Children's home run by Cambian Childcare Limited

Inspection report children’s home: 2556596 1 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

This is a privately owned children’s home which is registered to provide care and accommodation for up to two children who may have emotional, behavioural and/or learning difficulties.

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Information about this children’s home

There is currently one child living at the home. The child was spoken to as part of the inspection.

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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 23 February 2021 to carry out a monitoring visit. A further monitoring visit was carried out on 31 March 2021. The reports are published on the Ofsted 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/or widespread failures that mean children and young people 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. Inspection report children’s home: 2556596 2 Date of last inspection: This is the home’s first full inspection since it was registered in November 2019.

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inadequate

Overall judgement at last inspection: Not applicable

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Enforcement action since last inspection:

A monitoring visit was carried out on 23 February 2021 to ensure that children remained safe, following concerns identified from safeguarding notifications. During this visit, the inspectors found significant shortfalls in safeguarding practice and procedures in the home. The interim manager and staff did not appropriately respond to incidents that occurred, nor did they implement effective strategies to safeguard and protect the children living in the home.

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Enforcement action since last inspection:

Following this visit, two compliance notices, in relation to regulation 12, the protection of children standard, and regulation 13, the leadership and management standard, were issued. A restriction notice was also issued.

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Enforcement action since last inspection:

On 31 March 2021, a further monitoring visit was carried out to assess the progress made by the provider in meeting the two compliance notices. The compliance notices were not met and were issued again in relation to regulation 12 and regulation 13.

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Recent inspection history

Not previously inspected Inspection report children’s home: 2556596 3

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inadequate

The home opened in November 2019. Since then, the registered manager has left, and leaders, the acting manager and staff have not responded appropriately to incidents. They did not implement effective strategies to safeguard and protect the children living in the home.

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inadequate

Three children have moved into the home and two children have moved on from the home. The two children moved on as staff were unable to keep them safe or meet their needs. Children who have lived in the home have not made suitable progress and have experienced short placements due to staff not being able to keep them safe. This contributes to children experiencing instability, change and disruption.

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inadequate

Impact risk assessments are compiled when children move into the home. However, not all risks included in the referral information are transferred to appropriate risk management plans. Therefore, interventions are not put in place to minimise all known risks to children. This fails to ensure that children are appropriately safeguarded.

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inadequate

There is evidence of poor matching of the children living in the home. Two children with very similar needs and risks lived together in the home, which led to significant safeguarding incidents and an escalation in their risk levels and incidents of going missing from the home. The staff team was unable to manage these incidents safely.

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inadequate

Children living in the home have experienced an inconsistent, inexperienced staff team who have lacked the necessary skills and knowledge to keep the children safe. Children have not had the opportunity to build positive relationships with the adults responsible for caring for them. Work has not been consistently carried out with children to help them to understand how to keep themselves safe. The provider accepted that improvements were required in this area and has identified a new staff team for the child currently in placement. The child had now started to engage in activities with the staff team and is spending more time in the home.

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inadequate

Not all children have had appropriate support, advice and guidance in regard to their education, health and well-being. Children have not engaged in education or training and some children have not had their health needs met. The manager has not ensured that there is a consistent plan in place for staff to follow to ensure that all children are supported to regain confidence in their education and address their health needs. This is a missed opportunity to support all children’s learning needs and help them to lead healthy lifestyles.

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inadequate

The home is a large detached house and the main living areas and outdoor garden space are well maintained. However, the standard of the child’s bedroom is poor and Inspection report children’s home: 2556596 4 it was unclean and untidy. There were several stale plates of food in the bedroom, clothes piled on the floor, stained and unclean carpets, and cracked tiles in the en- suite bathroom. This does not provide the child with a hygienic, safe and comfortable bedroom.

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inadequate

The staff support the child to spend time with family and friends. The staff make the necessary arrangements and drive the child to and from visits. The child’s mother was spoken to as part of the inspection and she said that the staff keep her updated about her child.

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

Since the home opened, there have been a number of significant safeguarding incidents. Children have been at risk of harm and have suffered harm since living in the home. Incidents have not always been reported and recorded appropriately. Leaders, managers and staff do not demonstrate that they have the skills and experience to keep children safe.

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

The home has had two monitoring visits since February 2021 and immediate action has not always been taken to ensure that the home is compliant with regulations. The provider made the decision to reduce the number of children living in the home to one. This has enabled the provider to start to make some improvements in the home and stabilise the current placement for the child.

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

Since the home opened, there have been a high number of missing-from-home episodes. The children who went missing from the home were assessed as at high risk of sexual exploitation. Staff did not have a consistent response to these incidents and the interim manager did not identify clear strategies for staff to follow to reduce this risk. Additionally, not all children had access to return home interviews. This did not provide children with an independent person to talk to and did not enable the staff team to understand the risks posed to children when they were away from the home. However, since the home has been under an enforcement notice there has been a decline in the number of missing-from-home episodes for the child currently living there.

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

There have been incidents when staff have had to physically intervene. Shortfalls were identified in the recording of the physical interventions, which lack detail and robust management evaluation. This prevents effective oversight of whether the intervention used was necessary, proportionate and effective. Children are not consistently provided with an independent debrief following a physical intervention. They are often spoken to by the same staff involved in the hold. This prevents the child being able to raise any concerns in relation to the physical intervention. Staff are not consistently offered debriefs following incidents of restraint, which prevents the opportunity for reflection and learning.

