Children's home run by Derby City Council in Derby

Inspection report children‘s home: SC065730 1 SC065730 Registered provider: Derby City Council

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a local authority children‘s home that provides short breaks for up to 10 children and young people who have sensory impairment and/or learning disabilities and/or physical disabilities. The trust that provides the nursing care is registered with the Care Quality Commission and subject to separate inspection.

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Information about this children’s home

Inspection dates: 25 to 26 September 2017

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Overall experiences and progress of

children and young people, taking into account

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good

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

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good

The effectiveness of leaders and managers requires improvement to be good

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good

The children‘s home provides effective services that meet the requirements for good.

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good

Date of last inspection: 2 February 2017

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good

Overall judgement at last inspection: Sustained effectiveness

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Key findings from this inspection

 Children and young people have positive, enjoyable and enriching experiences Inspection report children‘s home: SC065730 2 during their short breaks at this home.  Their needs are well met by experienced and knowledgeable staff who know them well.  Residential and nursing staff provide care which meets the social and medical needs of children and young people.  Staff communicate well with schools and with parents. This promotes consistency between the short break service, schools and home.  Parents and professionals say the service is highly beneficial to the experiences of children and young people.

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Key findings from this inspection

The children‘s home‘s areas for development:

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Key findings from this inspection

 Safeguarding practice requires improvement. This includes risk assessment of children and young people, supervision of children and young people, recruitment of agency staff, fire safety procedures and updating the locality risk assessment.  Leadership and management requires improvement. This includes supervision frequency, case records, the workforce plan and submission of an up-to-date statement of purpose to Ofsted.

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Inspection date Inspection type Inspection judgement

02/02/2017 Interim Sustained effectiveness 11/10/2016 Full Good 19/01/2016 Interim Sustained effectiveness 27/08/2015 Full Good Inspection report children‘s home: SC065730 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 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—

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Requirement Due date

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.

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Requirement Due date

This is in reference to the risk of missing from care and risks associated with self-injurious behaviour. The manager must ensure that there are up to date, detailed and specific risk assessments, and clear strategies to reduce harm, and detail how these will be implemented and monitored.

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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—

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Requirement Due date

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 harm.

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Requirement Due date

This is with particular reference to ensuring the supervision of young people as stated in care plans.

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. 11/10/2017 Inspection report children‘s home: SC065730 4 (Regulation 16(3)(a)(b)) After consultation with the fire and rescue authority, the registered person must ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children‘s safety. The requirements are that full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2.

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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. This is with particular regard to ensuring that all staff receive well-coordinated and regular supervision.

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Requirement Due date

The registered person must maintain records (―case records‖) for each child which— include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry.

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children‘s home at least once in each calendar year taking into account the requirement in regulation 12(2)(c) (the protection of children standard). When conducting the review, the registered person must consult, and take into account the views of, each relevant person.

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Recommendations

 The registered person should have a workforce plan which can fulfil the workforce related requirements of regulation 16, schedule 1 (paragraphs 19 and 20). The plan should: Inspection report children‘s home: SC065730 5 Detail the necessary management and staffing structure, (including any staff commissioned to provide health and education), the experience and qualifications of staff currently working within the staffing structure and any further training required for those staff, to enable the delivery of the home‘s statement of purpose; Detail the processes and agreed timescales for staff to achieve induction, probation and any core training (such as safeguarding and health and safety and mandatory qualifications); Detail the process for managing and improving poor performance; Detail the process and timescales for supervision of practice (see regulation 33 (4) (b)) and keep appropriate records for staff in the home.

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Recommendations

The plan should be updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home‘s manager. (‗Guide to the children‘s homes regulations including the quality standards‘, page 52, paragraph 10.8)

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Overall experiences and progress of children and young people: good

This short-break provision provides good experiences for children and young people. The service provides care for children and young people who have diverse and complex needs. These needs include learning disabilities, autistic spectrum disorders, significant health needs, physical disabilities and sensory impairments. The residential and nursing staff ensure that children and young people receive good quality care and support. Shortfalls in safeguarding and in leadership and management do not currently impact on the experience and progress of children and young people.

