Children's Home run by Cambian Childcare Limited in Shropshire

Inspection report children‟s home: SC476267 1 SC476267 Registered provider: Cambian Childcare Limited.

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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 is run by a private organisation and offers care and accommodation for up to five young people who may have emotional and/or behavioural difficulties.

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Information about this children’s home

Inspection dates: 20 to 21 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 children are not protected or their welfare is not promoted or safeguarded and the care and experiences of children are poor and they are not making progress.

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inadequate

Date of last inspection: 28 February 2017

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inadequate

Overall judgement at last inspection: declined in effectiveness

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Enforcement action since last inspection:

None Inspection report children‟s home: SC476267 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

 There is a failure to ensure that risk is appropriately assessed and managed.  Staff implementation of children‟s plans to manage and address behaviour is weak and ineffective.  The home aims to provide care for children who may be the victims of sexual abuse. However, not all of the staff have received training that informs this type of care and consequently staff do not have the requisite skills or experience to deal with and support children who have experienced sexual abuse and who display sexualised or associated behaviours.  Staff have not given sufficient attention to or taken account of the impact on individual children of being placed in a group of children who have complex, challenging and differing needs.  Staff do not receive regular practice supervision from their line manager.  Children have not received care from a consistent or stable staff group: 14 staff have left the home since September 2016 and nine staff have joined the home.

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Key findings from this inspection

In addition, there have been three different managers in the home during the same period.  Managers and staff have failed to manage incidents of self-harm effectively and, consequently, further incidents have occurred.  The registered manager has poor oversight of bullying incidents and this has left children vulnerable.  There are recurring and significant regulatory breaches in the safe recruitment of staff.  Some children display inappropriate and sexualised behaviours that have a direct and adverse impact on other children living in the home. Staff have been ineffective in dealing with these behaviours.  Inspectors found that one primary fire exit was blocked and the boiler room was being used to store a large amount of paper records, creating a fire hazard.  The living conditions are poor.  Staff do not record all the required details following a physical restraint.  Staff do not understand or promote children‟s health needs.

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Key findings from this inspection

 Staff do not help children to have a voice.  Staff rotas lack the detail to validate which staff are on duty at any given time. Inspection report children‟s home: SC476267 3 The children‟s home‟s strengths

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Key findings from this inspection

 Children take part in a range of individualised activities.

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Inspection date Inspection type Inspection judgement

28/02/2017 Interim Declined in effectiveness 16/08/2016 Full Good 08/02/2016 Interim Not judged 22/12/2015 Full Requires improvement Inspection report children‟s home: SC476267 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

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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to understand and apply the home‟s statement of purpose and ensure that staff understand and apply the home‟s statement of purpose. (Regulation 6(1)(a)(2)(a)(b)(i)) 17/01/18

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Requirement Due date

The children‟s views, wishes and feelings standard is that children receive care from staff who take their views, wishes and feelings into account in relation to matters affecting the children‟s care and welfare and their lives.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to: ensure that staff ascertain and consider each child‟s views, wishes and feelings, and balance these against what they judge to be in the child‟s best interests when making decisions about the child‟s care and welfare; help each child to express views, wishes and feelings and help each child to understand how the child‟s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child. (Regulation 7(1)(c)(2)(a)(iii)) 17/01/18

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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.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff have the skills to recognise incidents or indications of bullying and how to deal with them. (Regulation 11(1)(a)(b)(c)(2)(a)(xiii)) 17/01/18 Inspection report children‟s home: SC476267 5 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 that staff:

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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; and that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child‟s health. (Regulation 12(1)(2)(a)(i)(b)(d)) 17/01/18

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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.

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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

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 staff work as a team where appropriate; ensure that staff have the experience, qualifications and skills to meet the needs of each child; and ensure that the home has sufficient staff to provide care for each child. (Regulation 13(1)(a)(b)(2)(1)(a)(b)(c)(d)) 17/01/18

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Requirement Due date

The care planning standard is that children receive effectively planned care in or through the children‟s home. (Regulation 14(1)(a)) 17/01/18

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if:

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children; 17/01/18 Inspection report children‟s home: SC476267 6 the child‟s placing authority consents in writing to the monitoring or surveillance. (Regulation 24(1)(a)(b))

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children‟s home. (Regulation 25(1)(a)) 17/01/18

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Requirement Due date

The registered person must ensure that full and satisfactory information is available in relation to any individual employed to work in the children‟s home in respect of each of the matters in Schedule 2. (Regulation 32(3)(d)) 17/01/18

