Children's home run by Action for Children in Watford

Requires improvement

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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because:

 Care planning is poor. The lack of written detail results in some children and young people not having their needs consistently met.  Staff restrict the liberty and movement of children and young people.  Lack of staff adherence to the procedures for the use of listening devices compromises children’s and young people’s privacy.  Staff do not consistently follow risk-management strategies.  Safeguarding procedures lack accountability. Children’s and young people’s files do not evidence the outcomes about child protection concerns.  Staff’s implementation of medication procedures is not robust and does not promote the safety of children and young people.  Lack of attention to detail and oversight by the manager means that inconsistent staff practice is not picked up.  The management team has failed to meet statutory requirements from the last inspection fully.

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The children’s home’s strengths

 All children and young people attend full-time education. Staff work with families, transport and a range of schools to ensure good connections when children and young people come for short breaks and have to attend school.  Children and young people are very relaxed in their setting and have positive relationships with staff.  Children and young people live in a vibrant and stimulating environment. The service is well resourced with play equipment, a sensory room and arts and crafts, in order to encourage sensory play.

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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 within the given timescales.

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Requirement Due date

12: The protection of children standard:

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Requirement Due date

In order to meet the protection of children standard, to ensure that children are protected from harm and enabled to keep themselves safe, the registered person must ensure that staff: (2)(a)(i) 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. This is with particular regard to risk management strategies to keep children and young people safe in wheelchairs and the use of medication for managing behaviour. 28/02/2017

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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: (1) enables, inspires and leads a culture in relation to the children’s home that: (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to: (a) 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; (b) ensure that staff work as a team when appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (e) ensure that the home’s workforce provides continuity of care to each child; (f) 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; (g) demonstrate that practice in the home is informed and

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Requirement Due date

28/02/2017 improved by taking into account and acting on: (i) research and developments in relation to the ways in which the needs of children are best met; (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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Requirement Due date

The registered person must ensure that: (a) the privacy of children is appropriately protected; (b) children can access all appropriate areas of the children’s home’s premises; and (c) any limitation placed on a child’s privacy or access to any area of the home’s premises: (i) is intended to safeguard each child accommodated in the home; (ii) is necessary and proportionate; (iii) is kept under review and, if necessary, revised; and (iv) allows children as much freedom as is possible when balanced against the need to protect them and keep them safe. (Regulation 21) 28/02/2017

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (2) In particular the registered person must ensure that: (c) a record is kept of the administration of medicine to each child. (Regulation 23) 28/02/2017

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy. (Regulation 24 (1)(d)) 28/02/2017

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Requirement Due date

29: Continuing professional development: registered person and responsible individual: 28/02/2017 The registered manager must undertake such continuing professional development as is necessary to ensure that the registered manager has the skills needed for managing the home. (Regulation 29 (4))

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Requirement Due date

34: Policies for the protection of children:

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Requirement Due date

The registered person must provide for records to be kept of an allegation of abuse or neglect, and the action taken in response. (Regulation 34 (2)(d)) 28/02/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Keep all children’s case records up to date. This is with particular regard to streamlining files and prioritising information in children’s and young people’s short break and ‘All about me’ plans. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.3)  Record information about the child in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14)

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Information about this children’s home

The home is registered to provide care for up to four children with learning disabilities and/or physical disabilities. The home provides short-break care. The home forms part of a large charitable organisation.

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Recent inspection history

Inspection date Inspection type Inspection judgement 24/03/2016 Interim Sustained effectiveness 01/12/2015 Full Good 06/03/2015 Interim Sustained effectiveness 14/05/2014 Full Good

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Requires improvement

While children and young people make progress at the service, some staff practices compromise children’s and young people’s positive experiences and rights. For example, their privacy is not always respected. Listening devices proposed for the use of monitoring children’s and young people’s activity during bedtime, particularly those who may have epileptic seizures, are routinely used and left on. Private conversations in bedrooms can be overheard by other children, young people, staff and visitors to the home.

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Requires improvement

Children and young people do not always have free movement around the home. For example, staff sit on bean bags in the open doorway of the sensory room to prevent children and young people exiting and entering the room.

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Requires improvement

One young person has experienced physical restraint while out in the community because risk management strategies have not been routinely implemented. This incident would not have happened had staff used the required wheelchair restraint devices, as set down in the young person’s care plan.

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Requires improvement

Transitions to the short-break service are handled sensitively and taken at a gentle pace. Developments in child-centred recording formats include a range of photos and social stories to help children, young people and their families understand and look back on the transition to spending time away from home. Records clearly show that introductions are arranged according to the individual needs of the child or young person and their family.

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Requires improvement

The registered manager is also developing booklets, with photos as visual points of reference, for all children and young people to use to be able to communicate their experiences to others. These developments are ongoing, with further work required, to ensure that children and young people have meaningful information about their care, experiences and progress.

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Requires improvement

New notice boards with symbols, pictures and photographs show how the manager and staff are working on communication processes that all children and young people can use. Currently, children and young people can point to a symbol or picture, or detach pictures to give to staff to express their views and wishes.

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Requires improvement

Children and young people enjoy a range of activities, which include trips on public transport, and visits to a farm, a sculpture park and outdoor play areas. At the time of this inspection, children, young people and their families were looking forward to the forthcoming Christmas party at a local community hall. Focused activities, such as train travel, cooking and visiting new places, enable children and young people to gain confidence and develop their independence skills. Children and young people enjoy joining staff in the kitchen. Making pizza and fruit salad gives children and young people excellent sensory experiences in addition to developing domestic and independence skills. They enjoy trying new foods and exploring different cultural experiences. For example, recent photo displays show children and young people enjoying Diwali and preparing for Buddhist celebrations.

