Children's home run by Derbyshire County Council in Derbyshire Dales

Inspection report children’s home: SC036186 1 SC036186 Registered provider: Derbyshire County 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

A local authority operates this children’s home, which provides care for up to eight children and young people who have learning and/or physical disabilities, including sensory impairment, under short-break arrangements.

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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: 20 September 2017

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requires improvement to be good

Overall judgement at last inspection: inadequate

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Enforcement action since last inspection:

None Inspection report children’s home: SC036186 2

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Key findings from this inspection

This children’s home requires improvement to be good because:

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Key findings from this inspection

 The manager and staff have not maintained effective communication with partner agencies in relation to addressing safeguarding concerns and providing effective care to young people.

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Key findings from this inspection

 Staff have failed to complete or review safe-care plans, which are designed to identify the risks and vulnerabilities of young people and guide staff practice in managing and reducing risks.

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Key findings from this inspection

 Following a number of medication errors, the medication system has been overhauled. The new medication system has not yet been tested over time to confirm that it is sufficiently robust.

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Key findings from this inspection

 The physical presentation of the home is much improved; however, some work remains, particularly with regard to the outdoor areas, to make the home an acceptable environment for young people to live in.

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Key findings from this inspection

 The manager and senior staff have not been able to recruit new staff to work night shifts. This means that relief staff, or staff from day shifts, have to make up this shortfall.

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Key findings from this inspection

 Staff members have not followed policies and procedures for the benefit of young people. For example, staff have not shared important information about a young person, and are not taking appropriate action.

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Key findings from this inspection

 Since the last inspection, managers and leaders have taken decisive action and developed a detailed and comprehensive improvement plan. They have implemented this plan, leading to improvements across the service.

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Key findings from this inspection

 Young people receive good care from a dedicated and committed staff team. Detailed care plans help to guide staff practice.

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Key findings from this inspection

 Young people enjoy their short breaks. They make friends and have fun, while at the same time their families benefit from a break in their caring responsibilities.

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Key findings from this inspection

 The manager ensures that staff are recruited in accordance with safer recruitment procedures. This minimises the risk of inappropriate adults caring for young people. Inspection report children’s home: SC036186 3

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Inspection date Inspection type Inspection judgement

20/09/2017 Full Inadequate 23/02/2017 Interim Sustained effectiveness 05/10/2016 Full Outstanding 23/03/2016 Interim Sustained effectiveness Inspection report children’s home: SC036186 4

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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

In meeting the quality standards, the registered person must, and must ensure that staff-

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5(d))

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Requirement Due date

This is with particular reference to ensuring that good communication takes place with agencies working with young people. 15/12/2017

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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-

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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. (Regulation 12(1)(2)(a)(i))

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Requirement Due date

This requirement is made in relation to young people’s risk assessments being completed to a satisfactory standard, taking into account known information. 15/12/2017

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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)) 15/12/2017 Inspection report children’s home: SC036186 5

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Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. Children’s homes must comply with relevant health and safety legislations (alarms, food, hygiene etc.); however in doing so, homes should seek as far as possible to maintain a domestic rather than ‘institutional’ impression. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.9)

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Recommendations

 As outlined in 10.1, the registered person should plan staffing levels to ensure that they meet the needs of children and can respond flexibly to unexpected events or opportunities. Staffing structures should promote continuity of care from the child’s perspective. If children complain, or give a view on how the staffing structure could be improved to promote the best care for them, appropriate action should be taken. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.15)

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Recommendations

 The registered person is responsible for ensuring that all staff consistently follow the home’s policies and procedures for the benefit of the children in the home’s care. Everyone working at the home must understand their roles and responsibilities and what they are authorised to decide on their own initiative. There should be clear lines of accountability. Each home must have clear arrangements in place to maintain effective management when the manager is absent, off duty, or on leave. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.20) Inspection report children’s home: SC036186 6

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improvement to be good

This service was inadequate at the last inspection because of significant failures. Young people were not safeguarded, and managers and staff did not promote their welfare effectively. Leaders and managers have taken quick and decisive action to rectify these shortfalls. Evidence from this inspection demonstrates that improvements have been made in a relatively short period of time. However, at this stage, managers are not able to provide evidence of effective and sustained change, and need time to demonstrate this. Additionally, shortfalls identified in this inspection mean that the service requires improvement to be good.

