Midmeadows

Inspection report for children’s home – monitoring visit: SC457025 1 SC457025

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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 owned by a private company. It is registered to provide care and accommodation for up to four children who have been subject to early-life trauma, causing them to have social and emotional difficulties.

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Information about this children’s home

The manager was registered with Ofsted in September 2019 and has a level 5 diploma in leadership and management.

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This monitoring visit

The home was last inspected in January 2020. This monitoring visit was carried out to enable the regulator to obtain an up-to-date assessment of the staff’s ability to safely manage children’s behaviour.

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This monitoring visit

Due to the COVID-19 (coronavirus) pandemic, Ofsted did not carry out a physical visit to the home. The inspector gathered evidence in several different ways, including holding video calls with the manager and the staff, and asking them to provide electronic documents for the inspector to review.

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This monitoring visit

Since the last inspection, three children have lived at the home. Currently, there is one child. Mistakes have been made by managers and staff which have resulted in children’s placements being suddenly ended. As a result, there has been an internal review of children’s placements. This has helped managers to recognise the shortfalls in practice and to bring in new ways of working with children.

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This monitoring visit

This change is noticeable when a child moved into the home in November 2020. Staff have developed a strong relationship with the child to encourage him to follow well-established routines. This includes encouraging the child to follow a bespoke programme of education and to eat a healthy meal with staff, prepared from scratch. This individual attention builds relationships and trust between staff and the child. Inspection report for children’s home – monitoring visit: SC457025 2 Staff have helped the child to continue with his hobbies and interests during the COVID-19 pandemic. For instance, staff go on regular bike rides and play basketball with him. They also play indoor games such as pool and cards. The child is affected by attention deficit hyperactivity disorder (ADHD) and these activities calm him and help him to manage his anxieties. However, although staff practice is good, risk assessments are missing details about the impact that ADHD has on the child’s

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This monitoring visit

behaviours. They do not contain examples of good practice in which staff have used their therapeutic training to help the child to manage his behaviours. This risks inconsistent care for the child when new staff join the home.

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This monitoring visit

Staff work with a range of health professionals, including the organisation’s clinical team. Staff talk with the child about healthy eating and about the dangers of smoking. This coordinated approach to healthcare means that the child’s physical and emotional health needs are met.

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This monitoring visit

The child’s social worker told the inspector that she is pleased with how staff welcomed her child into the home and continue to support him. The child’s parent said there was nothing the home could do to improve.

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This monitoring visit

However, another social worker, who was working with another child who has left the home, said that staff did not understand her child’s trauma or relate to her in a therapeutic way. As a result, staff did not help the child to manage her complex behaviours, which escalated during the short time she lived in the home.

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This monitoring visit

When there is a concern about staff practice, or when children complain about a member of staff, managers are slow to act. This means that poor practice remains unchallenged and children do not feel that staff listen to them and take their concerns seriously.

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This monitoring visit

Staff have continued to access online training, but three of the six staff have not undertaken online training in self-harm, and one staff member does not have training in ADHD. Additionally, three staff do not have ‘Prevent’ training. These deficits compromise the staff’s ability to keep children safe. It is acknowledged that the staff’s face-to-face training has been impacted by restrictions associated with COVID-19. However, managers have not been creative enough in updating the staff’s skills in behaviour management training. Children’s placements have ended because staff have not had the skills to manage children’s complex behaviours.

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This monitoring visit

Monitoring by managers is not always effective. For instance, managers lack professional curiosity when records fail to show that staff have acted to de-escalate and manage children’s complex behaviours. This means that potentially poor practice goes unchallenged and children are left at risk. Following a review of incidents, managers do not create an audit trail of their own actions. This creates a lack of accountability, and in turn hinders the monitoring activity of the regulator and the independent visitor. Furthermore, the locality risk assessment contains out-of-date information, and has not been shared with the relevant safeguarding agencies. Additionally, during the inspection, managers struggled to produce an up-to-date Inspection report for children’s home – monitoring visit: SC457025 3 record of staff training. The managers’ poor monitoring jeopardises recent improvements in the quality of care.

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This monitoring visit

More positively, managers ensure that staff receive regular, good-quality supervision and an annual appraisal.

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Recent inspection history

Inspection date Inspection type Inspection judgement 13/01/2020 Full Good 14/11/2018 Full Outstanding 22/01/2018 Full Good 12/01/2017 Interim Sustained effectiveness Inspection report for children’s home – monitoring visit: SC457025 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 protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

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

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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. (Regulation 12 (1) (2)(a)(i))

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Requirement Due date

This relates to risk assessments not containing guidance for staff on the impact of attention deficit hyperactivity disorder on a child, or positive behaviour management strategies based on the staff’s therapeutic training. 28 March 2021

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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—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

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

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Requirement Due date

demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

feedback on the experiences of children, including complaints received. (Regulation 13 (1)(a)(b) (2)(g)(i)(ii))

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Requirement Due date

This relates to managers not immediately acting on a complaint from a child. 28 March 2021 Inspection report for children’s home – monitoring visit: SC457025 5 The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

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

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Requirement Due date

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

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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)(c)(h))

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Requirement Due date

This relates to shortfalls in staff training and in managers’ monitoring activity. 28 March 2021

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year, taking into account the requirement in regulation 12 (2)(c) (the protection of children standard).

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Requirement Due date

When conducting the review, the registered person must consult, and take into account the views of, each relevant person. (Regulation 46 (1) (2))

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Requirement Due date

The relates to the location risk assessment containing out-of- date information, and there being no evidence of the assessment being shared with relevant safeguarding agencies, such as the police. 28 March 2021

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Recommendations

 The registered person should have a workforce plan which can fulfil the workforce-related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should be updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home’s manager. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8’) Inspection report for children’s home – monitoring visit: SC457025 6

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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: Caretech Ltd, Metropolitan House, 3 Darkes Lane, Potters Bar EN6 1AG

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Inspector

Karen Gillingwater, Social Care Inspector Inspection report for children’s home – monitoring visit: SC457025 7 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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Inspector

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Inspector

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Inspector

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