Children's Home run by Cambian Childcare Limited in Dudley

Good

The children‟s home provides effective services that meet the requirements for good.

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The children’s home provision is good because:

 Young people feel very safe.  Young people enjoy the well-maintained and homely environment.  Young people find staff to be warm and nurturing, with high expectations of what young people can achieve.  Staff are vigilant, well organised, and energetic.  Staff help young people to continue to practice and celebrate their religion.  Young people‟s transitions into and out of the home are very well planned. Young people look forward to moving in after their introductory visits and continue to feel well looked after when they move out and on to semi- independence.  Young people see their parents, relatives and people who are important to them because staff and managers have a „can do‟ approach.  Young people understand their care plans: they are taking part, learning how to be more in control of their behaviours, and are more positive about the future.  Staff work very well with social workers, specialist police and their in-house

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The children’s home provision is good because:

psychologist. This helps to make young people as safe as they can be at times when they go missing and when self-harm behaviour persists.  The manager and her deputy are energetic and well organised in leading the daily operation of the home. They ensure that good teamwork maximises the help and protection young people require. However, the wider organisation has not provided sufficient support to the manager, particularly with respect to staff retention, training, and professional development. One other area of improvement involves assessing self- administration of medication.

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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 (England) Regulations 2015 and the „Guide to the children‟s homes regulations including the quality standards‟. The registered person(s) must comply within the given timescales.

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Requirement Due date

Ensure that the employment of any person on a temporary basis at the children‟s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 31(1)) 20/08/2016

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Requirement Due date

Ensure that individuals recruited to work in the home have the appropriate experience, qualification and skills, and are mentally and physically fit for the purposes of the work that they are to perform. (Regulation 32(3)(b) and (c)) 20/08/2016

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Requirement Due date

Ensure that the registered person provides for all employees to undertake appropriate continuing professional development and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(a) and (c)) 20/08/2016

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Requirement Due date

Ensure that the registered person completes a review of the quality of care provided for children (“a quality of care review”) at least once every six months. (Regulation 45(1)) 20/08/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Ensure that the manager continues to develop skills in anticipating difficulties and reviewing incidents, such as learning from disruptions and placement breakdowns. They are responsible for proactively implementing lessons learned and sustaining good practice. („Guide to the children‟s homes regulations including the quality standards‟, page 55, paragraph 10.24)

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Recommendations

 Ensure that children who wish to keep and take their own medication are supported to, if they are able to do so safely. Staff should be mindful that children holding their own prescribed medication must only use it for themselves in accordance with the prescription. („Guide to the children‟s homes regulations including the quality standards‟, page 35, paragraph 7.16)

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Information about this children’s home

The home is part of a large limited company. It provides care for up to five children and young people with emotional and behavioural difficulties. The home specialises currently in helping young people who have associated mental health difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

11/02/2016 Interim Improved effectiveness

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Good

Staff create a very homely atmosphere and maintain the home well so that young people enjoy living here. Staff are vigilant and well organised. Enlarged photo canvasses and photo frames decorate the walls, showing young people enjoying recent trips out and celebrations. Young people have their bedrooms just how they like them. Young people and staff frequently eat together at the dining table. Young people enjoy playing and relaxing in the garden. They proudly share the cakes they make. Young people have progressed significantly in their ability to participate with activities, given the restrictive secure environments that they previously lived in. One young person‟s social worker said: „This has just been the most positive experience ever – their approach is entirely different – they are letting her live normally – having items around her and experiencing real life; we did not envisage that she could do so well and go so long without another hospital

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Good

admission. They include her; she has good relationships, she understands her plan and is positive about her future.‟

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Good

Young people make good progress in relation to their emotional and psychological well-being. An on-site psychologist is easily available to staff and young people. She assesses, advises and helps them all. She also works alongside the local community mental health service, so that young people get the right help in a timely way. Young people are reassured by the psychologist‟s expertise and her input enhances the quality of staff‟s work with them. The psychologist creates positive relationships with young people and shows them that she keeps them in mind when she is away. For example, she gave one young person her plant to tend during her absence: this provided an ongoing link for that young person to remember and use the advice and self-help strategies that the psychologist had given her with a view to reporting back success when the psychologist returned.

