Children's Home run by Cambian Childcare Limited in Warrington

Unique reference number SC456800 Inspector Pamela Nuckley 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 Michael Ore Registered manager POST VACANT Date of last inspection 21/01/2014 2 of 13 Inspection date 19/11/2014

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Previous inspection satisfactory progress Enforcement action since last inspection There has been no enforcement action since the homes last inspection.

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Overall effectiveness good

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

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Overall effectiveness

Young people have made good progress. One young person said, 'Due to the good support I have received here I am ready for independence. I feel confident that I have the skills to look after myself.’ A professional commented, ‘…… (name) has made excellent progress over the years. Significantly in being able to keep themselves safe. This is down to the excellent work done with them in understanding risks.’ As a result, young people say that they feel safe and protected within the home. They say there is a culture of openness and trust, and that they can talk to any member of staff about worries or concerns and feel confident that they will be listened to. This practice has enabled young people to raise issues in a mature way with outside agencies and they have seen the benefits of doing this.

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Overall effectiveness

Young people have benefitted from a stable and experienced staff group. Staff demonstrated their commitment to addressing welfare issues that supports young people living in this home. The staff work closely with other services to promote positive outcomes for young people. This is especially evident in ensuring young people receive a good education and have aspirations for their future.

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Overall effectiveness

The Registered Manager has recently left. The company has been proactive and in taking steps to alleviate disruption within the home. They ensured that a suitable 3 of 13 acting manager was in place before their departure. Therefore, a good handover was given. The acting manager has submitted an application to Ofsted. Young people and staff were very complimentary about her. One young person said, ‘She is great. She has spent lots of time with us. She stays for tea and into the evenings getting to know us.’ A member of staff said, ‘In the short time she has been here she has already discussed development opportunities with me and this has given more confidence in my role.’ The acting manager has a clear focus on future developments. She has audited the homes paperwork and has an action plan in place. This plan identified some of the shortfalls raised within this report.

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Overall effectiveness

Areas for further improvement relate to: Regulation 33 reports robustly monitoring the quality of care in the home and placement plans being up dated. In addition to this, health and education plans require updating and records overall need to demonstrate the progress young people have made. 4 of 13

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Information about this children’s home

The home is owned by a national provider. It provides care and accommodation for up to two young people with emotional and behavioural difficulties. It is also registered as a school.

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Inspection date Inspection type Inspection judgement

21/01/2014 Interim satisfactory progress 16/05/2013 Full good

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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 there is a permanent record which includes the information, documents and records specified in Schedule 3. This is specifically in relation to updating placement and care plans (Regulation 28 (1) (a)Schedule 3) 31/12/2014

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Reg. Requirement Due date

(2001) ensure that the quality of care is robustly monitored within the home. (Regulation 33 (3) (b)) 31/12/2014

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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 young people's physical, emotional and development needs 5 of 13 are promoted. This is specifically in relation to updating the health plan (NMS 6.1)  ensure that young people's learning is promoted and supports their development. This is specifically in relation to updating young people's education plans (NMS 8.1)  ensure that all records are clear, up to date and contribute to an understanding of a child's life. (NMS 22) 6 of 13

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Outcomes for children and young people good

Young people have come to this home in a planned way. Placement planning meetings take place and reviews are held within timescales. The home also undertakes their own impact risk assessments that help to ensure that the home can meet young people’s needs. However, the local authority placement plans have not always been updated from the young person’s prior placement. There have been delays in securing this information with, in one example, a period of five months elapsing before the home chased this. This has the potential to impact on the care that young people receive and staffs understanding of the plan for them.

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Outcomes for children and young people good

The homes individual placement plans, show that young people are consulted about their care and they reflect their individuality. Young people say that they are fully consulted on their care and have opportunities to discuss daily living and future plans. One young person said, ‘I have just picked new wallpaper and paint for my room. I am also designing how Christmas decorations will reflect our style.’ Another said, ‘I was able to choose the college course that I wanted to do.’ This ensures that young people feel valued and can influence decisions on their care and future aspirations. They continued to say that they are actively encouraged to make positive choices and to use every opportunity to develop and reach their individual potential.

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Outcomes for children and young people good

Young people say that relationships between them and staff are very good. Young people were keen to relay that they feel respected, valued and well cared for. One young person said, ‘I am leaving soon and I have made good friends with the other young person here. I will miss her but I am confident that she will be well cared for.’ Both young people stated that they have confidence in the staff team who look after them.

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Outcomes for children and young people good

The home actively acknowledges racial, religious, gender and other differences and encourages open discussion and learning on such issues. Young people are assisted to develop a healthy sense of self and to recognise the rights and feelings of others. This enables them to more easily engage with the wider community and with each other. As a result, young people say that bullying does not happen in this home.

