Children's Home run by Cambian Childcare Limited in Cambridgeshire

Inspection report children’s home: 1257796 1 Registered provider: Cambian Childcare Limited Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

The home is owned by a private company. It is registered for up to 16 children who have ongoing mental health needs and challenging behaviours that may prevent them from functioning in the community without continued support. There is a separately registered school on-site. The manager registered with Ofsted in December 2018.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

inadequate

How well children and young people are helped and protected inadequate

p.1

inadequate

The effectiveness of leaders and managers inadequate

p.1

inadequate

There are serious and widespread failures that mean children and young people are not protected and their welfare is not promoted or safeguarded.

p.1

inadequate

Date of last inspection: 23 January 2019

p.1

inadequate

Overall judgement at last inspection: improved effectiveness

p.1

inadequate

Enforcement action since last inspection: none Inspection report children’s home: 1257796 2

p.1

Inspection date Inspection type Inspection judgement

23/01/2019 Interim Improved effectiveness 19/06/2018 Full Requires improvement to be good 26/07/2017 Full Requires improvement to be good Inspection report children’s home: 1257796 3

p.2

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.

p.3

Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

p.3

Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

p.3

Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

p.3

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.3

Requirement Due date

understand and apply the home’s statement of purpose;

p.3

Requirement Due date

understand and apply the home’s statement of purpose;

p.3

Requirement Due date

protect and promote each child’s welfare;

p.3

Requirement Due date

treat each child with dignity and respect;

p.3

Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably; and

p.3

Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to—

p.3

Requirement Due date

meet the needs of each child. (Regulation 6 (1)(a)(b)(2)(a)(b)(i) (ii)(iii)(vii)(c)(i))

p.3

Requirement Due date

In particular, ensure that children’s rooms are cleaned to an acceptable standard. 03/07/2019

p.3

Requirement Due date

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 26/07/2019 Inspection report children’s home: 1257796 4 registered person to ensure—

p.3

Requirement Due date

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;

p.4

Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm; and

p.4

Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (1)(2)(a)(i)(b)(d)) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

p.4

Requirement Due date

helps children aspire to fulfil their potential; and

p.4

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.4

Requirement Due date

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;

p.4

Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

p.4

Requirement Due date

ensure that the home has sufficient staff to provide care for each child;

p.4

Requirement Due date

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; and

p.4

Requirement Due date

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)(d)(f)(h))* 26/07/2019*

p.4

Requirement Due date

For the purposes of paragraph (3)(b), an individual who works in the home in a care role has the appropriate qualification if, by 19/09/2019 Inspection report children’s home: 1257796 5 the relevant date, the individual has attained—

p.4

Requirement Due date

the Level 3 Diploma for Residential Childcare (England) (‘the Level 3 Diploma’); or

p.5

Requirement Due date

a qualification which the registered person considers to be equivalent to the Level 3 Diploma.

p.5

Requirement Due date

in the case of an individual who starts working in a care role in a home after 1 April 2014, the date which falls 2 years after the date on which the individual started working in a care role in a home; or

p.5

Requirement Due date

in the case of an individual who was working in a care role in a home on 1 April 2014, 1 April 2016. (Regulation 32 (4)(a)(b)(5)(a)(b)) The registered person must ensure that all employees—

p.5

Requirement Due date

undertake appropriate continuing professional development; and

p.5

Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(a)(b)) 26/07/2019

p.5

Requirement Due date

* These requirements are subject to a compliance notice.

p.5

Overall experiences and progress of children and young people: inadequate

Significant shortfalls in the management and staffing of the home and in the physical environment have resulted in inadequate care. These shortfalls have put children at serious risk of harm. A history of poor inspection outcomes and repeated regulatory breaches relating to staffing demonstrate a lack of capacity to improve the care provided and to ensure children’s safety.

p.5

Overall experiences and progress of children and young people: inadequate

There are insufficient numbers of experienced staff to provide good-quality and safe care to the children. The staff are required to support children who have highly complex needs and present with high-risk self-harming behaviour. The number of staff on shift who are in the probationary period frequently outnumber post-probation staff.

p.5

Overall experiences and progress of children and young people: inadequate

Despite staffing difficulties, the service has continued to admit new children. New staff do not always feel confident to manage the children’s needs. As a result, there are times when inexperienced staff are asked to deal with situations that they do not have the Inspection report children’s home: 1257796 6 experience or confidence to manage. This contributes to poor decision-making that puts children at risk.

