Children's home run by The National Centre for Young People with Epilepsy in Tandridge

children and young people since the most recent full inspection

This home was judged Requires improvement at the full inspection. At this interim inspection Ofsted judge that it has sustained effectiveness .

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children and young people since the most recent full inspection

Since the last full inspection the manager has successfully registered with Ofsted; she is suitably experienced and has the necessary qualifications. She understands the strengths of the home and is aware of areas for development. She is presently in the process of identifying areas for improving practice in the homes across the site. She has a child-centred approach to management and is involving young people and staff in developments and decision making. There are now comprehensive development plans in place, which are realistic and achievable. In recent months, the management team have focused on meeting the requirements and recommendations made at the last inspection. There are currently decisions being made within the organisation to review the Registered Managers role within this children’s home. At present, her role is extensive and described as ‘overwhelming.’ Since the last inspection, there have been no new admissions and one discharge.

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children and young people since the most recent full inspection

The decision was made to end this placement due to the home not being able to meet the young people’s needs. Staff worked collaboratively with the parents and placing authority to ensure the young person was supported and prepared to make this transition. The main impact across the homes continues to be the high number of vacant staffing positions. The management team have weekly recruitment working groups to discuss strategies and there continues to be a focused recruitment-and-retention drive in operation. The organisation has taken the decision to recruit from overseas to ensure there are sufficient staff on site. However, to date there remains a shortage of staff. Staff priority has been to keep the young people safe and manage each shift on a day-to-day basis. Progress has been seen for some individuals however, this has been limited due to the staffing levels. The management team have made the decision not to undertake any further

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children and young people since the most recent full inspection

assessments for placements until staffing levels increase to ensure stability in the houses. During discussion, staff demonstrated understanding that young people’s learning disabilities makes them highly vulnerable and were able to demonstrate how they would act on concerns. However, since the last inspection, there has been serious notifications received into Ofsted and the homes safeguarding policy has not been followed in all cases to ensure young people are protected and that information is shared. There was a significant delay in staff recognising a safeguarding concern and reporting this and in seeking appropriate medical attention. Although internal investigations have taken place, some shortfalls have not been recognised. Staff have received regular safeguarding training, however this has not been fully embedded into their knowledge and practice. In addition, when decisions are made to move staff to another house pending internal investigations this has not been

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children and young people since the most recent full inspection

risk assessed. It is not evident the reason for these decisions or if young people are being fully safeguarded through this practice. In other cases, allegations or suspicions of harm have been promptly and appropriately shared with external safeguarding agencies and significant events and updates are being regularly communicated to Ofsted. Staff attend relevant professionals meetings and share appropriate information about young people's well-being. This demonstrates effective partnership working. Medication procedures have been strengthened with increased oversight and auditing taking place. There is now a greater awareness of medication arrangements and action is taken following errors. The team continue to seek to reduce any medication errors. Shift leaders currently do not undertake regular medication checks at the end of each shift. This had led to a delay in identifying some medication errors and is an area that could be further improved.

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children and young people since the most recent full inspection

Staff are now receiving regular formal supervision. The supervision policy has been amended to ensure the frequency of supervisions is now achievable. The format has also been revised and as a result, staff are being adequately supported to reflect on and improve their professional practice. Staff undertake a detailed induction to provide them with the competencies required to meet the complex needs of the young people. This is now being seen in practice for new staff. Since the last inspection, the manager has obtained copies of the plans for the care of young people prepared by the child’s placing authority, their placement plans and minutes from reviews. When there has been a delay in obtaining paperwork, there is evidence to demonstrate the manager has taken action to gain this. It is now possible for staff to monitor the progress young people are making in respect of the plans for them. Risk assessment documents have been reviewed and include additional information

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children and young people since the most recent full inspection

to ensure staff are fully aware of arrangements to reduce any known risks. Review processes are now robust and reflect any additional support needs that have been identified. Behaviour plans have been implemented in conjunction with the psychology team and individual programmes have been provided for young people. This is enabling young people to be supported to keep themselves and others safe. Staff are due to undertake training in understanding and supporting young people in relationships and sexual well-being. This will strengthen and support staff knowledge further. The monthly monitoring reports are undertaken by a new independent visitor. This has resulted in robust monitoring of the service. This level of monitoring is effectively used by the management and staff team, ensuring action is taken to address any shortfalls. There is a greater awareness of key issues. Although it is clear, some internal monthly monitoring takes place by the manager, there is not a

