Children's home run by RNIB Charity in Camden

Inspection report for children’s home - monitoring visit: SC485607 1 SC485607

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RNIB Charity

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This is a large children’s home that provides care and accommodation for up to 30 children and young people in five purpose-built bungalows. The children and young people have a visual impairment, a learning and/or physical disability and/or sensory impairment. One of the bungalows is also registered by the Care Quality Commission and provides a specialist service to children and young people who have high health and medical needs who require long-term ventilation, or who have life-threatening or life-limiting conditions. The establishment is owned by a large national charity. The majority of the children and young people attend a registered school on the same site. Some young people remain at the home until the age of 19 to complete their education.

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This monitoring visit

Ofsted completed a full inspection in August 2017 and judged that the home required improvement to be good. The home was then inspected in November 2017 and judged to have sustained effectiveness. A further monitoring inspection took place in December 2017, following Ofsted receiving a number of concerning notifications. These concerns related to healthcare and safeguarding practice. A restriction of accommodation notice was placed on the home following this monitoring inspection. A compliance notice was also served in respect of medication.

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This monitoring visit

On 20 February 2018, a monitoring inspection took place to ensure that the provider had met the compliance notice and had not admitted any further children or young people. The visit found that the compliance notice had been met and no further children or young people had been placed in the home. However, further failures with regards to protecting children and young people were identified. A compliance notice was served in respect of child protection.

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This monitoring visit

This monitoring inspection took place following Ofsted receiving a notification from Inspection report for children’s home - monitoring visit: SC485607 2 the provider relating to potentially abusive practice towards a child.

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This monitoring visit

Ofsted was notified, by the provider, of a significant child protection concern on 26 February 2018. The incident occurred on 20 February 2018. No actions were taken by the organisation until 25 February 2018, when a member of staff raised concerns with senior managers. This then prompted an appropriate response from the provider, and actions were taken to protect children and young people. The delay in this incident being effectively addressed placed children and young people at significant risk. A member of staff unilaterally changed a child’s agreed plan for managing specific behaviours on 20 February 2018. Although the placing service was made aware of the change, it was not made aware of how the new strategies would be implemented. This led to a child being treated in a potentially abusive manner. This also happened on 21 February 2018, with the same child. The provider has now taken effective actions, and relevant professionals are involved in

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This monitoring visit

The provider has failed to ensure that risk is effectively managed with regards to specific behaviours that children and young people may exhibit. This means that staff lack clarity and guidance about how to manage these behaviours. There is an existing compliance notice in place for the provider’s failure to ensure that effective actions are taken when there are serious concerns. A further compliance notice, relating to how risk is managed, has also been served on the provider.

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This monitoring visit

Management systems remain ineffectual in the home. The registered manager and registered provider are being supported by external management consultants. However, there continue to be serious issues occurring in the home. Quality assurance systems are failing to identify these quickly. For example, incidents are only identified by staff raising concerns several days after the event. There are widespread systemic failures in how leaders and managers ensure that the care provided to children and young people is safe, effective and appropriate. The provider has failed, and continues to fail, to use monitoring and review systems to make continuous improvements in the quality of care provided in the home. This shortfall is further affected by failures in how the registered manager and responsible individual respond to concerns when they do arise. For example, during this inspection visit, the inspector noted further concerns about the safety of a child

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This monitoring visit

that had not been referred to the appropriate statutory agencies. Ofsted ensured that these concerns were referred to the local safeguarding authority. The lack of skill shown by the registered manager and responsible individual is a significant concern.

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This monitoring visit

There are currently four individual residences for children and young people in use. The inspector reviewed children’s and young people’s risk management plans with specific reference to managing pubescent development. The majority of these plans are appropriate and contain sufficient detail for staff to provide effective care. However, there are inconsistencies and concerns in some plans: Inspection report for children’s home - monitoring visit: SC485607 3  Some young people have risk assessments that lack detail about how bathing should be managed and what risks, if any, are present.  Some plans are not individualised to the young person and have clearly been adapted from other young people’s plans with only names and gender references changed.  There are references to the sexuality of young people but no explanation as to the relevance of this recording.  Where young people require specific boundaries with regards to ‘hugs’ and

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This monitoring visit

‘cuddles’ from staff, there is no clarity of guidance in plans to determine how this should be undertaken.  One child has no recorded guidance on promoting sexual health or well- being.

