Children's home run by Cambian Childcare Limited

Inspection report for children’s home: 2730001 1 Registered provider: Cambian Childcare Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is owned by a large national company. It provides care for up to two children with mental health difficulties who may not be able to live in the community without continued support. The home aims to provide children with a period of stabilisation and assessment. At the time of this inspection, two children were living at the home.

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Information about this children’s home

The manager registered with Ofsted at the same time as the home in June 2023.

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Information about this children’s home

There is a separately registered school on site. The inspector only inspected the social care provision.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Date of last inspection: 22 November 2023

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good

Overall judgement at last inspection: good

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good

Enforcement action since last inspection: none Inspection report for children’s home: 2730001 2

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Inspection date Inspection type Inspection judgement

22/11/2023 Full Good Inspection report for children’s home: 2730001 3

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Overall experiences and progress of children and young people: good

This inspection was brought forward to address specific concerns received by Ofsted.

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Overall experiences and progress of children and young people: good

The two children living at the home were spoken to during the inspection. The children are positive about the care they receive and have good relationships with staff. There have been two planned moves out of the home, and one child has had an unplanned move.

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Overall experiences and progress of children and young people: good

Clear assessments and planning support children’s moves to the home. The clinical team is involved in the pre-admission process. Assessments explore whether moves are appropriate for both the child who is moving to the home and the other child already living at the home. The manager ensures that meetings take place to gather information before the move is agreed. Following one unplanned ending, a critical review was carried out to identify any learning.

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Overall experiences and progress of children and young people: good

There is an on-site clinical team. Managers work closely with the clinical team to ensure that there is a consistent and informed approach. There are weekly meetings to discuss children and the plans that outline their care. Children can make requests about their plans and supervision levels and receive an outcome to these requests. The clinical team is in contact with local health services. A plan with the local hospital was developed for one child who required a high number of hospital visits.

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Overall experiences and progress of children and young people: good

Children are registered at the on-site school. They have increased attendance. When children do not attend school, they are provided with educational work and supported by staff. The headteacher and manager work well together. A daily handover between school staff and care staff ensures that updates are shared before and after school. This means that all adults working with the child are aware of their current risks and presentation before supporting them.

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Overall experiences and progress of children and young people: good

Staff support children’s interests. Children take part in a range of activities, including arts and crafts, shopping and trips to the beach. Children are involved in planning what activities they want to do.

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Overall experiences and progress of children and young people: good

Children like their bedrooms and are involved in choosing how they are decorated. A new gate has been fitted to allow children access to the wider site without being near to the main gates, which pose a risk.

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Overall experiences and progress of children and young people: good

Staff carry out room searches when they are concerned that children may have harmful items. The searches are recorded and explain the reasoning for the search. However, when it is not appropriate to tell children about the search before this happens, they are not informed afterwards. This could affect children’s feeling that their bedroom is a safe, private space for them. Inspection report for children’s home: 2730001 4

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

The children feel safe at the home. Staff understand children’s risks and the supervision levels they require to ensure their safety. Children’s risk management plans are detailed and provide strategies for staff.

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

Incidents of self-harm are managed in line with children’s individual plans. Staff seek medical attention for children following incidents of self-harm. Staff talk to children about their risks. One child has been able to identify when they feel they have items available to them which could be a risk. This child is starting to learn to manage their risks more independently.

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

Missing-from-home incidents are rare. Staff understand the processes to follow when children go missing from home. Appropriate action from the staff reduces the risk of incidents reoccurring.

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

Safer recruitment is followed for new members of staff. There is an induction process for new staff, which helps them to learn their roles.

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

New systems are in place to ensure that ligature knives are stored carefully. Following a concern about ligature knives being left at a hospital, immediate actions were taken. All members of staff are familiar with the process of signing ligature knives in and out and carry these with them at the home. Therefore, there is a clear record of where these items are to ensure that children cannot access them.

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

Restraints are proportionate and used when necessary. Following restraints, children and staff receive debriefs. During a debrief, one child raised a concern about a restraint, and there is a lack of exploration with the child about this concern. There is no recorded rationale for why managers did not report the concern to the local authority designated officer (LADO).

