Children's home run by Cambian Childcare Limited in Hammersmith and Fulham

Inspection report children's home: 1236620 1 Registered provider: Cambian Childcare Ltd

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is registered to provide care and accommodation for up to four children who have emotional and/or behavioural difficulties. This home is dedicated to providing safety, care and therapy to children who have experience of child sexual exploitation and sexual abuse.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and/or widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and/or the care and experiences of children and young people are poor and they are not making progress.

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inadequate

Date of last inspection: 17 January 2017

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inadequate

Overall judgement at last inspection: Requires improvement Inspection report children's home: 1236620 2

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Key findings from this inspection

This children‟s home is inadequate because

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Key findings from this inspection

 The home is not providing the service that is described in its statement of purpose. The therapeutic support described is not consistently available. Care plans do not detail how progress will be achieved, monitored or measured against the therapeutic model used.

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Key findings from this inspection

 Staff, including the manager and deputy, lack experience, understanding and knowledge of caring for young people who are victims of child sexual exploitation. Staff could not explain the therapeutic process of „stabilisation‟ used in the home.

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Key findings from this inspection

 Risk assessments and care plans do not support staff to understand how to manage risk or care effectively for the young people.

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Key findings from this inspection

 The action taken following a very serious incident is insufficient to ensure staff have the knowledge and skills needed to safeguard and protect young people.

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Key findings from this inspection

 Young people‟s unsupervised access to the community, access to phones, the internet and contact with others is restricted. These restrictions are not supported by individual risk assessments or court orders.

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Key findings from this inspection

 Records of restraints are disorganised and are not fully complete. Records of complaints made could not be found during the inspection.

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Key findings from this inspection

 Young people get on well with the staff. Bedrooms are personalised and young people have taken the time to make the home their own.

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Key findings from this inspection

 Young people are involved in a wide range of activities.

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Inspection date Inspection type Inspection judgement

17/01/2017 Full Requires improvement Inspection report children's home: 1236620 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet 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

6: The quality and purpose of care standard

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Requirement Due date

6.—(1) The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

(a) understand the children‟s home‟s overall aims and the outcomes it seeks to achieve for children;

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(b) use this understanding to deliver care that meets children‟s needs and supports them to fulfil their potential.

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(2) In particular, the standard in paragraph (1) requires the registered person to—

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(a) understand and apply the home‟s statement of purpose;

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(i) understand and apply the home‟s statement of purpose;

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(ii) protect and promote each child‟s welfare;

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(iii) treat each child with dignity and respect;

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(iv) provide personalised care that meets each child‟s needs, as recorded in the child‟s relevant plans, taking account of the child‟s background;

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(v) help each child to understand and manage the impact of any experience of abuse or neglect;

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(vi) help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult;

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(ix) make decisions about the day-to-day arrangements for each 10/06/2017 Inspection report children's home: 1236620 4 child, in accordance with the child‟s relevant plans, which give the child an appropriate degree of freedom and choice. 12: The protection of children standard

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Requirement Due date

12.—(1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

(iii) have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

(iv) manage relationships between children to prevent them from harming each other;

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(v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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(vi) take effective action whenever there is a serious concern about a child‟s welfare; and

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(b) that the home‟s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. 10/06/2017

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13. The leadership and management standard

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13.—(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that—

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(a) helps children aspire to fulfil their potential; and

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(2) In particular, the standard in paragraph (1) requires the registered person to—

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(a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home‟s statement of purpose;

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(b) ensure that staff work as a team where appropriate; 10/06/2017 Inspection report children's home: 1236620 5 (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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(d) ensure that the home has sufficient staff to provide care for each child;

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(e) ensure that the home‟s workforce provides continuity of care to each child;

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(f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home;

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(g) demonstrate that practice in the home is informed and improved by taking into account and acting on—

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(i) research and developments in relation to the ways in which the needs of children are best met; and

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(ii) feedback on the experiences of children, including complaints received; and

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(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 11: The positive relationships standard

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11.—(1) The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

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(b) an understanding about acceptable behaviour; and

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(c) positive responses to other children and adults.

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(2) In particular, the standard in paragraph (1) requires the registered person to ensure—

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(i) meet each child‟s behavioural and emotional needs, as set out in the child‟s relevant plans;

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(ii) help each child to develop socially aware behaviour;

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(iii) encourage each child to take responsibility for the child‟s 10/06/2017 Inspection report children's home: 1236620 6 behaviour, in accordance with the child‟s age and understanding;

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(iv) help each child to develop and practise skills to resolve conflicts positively and without harm to anyone;

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(v) communicate to each child expectations about the child‟s behaviour and ensure that the child understands those expectations in accordance with the child‟s age and understanding;

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(vi) help each child to understand, in a way that is appropriate according to the child‟s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful;

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(vii) help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship;

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(viii) strive to gain each child‟s respect and trust;

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(ix) understand how children‟s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children;

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(x) are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same;

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(xi) de-escalate confrontations with or between children, or potentially violent behaviour by children;

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(xii) understand and communicate to children that bullying is unacceptable; and

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(xiii) have the skills to recognise incidents or indications of bullying and how to deal with them; and

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(b) that each child is encouraged to build and maintain positive relationships with others. 35: Behaviour management policies and records

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35.—(1) The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out— 10/06/2017 Inspection report children's home: 1236620 7 (a) how appropriate behaviour is to be promoted in the children‟s home; and

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Requirement Due date

(b) the measures of control, discipline and restraint which may be used in relation to children in the home.

