Children's home run by Cambian Childcare Limited in Hammersmith and Fulham

Inspection report children’s home: SC067899 1 SC067899 Registered provider: Cambian Childcare Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is one of a number of children’s homes operated by a private company. It is registered to provide care for up to seven children who may have emotional and/or behavioural difficulties.

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Information about this children’s home

The home operates under a block contract arrangement with the local authority in which it is situated. The decision has been made by the provider, in consultation with the local authority, that the home will only provide care for up to four children. This is reflected in the home’s statement of purpose. At the time of the inspection, there were three children living in the home. Two of the children spoke to inspectors about their experiences living in the home.

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Information about this children’s home

The current manager was registered with Ofsted on 31 August 2017.

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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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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 and young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Date of last inspection: 20 January 2020

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report children’s home: SC067899 2

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Inspection date Inspection type Inspection judgement

20/01/2020 Full Good 11/07/2018 Full Good 26/07/2017 Full Good 20/03/2017 Interim Declined in effectiveness Inspection report children’s home: SC067899 3

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inadequate

Since the last full inspection, managers have failed to maintain effective management oversight of the home, and there has been a lack of clear leadership and guidance to the team. This has negatively affected the quality of care provided to children.

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inadequate

The manager and staff feel that they do not have the required skills or training to understand or meet the specific needs of all children living in the home. This has resulted in some children being looked after by staff who are not suitably trained to respond to their emotional health needs.

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inadequate

Children have raised concerns about staff calling them names, mimicking their behaviour and speaking to them in a derogatory manner. On one occasion, the behaviour of staff led to a child going missing from home as he was unhappy about the way he had been spoken to by staff. These concerns had been recorded but not shared with the manager, or addressed in line with the organisation’s safeguarding policy.

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inadequate

Children struggle to develop a sense of belonging in the home. They say it feels more like a youth centre and that they often have to ask staff to spend time with them rather than staff spending time with them willingly. One child said, ‘Staff put paperwork first. They always have loads to do and I feel they are too busy for us, so we kick off to occupy ourselves.’ There is evidence of some consultation with children about planned activities in the home. External activities have been restricted due to the COVID-19 pandemic and group activities have now started to resume.

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inadequate

Many areas of the home are in need of redecoration and refurbishment. Children’s bedrooms are not personalised. Delays in furniture being replaced mean that bedrooms are not suitably furnished. Following a child making threats to harm himself, his bedroom window was boarded up for several weeks. This resulted in him not having access to natural light or air in his bedroom at a time when he was experiencing low mood.

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inadequate

The quality of the direct-work sessions that take place with children is variable. In addition, some recordings are poor, and it is not clear what has been discussed. Serious incidents referred to in direct-work sessions had not been followed up by staff, and opportunities to have key conversations with children following incidents had been missed.

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inadequate

Children are supported to access specialist mental health services. However, staff and managers say that they do not know how to respond to a child’s mental health needs. Physical health needs are understood and responded to. Children have access to external health services, and referrals are made as required. Inspection report children’s home: SC067899 4 Staff work closely with education providers. Practical support and financial rewards are in place to encourage children’s attendance and outcomes, but these are not always effective. Plans and expectations for children when they are on a reduced timetable or refusing to attend school are not robust, and children often choose not to engage.

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inadequate

Children whose first language is not English make good progress in developing their English language skills when living in the home. They are supported to attend specialist college courses and the team uses a range of communication methods to ascertain children’s wishes and feelings. Key documents are translated as required and assist children living in the home.

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

Children say that they feel safe living in the home but that they don’t always feel listened to. Other professionals say they believe children are safe in the home, and recognise that the team would benefit from further mental health training to meet the needs of all children living in the home. However, poor safeguarding practices and failure to follow procedures have compromised the safety and welfare of children living in the home.