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Outcomes for children and young people good

The home offers young people a wide range of activities and encourages them to pursue their own particular interests. This gives the young people the opportunity to have new experiences and learn new skills. One young person said, ‘We went to a holiday village in the summer holidays, it was great. I love going to the cinema and watching funny films.’ Another young person said, ‘I’m on an independence plan and on a budget. I prefer to do art projects in the home, watch television or go out with friends. I not only prefer to do these things, it is more realistic, as I will not have the money to do loads when I leave.’ As a result, young people engage in activities that are individual to their needs. 7 of 13 Staff guide and encourage young people in their education, with good results. One young person said, ‘I left school with five exam results but some were not as good as I hoped. Therefore, I have picked a college course that will help with my chosen

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Outcomes for children and young people good

career in art but I am also resitting my maths and English. Another young person said that they did not like school but acknowledge that education is important and that staff encourage not only their regular attendance, but also offer practical support. For example, helping with homework. Therefore, young people’s attendance is improving, they feel they are doing well and have ambitions for their future.

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Outcomes for children and young people good

Young people engage and learn about a range of health-related issues. They have achieved consistent improvements to their health and fitness and are learning the importance of a well-balanced diet and exercise. For example, one young person has enrolled in a gym and another now takes responsibility for administering their own medication. This ensures that young people understand the importance of good health and that they are preparing for independence. In addition to this, all young people have had their emotional health assessed by the company’s Children and Adolescent Mental Health Service (CAMHS). The CAHMS team also attend staff meetings to discuss strategies and current behaviours. This ensures that care is given to raise young people’s self-esteem. One young person has completed life story work with the local authorities CAHMS team. She said this has given her a better understanding of her history and has led her to research issues that explain how

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Outcomes for children and young people good

traumatic experiences can impact on their health and behaviour. Documented key working sessions show how this positive work has improved outcomes for young people. But these improvements or any actions identified are not consistently reflected in the young people’s health plans. This has the potential to impact on young people’s health and staffs understanding of their health needs.

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Outcomes for children and young people good

Young people benefit from appropriate contact, in line with their placement plan, with family, friends and other people who are important to them. Young people are supported by staff whenever necessary during family visits. Placement plans and contact records make explicit the authorised arrangements for contact between each young person, their family, friends and their social workers.

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Outcomes for children and young people good

Young people say they have learnt skills over time to ensure that they are ready for independence. One young person said, I have been here for nearly three years. In the last year I have been working on independence skills such as cooking, sewing and completing curriculum vitae. I do everything for myself and I am ready.’ They continued to say that they have been fully included, through reviews on planning their independence. A social worker said, ‘Due to the excellent progress, skills and confidence that …..(name) has made we were looking to move them straight into independence at an early age.’ But a recent development has changed this plan, due to unknown risks. The young person is not happy about this and has contacted an advocate to help her challenge the local authority on this decision. Staff say that they have offered their support and continue to do so but the young person wishes to do this herself. The young person said, ‘I need to do this for myself because I will not

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Outcomes for children and young people good

8 of 13 have anyone to do this for me when I leave.’ This shows that young people have the confidence to raise issues and are applying their independence skills.

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Quality of care good

The staff place the welfare of each young person at the centre of their care. They encourage relationships based on trust, honesty and respect which leads to a mutual understanding. This therefore enables them to work with young people to reach their full potential.

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Quality of care good

Encouraging young people's educational and personal development is recognised as being central to the life of the home. Strong links have been forged between the home and educational provisions. As a result, education attendance is improving and young people have aspirations for their future. Their progress is recognised and celebrated through an incentive chart and with personal items. However, education plans do not reflect the progress that young people have made or that any actions that were initially identified have been carried out. For example, the plan says that a computer is needed. The computer was purchased over six months ago but it is unclear as to what impact this has made and how this has improved outcomes for young people. In addition to this, the plans contain lots of statistical information that has not been effectively evaluated. This does not ensure that the home can evidence the good improvements that young people have made within education.

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Quality of care good

Young people live in a healthy environment where their physical, emotional and psychological health is promoted and where they are able to access services, including health agencies and specialised services, to meet their health needs. Young people are encouraged to take responsibility for their health and lifestyle choices. Effective policies and procedures concerning the storage, handling, administration and disposal of medication safeguard young people's welfare. All staff have received up-to-date safe medication and first aid training. As a result, young people receive their medication in line with their prescription. The home has appropriate consents in place that allow for emergency treatment if needed. Appropriate support from medical professionals is provided. A good level of liaison takes place between staff and these professionals to ensure young people's health needs are fully met. Specific health specialists are invited to staff meetings. For

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Quality of care good

example, a nurse has attended to refresh training in administering an Epipen for a young person who has suffered from anaphylactic shock in the past. As a consequence, all staff understand the signs, symptoms and how to administer the medication. Young people confirm that staff support them to attend medical appointments and that all health issues are dealt with promptly and sensitively.

