Children's Home run by Derbyshire County Council in Derbyshire

Unique reference number SC036262 Visit date 16/12/2014 Inspector Katarina Djordjevic Monitoring report for a Children's Home Monitoring Report: SC036262, 16/12/2014 2 of 5

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Brief description of the service

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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Outcome of monitoring visit

On 19 November 2014 a full inspection was undertaken and an overall effectiveness judgement of inadequate was given. As a result of the shortfalls identified, two compliance notices were issued regarding safeguarding practices and medication practices. The purpose of this monitoring visit was to assess if the compliance notices have been addressed.

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Outcome of monitoring visit

The full inspection identified that there had been delays in staff reporting allegations made against staff to the Registered Manager. Additionally, the Registered Manager had 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.

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Outcome of monitoring visit

The management team have taken steps to address these shortfalls. Discussions regarding safeguarding procedures have taken place in the two staff meetings held since the full inspection. A training session regarding the home’s whistleblowing policy facilitated by a member of the local authority’s safeguarding team has been held. Additionally, individual supervision sessions have been held with seven of the staff team. These supervision sessions focussed on whistleblowing procedures and the Local Safeguarding Children Board’s (LSCB) procedures regarding dealing with allegations against staff. Staff have also been given copies of these procedures which they have signed to demonstrate they have read. Discussions with the manager highlighted that staff demonstrated their understanding of procedures in the training session and their individual supervisions. Actions taken help to ensure young people are protected from the risk of harm and abuse.

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Outcome of monitoring visit

The full inspection identified poor and potentially unsafe medication practices. Some young people were not given medication as prescribed and these shortfalls had not been identified by staff. This raised concerns about the competency and ability of staff to manage medication safely. Medication ‘error/near miss’ incident report forms had not been completed in line with the home’s procedures. Staff training records identified that not all staff had received medication training; some of these staff were administering medication. The shortfalls in medication practices also called into question the effectiveness of the training. There had also been a lack of management oversight as staff who have not received medication training had been administering medication.

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Outcome of monitoring visit

A review of staff meeting minutes and staff supervision records was undertaken during Monitoring Report: SC036262, 16/12/2014 4 of 5

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Outcome of monitoring visit

this visit. Shortfalls in medication practices identified at the full inspection have been discussed in the two staff meetings held since the full inspection. Additionally, seven of the staff team have had individual supervision sessions where medication practices were discussed. Information has been obtained from the prescriber of a young person’s medication to clarify times to be administered and any possible side effects if the young person refuses to take the medication. This helps to ensure young people’s health needs are being met.

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Outcome of monitoring visit

Staff have also been instructed to access the on-line training regarding the management of medication. Not all staff have completed this training. At the full inspection it was identified that some staff administering medication had not received training in medication procedures. This inspection identified that one of these staff members had still not had medication training, or had supervision to discuss medication practice. This member of staff was still administering medication. The inspector raised this with the manager during this visit and the manager arranged supervision for the following day for this member of staff. The manager instructed the member of staff on the day of this inspection not to administer medication until after their supervision.

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Outcome of monitoring visit

A review of young people’s medication records identified that some improvements have been made. However, records demonstrate that some young people are still not being given/offered their medication as prescribed; there were a significant number of incidents where the inspector identified that medication has not been given. Some young people’s medication records did not always include the dosage of the medication which is not in line with procedures. Furthermore, there is no evidence that these shortfalls have been identified by any of the team including using the medication ‘error/near miss’ incident report forms. This calls into question the competence of staff and their accountability. Although the management team have taken some actions, these have not been effective in ensuring young people’s health needs are being met which potentially places them at risk of harm. This compliance notice has therefore not been met.

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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 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 Monitoring Report: SC036262, 16/12/2014 5 of 5

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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 medication which is prescribed for a young person is administered as prescribed (Regulation 21 (1) (2) (b)) * 05/01/2015

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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) 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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About this monitoring visit

The purpose of this visit was to monitor the action taken and progress made by the Children's Home following an Ofsted inspection.

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