Children's Home run by Cambian Childcare Limited in Lancashire

Inspection report children’s home: SC478468 1 SC478468 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 offers medium- to long-term care for a maximum of five young people who have emotional and behavioural difficulties. A large national provider of children’s residential services operates the home.

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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 requires improvement to be 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

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection:

None Inspection report children’s home: SC478468 2

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Key findings from this inspection

This children’s home requires improvement to be good because:  There is a new manager in place who has had a limited time to embed a culture of good practice in the home.  Poor matching of young people’s needs has resulted in multiple placement breakdowns due in part to inconsistent management and inexperienced staff.  The home’s fire risk assessment has not been followed by staff. As a result, young people have kept cigarette lighters in their bedrooms. This is despite a requirement also raised at the previous full inspection in October 2016 linked to fire safety at the home.  Medication has not been given to young people as prescribed; this is also despite a requirement being raised at the previous inspection in March 2017.  Behaviour management strategies including the use of sanctions are inconsistent and fail to address unacceptable behaviour. Young people do not, therefore, benefit from clear behaviour management strategies.

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Key findings from this inspection

 Ofsted has not been notified when serious incidents have occurred at the home.  Staff do not always listen to young people or act on their wishes and feelings and do not keep them informed of the outcomes of their complaints.  Key-working sessions are poor. They do not clearly document the work that staff complete with young people to help them feel safe.  Supervisions, particularly following serious assaults on staff, are not being recorded; this is also despite a requirement that was raised at the previous full inspection in October 2016.

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Key findings from this inspection

The children’s home’s strengths:  Engagement in education increases during placement, particularly for those who have not been in formal education for significant periods of time. Some have recently taken exams and are engaged in their post-16 education.  Staff have remained committed to a previous young person that they cared for, despite it being a complex and challenging placement.  There is evidence of good relationships between staff and the current young person in placement.  Leaders and senior managers are committed to making sustained improvements to the service and are providing support to the acting manager and staff. Inspection report children’s home: SC478468 3

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Inspection date Inspection type Inspection judgement

30/03/2017 Interim Sustained effectiveness 05/10/2016 Full Good 07/01/2016 Interim Sustained effectiveness 15/07/2015 Full Good Inspection report children’s home: SC478468 4

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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

7: The children’s views, wishes and feelings standard

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Requirement Due date

Ensure that children receive care from staff who develop positive relationships with them; engage with them; and take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. (Regulation 3(a)(b)(c)) 31/10/2017

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults. encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding (Regulation 11(a)(b)(c)(iii)) 31/10/2017

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Requirement Due date

The registered person must ensure that children are protected from harm and enabled to keep themselves safe. In particular, the home must ensure that it has all available information about a child’s risks and vulnerabilities prior to admission, in order to assess whether a child is at risk to themselves and/or others. (Regulation 12(1)(2)(a)(i)) 31/10/2017

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Requirement Due date

The registered person must demonstrate that any medicine prescribed for a child is administered as prescribed. (Regulation 23(2)(b)) 31/10/2017

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Requirement Due date

Since the Regulatory Reform (Fire Safety) Order applies to the home the registered person must ensure that the requirements of that order and any regulations made under it are complied with. This is with specific reference to the home’s fire safety risk assessment and allowing young people to have cigarette lighters in their bedrooms. (Regulation 25(2)(b)) 31/10/2017

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience at the frequency prescribed in the home’s own 31/10/2017 Inspection report children’s home: SC478468 5 policy, and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(b)(c)) The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39(3)) 31/10/2017

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; and if there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40(4)(b)(e)) 31/10/2017

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Recommendations

 To meet the care planning standard, the registered manager must demonstrate that the home only accepts a placement once they are satisfied that the home can respond effectively to the young person’s assessed needs and after a full assessment of the impact on the existing group of young people. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.4)

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improvement to be good

Since the last full inspection in October 2016, six young people have moved into the home and six young people have been discharged. Placements have at times been poorly risk assessed as suitable. Some placements have lasted for no longer than two weeks. Transitions to next placements have sometimes been abrupt. For example, staff woke a young person to inform them that they were leaving in two hours and told them to collect their belongings. This places low value on the emotional well-being of young people and reduces their ability to be emotionally resilient.

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improvement to be good

On occasions, staff do not follow young people’s behaviour management plans in respect of behaviours such as causing damage to the home. For example, young people have taken food from the fridge, pasta, yoghurts and cheese, and thrown these items across walls and floors. Bottles of water have been dispensed over staircases. Staff have documented how they cleaned up the environment and that the sanction that was to be put in place was withdrawn, as the food, the manager reported, ‘was going out of date the next day anyway’. As a result of such actions, young people do not learn about acceptable, appropriate and safe behaviours.

