Children's Home run by Cambian Childcare Limited in Middlesbrough

Unique reference number SC454266 Inspector Nicholas Murphy Type of inspection Full Provision subtype Children's home

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Registered person Cambian Childcare Limited Registered person address Pinnacle House 2 Oakwood Square, Cheadle Royal Business Park CHEADLE Cheshire SK8 3SB Responsible individual Lorna Ann Fearon Registered manager David Thomas Lambert Date of last inspection 13/01/2014 2 of 9 Inspection date 05/11/2014

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Previous inspection good progress Enforcement action since last inspection there has been no enforcement action since the last inspection

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Overall effectiveness good

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

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Overall effectiveness

The home provides a good standard of care for young people. The staff group is stable with little turnover, providing consistency and predictability for young people. Staff meet the needs of young people in line with detailed and purposeful care plans which are closely tailored to individual circumstances. However, despite the best efforts of staff in supporting young people, their education and health outcomes are not consistently good. Some young people have very complex emotional needs and as a result are still developing social skills, confidence, and resilience.

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Overall effectiveness

Staff encourage and enable young people to share their views and opinions freely. They are able to exercise choice over many areas of their lives. The home provides a range of leisure opportunities which stimulate young people’s interests and give them new experiences. One young person said, ‘I’d never been to the theatre before I came here but I really enjoyed it when staff took me.’

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Overall effectiveness

Relationships between staff and young people are generally good, young people frequently choosing to spend time with staff. Young people trust staff to act in their best interests, to advocate on their behalf, and to listen to them when they are troubled. 3 of 9 Young people say they feel safe. The home has a high-profile stance on bullying which is very effective. Incidents of young people missing from home have reduced. Staff manage challenging behaviour very well, containing aggressive or violent outbursts with calmness and skill. The number of incidents of restraint is therefore low and continuing to decline.

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Overall effectiveness

Two recommendations have been made in relation to minor shortfalls. 4 of 9

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Information about this children’s home

The home provides accommodation for up to four children who may have emotional and/or behavioural difficulties. The home is operated by a private company.

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Inspection date Inspection type Inspection judgement

13/01/2014 Interim good progress 21/11/2013 Full good

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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 staff have appropriate training, supervision and support if they are required to supervise and facilitate contact (NMS 9.2)  ensure that the home provides a comfortable and homely environment and is well maintained and decorated, specifically that the bathroom windows provide adequate privacy. (NMS 10.3) 5 of 9

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Outcomes for children and young people adequate

Most young people view their placements here as a positive improvement on their previous circumstances. They are developing greater self-confidence and have good relationships with staff. In general, young people are achieving progress against the goals set out in their care plans.

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Outcomes for children and young people adequate

Young people are well-informed about how to keep themselves healthy. Mostly, they make positive lifestyle choices, although some continue to smoke and a minority use substances. Young people make some progress in improving their emotional well- being, and develop a better understanding of their family histories and circumstances.

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Outcomes for children and young people adequate

Some young people struggle to maintain full or punctual school attendance, though others do well in this respect. All, however, are doing better in both school attendance and attainment since their admission here. Older young people who have left school are positively engaged in further education and training placements.

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Outcomes for children and young people adequate

Young people participate well in the local community. They see friends and family on a regular basis and derive benefit from this contact. Some have also developed an awareness of the needs of people in society who are disadvantaged. For example, one young person has taken part in charity fund raising events.

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Outcomes for children and young people adequate

Young people are able to practise skills which will be useful to them in adult life. They use the kitchen to make meals or bake cakes and take responsibility for washing their clothes. One older young person has been allocated a budget to buy food staples which she keeps in her own fridge in the kitchen. She is also paying a weekly amount to the home in lieu of electricity and gas charges, in order to prepare herself for the reality of independent living.

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Quality of care good

In the main, staff and young people enjoy good relationships. Young people often choose to be with staff and like the attention this gives them. One young person said, ‘I really like the staff, they make me laugh. When I get angry they spend time with me and help to distract me from my feelings.’ Young people also get on well with each other, respecting each other’s need for their own space while also enjoying group activities and outings.

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Quality of care good

Weekly meetings enable young people to express their views about aspects of life in the home. Suggestions are listed on a board in the staff office so that all the staff can consider what the young people are saying. In addition, there is a formal complaints 6 of 9 process. This has been used only once since the last inspection. Nevertheless, the way in which the Registered Manager dealt with it demonstrates the home’s commitment to taking the views of young people seriously.

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Quality of care good

Each young person’s care plan is detailed and kept up to date by the key worker. They are consistent with the local authority plan and decisions made at looked after reviews. Plans are highly individualised and centred on the needs of each young person. Daily reports and weekly and monthly summaries assess the progress that each young person is making. These are discussed in staff meetings and so enable staff to be consistent in taking action to address difficulties. Staff involve young people in their own plans through regular one-to-one sessions. Progress is praised and, where there are setbacks, staff encourage the young person to suggest their own ways of moving forward.

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Quality of care good

The home ensures that young people have access to all the necessary health services. There are good links with the local child and adolescent mental health service (CAMHS). Working with the registered provider’s own trainee psychologist, this partnership helps to support young people with specific emotional health needs. Some young people choose not to attend health checks, for example those who have a phobia about the dentist. However, staff continue to persist in encouraging them, by seeking out dental surgeries which specialise in children with this problem.

