Children's Home run by Cambian Childcare Limited in Cambridgeshire

Inspection report for children’s home - monitoring visit: 1257796 1

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Cambian Childcare Ltd

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This home is registered for up to 16 children who have mental disorders. It is privately owned and has a separately registered school on site.

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This monitoring visit

On 28 and 29 November 2017, an inspector carried out a monitoring inspection of the home. At this inspection, the inspector found that:

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This monitoring visit

 there were not enough qualified and experienced staff at the home to manage effectively the significantly challenging behaviour of the children accommodated and ensure their safety and well-being;  there was considerable damage to the furniture in the home;  a number of errors and omissions in recording had not been identified in the day-to-day and senior management monitoring of the service.

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This monitoring visit

Ofsted issued a restriction of accommodation and a compliance notice relating to leadership and management on 6 December 2017. To evaluate the progress that the home had made in meeting the compliance notice, a further monitoring inspection was undertaken by an inspector on 9 January 2018. The organisation had made progress but had not yet met the compliance notice. Due to the progress made, Ofsted has re-issued the compliance notice rather than escalating to a higher level of intervention.

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This monitoring visit

The organisation has undertaken a staffing review which has identified issues in relation to the number and experience of staff and the reliance on agency staff. As a result, it has taken steps to recruit additional staff. This includes recruiting some staff from an agency who have been working at the home. These staff already have some knowledge of the children and their needs. In addition, some staff from other Inspection report for children’s home - monitoring visit: 1257796 2 homes in the organisation are helping to cover gaps in the rota. Although these staff are still new to the home and the children, they do have an awareness of the organisation’s procedures. Managers recognise the importance of retaining staff so that they develop their knowledge and experience. They have reviewed the pay structure and the shift patterns to make working at the home more attractive. However, despite these measures, at the time of the inspection, there were still staff

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This monitoring visit

shortages, resulting in a significant use of agency staff (although to a lesser degree than previously). This means that children are being looked after by a wider range of adults, and this will affect children’s ability to build good, positive relationships with the adults who look after them. Staff said that while the frequency and intensity of incidents has reduced to a degree, they do continue and are more likely when agency staff are being used. These incidents have an impact on other children who are living at the home. They experience the damage to property and disruption of the incidents. Further, the availability of staff to look after and meet the needs of all children is reduced as they deal with high-profile incidents. Staff and children said that this continues to be an issue.

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This monitoring visit

The current staff group still has a low level of experience and aside from managers, only one staff member is appropriately qualified. The only member of care staff who has an appropriate qualification at level 3 is a team leader; the two remaining team leaders are unqualified, as are all care staff. The majority of staff have worked at the home for a year or less. This does not provide a suitably qualified and experienced staff team to deal with the complex needs of the children who live at the home. Similarly, a lot of training for the staff is in progress or planned, but the amount of completed training is not currently at a suitable level. For example, training for working with challenging behaviour is recorded as in progress, but is not completed for all staff. While the intention and plans to train staff are in place, staff do not currently have the training that they need to meet all of the children’s needs.

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This monitoring visit

The managers have had a meeting with the local police to discuss how they work together and when it is appropriate to call the police. Both the managers and the police described that meeting as helpful. The number of times the police have been called to the home has declined significantly since the meeting. This reduces the trauma for children, of being dealt with by the police, and the likelihood of them becoming involved in the criminal justice system.

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This monitoring visit

The managers have introduced new monitoring processes to try to ensure that records are up to date, full and accurate. However, despite greater clarity in records of physical interventions, one of 12 read at the inspection had not been signed by a manager. The managers had recorded a brief evaluation of the records they had signed. The managers are not routinely speaking to all of the staff involved after a physical intervention. This can limit managers’ awareness of what happened and the opportunity to reflect on the way that staff have intervened with children and to improve practice. Inspection report for children’s home - monitoring visit: 1257796 3 In a monitoring visit by the independent visitor in December, they identified that a number of the placement plans for the children were out of date. The staff have reviewed these, and they have been read and signed by the managers. This helps to ensure that plans for children are up to date and appropriate. There is a central file

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This monitoring visit

for care staff which includes the plans and risk assessments for the children. A comprehensive risk assessment for one child, which was in this file, was 14 months out of date. The assistant manager said that she had identified this and was trying to get a password to review the assessment on the computer. She had found an updated risk assessment on the clinical team’s file, but had not made this available to the care staff. The risk assessment had been signed by 25 staff in the preceding three days, despite it being so clearly out of date. This does not ensure that children’s risks are regularly reviewed and that the staff team knows how to reduce the risks to the children. It also questions the degree to which the staff have read and understood the records which they sign. Some staff said that they had been encouraged to sign records without reading them, but this was denied by the managers. The bullying log could not be found on the day of the inspection. While

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This monitoring visit

the managers point out that the information is also recorded in the incident reports, so has not been lost, it is of concern that so significant a record could not be found.

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This monitoring visit

The managers have increased their focus on maintenance of the building and putting right any damage. Broken furniture has been replaced, or replacements are on order, and redecoration is taking place. This reduces to some degree the impact that damage to furniture and graffiti on walls has to the children who were not involved in it. It means that the time when the children are living in an unsuitable environment is significantly reduced. Some bedroom doors are propped open by chairs during the day at the children’s request. These are fire doors, and the safety issues relating to this practice have not been assessed. As this is happening during the day, the potential risk may be less than if it were during the night. However, the failure to assess the risk does potentially increase the risk to children.

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This monitoring visit

The progress towards meeting the requirements from the previous inspection was not looked at on this occasion. A later date has been set for these, and Ofsted will review them at the next full inspection of the home.

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Recent inspection history

Inspection date Inspection type Inspection judgement 26/07/2017 Full Requires improvement to be good Inspection report for children’s home - monitoring visit: 1257796 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 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 to aspire to fulfil their potential and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home has sufficient staff to provide care for each child; and 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)(d)(h)) * 02/03/2018

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Requirement Due date

The registered person must ensure that no measure of control is excessive, unreasonable or contrary to The Children’s Homes (England) Regulations. (Regulation 19 (1)).

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Requirement Due date

In particular, the registered person must ensure that children are not routinely deprived of their liberty without a court order, as set out in the ‘Guide to the children’s homes regulations including the quality standards’, page 50, paragraph 9.63. 14/02/2018

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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 are complied with in respect of the home. (Regulation 25 (2)) 14/02/2018

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Requirement Due date

The registered person must ensure that within 48 hours of the use of measure of control, discipline or restraint in relation to a child in the home, the registered person, or a person who is authorised by the registered person to do so has spoken to the user about the measure and has signed the record to confirm it is accurate. (Regulation 35 (3)(b)(i)(ii)) 14/02/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(e)) 14/02/2018 Inspection report for children’s home - monitoring visit: 1257796 5 *These requirements are subject to a compliance notice.

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000.

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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

Clive Lucas, social care inspector Inspection report for children’s home - monitoring visit: 1257796 6 to 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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Inspector

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Inspector

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Inspector

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