Children's Home run by Cambian Childcare Limited in Somerset

Inspection report children’s home: 1240802 1 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 is registered to provide care and accommodation for up to four children who have emotional and/or behavioural difficulties. This home is dedicated to providing safety, care and therapy to children who have experienced or are at risk of child sexual exploitation and sexual abuse.

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Information about this children’s home

Inspection dates: 28 to 29 November 2017

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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

Date of last inspection: 24 January 2017

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requires improvement to be good

Overall judgement at last inspection: requires improvement

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requires improvement to be good

Enforcement action since last inspection: none

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Key findings from this inspection

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

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Key findings from this inspection

 The protection of children relies on restriction of their liberty. It is not clear that the rights and entitlements of children are met in this home. The justification for Inspection report children’s home: 1240802 2 some restrictive practices remains arbitrary. Some children find this frustrating, they do not feel listened to and describe feeling trapped rather than rescued.  All children are placed away from their home area. Parents, family and friends are not allowed to visit the home. Neither are independent visitors or advocates provided for those children estranged from their families.  Children are not well prepared for their futures. The care designed to protect them does not allow for them to develop sufficient skills to develop an understanding of risk, learn from mistakes and keep themselves safe.  Regular support and supervision have not been provided to the manager of the home.

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Key findings from this inspection

 The home is led by a capable and engaging manager. Within hours of the inspection, she had made changes and implemented new policies to address some of the concerns identified at this inspection.  Children are safe, and say that they feel safe in this home. They get on with most of the staff, most of the time.  Behaviour management, imposing clear boundaries and expectations on children, is a particular strength of the home. Children are learning negotiation skills, which avoid communicating their needs in ways that are dangerous to others.  Children have made some progress, particularly around education attendance. They have made some investment in the home, personalising their bedrooms and contributing to choosing activities and menus. Significantly, all have stopped smoking since admission to this home.  Parents and professional stakeholders alike are complimentary about the home and the services it provides.

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Inspection date Inspection type Inspection judgement

24/01/2017 Full Requires improvement Inspection report children’s home: 1240802 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The registered person must ensure that suitable facilities are provided within the children’s home for any child accommodated there to meet privately at any reasonable time with the child’s parents, friends, or relatives. (Regulation 22(1)) 30/12/2017

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Requirement Due date

Fitness of workers. (1) The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. (2) The registered person may only— (a) employ an individual to work at the children’s home; or (b) if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3). (3) The requirements are that— (a) the individual is of integrity and good character; (b) the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; (c) the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and (d) full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2.

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Requirement Due date

(Regulation 32(1)(2)(a)–(b)(3)(a)–(d)) 30/12/2017

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Requirement Due date

The registered person must ensure that all staff (in particular the manager) 4 (b) receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b)) 30/12/2017

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Recommendations

 Managing medicines in care homes (March 2014) is a guideline that applies across both health and social care. In particular, ensure the appropriate storage of medication and the accuracy of medication records. (‘Guide to the children’s homes regulations including the quality standards’, paragraph 7.17, page 35) Inspection report children’s home: 1240802 4  All children must have access to appropriate advocacy support, and where possible this should be provided by a person that the child chooses. Looked-after children are entitled to an independent advocate to advise them and ensure they have the support needed to express their views, wishes and feelings about their care and lives. (‘Guide to the children’s homes regulations including the quality standards’, paragraph 4.16, page 23)

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Recommendations

 A deprivation of liberty may occur where a child is both under continuous supervision and control and is not free to leave the home. A children’s home cannot routinely deprive a child of their liberty without a court order. In particular, where a court order is in place, the detail should be known to the carers. (‘Guide to the children’s homes regulations including the quality standards’, paragraph 9.63 page 50)

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Recommendations

 Just as in a family home, children should be able to access all shared areas of their home unless there are specific reasons why this would not meet a child’s needs. Limits on privacy and access may only be put in place to safeguard each child in the home (regulation 21(c)(i)). Any decisions to limit a child’s access to any area of the home and any modifications to the environment of the home must only be made where this is intended to safeguard the child’s welfare. All decisions should be informed by a rigorous assessment of that individual child’s needs, be properly recorded and be kept under regular review. (‘Guide to the children’s homes regulations including the quality standards’, paragraph 3.10, page 15)

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improvement to be good

Children living in this home have experienced, or are at serious risk of serious abuse. Restrictions to secure their immediate safety on admission to the home remain in place for long periods. This practice impacts on children’s experiences, rights and entitlements.

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improvement to be good

Children say that they get on with staff most of the time and all can identify favourites whom they feel they get on with and can talk to.

