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

Inspection report children’s home: SC433290 1 SC433290 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

The home is registered to provide care for six children who may have emotional and/or behavioural difficulties. The home forms part of a large social care company.

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Information about this children’s home

Inspection dates: 19 to 20 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: 12 September 2017

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requires improvement to be good

Overall judgement at last inspection: declined in effectiveness

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Enforcement action since last inspection:

At the interim inspection on 12 September 2017, Ofsted issued a restriction notice and four compliance notices. On 4 October 2017, a monitoring visit took place to monitor the restriction notice and two of the compliance notices. Some progress was noted. However, the compliance notice in relation to regulation 12 had not been met and a further compliance notice was issued. A monitoring visit took place on 7 November 2017 to monitor the restriction notice and three compliance notices. Steps had been taken to meet the compliance notices. The home has been compliant with the restriction notice, as no further young people have been admitted to the home. However, due to the lack of progress in addressing concerns and sustaining progress, the restriction notice is extended to 31 January 2018. Inspection report children’s home: SC433290 2

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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 leadership and management of the home are poor. Any improvements that are made are not sustained, and further shortfalls are not identified. This prevents the quality of care provided from improving.  Staff do not consistently follow risk management strategies in relation to episodes when young people misuse substances. This places young people at risk of harm.  Bullying continues at the home, and staff do not recognise and manage this in line with their zero tolerance policy, which is detailed in the statement of purpose.  Staff do not record that they offer young people medication in line with their prescription.  The manager has not ensured that she has all of the necessary information from a young person’s child and adolescent mental health services (CAMHS) risk management plan, as this data is not available at the home to inform staff how to safely and effectively manage the young person’s behaviour.

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Key findings from this inspection

 The manager has accepted a referral for a new young person to the home with insufficient information to make a safe and informed decision on whether the home can meet their needs or their compatibility with the young people already living there.

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Key findings from this inspection

 Staff remain resilient and continue to work well with young people following numerous challenges, including assaults on staff by young people.  Staff develop positive relationships with young people’s families, who report feeling welcome when they visit the home.

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Inspection date Inspection type Inspection judgement

12/09/2017 Interim Declined in effectiveness 31/05/2017 Full Requires improvement to be good 27/02/2017 Interim Sustained effectiveness 11/05/2016 Full Good Inspection report children’s home: SC433290 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

12: The protection of children standard 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— (2)(a)(i) 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)). In particular, ensure that staff follow risk assessments and accurately record that they have done so. 19/01/2018

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Requirement Due date

13: The leadership and management standard (1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that – (a) helps children aspire to fulfil their potential and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b), (2)(c)(h)) 19/01/2018

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Requirement Due date

11: The positive relationships standard (1) The positive relationship standard is that children are helped to develop, and to benefit from, relationships based on – (a) mutual respect and trust: (b) an understanding of acceptable behaviour: and (c) positive responses to other children and adults. In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff- (xiii) have the skills to recognise incidents or indications of bullying and how to deal with them. (Regulation 11(1), (2)(a)(xiii)) 19/01/2018

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Requirement Due date

10: The health and well-being standard The health and well-being standard is that – 19/01/2018 Inspection report children’s home: SC433290 4 (a) the health and well-being needs of children are met: (b) children receive advice, services and support in relation to their health and well-being; and (c) children are helped to lead healthy lifestyles. In particular, the standard in paragraph (1) requires the registered person to ensure that staff help each child to— achieve the health and well-being outcomes that are recorded in the child’s relevant plans. (Regulation 10(1)(a)(b)(c), (2)(a)(i)) The education standard is that children make measurable progress towards achieving their educational potential and are helped to do so. In particular, the standard in paragraph (1) requires the registered person to ensure that staff– (viii) staff help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational

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Requirement Due date

and training support throughout the period of exclusion or non- attendance and to return to school as soon as possible. (Regulation 8(1), (2)(a)(viii)) 19/01/2018

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Requirement Due date

The registered person must prepare and implement a policy (the behaviour management policy) which sets out- (1)(a) how appropriate behaviour is to be promoted in the children’s home; and (b) the measures of control, discipline and restraint which may be used in relation to children in the home. (2) The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (Regulation 35(1), (2) 19/01/2018

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Recommendations

 Staff should be familiar with the home’s polices on record keeping and understand the importance of careful, objective and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4). In particular, staff should ensure that offers of return home interviews are recorded and that case records are accurate and detailed.  For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9). In particular, review the suitability of the rug in the hall and provide a working computer for young people’s use. Inspection report children’s home: SC433290 5

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improvement to be good

Young people are making limited progress in their academic development. School attendance is inconsistent. One young person’s attendance is 63%, another 40% and one young person has only attended education for eight hours during November 2017. While this represents some progress from their starting points, this limited access to education has the potential to affect young people’s life chances. When young people refuse to attend school, staff do not provide them with educational activities or establish routines for them at the home. Staff do work in partnership with education personnel and it is evident that home staff maintain frequent contact with teaching staff in an attempt to address the lack of attendance. It is clear that staff put incentives in place for young people to attend school but that these are not always effective.