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Overall experiences and progress of children and young people: good

Children and young people are nurtured and valued. They develop positive relationships with staff. This helps children and young people to feel secure and settled within the service. Consequently, parents, families and carers feel confident about letting their children have short breaks away from their home. One parent said: ‗They know him well, he knows them, and they know what he likes.‘

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Overall experiences and progress of children and young people: good

Managers and staff carefully consider and assess placements. A wide range of issues influence the timing of short breaks. Essentially, managers focus on ensuring the compatibility of the group, to promote positive group dynamics. In some cases, this careful matching promotes friendships. In other cases, it enables shared interests. Some children and young people need personal space. In such cases, managers plan short breaks with sufficient staff to allow individual activities and a quieter environment.

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Overall experiences and progress of children and young people: good

Admissions to the service are sensitively planned. A programme of introductions enables children, young people and their families to get to know the service. Introductions increase from teatime visits to overnight stays. Partnership work with parents and carers is strong. Parents and professionals confirm that positive introductions to the service Inspection report children‘s home: SC065730 6 have been essential in minimising disruption to children and young people. One parent said: ‗He has settled in really well – we are surprised!‘ Successful introductions lead to increased short breaks. Many young people have enjoyed short breaks, which have spanned from their childhood to their teenage years.

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Overall experiences and progress of children and young people: good

Some children and young people are non-verbal or have communication difficulties. Staff use a variety of communication methods to explain routines and provide choices. Staff are keen to promote improved communication with children and young people. This ensures that children and young people can contribute their views, choices and wishes in their day-to-day living. In addition, the service has set up the children‘s council and provided a suggestions box. This further increases the participation of children and young people.

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Overall experiences and progress of children and young people: good

Children and young people do not spend more than 75 days a year at this provision. Parents and carers are responsible for their children‘s educational and healthcare needs. However, during short-break stays staff support children and young people in their daily routines. Education is promoted. Children and young people continue to attend school and other educational provisions. Routines ensure that children and young people are rested and prepared for the school day. Staff communicate with schools and with parents through the use of communication books. This promotes consistency between the short-break service, school and home.

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Overall experiences and progress of children and young people: good

The complex health needs of the children and young people require high levels of medical and social care planning. They receive care and support from qualified nursing and residential care staff. Nursing staff provide 24-hour support to attend to the health needs of children and young people. A lead nurse supervises the nursing staff. Medication is administered, recorded and audited by the nursing staff. The lead nurse has overall responsibility for ensuring that arrangements for the administration of medicines are safe.

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Overall experiences and progress of children and young people: good

Managers and staff work within a constrained budget, so have to be creative with their ideas for activities. Despite this, children and young people continue to enjoy positive and enriching activities when they visit this service. They have opportunities to enjoy activities of their choosing. They enjoy the purpose-built facility, where they have space, both indoors and outdoors, to expend energy and have fun. The can choose from mobility-friendly playground equipment, bikes, trikes and scooters. Staff support all children and young people to take part in activities, regardless of mobility. This helps them to strengthen their bodies, improve coordination and improve muscle tone. They have lovely gardens, with a vegetable and herb plot. Inside they can relax and play in the sensory and soft rooms. Children and young people are taken on trips within the community and to places of interest. Pantomime tickets are already booked for

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improvement to be good

Safeguarding incidents in this short-break service are rare. There have been no Inspection report children‘s home: SC065730 7 significant incidents since the last inspection. Parents and professionals confirm that they have no concerns about the service keeping children and young people safe. However, some safeguarding arrangements need improvement. There are no serious or widespread failures that leave children or young people at risk of harm.

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improvement to be good

Risk assessments for children and young people are variable in quality and detail. Some risk assessments are poor. They are out of date, inaccurate and lack detail. This means that they fail to provide clarity to staff. When risks are assessed as high, records lack strategies to manage, track or review risks. This relates particularly to self-injurious behaviours.

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improvement to be good

Children and young people have plans, which outline required staffing ratios. This means that children and young people are provided with a level of supervision which keeps them safe. Managers check that staffing levels are maintained. This inspection found that some staff had not adhered to agreed staffing ratios. Although an isolated incident, this demonstrated that some staff do not fully understand their roles and responsibilities in relation to protecting children and young people. While managers have taken immediate action to investigate this shortfall, it will be set as a requirement.