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

Referrals to the LADO are generally made promptly. Several allegations made by children have been referred to the LADO, and guidance from the LADO has been followed by managers. Two allegations have not been reported promptly. One of these is still being investigated. One delay in reporting an allegation was not reviewed fully by managers to ensure that the staff involved understand their responsibilities.

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

Children have high levels of observations. However, on one occasion, staff did not follow the correct observation levels for a child. This meant that staff were not following the child’s agreed care plan and could have placed the child at risk of harm.

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

Since the last inspection, there has been one medication error, where a child was given an additional dose of medication. Medical advice was sought following this error. There was no follow up from managers following this error. This means that managers have not explored why the error occurred or satisfied themselves that the staff member has the skills to safely administer medication. Inspection report for children’s home: 2730001 5

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The effectiveness of leaders and managers: good

The manager is experienced and qualified for the role. She knows the children well and understands the progress they make. Professionals are positive about the support offered to children by the manager and staff.

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The effectiveness of leaders and managers: good

Staff said that they feel supported by the manager. Supervision sessions and team meetings take place regularly. This supports staff development.

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The effectiveness of leaders and managers: good

Staff receive relevant training through a clear training offer. Staff also access regular workshops that specifically represent children’s needs. This gives staff opportunities to regularly discuss the children’s presenting needs and how best to support them.

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The effectiveness of leaders and managers: good

Management oversight is clear. There are new systems to monitor actions taken following incidents and concerns. These include clear recording about the rationale for decisions and lessons learned from incidents. This helps the manager to identify if there are any actions that need to be put in place to reduce the risk of similar incidents occurring again. However, the manager does not always record the date that the oversight is carried out.

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The effectiveness of leaders and managers: good

Managers are aware of areas for staff development. Some incident and restraint records do not include enough detail. There are limited details about the de-escalation techniques used by staff during these incidents. Although the manager is aware of this, no actions have been taken to address this.

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The effectiveness of leaders and managers: good

Managers have not carried out appraisals with staff annually. This means that leaders and managers are not providing the necessary support and oversight to help staff develop their skills and knowledge.

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The effectiveness of leaders and managers: good

The manager has written quality of care reports. However, feedback from children, families, professionals or staff is not included. The actions identified from the manager’s review of the quality of care are limited. This reduces the effectiveness of the report in identifying and driving improvements. Inspection report for children’s home: 2730001 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, The Children’s Homes (England) Regulations 2015 and the ‘Guide to the Children’s Homes Regulations, including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

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

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Requirement Due date

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

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Requirement Due date

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

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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

are familiar with, and act in accordance with, the home’s child protection policies. (Regulation 12 (1) (2)(a)(iii)(v)(vi)(vii))

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Requirement Due date

In particular, ensure that: safeguarding concerns are reported promptly and appropriately on all occasions; staff follow children’s plans; staff are clear on their roles and responsibilities in safeguarding children; referrals to the LADO are submitted following allegations in a timely manner. 22 November 2024

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Requirement Due date

The registered person must ensure that all employees—

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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)(c)) 22 November 2024

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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. 14 February 2025 Inspection report for children’s home: 2730001 7 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 feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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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.

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Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1) (2)(b)(c) (5))

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Recommendations

 The registered person should ensure that children’s rooms are only searched if the child has been informed or asked for their permission, unless there are reasonable grounds for believing that there is a risk to the child’s or another person’s safety or well-being. If they are not informed beforehand for safety reasons, children should be informed following the search so that they are aware. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 16, paragraph 3.20)  The registered person should ensure that medicines are administered in line with a medically approved protocol and the child’s prescription. Where there are errors with administering medication, these should be explored and appropriate actions taken to ensure that staff are competent to continue administering medication. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 35, paragraph

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Recommendations

7.15)  The registered person should ensure that staff are familiar with the home’s policies on record-keeping and understand the importance of careful, objective and clear recording. This specifically relates to ensuring that staff provide details about any de- escalation techniques they use when managing incidents and that dates are added to documents to show when they were carried out. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 62, paragraph 14.4)

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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 for children’s home: 2730001 8

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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

Leanne Lyon, Social Care Inspector Inspection report for children’s home: 2730001 9 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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