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improvement to be good

Young people engage in some recreational activities. Young people say they watch television, ‘chill’ and listen to music. Individual young people go out with staff to the cinema and one did attend a dance class. Staff recognise the importance of young people’s contact with their families and encourage this where it is agreed with social workers. However, contact sessions have not been safe for one individual, and they return to the home under the influence of cannabis. Staff engage in direct work sessions and encourage young people to engage with specialist services, but this is proving ineffective and the individual continues to misuse cannabis.

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improvement to be good

One young person is currently receiving care from CAMHS. The CAMHS therapist has developed a risk management plan that should inform the young person’s care. Although the CAMHS therapist has shared this document with the home, it was not available for review at the home and could not be located. The CAMHS therapist considers this plan essential to inform the staff team on how to support and respond to the young person, particularly at times of crisis.

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improvement to be good

The CAMHS therapist has also asked the staff to monitor carefully whether the young person takes their medication. However, staff are not consistently recording whether they offer the young person their medication or why it is not taken. The records are not clear, and dates missed out completely. Moreover, despite staff encouragement, the young person does not consistently attend planned CAMHS appointments for therapy or medication reviews. This does not promote young people’s emotional health and well- being. On a more positive note, one young person has recently had all of their immunisations, which promotes their physical health.

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improvement to be good

One young person has left the home in an unplanned way. The manager supported the young person to understand why she could not remain living at the home. Due to escalating challenges and an assault on staff, the young person left the home and needed an emergency placement at a hotel arranged by the placing authority. With staff help, other young people develop strategies to manage their own behaviour, for example going for a walk when feeling frustrated. Inspection report children’s home: SC433290 6

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improvement to be good

Staff are not following the strategies identified to counteract known risks, thereby compromising the health and safety of young people. For example, when young people have been smoking cannabis, staff do not always monitor them to check on their welfare, as stipulated in the risk assessments. Following consultation with the children looked after nurse and the local Eclipse team, the manager has removed the requirement to seek medical advice on each occasion when young people are under the influence of cannabis. While staff have received training regarding individuals who misuse substances, to help them recognise when young people are under its influence, post-incident monitoring by staff remains as a risk management measure for every episode of suspected substance misuse. This measure is of paramount importance, but is not always completed by staff, or is completed by staff but not adequately recorded.

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improvement to be good

Young people say that they feel safer now that there are fewer young people living at the home. However, there are safeguarding concerns that the manager and staff have not managed effectively, including incidents of bullying. Young people continue to demonstrate bullying behaviours. The home’s statement of purpose describes a zero tolerance approach to bullying and staff have received training in managing bullying behaviour within the last three months. However, they do not put this into practice effectively.

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improvement to be good

The bullying log records two incidents of bullying since 7 November 2017. However, other incidents have occurred which have not been reported or recognised as bullying behaviour. For example, there have been instances of verbal threats, throwing items at other young people, writing abusive graffiti on a young person’s bedroom door, breaking others’ belongings, and taking and wearing other young people’s clothes. Staff are beginning to manage the occasions when young people enter and spend time in each other’s bedrooms. Alternative communal rooms remain available, and only one occasion has occurred where a young person decided that they wanted their peer to leave their bedroom. Unfortunately on this occasion, frustrations escalated and resulted in a young person being injured and receiving consequences from staff due to their behaviours.

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improvement to be good

Staff have not used restraint since the last inspection, therefore staff have used de- escalation techniques to some good effect. However, there has been considerable damage caused to the home and injuries to staff when young people have presented with challenging behaviour. Staff called the police on one occasion, to manage young people’s extreme behaviour that was beyond the staff’s control. Although young people are now facing criminal charges, and the likelihood is that this will negatively influence their future life prospects, the measure was used due to another young person stating that they did not feel safe.

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improvement to be good

Staff understand what to do when young people go missing, and they report incidents to the police and the local authority. Staff will follow young people out of the home to waiting taxis, but then do not always track where young people go or look for them in Inspection report children’s home: SC433290 7 familiar places once they have left the home. Staff state that independent return interviews are offered to young people but that young people refuse to engage. The staff do not record this lack of engagement, so it appears on paper that return interviews are not offered to young people.

