Children's Home run by Cambian Childcare Limited in Shropshire

Inspection report children‟s home: SC476326 1 SC476326 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 is registered to provide care and accommodation for up to five children who have emotional and/or behavioural difficulties. A private company runs this home.

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Information about this children’s home

Inspection dates: 22 to 23 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, 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: 16 January 2017

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inadequate

Overall judgement at last inspection: improved effectiveness

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Enforcement action since last inspection:

None. Inspection report children‟s home: SC476326 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

 Children are not safe.  Children do not make progress.  Children are not treated with dignity and respect.  Staff fail to de-escalate challenging behaviour.  There is a high number of physical restraints. Records of these incidents are poor.  Staff do not tackle incidents of bullying effectively.  Children‟s health needs are not being met.  The arrangements for the administration of medication are inadequate.  Staff training, supervisions and appraisals are poor.  Managers do not make sure that staff are safely vetted.

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Inspection date Inspection type Inspection judgement

16/01/2017 Interim Improved effectiveness 24/08/2016 Full Requires improvement 19/02/2016 Interim Improved effectiveness 09/10/2015 Full Requires improvement Inspection report children‟s home: SC476326 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, seek to secure the input and services required to meet each child‟s needs and 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. (Regulation 5(b)(c)) 12/01/2018

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Requirement Due date

The quality and purpose of care standard requires the registered person to ensure that staff- treat each child with dignity and respect provide personalised care that meets each child‟s needs, as recorded in the child‟s relevant plans, taking account of the child‟s background. (Regulation 6(2)(b)(iii)(iv)) 12/01/2018

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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. (Regulation 7(1)(c)) 12/01/2018

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Requirement Due date

The education standard is that children make measureable progress towards achieving their educational potential and are helped to do so. (Regulation 8(1)) 12/01/2018

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Requirement Due date

The health and well-being standard is that the health and well-being needs of children are met and that children receive advice, services and support in relation to their health and well-being. (Regulation 10(1)(a)(b)) 12/01/2018

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships. In particular, the standard in paragraph (1) requires the registered person to ensure that staff- 12/01/2018 Inspection report children‟s home: SC476326 4 understand and communicate to children that bullying is unacceptable; have the skills to recognise incidents or indications of bullying and how to deal with them. (Regulation 11(2)(a)(xii)(xiii)) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure that staff— 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. (Regulation 12(1), (2)(a)(i)) 12/01/2018

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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 helps children aspire to fulfil their potential and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to- 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 have the experience, qualifications and skills to meet the needs of each child use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b), (2)(a)(c)(h)) 12/01/2018

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Requirement Due date

The care planning standard is that children have a positive experience of arriving at or moving on from the home. (Regulation 14(1)(b)) 12/01/2018

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children‟s home. (Regulation 23(1)) 12/01/2018

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children. (Regulation 24(1)(a)) 12/01/2018

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Requirement Due date

The registered person may only employ an individual to work at the children‟s home if the individual satisfies the requirements in paragraph (3). The requirements are that the individual has the appropriate 12/01/2018 Inspection report children‟s home: SC476326 5 experience, qualification and skills for the work that the individual is to perform and full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. For the purposes of paragraph (3), an individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained he Level 3 Diploma for Residential Childcare (England) (“the Level 3 Diploma”). The relevant date is in the case of an individual who starts working in a care role in a home after 1st April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home.

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Requirement Due date

(Regulation 32(2)(a), (3)(b)(d), (4)(a)(b), (5)(a)) The registered person must ensure that all employees receive practice- related supervision by a person with appropriate experience and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(b)(c)) 12/01/2018

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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 details of the child‟s behaviour leading to the use of the measure. 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 has signed the record to confirm it is accurate. (Regulation 35(3)(a)(ii)(b)(i)(ii)) 12/01/2018

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Requirement Due date

The registered person must maintain records (“case records”) for each child which include the information and documents listed in Schedule 3 in relation to each child. (Regulation 36(1)(a)) 12/01/2018

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Overall experiences and progress of children and young people: inadequate

Children receive poor-quality care. They do not make progress and are not safe.

