Children's home run by Cambian Childcare Limited in Hammersmith and Fulham

Inspection report children’s home: SC457272 1 SC457272 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 children’s home provides care and accommodation for up to three children who have emotional and/or behavioural difficulties. A private organisation owns and operates this home.

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Information about this children’s home

Inspection dates: 13 to 14 December 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 inadequate

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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: 9 November 2017

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requires improvement to be good

Overall judgement at last inspection: inadequate Inspection report children’s home: SC457272 2

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Enforcement action since last inspection:

Following the last full inspection, the home was judged as inadequate. Two compliance notices were served. These were in regard to Regulation 12, the protection of children standard, and Regulation 13, the leadership and management standard. The compliance notices were monitored at this inspection. The provider has met the majority of the steps that were set out in the notices. Although some further improvement is required, the concerns relating to the children’s safety and well-being have been addressed.

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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 location risk assessment fails to fully identify potential risks to the children.  Internal and external monitoring arrangements are not strong enough. They do not contribute to identifying areas for improvement.  The manager had failed to address the actions in the home’s fire risk assessment until the day of the inspection.  Some of the children lack the routine that they need to engage fully in educational activities.  Some of the staff have not completed their induction booklets.  The staff have not all received an annual appraisal.  Some of the staff who administer medication to the children have not been assessed as competent to do so.  The exterior of the home does not provide the same good-quality feel as the interior. The outside wall opposite the kitchen window has paint that is flaking off, and is unsightly.  There is an insufficient supply of indoor activities and pastimes for children.

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Key findings from this inspection

 The children do not have access to a computer for their sole use. They are only able to use the home’s computer, which is in the staff team’s office.

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Key findings from this inspection

 The children have positive relationships with the staff. The children feel supported and safe, and are able to express their views and wishes.  The manager has rigorously challenged external agencies to try to identify education placements for the children.  The children are happy living at the home. They say that they feel safe.  The children receive care from a dedicated and stable staff team that is knowledgeable about their individual needs. Inspection report children’s home: SC457272 3

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Inspection date Inspection type Inspection judgement

09/11/2017 Full Inadequate 23/02/2017 Interim Declined in effectiveness 07/07/2016 Full Good 10/02/2016 Interim Sustained effectiveness Inspection report children’s home: SC457272 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 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 that staff support each child’s learning and development (Regulation 8(1)(2)(a)(ii)).

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Requirement Due date

This is with particular regard to ensuring that when children placed in the home are not participating in education, in the interim, the child is supported to sustain or regain their confidence in education, and is engaged in suitable structured activities through an effective daily routine. 19/01/2018

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Requirement Due date

The positive relationship standard is that children are helped to develop, and to benefit from, relationships based on 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 help each child to develop and practise skills to resolve conflicts positively and without harm to anyone. (Regulation 11(1)(c)(2)(a)(iv)) 19/01/2018

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff have the experience, and skills to meet the needs of each child. (Regulation 13(1)(b)(2)(c))

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Requirement Due date

This is with particular regard to completing mandatory training in equality and diversity awareness and a medication competency assessment. 26/01/2018

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Requirement Due date

The registered person must ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 and any regulations made under it, except for article 23 (duties of employees), are 19/12/2017 Inspection report children’s home: SC457272 5 complied with in respect of the home. (Regulation 25(2)(b)) The registered person must ensure that each employee completes an appropriate induction and that all employees have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(1)(a)(4)(c)) 19/01/2018

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating the quality of care provided for children, the feedback and opinions of children about the children’s home, its facilities and the quality of care provided in it, and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. (Regulation 45(2)(a)(b)(c)) 26/01/2018

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year taking into account the requirement in regulation 12(2)(c) (the protection of children standard). (Regulation 46(1)) 05/01/2018