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(2) The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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(3) The registered person must ensure that—

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(a) within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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(ii) details of the child‟s behaviour leading to the use of the measure;

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(iii) the date, time and location of the use of the measure;

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(iv) a description of the measure and its duration;

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(v) details of any methods used or steps taken to avoid the need to use the measure;

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(vi) the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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(vii) the effectiveness and any consequences of the use of the measure; and

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(viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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(b) within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)—

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(i) has spoken to the user about the measure; and

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(ii) has signed the record to confirm it is accurate; and Inspection report children's home: 1236620 8 (c) within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure.

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Requirement Due date

(4) Paragraph (3) does not apply in relation to restraint that is planned or provided for as a matter of routine in the child‟s EHC plan or statement of special educational needs. 16: Statement of purpose

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16.—(1) The registered person must compile in relation to the children‟s home a statement (“the statement of purpose”) which covers the matters listed in Schedule 1.

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(3) The registered person must— (a) keep the statement of purpose under review and, where appropriate, revise it; and

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(b) notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision.

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(5) Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose.

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(6) Nothing in paragraph (5) or regulation 46 (review of premises) requires or authorises the registered person to contravene or not comply with—

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(a) any other provision of these Regulations; or

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(b) any conditions in relation to the registration of the registered person under Part 2 of the Care Standards Act 2000. 10/06/2017

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*These requirements are subject of a compliance notice.

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Recommendations

 Where children placed in a home are not participating in education because they have been excluded or are not on a school roll for some other reason, the registered person and staff must work closely with the placing authority so that the child is supported and enabled to resume full-time education as soon as possible. In the interim, the child should be supported to sustain or regain their confidence in education and be engaged in suitable structured activities. If no education place is identified by the placing authority, the registered person must challenge them to meet the child‟s needs under regulation 5. („Guide to the children‟s homes regulations including the quality standards‟, page 28, paragraph 5.15) Inspection report children's home: 1236620 9  When a child returns to the home after being missing from care or away from the home without permission, the responsible local authority must provide an

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Recommendations

opportunity for the child to have an independent return home interview. Homes should take account of information provided by such interviews when assessing risks and putting arrangements in place to protect each child. („Guide to the children‟s homes regulations including the quality standards‟, page 45, paragraph 9.30)

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Recommendations

 Children should have access to a computer and the internet to support their education and learning, unless there are specific safeguarding reasons why this would be inappropriate. In such cases, the home should consider whether and how it can support the child to access a computer and the internet safely. („Guide to the children‟s homes regulations including the quality standards‟, page 29, paragraph 5.19)

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Overall experiences and progress of children and young people: inadequate

Young people do not receive individualised care. Planning for young people is not linked to addressing their emotional needs. Day-to-day planning for young people not engaged in education is unclear. Activities are not consistently linked to learning and some arrangements appear to be agreed on the spur of the moment without full consideration.

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Overall experiences and progress of children and young people: inadequate

Staff described young people as being in a „stabilisation period‟, but had very little knowledge of this process and how it is delivered, monitored or measured. Care planning does not make reference to this model. During a team meeting, the manager stated that she felt a young person was „ready for the next stage of intervention‟; however, she could not quantify this statement.

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Overall experiences and progress of children and young people: inadequate

The practices of restricting contact with family and friends and restricting unsupervised access to the community are not supported by risk assessments. One young person made a complaint after her post had been opened by a member of staff and the letter left for others to see. These practices do not demonstrate consideration of young people‟s rights and entitlements.

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Overall experiences and progress of children and young people: inadequate

Staff were unable to provide effective care to protect the welfare of a previous resident. Her move from this home was sudden and unplanned. She was distressed at not being able to return to the home following a hospital admission.

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Overall experiences and progress of children and young people: inadequate

Staff lack experience of working with very vulnerable and challenging young people who have been sexually exploited. The basis of relationships between young people and staff is unclear. Some of the staff practice is naive and demonstrates a lack of clear understanding of young people‟s needs. There is also a lack of challenge to inappropriate language or unacceptable behaviour. Care practice is not delivered in a planned or well- Inspection report children's home: 1236620 10 thought-out way.

