Children's Home run by Cambian Childcare Limited in Cambridgeshire

Inspection report for children’s home - monitoring visit: 1257796 1

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Cambian Childcare Ltd

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This home is registered for up to 16 children who have mental disorders. It is privately owned and has a separately registered school on site.

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Information about this children’s home

Inspection dates: 28 and 29 November 2017

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This monitoring visit

This monitoring inspection took place because of serious concerns raised by the police to Ofsted in relation to the level of staffing and the subsequent behaviour management of the children at the home. There had also been three serious notifications, which were received from the home on 24 November 2017, all for events which took place on 23 November 2017.

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This monitoring visit

The inspector found that there are not enough qualified and experienced staff at the home to manage effectively the significantly challenging behaviour of the children accommodated and ensure their safety and well-being. This is of particular concern given the specialist nature of this home. The inspector found, through discussion with the home’s management and the staff, and through examination of records, that four of the staff have recently handed in their notice and are due to leave the home in either December 2017 or January 2018. The constitution of the staff team is such that, apart from the registered manager and two deputy managers, only two residential support staff have a relevant qualification at level 3. In addition, there are three therapeutic practitioners who have psychology degrees. The remaining staff are waiting to begin or working towards their level 3 qualification. In terms of

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This monitoring visit

experience, again with the exception of the registered manager and two deputy managers, staff have a low level of experience of working in this home or in a role which is directly relevant to meeting the specific and complex needs of the children. Twenty of the 26 staff have worked at the home for less than a year, with several having only recently started. The four staff who are due to leave are a qualified team leader and the three therapeutic practitioners. Two of them are among the six staff who have worked at the home for over a year. A number of agency staff Inspection report for children’s home - monitoring visit: 1257796 2 support the staff team, although the registered manager tries to use a consistent group. The current staffing complement is insufficient in terms of qualifications, experience and numbers needed to manage effectively the behaviour of, and provide a good level of care for, the number of children in the home, especially

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This monitoring visit

given the specialist nature of this home. The staff have been unable to manage effectively the recent increase in significant behaviour incidents and take effective action when serious incidents occur. This places children at risk of significant harm.

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This monitoring visit

Some of the staff have advised the police that the reason they call them is that there are insufficient staff to manage the children’s recently challenging behaviour, although the home’s management disputes this. Staff informed the inspector that, while staff numbers may seem appropriate, there can be issues with the ‘calibre’ of staff and, at times, several staff are required to deal with an incident, leaving a reduced number to care for the other children. One member of staff stated that ‘everybody’ feels that the home is understaffed and that the staff are overworked. A child said that they were not able to speak to agency staff in the same way that they could with the permanent staff. Some of the children spoke about being threatened by the behaviour of other children and feeling unsafe in the home, and the police being called frequently.

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This monitoring visit

It is of serious concern that one of these children had been physically assaulted by another child very recently. This happened in a community meeting which both children attended despite previous threats having been made by one child against the other.

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This monitoring visit

One child informed the inspector that the disturbances happen every night and the home goes into ‘lock down’ whereby the two corridors are locked. Managers and the staff spoke of ‘constant assaults on staff’ and ‘massive property damage’. One member of staff stated that it felt like there was a lack of structure, with a feeling that the children were in charge, and also that the staff were ‘firefighting’ and that this required a higher number of staff. Managers and staff spoke of the impact on other children, one of whom is reluctant to come out of his room when there is a disturbance in the home. The staff spoke of not always having the capacity to give attention to less demanding children at times. The accounts of management and staff demonstrate that the home is organised in such a way that it is unable to meet the complex individual needs of all the children accommodated. The serious incidents that have occurred, and the inability of staff to address these effectively,

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This monitoring visit

have had a negative impact on children’s emotional well-being and left some children feeling unsafe.

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This monitoring visit

There is considerable damage to the furniture in the home. At the time of the inspection, the kitchen/dining room on one corridor had a number of broken cupboard doors and no table or chairs. The children had to go to the other corridor to use another dining area. It is of serious concern that one child was sleeping on a mattress on the floor, as she continually breaks the beds that have been provided. The registered manager said that they are constantly replacing furniture. However, failing to control the damaging behaviour is resulting in periods when children do not Inspection report for children’s home - monitoring visit: 1257796 3 have the necessary furniture that they require to meet their needs.

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This monitoring visit

The inspector reviewed a selection of records and found a number of errors and omissions which had not been identified in the day-to-day and senior management monitoring of the service.

