Children's home run by Cambian Childcare Limited in Stockport

Inspection report children’s home: SC476261 1 SC476261 Registered provider: Cambian Childcare Ltd Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home provides care and accommodation for up to five children, aged between eight and 18 years, with complex behaviours due to early childhood trauma. The home is privately owned by a large national provider.

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Information about this children’s home

The home has a registered manager however they have submitted their resignation and are currently working their notice period.

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Information about this children’s home

Due to COVID-19 (coronavirus), at the request of the Secretary of State, we suspended all routine inspections of social care providers on 17 March 2020.

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Information about this children’s home

We last visited this setting on 3 March 2021 to carry out a monitoring visit. The report is published on our website.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children are not protected or their welfare is not promoted or safeguarded, and the care and experiences of children and young people are poor, and they are not making progress.

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inadequate

Overall judgement at last inspection: requires improvement to be good Inspection report children’s home: SC476261 2

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Enforcement action since last inspection:

A monitoring visit took place on 29 January 2021 due to concerns received by Ofsted in regard to allegations of poor staff practice. The inspector found serious shortfalls that resulted in Ofsted issuing two compliance notices under regulation 12, the protection of children standard; and regulation 13, the leadership and management standard. A monitoring visit took place on 3 March 2021 that found the provider had failed meet the compliance notices. As a result, compliance notices were issued again under regulation 12 and regulation 13. Inspection report children’s home: SC476261 3

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Inspection date Inspection type Inspection judgement

13/05/2019 Full Requires improvement to be good 18/09/2018 Full Good 05/03/2018 Interim Declined in effectiveness 05/12/2017 Full Good Inspection report children’s home: SC476261 4

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inadequate

Children are not protected from harm or the risk of further harm. The provider has failed to meet the compliance notices issued at the last inspection, and this has led to the judgement of inadequate.

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inadequate

Children who were spoken to told inspectors that they like living at the home, and were observed to enjoy days out with staff. However, one child told inspectors that she was unhappy, as another child was ‘mean’ to her. Although managers were aware of an incident she described, staff had failed to record an incident report to detail the actions taken. Managers had also not updated her risk assessment to reflect the bullying behaviour she had experienced. This included being threatened and locked outside of the home by another child. There was no evidence of staff completing work with the children to prevent further incidents of bullying. As a result, children are not protected from harm.

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inadequate

One child demonstrates what is described in her plans as ‘major’ sexualised behaviours. Records show that the strategies used by staff to manage this behaviour have been ineffective. In addition, staff have not completed direct work with the child to address this behaviour and to help reduce the impact of this behaviour on other children. This leaves children exposed to inappropriate sexualised behaviour.

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inadequate

Complaints by children are not addressed in line with the provider’s policies and procedures. Contrary to the organisation’s procedures, one child has not received a formal update on a complaint she made about a member of staff. One child complained that she was refused access to the kitchen when she felt nauseous and hungry as a side effect of the medication she was prescribed. She complained that she was offered fruit that had previously been thrown on the floor. This complaint has not been formally recorded or managed as a complaint, and these concerns have not been properly investigated. As a result, children cannot be confident that their concerns will be listened to and addressed in order to improve the quality of care they receive.

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inadequate

Although some areas of the home have been redecorated, some areas are poorly maintained. Inspectors found rubbish that had been thrown into the garden from a bathroom window, but this had not been identified by managers or staff. Children’s routines are displayed in communal areas. These routines include specific laundry days, scheduled bath times for children, and times of ‘kitchen closure’. This gives an institutionalised feel and does not create a homely atmosphere for children.

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

Children remain at risk of significant harm. Risk assessments are not up to date, do not include all known risks for children and do not provide staff with clear guidance Inspection report children’s home: SC476261 5 on how to safeguard children effectively. Consequently, staff are not fully informed of all known risks to children and the strategies they must implement to protect them from harm.

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

The response to and management of bullying at the home are ineffective. This means that children are not safeguarded effectively.

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

Leaders and managers have failed to take swift and effective action in response to allegations made against staff. For example, at the time of the inspection, an allegation was made following the restraint of a child. Managers did not take prompt action in response to the incident. The member of staff was allowed to continue working on shift caring for children, and managers did not inform the designated officer in the local authority of the allegation. Such action compromises the safety of children and prevents other safeguarding partners from undertaking investigations and safeguarding children effectively.

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

Restraint practice is poor, and places children at risk of harm. Staff have used ground holds to restrain a child. This is outside of the provider’s approved model of restraint and staff have not had training in using such a hold. Managers have failed to identify and address this incident of poor practice. Plans for the child did not include any agreed positive handling strategies. Staff remain uninformed about how to respond safely and effectively to manage the child’s behaviour.