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This monitoring visit

Where risk is noted, it is not clear to staff how to provide effective care. This also means that, in some instances, the privacy and dignity of children and young people is negatively affected. The inconsistent approaches across the four residences further demonstrate the lack of skill of the registered manager and provider in providing consistent care to children and young people. This shortfall is further affected by staff not having relevant training in how to provide effective adolescent care.

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This monitoring visit

During the inspection visit, the inspector was told of a medication error. A young person’s prescribed dosage of medication was not recorded and appeared to be missed. This happened on 22 February 2018 and was not identified until 27 February 2018. A member of the care staff noted this discrepancy and raised concerns with senior managers.

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This monitoring visit

This inspection visit has identified significant concerns with how the safety and welfare of children and young people is promoted. The restriction of accommodation notice remains in place until 14 March 2018. A compliance notice will also be served. The provider also has further requirements outstanding from the monitoring inspection of 20 February 2018, which are included in this report.

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Recent inspection history

Inspection date Inspection type Inspection judgement 20/11/2017 Interim Sustained effectiveness 22/08/2017 Full Requires improvement to be good 29/03/2017 Interim Declined in effectiveness 14/11/2016 Full Good Inspection report for children’s home - monitoring visit: SC485607 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

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—

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Requirement Due date

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.* (Regulation 12 (1)(2)(a)(i)) 30/04/2018*

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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—

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Requirement Due date

that staff understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person

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Requirement Due date

that staff take effective action whenever there is a serious concern about a child’s welfare.* (Regulation 12 (1)(2)(a)(v)(vi)) 30/04/2018*

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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 aspire to fulfil their potential and promotes their welfare. (Regulation 13 (1)(b)) 30/04/2018

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Requirement Due date

The leadership and management standard is that the registered person must—

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Requirement Due date

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

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Requirement Due date

ensure that the home’s workforce provides continuity of care 30/04/2018 Inspection report for children’s home - monitoring visit: SC485607 5 to each child

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(a)(c)(e)(h)) 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)) 30/04/2018

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Requirement Due date

A responsible individual must have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated. (Regulation 26 (7)(b)) 30/04/2018

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Requirement Due date

A person may only manage a children’s home if, having regard to the size of the home, its statement of purpose, and the number and needs (including any needs arising from any disability) of the children, the person has the appropriate experience, qualification and skills to manage the home effectively and lead the care of children. (Regulation 28 (1)(b)(I)) 30/04/2018

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Requirement Due date

The registered manager must undertake such continuing professional development as is necessary to ensure that the registered manager has the skills needed for managing the home. (Regulation 29 (4)) 30/04/2018

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Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development. (Regulation 33 (4) (a)) 30/04/2018

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Requirement Due date

The registered person must prepare and implement a policy which is intended to safeguard children accommodated in the children’s home from abuse or neglect; and sets out the procedure to be followed in the event of an allegation of abuse or neglect. The procedure to be followed in the event of an allegation of abuse or neglect must, in particular, provide for the prompt referral of an allegation about current or ongoing abuse or neglect in relation to a child to the placing authority and, if different, the local authority in whose area the home is located. (Regulation 34 (1)(a)(b)(2)(b). 30/04/2018

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if there is any other incident relating to a child which the registered person considers to be serious. 30/04/2018 Inspection report for children’s home - monitoring visit: SC485607 6 (Regulation 40 (4)(e))

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Requirement Due date

*These requirements are subject to a compliance notice.

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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.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: SC485607 7

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Children’s home details

Registered provider address: c/o RNIB, 105 Judd Street, Camden, London WC1H 9NE

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Inspector

Pete Hylton, social care inspector Inspection report for children’s home - monitoring visit: SC485607 8 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, 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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