adequate awareness of the individual needs of each young person in the home to care safely for them and to meet their needs.

p.7

Quality of care inadequate

The administration of medication to young people is inadequate and inaccurate. On one occasion a young person received the wrong medication and on another occasion too many tablets were given to a young person. The home has also retained medication belonging to a young person no longer living in the home. Entries have been made in the medication records with amounts crossed out and no signatures. The incorrect and inaccurate administration of medication potentially places young people at risk of significant harm.

p.7

Quality of care inadequate

The layout and facilities of the home are conducive with the purpose, aims and objectives of the service. It is appropriately located and maintained to a good standard. All young people are able to personalise their bedrooms. This gives young people a sense of belonging.

p.7

Keeping children and young people safe inadequate

Young people do not always feel safe in the home or feel staff keep them safe. Staff also confirm that there have been times when they have not been able to keep young people safe. Young people report staff using a disproportionate amount of force during restraints and making inappropriate comments to them. As a result, young people do not live in a home where they are safe and this significantly compromises the welfare and safeguarding of young people in the home.

p.7

Keeping children and young people safe inadequate

Young people are admitted into the home based on incomplete and limited information from placing authorities. Admitting young people into the home without adequate information and impact risk assessments potentially places young people of significant risk of harm.

p.7

Keeping children and young people safe inadequate

Individual risk assessments fail to effectively safeguard young people. Risk assessments do not address the risk-taking behaviours of young people as they do not adequately cover significant areas of concern or detail the measures staff need to 8 of 10 take to minimise these behaviours. Relief staff do not routinely read young people’s risk assessments to familiarise themselves with young people’s risk management strategies before taking them out on activities. This means that staff are not always adequately aware of young people’s risk taking behaviours to safely care for them. This has the potential to place young people at risk of harm because young people are cared for by staff who may not be fully aware of their individual needs.

p.7

Keeping children and young people safe inadequate

Inadequate records are completed when young people go missing from the home. Key information about young people’s missing behaviours are not captured or reviewed. Furthermore, it is not clear if staff at the home follow agreed protocols and take all necessary steps to ensure that young people are protected from harm. This potentially places young people at significant risk of harm and is detrimental to their welfare.

p.8

Keeping children and young people safe inadequate

All core and relief staff working in the home are appropriately vetted by the organisation. This is monitored by the manager to ensure staff are suitable to work with vulnerable young people. The manager, however, does not monitor the vetting of agency staff working in the home and is unable to demonstrate their suitability to work in the home.

p.8

Keeping children and young people safe inadequate

Young people participate in fire drills which means that in the event of a fire they know how to safely exit the home. Regular health and safety and fire checks are completed in the home. However, there have been three occasions when the tests of alarms and fire equipment have not been checked. This potentially places young people at risk of harm because defective alarms or equipment may hinder their safe evacuation from the home. Staff use their own cars to transport young people to appointments before the appropriate checks are undertaken. This is necessary to ensure the cars are safe and staff have the correct insurance. Young people are at risk of harm if cars are not adequately serviced or maintained.

p.8

Leadership and management inadequate

This is the home's first inspection since it was registered by Ofsted in April 2014. The home has a permanent manager in place. The Registered Manager has a number of years’ experience of working in and managing children’s residential care. In addition, the Registered Manager holds a suitable level vocational qualification in the leadership and management of children’s residential care.

p.8

Leadership and management inadequate

Leadership and management is inadequate because young people are not adequately safeguarded. Their behaviour is not managed effectively enough and their health and educational needs are not being met.

p.8

Leadership and management inadequate

The Registered Manager has reviewed the Statement of Purpose and young person’s guide to ensure that placing authorities, young people and their families understand the aims and objectives of the service. The Statement of Purpose, however, has not 9 of 10 been amended to accurately reflect those working in the home. As a consequence, the Statement of Purpose is not translated into practice.

p.8

Leadership and management inadequate

The Registered Manager has inadequate monitoring processes to effectively manage the home. The monitoring has not identified gaps in records and the poor and unsafe practice within the home. As a result, leaders and managers are unable to adequately understand the strengths and weaknesses of the home.

p.9

Leadership and management inadequate

The Registered Manager has failed to notify Ofsted of significant events that have occurred in the home. This means that the regulator has been unable to review the actions taken by the provider in response to serious incidents that have taken place.

p.9

Leadership and management inadequate

Although staff are receiving formal supervision they have not always felt equipped to adequately and safely care for the young people in the home. This is because there is an insufficient number of suitably qualified and experienced people working in the home. The home has an inexperienced staff group with only three members of staff qualified to the required level. Staff sickness has meant that on several occasions there has not been a qualified member of staff working on shift in the home. As a result, young people, some with very challenging behaviours, have not always had staff who could appropriately care for them. Website: www.ofsted.gov.uk

p.9

Leadership and management inadequate

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.

p.10

Judgement Description

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

p.10

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.10

Judgement Description

Adequate A service that only meets minimum requirements.

p.10

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.10

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.

p.10

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.

p.10