Children's Home run by Cambian Childcare Limited in Dorset

Inspection report children’s home: 1159868 1 Registered provider: Cambian plc

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

 This privately owned home is operated by a large national provider of services for children.  The home is registered for up to three children and young people who may have emotional and/or behavioural difficulties.  The former registered manager left the home on 22 January 2018. The new registered manager started in post on 8 May 2018 and was registered on 16 August 2018.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: improved effectiveness

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: 1159868 2

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Inspection date Inspection type Inspection judgement

23/03/2018 Interim Improved effectiveness 27/11/2017 Full Good 26/04/2016 Full Requires improvement Inspection report children’s home: 1159868 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

6: The quality and purpose of care standard

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and the outcomes it seeks to achieve for children. In particular, the standard in paragraph (1) requires the registered person to ensure that staff protect and promote each child’s welfare; provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background; provide to children living in the home the physical necessities they need in order to live there comfortably; provide to children personal items that are appropriate for their age and understanding; and ensure that the premises used for the purposes of the home are designed and furnished so as to meet the needs of each child. (Quality Standard 6 (1)(2)(b)(ii)(iv)(vii)(c)(i) and (ii)).

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Requirement Due date

In particular, the registered person should ensure that the quality of the home’s environment is improved to provide an attractive, homely and safe place for children to live, that children are only accepted for admission if their specific needs can be met, and that wi-fi is provided for all of the children, in consultation with their placing authorities. 12/10/2018

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) 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; have the skills to identify and act upon signs that a child is at risk of harm; manage relationships between children to prevent them from harming each other; and are familiar with, and act in accordance with, the home’s child protection policies; that the home’s day-to-day 10/09/2018 Inspection report children’s home: 1159868 4 care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Quality Standard 12 (1)(2)(a)(i)(iii)(iv)(vii) and (b)).

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Requirement Due date

In particular, ensure that the risks posed by individual children are accurately assessed, that any safeguarding concerns are fully documented at the time of the incident and that staff have access to a brief, clear set of guidelines which explain the actions to be taken in the event of concerns about a child. 23: Medicines

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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. In particular, the registered person must ensure that medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them and that a record is kept of the administration of medicine to each child. (Regulation 23 (1)(2)(a) and (c)).

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Requirement Due date

In particular, ensure that there is a reliable and safe system for recording medicines given to adults outside the home (parents, schools) for administration to the child. 10/09/2018

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation. In particular, ensure that accurate and detailed records are kept of each complaint, including the outcome of the complaint and how the outcome was conveyed to the child. (Regulation 39 (3)). 10/09/2018

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Recommendation

 Ensure that in non-nursing care homes, controlled drugs are administered by appropriately trained and competent care home staff and this should be witnessed by another appropriately trained care home staff member. (‘Guide to the children’s homes regulations including the quality standards’, April 2015, page 35, paragraph 7.17, and the National Institute for Health and Care Excellence (NICE): ‘Managing Medicines in Care Homes Guideline’, March 2014, pages 154– 155). Inspection report children’s home: 1159868 5

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improvement to be good

The home requires improvement to be good because there are significant shortfalls in the quality of the environment:  The thatched roof is in a poor state of repair. This was first highlighted in an interim inspection report in November 2014.  The carpets throughout the house are stained, particularly on the landing.  Some time ago, the manager, staff and independent visitor identified the need for bathroom refurbishment, but this has still not been done.  The downstairs toilet flooring does not cover the floor area under the pedestal, which makes this area difficult to clean thoroughly.  There are institutional-looking cupboards on the landing. These were padlocked when the inspector arrived, which does not provide a homely environment.  The doorbell was covered in an unidentified brown substance, which appeared unpleasant to anyone approaching the door. The bell was replaced during the inspection.

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improvement to be good

 There are wasps in the garden, which readily come into the home whenever the windows and doors are opened. Pest control had visited but were unable to find the nest.  An inspection requirement made in November 2017, regarding lack of wi-fi in the home, has still not been met. The children and young people find the lack of wi-fi frustrating, because it limits their access to some areas of the internet. During the inspection, the registered manager commenced action to improve some of the areas identified above. The experiences and outcomes for children and young people have been variable. Two individuals, one of whom has recently left the home, have made good progress in their education, but another young person has been out of full-time education for some years. This young person still only receives 10 hours of education per week. This falls well short of the 25 hours per week to which he is legally entitled. No requirement has been made,

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improvement to be good

because the registered manager has taken appropriate action to try to remedy the situation. During the inspection, discussion took place about the therapeutic provision for a young person who displayed behaviours which were potentially a risk to other children. Some of these behaviours were already documented when he came into the home. This young person did receive some therapeutic input early in his placement, but this was insufficient to eliminate the risk to other children and young people. Further incidents led to the young person being moved from the home. This was a negative outcome for that individual and also for several other children. Children and young people’s healthcare and dietary needs are generally well met. Medicines under the staff’s direct control are managed safely. However, an inspector found an empty prescription-only medication packet on a young person’s bedroom floor. Recently, some medication had been handed over to the young person’s parent before