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

There have been significant shortfalls around allegation management. The manager was not aware that children had made allegations about the behaviour of staff which have not been investigated. The concerns had also not been shared with appropriate agencies, and support was not offered to the child or staff involved in the allegation.

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

Decision-making relating to children moving into the home is not always clear. One child moved into the home despite a risk assessment indicating he would not be suitably matched. The reason for him then moving in was not documented. The team has shared concerns about the suitability of the child’s placement with his placing authority.

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

Risk and behaviour management plans are in place, but do not identify triggers or strategies effectively for staff to follow to keep children safe. Key correspondence from a professional about a child’s mental health diagnosis had been missed and was not reflected in the child’s plans. The staff team is not ligature trained and there are no ligature cutters available in the home, despite this being a known risk for one child.

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

Practices around the administration of medication are not robust. There is a lack of clarity and guidance for staff around administering some prescribed medication, and recordings are inconsistent. This has resulted in staff administering prescribed sedative medication without guidance around how to identify when it is required by the child.

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

Physical interventions are not used in the home. However, staff and children say de- escalation strategies used are not effective and can result in behaviours escalating. A recent incident resulted in the police being called to manage behaviours in the home. At the time of the inspection, the manager was not aware of the full details of Inspection report children’s home: SC067899 5 the incident and had not had the opportunity to complete debriefs with those involved.

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

The record for complaints is unsatisfactory. One child’s records reflect their request to make a complaint. This was not followed up by the staff on duty or passed on to the manager. Children say they do not know how to make a complaint.

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

Plans for children who are due to leave the home when they turn 18 years of age are not clear. Pathway plans are not up to date and do not reflect children’s individual needs or vulnerabilities, such as the impact of language barriers or not having any family in the UK.

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

Incentives are in place to discourage children from going missing from home, and there has been a reduction in the number of missing incidents for some children. When children do go missing from home, staff try to maintain phone contact with them. However, opportunities to encourage their return are missed as staff do not routinely follow children or go looking for them.

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

Sanctions are rarely used. However, when sanctions are used, they focus on high monetary reparations rather than being educational or restorative.

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The effectiveness of leaders and managers: inadequate

The inspection identified significant weaknesses in management oversight of the home. The manager is suitably skilled and experienced, and the majority of staff have worked in the home for over five years. Any staffing shortfalls are covered by staff from other homes within the organisation.

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The effectiveness of leaders and managers: inadequate

Staff say that the team is settled. However, morale is low due to planned changes to the staffing structure and because of the way staff are spoken to by managers. Allegations raised about the conduct of staff and managers had not been shared with the manager or responsible individual and had not been addressed.

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The effectiveness of leaders and managers: inadequate

Staff do not always have supervision in line with the organisation’s supervision policy. There have been instances when supervisions have been missed as it was felt they were not needed. This prevents staff and managers from having the opportunity to discuss key issues and reflect on practice in the home. Issues raised in supervision are not routinely addressed and, in some cases, serious issues were raised that the manager was not aware of.

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The effectiveness of leaders and managers: inadequate

Monitoring systems are in place. However, there are discrepancies in the information shared as part of the inspection process, and shortfalls were identified around information sharing with the team. Not all safeguarding incidents had been reported to Ofsted as required by regulations.

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The effectiveness of leaders and managers: inadequate

Staff have not received specialist training to meet the individual needs of the children they care for. For example, none of the staff working at the home have completed training around low mood or depression, mental health or post-traumatic stress disorder. Inspection report children’s home: SC067899 6 The requirement and recommendation made at the last inspection have not been met. Inspection report children’s home: SC067899 7

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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, the 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 quality and purpose of care standard is that children receive care from staff who— understand the children’s home’s overall aims and outcomes it seeks to achieve for children; use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. In particular, the standard in paragraph (1) requires the registered person to— understand and apply the home’s statement of purpose; ensure that staff— treat each child with dignity and respect; provide to children living in the home the physical necessities they need on order to live their comfortably; ensure that the premises used for the purposes of the home are designed and furnished so as to— meet the needs of each child; and enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b) (2)(a)(b)(iii)(vii)(c)(i)(ii)) This specifically relates to improving the standard of decor and furnishings in the home and ensuring that children’s