p.5

Overall experiences and progress of children and young people: inadequate

Managers have failed to provide children with a clean and hygienic home. Management monitoring of the environment is ineffective. These failings present a health risk as well as conveying little value to the children and compromising any effort to create a homely environment. The communal rooms are stark and institutional. The conditions are unacceptable. For example:  Bedroom floors were dirty.  Bedroom walls were stained with dust and there were insects on the window sills.  There was a strong odour in two bathrooms.  Several sinks were stained and full of debris.  There was rubbish on the bathroom floors.  Toilets were stained and dirty.  One toilet was broken away from the wall and remained on the floor attached by a waste pipe following an incident the previous day. Managers enable the children to contribute to regular multi-agency reviews of their care. These meetings include children and clinical, education and care staff. The frequency

p.6

Overall experiences and progress of children and young people: inadequate

and make up of these meetings enable managers to have a good overview of the progress that children make.

p.6

Overall experiences and progress of children and young people: inadequate

The children are making some progress. Children and professionals spoke about the reduction in children’s self-harming behaviours. Some children are making progress with their education. This includes children who had previously refused to attend school. Children recognise the progress that they have made. However, there are times when staff are not able to respond to the children because they have to regularly prioritise managing high-level incidents.

p.6

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

Managers have failed to ensure that children are looked after by staff who are sufficiently experienced, skilled and qualified. This has culminated in serious incidents.

p.6

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

One incident put a child at significant risk of death. The management decision-making about staff deployment coupled with staff members’ decision-making resulted in a series of errors. This meant that a child was not supervised in accordance with their presenting behaviour risk management plan. Despite the child being rated at the highest level of risk, the staff did not follow the clear guidance in the child’s risk assessments or in the child’s presenting behaviour management plan. All of which contributed to the child being alone in the community and at significant risk.

p.6

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

Managers do not ensure that allegations against staff are investigated with enough professional curiosity or urgency. For example, managers have failed to investigate thoroughly the reasons and motivation for some poor practice. This lack of swift, Inspection report children’s home: 1257796 7 decisive action and curiosity does not safeguard children.

p.6

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

Managers review risk assessments. Despite this, some risk assessments are unclear and contain conflicting information. In addition, prior to the inspection, managers had not written risk assessments relating to children smoking on the roadside outside the gate to the home. As a result, risks and the actions necessary to mitigate them are not always captured and when they are, mitigating actions are not always consistent or clear enough.

p.7

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

When concerns about potential radicalisation have arisen, the manager has taken appropriate action. She has consulted with professionals and arrived at balanced conclusions.

p.7

The effectiveness of leaders and managers: inadequate

The registered manager is appropriately qualified and experienced for the role.

p.7

The effectiveness of leaders and managers: inadequate

Managers review serious incidents. However, they do not fully explore their causes or generate actions that are proportionate to the severity of incidents. Investigations are not completed with enough urgency or depth.

p.7

The effectiveness of leaders and managers: inadequate

Managers have failed to recognise or evaluate the continued staffing issues that clearly link to each incident. Several new, probationary and unqualified staff work alone with children during times of significant challenge and risk. There is a consequential pressure on the entire staff team that has not been recognised or addressed. Despite these pressures, the responsible individual and registered manager continued to accept new admissions. This fails to provide safe or adequate care for highly vulnerable children.

p.7

The effectiveness of leaders and managers: inadequate

The staff do not receive formal, reflective supervisions with enough regularity. In addition, therapeutic staff do not routinely take up offers of supervision from therapeutic leads. This does not provide staff with the support that they need emotionally or practically. It does not support staff to reflect on significant incidents and does not help staff to learn and develop in response to these incidents.

p.7

The effectiveness of leaders and managers: inadequate

The manager monitors training progress. There are seven members of staff who have recently achieved a relevant level 3 qualification. However, there are staff who have not achieved a relevant level 3 qualification in the requisite time frame.

p.7

The effectiveness of leaders and managers: inadequate

Overall, management monitoring is ineffective. Some significant shortfalls identified at this inspection, such as the cleanliness of children’s rooms and the staffing issues, have not been identified through the existing monitoring arrangements.

p.7

The effectiveness of leaders and managers: inadequate

Feedback from professionals was consistently positive. They said that children are making progress and that communication with the managers is good.

p.7

The effectiveness of leaders and managers: inadequate

The manager has improved the way in which complaints are managed. As a result, this previous shortfall has been addressed. Inspection report children’s home: 1257796 8 Because of the concerns identified throughout this inspection, Ofsted is likely to take further enforcement action.

p.7

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 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.

p.8

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: 1257796 9

p.8

Children’s home details

Registered provider: Cambian Childcare Limited

p.9

Children’s home details

Registered provider address: 4th Floor, Waterfront, Manbre Wharf, Manbre Road, Hammersmith, London W6 9RU

p.9

Inspectors

Ashley Hinson: social care inspector Deirdra Keating: social care inspector Inspection report children’s home: 1257796 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.

p.9

Inspectors

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 terms of the Open Government Licence. To view this licence, visit http://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 .

p.10

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.10

Inspectors

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

p.10