Children's Home run by Cambian Childcare Limited in Derbyshire

Inspection report children‟s home: SC476289 1 SC476289 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 provides long-term care and therapy for up to five children and young people who have emotional and/or behavioural difficulties. The registered provider is a private company operating a range of children‟s homes across the country.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children‟s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 1 February 2017

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requires improvement to be good

Overall judgement at last inspection: Declined in effectiveness

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Enforcement action since last inspection

None Inspection report children‟s home: SC476289 2

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Key findings from this inspection

This children‟s home requires improvement to be good because:

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Key findings from this inspection

 The home has, until very recently, been without a registered manager for a substantial period of time. Leadership and management have been inconsistent, negatively impacting on children and staff.  A number of experienced staff have left, or are leaving. Recruitment of new staff has been successful, but children have struggled with staff changes.  Staff instability has impacted on the capacity of children to form sustained, positive, nurturing relationships.  Children have experienced problems in peer relationships.

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Key findings from this inspection

 All children living in the home have an appropriate education provision in place. School attendance is good.  Staff and children benefit from excellent in-house clinical support. Regular team around the child (TAC) meetings provide a forum for information to be shared and care plans updated.  Safeguarding practice is good, ensuring that children are cared for as safely as possible.

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Inspection date Inspection type Inspection judgement

01/02/2017 Interim Declined in effectiveness 24/08/2016 Full Good 15/02/2016 Interim Improved effectiveness 20/10/2015 Full Good Inspection report children‟s home: SC476289 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 In order to meet the leadership and management standard, the registered person is required to— 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; ensure that the home‟s workforce provides continuity of care to each child; use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(2)(a)(e)(h)) 31/07/2017

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Requirement Due date

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”)— (i) has spoken to the user about the measure; and (ii) has signed the record to confirm it is accurate; and (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. (Regulation 35(3)(b)(c)) 31/07/2017

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improvement to be good

The home has experienced a period of instability since the last full inspection. Changes in staff and in management arrangements have had a negative impact on the progress and experience of children. Children have struggled with new staff joining the home. Children perceive that different staff have different expectations, even though staff put a lot of effort into providing consistent care. Changes in management arrangements have compounded the situation as the home has lacked clear leadership. Inspection report children‟s home: SC476289 4 One social worker spoke very positively about the home, describing the staff as „wonderful‟. She felt that communication from the home was very good, but that, due to frequent changes in staff, the child she had placed there was struggling. The majority of children living in the home have significant attachment difficulties, so changes in staff undermine the effectiveness of therapeutic, nurturing care, as children feel less secure.

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improvement to be good

The home benefits from excellent in-house clinical support. This has continued through this period with assessments of children‟s emotional health and well-being, direct work with children, as well as clinical supervision for staff. Staff have appreciated having a reflective space in which to discuss how to meet children‟s needs. Clinical care plans are very good and support staff to provide children with highly individualised care. Children receive specialist help, with staff referring to external agencies where necessary. Physical and emotional health and well-being needs are met. Children are actively supported to develop positive self-esteem and a positive sense of identity. Issues of diversity, including gender identity, religion and culture, are managed very well. A key ethos of the home is supporting children to overcome previous experiences of trauma and build emotional resilience. While this has been an outstanding

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improvement to be good

area of practice in the past, this work has been a challenge to progress against a backdrop of staff and management instability. Children‟s progress and experiences have been variable. All children have appropriate education provision in place, and attendance is good. Some children have struggled at school, with some behaviour exhibited in the home also presenting at school. One child was subject to a fixed-term exclusion at the time of the inspection. Staff maintain positive relationships with education providers and children generally make good progress. Staff ensure that children have a quiet place to complete homework. The home environment is tailored to children‟s needs, and is a well-presented, welcoming home. Children have lots of opportunities to contribute to how the home is run, and shape their care plans. Bedrooms reflect children‟s individual tastes and interests. Peer relationships have been difficult. At times, some children have said that they are

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improvement to be good

fearful of other children in the home, and have been overwhelmed by changes. Staff have very good insight into the needs and vulnerabilities of children in the home. Staff, supported by the clinical team, produce high-quality care plans. Most interventions are based on attachment-based theory, and new staff are in the process of forming relationships with children and developing their own skills and experience in this type of work. Children have access to a range of social, recreational and educational opportunities. Children take part in activities in the community, and this provides an opportunity for children to develop age-appropriate independence skills. Staff are in the process of formalising plans for children around taking age-appropriate risks and being open to new challenges and positive opportunities. Admissions and discharges are managed well. Staff fully consider the impact of a new admission on children living in the home, and whether they have sufficient skills and

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improvement to be good

staff to meet needs. Very good-quality direct work is undertaken with children. This Inspection report children‟s home: SC476289 5 extends to planning for transitions. Placement endings are managed sensitively and as positively as possible, with children having photographs and other mementos to take with them as they leave.