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Requirement Due date

The health and well-being standard is that— The health and well-being needs of children are met. In particular, the standard in paragraph 1 requires the registered person to ensure— that staff help each child to— understand the child’s health and well-being needs and the options that are available tin relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding. (Regulation 10 (1)(a) (2)(a)(ii)) 23 July 2021 Inspection report children’s home: SC067899 8 This specifically relates to developing staff’s understanding of children’s health needs and being aware of any diagnosed conditions. The positive relationships standard is that children are helped to develop, and to benefit from relationships based on— positive responses to other children and adults. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— are provided with supervision and support to enable them to

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Requirement Due date

understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children do the same. (Regulation 11 (1)(c) (2)(a)(x)) This specifically relates to ensuring that supervision takes place in line with the organisation’s policy and that any issues raised are addressed by managers. 23 July 2021

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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. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— have the skills to identify and act upon signs that a child is at risk of harm; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; are familiar with and act in accordance with, the homes child protection policies; that the home’s day-to-day care is arranged and delivered so as to keep each child safe and protect each child effectively from harm. (Regulation 12 (1) (2)(a)(iii)(v)(vii)(b)) This is specifically in relation to ensuring that allegations are investigated. Staff should understand children’s individual needs and that there are clear strategies in place to enable staff to appropriately respond to children. The manager

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Requirement Due date

should be able to demonstrate the rationale for accepting placements, and that the decisions are based on being able to meet children’s needs. 6 June 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— 6 June 2021 Inspection report children’s home: SC067899 9 promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— ensure that staff have the experience, qualifications and skills to meet the needs of each child; 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; use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(b) (2)(c)(f)(h)) This specifically relates to ensuring that incidents and practice in the home are overseen and evaluated by the manager. Staff should have access to relevant mental health

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Requirement Due date

training, including ligatures, and training to care for children who are experiencing post-traumatic stress disorder. *The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— demonstrate that practice in the home is informed and improved by taking into account and acting on— feedback on the experiences of children including complaints received. (Regulation 13 (1)(b) (2)(g)(ii)) This specifically relates to ensuring that children are supported to make complaints and that any concerns raised are listened to and addressed. 6 June 2021

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Requirement Due date

The care planning standard is that children— receive effectively planned care in or through the children’s home; and have a positive experience of arriving at or moving on from the home. In particular, the standard in paragraph (1) required the registered person to ensure— that arrangements are in place to— plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with 23 July 2021 Inspection report children’s home: SC067899 10 arrangements agreed with the child’s placing authority. (Regulation 14 (1)(a)(b) (2)(b)(iii)) This specifically relates to ensuring that decision-making relating to transitions is clearly recorded and that pathway plans are up to date and reflect children’s vulnerabilities and risks. Subject to paragraph (6), the registered person must establish a procedure for considering complaints made by or on behalf of children. The registered person must ensure that a record is made of

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Requirement Due date

any complaint, the action taken in response, and the outcome of any investigation. (Regulation 39 (1)(3)) This requirement was made at the last inspection and is restated. 23 July 2021

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if— a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child— is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii) and (e)) 23 July 2021

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Requirement Due date

* These requirements are subject to a compliance notice.

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Recommendations

 The registered person should ensure that any sanctions used are restorative in nature and that they maximise the opportunity for children to reflect and learn. (‘Guide to the children’s home regulations including the quality standards’, page 46, paragraph 9.38) Inspection report children’s home: SC067899 11

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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: SC067899 12

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Children’s home details

Registered provider: Cambian Childcare Limited

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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

Caroline Bertram, Social Care Inspector Pauline Yates, Social Care Inspector Inspection report children’s home: SC067899 13 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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