Children's Home run by Cambian Childcare Limited in Staffordshire

Inspection report for children’s home - monitoring visit: 1258091 1

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Cambian Childcare Limited

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

The home is privately owned and provides care for up to five children who have suffered early life trauma. The home provides therapeutic support from an in-house clinical team.

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Information about this children’s home

The registered manager has been in post since December 2018.

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This monitoring visit

Ofsted last visited the home to complete a full inspection on 4 and 5 August 2021. At the inspection, serious and widespread failures were found that meant children were not protected and their welfare was not promoted or safeguarded. As a result, the home was judged to be inadequate.

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This monitoring visit

Due to the significant concerns found during the inspection, Ofsted raised eight requirements and issued two compliance notices under regulations 10 (The health and well-being standard) and 12 (The protection of children standard).

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This monitoring visit

On 23 September 2021, a monitoring visit took place to review the two compliance notices. The inspector did not review the remaining requirements and these remain in place.

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This monitoring visit

During the visit, the inspector found that, while some action had been taken, this was not sufficient to meet the steps within the compliance notice issued under regulation 10 and further shortfalls were found, including further incidents of the misadministration of medication.

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This monitoring visit

Staff do not always share relevant medical information. For example, staff received a letter from one child’s consultant that held information detailing a change in medication dosage. This letter was then filed away without the information being Inspection report for children’s home - monitoring visit: 1258091 2 communicated or documented in the child’s records. As a result, the child received the incorrect dosage of medication for three weeks.

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This monitoring visit

Records of medication administration are not always completed accurately. On receipt of new medication for one child, staff and managers failed to recognise that incorrect prescribing information had been entered onto the administration record. As a result of this error, the child received an overdose of medication.

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This monitoring visit

Furthermore, there have been further occurrences of staff not following information outlined in children’s health plans. For example, when a child returned home from a hospital admission, staff later administered medication that he had already received that morning. This means that the child had received a third overdosage of medication within a seven-week period.

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This monitoring visit

Ofsted are not always notified of significant events. For example, managers did not submit a notification for one of the medication errors, which resulted in a child receiving an additional dosage of his medication. Because of this, the regulator does not always have up-to-date information of the home.

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This monitoring visit

Staff receive additional training that reflect safeguarding procedures. Managers ensure that staff receive in-depth training workshops that include the processes to follow in case of a complaint or allegation. This ensures that staff have the skills and knowledge to keep children safe from harm.

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This monitoring visit

Managers use supervision to aid in the development of staff. For example, staff have been provided with a safeguarding quiz to complete. This allows managers to highlight staff’s strengths and weaknesses and provide further support where required.

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This monitoring visit

Following this monitoring visit, one compliance notice under regulation 10 (The health and well-being standard) remains in place and an additional requirement under regulation 40 has been issued. Inspection report for children’s home - monitoring visit: 1258091 3

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Recent inspection history

Inspection date Inspection type Inspection judgement 04/08/2021 Full Inadequate 08/05/2019 Full Good 31/07/2018 Interim Declined in effectiveness 11/04/2018 Full Good Inspection report for children’s home - monitoring visit: 1258091 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

*The 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; and

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Requirement Due date

children are helped to lead healthy lifestyles.

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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

achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

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Requirement Due date

take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs; and

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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)(c) (2)(a)(i)(iii)(c))

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Requirement Due date

This specifically relates to managers and staff ensuring that they understand and follow guidance provided by children’s medical and health professionals.

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Requirement Due date

This requirement was made at the last inspection and is restated. 14 November 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— 29 September Inspection report for children’s home - monitoring visit: 1258091 5 helps children aspire to fulfil their potential; and

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

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

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

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Requirement Due date

feedback on the experiences of children including complaints received; 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)(c)(f)(g)(ii)(h))

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Requirement Due date

This specifically relates to leaders and managers ensuring that children are cared for by staff who have the skills, knowledge, experience and ability to meet their needs.

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Requirement Due date

Leaders and managers should ensure that any shortfalls, identified when monitoring and reviewing the care that children receive, are responded to promptly. This includes the investigation of poor staff practice, during which stringent measures should be in place to ensure that children remain safe.

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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

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— 29 September Inspection report for children’s home - monitoring visit: 1258091 6 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

ordered for a patient, for provision to the patient, under or by virtue of the National Health Service Act 2006 or section 176(3) of the Health and Social Care (Community Health and Standards) Act 2003. (Regulation 23 (1) (2)(b)(c) (4)(a))

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Requirement Due date

This specifically relates to the manager and staff ensuring that children’s medication is stored, recorded and administered safely.

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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

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development;

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(a)(b)(c))

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Requirement Due date

This specifically relates to managers ensuring that staff receive regular and good-quality supervision which enables them to reflect on their practice and identify improvements. This is in addition to staff receiving an appraisal at least yearly.

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Requirement Due date

This requirement was made at the last inspection and is restated. 29 September

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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— 29 September Inspection report for children’s home - monitoring visit: 1258091 7 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;

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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 per- son to do so (“the authorised person”)—

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Requirement Due date

has spoken to the user about the measure;

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Requirement Due date

has signed the record to confirm it is accurate;

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Requirement Due date

within 5 days of the use of the measure, the registered per- son 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 specifically relates to leaders and managers ensuring that children are only physically restrained as a last resort. In the event of such, that children receive the appropriate support afterwards and that any measure used is recorded appropriately.

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Requirement Due date

This requirement was made at the last inspection and is restated. Inspection report for children’s home - monitoring visit: 1258091 8 The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation;

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Requirement Due date

an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious;

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Requirement Due date

there is an allegation of abuse against the home or a person working there;

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Requirement Due date

a child protection enquiry involving a child—

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Requirement Due date

concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

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)(e))

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Requirement Due date

This specifically relates to the manager providing Ofsted and other relevant agencies with accurate information regarding serious incidents. 14 November 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

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. (Regulation 45 (1) (2)(a)(c))

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Requirement Due date

This specifically relates to the manager ensuring that the quality-of-care review effectively evaluates the care children receive. In addition, that clear actions are identified to rectify any shortfalls in order to improve the care children receive. 29 September Inspection report for children’s home - monitoring visit: 1258091 9 This requirement was made at the last inspection and is restated.

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Requirement Due date

*These requirements are subject to a compliance notice.

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: 1258091 10

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Children’s home details

Registered provider: Cambian Childcare Limited

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Children’s home details

Registered provider address: Cambian Childcare Limited, Metropolitan House, 3 Darkes Lane, Potters Bar, Hertfordshire EN6 1AG

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Inspector

Kev Brammer, Social Care Inspector Inspection report for children’s home - monitoring visit: 1258091 11 to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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