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

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

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Information about this children's home

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

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Information about this children's home

The manager has been registered with Ofsted since 23 June 2020.

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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. We last visited this setting on 28 October 2020 to carry out an assurance visit. The report is 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 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.

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inadequate

Date of last inspection: 25 February 2020

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inadequate

Overall judgement at last inspection: Sustained effectiveness

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inadequate

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

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Inspection date Inspection type Inspection judgement

25/02/2020 Interim Sustained effectiveness 24/09/2019 Full Requires improvement to be good 09/01/2019 Interim Sustained effectiveness 17/07/2018 Full Requires improvement to be good Inspection report children's home: SC065261 3

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inadequate

Leaders and managers have not taken the right action to ensure that children are provided with the care and support that they need. Some children are not having the correct level of staff support as required in their care plans. This places the children and staff at risk and limits the children’s development opportunities and leisure choices.

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inadequate

Children’s progress and their opportunities and experiences are variable. Not all children are provided with continuity of care. At times, children are being cared for by adults who they do not know well. Opportunities for children to develop trusting and meaningful relationships are limited because of ongoing difficulties with the retention of staff.

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inadequate

At times, children are looked after by agency or temporary staff. These staff are not all provided with sufficient information to meet the children’s needs. Not all agency staff spoken with were aware of children’s specific health needs despite being allocated to care for them.

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inadequate

Parents, staff and professionals who contributed to this inspection raised concerns about the high turnover of staff. One parent said she is worried that her child is being looked after by staff who he does not know. The same parent said her child told her that he did not feel safe. Another parent said that there have been several occasions when she has phoned the home and the member of staff looking after her child had limited knowledge about their needs. Another parent told the inspectors, ‘In recent months, I have dreaded taking my child back to the home because I do not know who will be looking after him. I am concerned about my child’s safety.’

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inadequate

Not all children’s plans contain detailed essential information. The targets set for some children are too broad and do not reflect their education, health and care plans. Children’s development and progression varies. During the inspection, some staff did not positively challenge children and help them to expand their skills because they either did not know them well enough or because there was insufficient staff. Some parents also told inspectors that they are concerned about the lack of progress their child is making.

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inadequate

Children’s dining experiences are varied. Opportunities for children to explore a range of foods that broadens their diet are limited. The evening meal that is prepared and transported from the main kitchen does not provide children with sufficient choice. Alternative options that are available for children are sometimes frozen ready meals. A mealtime observed during the inspection was not well managed and did not provide children with good opportunities to develop appropriate social skills. Inspection report children's home: SC065261 4 The quality of accommodation provided to children varies depending on which house they live in. Some houses are well maintained, and bedrooms are nicely personalised. In other houses, there are ongoing maintenance and housekeeping needs. Several bathrooms and kitchens require improvement and refurbishment. Staff told inspectors that they report maintenance concerns, but they do not know

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inadequate

when the work will be completed. The quality and variance of children’s living environment has been raised as a concern in previous inspections. Leaders and managers have not taken adequate action to prioritise making necessary improvements.

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inadequate

The permanent staff who work in the homes do know the children well. They genuinely want the best for the children in their care. These staff have worked beyond their contracted hours to ensure, where possible, children are looked after by someone they know and trust. Parents spoke highly of the commitment, stickability and resilience of these staff. As a result, some children are making progress in some aspects of their lives, such as managing their anxieties better and developing independent living skills.

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

Children’s safety is compromised because of severe staffing shortages. Children who should be receiving increased staff support, as agreed in their care plans, have not been receiving this support consistently, if at all.

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

Leaders and managers have failed to implement suitable safety plans to mitigate the staffing shortfalls. The reliance on the use of agency staff has, at times, resulted in children being supported by no permanently employed staff. Leaders and managers have allowed agency staff to care for children with complex health and social needs on their own, despite not being assured that they fully understand the children’s needs.

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

Inspectors identified unacceptable health and safety hazards within the children’s living environments. These include, a broken glass window, unsafe portable air conditioning, nails sticking out of a doorway and paddling pools left in a shared garden containing used water. In addition, the management of infection control is poor. Domestic washing machines are being used to wash soiled items without adherence to the necessary health and safety guidelines. Consequently, the risk of cross-contamination is high. Senior leaders took immediate action to rectify these concerns during the inspection.

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

Incidents of restraint and behavioural incidents continue to occur, as do staff injuries. The behaviour management team and senior managers have good oversight of these incidents. Senior leaders are reviewing patterns and trends of behaviours and acknowledge that inconsistent staffing and the quality of care provided to children are contributing factors to these incidents.

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

New systems to improve the management and oversight of medication have been introduced. Only staff who have been trained are permitted to administer Inspection report children's home: SC065261 5 medication. Monitoring of medication is effective; errors identified have been managed well. Despite these improvements, not all records are well maintained and require further improvement.