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Recommendations

 Ensure that the children’s home is a nurturing and supportive environment. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9) This is with particular regard to ensuring that the outside area of the home is well maintained.  Children should have access to a computer and the internet to support their education and learning, unless there are specific safeguarding reasons why this would be inappropriate. In such cases, the home should consider whether and how it can support the child to access a computer and the internet safely. (‘Guide to the children’s homes regulations including the quality standards’, page 29, paragraph 5.19)  Ensure that children are offered a wide range of activities both inside and outside of the home and are encouraged to participate in those activities. (‘Guide to the children’s homes regulations including the quality standards’, page 31, paragraph

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Recommendations

6.5)  Ensure that staff have the relevant skills and knowledge to be able to: respond to the health needs of children and administer minor illness treatment. (‘Guide to the children’s homes regulations including the quality standards’, page 34, paragraph 7.12) This is with particular regard to ensuring that the instructions for administration of medication are visible.  Homes set up for emergency placements as indicated and detailed in their Inspection report children’s home: SC457272 6 statement of purpose will require sufficient staff trained and skilled in the admission and care of children, when their full background may not be known. (‘Guide to the children’s homes regulations including the quality standards’, page 57, paragraph 11.6)  Any individual appointed to carry out visits to the home as an independent person must make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the home’s care.

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Recommendations

(‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5)

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improvement to be good

The home requires improvement to be good. Although the provider has made progress since the last inspection, this inspection has identified a number of weaknesses in practice concerning the leadership and management of the home. The serious safeguarding concerns that were identified at the last inspection have been acted on.

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improvement to be good

The procedures for the safe and effective administration of prescribed medication are sufficient. However, the staff have covered the children’s non-prescribed medication boxes with a label, to name each box. This has resulted in essential information being hidden by the label. In addition, although the staff have completed medication training, the manager has not assessed all of the staff as competent to administer medication to the children.

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improvement to be good

The children eat healthy home-cooked food. The staff sit with the children at mealtimes, encouraging the children’s social skills. The children are able to access the services and support that they need to meet their physical and emotional needs. Some children attend a local gym and engage in physical activities. The organisation’s clinician is new to the home. While they are not engaging with the children currently, they have visited, and have begun to build relationships. There is a plan for the clinician to start working with the children and the staff. All of the children are registered with a doctor, a dentist and an optician, and attend appointments when needed. This engagement ensures that the children’s basic health needs are met.

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improvement to be good

One child who had not received education since living at the home has now started to attend education. The home has communicated with external agencies to identify a suitable provision. The staff support the child to attend, and recognise the child’s potential sources of anxiety for the child, such as waiting outside the school and the journey to and from school. The support that the staff provide enables the child to go to school. Another child does not have an education provision identified. The manager has rigorously challenged external agencies and advocated on behalf of the child, who is keen to attend education. However, the staff are failing to ensure that they implement a Inspection report children’s home: SC457272 7 positive daily routine for this child. The child has late nights, watching television in their room, and stays in bed until the early afternoon. This lack of routine means that this

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improvement to be good

The children benefit from positive relationships with the staff. The children receive praise and recognition of their achievements and progress made. The children all speak positively about the staff, and enjoy spending time with them. The children confirm that the staff respect their privacy, that they feel listened to, and that the staff care about them.

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improvement to be good

The staff support the children to express their views. The manager is a good advocate for the children. Key-work sessions and residents’ meetings enable the children to have a formal forum for voicing their opinions. These regular opportunities enable the children to contribute to their ideas to the day-to-day running of the home. This engagement improves the children’s self-esteem, as they willingly contribute in the knowledge that the staff listen to and value their ideas.

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improvement to be good

The children’s individual plans identify their needs, and the role of the staff in meeting these needs. All of the staff have sufficient knowledge of the children and the children’s main goals and how these are to be met. These plans help the staff to take a consistent approach to the children’s care.

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improvement to be good

The children engage in some activities outside the home. They spend time with their friends, go to the cinema, go roller-skating and go shopping with staff. The recent purchase of a trampoline following the children’s request provides the children with outdoor play equipment. There is a small selection of board games and books. However, these are in poor condition, with missing elements. There is an insufficient supply of activities and pastimes in the home for the children.