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children and young people since the most recent full inspection

six monthly review in operation to ensure trends and patterns are being fully evaluated. This requirement is repeated to ensure monitoring is thorough and purposeful as intended. The arrangements for health and safety have been revised to ensure compliance with the homes policies. Legionella risk assessments have now been acted upon and remedial work taken place. This enables young people and staff to be fully protected by the homes arrangements for health and safety. Since the last inspection, formal handover processes between day and night staff have been implemented. This is enabling information to be communicated. There are inconsistencies in the use of these systems across each of the houses. The managers need to continue to review this procedure to ensure it is effective. Young people show affection for the care staff and there is a relaxed atmosphere in the home. It is evident young people have fun and develop as a result. This was

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children and young people since the most recent full inspection

echoed by a parent’s. Comments included ‘staff observation is amazing,’ and ‘he could not be in a better place or with better staff.’ Young people's views are gained in areas of their care. Staff actively seek the views of young people as part of their everyday practice. This is based on a good knowledge of each young person's needs, which enables staff to tell if someone is unhappy and to respond accordingly. However, individualised communication systems are still not being consistently implemented. This is not providing young people with the tools to be able to communicate with staff or people who do not know or understand how the young person is communicating.

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children and young people since the most recent full inspection

Since the last inspection, work has been done to evaluate the current level of service and to plan ahead for future developments in the coming year. Staff are genuinely enthusiastic about the care of young people.

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Information about this children's home

The home provides education and residential care for up to 60 young people, aged from 8 to 18 years old, across eight separate homes. Young people access the organisation's special school, which is approved by the Department for Education. Young people, with a variety of disabilities, primarily learning difficulties, autism, complex health needs and physical disabilities, are accommodated for 38 weeks or 52 weeks. Young people who stay at the home do not necessarily have a diagnosis of epilepsy. An adult college and some houses exclusively for 18 - 25 year olds are on the same site. These are separately regulated by the Care Quality Commission. The provider organisation is a registered charity

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

13/10/2015 CH - Full Requires improvement

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Recent inspection history

09/10/2014 CH - Interim sustained effectiveness

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

In order to meet the protection of children standard, the registered person must ensure that staff:

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Requirement Due date

(2)(a)(iii) have the skills to identify and act upon signs that a child is at risk of harm, (vi) take effective action whenever there is a serious concern about a child’s welfare, (viii) are familiar with, and act in accordance with, the home’s procedure under regulation 36(1) (policies for the protection of children). (b) ensure 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 home. In particular, complete risk assessments when staff are moved pending internal investigations. 25/03/2016

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Requirement Due date

13 The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard the registered person is required to:

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Requirement Due date

(2)(d) ensure that the home has sufficient staff to provide care for each child. 25/03/2016

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Requirement Due date

Establish and maintain a system for monitoring, reviewing and evaluating the quality of care provided for children and the feedback and opinions of children about the children’s home.

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  Ensure the policy in relation to relationships and sexual well-being is fully embedded to enable staff to help children to understand what makes a healthy relationship. (The Guide to the Quality Standards, page 39, paragraph 8.10)

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Recommendations

 Review the handover process to ensure everyone at the home understands their roles and responsibilities. (The Guide to the Quality Standards, page 54, paragraph 10.20)

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Recommendations

 Ensure shift leaders are monitoring medication arrangements. (The Guide to the Quality Standards, page 54, paragraph 10.21)

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Recommendations

 Ensure individualised communication systems are implemented in practice. (The Guide to the Quality Standards, page 24, paragraph 4.24)

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What the inspection judgements mean

At the interim inspection we make a judgement on whether the home has improved in effectiveness, sustained effectiveness, or declined in effectiveness since the previous full inspection. This is in line with the Inspection of children's homes: framework for inspection.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This inspection focused on the effectiveness of the home and the progress and experiences of children and young people since the most recent full inspection.

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Information about this inspection

This 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 Children's Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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