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Requires improvement

Children and young people get a firm sense of belonging and familiarity as soon as they arrive at the service. They stay in a well-maintained and personalised environment. Staff ensure that personal possessions, name plaques, bedding and toys are placed in each room prior to children and young people arriving.

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Requires improvement

Safeguarding requires improvement because risk assessment and management are not consistent and robust.

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Requires improvement

Care planning information is cumbersome and does not give staff clear direction about how to care for children and young people day-to-day. Files are disorganised and essential documentation is difficult to come by. For example, some children and young people, who have not been supported with the correct mobility aids, still have care plans with this essential information missing.

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Requires improvement

Staff also fail to follow essential information in risk management plans. As a result, one young person was able to get out of a wheelchair because staff did not use the correct restraining equipment.

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Requires improvement

While the manager has experience of liaising with safeguarding agencies in order to look into child protection concerns, she does not maintain consistent records about her referrals. This shortfall means that the outcomes of the safeguarding actions taken by the registered manager cannot be verified.

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Requires improvement

Recording of physical intervention is improved. However, there is a lack of clarity about the use of medication in managing children’s and young people’s emotional distress and resulting behaviours. While all medications are recorded in children’s and young people’s medical files, there is no mention of this intervention in their behaviour plans. The home is located in a quiet residential area. There are no concerns about risk or criminal activities that may place children and young people at risk. The manager meets regularly with the police to maintain positive relationships and share information. Children and young people do not go missing because of the secure environment and staff vigilance. There are no concerns about child sexual exploitation of the children and young people.

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Requires improvement

Staff resistance to change and shortfalls in strategic management hamper the operation and development of this service. Statutory requirements from the last inspection are not fully met. For example, review and monitoring processes are not yet driving consistent staff practice.

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Requires improvement

The registered manager and staff fail to learn from mistakes and complaints. For example, a young person’s care plan was not updated with essential information, despite the manager having investigated a formal complaint from parents.

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Requires improvement

Inconsistent staff practice also undermines the improvements made in the safe management of medication. Medication procedures have been re-written and additional training put in place due to an error in medication by staff. However, staff still fail to follow basic administration and recording procedures. For example, staff sign medication records when they decant medicines from the main bottle and not at the point of administration of the medication to the child or young person.

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Requires improvement

The management team’s efforts to maintain stability during a challenging period of organisational change have had a varied impact on staff cohesion, practice and acceptance of change. For example, managerial consultation with staff about changing the short-break service’s opening times and working hours for staff resulted in a schedule of staff training. Staff have recently attended training on the role of the shift coordinator, the role of the key worker and recording. However recording remains poor. Basic practices, such as restriction of liberty and lack of respect for children’s and young people’s privacy, as observed on this inspection, show shifts are not being led appropriately.

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Requires improvement

The registered manager has managed this home since June 2013 and is currently working towards her level 5 diploma in leadership and management. The majority of staff are qualified, with the remaining staff being about to complete or enrol on their level 3 diploma in caring for children and young people. Completion of refresher training is inconsistent. For example, the manager and deputy manager have not refreshed their epilepsy training since May 2013. Another member of staff, who was shift-leading during this inspection, has not refreshed the same training for two years. The manager’s safeguarding for managers training is now six years out of date.

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Requires improvement

Staffing levels and core training of other staff ensure that children’s and young people’s health and medical needs are well cared for. But the manager should lead by example and ensure that all her training is up to date to promote best practice and drive informed review of staff practice and outcomes for children and young people.

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Requires improvement

Managers are attempting to lift morale and streamline practice and procedure. For example, listening to staff about rotas now informs a rolling rota. Staff meetings and supervision ensure that all staff have the opportunity to discuss the individual needs and group dynamics of children and young people. Planning admissions and compatibility processes to match children and young people to their new short- break arrangements are developing well.

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Requires improvement

The management team is focused on attempting to work on areas for development and acknowledges the need for the service to improve. Action plans are in place. Meetings with staff are regular and are used to gain feedback and gauge progress.

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Requires improvement

The registered manager shows good commitment to canvassing feedback to drive improvement in the service. For example, the staff team has made good progress in consulting with children and young people. The manager personally reviews each child’s and young person’s stay by reading the ‘My stay’ book. They are asked about their experience at the end of each stay. The manager notes children’s and young people’s favourite experiences and any new ideas they may have. For example, one young person now enjoys more football as a result of this regular survey.

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Requires improvement

The management and staff team also involve parents and carers in the regular review of the service. For example, the recent reintroduction of annual home visits. These early plans includes changes to staff working patterns to accommodate home visits in order to review the needs of the individual child and the family.

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Requires improvement

The manager and staff value partnership working with families. They maintain regular contact, with the home-to-school-to-short-breaks diary handing over information on a daily basis. Parents also use written surveys as an opportunity to provide feedback and ideas.

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Requires improvement

Independent monitoring is regular, often highlighting some of the shortfalls as identified in this inspection, but always positive about the quality of short breaks offered to children and young people. While staff and managers work hard to care for children and young people, they have failed to address fully some requirements from the last inspection and issues arising from independent monitoring visits. Shortfalls also emerge, due to lack of strategic management, disorganised recording processes and the day-to-day monitoring of staff practice.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against ‘Inspection of children’s homes: framework for inspection’.

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What the inspection judgements mean

An outstanding children’s home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children’s home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children’s home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children’s home is not yet delivering good protection, help and care for children and young people. A children’s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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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 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

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Information about this inspection

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, work- based learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for children looked after 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

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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