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improvement to be good

The staff support children to have contact with their families and other significant people in their lives. The manager ensures that there are sufficient staff on duty to provide transport for the children, so that they can spend time with their families. The children’s families are welcomed to the home, and are able to spend quality time with their children. When required, the staff supervise contact in line with the children’s individual plans. The staff provide feedback regarding contact to the relevant external agencies. This feedback ensures that appropriate decisions are made to safeguard children.

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improvement to be good

The manager and staff have made substantial changes to the decor and furnishings of the home. New sofas, furnishings and decoration now ensure that children live in a home that is welcoming and homely. The children’s individual bedrooms have new wardrobes and desks, providing a pleasant environment for them to relax in. The staff have ensured that the outside area is clear of debris. However, the outside wall opposite the kitchen window has paint that is flaking off the wall, and is unsightly. The exterior of the home does not provide the same good-quality feel as the interior.

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improvement to be good

The children have made sufficient progress in developing their independence skills since living at the home. They develop skills that include cooking meals, keeping their Inspection report children’s home: SC457272 8 bedrooms tidy and budgeting. These skills support the children to become more independent.

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improvement to be good

The staff adequately protect the children. The children receive high supervision levels. They say that they feel safe living at the home. The children can each identify a member of staff with whom they can talk if they have a concern.

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improvement to be good

The staff receive safeguarding training and they follow the safeguarding policy. These actions ensure that external agencies are aware of any concerns, and enable the implementation of agreed strategies for safeguarding the children. The staff adopt these strategies and the children’s welfare is promoted.

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improvement to be good

There have been no incidents of bullying at the home since the last inspection. On occasion, there are some low-level incidents between the children. However, there is a lack of evidence of the action that the staff take to reduce the risk of these incidents escalating. This fails to support the children to resolve conflict positively.

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improvement to be good

There have been no incidents of children going missing from the home since the last inspection because the children are supervised in line with their placement plans. Some children are able to spend time away from the home and the staff support them to spend quality time with their friends. The staff meet with the parents of the children’s friends. The staff know where the children are and provide transport for them. Trusted time away from the home helps the children to develop social skills and learn how to keep themselves safe.

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improvement to be good

The staff have received training and have a sufficient understanding of the risks and signs of child sexual exploitation. This awareness helps to safeguard the children.

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improvement to be good

The staff provide positive behaviour management that works well. There has been a significant decrease in the number of incidents taking place in the home. This is because the staff have received training that enables them to support the children’s needs. In addition, the children’s individual risk assessments detail identified risks and the action required to reduce these risks. These assessments, in conjunction with the children’s plans, identify potential triggers for the children, and the strategies that the staff should implement to support the children. As a result, there have been no physical interventions or sanctions since the last inspection. Instead, the children have received positive rewards in recognition of how they have responded to situations. These techniques help to recognise and reinforce the children’s positive behaviour.

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improvement to be good

During the inspection, concerns were identified regarding a lack of action taken to address outstanding recommendations from the fire risk assessment. The provider had failed to replace a smoke seal around a door leading from the kitchen. In addition, weekly fire checks undertaken by staff had failed to identify that two of the fire doors Inspection report children’s home: SC457272 9 would not close properly, despite the staff reporting that the doors had been checked on the day of the inspection. These significant shortfalls were addressed at the time of the inspection, which therefore reduced the potential risk to the children and staff. However, it is of significant concern that, despite the manager’s review of the fire risk assessment and the weekly health and safety checks being undertaken, the staff and managers had failed to identify these shortfalls.

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improvement to be good

The children do not have access to the internet. In addition, they do not have access to their own computer, but have to use the staff team’s computer in the office. While this safeguards all children, it is not individually risk assessed and does not fully enable the children to access the resources they need to support their education.