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Quality of care good

The atmosphere within the home is normally very relaxed and young people confirm that they enjoy living here. Staff respond to any grumbles or concerns quickly and 9 of 13 resolve them at the first stage. Young people confirm that they rarely need to make a formal complaint because staff listen and respond to them appropriately. Young people are aware of the home's internal complaints procedure and feel confident that complaints will be addressed effectively. The young people's guide to the home gives comprehensive information about a variety of external organisations that they can contact if they wish to. One young person has been able to raise a concern independently because of the good practices in place. There has been one complaint recorded within this inspection year. The young person confirmed that this was dealt with quickly and by someone independent from the home. They also said that they were kept informed of the progress of the complaint, were happy with the outcome

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Quality of care good

and received a letter which outlined the findings. This means that young people are confident to raise any concerns they may have and feel respected by the process.

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Quality of care good

The location of the home provides good access to a range of community resources. Each young person has their own bedroom which they are encouraged to personalise. Their bedrooms reflect their interests.

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Keeping children and young people safe good

Young people say they are safe. One young person said, ‘I have learnt so much over the years. Staff have discussed lots of safety issues with me and I have been able to keep myself safe because of this.’ Another young person said, ‘Staff are doing things with me so I know how to keep myself safe. I am learning about safety on line.’ A social worker stated: 'I would say the one area that this home does extremely well in, is the excellent safeguarding procedures in place and work undertaken with young people.’ They are now making more positive choices and this is down to the hard work staff have done.’ This shows that young people take full advantage of all the support being offered to keep them safe and are making positive choices.

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Keeping children and young people safe good

Staff have access to clear information, support, guidance and advice about child protection and safeguarding requirements. Staff understand their responsibility to protect young people and are able to demonstrate what actions they would take to keep young people safe. Staff are confident about their responsibilities and know what to do if an allegation is made about the home's manager or another member of staff.

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Keeping children and young people safe good

The privacy of young people is respected and their information is confidentially handled. Young people's care records are maintained securely and their contents are not discussed inappropriately. Staff are aware of those young people who enjoy quiet time in their rooms. Staff ensure that they do not enter young people's rooms without knocking. However, a good balance is achieved between respecting young people’s wish for privacy and ensuring their safety.

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Keeping children and young people safe good

Young people who had a history of being reported missing from home, prior to being placed here, have not been reported missing from home for a significant period of 10 of 13 time. There has been one episode and that was when they were first placed. The home follows the local authority’s policy and procedures regarding young people who leave the home without staff permission. The home has established very good protocols and reporting systems with the local constabulary and with the local safeguarding board. Young people confirmed that they are actively discouraged from having unauthorised absences. Good individualised risk assessments show the vulnerability of young people and they are reviewed frequently. The missing from home police co-ordinator has attended a staff meeting to keep staff up to date with legislation and protocols. Due to these good arrangements, coupled with the good activities on offer and individual discussions with young people, there has been a

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Keeping children and young people safe good

significant reduction in young people being reported missing from the home.

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Keeping children and young people safe good

Young people are encouraged to behave well and to establish, achieve and maintain levels of behaviour that are socially acceptable and that will sustain them in the wider community. Staff are acutely aware of the need to balance their interventions with positive feedback about young people's achievements, rather than just punishing poor behaviour. Young people said that their behaviour had improved because there are good incentives. This is reflected within the minimal use of sanctions. In addition to this, effective monitoring by the manager, has led to some sanctions being overturned because they were either too harsh or not relevant to the misdemeanour. As a result, young people said that they are fully included in any consequence they are given and that they are fair.

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Keeping children and young people safe good

Staff are fully trained in physical intervention techniques to support young people if required. The good relationships staff have with young people and the de-escalation techniques they use have been instrumental in effectively managing unacceptable behaviour. Therefore, there have been no incidents requiring physical intervention since the home’s last inspection.

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Keeping children and young people safe good

The home has in place established systems and structures to maintain safe practices and fulfil health and safety obligations. All services and utilities are inspected regularly. Fire safety is given appropriate importance and fire drills are carried out routinely. This means that young people and staff know what to do in the event of an emergency.

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Keeping children and young people safe good

Young people benefit from a stable staff team. There has been only one new appointment since the last inspection. This ensures that young people are cared for by a consistent staff team. The home has a robust recruitment policy and practice. All visitors to the home are monitored and sign in and out of the visitors’ book. These systems reflect the importance of the young people's safety.