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Overall experiences and progress of children and young people: inadequate

Staff do not make adequate arrangements to improve children‟s health. Children do not have access to the services that they need. For example, managers and staff do not make sure that children can access the therapeutic support that they need, despite this being an expectation of the children‟s placing authorities. Managers and staff have failed to challenge other professionals effectively to tackle this issue. Consequently, children‟s emotional well-being is not being promoted. Furthermore, staff do not support children who have specific medical conditions to access appropriate specialist support. Children have been failed because of this poor practice. Inspection report children‟s home: SC476326 6 Poor medication records mean that it not possible to distinguish which staff have administered medication to children or when. On several occasions, a child has countersigned for their own medication. This practice is unsafe, and does not promote or

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Overall experiences and progress of children and young people: inadequate

safeguard children‟s health and well-being.

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Overall experiences and progress of children and young people: inadequate

Children do not benefit from planned, individualised direct work. Staff do not enable children to reflect on their behaviours, risks or circumstances. For example, essential sessions with children regarding inappropriate touching and bullying have not taken place. This absence of support and guidance means that children are not given opportunities to learn how to behave more appropriately or to have their perceptions and actions challenged.

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Overall experiences and progress of children and young people: inadequate

Case files do not contain children‟s local authority placement plans. Consequently, staff do not have any knowledge about one child‟s complex and traumatic history. This means that staff do not have vital information to inform their practice.

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Overall experiences and progress of children and young people: inadequate

The apathy of the staff team has hindered children‟s academic progress. Although children attend school regularly, they are not encouraged to reach their educational potential. Children‟s personal education plans are out of date. Staff are not aware of children‟s educational needs and are therefore unable to support them adequately. For example, one child‟s key workers were unaware that their „key child‟ had a statement of special educational needs.

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Overall experiences and progress of children and young people: inadequate

Staff do not treat children with dignity and respect or provide them with the support that they need. Staff fail to take account of children‟s traumatic experiences and do not understand the impact that they have. For example, a child will not leave their bedroom at night to use the toilet and, consequently, is urinating in their room. Staff do not take effective action to help, understand or support the child, simply stating that they „discourage this behaviour‟. Staff are apathetic about the child‟s emotional needs and the impact that this has on her. The only action taken by managers and staff has been to change the flooring to disguise the odour.

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Overall experiences and progress of children and young people: inadequate

Consultation with children is poor. Staff do not consistently seek feedback or children‟s views, wishes and feelings about the home or their individual plans. As a result, children cannot influence the running of the home or the plans affecting their lives.

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Overall experiences and progress of children and young people: inadequate

Children do not always have positive experiences when they move into the home. For example, when one child was referred to the home the registered manager wanted to make sure that the child‟s move was undertaken in a planned way. The responsible individual overruled this decision. Consequently, the child moved in with insufficient planning. This affected the welfare of the child and the experiences of the other children already living at the home.

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Overall experiences and progress of children and young people: inadequate

Children spend time with their families. Staff facilitate and supervise these meetings. However, a placing authority specified that a child should spend additional time with their family, yet this has not happened. As a result, the child has not benefited from additional time with the people important to them. Inspection report children‟s home: SC476326 7

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

Children are not safe, nor do they feel safe living at this home.

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

Staff do not manage children‟s behaviour effectively. They do not respond to incidents quickly enough, and they fail to prevent them from escalating to the point when physical restraint is required. Records of these incidents are poor. As a result, it is unclear whether restraints are necessary and proportionate or that children are safe. Records do not clearly outline the triggers to a child‟s behaviour or the measures taken by staff to de-escalate the situation. As a result, the justification for the use of the measures taken is not clear. For example, staff used physical restraints after a child had „a troubled start to the morning‟. One child has been restrained 23 times over a five-month period. The registered manager does not ensure that feedback is sought from the child after they have been restrained. These shortfalls place children at risk of harm.