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

The home environment poses a risk to children. For example, a member of staff was unable to identify the child’s bedroom door that had triggered the alarm, when it sounded. Furthermore, one child’s bedroom has been recently fitted with blinds. Inspectors found that these had been damaged and the pull-cord system was missing. The child has previously demonstrated self-injurious behaviour and expressed suicidal thoughts. However, the management team was unaware of the damage that had taken place and was unaware the cord was missing. In addition, fire doors were not closing effectively. Managers’ monitoring of health and safety has failed to address and rectify these concerns. Consequently, the home environment places children at risk of harm.

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The effectiveness of leaders and managers: inadequate

The registered manager is the subject of an internal investigation and is no longer working in a management role in the home. This is due to shortfalls in safeguarding practice that were identified at previous monitoring visits. Despite this, the registered manager continues to work as a shift leader and described himself as a role model for other staff in the home. Despite the continuing investigation, the registered manager is not the subject of any additional monitoring or supervision. Further work has not been completed to ensure that he is now able to respond appropriately to allegations or concerns raised by children. In addition, the registered manager has resigned from his position and has not submitted a voluntary cancellation form to Ofsted in line with regulatory processes. Inspection report children’s home: SC476261 6 A registered manager from another setting is currently in day-to-day charge at the

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The effectiveness of leaders and managers: inadequate

home in addition to her other responsibilities for the home she is registered to manage. She is supported by a quality assurance manager.

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The effectiveness of leaders and managers: inadequate

At this visit, Ofsted found that managers and staff had failed to take swift and effective action in response to allegations against staff. The inspector identified additional shortfalls in the management of children’s risk. As a result, the safety and well-being of children are compromised.

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The effectiveness of leaders and managers: inadequate

Leaders and managers do not always ensure that staff provide continuity of care for children. For example, during the restraint of a child, staff were not in agreement with what strategies to use and did not work effectively together to manage the behaviour of the child. This resulted in the child sustaining injuries.

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The effectiveness of leaders and managers: inadequate

Agency staff working at the home do not have the confidence and skill to effectively care for the children. For example, an agency member of staff was unable to explain to inspectors the key strategies he should follow to safeguard the child who had made an allegation. This lack of knowledge compromises the safety of children. As a result, children are not safeguarded effectively.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to ensure that the staff roster accurately reflects the staff working in the home at any one time. As a result, it is not clear if children were being suitably and safely cared for.

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The effectiveness of leaders and managers: inadequate

Staff do not receive regular supervision to support them in their role. For example, one staff member in her probationary period has not received supervision in line with the company’s supervision policy. Supervision and handover records demonstrate inconsistent practice from managers and staff, and this has not been appropriately responded to by managers. Furthermore, managers do not respond to and investigate all complaints raised by staff. This demonstrates that staff are not supported in their role, which has an adverse impact on the consistency and quality of care provided for children.

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The effectiveness of leaders and managers: inadequate

Monitoring and review systems are ineffective. For example, one record of restraint details injuries suffered by two members of staff, including cuts and bruises. However, the management evaluation of the record states that no injuries were sustained. In addition, there is no evidence of a debrief with one of the staff members concerned. This failure to complete and oversee records thoroughly indicates the managers’ and staff’s lack of understanding of their roles and responsibilities. This means that leaders and managers are not acting to improve the experiences, care and safety of children. As a result, children’s progress, welfare and safety are compromised.

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The effectiveness of leaders and managers: inadequate

Furthermore, managers failed to give the annex A to inspectors. This prevents the regulator from identifying patterns and trends, and monitoring change and progress.

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The effectiveness of leaders and managers: inadequate

Due to the concerns raised at this inspection, an urgent notice to vary the conditions of the setting has been served, which reduces the number of children who can be Inspection report children’s home: SC476261 7 accommodated from five to two. In addition, four compliance notices were issued under:

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The effectiveness of leaders and managers: inadequate

 regulation 12, the protection of children standard  regulation 13, the leadership and management standard  regulation 20, restraint and deprivation of liberty  regulation 35, behaviour management policies and records. Inspection report children’s home: SC476261 8

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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 positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

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Requirement Due date

an understanding about acceptable behaviour;

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Requirement Due date

and positive responses to other children and adults.