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This monitoring visit

 There was one record of a physical intervention of a child which actually included three incidents over an 11-hour period. These were separate incidents which had not been recorded separately. Having them on one form gives a false picture of the number of physical interventions that are taking place and can be misleading to managers when reviewing the frequency of incidents.  One incident when a child physically assaulted another child was recorded on an incident form (although with an incorrect date). The form referred to staff prising one child’s hands from the other child’s hair. The notification of this event, which was sent to Ofsted, referred to a ‘hold’ being used, but there was no record of this in the physical intervention book. Consequently, the details of the hold are not recorded and, again, this gives an inaccurate picture of the number of physical interventions that are taking place in the

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This monitoring visit

home. Furthermore, this prevents managers from monitoring and reviewing the full details of the physical restraint, because these were not recorded.  The hard copy of an incident report for one child was not on their file and could not be found. There was a record of this on the home’s computer.  The home keeps a logbook which regularly shows which staff are dealing with which children, but this failed to make any reference to two physical interventions which took place on 27 November 2017. It only states that staff were ‘supporting’ children. Although the physical interventions were recorded in the dedicated log, this is an indication of inconsistent record keeping.  The police have a record of a call to the home on 22 November 2017, but the registered manager could not find any record of this.  The home keeps a spreadsheet overview of incident reports, but this does not include an incident that took place on 1 November 2017 when the police were

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This monitoring visit

called to the home because of criminal damage that a child had caused. An incident report had been recorded, but not transferred to the spreadsheet.  The rota showed the registered manager working at the home on 27 November 2017 when, in fact, she was not working.

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This monitoring visit

Although from the records examined, these appear to be isolated errors, this demonstrates a picture of a system that is ineffective in ensuring that important records about significant incidents in children’s lives are kept reliably. This prevents the effective monitoring and review of the impact of the operation of the home on children. Some of these errors further indicate that day-to-day and senior management monitoring is not identifying errors or omissions. It is of serious Inspection report for children’s home - monitoring visit: 1257796 4 concern that the records in the home cannot be relied on. The failure to keep records of all incidents does not allow managers to monitor incidents in the home and take any necessary action.

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This monitoring visit

The registered manager and deputy manager informed the inspector that doors are being locked, both inside the home, to prevent some children having contact with other children, and externally, to prevent children from going missing. The registered manager and the staff are not keeping records of the reasons for this or the time and duration of it happening. Staff did say that it happens more at night, to prevent children going missing, and that when one child (who left in July 2017) was at the home it happened on a ‘pretty much constant basis’. Those children who wanted to leave the building would have to ask staff to unlock the door. Due to an inability to manage some very challenging behaviour, the home has been separated into two corridors. Each has a separate staff team, and the doors are locked to prevent children from moving between corridors. While it would be understandable to take emergency action to keep a child safe in infrequent and unpredictable

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This monitoring visit

circumstances, the frequent locking of doors is depriving children of their liberty. The external front door was being locked in a way which was not over-ridden when the fire alarms went off. The appropriateness of this practice had not been checked with anyone with suitable experience of fire safety, which potentially put children at risk of significant harm. In an action plan sent to Ofsted on 30 November 2017 by Lorna Fearon, Operations Director, Cambian Care has assured Ofsted that this will no longer happen.

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This monitoring visit

The registered manager has not sent Ofsted notifications of all significant incidents, as set out by the Children’s Homes (England) Regulations 2015. On 17 and 20 November 2017, the police were called to the home. On the first occasion, the staff had dialled ‘999’ to call the police to the home because two children had caused damage and one of them had forced their way into an area of the home and removed a set of keys. On the second occasion, a child was arrested for breach of the peace. Ofsted was not notified of either of these incidents. This prevents Ofsted, as the regulator, from monitoring what is happening in the home and assessing whether any regulatory action is required in order to ensure that the children are safeguarded effectively.

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Recent inspection history

Inspection date Inspection type Inspection judgement 26/07/2017 Full Requires improvement to be good Inspection report for children’s home - monitoring visit: 1257796 5

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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 quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and the outcomes it seeks to achieve for children and use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. (Regulation 6 (1)(a)(b)(2)(c)(i)) 31/01/2018

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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 to aspire to fulfil their potential and promotes their welfare.

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Requirement Due date

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; ensure that the home has sufficient staff to provide care for each child, and use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(c)(d)(h)) 05/01/2018*

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Requirement Due date

The registered person must ensure that no measure of control is excessive, unreasonable or contrary to The Children’s Homes (England) Regulations. (Regulation 19(1))

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Requirement Due date

In particular, the registered person must ensure that children are not routinely deprived of their liberty without a court order, as set out in the ‘Guide to the children’s homes regulations including the quality standards’, page 50, paragraph 9.63. 05/01/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 05/01/2018 Inspection report for children’s home - monitoring visit: 1257796 6 *These requirements are subject to a compliance notice.

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: 1257796 7

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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 Group, 4th Floor Waterfront Building, Chancellors Road, Hammersmith Embankment, London W6 9RU

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Inspector

Clive Lucas, social care inspector Inspection report for children’s home - monitoring visit: 1257796 8 to 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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