Children's Home run by Cambian Childcare Limited in North Yorkshire

Inspection report children‟s home: 1159397 1 Registered provider: Cambian Childcare Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a privately run children‟s home. It provides care for up to four children or young people who have emotional and/or behavioural difficulties. This home caters specifically for young people who have been subject to child sexual exploitation. Education is provided on site.

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Information about this children’s home

Inspection dates: 21 to 22 November 2017

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

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inadequate

Overall judgement at last inspection: declined in effectiveness

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Enforcement action since last inspection:

The home has been subject to three compliance notices issued in relation to the positive relationships standard, the protection of children standard and the leadership and management standard. A restriction of accommodation notice is in place. Inspection report children‟s home: 1159397 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 staff are unable to prevent the young people from going missing. During the time that they are away from the home, the young people are at risk of being sexually exploited and misuse substances.  Risk assessments do not contain effective measures to enable staff to mitigate the risks to the young people.  The young people do not make any progress in terms of their education, health or emotional well-being. The manager has failed to sufficiently challenge placing authorities to secure better outcomes for the young people.  Staff have not helped each young person to develop an understanding of, and the skills to recognise and withdraw from, damaging and exploitative relationships.  The care that is delivered is not consistent with the statement of purpose. The manager does not ensure that all those providing care to the young people understand and apply it in their practice.  The staff team lacks the qualifications, experience and skills to meet the needs

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Key findings from this inspection

of the young people, who have experienced sexual exploitation and trauma in their lives.

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Key findings from this inspection

 The manager has improved the quality of the information available to the staff. This ensures that care is based on up-to-date, comprehensive information.  The manager has improved the regularity and quality of supervision of the staff. This will support their practice and identify the areas where they need to develop.  The home has been redecorated and provides a homely, comfortable environment for the young people.

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Inspection date Inspection type Inspection judgement

18/08/2017 Interim Declined in effectiveness 24/04/2017 Full Requires improvement to be good 24/11/2016 Interim Declined in effectiveness 27/06/2016 Full Good Inspection report children‟s home: 1159397 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

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child‟s placing authority effectively in the child‟s care, in accordance with the child‟s relevant plans;

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Requirement Due date

seek to secure the input and services required to meet each child‟s needs;

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Requirement Due date

if the registered person considers, or staff consider, a placing authority‟s or a relevant person‟s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child‟s needs are met in accordance with the child‟s relevant plans; and

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate, having regard to the range of needs of children for whom it is intended that the children‟s home is to provide care and accommodation. (Regulation 5(a)(b)(c)(d)) 11/02/2018

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children‟s home‟s overall aims and the outcomes it seeks to achieve for children:

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Requirement Due date

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—

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Requirement Due date

understand and apply the home‟s statement of purpose; ensure that staff - 11/02/2018 Inspection report children‟s home: 1159397 4 understand and apply the home‟s statement of purpose. (Regulation 6(1)(a)(b) and 6(2)(a)(b)(i))

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Requirement Due date

Specifically, that the registered person and the staff ensure that young people receive education, health and therapeutic services as specified in the statement of purpose.

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Requirement Due date

The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so.

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Requirement Due date

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

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Requirement Due date

understand the barriers to learning that each child may face and take appropriate action to help the child to overcome any such barriers. (Regulation 10(1) and 10(2)(a)(iii)) 11/02/2018

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

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

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Requirement Due date

take part in activities, and attend any appointments, for the purpose of meeting the child‟s health and well-being needs. (Regulation 10(1)(a) and 10(2)(a)(iii)) 11/02/2018

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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—

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Requirement Due date

an understanding about acceptable behaviour; and

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Requirement Due date

positive responses to other children and adults.

