Children's Home run by Derbyshire County Council in Derbyshire

Unique reference number SC036262 Inspector Katarina Djordjevic Type of inspection Full Provision subtype Children's home

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Registered person Derbyshire County Council Registered person address County Hall Matlock Derbyshire DE4 3AG

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Responsible individual Ian Johnson Registered manager POST VACANT Date of last inspection 27/02/2014 2 of 10 Inspection date 19/11/2014

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Previous inspection good progress Enforcement action since last inspection None

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Overall effectiveness inadequate

Outcomes for children and young people good Quality of care inadequate Keeping children and young people safe inadequate Leadership and management inadequate

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Overall effectiveness

This home is inadequate due to significant shortfalls in quality of care, safeguarding and leadership and management which led to an overall effectiveness judgement of inadequate. Young people’s safety and well-being is compromised because safeguarding procedures are not always followed. Furthermore, poor and unsafe medication practices do not ensure young people’s health needs are being met and poses a risk of harm to young people. Internal monitoring systems and visits carried out by the independent visitor have not been effective in identifying shortfalls in practices.

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Overall effectiveness

Nine requirements have been made relating to: safeguarding procedures; medication practices; sanctions; complaints’ records; recruitment practices; staff training; staffing rotas; notifications and management monitoring systems. Three recommendations have been made regarding the recording of physical interventions; the home’s Statement of Purpose and young people’s placement plans and risk assessments (known as safe care plans).

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Overall effectiveness

The home has gone through an unsettled period recently. The local authority is currently re-organising their children’s residential services. As a result, a new manager and deputy manager have been appointed. The new management team are in the process of assessing the home’s strengths and needs and have 3 of 10 demonstrated a commitment to making improvements during this inspection.

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Overall effectiveness

Young people are happy and settled at the home and they do make good progress during their time at the home. There is also evidence of good partnership working. 4 of 10

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Information about this children’s home

This children's home is owned and managed by the local authority. It can accommodate up to four young people with emotional and/or behavioural difficulties.

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Inspection date Inspection type Inspection judgement

27/02/2014 Interim good progress 23/10/2013 Full good 13/12/2012 Interim good progress 14/06/2012 Full good

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that the home's child protection procedures are followed in the event of an allegation against a member of staff; and that all allegations are dealt with promptly (Regulation 16 (1) (a) (b)) * 10/12/2014

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Reg. Requirement Due date

(2001) ensure sanctions imposed are not excessive and are relevant to the behaviour; and that records give clear details of the behaviours and the sanction imposed (Regulation 17 (1), 17B (3) (a)) 31/12/2014

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Reg. Requirement Due date

(2001) make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home. This includes ensuring any 10/12/2014 5 of 10 medication which is prescribed for a young person is administered as prescribed (Regulation 21 (1) (2) (b)) *

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Reg. Requirement Due date

(2001) ensure records of all complaints are kept at the home and are readily available for inspection (Regulation 24 (5)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure that full and satisfactory information as detailed in Schedule 2 is obtained when employing new staff (Regulation 26 (3) (d)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure that all persons employed by the home receive appropriate training, supervision and appraisal (Regulation 27 (4) (a)) 31/12/2014

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Reg. Requirement Due date

(2001) ensure that the records specified in Schedule 4 are kept up to date. This is with specific reference to ensuring that the staff duty rosters accurately reflect actual hours worked and includes the hours worked by the manager (Regulation 29 (1) Schedule 4 (11)) 31/12/2014

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Reg. Requirement Due date

(2001) shall without delay notify the persons indicated in respect of the event in column 1 of Schedule 5. This is with specific reference to notifying Ofsted of allegations made against staff at the home (Regulation 30 (1)) 31/12/2014

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Reg. Requirement Due date

(2001) establish and maintain an effective system for monitoring and improving the quality of care provided in the children’s home. (Regulation 34 (1) (a) (b)) 31/12/2014

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Reg. Requirement Due date

*These requirements are subject to a compliance notice

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure all records of restraints give clear details of actions taken including de-escalation techniques used leading up the to the restraint (NMS 3.14)  amend the Statement of Purpose to ensure it reflects the needs of young people with emotional and behavioural difficulties; and that it refers to the relevant legislation (NMS 13.1)  ensure young people's placement plans and safe care plans clearly indicate where and when they have been updated and amended (NMS 25.2) 6 of 10

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Outcomes for children and young people good

Young people make good progress at the home given their starting points. They enjoy living at the home and have positive relationships with staff which means they are able to raise any concerns they may have. Young people's self-esteem and confidence improves as they are listened to and suggestions made are acted upon where appropriate.

