Children's Home run by Cambian Childcare Limited in Bedford

Inspection report children’s home: 1230416 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

This children’s home offers care and accommodation for up to three children who have emotional and/or behavioural difficulties who have been subject to, or are at risk of, child sexual exploitation.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers requires improvement to be good

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good

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

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good

Overall judgement at last inspection: Good

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Key findings from this inspection

 The children have education plans tailored to their individual needs. The children are able to engage in learning at the organisation’s local school. Inspection report children’s home: 1230416 2  The staff nurture positive relationships with the children and want them to do well and make progress.  The staff support the children to progress their independence skills when they are ready to move on from the home.  The staff and the manager communicate effectively with placing authorities and the police.  The staff take effective action when the children go missing from the home.  Clear and current risk assessments and behaviour plans identify the strategies to reduce risks and manage behaviour.  Clinical support is available for the staff and for the children. This provides further safeguards and supports specific direct trauma work with the children.  The children are encouraged to be healthy. Staff engage them with the gym

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Key findings from this inspection

and other activities that the children enjoy.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 Impact assessments are not sufficiently detailed and, therefore, do not meet the needs of all of the children.  Not all of the staff follow the appropriate medication procedures for the children. This has led to an incident and a subsequent review of practice.  There have been several staff changes. This does not provide adequate consistency of care.  Training is in place, but it is not wholly effective and does not provide the staff with all of the skills that they require.  The internal monitoring is not sufficiently robust.  The location risk assessment does not include enough relevant information about factors affecting the position of the home.  There have been several changes of staff since the home opened. This means that many of the staff are new and do not yet have a breadth of skills and experience.

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Inspection date Inspection type Inspection judgement

24/08/2016 Full Good Inspection report children’s home: 1230416 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

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that helps children aspire to fulfil their potential and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13(1)(a)(b)(2)(c)) 19/6/2017

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23(1)) 19/6/2017

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Recommendations

 The registered person should only accept placements for children when they are satisfied that the home can respond effectively to the child’s assessed needs as recorded in the child’s relevant plans, and when they have fully considered the impact that the placement will have on the existing group of children. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.4)  The registered person should review the appropriateness and suitability of the location and premises of the home at least once a year. This review should include the identification of any risks and opportunities presented by the home’s location and strategies for managing these. (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.1)  The registered person should undertake a review that focuses on the quality of the care provided by the home, the experiences of the children living there and

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Recommendations

the impact the care is having on outcomes and improvements for the children. (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.2) In particular, ascertain and consider the opinions of children, their parents, Inspection report children’s home: 1230416 4 placing authorities and staff.

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Overall experiences and progress of children and young people: good

This home opened in June 2016. It continues to develop and build on practice. There have been a number of changes in relation to the children and staff since the home has opened. One child has been in placement since the home opened. She has positive relationships with staff and is making progress with her education and independence skills. She is undertaking exams and is now rarely absent from the home without consent. She is settled and the staff know her well. Two of the children have moved on from the home since the last inspection. These moves were due to the children’s escalating behaviours, which presented significant risks to themselves and others. Staff worked hard to engage with the children and to ensure that safeguards were in place. During this time, the manager ensured good communication and appropriately challenged the local authority to progress plans. However, due to the increase in risky behaviours, the children moved into secure

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Overall experiences and progress of children and young people: good

placement/hospital. Recently, there have been three new admissions to the home. One child said, ‘It feels really nice here and the staff are nice. I get to do activities and I get on with the other girls.’ The children benefit from one-to-one staffing. The children’s files hold relevant information about the children’s experiences and needs. The staff are briefed well on the level of care required and the individual needs of the children. This enables them to provide good-quality care. Placing authorities are happy with the service provided to the children. A social worker said, ‘The home has been brilliant. The staff are doing some really good work with her. They know her likes and dislikes. There have been incidents, but the staff keep her safe.’ Children’s needs are considered and support is in place to help them to get to know their new home and to build relationships. The children all have education plans. They access the organisation’s local school and

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Overall experiences and progress of children and young people: good

they each have individual timetables. The children have all struggled previously to engage with education and, as a result, there are gaps in their learning. Education is an area which continues to be a focus. The staff and the manager carefully consider the children’s emotional needs to help them to adapt to a school environment again. There is daily communication between the school staff and the home’s staff. The manager monitors progress and attendance. Risk matrices assess the behaviours of the children attending school and consider how likely they are to engage with each other. The school is a valuable resource which provides a small, safe place for children to learn. The children’s health plans are clear and the staff support them to attend all of their health appointments. The staff support a child to attend the gym and to go horse riding. Inspection report children’s home: 1230416 5 This child is training with a staff member to participate in a half marathon. The staff help

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Overall experiences and progress of children and young people: good

the children to stay physically healthy by encouraging them to participate in activities that interest them. The staff and the manager support the children to maintain links with their families. The staff acknowledge the importance of family contact. The manager makes continued efforts to keep families and carers informed of any incidents. This helps the lines of communication to remain open.

