Children's Home run by Cambian Childcare Limited in Shropshire

Inspection report for children’s home - monitoring visit: SC476252 1 SC476252 Registered provider: Cambian Childcare Limited

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Information about this children’s home

This home cares for up to three children and specialises in providing therapeutic services for children who have experienced early life trauma.

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Information about this children’s home

There is an interim manager in post who is yet to register with Ofsted.

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This monitoring visit

Ofsted last visited the home to complete a full inspection on 24 and 25 May 2022. The inspector found serious and widespread failures in relation to the leadership and management of the home. As a result, the home was judged to be inadequate. A compliance notice under regulation 13, the leadership and management standard, was also issued.

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This monitoring visit

On 6 July 2022, Ofsted undertook a monitoring visit. The purpose of the visit was to review the provider’s progress. The inspector found that the compliance notice in relation to regulation 13 was not met. Concerns remained in relation to the leadership and management of the home.

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This monitoring visit

Leaders’ and managers’ oversight of physical intervention is not effective. Some staff are not skilled or experienced in de-escalating children’s behaviours. This means that children receive care by adults who do not understand their needs. Also, records of physical restraint illustrate that this is not always used as a last resort. In addition, not all staff respond to children’s behaviour in line with the home’s model of care.

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This monitoring visit

Not all staff have received training that is pertinent to children’s needs. This includes yearly refresher training in the home’s physical restraint technique. One child has alleged that a staff member bruised them during a physical restraint. This staff member is currently suspended pending an investigation. Their refresher training in physical restraint remains out of date. There has been a lack of monitoring by leaders and managers in respect of staff training. This has compromised children’s safety. Inspection report for children’s home - monitoring visit: SC476252 2 Leaders and managers have made some improvement to their monitoring systems. However, they do not promptly address shortfalls in practice. Neither do they review and evaluate in depth any action taken. This means that shortfalls in practice are often not addressed. As a result, managers cannot be certain that children are receiving good-quality care.

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This monitoring visit

The provider has undertaken a review of the service. This concluded with 17 recommendations to improve the quality of care that children receive. However, the interim manager is not yet aware of the outcome of this review. Consequently, there is no action plan in place to meet the recommendations. Therefore, the effectiveness of this review is not yet known.

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This monitoring visit

Managers have reviewed the skills and competency of all staff. Staff have detailed and comprehensive development plans. They have started to put in place training to meet any gaps or shortfalls, particularly in relation to attachment, therapeutic parenting, transitions and endings. As a result, staff show more empathy in their approach and children feel listened to and cared for.

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This monitoring visit

The new interim manager has ensured that staff understand their roles and responsibilities. This includes the interim manager’s expectations in respect of the care that children receive. The interim manager is providing better oversight of key- work sessions with children. These sessions are much more creative and enjoyable for children. Debriefs are also occurring with all children after any incidents. These interactions provide children with reassurance and are helping them to remain settled.

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This monitoring visit

Children are engaging much better with staff. This is because their relationships have improved. The interim manager is often seeking to ascertain children’s views. As a result, they become aware quickly of any worries that children have. In addition, they take prompt action to ensure that children feel listened to.

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This monitoring visit

Most children feel happy and safe living in the home. However, one child no longer wants to live in the home. The interim manager is helping to support their transition to a new home.

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This monitoring visit

As a result of the above concerns, the inspector found that the compliance notice in relation to regulation 13 was not met. This notice was reissued. Ofsted will review the requirements and recommendations at the next full inspection. Inspection report for children’s home - monitoring visit: SC476252 3

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Recent inspection history

Inspection date Inspection type Inspection judgement 24/05/2022 Full Inadequate 23/03/2022 Interim Sustained effectiveness 14/04/2021 Full Requires improvement to be good 09/09/2019 Full Good Inspection report for children’s home - monitoring visit: SC476252 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

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans;

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Requirement Due date

seek to secure the input and services required to meet each child’s needs;

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Requirement Due date

if the registered person considers, or staff consider, a placing authority’s or a relevant person’s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans; and

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5 (a)(b)(c)(d))

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Requirement Due date

This specifically relates to the registered provider ensuring that—

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Requirement Due date

 they communicate any significant changes or incidents in the home to children’s professionals  professionals are consulted with in relation to decisions made about the care children receive, such as therapeutic intervention  managers escalate concerns expressed by staff about the performance of a placing authority, such as poor communication. 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 5 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

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

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Requirement Due date

ensure that any care that is arranged or provided for a child that—

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Requirement Due date

relates to the child’s development (within the meaning of section 17(11) of the Children Act 1989) or health; and

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Requirement Due date

is not arranged or provided as part of the health service continued under section 1(1) of the National Health Service Act 2006(a), satisfies the conditions in paragraph (3).

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Requirement Due date

that as far as reasonably practicable 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; and

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Requirement Due date

is under the supervision of a person who is appropriately skilled and qualified to supervise that care;

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Requirement Due date

treat each child with dignity and respect. (Regulation 6 (1)(a)(b) (2)(b)(iv)(d)(i)(ii) (3)(c)(i)(ii)(iii))

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Requirement Due date

The registered person should ensure that children receive care as outlined in the home’s statement of purpose. In addition, the registered person should ensure that children’s views are listened to, that they are able to make choices and that these are respected. 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 6 This requirement was made at the last inspection and is restated.

