Children's home run by Action for Children in Watford

Inspector Debbie Young

This monitoring visit . The interim inspection on 24 January 2017 judged the home to have declined in effectiveness .

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Inspector Debbie Young

This home is subject to a compliance notice, which was issued following the interim inspection. There are concerns about the unsafe arrangements for the handling, recording, safekeeping and safe administration of medication in the home. There have been six medication errors since December 2015.

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Inspector Debbie Young

In order to evaluate the progress that the home has made in addressing these concerns, a monitoring visit was undertaken on 21 February 2017.

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Inspector Debbie Young

The registered manager has taken the required steps to meet the compliance notice.

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Inspector Debbie Young

A working matrix is in place, which identifies the busiest times for the staff team. The shift times have been adapted to accommodate these peak times. With effect from 16 February 2017, staff members who lead the shifts are starting earlier to ensure that an appropriate handover takes place. This change is in its infancy and as such is not tested in the medium- to long-term.

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Inspector Debbie Young

The shift leaders are all qualified to level 3 and are responsible for the oversight and administration of medication. Electronic fobs monitor and record the staffing hours, to ensure that the staff are not leaving early or arriving late. This enables the managers to review the timesheets and to make sure that there is sufficient staffing to meet the children’s needs.

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Inspector Debbie Young

All of the staff are suitably trained and attend a one-day medication training course annually. During this training, the staff work through scenarios and practise recording and handling medication. The trainer signs off the staff members who have successfully completed this training. Following this, there is a period when new staff observe and shadow the medication process. They start to undertake this task when they are confident. The organisation has now stipulated additions to the current training programme. Six observations of staff administering medication are to be undertaken within a six-week timeframe. This is likely to strengthen the processes for the administration of medication and provide better oversight of new staff.

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Inspector Debbie Young

Handovers are taking place regularly. They are informative, with all staff members sharing information fully. The staff members spoken to during the inspection advised that the handovers are more concise on weekday mornings. This is due to the limited time before the children’s transport arrives to take them to school. The staff members read the children’s care plans and medication sheets and sign to indicate that medication has been administered in accordance with the children’s plans. The manager and deputy managers review the handover records and the medication documents in the morning ‘regroup’ meetings. There is clear guidance and discussion at this meeting and examples of good recording are shared with the team.

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Inspector Debbie Young

The medication room is stocked with the relevant equipment. Additional tools are in place to assist the staff. The staff have laminated prompt cards with them for the duration of the shift and there are whiteboards in the kitchen, dining room and outside children’s bedrooms. These boards are used to record the medication for each shift and act as useful reminders for the staff during busier periods.

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Inspector Debbie Young

The medication sheets provide clear and accurate records. The shift leader reviews these records at the end of each shift and the managers review the records daily. There have been no further medication errors since 9 January 2017.

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Inspector Debbie Young

A number of staff said that there is additional pressure during some shifts due to the complex needs of the children. This is an ongoing issue and the registered manager confirms that there is a recruitment plan in place. There is evidence of forward thinking and planning to prevent future issues.

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Inspector Debbie Young

The requirements and recommendations raised at the last inspection have not been reviewed during this monitoring visit. They are restated and will be reviewed at the next inspection.

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Information about this children’s home

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

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Statutory requirements

This section sets out the actions that 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

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. 06/03/2017

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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)) 06/03/2017

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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)) 06/03/2017

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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)) 17/04/2017

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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 with 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.  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 home regulations including the quality standards’, page 54, paragraph 10.15)

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection. This inspection was carried out under the Care Standards Act 2000. out in 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 this guidance, please telephone 0300 123 4234 or email enquiries@ofsted.gov.uk .

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Information about this inspection

to 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

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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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