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improvement to be good

A number of effective relationships with health professionals support the welfare of children. Health needs are met, children are registered with a GP and offered regular check-ups. Children can also choose to engage in specialist services when they are ready. These help them understand and recover from past trauma and abuse.

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improvement to be good

The manager and staff do their best to work with and include those who are important to children in their lives. However, the organisational policy doesn’t allow for parents, family or friends to visit the home. This unacceptable rule applies even when children have regular unsupervised meetings with those important to them. Inspection report children’s home: 1240802 5 Some areas of the home, in particular the office, are often locked with staff inside. The rules around this are unclear as it appears that children are allowed in sometimes and in the evenings. There is quite a lot of information about children on the office walls, creating potential breaches of confidentially.

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improvement to be good

Children are encouraged to attend education. For some, this is an improvement and they are managing to catch up with school work and study towards taking exams. Those who refuse to attend are helped to understand the importance of education. They are also offered alternative activities to keep them engaged during school hours.

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improvement to be good

Children develop practical independence skills. There are encouraged to cook and try out new activities to broaden their experiences and build confidence. Children enjoy a good range of leisure activities.

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improvement to be good

While there is no evidence of any errors in administration of medication, staff are not following the policy for ensuring safe storage and accurate record-keeping. There is some confusion about the home keeping a stock of non-prescribed medication. Painkillers and other homely remedies were not in available for a child suffering with a cold and headache.

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improvement to be good

While children are safer in this home, they are displaced from their area of origin. The home is quite isolated and the young people do not have the means or the ability to contact anyone who may pose a threat. This may be appropriate in the short term but the restrictions and controls imposed are barriers to gaining independence skills and understanding the ongoing vulnerabilities of the children. It is difficult to see how an accurate account of ongoing risk can be calculated. Some restrictive practice is arbitrary and not appropriate for all children.

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improvement to be good

Children do not have access to an independent visitor or advocate. This is particularly relevant where children are estranged from their families and do not maintain any contacts from their past. Most children do not have access to a phone without having to ask staff. Other electronic methods of communicating with those outside the home are also restricted as a matter of course.

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improvement to be good

Arrangements for the recruitment of agency staff do not follow the usual robust procedures and checks as for permanent staff. This may lead to inappropriate adults working with vulnerable children.

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improvement to be good

Behaviour management is based on the application of clear expectations and boundaries. Staff understand the impact of historic trauma and circumstance on communication. They deal with difficult and dangerous behaviour through negotiation. Involvement of the police in the lives of children is avoided. Restraint is always a last resort and has only been used once since the previous inspection. This was to avoid very serious injury. Inspection report children’s home: 1240802 6 Opportunities for children to go missing from this home are limited. All are provided with one-to-one staffing, they do not have the means (transport, money or confidence) to get very far and do not have the opportunity to communicate with those who may assist or encourage them to leave. Children have not gone missing since before the previous inspection.

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improvement to be good

Complaints are taken seriously and responded to effectively to the satisfaction of the children.

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

Organisational policies that dictate arbitrary restrictive practices have limited the progress made by this home since the last inspection. Children do not feel listened to about important decisions that affect their lives. There is a sense that at least two feel entrapped and disempoweredy a home set up to rescue them.

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

Consistency of staffing has been problematic. Although there is now a small core team of long-term staff, in the last few months there have been more than 22 different staff caring for children.

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

Senior leaders have failed to provide regular supervision and support for the manager.

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

Some aspects of the care provided are not clear to staff. One child may be subject to a court order. The detail and content of this order are not known to the carers and there has been a lack of challenge about this anomaly.

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

The home is managed by a confident and caring leader. Developments since the last inspection have addressed the requirements made at the previous inspection. There are also improved systems for care planning and records are clearer. The manager is meeting with children prior to admission and making sure that their move is as comfortable as possible. The manager has made sure that a child’s dedication to horses and talents for riding have been taken into account and continue to be nurtured.

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

Essential and specialist training is provided to staff. Attendance at expert conferences also informs practice and improves understanding of children’s situations.

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

Children are involved in the development of the home. They have provided feedback and contributed to appraisals of care staff.

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

Processes for monitoring of the home by the independent visitor and the manager are contributing to improving the home. The manager is engaging and keen to get the best possible services for children. Improvements following this inspection are already making a difference to children. Inspection report children’s home: 1240802 7

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the 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: 1240802 8

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Children’s home details

Registered provider: Cambian Childcare Ltd

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Children’s home details

Registered provider address: Cambian Group, 4th Floor, Waterfront Building, Chancellors Road, Hammersmith Embankment, London W6 9RU

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Inspector

Janice Hawtin, social care inspector Inspection report children’s home: 1240802 9 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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