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Outcomes for children and young people good

Young people are proud of the progress they have made since living at the home and as a result they are more confident and are more able to face life's challenges. A young person told the inspector that their ‘life had turned around’ since being at the home: and that they now look forward to the future as they didn’t think they could achieve anything before. Feedback from social workers and independent reviewing officers (IRO) confirms that young people make good progress in all areas of their lives given their starting points.

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Outcomes for children and young people good

Young people’s confidence and social skills also improve greatly as they are supported to pursue their individual interests and hobbies including being involved in community sports teams. They are also supported to undertake voluntary work which helps prepare them for adulthood as well as giving something back to the wider community.

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Outcomes for children and young people good

Young people’s risk-taking behaviours, including going missing and self-harm behaviours, reduce during their time at the home. Young people learn about the impact of their behaviours on themselves, their futures and on others. On occasions where young people’s behaviours have put them at risk, prompt action is taken by staff, who work collaboratively with other agencies such as the police.

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Outcomes for children and young people good

Young people’s challenging and aggressive behaviours improves. This means that they are safer and they are more likely to achieve better outcomes. This is because there are clear and firm boundaries put in by staff. Young people also told the inspector that they now know what behaviour is expected of them

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Outcomes for children and young people good

Young people’s health has also improved since living at the home. This is because they are eating healthier foods and they are not engaging in substance or alcohol misuse. They are learning to take responsibility for their health. Additionally, young people’s emotional health improves which helps them to understand their situation and proceed in their next stages of life. Comments received from IROs confirm that young people’s emotional health has improved since living at the home; young people are now able to form and maintain positive relationships.

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Outcomes for children and young people good

Some young people make excellent progress and other young people make good progress in achieving their academic potential. All young people attend educational 7 of 10 provisions based on their individualised needs and interests; their attendance is good. Some young people have achieved their GCSE’s and some young people have recently applied to go to University. As a result, young people’s future life chances improve greatly.

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Quality of care inadequate

Quality of care is inadequate because young people’s health is placed at risk due to poor and unsafe medication practices. Some young people are not given medication as prescribed. There was no evidence that any of these shortfalls had been identified by staff. This raises concerns about the competency and ability of staff to manage medication safely. The inspector also noted that the medication file contained medication ‘error/near miss’ incident report forms. There was no evidence that these had been completed in line with the home’s procedures. An examination of staff training records identified that not all staff had received medication training; some of these staff were administering medication. The shortfalls in medication practice also calls into question the effectiveness of the training. There has also been a lack of management oversight as staff who have not received medication training have been

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Quality of care inadequate

Young people receive care based on their individualised needs. Placement plans and risk assessments (known as safe care plans) give good details of young people’s needs and risks, and how to meet them. These documents are reviewed regularly. However, when placement plans and safe care plans are updated, dates are not included which makes it difficult to assess what is current information and, difficult to monitor progress made.

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Quality of care inadequate

Young people are supported with their physical and emotional health needs. They are encouraged and supported to attend their routine and specialist health appointments. Staff work closely with other professionals, including the child and adolescent mental health services (CAMHS). Staff have monthly meetings with the CAMHS team to discuss young people’s behaviours and needs. Young people eat a healthy diet and are encouraged to take regular exercise.

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Quality of care inadequate

Young people feel listened to and know that their views and suggestions will be considered. This helps them to feel valued. There are a range of systems where young people are able to contribute to the running of the home. Weekly meetings are held where young people are able to choose the weekly menus and put forward suggestions for activities.

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Quality of care inadequate

Young people receive good practical and emotional support to maintain contact with their families and people who are important to them. This helps to retain their individual identity.