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improvement to be good

Staff have failed to consistently act on complaints that the young people have raised. For Inspection report children’s home: SC478468 6 example, when a young person made staff aware that items had been stolen from their bedroom, staff did not log the young people’s concerns and did not always keep them informed about what actions they were taking. The manager stated that a complaint form was given to the young people to complete, which was declined. As a result, no investigation or recorded outcome was discussed with the young people. This devalues young people’s views and contributes to their not being involved in their care.

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improvement to be good

There have been inconsistencies in the staff team due to the use of agency staff and staff from other children’s homes to cover shifts in the home. The home has seen 11 members of staff leave their employment since the last full inspection in October 2016. The manager returned from maternity leave in the spring of 2017. Annual leave has taken her away from the home over most of the summer period. Consequently, there has not always been robust managerial oversight of the home.

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improvement to be good

Key-working sessions are poor and do not link with the aims and objectives of the placement. They are reactive and do not support young people’s understanding about risk-taking behaviours, keeping safe or relationships. For example, when a young person was recently diagnosed with bronchitis the general practitioner suggested that they should stop smoking. Following the appointment, staff at the home failed to discuss the concerns that the doctor had about the young person’s health. The manager stated that ‘should the young people wish to give up smoking, advice on how they can do this is displayed on the young person’s notice board.’ This meant that the opportunity to have a face-to-face discussion was missed.

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improvement to be good

Staff are not consistently evidencing that they are administering prescribed medicines as specified by health professionals to ensure their safe and effective use. For example, a contraceptive pill has been prescribed to be issued to a young person at the same time each day. The medical records indicate that times of issue range from morning and evening and are not consistent. The manager suggested that this was of little consequence, as the medication had been prescribed for specific medical issues and not to prevent the young person from becoming pregnant.

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improvement to be good

The current young people are happy and stated that they feel safe. Although they have lived in the home for a relatively short period of time, they are making progress and have formed good relationships with staff. For example, they have attended school. One young person asked for his reduced timetable to be increased to full time as he is enjoying the school so much. A good-quality, structured daily planner is in place, which supports the young person’s feelings of safety. The young person enjoys this structure and routine in his daily life. He likes the home and he wishes to personalise it further with a fish tank.

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improvement to be good

Individualised care is good. Staff have sourced activities for the current young people based on their likes, such as trampoline, snooker and walks on the beach. Staff have taken time to get to know them and they understand their needs. One young person said, ‘This is the best care home I’ve been in. They have really helped me turn my life around.’ Inspection report children’s home: SC478468 7 Young people develop the independence skills that they need as they approach adulthood. They grow in confidence and have clear aspirations. One young person has recently passed her driving test. She has recently returned to her home town, living with foster carers, to start a radio production course.

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improvement to be good

Young people are supported to keep in appropriate contact with their families. Some of the young people live a long way from home and there are serious risks to their safety in their home areas. As a result, contact is generally carefully planned and supervised closely.

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improvement to be good

Young people appreciate the help and support that they receive from staff to attend regular health checks. Specialist support from the home’s own clinical psychologist helps young people to understand their feelings and anxieties and improves their emotional well-being. Eating healthily and thoroughly enjoying a new range of more physical activities keep young people physically fit, and they experience a great sense of achievement.

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improvement to be good

There has been poor managerial oversight of the home and inconsistencies with staffing, which have resulted in staff being unable to support young people’s behaviour. Inexperienced staff have not been skilled in de-escalating situations and have not helped young people to develop the ability to self-regulate their behaviour. As a result, young people have been given notice by the home and have had to move on to other placements. This does not suggest well thought-out placement matching.

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improvement to be good

Impact risk assessments are prepared by the manager after she has agreed to take the placement with the local authority. The assessments are generally generic and poorly recorded. For example, the section about how to manage identified risks to young people is left blank.

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improvement to be good

The home’s fire risk assessment has not been implemented by the manager. The assessment clearly states that cigarette lighters are handed in during the evening to reduce any risk of fires at night. A tour of the third floor and attic bedroom found that there was a cigarette lighter on the floor in one room. The manager explained that she had not asked the young person to hand in their lighters, as it would have been ‘institutional’ to do so. This means that the fire safety risk assessment is not accurate and it fails to ensure that there are comprehensive plans in place to manage fire safety in the home.