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improvement to be good

Managers and staff have now assessed each young person’s needs for privacy and dignity. Those young people at heightened risk of exposing themselves now have rooms with frosted windows, designed to provide them with the privacy they require to ensure their dignity. These improvements are in line with major improvements made to the fabric of the building. The home has been redecorated throughout, with new soft furnishings including carpets, curtains and sofas. The home is now well presented and feels comfortable. Some bathrooms have been refitted, internal doors have been replaced, and high-level door locks have been removed. The manager has a substantial plan of improvement works for the building. The outside area remains poor, and requires further improvement to be good.

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improvement to be good

Staff and managers develop good, detailed care plans for young people. These plans provide information for staff about the young people they care for. They detail the things that young people enjoy, and promote the overall development of young people. For example, some young people benefit from sensory stimulation, therefore staff provide activities specifically in response to this. Care plans are reviewed on a monthly basis. Information received from families, or from other agencies, is taken into account, and plans are amended accordingly. This means that young people benefit from detailed care plans that are up to date and accurate, and support the care practice of staff.

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improvement to be good

The home continues to provide a highly valued service to families. One parent interviewed in this inspection stated: ‘It is really good, life-saving.’ She described her son as looking forward to his stays, having made good friends since starting the short-break service, and having developed excellent relationships with staff. This parent felt that the staff were very flexible and would alter their care practices in line with the changing needs of young people. She said: ‘They are flexible and change their practices to fit in with the young person. This is vital.’ Consequently, young people enjoy staying at this home and, simultaneously, families receive the break they need.

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improvement to be good

Young people and their families who are new to the service receive good, sensitive support. Staff meet with the family and collate all the required information to provide good and effective care. The young people and their families have the opportunity to visit the home. Transitions are staggered, and at a pace that is right for the young Inspection report children’s home: SC036186 7 people and their families. Partner agencies are contacted and crucial information is obtained to help staff provide good care; this promotes the young people’s development.

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improvement to be good

Leaders and managers have not yet ensured that safe-care plans for young people address their individual vulnerabilities and risks. Plans have not been subject to regular review or updated with information of a safeguarding nature. For example, a safe-care plan for one young person was not reviewed or updated on receipt of important information from a partner agency. In respect of another young person, no safe-care plan was completed at all. The service was relying on a poor-quality risk assessment from another service. This means that the staff who care for young people cannot provide safe care because they do not know about the risk factors affecting the young person, and what action to take. This remains a shortfall.

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improvement to be good

The last inspection identified significant shortfalls in the medication system. There had been several medication errors at the service, resulting in young people receiving out-of- date and/or incorrect medication. In response to these errors, senior managers suspended the service on two occasions. At the point of this inspection, the service had been reopened. The medication system has been completely overhauled, being replaced with a new system that uses additional, robust checks. Additional actions have been undertaken by leaders and managers to ensure that it is safe:

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improvement to be good

 All staff have been retrained and tested on their understanding of the new medication system. This training was delivered by colleagues in the health service, and includes a robust checking and monitoring system to guard against out-of-date and incorrect medication coming into or leaving the service.

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improvement to be good

 Staff practice in relation to medication is monitored through regular and more robust auditing processes.

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improvement to be good

 All staff are subject to improvement action plans to monitor and support their development in relation to medication.

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improvement to be good

 Managers are now subject to rigorous monitoring, training and oversight, and are held to account to ensure that this system is safe, and fit for purpose.

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improvement to be good

These steps are positive and provide an early indication that this new medication system will ensure young people’s safety. However, given that medication errors have the potential for significant and far-reaching consequences, and the system is not yet fully tested, a requirement will remain to ensure that this system is fully effective and safe for young people going forward.