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Good

Young people understand their care plans. Staff have helped them to gain confidence to have their say in meetings and to read documents that are about them. For example, young people understand what they need to do to prepare for their return to education. They know how tutoring in the home, visiting local schools, and completing homework are part of this. Young people can also attend the fortnightly meetings that staff have with their psychologist (this is where adults plan the ways that they will work with each young person to maximise their progress in the light of their continuing difficulties). Young people have visual timetables in their bedrooms and copies of their activity plans, so that they know exactly what is happening each day during the week. Staff are upbeat about what young people can do and take opportunities to talk with them about important subjects that they need to understand and think about. A social worker said, „the

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Good

education side is amazing‟. All this promotes young people‟s learning, health and self-esteem. It helps young people to understand how central they are to all that is being done and to realise how thoughtfully staff provide their individualised care. One young person wrote for her recent review of care meeting: „I would like to stay here for as long as I need to and then go home, not go to foster care first.‟

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Good

Some young people at the home follow the Muslim faith. Staff who share this faith support young people in the practice of their faith and work hard to help all young people understand and support one another in this. For example, staff sourced traditional women‟s dress and all young people dressed up and ate a traditional meal together to celebrate a religious event.

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Good

Young people see their parents, relatives and people that are important to them. Staff and managers prioritise this because young people often feel cut off from important people in their lives and this adds to their worries. Managers and staff are organised and often take the lead in promoting this contact. They discuss with social workers and reviewing officers how to overcome barriers to contact and find practical solutions to ensure that it goes ahead safely. For example, one young person is delighted that staff are helping her to see her brothers and sisters. Staff help her to prepare for the visit and to discuss her feelings and anxieties. They make sure that she has good support throughout the visit and that she can talk about it afterwards. Similarly, managers and staff offer good, sensitive support to young people when they have phone conversations with significant family members and friends. They are alert to the fact that young people might be upset

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Good

and particularly vulnerable after a phone call.

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Good

Young people look forward to moving here and want to be here. Prior to admission, the manager and staff visit prospective new young people where they are living. They give young people a good idea of what the home is like and enable them to meet some staff. Staff then make an individual plan of introductions to suit each young person. For example, one young person had some short visits and a meal at the home as well as trial overnight stays in their chosen bedroom. This personalised planning empowers young people and helps them to engage well in the home right from the start.

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Good

Young people are prepared well for transitions out of the home and staff maintain close relationships with them, especially in the early stages of their moves. Young people get good help to prepare practically and emotionally for living alone as independent adults. For example, staff provide help and encouragement with budgeting, cooking, laundry and maintaining good daily routines. When young people move, staff give young people a send-off party and plenty of memorabilia to take as a reminder of their time here. They make sure that young people have all their belongings. They keep in regular phone contact and visit daily. Staff are warm, encouraging and helpful, recognising that young people still need support until they have made good relationships with other adult helpers. A young person said: „They are there; they supported me through highs and lows and I have had quite a few.‟

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Good

Young people are leading a much healthier lifestyle than in former secure and/or hospital placements. Staff help them to adopt a healthy diet and exercise routine as well as providing regular opportunities to be out in the local community and further afield. Staff take time to help young people to make healthy smoothies and they go to the gym with them. They talk regularly about the benefits of a good diet and regular exercise, but tailor this carefully to the individual needs and difficulties of each young person. Staff help young people to establish and maintain attendance at local dance and drama classes so that they engage with new people, gain confidence, and keep fit in an enjoyable way. Staff also help young people to understand the medication that they are taking and to review with the appropriate medical experts whether this medication is still necessary and helpful.