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The effectiveness of leaders and managers: inadequate

The impact and effectiveness of the management of the home is inadequate. The inspection identified a number of shortfalls. The two compliance notices that were issued following the last inspection have not been fully met. However, there has been progress made and the unmet aspects do not have a significant impact on the children’s safety. Further requirements have been raised in order to improve the quality of care provided for the children.

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The effectiveness of leaders and managers: inadequate

The manager has failed to meet all of the actions set out in the compliance notice. The staff have not all completed the full induction booklet. Failure to provide an effective induction means that staff may not be sufficiently equipped to provide safe and effective care for the children. The manager has updated the locality risk assessment to include known risks with regard to the local skatepark. However, the manager has failed to identify additional potential risks to the children and staff in the document, such as the close proximity of the home to a road and a nearby train line. While action has been taken to reduce the risks presented by the proximity of the road, through the locking of the front door, the document fails to record this. A lack of clearly documented risk- reduction strategies means that staff do not benefit from the guidance that they should be able to expect.

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The effectiveness of leaders and managers: inadequate

This inspection identified further shortfalls. Some of the staff require additional training. Terminologies used in conversation and in some children’s records are inappropriate, and could potentially categorise a child without professional diagnosis.

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The effectiveness of leaders and managers: inadequate

The statement of purpose states that the home accepts emergency placements for children. However, not all of the staff have the skills or training to meet the needs of a child whose full history is unknown.

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The effectiveness of leaders and managers: inadequate

The internal and external monitoring arrangements for the home are ineffective. The manager has undertaken a detailed review of the home. However, the review fails to evaluate the effectiveness of the service, or reflect on shortfalls or the action that has been taken to improve the quality of care. In addition, it is unclear how the staff members’ and children’s input is used to make changes and improvements. External Inspection report children’s home: SC457272 10 monitoring has failed to identify the shortfalls that were evident at the last inspection. The staff have not all received an annual appraisal. Therefore, they have not been provided with a formal forum for reflecting with the manager on their performance, assessing the previous aims set, or identifying further targets for the coming year.

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The effectiveness of leaders and managers: inadequate

The management team has taken action to meet the majority of the steps identified in the two compliance notices. The staff receive supervision, providing them the opportunity for discussing the children, raising any concerns and managing their responses to incidents. The staff have received training in supervising family contact, self-harm, physical intervention and child sexual exploitation. This training supports the staff to meet the individual needs of the children in these areas. The manager has developed the impact risk assessment, adding a checklist to strengthen the identification of the children’s risks and needs. This document has the potential to help the manager to ensure that only children whose assessed needs can be met are admitted to the home.

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The effectiveness of leaders and managers: inadequate

The manager has assessed each new staff member’s competency in undertaking waking- night and sleep-in duties. In addition, new staff will undertake these duties with an experienced member of staff. This practice helps to ensure that the children receive care from sufficiently able staff. The manager has ensured that all significant events are notified to Ofsted. This enables Ofsted to monitor the action that the home is taking to reduce the risk of a recurrence.

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The effectiveness of leaders and managers: inadequate

The manager is suitably qualified and experienced. She holds a relevant level 4 diploma in leadership and management. The provider has made some alterations to the manager’s role to support the required improvements at the home. These improvements include the manager being able to solely focus on the home, rather than supporting other managers within the company.

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The effectiveness of leaders and managers: inadequate

The staff speak positively about the support that they receive from the manager and senior management in the organisation. One member of staff described the manager as ‘firm but fair’. The staff member said, ‘She has a lot of passion for her job, and she cares about the children and the staff.’

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The effectiveness of leaders and managers: inadequate

Feedback from professionals is generally positive. One placing social worker said, ‘Communication is excellent. I receive weekly reports, and at least one email a day providing an update.’

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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 Inspection report children’s home: SC457272 11 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: SC457272 12

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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

Natalie Burton: social care inspector Mandy Nightingale: HMI social care Inspection report children’s home: SC457272 13 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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