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improvement to be good

the young person went to stay with her. The young person had not been risk assessed Inspection report children’s home: 1159868 6 as able to manage this medication by himself. It is unclear why he had the empty packet in his bedroom. This incident highlighted the fact that the home does not yet have a reliable system for recording medication which goes outside the home for other adults to administer, such as teachers or parents. Although this young person was not placed at significant risk of harm, this lack of consistent recording is a loophole in the medicines recording system. This has the potential to cause further omissions. There have not always been two staff available to sign for controlled drug administrations. In children’s homes, a second signature is recommended as an appropriate safeguard for ensuring accurate and timely administration of controlled medicines. The relationships between staff and children and young people are good. Children and

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improvement to be good

young people receive good-quality individual support. They engage in therapeutic parenting conversations with their key workers. The topics include behavioural guidance and how to keep safe online and in the community. The children and young people are regularly consulted about daily life within the home. They can choose their meals and activities. Recently, they asked if they could work with a graffiti artist. Together, they produced some bright, colourful pictures which now decorate the home. One young person is planning a sailing adventure. He also enjoys cooking and regularly helps the staff to prepare healthy meals, which provides him with some skills for his future independence. Another young person has been away for a short break with staff to a well-known theme park. These activities give the children and young people positive memories and rewarding life experiences.

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improvement to be good

Risk assessments are generally good. One individual risk assessment identified the potential for harmful behaviour towards other children. However, additional security measures, in the form of bedroom door alarms, were only put into place after the individual moved out of the home. This suggests that the potential risks posed by this young person, even though documented, had not been fully evaluated or understood. The company has a good corporate safeguarding policy, although it is too complicated to access in an urgent situation. The registered manager was advised to obtain a quick- access, simplified guide for the staff. This was obtained during the inspection.

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improvement to be good

The home has received two complaints since the last inspection. Both have been investigated. There is a shortfall in the recording of one of the complaints. In addition, it also does not provide an account of any feedback given to the young person about their complaint. The registered manager has managed two safeguarding incidents well. He has communicated effectively with the local authority designated officer. However, in one case, the manager did not complete a chronology of events to sufficiently evidence the Inspection report children’s home: 1159868 7 timing of events and to account for delay created by other agencies. remain As a result the safeguarding audit tail is incomplete. The staff have access to clear and detailed behaviour management plans. These documents contain strategies to help the staff to respond to any inappropriate behaviour. The children and young people benefit from a clear system of rewards and

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improvement to be good

restorative measures. There have been very few serious incidents in the home since the last inspection. Those which have taken place are well recorded and show that the manager and staff team respond to the children and young people appropriately, without escalating the situation unnecessarily. It is very positive that no children and young people have gone missing since the last inspection. Also, there have been no restraints.

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

The registered manager was registered with Ofsted on 16 August 2018, a week before this inspection took place. Prior to his registration, the home had been without a registered manager for 29 weeks. The now-registered manager arrived in post in May 2018. Since his arrival, he has brought about a number of positive changes. For example, the registered manager has recently led the review of all the children and young people’s file information. The office is informal but well ordered, with confidential documents locked away in a cupboard so that the rest of the space can be shared by the staff and young people. The staff and registered manager’s personal qualities, knowledge and experience are the home’s greatest strength. They are very child-centred and work hard to achieve positive outcomes for children and young people. The home is fully staffed. The home is recruiting to fill posts which may become vacant

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

and to cover for staff sickness and maternity leave. Staff recruitment is well managed and there is a safe system in place to ensure that children and young people are protected as far as possible from unsuitable staff. Staff supervision has been managed well. Staff training is generally good. However, the company has been slow in starting recently appointed staff on their level 3 qualifications. Five out of nine staff currently hold this award. The responsible individual stated that none of the staff who have yet to achieve the award has exceeded the deadline. Management monitoring is generally good, with clear systems in place to manage the home well. The registered manager is well supported by his line manager. An independent visitor reports on the home every month. The requirement made at the interim inspection has been acted upon. This concerned the home’s contact with placing authorities to obtain missing paperwork for the children

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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 Inspection report children’s home: 1159868 8 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: 1159868 9

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Children’s home details

Registered provider address: Cambian, Waterfront, Hammersmith Embankment, Chancellors Road, London W6 9RU

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Children’s home details

Responsible individual: Nicola McClements

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Inspector(s)

Heather Chaplin, social care inspector Inspection report children’s home: 1159868 10 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(s)

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Inspector(s)

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Inspector(s)

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