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Quality of care good

The home works closely with schools and training providers to ensure that young people can derive the maximum benefit from education. When there are difficulties in school, staff liaise with head teachers and others to resolve them speedily. They also advocate for young people and help teaching staff to understand that looked after young people often need a more sensitive and tolerant approach.

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Quality of care good

Staff enable young people to enjoy a wide range of activities. These include physical pursuits such as swimming and table tennis as well as outings to the cinema and trips to amusement parks. Visits to the theatre are very popular. Young people have gone on holiday to London, a very enjoyable experience which also made them aware of the diversity of cultures compared to their home area. A social worker said, ‘The home has been good at promoting and developing the young person’s interests. Staff have been really creative, for example by finding a youth club which fits the young person’s needs and which they really enjoy attending.’

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Quality of care good

The home is maintained to a high standard, spacious, comfortable and well-furnished and decorated. However, the bathroom windows are not sufficiently opaque and so do not provide the required level of privacy. Young people’s investment in the home is demonstrated by the way in which they decorate their rooms with personal items and photos. One young person’s room has a small adjoining area which has been fitted out as a sensory space, with soothing lighting. 7 of 9

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Keeping children and young people safe good

The home’s robust approach to risk management ensures that young people are protected from harm. Thorough assessments of potential risks to young people’s safety are updated on a regular basis. Checks on the home’s equipment and services, and arrangements for fire safety, are sound. Records of staff vetting checks are in place, giving assurance that adults who work in the home are suitable. Individual risk assessments on each young person take account of their particular needs and behaviours. They clearly identify actions that staff must take to reduce the risk of harm and so keep young people safe. The range of measures that staff have in place to protect young people is clearly effective. Young people consistently say that they feel safe within and outside the home.

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Keeping children and young people safe good

The frequency of occasions when young people go missing varies, but the general trend is downwards. The home has good relationships with the local police to manage incidents and to ensure that the period of the young person’s absence is minimised. Recording of missing episodes is very detailed, and includes a discussion with the young person on their return. This helps young people to reflect upon the potential risks attached to such behaviour and understand the concerns of staff when they are not where they should be.

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Keeping children and young people safe good

For most of the time young people are well behaved and adhere to the reasonable rules within the home. At times, however, young people can be extremely challenging and occasionally violent. Staff are skilled at managing this kind of behaviour. They respond to aggression calmly and patiently, sometimes ignoring difficult behaviour while maintaining discreet monitoring of the situation. A parent said, ‘The home provides a regime which isn’t negotiable, it gives my child a lot of structure. The staff can handle my child’s behaviour, they won’t give in.’ This approach is almost always effective, but occasionally staff need to use restraint to keep people safe. Following such incidents, both young people and staff involved are debriefed. This helps young people to reflect on their behaviour and to think of more acceptable ways to deal with disappointment or frustration. One young person said, ‘Staff were right to restrain me for my own good, and they talked me through it

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Keeping children and young people safe good

afterwards.’ For staff, such reflective discussion enables them to evaluate how they dealt with the incident and think about what else, if anything, could have been done to manage it.

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Keeping children and young people safe good

As a result of this considered and child-centred approach to behaviour management, the number of restraints has reduced. At times, staff have to involve the police when the risk to staff and others cannot be safely contained. Even in these extreme situations, staff will always seek an outcome which does not result in the young person being criminalised. For lower level misbehaviour, staff can use sanctions. However, these are applied sparingly, and only when staff feel that they will result in a lasting impact on the young person’s behaviour. 8 of 9

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Leadership and management good

The Registered Manager has been registered for just over a year, but has experience as manager in other settings and is suitably qualified. He leads his staff team effectively, ensuring that the child-focused ethos of the home is visible, understood, and shared by staff.

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Leadership and management good

One social worker acknowledged the contribution the staff make to improving young people’s lives, commenting, ‘They understand the young person’s needs really well, staff advocate very strongly on their behalf, the staff are the experts, it has made for a very positive placement.’

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Leadership and management good

The home has good capacity for further improvement. One recommendation was made at the last inspection in respect of young people’s access to toilet and bathroom facilities. This has been addressed by designating the former staff sleep-in room (with en-suite) as a young person’s room. It is also planned to convert the utility room to an additional toilet, further improving the comfort of young people.

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Leadership and management good

Monitoring of the home’s operation is robust. The external visitor’s reports are thorough and provide recommendations for action to address any deficiencies. The Registered Manager’s own monitoring reports take full account of the views of young people, parents and social workers, enhancing the assessment of the home’s strengths and areas for development. They provide a good analysis of how well the home is supporting young people to achieve better outcomes.

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Leadership and management good

Most staff have been at the home since it opened, providing a stable, consistent and experienced team. One member of staff recognised the significance of this, saying, ’This is a settled staff group, we work well together, we support each other and know the young people really well.’ Although most staff are not yet qualified, they are making good progress to achieve the required qualification. Support for staff through formal supervision is good. Additionally, staff have access to a range of training opportunities which increase their skills in supporting young people with complex needs. However, supervising contact between young people and their families is one area of work where staff have not received training. This means that they may not be able to fully assess and evaluate the quality of contact and so ensure that it continues to be beneficial for the young person. Website: www.ofsted.gov.uk

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Leadership and management good

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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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