Children's home run by Action for Children in Watford

Inspection report children's home: SC438751 1 SC438751 Registered provider: Action for Children

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Full inspection Inspected under the social care common inspection framework

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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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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

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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requires improvement to be good

Date of last inspection: 24 January 2017

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requires improvement to be good

Overall judgement at last inspection: Declined in effectiveness

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requires improvement to be good

Enforcement action since last inspection: A compliance notice was issued on 2 February 2017 in relation to recurring medication errors. A monitoring visit took place on 21 February 2017 to assess the changes. The compliance notice was met.

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Key findings from this inspection

This children’s home requires improvement to be good because: Inspection report children's home: SC438751 2  Since the last inspection, the quality of the internal decoration has deteriorated. There is damage to walls and equipment.  The number of incidents is increasing. Staff try hard to de-escalate and distract, but this is not always effective.  As some of the short breaks have been cancelled due to challenging behaviours, the home does not provide a consistent service for children in keeping with the home’s statement of purpose.  The parents spoken to during the inspection were not happy with the level of communication from the staff and the management team.  Parents feel that communication regarding aspects of their children’s care plans is slow, and they say that children’s items regularly go missing.  The staff complete risk assessments. However, these do not fully reflect the living arrangements for children and potential areas of restriction of liberty.

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Key findings from this inspection

 Very extreme physical behaviours present potential hazards to the staff and children. The staff use de-escalation techniques; however, these techniques are not always effective and do not meet the needs of all of the children.  There is no process to assess the impact or matching of placements.  The registered manager does not undertake group dynamic assessments to identify the potential impact on individual children within the group environment.

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Key findings from this inspection

 Communication books are used to support good links with schools.  The staff build good relationships with the children and provide nurturing care.  Since the last inspection, the manager has made efforts to improve the morale of the staff team.  There is regular effective internal and external monitoring.

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Inspection date Inspection type Inspection judgement

24/01/2017 Interim Declined in effectiveness 24/10/2016 Full Good 21/03/2016 Interim Improved effectiveness 16/11/2015 Full Requires improvement Inspection report children's home: SC438751 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet 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

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on mutual trust and respect and an understanding about acceptable behaviour.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff de-escalate confrontations with or between children, or potentially violent behaviour by children and help each child to develop and practise skills to resolve conflicts positively and without harm to anyone. (Regulation 11(1)(a)(b)(2)(a)(iv)(xi)) 01/08/2017

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff 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 and that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12(1)(2)(a)(i)(d)) 01/08/2017

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that helps children to aspire to their full potential and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to 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, and 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 the care provided in the home. (Regulation 13(1)(a)(b)(2)(a)(f)) 01/08/2017 Inspection report children's home: SC438751 4 Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16(5)) 01/08/2017

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Requirement Due date

The registered person must ensure that children can access all appropriate areas of the children’s home premises and that any limitation placed on a child’s privacy or access to any of the home’s premises is kept under review and, if necessary, revised. (Regulation 21(b)(c)(iii)) 01/08/2017

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Recommendations

 Ensure that there are effective working relationships and good communication with relevant persons, in particular parents. (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.3)  Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4) This is with particular reference to the recording of supervisions.

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improvement to be good

Since the last inspection, the quality of the internal decoration has deteriorated. There is damage to walls and equipment. This does not provide a welcoming place for the children to enjoy their short-break experiences, and it does not reassure new children and parents who visit the home. The registered manager arranges for repairs to take place quickly, however the environment continues to be below the expected standard. This is due to recurring incidents.

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improvement to be good

Staff try hard to de-escalate and distract children who are displaying unwanted behaviours, but this is not always effective. During these times, the staff guide other children away from the area in which they are playing or relaxing to a safer location in the home. This disrupts their chosen activity and experience.

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improvement to be good

Children are very aware of the incidents of negative and heightened behaviour, as are the children’s parents. The parents are given the option for their children not to access their short breaks on some occasions when there are particular challenges at the home. This does not provide a consistent service for children, and it is not in keeping with the home’s statement of purpose. Inspection report children's home: SC438751 5 A representative from the placing authority stated, ‘It has been a challenge recently for them [the service] to meet the needs of the young people.’ The increase in the number of incidents happening in the home reflects this. These incidents are often very physically challenging toward the staff and potentially the other children. This has a significant negative effect on the individual experiences of all of the children.

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improvement to be good

Parents who were spoken to during the inspection said that they are not happy with the level of communication from the staff and the management team. One parent said, ‘They [the staff] are very slow to get a response from. The communication has been shocking.’ Parents also feel that communication regarding aspects of their children’s care plans is slow, and they say that children’s items regularly go missing. Meetings are being held to address the concerns, but there has been an impact on the quality of relationships between the staff and parents.