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The effectiveness of leaders and managers: inadequate

This home does not have a good inspection history. Since 2015, the home has not achieved a judgement by Ofsted that is any more than requires improvement. Despite several changes in the senior leadership team during this period, not enough has been done to make and sustain necessary improvements.

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The effectiveness of leaders and managers: inadequate

Since the home’s last full inspection in September 2019, the organisation has appointed a new leadership team. This senior leadership team support the registered manager. However, t he registered manager, so far, has not demonstrated the capacity to sufficiently improve the home to achieve a good judgement. Leaders and managers have failed to implement a safety plan that strategically and dynamically addresses the continued shortages of staff.

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The effectiveness of leaders and managers: inadequate

At the home’s assurance inspection in February 2020, three regulatory requirements were raised. These include the quality and purpose of care standard, the positive relationships standard and the leadership and management standard. Inspectors found that leaders and managers have not taken sufficient action to meet these requirements and they are again repeated at this inspection.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to ensure that children are looked after by staff who are compliant with basic mandatory and specialist training. Consequently, some children are being cared for by some adults who do not have the skills and knowledge to meet their needs.

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The effectiveness of leaders and managers: inadequate

Opportunities for permanent and agency staff to reflect on their practice to improve the quality of care provided are inconsistent. The registered manager has not ensured that all agency and permanent staff receive regular formal supervision. Supervision records are not well maintained. Where concerns are raised, there is a lack of follow up action.

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The effectiveness of leaders and managers: inadequate

Monitoring of this home by the independent person and managers is not effective. They fail to rigorously identify and tackle the negative impact that staff shortages are having on children’s safety, welfare, and well-being.

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The effectiveness of leaders and managers: inadequate

As a result of this inspection, Ofsted restricted the home’s registration. Ofsted will monitor this restriction and the ongoing performance of the home. Inspection report children's home: SC065261 6

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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 quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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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 and apply the home’s statement of purpose;

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Requirement Due date

understand and apply the home’s statement of purpose;

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably.

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Requirement Due date

that the care is delivered by a person who—

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Requirement Due date

has the experience, knowledge and skills to deliver that care. (Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(vi)(c))

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Requirement Due date

This specifically relates to leaders and managers ensuring that there is sufficient permanent staff to meet the care plan needs of the children.

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Requirement Due date

In addition, leaders and managers should ensure that the home remains in good condition and is clean, and repairs and to damage are actioned without delay. 3 September 2021 Inspection report children's home: SC065261 7 The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills.

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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

develop the child’s interests and hobbies;

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Requirement Due date

participate in activities that the child enjoys and which meet and expand the child’s interests and preferences; and

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Requirement Due date

make a positive contribution to the home and the wider community; and

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Requirement Due date

that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1) (2)(a)(i)(ii)(iii)(b))

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Requirement Due date

In particular, ensure that staffing shortages do not impact on children’s opportunities to enjoy meaningful and enjoyable activities in the community. 3 September 2021

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being.

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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

that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (1)(a)(b) (2)(a)(c))

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Requirement Due date

This specifically relates to staff being provided with expert training so that they can better support the children to improve their health outcomes.

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Requirement Due date

Leaders and managers must ensure that children’s dining experiences are improved and that their diet is nutritious and 3 September 2021 Inspection report children's home: SC065261 8 provides choice. In addition, ensure that more action is taken to help children who have restricted diets.

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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; and (c) 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; 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

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

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Requirement Due date

that each child is encouraged to build and maintain positive relationships with others. (Regulation 11 (1)(b)(2)(i)(ii)(iii)(iv)(xi)(b)) 3 September 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.

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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

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. (Regulation 12 (1) (2)(d)) 3 September 2021 Inspection report children's home: SC065261 9 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 staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

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

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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

research and developments in relation to the ways in which the needs of children are best met; and

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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)(c)(d)(f)(g)(i)(h))

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Requirement Due date

In particular, the registered person should ensure that the manager’s and independent visitor’s monitoring is effective. 3 September 2021

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home.

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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

manage and review the placement of each child in the home. 3 September 2021 Inspection report children's home: SC065261 10 (Regulation 14 (1)(a) (2)(b)(i)(ii))

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Requirement Due date

In particular, the provider should ensure that all care plans are clear, concise and relevant to the child’s current needs and behaviours.

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Requirement Due date

The registered person must ensure that all employees— undertake appropriate continuing professional development. (Regulation 33 (4)(a))

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Requirement Due date

In particular, all staff should complete all basic mandatory training and specialist courses to meet the needs of the children they care for. 3 September 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: SC065261 11

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Children’s home details

Provision sub-type: Residential special school

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Children’s home details

Registered provider: Cambian Autism Services Limited

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Children’s home details

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

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Children’s home details

Registered manager: Melanie Micklewright

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Inspectors

Sharron Escott, Social Care Inspector Denise Jolly, Senior Social Care Inspector Wendy Anderson, Social Care Inspector Inspection report children's home: SC065261 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

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