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Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development and receive practice-related supervision by a person with appropriate experience. (Regulation 33(4)(a)(b)) 17/01/18

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes:

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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”) has spoken to the user about the measure; and 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)(a)(b)(i)(c)) 17/01/18

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Requirement Due date

The registered person must maintain in the home the records in schedule 4. This includes a copy of the staff duty roster of persons working at the home, and a record of the actual rosters worked. (Regulation 37(4)(3)) 17/01/18

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Requirement Due date

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)) 17/01/18 Inspection report children‟s home: SC476267 7

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Overall experiences and progress of children and young progress: inadequate

Children‟s progress and experience is inadequate. Incidents occur that put children at risk of sexual, emotional and physical harm. Opportunities to safeguard children are missed because staff fail to remain vigilant.

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Overall experiences and progress of children and young progress: inadequate

Staff fail to meet the individual needs of children. For example, a child is known to use Makaton to support their communication but this essential information is missing from the child‟s care plan and staff do not have training in this method of communication. This shortfall is unacceptable and leaves the child without their primary method of securing meaningful participation in matters that are important to them.

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Overall experiences and progress of children and young progress: inadequate

Staff do not understand or promote children‟s health needs. For example, one child has a chipped tooth and although staff have been aware of this for at least five months, the child still has not received the appropriate treatment. This delay in addressing the child‟s need for dental care is unacceptable. Staff are not aware of the different medications that children are prescribed and what the medicine is prescribed for. For example, staff were unsure whether a child‟s medication was prescribed for sleeping, relaxing or his appetite.

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Overall experiences and progress of children and young progress: inadequate

Managers have failed to ensure that the children‟s guide gives children essential information about how to speak to an independent person or how to make a complaint.

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Overall experiences and progress of children and young progress: inadequate

Neither the staff nor the manager consistently identify when bullying occurs. The manager and staff are unaware of the impact of bullying on individual children and have no effective strategy or method to deal with it. For example, some staff and the manager told inspectors that there had been no incidents of bullying. However, other staff said that children bully each other on a daily basis. A member of staff told the inspectors that staff intervention had „little effect on the children‟s behaviour‟. Incidents of bullying are not reflected in records nor do records show what action is taken to support the children.

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Overall experiences and progress of children and young progress: inadequate

Children‟s relationships with staff are adversely affected by multiple changes in the staff group over a lengthy period of time. For example, 14 staff have left the home since September 2016 and nine staff have joined the home. In addition, there have been three managers in the home during the same period. This means that children have not been able to form or sustain meaningful relationships with the adults who care for them.

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Overall experiences and progress of children and young progress: inadequate

Managers and staff have failed to ensure that the home is appropriately maintained. Inspectors found mould in a kitchen cupboard and in a young person‟s bedroom. One Inspection report children‟s home: SC476267 8 young person‟s bedroom window was blocked by a refuse bin. Inspectors found that one fire exit was blocked and the boiler room was being used to store a large amount of paper records, creating a fire hazard. This means that children‟s health and safety is unnecessarily compromised.

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Overall experiences and progress of children and young progress: inadequate

Staff are not trained to deliver significant aspects of the care that children need and, for instance, do not receive guidance on how to support positive and ongoing contact between children and their families. This means that the ability of staff to ensure children‟s safety during contact is compromised.

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Overall experiences and progress of children and young progress: inadequate

There are some positive features of care. For example, children take part in a range of individualised activities, which include children attending scouts and guides. Children also enjoy spending time on their bikes and going to the cinema. Some children have made progress. For instance, one child is calmer and is beginning to manage their feelings better. Another child is now able to manage more time in school.

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

Children‟s individual risk assessments are ineffective and do not accurately portray an up-to-date assessment of risk. Furthermore, managers have failed to implement an effective behaviour management strategy. For example, an unnecessary and potentially harmful incident occurred when two children went swimming together. This activity was not risk-assessed or agreed by a manager prior to the activity taking place. The children went out of the sight of staff and later both children made allegations of seeing each other naked and engaging in physical touching. Although this was reported at the time to the relevant authorities, this incident shows that staff have a poor oversight of risk, especially given children‟s known histories and vulnerabilities.

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

Inspectors were told that staff used a „positive sanction system‟. However, staff practice shows poor consistency in implementing behaviour management strategies. For example, one child has not received a positive sanction for a month. Despite the manager finding some sanctions to be harsh, she has not challenged this practice. This demonstrates poor management capacity to make improvements to the quality of care that children receive.

