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 and 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

A monitoring visit took place on 13 December 2017 due to a high number of concerning notifications relating to safeguarding practices and medication errors. Considerable shortfalls were identified with meeting young people’s overall healthcare needs, and safeguarding procedures to protect children were poor. The outcome of the visit on 13 December 2017 was that a compliance notice was issued in relation to medication practices and five requirements were made. A notice restricting accommodation was issued to ensure that other young people do not move in to the home.

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This monitoring visit

This monitoring inspection took place to ensure that the restriction notice had been complied with, to review the progress made since the last monitoring visit and to review the compliance notice and requirements.

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This monitoring visit

This visit has raised serious concerns about safeguarding and care practices within the home. Inspection report for children’s home – monitoring visit: SC485607 2 Progress since the last inspection visit has been significantly slow with regards to improving the protection of children. Staff are familiar with child protection policies but these policies are flawed. For example, inspectors were told, during the inspection visit, that the safeguarding policy was not available as it is under review. The corporate policy provided contained little relevant information. This means that staff do not have clear guidance about how to safeguard young people. This shortfall has previously been identified at the interim inspection and the last monitoring visit.

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This monitoring visit

Staff have received safeguarding training. However, this training requires improvement. This is because it does not equip staff with the required knowledge to properly progress concerns about the safety and welfare of young people. Staff spoken to during this inspection did not know about the role of the multi-agency safeguarding hub or understand that they could refer child protection concerns directly to this team. This is because the training is not clear. It is heavily focused on internal organisation processes and makes reference to adult services. In addition, staff are not made aware that concerns need referring to both the host authority and young person’s placing authority (if they are different). The organisation’s policy relies too heavily on managers making decisions about whether a concern is of a safeguarding nature rather than referring the concern to the local safeguarding team. This means that there is the potential for difference in opinion and for delay in

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This monitoring visit

decision making. This places children at risk.

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This monitoring visit

Since the last inspection, the registered manager has again failed to follow safeguarding processes properly. The registered manager did not take effective action regarding a serious concern about a child’s welfare. Staff on duty shared their concerns immediately with her in writing and verbally about the potential of harm to a child. The registered manager (in her role as designated safeguarding lead that evening) did not refer this to the emergency duty team.

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This monitoring visit

The member of staff referred to in the allegation remained on shift during this time and appeared at the hospital with the young person the next day. Staff referred this matter to the National Society for the Prevention of Cruelty to Children due to the poor response from the registered manager and other managers in the home. The registered manager does not have the necessary skills to ensure that safeguarding processes are followed competently to protect young people. As a consequence, safeguarding failures within the home persist.

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This monitoring visit

As a result of the above concern, staff shared worries about a comparable incident that took place in October 2017 involving another young person and the same member of staff. Ofsted were not notified of this potentially serious event. Detailed records of the alleged incident and follow-up actions were not available during this inspection. The registered manager did not refer this matter to the multi-agency safeguarding hub or to the local area designated officer. This means that the registered manager has failed to share this information. This could place young people at further risk of harm. Inspection report for children’s home – monitoring visit: SC485607 3 Since the last monitoring inspection, there has been a reduction in the number and severity of medication errors. Although there have been errors, these have been swiftly identified the same day, advice from a health professional has been sought

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This monitoring visit

and a ‘lessons learned review’ completed of all incidents. There have been no serious shortfalls with regards to staff meeting the healthcare needs of young people. There is increased oversight by managers to drive improvement. Nearly all staff have now received updated medication training. There is a new nurse manager overseeing the complex healthcare needs of young people. There are two care consultants overseeing the required changes for the safe administration and recording of medication. Medication checks, stock takes and increased monitoring are now in place to improve the administration of medication. The medication policy and training have been improved to assist staff in their care of young people.

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This monitoring visit

Since the last monitoring inspection, all staff have now received a formal, practice- related supervision. A care consultant is ensuring that supervision takes place and to a good-enough standard. Previously, many staff had not had supervision for several months. Notes of these sessions are now of a good standard, and training and professional development are discussed as part of supervision. However, this will need future monitoring to ensure that it is sustained.

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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 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 *

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Requirement Due date

(Regulation 12 (1) and (2)(a)(v)(vi)) 30/04/2018

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Requirement Due date

The leadership and management standard is that the registered person must 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 use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1) and (2)(a)(h)) 23/02/2018

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Requirement Due date

The registered person must ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13 (2)(c)) 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)) 23/02/2018

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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 person must prepare and implement a policy which is intended to safeguard children accommodated in 30/04/2018 Inspection report for children’s home – monitoring visit: SC485607 5 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) and (2)(b) 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. (Regulation 40 (4)(e)) 30/04/2018

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Requirement Due date

*This requirement is 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.

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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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Inspectors

Anna Gravelle, social care inspector Pete Hylton, social care inspector Inspection report for children’s home – monitoring visit: SC485607 6 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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Inspectors

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Inspectors

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Inspectors

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