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improvement to be good

There have been no incidents of children or young people going missing from the short- break service. The staffing ratios and monitoring keep children and young people safe. Children and young people have individual missing from care protocols. However, they are scant in detail and don‘t reflect known risks. This means that staff do not have clear plans to follow in the event that a child or young person goes missing.

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improvement to be good

Physical interventions have not been used since the last inspection. Behaviours are managed through diversion and de-escalation. Managers are aware that not all staff have completed physical intervention training. Managers ensure that each shift has a member of staff who has the required training. However, managers need to take a robust approach to ensure that all staff have successfully completed this mandatory training. It is important that all staff have the necessary skills to undertake physical interventions, if required.

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improvement to be good

Staff recruitment processes are not consistently robust. This is with specific reference to the checks undertaken on agency staff. There is a need to ensure that all necessary documents are reviewed prior to new appointments being made, in particular the training and qualifications of agency staff.

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improvement to be good

Health and safety arrangements in the service are priorities. The prescribed level of public and employee liability insurance is in place. The service has a continual programme of maintenance. This ensures that any damage is repaired and that remedial work is undertaken. Managers ensure that regular health and safety checks are carried out. This includes checking fire equipment. The registered manager completed a rigorous location risk assessment, but the annual review of risk is now required. The location risk assessment demonstrates that managers are up to date about risks in the locality. Inspection report children‘s home: SC065730 8 Fire safety is an area which managers have started to improve on. Staff learn about fire safety as part of their induction and formal training. Children, young people and staff take part in fire evacuation drills and simulations. However, managers are not able to show that all children, young people and staff have taken part in a drill. In addition,

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improvement to be good

records do not show the response and effectiveness of the fire drills. This means that managers cannot be sure that all children, young people and staff are aware of the procedure to follow in the event of a fire.

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improvement to be good

The majority of staff have good safeguarding knowledge. All staff have received mandatory safeguarding training. Also, some staff have had specific child protection training. This training includes awareness of radicalisation and extremism, sexual exploitation, internet safety and social media. This ensures that staff know how to respond to safeguarding concerns.

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

The registered manager is experienced and well qualified. She has completed her level 5 diploma in leadership in health and social care. This means that she has the required qualification to manage the home. Two knowledgeable and experienced assistant managers support her.

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

Managers provide daily support to the staff team. Staff say that managers are approachable and supportive. However, staff supervisions have not taken place as frequently as outlined in procedures. This does not support managers to have oversight of staff performance or enable childcare practice to be monitored.

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

The registered manager has a workforce development plan. This provides an overview of staffing arrangements. Managers use a separate training matrix to show staff training. This is not accurate or up to date. This means that managers are not clear about the training needs of staff. It also means that the independent visitor and inspectors are unable to get an accurate overview of staff training.

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

Case records are not consistent. They do not always contain the documents required in regulation, such as education and health plans. Care plans are variable in quality and content. They are not kept up to date, signed or dated. This does not give a clear picture of care planning and progression.

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

The statement of purpose provides a guide to parents and placing authorities. It outlines the aims and objectives of the service and the care provided. This document requires amendment to ensure that it contains all of the matters specified in regulation. This includes an up-to-date staff list. The manager needs to ensure that a copy is provided to Ofsted.

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

Partnership arrangements with parents and health, education and social care professionals are positive. Parents and professionals report high levels of satisfaction with the quality of care. They confirm that children and young people have positive experiences in their short breaks. Importantly, managers and staff communicate well. Inspection report children‘s home: SC065730 9 They make sure that parents and professionals receive updates on all matters.

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

Managers report that staff morale has not been good. This is due to the impact of budgetary pressures. Despite this, staff say that they enjoy their work and remain dedicated to their roles. They have ensured that shifts are covered where needed. This has reduced the need for agency staff. Consequently, children and young people benefit from care provided by staff who know them well.

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

The registered manager is clear about the shortfalls identified within this inspection. She is committed to taking decisive action to rectify the shortfalls.

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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: SC065730 10

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Children’s home details

Registered provider address: Treasurers Department, Council House, Corporation Street, Derby DE1 2FE

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Inspector

Amanda Ellis, social care inspector Inspection report children‘s home: SC065730 11 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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