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

Staff have failed to ensure that physical restraint records are completed in line with regulation. For example, some records are difficult to read and do not provide evidence that staff have received a debrief session. There is also no evidence to show that children are offered medical advice after a restraint. The manager has signed off the records without challenging staff over missing information. This is another example of ineffective managerial oversight of staff practice.

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

Staff have little understanding of children‟s emotional needs and do not realise the importance of following children‟s comfort or security routines. For example, one child likes to have the comfort of a staff member staying with her until she falls asleep. Recently, despite staff being aware of this, they failed to stay with her and instead left Inspection report children‟s home: SC476267 9 her alone and awake. This followed a day when the child had presented with extremely complex and challenging behaviour. As a result of this failure to respond to the child‟s emotional needs the child became distressed and unable to settle. The child then left her bedroom and assaulted staff. Staff fail to take account of individual children‟s behaviour towards other children. For example, one child is known to display sexualised behaviour and targets this behaviour towards another child, making sexualised comments and

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

requests for sexual contact. Despite staff and the manager knowing about this potentially harmful behaviour there is no risk management plan in place to protect either of the children. The absence of any strategy or plan to manage or intervene in this situation is unacceptably poor practice and means that a child continues to be exposed to sexually harmful and distressing language on a regular basis.

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

The pre-placement work to match children living together in the home is very poor. For example, some children have a history of sexual trauma and other children do not. This has led to some children seeing the other children they live with inappropriately removing their clothes in public without having an understanding of why it is happening. There is no management guidance or written information to help staff to support the children or maintain the naked child‟s dignity. Staff display an alarming lack of professional insight and skill by simply asking the child why they are behaving in this way.

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

Managers and staff have failed to manage incidents of self-harm effectively. This poor practice has led to further incidents occurring. For example, on two occasions a child has been able to use hairspray to self-harm. Staff took some appropriate action after the first incident, including the removal of aerosol products. However, the same child was admitted to hospital after ingesting hairspray again to self-harm. This means that despite staff knowing that the child was at risk, they failed to put effective measures in place to prevent the child from doing the same thing twice.

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

There are recurring regulatory breaches in the safe recruitment of staff. For example, an agency member of staff worked at the home without her identification being checked or qualifications being documented as required. Furthermore, this member of staff cited brief reasons for leaving previous childcare employment but no subsequent exploration or follow up checks were made. This agency member of staff also had a previous conviction, which was clearly noted on their employment file. However, the registered manager was unaware of this.

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The effectiveness of leaders and managers: inadequate

The registered manager has worked in the home since April 2017. She has her level 4 diploma in leadership and management for care.

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The effectiveness of leaders and managers: inadequate

Despite the home‟s aims being to provide care to children who may be the victim of sexual abuse, staff are not trained to work with children who are victims of abuse. Neither are staff trained in understanding the risks to children of radicalisation, child sexual exploitation and social media. Inspection report children‟s home: SC476267 10 The manager is aware that staff morale is low, with staff reporting that they are exhausted. Despite this, staff have not received regular practice supervision with their line manager.

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The effectiveness of leaders and managers: inadequate

Although social workers told inspectors that they had made complaints to the home, the registered manager said that she had no knowledge of these. There seemed to be confusion about the threshold over what is deemed a complaint.

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The effectiveness of leaders and managers: inadequate

Staff rotas are difficult to read and on occasions use staff nicknames. There are various copies of the rota. This means that it is difficult to understand which staff have worked on any given day. This poor quality of management oversight has the potential to compromise the effective investigation and management of any allegation or workforce issue that may arise in the future.

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The effectiveness of leaders and managers: inadequate

Staff use bedroom door alarms, to monitor children moving around during the night. However, staff implement this method of surveillance without the required consent from the placing authority.

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The effectiveness of leaders and managers: inadequate

The home‟s statement of purpose says, „Our vision is to provide the highest possible level of care to the children that reside at [the home] and to promote a relaxed and homely and welcoming environment… We believe that children thrive only when they feel that the people around them genuinely care for their well-being and safety and are interested in spending time with them and getting to know them as individuals and promote positive role models. All these positive, stable relationships help the child feel secure and cared about and for.‟ The serious shortfalls identified at this inspection show that the registered manager and staff are not meeting the ethos or particulars of the statement of purpose. This means that commissioners are misinformed about the service.

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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 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: SC476267 11

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Children’s home details

Registered provider: Cambian Childcare Limited

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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

Louise Battersby, social care inspector Alison Cooper, social care inspector Inspection report children‟s home: SC476267 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

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