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Good

Managers, the psychologist and staff understand young people‟s risks very well. They see the clear link between young people‟s risky behaviour, their emotional health and the impact of past abuse and harm. They are skilled at helping young people who self-harm, go missing, and/or make false allegations that adults or peers have harmed them. Their response is effective and involves all other agencies in accordance with good safeguarding practice. The input that young people receive is helping them to become increasingly safe. For example, serious and frequent self-harm is reducing for most young people. One young person told professionals at her review: „I am getting better; keeping myself calm and not hurting myself and others. I am talking about my feelings and not having fits.‟ This success is because staff are vigilant, nurturing and proactive. They keep young people busy and interested by providing them with relevant

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Good

activities and constant company. Young people feel safe because they are being equipped with helpful techniques to minimise their urges to self-harm. For example, one young person has planted an herb garden. She tends to the plants and uses the taste and smell of the different leaves to soothe and distract herself. Each young person also has an individual „safety plan‟ to prompt them, with things to do if they are starting to feel that they need to self-harm. For some young people, the plan includes a colour chart that they use to show how likely they are to self-harm without having to actually discuss it. Young people are very vulnerable if they are missing. They are at high risk if they self-harm while missing and they are also vulnerable to alcohol misuse, drug misuse and child sexual exploitation. Staff work on building positive relationships and active lifestyles to decrease the likelihood of young people going missing, but

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Good

they know that young people continue to experience triggers, such as fears about moving on to independent living. A child sexual exploitation police specialist describes the work staff do with young people as „holistic and relevant.‟ The police specialist conducts return interviews when young people have gone missing from the home. She recently said, „The manager and deputy provide around-the-clock care and support. Staff consistently listen and respond. On a daily basis, staff are provide up-to-date targeted work to encourage young people to make informed decisions about their lives. Diversionary activities increase self-esteem and encourage positive relationships. This helps to reduce the opportunities for missing episodes or isolation. Your team have supported all of the work that I do in the [child sexual exploitation] team; and continue to update me and share information to ensure all involved in their lives are giving the best possible support and care.‟

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Good

Staff and managers respond well to every incident of a young person going missing. Staff are alert to the way that young people behaviour and do all they can to prevent them from feeling the need to go missing. If young people do go, they follow and try to help them. Managers and staff work very closely with specialist police for missing and vulnerable young people. They also work closely with emergency, hospital and community mental health staff. They try to find out all that they can about where the young people have gone to and who they have been with. They work with staff from other children‟s homes where young people have friends who are also looked after. They share intelligence and plan regularly with all professionals to review and revise their response. One young person had to return to in-patient care after four months, but professionals were impressed with how well this young person‟s situation was managed. An emergency duty social

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Good

worker from the placing authority involved said, „I was impressed with the high standard of skills that came across when speaking to the team: they provided all round care for the young person during this difficult time; attending hospital and the police station; ensuring that important paperwork was obtained. They were also planning ahead. They are one of the most professional residential teams I have liaised with in many years of working in the out of hours team.‟

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Good

Young people feel very safe, despite the difference that they experience between living in the community compared to previous hospital or other secure settings. This is due to the good-quality care and support provided by managers, staff and the psychologist. Sufficient numbers of safely recruited staff are available to young people day and night. Staff are insightful and well advised. They ensure that the young people feel safe, despite the severity of their unsafe behaviours. The psychologist is key in helping the young people to minimise urges to self-harm or run away and shows staff how to put strategies into practice. Strategies often involve a sensory stimulus, combined with reassurance and close attention from adults. For example, there is a container of ice kept ready for a young person to plunge her hands into if she is starting to want to self-harm. Perfumes are also used to help distract young people from other smells that they associate with

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Good

negative thoughts. These good-quality practices minimise the number and frequency of serious incidents and reduce the need for staff to physically intervene with young people, lock away items, or search rooms. Overall, staff avoid an institutional feel, while making a significant contribution to young people‟s personal safety. However, young people who are likely to be able to safely use their prescribed medicated toothpaste without supervision have to ask staff for it from the locked medication cabinet. Staff and managers have not thought about reviewing the risks involved to see if the young people can safely increase their independence in this area.