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improvement to be good

The staff build good relationships with the children and they provide nurturing care. The staff are attentive to the needs of the children and they are keen to make sure that the children benefit from their time at the home. The staff encourage social interaction and help the children to feel comfortable in their environment.

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improvement to be good

During the inspection, the staff supported one child to communicate with a spell board. When he was asked by the inspector to share his views about the staff he said, ‘They are very, very, very cool.’ Children trust and know the staff. This helps the children to settle when they are away from their families.

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improvement to be good

Communication books support good links with schools. Meaningful information is shared, which helps to provide smooth transitions before and after the children’s short breaks.

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improvement to be good

The children have complex health needs. The staff support the children with their medication and personal care routines. The staff are responsible for administering and managing a variety of complex medications for most of the children.

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improvement to be good

A recent medication error resulted in a thorough investigation. There is consistent medication training for the staff and there is a clear message to all of the staff to follow the correct medication procedures. Medication management is improving due to the positive changes that have been implemented.

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improvement to be good

The home has experienced a challenging time in recent weeks. One child, who has significant emotional needs, is having an extended stay pending longer term care plans. This child resides in half of the home. This separation of living arrangements has a negative effect on other children because they cannot move around the home freely, and they are not able to access communal areas of the home when they want to. This limits their activity options and choices. Inspection report children's home: SC438751 6 The staff complete risk assessments, however these do not fully reflect the living arrangements for children and potential areas of restriction of liberty. Risk assessments are not reviewed and updated regularly, meaning that there is no clear evaluation of recent incidents. The staff do not add all of the recent incidents to the current assessments in a timely way. This does not provide sufficient safeguards.

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improvement to be good

The staff try hard to protect and safeguard the children in their care. A local authority social worker said, ‘My child seems to be doing well. They [the staff] have had to manage with not much notice.’ However, very extreme physical behaviours present potential hazards to the staff and children. Staff are skilled at trying to engage with the children. However, complex communication difficulties mean that the current behaviour management techniques are not proactive or effective enough. This could potentially result in an injury to a child who is not able to protect themselves.

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improvement to be good

There is no process to assess the impact or matching of placements. Several children have recently presented with very challenging behaviours. The registered manager has not reviewed the behaviour management policies to consider whether changes are required to reflect this significant change.

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improvement to be good

The staff have sufficient knowledge in relation to safeguarding protocols. They are confident in using and following the processes to escalate concerns, and they are aware of the whistle-blowing procedure. The registered manager investigates any concerns thoroughly and seeks advice from the local authority designated officer. This provides clear independent oversight.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has been in post since October 2015 and she has significant experience of working in residential care. She is suitably qualified for her role and she is a qualified social worker. There is a clear staffing framework and two senior service coordinators provide support.

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The effectiveness of leaders and managers: requires improvement to be good

The home accepts emergency placements when the placing authority requests care for children at very short notice. This service is designed to support families who are in crisis. The registered manager does not undertake group dynamic risk assessments to identify the potential impact on individual children within the group environment. This lack of assessment does not ensure that the children experience a calm and relaxing short break.

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The effectiveness of leaders and managers: requires improvement to be good

Since the last inspection, the manager has made efforts to improve the morale of the staff team. Regular meetings take place to discuss any concerns or issues. The staff described the registered manager as being ‘good at her job’ and they said that ‘the management team is supportive’. Inspection report children's home: SC438751 7 Supervisions take place regularly. However, some records of supervisions are unclear and therefore difficult to understand. Tracking of actions and progress is not always evident. This does not demonstrate that previous issues have been fully reviewed.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager monitors the mandatory training programme to ensure that all of the staff attend, and that their training is up to date. New staff are happy with the induction programme provided and they feel well supported.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager promptly addresses staffing issues and she provides support and guidance. This is effective, particularly when it is identified that there are specific areas of development. This improves practice and the level of care provided to the children. There is regular effective internal and external monitoring of the care provided. The registered manager seeks and records views from placing authorities, parents and children. This assists in driving forward improvements.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has met four of the five requirements and both of the recommendations raised at the last inspection. The unmet requirement relates to risk assessments; this requirement is raised again.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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 whom it is trying to help, protect and look after.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, 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’. Inspection report children's home: SC438751 8

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Children’s home details

Registered provider: Action for Children

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Children’s home details

Registered provider address: Action for Children, 3 The Boulevard, Ascot Road, Watford WD18 8AG

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Inspector

Debbie Young, social care inspector Inspection report children's home: SC438751 9 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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