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Requirement Due date

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

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Requirement Due date

help each child to develop the understanding and skills to recognise or 11/02/2018 Inspection report children‟s home: 1159397 5 withdraw from a damaging, exploitative or harmful relationship. (Regulation 11(1)(a)(b) and 11(2)(a)(vii))

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Requirement Due date

* 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

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

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Requirement Due date

assess whether each child is at risk of harm, taking into account information in the child‟s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child;

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Requirement Due date

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. (Regulation 12(1) and 12(2)(a)(i)(b))

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Requirement Due date

Specifically, that the staff receive additional training to ensure that they understand the home‟s safeguarding policy and procedures and how to implement them in day-to-day care. Staff must understand their role in taking immediate action to keep young people safe, their roles and responsibilities in respect of missing children, and the local missing from home protocol and their responsibilities within this. Staff should know how to support children who may be using illegal drugs and medicines. Risk management must consider all factors relating to risk and put in adequate measures to mitigate these risks. 11/02/2018

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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—

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Requirement Due date

helps children aspire to their full potential; and

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Requirement Due date

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

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13(1)(a)(b) and 13(2)(c))

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Requirement Due date

Specifically, the registered provider should review the staffing structure, including the experience and qualifications of those staff working within the core team of the home. This review should be recorded, detailing how the staff team‟s skills and knowledge will provide high-quality care 11/02/2018 Inspection report children‟s home: 1159397 6 to children in line with the home‟s statement of purpose. Further training and development opportunities, for those staff who are identified as requiring it from the review, should be provided.

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Requirement Due date

* 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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Requirement Due date

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. (Regulation 16(1) and 16(5))

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Requirement Due date

Specifically, to review the management and running of the children‟s home to ensure that its organisation, staffing and structure meet the aims and objectives as set out in the statement of purpose. To record any changes or actions taken as a result of this review. 11/02/2018

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Requirement Due date

* These requirements are subject to a compliance notice.

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Overall experiences and progress of children and young people: inadequate

The young people are not being protected from sexual exploitation at this home and the provider has failed to take the appropriate action to protect them from harm or the risk of further harm. The young people have made no progress in their educational, health or social development since their admission to the home. The provider has failed to fully meet the compliance notice issued at the last inspection. This has led to the judgement of inadequate.

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Overall experiences and progress of children and young people: inadequate

One young person has been admitted and two have left the home since the last inspection. Their discharge has not been as a result of positive progress, but because the home could not meet their complex needs and keep them safe.

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Overall experiences and progress of children and young people: inadequate

The young people refuse to attend the on-site education, and their educational attainment is well below that which would be expected for their peers. They spend the majority of every day in bed. Their response to the staff who try to persuade them to get up is to ignore them and utter verbal abuse. Staff have been unable to help the young people to overcome their barriers to learning and take part in any meaningful education. A requirement in respect of this is raised.

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Overall experiences and progress of children and young people: inadequate

The staff struggle to develop good daily routines and structured activities at the home. They accede to the young people‟s demands for meals at all times of day, and the young people spend most of their time in their bedrooms, engaging with staff only to go out shopping. These outings are regularly used to run away from staff and can result in protracted periods of being missing from home, when they are at risk of sexual exploitation and drug misuse. Inspection report children‟s home: 1159397 7 The young people show no signs of developing positive relationships with the staff. Despite improvements in the range, content and frequency of direct work with them, this is having no impact on the choices that they make. They continue to run away and be at risk of serious harm. Recognising and withdrawing from exploitative relationships have not been identified as priorities for individual work, and no sessions directly relating to

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Overall experiences and progress of children and young people: inadequate

this area have taken place with the young people. This limits the staff team‟s ability to help young people to remain safe and improve their outcomes and aspirations. A previous compliance notice regarding this is not met.

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Overall experiences and progress of children and young people: inadequate

Health outcomes for the young people are poor. They misuse substances and their sexual health is not protected. Their immunisations and dental care are not up-to-date. Although the staff refer them to a variety of specialist agencies for support, they are unable to secure the engagement of the young people with these services. The statement of purpose states that the home „offers a 12-month full-time programme for children and young people who have experienced or are at risk of sexual exploitation‟ and that this is „monitored through assessing behavioural, emotional and interpersonal functioning‟. The young people currently resident have consistently refused to engage in any therapeutic work from the point of their admission over 12 months ago. No progress from their starting points is evidenced in their psychological assessments. The programme has failed to effect any positive change. Despite this, they have remained at

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Overall experiences and progress of children and young people: inadequate

the home. Clinical staff and the manager have allowed this situation to continue without taking appropriate action to secure better outcomes for the young people.