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

The children present with complex issues and behaviours which require careful monitoring. Since the last inspection, there have been a number of incidents in the home. The manager notifies the relevant parties and takes robust action in response to the incidents. Integration plans and crisis safety plans provide guidance for the staff. A clinical team provides valuable support to the staff and undertakes direct work with the children. This input is vital in terms of the specific needs of the children and the level of risk. There is good communication between the clinical team and the manager. The clinical team has oversight of all incidents and there are open discussions with the manager and the staff about how to manage the behaviour effectively. The clinical support is relatively new for the service, having started in November 2016. It is enhancing the level of care provided to the children by providing specialist support as well as tracking children’s progress.

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

Recently, there have been three new admissions to the home in a short period. The manager has assessed that this is appropriate. However, the impact assessments lack detail and analysis and do not sufficiently account for the newer children and the period that they need to settle at the home. Therefore, the assessments do not fully consider the potential impact on the home. When children go missing from the home, the staff take effective action and make contact with the appropriate agencies. There is good communication with the police and other agencies. A police officer said, ‘They [the staff] have had some young people there with some complex needs and they have worked well in trying to help those young people. They always keep me informed of what is happening. We have had lots of strategy meetings and they always keep in contact.’ The manager responds appropriately to allegations and liaises with the designated

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

officer as required. The proper process is followed, which ensures that there is independent oversight of investigations. Physical interventions are used to keep the children safe when de-escalation techniques are not effective. The records of the interventions are concise and there is clear management oversight. The staff undertake debriefs with the children and discuss the children’s feelings about these incidents in key-work sessions. The use of positive and negative consequences helps to encourage good behaviour. These consequences are proportionate and overseen by the manager. There are positive rewards when the children make good choices, such as not leaving the home without consent, or for completing daily tasks and contributing to the running of the home. This Inspection report children’s home: 1230416 6 helps to recognise, reward and reinforce positive behaviour. One of the children has an independence plan in preparation for moving on. This helps

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

her to manage tasks with support from the staff team and the clinical team that she sees twice a week. The children know how to complain and they can access an advocate if they wish to. Current risk management and behaviour plans identify and assess the risk of self- harmful behaviours. Strategies to keep the children safe are evident. Self-harm has been a consistent area of concern in the home and continues to be high on the agenda. The clinical team provides support and advice to ensure that all of the staff understand the impact of working with children who have experienced, and continue to experience, significant trauma.

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The effectiveness of leaders and managers: requires improvement to be good

The manager is suitably qualified and experienced. He has been in post since the home opened. He started a career in health and social care in 2005 and holds the level 5 diploma. The staff feel that the home has good leadership and that they are well supported. One staff member said, ‘He is a good manager and I have a lot of time for him. He is professional, but will also sit and eat breakfast with the children and spend time with them.’ This ethos ensures that the home runs effectively and supports the staff. There have been a number of staff changes since the last inspection. Several staff members have left, some for further career opportunities and some due to the role not being what they perceived. This has led to some inconsistency and a new influx of staff. Training is in place, but it is not sufficiently robust as it is not progressed for all of the staff in a timely way. Therefore, there are gaps in knowledge and not all of the staff are

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The effectiveness of leaders and managers: requires improvement to be good

fully equipped to meet the complex and specific needs of the children. There is a clear recruitment plan in place to support the home. Some changes have been made by the company in order to attract and retain staff. Currently, there is a plan to recruit additional staff to ensure that potential shortfalls are covered. New staff describe the induction process as effective and informative. There is a ‘buddy’ system as well as access to training and a number of shadow shifts. Due to the high number of new staff in post, the number of staff qualified to level 3 is low. Many of the staff are now registered and progressing towards the level 3 qualification and others will commence the qualification when their probation period ends. However, this means that the majority of staff are not yet suitably qualified and trained. The staff access suitable supervision. Sessions take place regularly and records of the

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The effectiveness of leaders and managers: requires improvement to be good

sessions are made and kept. The staff have opportunities to access support and discuss current issues. There are senior management meetings in addition to the team meetings. This creates a space for effective communication between all of the staff and the senior managers regularly. There has been a recent significant incident of a child accessing medication from staff Inspection report children’s home: 1230416 7 without warning. This resulted in medical attention and staff intervention. A revised medication protocol was implemented following a full investigation. The protocol outlines the organisation’s expectations of all of the staff. Additional medication training is to take place within the next few weeks. The medication records reviewed during the inspection show that, on several occasions, the staff have not signed in accordance with the medication protocols. Failure to follow the protocols does not ensure that medication

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The effectiveness of leaders and managers: requires improvement to be good

administration is managed and recorded safely. The internal reporting is comprehensive but it does not include the views of other professionals, placing authorities and parents. Therefore, it is not clear how these important views contribute to improvements at the home. There is a locality risk assessment in place; however, it is not sufficiently detailed. It does not adequately identify local ‘hotspots’ for children, or the risks associated with the rural area. Therefore, it does not provide a full picture of the local environment and the potential risks to new children coming into the home.

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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: 1230416 8

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Children’s home details

Registered provider: Cambian Childcare Ltd

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Children’s home details

Registered provider address: Cambian, Waterfront, Hammersmith Embankment, Chancellors Road, London W6 9RU

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Inspector

Debbie Young, social care inspector Inspection report children’s home: 1230416 9 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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