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improvement to be good

The risk to young people of being harmed by those caring for them is minimised due to the manager ensuring that there is strict adherence to safe procedures for recruitment of staff. New staff undergo thorough vetting, including identity checks, before they get to Inspection report children’s home: SC036186 8 work with young people. An applicant’s work history is explored, and any anomalies accounted for in writing. References are sought and verified, and criminal history records are checked. This practice helps to keep young people safe.

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improvement to be good

The manager has created a very good and detailed location risk assessment. The manager considered a wide range of information from local schools and community resources, and focused on areas of concern. She sought the views of police and partner agencies, harnessing this information into an assessment that helps staff to plan for any potential risk in the local area. This helps to safeguard young people and staff when they are in the local area.

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improvement to be good

The health and safety of young people and staff remains a priority for the manager. She has maintained good practice in relation to fire and emergency evacuation procedures. This includes the provision of fire-fighting equipment, emergency escapes being checked regularly, and daily, weekly and monthly testing. Fire evacuation drills take place. This means that young people and staff know what action to take in an emergency.

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

Staff have not ensured that good communication takes place with partner agencies for the benefit and safety of young people. In relation to one young person, a psychologist wrote to the service advising them of work with the young person at school, and expressing some safeguarding concerns. The service did not act on this letter. It did not seek a multi-agency meeting nor liaise further with the psychologist or the school. The member of staff who did not bring the letter to the manager’s attention, either because they failed to recognise its importance or forgot, placed this letter on the young person’s file. This is a shortfall in relation to staff understanding their role and responsibilities in following the home’s policies and procedures. A further shortfall is that there was no communication with the psychologist or school in relation to work planned with the young person. This had important implications for the home, and for young people more

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

The manager is suitably qualified, but is not yet registered with Ofsted. Deputy managers, and an experienced, knowledgeable senior management team, support the manager. They demonstrate a determination to improve the service and make sure that it never ever again fails to meet the expected standards of care.

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

The manager has worked very hard since the last inspection to improve the service. She understands and accepts where things have gone wrong, acknowledging the fact that many of the deficits predated her arrival. She has made some significant changes to the service. The manager has implemented a comprehensive improvement plan. These improvements have included:

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

 Reviewing all of the quality assurance systems, including auditing, to make certain that these are robust and to identify problems early so that effective action can be taken Inspection report children’s home: SC036186 9  Ensuring that all staff and managers are subject to individual improvement plans designed to support their development and monitor their work performance

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

 Significant refurbishment of the building

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

 Senior managers ensuring targeted, unannounced checking of the service

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

 All staff completing a significant amount of training to refresh and improve their practice

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

 Ensuring that managers have reviewed and written new practice guidance designed to help provide staff with direction and clarity over their care practice.

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

Staff have experienced a great deal of uncertainty and anxiety since the last inspection. The entire staff team is subject to improvement plans. Staff remain focused on young people, and want to improve the service and drive forward the improvements required. Staff receive regular professional supervision and guidance in their work. Staff report finding supervision helpful and supportive. Supervision processes have been further bolstered through the implementation of individual improvement plans that keep the staff team on track to improve care practice.

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

Staffing levels have recently changed, with an additional staff member on each shift and the introduction of a redesignation of duties for deputy managers, to provide a safer and more effective service. Each shift now benefits from a staff member who has designated responsibilities for the medication system and updating plans. Additionally, deputy managers will now be able to focus more on their management responsibilities, and this will help with tracking that essential tasks are carried out to an acceptable standard. The manager has not yet been able to resolve the problem of recruiting to the night care team. The manager has to call on relief and day staff to manage this situation. Further work is required to improve this situation.

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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 Inspection report children’s home: SC036186 10 children’s homes regulations including the quality standards’. Inspection report children’s home: SC036186 11

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Children’s home details

Registered provider: Derbyshire County Council

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Children’s home details

Registered provider address: County Hall, Matlock, Derbyshire DE4 3AG

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Inspector

Phillip Morris, social care inspector Inspection report children’s home: SC036186 12 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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