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

Children‟s movements are monitored through the use of bedroom door alarms. These measures are not adequately risk assessed, nor is the rationale for their use explained or reviewed.

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

Risk assessments are weak. They do not identify all the risks or strategies that staff need to follow in order to keep children safe. Risk assessments are not updated or reviewed after serious incidents, such as bullying. As a result, they do not reflect children‟s changing needs.

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

Staff fail to take action when children tell them that they are feeling bullied. Since January 2017, 22 incidents of bullying have been recorded. There is a high number of bullying incidents at the home, and children also report that they feel bullied when at school. Staff do not have the skills to deal with incidents of bullying. Staff do not take children‟s concerns seriously. Consequently, incidents of bullying go unchallenged. Staff minimise these incidents. For example, a member of staff told a child that if the child did not respond to comments, „then maybe they (the bullies) would not bully him, as they are getting nothing back‟. Staff have failed to intervene when children have returned home from school with bruises after being bullied. This left a child at risk. As a result, children‟s self-esteem, self-confidence and physical safety are compromised.

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

The registered manager has failed to ensure that children are cared for by adults who are safely vetted. Staff have been recruited who do not have the skills and experiences to care for children, with inadequate references and gaps in their employment history. The registered manager did not consider previous motoring offences or assess the risk of the potential impact of the offences. A member of staff‟s recruitment file also showed that their driving licence had expired in July 2016. The registered manager confirmed to inspectors that this member of staff continues to drive the company vehicle as part of their duties. This also involves transporting children. It is not clear if they are legally allowed to drive or hold appropriate insurance. These shortfalls place the children and the organisation at an unacceptable risk. Inspection report children‟s home: SC476326 8

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The effectiveness of leaders and managers: inadequate

The registered manager was registered with Ofsted in May 2017. She is suitably experienced and is working towards her level 5 diploma in leadership and management for residential childcare.

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The effectiveness of leaders and managers: inadequate

As a result of significant failures by the registered manager and senior managers, children‟s welfare is not being promoted and their progress is hindered. Staff training is poor. Staff do not have training in key areas that the provider purports to specialise in. These include sexual abuse, trauma and attachment. The home does not offer the service outlined in its statement of purpose. For example, the home‟s statement of purposes states, „The specialism of all Cambian homes is to support these children through an in-depth and integrated approach to recover from their unhealthy state and transfer, over time, in a controlled and safe environment, to achieve excellent outcomes that include a healthy inner model… We place great importance on the in-house services provided by the company and in the local community and ensure that all children have access to them while in our care.‟ However, children are not safe and do not receive the

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The effectiveness of leaders and managers: inadequate

Not all staff have attained the appropriate qualification to work with children. Staff supervision is ineffective, and this is a continuing shortfall from previous inspections. Supervisions sessions are infrequent and do not focus on children‟s needs or staff practice. This is also true of the supervision that the registered manager receives from the responsible individual. There is no record of an appraisal for the registered manager, and other staff members‟ appraisals have been delayed. As a result, the registered manager and staff are not receiving adequate support or guidance, and poor practice goes unchallenged. This demonstrates poor management oversight.

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The effectiveness of leaders and managers: inadequate

Management monitoring and monitoring by the independent person are inadequate. Managers have failed to identify safeguarding concerns and the significant failure to meet other regulatory requirements.

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The effectiveness of leaders and managers: inadequate

Because of the serious deficits identified in this service, Ofsted has issued a notice suspending the home‟s registration. This notice initially runs until 28 February 2018. Ofsted will visit the home during this period to monitor compliance with the notice. Inspection report children‟s home: SC476326 9

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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: SC476326 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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Inspectors

Jo Stephenson, social care inspector Inspection report children‟s home: SC476326 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 looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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