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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

meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans;

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Requirement Due date

help each child to develop socially aware behaviour;

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Requirement Due date

encourage each child to take responsibility for the child’s behaviour, in accordance with the child’s age and understanding;

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Requirement Due date

help each child to develop and practise skills to resolve conflicts positively and without harm to anyone;

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Requirement Due date

communicate to each child expectations about the child’s behaviour and ensure that the child understands those expectations in accordance with the child’s age and understanding;

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Requirement Due date

help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful; 23 May 2021 Inspection report children’s home: SC476261 9 help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship;

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Requirement Due date

de-escalate confrontations with or between children, or potentially violent behaviour by children;

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Requirement Due date

understand and communicate to children that bullying is unacceptable; and

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Requirement Due date

have the skills to recognise incidents or indications of bullying and how to deal with them; (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(xi)(xii)(xiii))

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Requirement Due date

This specifically relates to ensuring that direct work is completed with children.

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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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies; 23 May 2021 Inspection report children’s home: SC476261 10 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; and

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Requirement Due date

that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(v)(vi)(vii)(d)(e))

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Requirement Due date

This requirement was made at the last inspection and is restated and subject to a compliance notice.

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Requirement Due date

In particular, this relates to ensuring that risk assessments are up to date and include effective strategies for staff to follow. That effective action is taken to respond to allegations made against staff and the child protection policy is reviewed in relation to this.

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Requirement Due date

Additionally, this relates to ensuring that the premises and environment are designed to ensure that children are safe, and their needs are met.

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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

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;

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Requirement Due date

ensure that staff work as a team where appropriate;

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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

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

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Requirement Due date

ensure that the home’s workforce provides continuity of care for each child; 23 May 2021 Inspection report children’s home: SC476261 11 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;

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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)(a)(b)(c)(d)(e)(f)(h))

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Requirement Due date

This requirement was made at the last inspection and is restated and subject to a compliance notice.

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Requirement Due date

In particular, this relates to ensuring that there is a registered manager in day-to-day charge of the home and that there are effective monitoring and review systems in place to review and improve the quality of care provided for children.

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Requirement Due date

This also relates to ensuring that staff have the experience, qualifications, and skills to meet the needs of children, understand their roles and provide consistent and continuity of care for children.

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Requirement Due date

Restraint in relation to a child is only permitted for the purpose of preventing—

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Requirement Due date

injury to any person (including the child);

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Requirement Due date

serious damage to the property of any person (including the child); or

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Requirement Due date

Restraint in relation to a child must be necessary and proportionate. (Regulation 20 (1)(a)(b) (2))

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Requirement Due date

In particular, this relates to ensuring that records demonstrate that the threshold for restraint is clearly detailed, that management oversight reviews and evidences why the use of restraint was necessary and proportionate, and that agreed strategies are clearly detailed in plans for children. 23 May 2021

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must— 06 May 2021 Inspection report children’s home: SC476261 12 take adequate precautions against the risk of fire, including the provision of suitable fire equipment in the children’s home. (Regulation 25 (1)(a))

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Requirement Due date

This specifically relates to seeking advice on fire safety in the home from the appropriate fire authority and taking immediate action to reduce any risks identified.

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

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

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Requirement Due date

This requirement was made at the last inspection and is restated.

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Requirement Due date

This relates to ensuring that all staff receive supervision in line with the provider’s policies and procedures. 23 May 2021

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Requirement Due date

*Behaviour management policies and records

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Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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Requirement Due date

details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and 23 May 2021 Inspection report children’s home: SC476261 13 a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c))

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Requirement Due date

This requirement was made at the last inspection and is restated and subject to a compliance notice.

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Requirement Due date

In particular, this relates to ensuring that staff complete full and accurate records following incidents of restraint, and that the provider ensures that there is a clear record of the analysis and assessment as to the effectiveness of the measure used.

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date; and retain the records for at least 15 years from the date of the last entry. (Regulation 37 (1) (2)(a)(b)(c))

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Requirement Due date

This requirement was made at the last inspection and is restated.

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Requirement Due date

This specifically relates to ensuring that staff rosters are update and maintained in line with regulatory requirements. 23 May 2021

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Requirement Due date

Complaints and representations 23 May 2021 Inspection report children’s home: SC476261 14 Subject to paragraph (6), the registered person must establish a procedure for considering complaints made by or on behalf of children.

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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. (Regulation 39 (1) (2) (3))

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Requirement Due date

In particular, this relates to ensuring that any complaint from a child is recorded and actioned in line with the provider’s policy and procedure.

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Requirement Due date

*These requirements are subject to a compliance notice.

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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: SC476261 15

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Children’s home details

Registered provider: Cambian Childcare Ltd

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Children’s home details

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

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Inspectors

Jessica Forshaw, Social Care Inspector Dean Wilton, Social Care Inspector Inspection report children’s home: SC476261 16 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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