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Requires improvement

The manager has suitable qualifications and is in her first position as a registered children‟s home manager. She has been in post for a year now and has built well on her skills and knowledge. Her deputy manager is a competent, well-organised and respected childcare practitioner. The deputy manager builds strong and supportive relationships with young people that are pivotal to their progress and increased safety. The manager has developed good skills at working with other professionals and is making a good contribution to each young person‟s care plans. The manager is available to support staff and young people 24 hours a day, by phone. Much of young people‟s experience and good progress here can be attributed to the skills of the manager and deputy manager. The effectiveness of leadership requires improvement because staffing issues and gaps in support from the organisation threaten the continuity and sustainability of

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Requires improvement

the work being achieved with young people. For example, no staff apart from the manager and deputy have a level 3 diploma in residential care of young people. Some staff have recently started their diplomas, but the organisation is changing the way that training is delivered for the second time in one year. This is causing another delay in staff‟s progress towards qualification. In addition, no staff or managers have had the opportunity to undertake study that leads to a qualification in mental health. Despite this, good-quality sessional training provided by the psychologist means that the practice skills of staff and managers enable young people to make good progress. Staff retention is poor. Staff leave for various reasons, including for full-time social work study and promotion. However, some staff leave because they find the work too stressful, despite the good-quality supervision and support that they receive

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Requires improvement

from the manager, deputy manager and psychologist. Qualified staff are not being recruited and the manager finds it difficult to recruit staff who have the aptitude and resilience that is required. The manager spends a significant amount of time seeking new staff and is having to use bank staff, agency staff and staff from other homes. She minimises any adverse impact of this on the young people by ensuring that some familiar staff are used on every shift. A very positive atmosphere is maintained and all staff provide good-quality care. One young person said, „I don‟t mind who is here because I like them all.‟ Nevertheless, other young people are known to struggle more with their difficulties when unfamiliar people are caring for them. Various changes in the organisation‟s senior leadership has meant that three different senior managers have supervised the manager in the last six months. A new area manager is committed to improving the consistency of the support that

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Requires improvement

the manager and staff receive. However, the manager has not yet had her performance appraised. She is not yet receiving support that is making a difference to her difficulties with staff recruitment, retention and training. Young people are not adversely affected by this because the manager goes over and above to make herself available to staff, young people and other professionals. Nevertheless, both the manager and the deputy risk burnout. The manager and deputy manager know and understand the strengths and weaknesses of the home. They place good emphasis on detailed handover records and daily planning so that young people receive well-planned and consistent care. They take action about the shortfalls identified by Ofsted inspectors and the home‟s monthly independent visitor. They are usually good at reviewing incidents and helping young people and staff to cope with their feelings when things have

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Requires improvement

gone wrong. However, extra demands to address recruitment issues mean that the manager does not always spend enough time on monitoring and reviewing. She is completing three- and six-monthly reviews of care many months after the time period has passed. This makes it impossible to implement any improvements that are identified through the review process in a timely way. Similarly, during periods of frequent incidents, the manager does not always commit enough time to reflect on what is happening. For example, a self-harm incident occurred due to miscommunication between managers and staff about whether or not crockery was locked away. The manager did not identify learning from this mistake because she did not set aside enough time to reflect on the detail of the incident.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against „Inspection of children‟s homes: framework for inspection‟.

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What the inspection judgements mean

An outstanding children‟s home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children‟s home provides effective services that help, protect and care for children and young people, and have their welfare safeguarded and promoted. In a children‟s home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children‟s home is not yet delivering good protection, help and care for children and young people. A children‟s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or that result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children‟s home. Inspectors considered the quality of work and the difference that adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition, the inspectors have tried to understand what the children‟s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children‟s

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Information about this inspection

Homes (England) Regulations 2015 and the „Guide to the children‟s homes regulations including the quality standards‟. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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