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

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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

ascertain and consider each child’s views, wishes and feelings, and balance these against what they judge to be in the child’s best interests when making decisions about the child’s care and welfare;

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Requirement Due date

help each child to express views, wishes and feelings;

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Requirement Due date

help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child;

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Requirement Due date

regularly consult children, and seek their feedback, about the quality of the home’s care. (Regulation 7(1)(c) (2)(a)(i)(ii)(iii)(iv))

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Requirement Due date

The registered person should ensure that there are systems in place for staff to understand how children are feeling, in particular when changes or incidents occur in the home. The registered person should ensure that children’s emotional and mental well-being are well supported at all times. 4 September 2022

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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

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Requirement Due date

positive responses to other children and adults. 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 7 In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

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

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Requirement Due date

help each child to develop socially aware behaviour;

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

help each child to understand, in a way that is appropriate according to the child’s age and understanding, personal, sexual and social relationships, and how those relationships can be supportive or harmful;

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Requirement Due date

strive to gain each child’s respect and trust;

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Requirement Due date

understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children;

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Requirement Due date

are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same;

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Requirement Due date

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

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Requirement Due date

understand and communicate to children that bullying is unacceptable; and

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Requirement Due date

have the skills to recognise incidents or indications of bullying and how to deal with them; and Inspection report for children’s home - monitoring visit: SC476252 8 that each child is encouraged to build and maintain positive relationships with others. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(viii)(ix)(x)(xi)(xii)(xiii)(b))

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Requirement Due date

The registered person should ensure that managers and staff have the ability to recognise and respond appropriately to behaviour between children in the home. In addition, they should help children to understand what constitutes acceptable behaviour towards one another.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

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

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Requirement Due date

assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

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

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Requirement Due date

manage relationships between children to prevent them from harming each other;

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(b))

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Requirement Due date

This relates to the registered person ensuring that staff understand their role in keeping children safe. They must 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 9 also ensure that information contained in children’s risk assessments is accurate and that staff implement strategies to keep children safe.

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Requirement Due date

The registered person should ensure that recording in relation to safeguarding incidents and physical intervention is accurate, correct and legible.

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Requirement Due date

*The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

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

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Requirement Due date

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

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Requirement Due date

ensure that staff 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;

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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)(f)(g)(ii)(h))

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Requirement Due date

The registered person should implement a system that is able to assess and review the impact that the care provided by managers and staff is having on the progress and experiences of children. 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 10 The registered provider must ensure that all managers and staff have the knowledge and skills to meet the needs of the children that the home intends to care for and keep them safe.

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Requirement Due date

The provider must take effective action to address any shortfalls in managers’ or staff’s practice.

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Requirement Due date

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

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Requirement Due date

injury to any person (including the child);

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Requirement Due date

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

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Requirement Due date

a child who is accommodated in a secure children’s home from absconding from the home.

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Requirement Due date

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

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Requirement Due date

This specifically relates to the registered person and staff ensuring that physical restrictions on children’s movements are only used when proportionate and necessary. 4 September 2022

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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. (Regulation 26 (7)(b))

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Requirement Due date

This specifically relates to the registered provider ensuring that the responsible individual has the skills to oversee and supervise the management and the operation of the home effectively.

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Requirement Due date

This requirement was made at the last inspection and is restated. 4 September 2022

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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— 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 11 details of the child’s behaviour leading to 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 effectiveness and any consequences of the use of the measure; and

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Requirement Due date

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

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

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

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Requirement Due date

This refers specifically to the registered manager ensuring that staff clearly record the use of de-escalation techniques and the context of any incident that involves a physical restraint.

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Requirement Due date

The registered person must maintain records (“case records”) for each child which—

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Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

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Requirement Due date

are signed and dated by the author of each entry.

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Requirement Due date

if the child dies before attaining the age of 18, for 15 years from the date of the child’s death;

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Requirement Due date

in cases not falling within sub-paragraph (a), for 75 years from the child’s date of birth; 4 September 2022 Inspection report for children’s home - monitoring visit: SC476252 12 securely in the children’s home during the period when the child to whom the case records relate is accommodated there. (Regulation 36 (1) (2)(a)(b)(c))

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Requirement Due date

The registered person should have a system in place to ensure that children’s records are stored safely.

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person—

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Requirement Due date

if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires. (Regulation 44 (2)(a))

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Requirement Due date

The registered person should ensure that the independent person appointed to carry out visits to the home does so in a way that enables them to consult with children and professionals. This includes ascertaining children’s wishes and feelings in regard to the quality of care that they receive.

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Requirement Due date

This requirement was made at the last inspection and is restated. 4 September 2022

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendation

 The registered person should ensure that all staff, including the manager, receive regular supervision of their practice. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 61, paragraph 13.2 and 13.3)

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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.

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Children’s home details

Inspection report for children’s home - monitoring visit: SC476252 13 Unique reference number: SC476252

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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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Inspector

Sarah Berry, Social Care Inspector Inspection report for children’s home - monitoring visit: SC476252 14 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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