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

Inspection report for children's home: 2611190 1 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

This home is owned and operated by a large national provider. It provides care for up to 20 children with learning disabilities. The home’s statement of purpose says it provides therapeutic care for young people with an autistic spectrum disorder with an education, health and care (EHC plan) and/or a learning disability.

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Information about this children’s home

There is a school on site but only the residential children’s home was considered as part of this inspection.

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Information about this children’s home

The manager is suitably qualified and experienced and was present throughout the inspection. Children were seen and spoken to as part of this inspection, and their views were considered.

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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’s welfare is not promoted or safeguarded and/or 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: 2 November 2022

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inadequate

Overall judgement at last inspection: requires improvement to be good

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inadequate

Enforcement action since last inspection: none Inspection report children's home: 2611190 2

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Inspection date Inspection type Inspection judgement

02/11/2022 Full Requires improvement to be good 01/02/2022 Full Good Inspection report children's home: 2611190 3

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inadequate

Children’s progress and experiences have been impaired by poor behaviour management practice. This practice has led to children being physically and emotionally harmed. Children have been involved in incidents of harm towards each other. A shortage of suitably qualified and experienced staff and minimal staffing ratios have led to children not being supervised effectively. This has impacted on the overall care of children and on the provision of adequate levels of support when needed.

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inadequate

Children have made some progress, particularly in education. All the children have suitable education arrangements in place, and their learning and achievements are valued. Staff support children well with their education. One child has recently completed their GCSEs and is going on to college, while another child is at college and aspires to go to university.

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inadequate

Children have opportunities to engage in a range of activities in the home and local community. One child with an interest in horses attends local stables to have regular riding lessons and learn about caring for horses. A college course is currently being considered to further develop this interest. Children cannot always go off site for activities, unless this is a group activity, due to the lack of available staff to take children individually on activities. However, the physical environment provides lots of space for children to engage in outdoor activities.

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inadequate

Children are supported to have regular contact with their families and other people who are important to them. One child has started to build a friendship group away from the home, and this is positive for them. Family members spoken with said that communication from the home was an issue at times as they were not being provided with requested information. On occasion, this has left family members not knowing who to contact when they have had a concern about their child.

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inadequate

Children have, or are, building positive relationships with staff, and all the children could identify an adult they would go to if they had any worries or concerns. Staff are being supported to respond to children in a therapeutic way. However, the home’s model of care is not known to all staff and is not embedded in their practice.

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inadequate

Children are being supported to develop their independence skills and become more self-reliant. Transitions into the home have been well managed and well planned. Children have visited the home before moving in, which has supported them in managing their anxieties. Professionals and family members have also been part of the planning process, which has supported consistency and sharing of information.

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inadequate

The manager was proactive in responding to concerns about a young adult who was due to leave the home. They took appropriate action in ensuring that children were Inspection report children's home: 2611190 4 safeguarded and that support was in place to aid this transition. As a result, the young adult experienced a positive move out of the home.

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inadequate

Children are registered with relevant health professionals and are supported to attend appointments. However, for one child, there has been no follow up to a medical concern after an appointment was cancelled. This means a potential health issue has not been adequately reviewed by a medical professional. This could place the child at risk of poor health from an undiagnosed condition.

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inadequate

It is not always clear to professionals what therapeutic support and work is being undertaken with children. Information and reports are not shared with professionals and families, which prevents wider support from being provided if needed.

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inadequate

Overall, care planning is poor, and recorded information about children lacks detail and relevant information. This means that staff do not have a clear understanding of the child and their needs, targets and goals. Some significant information, for example previous self-injurious behaviour, is poorly recorded and does not provide staff with information on how to support the child and manage risks. This leaves children at risk of harm.

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inadequate

Errors in recording have not been identified by the manager or staff. This demonstrates a lack of management oversight and care and attention to detail that would show children they were valued. A professional commented that staff do not know the children, and this means that professionals have been unable to compile comprehensive plans for children.

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

Incidents of aggression between children have been poorly managed and have led to children being injured. Children have physically assaulted each other and have attempted to ‘restrain’ other children to manage incidents. There have been insufficient staff to safely manage and de-escalate incidents. On one occasion, a child accessed a knife and threatened other children. Staff have failed to intervene during incidents, which has led to physical and emotional harm being caused.

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

Children have received injuries because of physical altercations between them, and staff have not taken sufficient action to prevent this. Staff did not respond appropriately to a child with a head injury and they did not seek medical advice. This had the potential to place a child at risk of harm.

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

There was a lack of adequate support provided to a child following an incident where the child had stones thrown at them and was subject to verbal abuse. The child was left alone in their area of the home, despite staff commenting on the child crying and being distressed. The child called a family member for help and support. This lack of support when distressed has the potential to cause emotional harm to children. Inspection report children's home: 2611190 5 On four occasions during an incident, staff used a restraint technique that they were not authorised or trained to use. This had the potential to cause harm and distress to the child. Following incidents, staff and children do not routinely have suitable debriefs. This prevents children from having the opportunity to talk about their feelings and experiences of incidents. It minimises opportunities for staff to reflect on practice and learn from incidents to support the improvement of practice.