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Quality of care inadequate

Young people are actively encouraged and given practical support to pursue their 8 of 10 individual interests and hobbies. Some young people have a full programme of activities that they follow and really enjoy. For example, young people are members of local football teams and hockey teams.

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Quality of care inadequate

The home is a detached house situated in a residential area and has good access to community facilities. Communal areas are furnished and decorated to a good standard and young people help to choose the decor. Young people are actively encouraged to personalise their bedrooms which helps to reflect their identity and interests.

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Keeping children and young people safe inadequate

Young people are not fully protected from harm as safeguarding procedures are not always followed which places young people at risk of harm and abuse. There have been delays in staff reporting allegations made against staff to the Registered Manager. Additionally, the Registered Manager has not followed the local authority’s own safeguarding procedures. In one instance there was a severe delay in referring an allegation to the local authority designated officer (LADO); decisions had been taken to investigate by other senior managers in the local authority. Failure to implement the home’s procedures promptly and effectively does not adequately safeguard young people.

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Keeping children and young people safe inadequate

Young people know how to access the complaints procedure. Complaints made by young people are taken seriously and appropriate action taken. This ensures that young people have the confidence to raise any concerns they may have and this helps to protect them from the risk of harm. However, not all records of complaints are kept at the home and are not readily available for inspection, specifically complaints made against staff.

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Keeping children and young people safe inadequate

The management of young people’s behaviour is generally good as they know what is expected of them. Physical intervention is not used very often and records of each incident are kept. However, in some instances records lack detail. For example, one incident did not give details about what led to the assault on a member of staff which resulted in the young person being restrained. Sanctions are not used often. However, when they are, sanctions are, at times, excessive and are not appropriate for the misdemeanour. For example, a young person was banned from using the mini-bus for two weeks because they had gone missing.

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Keeping children and young people safe inadequate

The management of health and safety is generally good. Regular servicing of equipment and installations takes place as required. Weekly fire alarm tests are undertaken as required and fire drills are also carried out.

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Keeping children and young people safe inadequate

There are clear recruitment procedures, but these are not always followed. Gaps in employment are not always explored and references are not always obtained when a member of staff has been recruited from one of the local authority’s other children’s 9 of 10 homes. These shortfalls do not fully protect young people from the risk of harm.

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Leadership and management inadequate

A new manager was appointed on 13 October 2014. She has transferred from another local authority children’s home. The manager has many years’ experience, is a qualified social worker and is in the process of submitting an application to Ofsted to register.

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Leadership and management inadequate

The home’s Statement of Purpose was reviewed and updated at the beginning of October 2014. Although it is very detailed, it is very lengthy and repetitive in some areas, and some of the information is inaccurate. For example, on a number of occasions it refers to children and young people with disabilities, whereas this home is set up to look after young people with emotional and/or behavioural difficulties.

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Leadership and management inadequate

Young people are cared for by a staff team who have many years’ experience of working at the home. The home has gone through an unsettled period recently. Young people expressed some anxiety and concern to the inspector over the long- term future of the home. The Operations Manager, who was visiting the home on the second day of this inspection, met with young people to discuss their concerns and try and reduce their anxieties.

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Leadership and management inadequate

Staff receive regular supervision and have received a range of training. However, some staff have not received training in medication practices; self-harm and child sexual exploitation. These areas are all relevant to young people living at the home. This lack of training does not ensure that all staff have the necessary skills and experience to meet young people’s needs.

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Leadership and management inadequate

Staffing rotas do not always accurately reflect hours actually worked by staff. Also, rotas do not contain hours worked by the management team. These shortfalls make it difficult to accurately assess staffing levels and management cover.

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Leadership and management inadequate

The home’s monitoring systems have been ineffective in identifying some of the shortfalls identified during this inspection. For example, significant shortfalls in medication practices. Monthly visits are also carried out by an independent visitor and copies of these reports sent to the regulator Ofsted as required.

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Leadership and management inadequate

There is a system to notify appropriate authorities of all significant events relating to the protection of young people living at the home. However, Ofsted is not always notified of allegations made against staff. This prevents the regulator from monitoring safeguarding practices in the home. Website: www.ofsted.gov.uk

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Leadership and management inadequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information about this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

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