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Overall experiences and progress of children and young people: inadequate

The clinical psychologist appointed to this home has left the service. Therapeutic support to young people and staff is limited and not delivered to the level described in the statement of purpose. Access to the clinical therapeutic services, as described in the statement of purpose, has not been consistently available since the home first opened.

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Overall experiences and progress of children and young people: inadequate

Recent improvements in staffing numbers have given the staff more confidence to deal with the young people. Young people appear to be at home and relaxed in the house. They have invested time in improving the garden and have personalised areas of the home, particularly their own bedrooms.

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How well children and young people are helped and protected: inadequate

Staff have not received the training and guidance required to help them to identify when young people have misused substances. This is particularly worrying given a significant incident during which young people‟s lives were at risk because they took an illegal substance.

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How well children and young people are helped and protected: inadequate

Risk assessments do not include presenting issues, as described in placing authority information. In addition, assessments have not been effectively updated following significant incidents. Information has been copied and pasted between documents and some actions could not be explained by the staff on duty.

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How well children and young people are helped and protected: inadequate

Young people have recently gone missing from the home. Action taken by the home to access information from independent return interviews has not been successful. Therefore, information from these interviews is not added to risk assessments to help to prevent future occurrences of young people going missing from the home.

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How well children and young people are helped and protected: inadequate

Restraint records are not fully complete and are disorganised. Therefore, the ability to audit the records, for the purpose of preventing future physical intervention, is limited. There is a lack of independent oversight following two physical interventions by the registered manager. Some records are not signed by the manager. Staff are trained in restraint techniques.

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How well children and young people are helped and protected: inadequate

Young people who are described in referral documents as vulnerable and easily influenced by others were placed in neighbouring bedrooms. They were known to be communicating through the walls, planning to run off and keeping one another awake. Staff were slow to take appropriate action and only recently moved one young person following a series of problems.

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How well children and young people are helped and protected: inadequate

Young people who have recently moved into this home have been removed from situations in which they were exploited. A social worker remarked that she was pleased that a young person was forming relationships with the staff and that incidents of going missing from the home had reduced.

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How well children and young people are helped and protected: inadequate

Safer recruitment practices are followed. However, it is not clear how managers and Inspection report children's home: 1236620 11 leaders decided that staff have or can develop the suitable experience, knowledge and understanding to work with complex vulnerable young people who have been sexually exploited. Inexperienced staff have been on duty together or lone working and their lack of experience does not safeguard or protect young people‟s welfare.

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How well children and young people are helped and protected: inadequate

Arrangements for the safe storage and administration of medication are in place. Records are kept of all homely remedies given to young people so that additional guidance can be sought if needed.

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How well children and young people are helped and protected: inadequate

Young people know how to make a complaint. Records of those made since the previous inspection could not be located during this inspection, making it impossible to identify if the action taken had been appropriate.

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The effectiveness of leaders and managers: inadequate

The home is not providing the therapeutic service that is described in the statement of purpose. Staff have limited knowledge and experience of dealing with complex vulnerable young people. Very few staff, including the manager and deputy, have sufficient experience of working with young people who have been sexually exploited and abused.

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The effectiveness of leaders and managers: inadequate

The team‟s ability to understand and prioritise the improvements needed is limited. Fundamental aspects of the care provided to young people are missing. This is evident in the behaviour of staff and their presentation.

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The effectiveness of leaders and managers: inadequate

The manager has failed to ensure that the home‟s records underpin the delivery of good care. Records do not support the team‟s understanding of the young people‟s needs. For example, risk assessments and care plans contain limited and misleading information. These documents fail to direct staff in how to provide care to young people. Physical restraint records are not well ordered and complaints records are missing. Therefore, opportunities to develop and improve practice through the monitoring of records are missed.

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The effectiveness of leaders and managers: inadequate

The clinical psychologist, who was beginning to make a difference by providing support and guidance to the staff, has resigned from the service.

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The effectiveness of leaders and managers: inadequate

Staff have not received the training and guidance they need in order to provide a quality service and to protect young people. Staff are concerned about this. Their understanding of concerns is not reviewed during supervision meetings. Reflective practice following significant incidents is ineffective in identifying and taking effective action to deal with shortfalls.

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The effectiveness of leaders and managers: inadequate

Ofsted and other agencies have been notified of significant incidents involving young people. Inspection report children's home: 1236620 12

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the „Social care common inspection framework‟, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children‟s Homes (England) Regulations 2015 and the „Guide to the children‟s homes regulations including the quality standards‟. Inspection report children's home: 1236620 13

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Children’s home details

Registered provider: Cambian Childcare Ltd

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Children’s home details

Registered provider address: 4th Floor, Waterfront, Hammersmith Embankment, London, W6 9RU

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Inspector

Janice Hawtin: social care inspector Inspection report children's home: 1236620 14 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children‟s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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