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

Children say that they feel safe in the home. Risks in the home and community are managed well. There is a very low incidence of children leaving the home unauthorised. This reduces risks from the community. Safeguarding procedures are effective and staff follow plans appropriately. A strength of the home is supporting children to regulate their own behaviour and manage difficult emotions. Progress in this area is not always straightforward, but some very good work to support children‟s behaviour is evident. Peer relationships are sometimes a source of anxiety for children, along with uncertainty about staffing. Children need very consistent care, and time to build trusting relationships. Some children in the home have significant attachment difficulties, and inconsistent staffing is very difficult for them to cope with. Staffing difficulties have coincided with a deterioration in behaviour. Children have struggled with new staff,

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

feeling less secure in expectations regarding behaviour. The accessibility of familiar, experienced staff is important, and staff provide this reassurance. Physical interventions have remained high. Recording of incidents is clear and includes reference to antecedents, and what strategies staff employ to de-escalate situations before physical intervention becomes necessary. There is evidence of learning from this information, as well as information being used to revise care plans and risk assessments. The use of physical intervention and restraint is proportionate and is only used when necessary to safeguard children and staff. Staff are appropriately trained in the use of de-escalation techniques and restraint. A shortfall was noted in the management oversight of records relating to restraint, with some delays in records being signed by the manager. A requirement has been made to address this. Allegations against staff are managed appropriately. Managers refer to appropriate

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

agencies and take swift action to protect children. Appropriate support is provided to children in these circumstances, as well as the person who is the subject of the allegation. Recruitment processes are robust and reduce the risk of unsuitable adults working with children. New staff have a thorough induction, which includes training on safeguarding. Regular supervision and appraisal ensures that staff suitability is continually assessed once they are employed in the home. Staff are first-aid trained and also receive training in fire safety. The home has an up-to-date location risk assessment. This details any risks in the local area, including physical risks and levels of crime in the area. The physical environment is safe and free of any obvious health and safety hazards. Staff and managers ensure that checks are undertaken on a regular basis. This enables managers to assess whether the Inspection report children‟s home: SC476289 6

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

home is safe and that children are protected from preventable harm.

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

Until very recently, the home had been without a registered manager for a substantial period of time. A new manager was appointed last year, but resigned before being registered. Another manager was appointed earlier this year and has subsequently been registered with Ofsted. The newly registered manager is suitably skilled and experienced. She has held a management position in a similar home and she demonstrates an in-depth understanding of child development and attachment. The registered manager has high expectations for children and staff. She understands the difficult position the home is in at the moment, but is working with senior managers to ensure that there are sufficient staff, appropriate levels of management oversight, and that the impact on children is minimised. Changes in management arrangements have been unsettling for staff, with a number of staff leaving or planning to leave. Experienced staff have increasingly worked longer

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

hours to support newer, less experienced staff. This has been a very unsettling time for children and they have clearly been adversely affected by the instability of staffing and management arrangements. The deputy manager has been working alongside less experienced staff in a senior role. This is very positive for staff and for children, as the deputy manager provides a strong sense of familiarity and stability. The consequences of this are that the deputy manager is prevented from fulfilling her management role while working shifts. A further requirement has been made to ensure that priority is given to stabilising the staff team through strong leadership and management, enabling staff to be clear about their roles and responsibilities. Supervision takes place regularly, with staff using this time to discuss the children and to discuss their own developmental needs. Team around the child meetings take place

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

regularly, providing very good opportunities for staff to reflect on practice and formulate plans. Social workers and other professionals feel that communication from staff is good, despite staff changes. Partnership working is effective. Staff have access to a broad range of training opportunities and feel that this, along with good clinical support, enables them to provide good-quality care. Case files are well maintained, and provide evidence of direct work being undertaken with children. The registered manager uses external monitoring of the home to continually raise standards. She has a good grasp of the strengths and weaknesses of the home, and is actively addressing areas where shortfalls are identified. Inspection report children‟s home: SC476289 7

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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: SC476289 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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Children’s home details

Responsible individual: Alison Blyth-Bishop

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Inspector

Corrinne Barker, social care inspector Inspection report children‟s home: SC476289 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 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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