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improvement to be good

A young person who had associations with a London gang was recently admitted to the home The young person made threats about the gang and said that someone from the gang was coming to collect her. The manager was unable to verify that she had informed the local police of these associated risks when the young person was admitted to the home and entering the local area. The local police were unable to recall whether a Inspection report children’s home: SC478468 8 conversation had taken place with the manager of the home regarding this matter.

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improvement to be good

On occasion, when concerns have been raised regarding staff practice, the management of the home has been proactive and has worked with the designated officer for the local authority and thoroughly investigated these concerns. The manager is reflective in practice and takes action to prevent recurrence when this is identified. This means that young people are consistently and effectively protected.

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improvement to be good

Young people are protected by sound recruitment processes that ensure that staff are carefully selected and checked to prevent unsuitable people from working in the home.

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improvement to be good

The environment is generally physically safe. Fire safety training and regular checks to the fire systems ensure that due care is taken to ensure that everyone is safe. Young people are involved in fire drills and are aware of what to do in the case of a fire.

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improvement to be good

The home is located, designed and of a size and layout to meet the needs of all the young people placed there. It has a good standard of decor and young people and staff have made the environment comfortable and homely. Young people are proud of their individual rooms, which are personalised and of a good size. They have a good outdoor space, where they engage in activities or spend time with the staff in the garden.

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

Since the last full inspection in October 2016, the registered manager has resigned. A new manager’s application was submitted to Ofsted in January 2017. However, because of delays in obtaining the applicant’s references, maternity leave and annual leave, the manager has not yet been registered. Management oversight of the home since the last inspection has not been sufficiently robust to ensure that good systems are in place to monitor and review young people’s continuous progress. The manager has begun to provide leadership in the home and, as a result, fewer staff are leaving, and the placements of the young people who are currently living at the home are stable.

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

The manager is an experienced and qualified member of staff. However, she has not previously been registered as a manager with Ofsted. She and her staff are child focused, which results in a home that is run for the benefit of young people. Staff talk positively about the support they receive from the manager.

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

The manager is committed to changing the ethos and running of the home. New systems are in place to equip staff with the skills to manage young people’s complex behaviours and to improve management oversight of the care that staff are providing to young people. Despite the introduction of new systems, there are still occasions when the response of staff to young people in times of crisis does not safeguard young people or staff. In addition, management oversight has sometimes failed to identify poor practice. This has resulted in young people’s welfare and safety being compromised and, consequently, the home not delivering care in line with its statement of purpose. Inspection report children’s home: SC478468 9 Despite placement matching and impact assessments being in place for young people, the current group of young people at the home have undoubtedly had a negative influence on each other and have contributed to escalating each other’s behaviours. This

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

demonstrates that the matching activity is not robust or effective in ensuring that positive matches are made, which will have minimal impact on the care of young people.

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

Supervision records do not identify the face-to-face meetings that the manager stated she had had with staff after they had been assaulted in the home by young people. Some of these incidents were very serious and compromised the safety and welfare of staff at the home. The manager stated that such incidents had taken place, but acknowledged that there was no written evidence to support this. Staff did not raise any concern about not being supported while on duty.

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

Senior staff working in the home are appropriately qualified, 10 of the 16 care staff have yet to obtain a level 3 childcare qualification. As a result, staff may not have the skills or experience to respond to young people in the most appropriate manner. The organisation is trying to address this as quickly as possible by enrolling the care staff onto relevant courses prior to their completing their six-month probation. This has caused a delay in staff achieving the qualification.

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

The home has not notified Ofsted of relevant issues in accordance with regulation. For example, a young person in crisis placed their life at risk by sitting on the third floor wall of a multi-story car park. This means that the regulatory body cannot review the actions taken by the home to maintain the ongoing safety of young people placed there.

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

The registered provider has appointed an independent regulation 44 visitor who undertakes regular visits to the home and reports on their findings. This means that the quality of care and welfare of young people are adequately monitored. Reports are sent to Ofsted in a timely manner and reflect accurately the current situation in the home. Consequently, the regulator has the opportunity to assess how well the home is responding to issues that may be identified to improve the service.

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

The management team promotes and embraces feedback, including that on issues arising from independent and internal monitoring processes. However, new ideas and emerging practice are not yet embedded throughout the managerial and staffing culture.

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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 differences 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 Inspection report children’s home: SC478468 10 making for the children and young people whom 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: SC478468 11

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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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Inspectors

Elaine Clare, social care inspector Jessica Forshaw, social care inspector (shadow) Inspection report children’s home: SC478468 12 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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Inspectors

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Inspectors

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Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

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