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

Overall, risk assessments are well written and contain sufficient information to support staff in managing risk and supporting children. However, not all staff read the risk assessments, and they are not consistently followed. For example, children who were playing on an e-scooter were not adequately supervised or followed by staff. This meant that staff were not there to de-escalate an incident of physical aggression between the children.

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

Not all safe recruitment practices are followed, and relevant information could not be located within staff files. The manager does not have easy access to staff files, as these are located in the school. This minimises the manager’s oversight and means that the manager did not have access to evidence that all recruitment checks had been completed before staff started working at the home.

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

Not all staff have received relevant fire evacuation training before working with children and in the home. Two staff members have not completed safeguarding training before working alone with children. This places children at risk of harm as staff have not been trained to minimise fire risks or recognise safeguarding concerns. The current induction completed by new staff does not contain all the relevant information relating to keeping children safe.

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The effectiveness of leaders and managers: inadequate

Some positive changes in systems and processes were identified; however, these are not yet fully embedded in the home. There has been a high turnover of staff, and as a result, the manager has been covering shifts. This means they have not been able to fulfil all of their management duties and responsibilities.

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The effectiveness of leaders and managers: inadequate

Staff do not have regular or meaningful supervision, and no staff have had an annual appraisal of their work. This limits opportunities for staff to reflect and learn from practice, take accountability for their working practices and be supported to learn and develop their skills.

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The effectiveness of leaders and managers: inadequate

Most staff have not had training relevant to the specific needs of the children. For example, staff have not all received training in autism or in safeguarding children with disabilities. As a result of the high turnover of staff, there is a lack of suitably qualified and experienced staff. This has impacted on the day-to-day care of children.

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The effectiveness of leaders and managers: inadequate

The manager has clear plans for the development and improvement of the home and is starting to implement change. However, progress is slow, and previous progress has not been sustained since the last inspection. Inspection report children's home: 2611190 6 The manager alerted the inspector to a possible breach in the conditions of registration of the home. This related to an unconnected staff member being given permission by senior managers to move into an unoccupied area of the children’s home for six months. This was not agreed by the manager nor the responsible individual for the home, who had raised their concerns to senior managers. There was evidence to show this person was moving into the home during the inspection.

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The effectiveness of leaders and managers: inadequate

Following discussions with senior managers, alternative arrangements were made for the staff member. Ofsted was assured that unused areas of the children’s home would not be used in this way again. Inspection report children's home: 2611190 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 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 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—

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Requirement Due date

satisfies the conditions in paragraph (3).

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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)(iv)(d) (3)(c)(i))

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Requirement Due date

In particular, this relates to ensuring that all children’s care plans contain all known and relevant information, are read 15 August 2023 Inspection report children's home: 2611190 8 and understood by staff and that staff delivering care are suitably trained and experienced.

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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.

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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;

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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

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

that each child is encouraged to build and maintain positive relationships with others. (Regulation 11 (1)(a)(b)(c) (2)(a)(i)(ii)(iv)(ix)(x)(xi)(b))

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Requirement Due date

In particular, this relates to supporting children to have positive relationships and to preventing peer-on peer-abuse. It also relates to staff having supervision and training to improve behaviour management. 15 August 2023 Inspection report children's home: 2611190 9 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

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

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)(iii)(iv)(v)(b))

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Requirement Due date

In particular, this relates to staff reading and following risk assessments, supporting children to have positive relationships and responding effectively to any concerns. 15 August 2023

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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 work as a team where appropriate; 15 August 2023 Inspection report children's home: 2611190 10 ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that 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

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)(b)(c)(d)(f)(h))

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Requirement Due date

In particular, this relates to ensuring that there are sufficiently trained and experienced staff on each shift to provide safe care to children. It also relates to the manager having effective oversight of the home and using information to make and sustain improvements.

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Requirement Due date

The registered person must compile in relation to the children’s home a statement (" the statement of purpose") which covers the matters listed in Schedule (1).

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Requirement Due date

Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose.

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Requirement Due date

Nothing in paragraph (5) or regulation 46 (review of premises) requires or authorises the registered person to contravene or not comply with—

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Requirement Due date

any other provision of these Regulations; or

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Requirement Due date

any conditions in relation to the registration of the registered person under Part 2 of the Care Standards Act 2000. (Regulation 16 (1) (5) (6)(a)(b)) 15 August 2023

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must—

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Requirement Due date

make arrangements for persons working at the home to receive suitable training in fire prevention. (Regulation 25 (1)(c)) 15 August 2023 Inspection report children's home: 2611190 11 The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home;

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (2)(a) (3)(d)) 15 August 2023

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Requirement Due date

ensure that each employee completes an appropriate induction;

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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 (1)(a) (4)(a)(b)(c))

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Requirement Due date

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. (Regulation 35 (1)(a)(b))

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Requirement Due date

In particular, this relates to staff being trained in behaviour management and restraint and adhering to the policy in relation to appropriate use of restraint and only using authorised techniques. 15 August 2023 Inspection report children's home: 2611190 12

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Recommendation

The registered person should develop effective working relationships with each child’s placing authority and with other relevant persons. This relates to improving communication between the home and all relevant persons. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 52, paragraph 10.3)

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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: 2611190 13

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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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Inspector

Sarah Orriss, Social Care Inspector Inspection report children's home: 2611190 14 inspects 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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