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Overall experiences and progress of children and young people: inadequate

Staff have implemented work to develop independence skills to help the young people to prepare for the adult world. Their achievements are being tracked and celebrated using individual workbooks. A recommendation made at the last inspection in respect of this is met.

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Overall experiences and progress of children and young people: inadequate

The home has recently being redecorated, and is a homely and inviting place for the young people to spend time.

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

Despite the home operating with only half the permitted number of residents, staff have demonstrated that they are unable to safeguard the young people. Missing from home episodes are not reducing for the young people currently placed. For example, one young person has been missing seven times in the last three months, sometimes for periods up to a week in duration. While missing from the home, the young people are extremely vulnerable to potential harm and exploitation. They have disclosed to staff that, during the time when they are missing, they are being subjected to sexual exploitation and are involved in dangerous situations. One young person told staff that they „didn‟t know how they were still alive‟ after getting into a car with a speeding driver who was under the influence of drugs.

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

There have been incidents where the young people have been found to be using illegal substances and misusing drugs. On one occasion, they were found smoking drugs in the Inspection report children‟s home: 1159397 8 grounds of the children‟s home.

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

The control measures identified to mitigate the risk of the young people absconding are inadequate and ineffective. Risk assessments for community outings identify a staffing ratio of only one to one, despite the history of the young people running away and going missing. The young people have repeatedly gone missing while on these outings, exposing them to the risk of further sexual exploitation and substance misuse. A requirement in respect of this is raised.

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

Staff have not used all the strategies at their disposal to protect the young people. They are confused about their legal position with regard to preventing the young people from leaving the premises. Although missing from care protocols are now clear and comprehensive, partners comment that the staff still „have a way to go‟ in their response to the young people going missing.

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

Behaviour management strategies within the home are weak. There is a discrepancy between the information about managing behaviour specified in the home‟s statement of purpose, the direction of the clinical team, and the views of the manager and some staff. There is no evidence of consequences for inappropriate or dangerous actions by the young people and, as a result, they are not developing an understanding of appropriate or safe behaviour.

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The effectiveness of leaders and managers: inadequate

This home has been the subject of widespread compliance action by Ofsted since the last full inspection. Improvements in the quality and regularity of supervision have been made by the manager, and the quality of documents such as behaviour management plans now supports staff to care for the young people more effectively. Unfortunately, this has not led to a positive impact on the care and progress of the young people. As a result, a number of compliance notices issued previously in the areas of positive relationships, the protection of children and leadership and management are being reissued.

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The effectiveness of leaders and managers: inadequate

The manager had failed to register her application in the required timescale, leaving the home without a registered manager for well over 26 weeks. However, this application has now been progressed.

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The effectiveness of leaders and managers: inadequate

The manager has failed to act on the inability of the staff to prevent the young people from going missing when they are involved in exploitative relationships and substance misuse. She has neglected to react to the absence of progress of the young people in education, health and emotional development. This inaction has resulted in the young people‟s positive outcomes being significantly reduced.

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The effectiveness of leaders and managers: inadequate

The manager has improved her engagement with a range of other professional agencies, such as the police and the specialised nurse for children who are looked after, with arrangements being put in place for more effective partnerships. However, these protocols are not always followed by staff, resulting in the health and well-being of the Inspection report children‟s home: 1159397 9 young people being compromised. For example, the specialist nurse for looked after children is not always notified of missing episodes.

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The effectiveness of leaders and managers: inadequate

Crucially, the manager has not challenged placing authorities sufficiently to move the young people when it has become apparent that the placement cannot meet their needs or keep them safe.

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The effectiveness of leaders and managers: inadequate

The majority of the staff are not appropriately qualified. Only three staff out of a staff team of 11 hold a relevant qualification. They are inexperienced in children‟s residential care and in working with children and young people who have been subject to sexual exploitation and trauma. They lack the necessary confidence and skills to meet the high level of need of these young people. Training needs are being identified and unqualified staff have enrolled on qualification courses. Unqualified and inexperienced staff continue to be recruited. This leaves both staff and young people vulnerable.

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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 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: 1159397 10

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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

Janet Black, social care inspector Inspection report children‟s home: 1159397 11 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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