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improvement to be good

Staff do not consistently record the measures of control that are used. Those that are used are not effective in changing young people’s behaviour. The strategy to reduce young people’s spending money for periods of three and seven days to reduce their ability to buy cannabis is ineffective. Young people continue to present as being under the influence of substances during periods when they have no access to money. This therefore brings into question how they are continuing to fund the purchase of illegal substances.

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improvement to be good

The current approach of using reparation to manage young people’s inappropriate use of taxis is also ineffective. This is because the period over which the reparation is due extends to March 2018, therefore lacks any meaningful impact. In addition, staff place young people on ‘supervised spends’ without recording this as a sanction. This does not support the young person to understand the purpose or the timeframe of the consequence, or how it will change their behaviour.

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improvement to be good

Young people know how to complain. They have complained on four occasions since the last inspection. One young person complained because she had to leave the home as she did not feel safe due to another young person’s behaviour. The manager responded to her concerns and took action and, due to this concern and other contributing factors, served notice on the other young person’s placement.

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improvement to be good

The physical environment is mainly clean and tidy. Some maintenance and practical issues remain outstanding, such as providing a replacement computer for young people to use and checking the suitability of the rug in the hall.

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The effectiveness of leaders and managers: inadequate

There has been no registered manager in post since January 2017. The acting manager has applied to be registered. She is currently completing her level 5 diploma in leadership and management in residential childcare. The home is not yet fully staffed by permanent staff, as there are currently three vacancies. Shortfalls are met by using bank staff and staff from other homes within the organisation. This has minimised the number of different staff working at the home. Currently, there are half the number of young people living at the home that the registration allows for, which means that staff have more time available to spend working with young people and completing necessary paperwork.

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The effectiveness of leaders and managers: inadequate

The internal and external monitoring and reviewing systems for this home are ineffective. For example, there is insufficient scrutiny of young people’s journals to ensure that the case recording undertaken by staff reflects young people’s lives and experiences. Furthermore, the systems in place to monitor whether direct work is undertaken are not completed, bullying logs are not fully completed during weekend Inspection report children’s home: SC433290 8 shifts which means that prompt overview of presenting behaviour is not possible, medication is not administered as prescribed and young people’s CAMHS risk assessment and management plans are not present at the home. The manager does not review the measures of control issued by staff for their effectiveness and appropriateness. As a result, staff repeat the same measures when they are ineffective. In addition, staff do not consistently record the measures that they use. The existing approach to behaviour

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The effectiveness of leaders and managers: inadequate

management fails to promote positive outcomes. It does little to support young people to understand why their behaviour is unacceptable and how they can make positive changes to improve.

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The effectiveness of leaders and managers: inadequate

The manager makes decisions regarding prospective placements without securing sufficient information. She informs staff that she has accepted a new referral for the home when she has insufficient information to make a safe and informed judgement regarding the home’s ability to meet the needs of each young person. Despite not having full information, during the inspection she described how the local authority social worker is visiting the young person to discuss the move to the home. This does not represent effectively planned care and places both the new young person and the existing group at risk of placement disruption.

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The effectiveness of leaders and managers: inadequate

Staff do not have the necessary training, knowledge and skills to understand issues about gender identity. Staff’s engagement with the specialist training provided for them by the CAMHS team has been limited, due to staff availability, however the training has been rescheduled to ensure that all staff can attend. Once completed, this training will help inform staff and develop their skills in understanding young people’s behaviour and how best to meet their individual needs.

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The effectiveness of leaders and managers: inadequate

Staff and leaders work in partnership with professional stakeholders and particularly well with young people’s families. For example, after the police raised the issue of staff not attending the station to provide written statements, this issue has been addressed by the home. While police officers note some improvement in their partnership working, this is still work in progress, including the sharing of missing from home risk assessments. The manager ensures that she notifies Ofsted in a timely manner of all significant events at the home. This ensures that the regulator has an oversight of patterns and trends at the home.

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The effectiveness of leaders and managers: inadequate

The manager has struggled to demonstrate the positive impact on young people from living at the home. Currently, there is a lack of clarity from leaders and managers regarding the strengths and weaknesses of the home and how to instigate and maintain developments in the care provided to improve the outcomes for young people. Inspection report children’s home: SC433290 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: SC433290 10

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Children’s home details

Registered provider: Cambian Childcare Ltd

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Children’s home details

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

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Inspector

Rebecca Quested, social care inspector Inspection report children’s home: SC433290 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. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the

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Inspector

terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Inspector

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Inspector

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

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