Children's Home, Residential special school run by Cambian Autism Services Limited in Dorset

Inspection report children’s home: SC065261 1 SC065261 Registered provider: Cambian Autism Services Limited Interim inspection Inspected under the social care common inspection framework

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Information about this children’s home

The children’s home is registered for up to 60 children who have autism spectrum disorders and/or learning disabilities. The service operates as a residential special school that also provides accommodation for 52 weeks of the year. As a result, it is registered as a children’s home. The home provides care across nine houses. The home is owned by a private national organisation. The registered manager left in July 2019. This post is currently vacant.

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Inspection date: 25 February 2020

Date of last inspection: 24 September 2019

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Inspection date: 25 February 2020

Judgement at last inspection: requires improvement to be good

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Inspection date: 25 February 2020

Enforcement action since last inspection: none Inspection report children’s home: SC065261 2

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children and young people since the most recent full inspection

This home was judged requires improvement to be good at the last full inspection. At the interim inspection, Ofsted judges that it has sustained effectiveness.

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children and young people since the most recent full inspection

Insufficient permanent staffing continues to affect all areas of the provision. This has been an ongoing issue for the previous three and a half years and reported on in previous inspections. Across the service there are currently 30 staff vacancies. These are covered by staff working overtime, bank workers and agency staff. Leaders and managers are striving to use the same agency staff, including a number who have worked at the home for a long time. However, it remains that children are cared for by several different adults rather than a core group of consistent carers. As stated at previous inspections, this does not aid in the development of strong relationships between children and staff. In addition, since 29 September 2019, 15 shifts were identified in two of the nine houses when over 50% of the staff on duty were agency staff. This practice is not recommended.

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children and young people since the most recent full inspection

Recruitment systems for agency staff lack rigour. Leaders and managers do not always ensure that the required information is in place before staff work with children. Specifically, files are not audited effectively to ensure that references are in place. In addition, not all agency staff are receiving required mandatory training to carry out their roles safely and in the best interest of children. This relates specifically to restraint training. Agency staff are now receiving good-quality supervision, which is reflective and helps them to improve their practice.

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children and young people since the most recent full inspection

The home has been without a registered manager since July 2019. Persons have been identified for this role, but an application is yet to be received by Ofsted.

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children and young people since the most recent full inspection

Safeguarding incidents are responded to appropriately. Good-quality records are maintained, providing evidence of effective working with external professionals. However, when an allegation is made against a member of staff, it is not consistently followed up in the member of staff’s supervision sessions to allow reflection on the event.

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children and young people since the most recent full inspection

Improvements continue to be made to the residential environment. The ongoing refurbishment programme is proving effective. However, the maintenance log does not provide leaders and managers with an effective monitoring tool as it does not record when work has been completed. Staff have an improved awareness of potential environmental hazards and these are swiftly addressed.

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children and young people since the most recent full inspection

Children are making progress. Staff are using effective strategies to help children develop their communication and independence skills and improve their diets.

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children and young people since the most recent full inspection

Since the previous inspection, four children have successfully moved into the home. Staff have completed good-quality compatibility risk assessments, which reflect the Inspection report children’s home: SC065261 3 risks a new child may present to the existing group and vice versa. In addition, two children have successfully left the home.

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children and young people since the most recent full inspection

The needs of children with complex health issues are well met. Leaders and managers ensure that there is clear information, guidance and protocols in place to support staff in meeting these needs.

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children and young people since the most recent full inspection

Improvements have been made in the management of medication, except for one house where discrepancies in stock medication records and balances were found. The medication policy has been reviewed and provides staff with clear guidance. New systems have been developed to provide leaders and managers with improved oversight of medication errors.

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children and young people since the most recent full inspection

The number of restraints has reduced since the previous inspection. Records of these incidents are mostly well maintained. However, the quality of discussions with children after they have been restrained is variable and not yet of a consistently good quality.

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children and young people since the most recent full inspection

Behaviour support plans identify children’s needs and are supported by risk assessments. However, these important documents are not consistently reviewed to ensure that they remain current. Staff are also not consistently signing and dating these documents.

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children and young people since the most recent full inspection

Fire safety precautions have improved. Fire doors now close as required and means of escape are clear from obstruction. The site fire risk assessment has been reviewed and now provides a clear picture of the service.

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children and young people since the most recent full inspection

Leaders and managers have completed a review of the quality of care provided by the home. They have identified ways to further improve the effectiveness of this report in driving forward improvements in the service.

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children and young people since the most recent full inspection

Complaint records are maintained but further improvement is needed to ensure that the complainants views of the complaint investigation outcome are clearly recorded.

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children and young people since the most recent full inspection

Leaders and managers’ monitoring has improved. They identify actions needed but do not always record when these have been completed. Inspection report children’s home: SC065261 4

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Inspection date Inspection type Inspection judgement

24/09/2019 Full Requires improvement to be good 09/01/2019 Interim Sustained effectiveness 17/07/2018 Full Requires improvement to be good 16/10/2017 Full Requires improvement to be good Inspection report children’s home: SC065261 5

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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

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— (a) 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; (b) ensure that staff work as a team where appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (d) ensure that the home has sufficient staff to provide care for each child; (e) ensure that the home’s workforce provides continuity of care to each child; (f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each

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Requirement Due date

child and use this understanding to inform the development of the quality of care provided in the home; and (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)(a)(b)(c)(d)(e)(f)(h)) 29/05/2020

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Requirement Due date

23: Medicines (1) 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)) 30/04/2020

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Requirement Due date

31: Staffing of children’s homes The registered person must ensure that the employment of any person on a temporary basis at the children’s home does 15/05/2020 Inspection report children’s home: SC065261 6 not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 31 (1)) In particular, leaders and managers must ensure that all agency staff have been recruited using safer recruitment practices, that they have the relevant experience to work in the home and that they receive essential training prior to caring for children. Leaders and managers are required to maintain training records of agency staff.

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Recommendations

 No more than half the staff on duty at any one time, by day or night at the home should be from an external agency. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 10.17)  Any child who has been restrained should be given the opportunity to express their feelings about their experience of the restraint as soon as is practicable, ideally within 24 hours of the restraint incident, taking the age of the child and the circumstances of the restraint into account. In some cases children may need longer to work through their feelings, so a record that the child has talked about their feelings should be made no longer than 5 days after the incident of restraint (Regulation 35 (3)(c)). Children should be encouraged to add their views and comments to the record of restraint. Children should be offered the opportunity to access an advocacy support to help them with this (Regulation 7 (2)(b)(iii)).

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Recommendations

(‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.60)  The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.2) In particular, where staff have been the subject of an allegation, this needs to be discussed in their supervision in a timely manner.  Regulations 35–39 detail the records that must be kept in children’s homes. All children’s case records (Regulation 36) must be kept up to date and stored securely whilst they remain in the home. Case records must be kept up to date and signed and dated by the author of each entry. (‘Guide to the children’s homes

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Recommendations

regulations including the quality standards’, page 62, paragraph 14.3) Inspection report children’s home: SC065261 7

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Information about this inspection

This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, 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: SC065261 8

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Cambian Autism Services Limited

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Children’s home details

Registered provider address: Metropolitan House, 3 Darkes Road, Potters Bar EN6 1AG

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Children’s home details

Responsible individual: Virginia Bellard

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Inspectors

Wendy Anderson, Social Care Inspector Sharron Escott, Social Care Inspector Polly Soper, Social Care Inspector Inspection report children’s home: SC065261 9 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 children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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