Children's home run by Action for Children in Watford

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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The effectiveness of the home and the progress and experiences of

This home was judged good at the full inspection. At this interim inspection, Ofsted judges that it has declined in effectiveness.

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The effectiveness of the home and the progress and experiences of

There were five requirements and one recommendation made at the last inspection. Two of these requirements have been met. A staff member who had not enrolled on the level 3 diploma for residential childcare by the relevant date has now commenced this qualification. This has a positive impact on the standard of the day-to-day care of the children as this training underpins practice. The management team shares relevant information with appropriate professionals in a timely way and actions are effective. This ensures good communication within the team around the child. A requirement was raised at the last inspection to ensure that the views of children, their parents, staff and placing authorities were considered as part of the manager’s internal monitoring. This monitoring is not yet due and therefore this requirement is restated and will be reviewed at the next inspection. Many of the children have complex health needs. This means that their medication

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The effectiveness of the home and the progress and experiences of

regimes require careful managing and oversight. Medication errors had been made and were reported on in the last inspection report and a requirement was raised in relation to ensuring that there are safe processes for the administration of medication to the children in the home. There have been two further medication errors since the last inspection. There has been an internal investigation as to how these have occurred, with further discussions at a recent staff team meeting. Staffing pressures, distractions and insufficient time to prepare before a shift are significant risk factors and have led to these further errors being made. This does not support children’s physical health and well-being. Medication errors have the potential to cause serious harm. It is of significant concern that the staff have not been sufficiently resourced to enable them to carry out this very important part of their role safely and effectively.

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The effectiveness of the home and the progress and experiences of

During this inspection, staff members expressed their concerns about the insufficient staffing levels on shifts, particularly during medication duties. The manager has identified a number of strategies to strengthen the process, such as additional staff on duty at busy periods, but this has not been implemented consistently. Necessary changes to reduce the risk of further errors are not in place. This means that the staff are not able to fulfil the required level of care to meet the individual needs of the children. The manager has failed to meet this requirement. It is restated and subject to a statutory requirement notice. The manager has been successful in the recruitment of staff since the last inspection. Shortfalls in safe recruitment practices were raised at the last full inspection. Review of a recruitment file for a new member of staff highlighted that there was no explanation of a gap in employment history. This does not provide

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The effectiveness of the home and the progress and experiences of

clear information to evidence that all enquiries are complete in order to assess suitability to work with children. The manager has failed to meet the recommendation.

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The effectiveness of the home and the progress and experiences of

The manager monitors and records the frequency of supervision. Staff are not receiving regular, effective supervision and there are significant gaps. A member of staff said, ‘I do not feel supported and I am not supervised regularly. I have to beg for supervision.’ This does not provide the staff with the consistent support that they should expect to receive. Furthermore, it has a negative impact on the efficient and good provision of care because staff do not feel valued or listened to.

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The effectiveness of the home and the progress and experiences of

Core staff and additional consistent agency staff are on duty during the week and weekends. The manager confirmed that the shifts take into account the required ratios of care for the children. However, staff members say that they feel under pressure on shift due to insufficient staffing levels. They say that current staffing levels do not provide sufficient help during medication times or when assisting children with their personal care. Despite the concerns raised, staff members spoke positively about the manager. One said, ‘The manager has some good ideas but she needs more support.’ Some staff say that there is poor planning of shifts, which has a significant impact on them because they have to identify staff to cover shifts at short notice due to illness. They are taking on the responsibility of sorting this out themselves during weekend shifts as well as taking care of the children. The home caters for children

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The effectiveness of the home and the progress and experiences of

who have a wide range of needs. There are currently two vacancies, one waking night worker and one residential worker. The staffing issues have the potential to affect the consistent levels of care if not managed effectively. During the inspection, two planned tea visits were booked in for the evening, in addition to the six children and six staff on duty. Following a cancellation of one tea visit, the manager was able to spend time with one family during their tea visit and show them around the home. However, the initial arrangements did not represent good planning on shift. This had the potential to place additional pressure on the staff who say that they are already stretched at peak times. Individual risk assessments for the children are completed but do not consistently include up-to-date information and do not fully reflect the current needs of the children. A child’s risk assessment did not record a significant self-harming incident

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The effectiveness of the home and the progress and experiences of

or an internet safety contract. This does not evidence the provision of adequate safeguards for the children or the staff. The risk assessment is not an accurate tool to assist staff to prevent and manage potential risks.

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The effectiveness of the home and the progress and experiences of

There are records of significant incidents but information is not consistently clear. A manager had not signed one report and another did not include the details of the child involved. This does not provide a comprehensive record and does not ensure that all safeguards are in place through the review of incidents.

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The effectiveness of the home and the progress and experiences of

Children have positive experiences at the home and they enjoy their time there. Observations of the children during the inspection found that they are comfortable and settled in their surroundings. The staff are attentive to the children’s needs and engage with them well. The staff have a good knowledge of the children’s individual needs. A social worker said that a child that she is working with has identified his stays as a part of his life that is going well. She said, ‘They [the staff team] have done a really good job. At first he didn’t want to go as it was an emergency stay and he had not been away from home before, but he is now starting to enjoy this and will continue to come.’ Parents are happy with the service and they speak positively about the level of care that their children receive. They are confident that the core staff team members know their children well and spend time getting to know them. The parents are

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The effectiveness of the home and the progress and experiences of

confident that the staff are committed to ensuring that the children are happy and well looked after. One parent said, ‘He [her son] absolutely loves it. They seem to do so much with him. They go bowling and go to dinner and he is very well loved. He has a good relationship with everyone.’ There is effective external monitoring reporting through regular visits. The manager engages well with this process to ensure that the identified actions are progressed to drive the service forward. There have been emergency admissions since the last inspection. A social worker advised that the management of these admissions is positive and that they are successful for the children and families. New children have tea visits with parents and this is progressed to unaccompanied visits at the pace of the child and family. There is clear management oversight of potential referrals. The manager considers the individual needs of the child and the

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The effectiveness of the home and the progress and experiences of

potential impact on the existing children already accessing the home before deciding whether the home can accept a new admission.

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Information about this children's home

The home provides short breaks for up to eight children who have a diagnosed learning difficulty and/or complex health needs. A charitable organisation operates this setting.

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Recent inspection history

Inspection date Inspection type Inspection judgement 24/10/2016 Full Good 16/11/2015 Full Requires improvement 16/07/2014 Full Adequate 22/05/2014 Full Inadequate

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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 In order to meet the protection of children standard, with particular reference to regularly reviewing risks and ensuring that they are matched with appropriate management strategies, the registered provider 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. 16/02/2017

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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. (Regulation 23 (1))* 16/02/2017

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety, ensuring that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1)(3)(d)) 16/02/2017

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b)) 16/02/2017

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Requirement Due date

The registered person must ensure that the system of monitoring, reviewing and evaluating the quality of care provides for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (2)(5)) 16/04/2017

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Requirement Due date

* These requirements are subject to a statutory requirement notice.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Ensure that all incidents of control, discipline and restraint are subject to systems of regular scrutiny to ensure that their use is fair. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.36.) This is in particular reference to ensuring that records are clear, detail the child’s name and that the manager has robust oversight of the records of incidents.

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Recommendations

 Plan staffing levels to ensure that they meet the needs of the children and can respond flexibly to unexpected events or opportunities. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.15)

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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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