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Leadership and management adequate

11 of 13 The Registered Manager left in November 2014. Ofsted were informed promptly along with the interim arrangements for managing the home. An acting manager has been in place for six weeks. Ofsted is currently processing her application for the Registered Manager’s position. She has the National Vocational Qualification (NVQ) at level 3 and is currently concluding the level 5 qualification in leadership and management. In addition to this, they have a degree in psychology and are completing a Doctor of Philosophy (Ph.D.) in Child Sexual Exploitation (CSE). She has several years’ experience of working with young people with behavioural difficulties as part of a clinical assessment team and as a deputy manager within a children’s home. She has also applied to manage another two homes within the company that are in close proximity to this home. There is a suitably qualified and highly experienced deputy manager who deputises in her absence.

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Leadership and management adequate

The acting manager is actively involved in the day-to-day operation of the home and has clear expectations that the staff team will achieve the best possible outcomes for all young people in their care. One young person said, 'This new manager has taken her time to get to know us. We appreciate this. It shows she is not just about paperwork.’ This shows that a good hand over has impacted on the relationships formed.

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Leadership and management adequate

Good communication is a feature of the home which enables staff to be well informed about daily events, routines and the progress of each young person. This is supported by excellent feedback from other professionals involved in the care of the young people. All professionals said that: the communication at this home is excellent; staff are very knowledgeable about the young people in their care; young people are fully consulted about their care; and the relaxed, homely and stimulating environment has brought about positive changes in young people.

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Leadership and management adequate

The provider meets all of the aims and objectives in the home's Statement of Purpose (SOP). Staff are competent and have a good understanding of their responsibilities. Most staff are qualified at National Vocational Qualification level 3 in caring for children and young people. Two members of staff are completing an equivalent qualification. Staff are well supported within the home and staff meetings are held regularly. Staff duty rotas and the manner in which staff are deployed confirm that the home keeps sufficient staff on duty at all times. Staff consider that the manager involves them in decision making. They feel that their opinions are valued and that they are encouraged to speak out if they have concerns, particularly in respect of young people's care or welfare. This means that young people experience a consistent approach that is personalised to meet their individual needs. Staff receive regular training that covers all recommended areas.

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Leadership and management adequate

Staff know and understand the stated aims and objectives of the service and are committed to meeting them. The commitment from staff is a strength of the home. For example, most staff absences are covered within the existing team, or by cover staff who are already known by the young people to ensure their continuity of care. All staff spoken to say: they enjoyed coming to work; that they had a strong team 12 of 13 who are committed to ensuring the safety of and good outcomes for young people; and that they thought the training offered and support given was very good.

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Leadership and management adequate

The acting manager is actively monitoring and evaluating the practice standards of staff, the quality of services being provided, and the impact the home is having on the care of young people. Supervision of staff is given a high priority. All staff have received annual appraisals. Staff are fully supported in their role and good have opportunities to develop within the organisation.

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Leadership and management adequate

At the homes last inspection two requirements and five recommendations were set to secure improvements. These have mostly been met. The SOP has been reviewed and reflects the home. All staff receive supervision regularly and all appraisal have been completed. This ensures that staff understand their role and have the opportunity to discuss developmental needs. Young people receive individual care that promotes all aspects of their individual identity because they are consulted on their care and have opportunities to express themselves. Any restrictions to contact are highlighted within young people’s plan and with the local authorities guidance and young people’s understanding. Therefore, young people are safeguarded. The home is well maintained. Young people are encouraged to keep the front of the home clean and free of litter. Effective evaluation of the negative consequences record shows that the

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Leadership and management adequate

acting manager is identifying trends and patterns within the homes records. In addition to this, the home was asked to ensure that placement plans were monitored and up dated. Although this was in relation to a past resident, a young person in placement does not have up to date plans. Therefore, this has been raised to a requirement.

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Leadership and management adequate

External monitoring of quality of care within the home is frequent. Ofsted receive these reports timely. However, this system has failed to pick up that several documents have not been updated for a significant period of time. For example, one young person’s placement and care plan relate to their last foster placement and heath and educational plans say they have been reviewed but no additional information has been added or show that actions have been implemented. This impacts on the overall records of the home because they do not show how the good outcomes for young people have been achieved. However, as part of the acting manager’s review of the service, she had identified these areas of improvements needed within her development plan.

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Leadership and management adequate

The acting manager has a development plan in place. She said, ‘My priority was to get to know the staff and young people well. Therefore, I have spent time with young people and having one to one sessions with staff. It is evident that young people have progressed and their life chances have improved but staff do not evidence that this is because of what they do. This is my next step.’ This shows that the acting manager is aware of the shortfalls around the homes records. These shortfalls are not currently impacting on the good outcomes for young people but have the potential to do so. 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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