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

Additionally, a child shared that a restraint triggered memories in relation to a previous traumatic experience. The manager failed to address this issue and did not implement plans to ensure that staff knew how to manage any future incident in a Inspection report children’s home: 2556596 5 different way. There was also evidence of a child receiving an injury during a restraint. Due to poor recording, it is not clear how the child sustained this injury. These shortfalls leave children at risk of harm.

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

There has been a significant incident involving an error with the administration of the child’s prescribed medication. Medical advice was given to stop the child’s prescribed medication. However, as this was not appropriately recorded or made known to all staff, some staff continued to administer the medication on a regular basis, without agreement from the medical experts. This meant that the child’s health and welfare was compromised.

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

There has been an improvement in the quality of risk management plans following the monitoring visits. However, not all strategies to minimise risks are recorded in the plans. For example, staff now conduct regular welfare checks and visual checks of the child when out with friends and family in the community, but this strategy is not recorded in the risk management plan. This means that not all staff are consistent in their approach to keeping the child safe.

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The effectiveness of leaders and managers: inadequate

There is currently no registered manager for the home. The registered manager left the home in March 2020. The current manager has been in post since that time. However, the application to register as manager was only submitted in April 2021. Despite the provider taking action to meet previous compliance action, there are still significant shortfalls in the leadership and management of the home.

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The effectiveness of leaders and managers: inadequate

Recording in the home is disorganised. The data required to complete the Annex A was not easily accessible and when provided, it was inaccurate. The manager was unclear on how many return home interviews had been completed for children when they had been missing from the home, as this information was not clearly recorded. Additionally, although a previous Regulation 45 report had been completed, this had not been sent to Ofsted within the necessary timescales.

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The effectiveness of leaders and managers: inadequate

The responsible individual has failed to maintain effective oversight of the home, despite the previous concerns raised by inspectors and subsequent compliance action. The responsible individual and the manager were not aware of the extent of the safeguarding concerns identified at the previous monitoring visits. Additional shortfalls have been identified during the full inspection. The provider has now identified a different responsible individual to have oversight of the home.

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The effectiveness of leaders and managers: inadequate

Although there is evidence supervision is taking place in line with company policy, the quality is variable. Electronic records of dates of supervision are in place, but these do not correspond to the supervision matrix. The manager has failed to record effectively the actions taken when staff raise concerns in their supervision. There was evidence that supervision notes are not being recorded in an effective and timely manner. For example, brief, hand-written supervision notes from February had not been clearly recorded at the time of the inspection. These shortfalls hinder the progress of staff practice and the quality of care being provided in the home. Inspection report children’s home: 2556596 6 Rotas do not clearly identify the staff members on shift and the hours worked. For example, it was reported that the provider had agreed that additional night staff could be used to safeguard the children. However, the rotas did not consistently

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The effectiveness of leaders and managers: inadequate

include the names of the staff used. This does not provide a clear record of who has worked in the home with the children and does not demonstrate that the safeguarding plans put in place were adhered to.

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The effectiveness of leaders and managers: inadequate

The provider has taken the necessary steps to meet the previous compliance notices, however, further shortfalls have been identified under regulation 12, the protection of children standard, and regulation 13, the leadership and management standard.

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The effectiveness of leaders and managers: inadequate

Despite the compliance action over the past three months and the home being led by the same manager, there have not been sufficient improvements to ensure that children are sufficiently safeguarded. Although the child living in the home has started to settle, there remain significant shortfalls and ongoing concerns in relation to the safety and welfare of children.

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The effectiveness of leaders and managers: inadequate

It is Ofsted’s view that the shortfalls highlighted at the visit are serious and demonstrate that safeguarding practice is still not sufficiently robust and does not promote the safety and welfare of children. Poor leadership and management practice and a lack of ability to take effective action to improve the quality of care in the home have compromised the safety, experience and progress of the children living in the home. Inspection report children’s home: 2556596 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, 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.

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Requirement Due date

This particularly refers to ensuring that all agreed strategies to reduce the risk of harm to a child are contained and recorded in the plans. 30 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—

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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

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)(f)(h)) 30 June 2021 Inspection report children’s home: 2556596 8 In particular, the manager must have robust monitoring and review systems in place to ensure that there is effective oversight of the quality of care being provided.

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them;

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

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Requirement Due date

a record is kept of the administration of medicine to each child.

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Requirement Due date

In particular, medication should be administered as directed by a medical professional. 30 June 2021

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Requirement Due date

satisfy the requirements in paragraph (5)(a) to (c); and

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Requirement Due date

have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated.

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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.

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Requirement Due date

In particular, there should be a clear record of staff supervision, including any follow-up actions when staff raise concerns in relation to practice. 30 June 2021 Inspection report children’s home: 2556596 9 The registered person must prepare and implement a policy ("the behaviour management policy") which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home; and

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Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home.

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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

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Requirement Due date

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 30 June 2021 Inspection report children’s home: 2556596 10 confirmation that they have spoken to the child about the measure.

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Requirement Due date

(Regulation 35 (1)(a)(b) (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c))

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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; and

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Requirement Due date

ensure that the records are kept up to date.

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Requirement Due date

In particular, ensure that rotas include the full names of all staff who work in the home and the actual hours worked. 30 June 2021

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Requirement Due date

The registered person must complete a review of the quality of care provided for children ("a quality of care review") at least once every 6 months.

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Requirement Due date

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review ("the quality of care review report").

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Requirement Due date

supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed. (Regulation 45 (1) (3) (4)(a)) 30 June 2021

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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: 2556596 11

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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

Suzanne Birchall, Social Care Inspector Judith Birchall, Social Care Inspector Inspection report children’s home: 2556596 12 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

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

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