Clayfields House Secure Unit

Inspection report secure children‘s home: SC036740 1 SC036740 Registered provider: Nottinghamshire 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

This secure children‘s home is managed by a local authority. It is approved by the Department for Education to restrict young people‘s liberty. The children‘s home can accommodate up to 20 young people, who are aged between 10 and 17 years. It provides for up to 14 young people placed by the Youth Custody Service and has up to four places for young people accommodated under section 25 of the Children Act 1989. Admission of any young person under section 25 of the Children Act 1989 who is under 13 years of age requires the approval of the Secretary of State. The commissioning of health services in this home is the statutory responsibility of NHS England under the Health and Social Care Act 2012. Education is provided on site.

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Overall experiences and progress of

children and young people, taking into account Good

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Overall experiences and progress of

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

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Overall experiences and progress of

The effectiveness of leaders and managers Requires improvement to be good

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Overall experiences and progress of

Outcomes in education and related learning activities Outstanding

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Overall experiences and progress of

Overall judgement at last inspection: Declined in effectiveness

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Overall experiences and progress of

Enforcement action since last inspection: None Inspection report secure children‘s home: SC036740 2

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Inspection date Inspection type Inspection judgement

08/03/2018 Interim Declined in effectiveness 23/05/2017 Full Outstanding 06/12/2016 Interim Declined in effectiveness 14/06/2016 Full Outstanding Inspection report secure children‘s home: SC036740 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 ─

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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

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

take effective action whenever there is a serious concern about a child‘s welfare and

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Requirement Due date

that 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 in relation to ensuring that room checks are carried out in line with the risk assessments. 30/09/2018

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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—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

In particular, the standard in paragraph (1) requires the 30/09/2018 Inspection report secure children‘s home: SC036740 4 registered person to—

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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. (Regulation 13 (2)(a))

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Requirement Due date

This is with particular regard to providing evidence that an issue raised by young people has been investigated and resolved.

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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.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

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Requirement Due date

a record is kept of the administration of medicine to each child.

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Requirement Due date

This is in relation to ensuring that young people receive their medication at the correct times. 30/09/2018

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33(3)(b))

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Requirement Due date

This is with particular regard to ensuring that all waking night staff receive supervision in line with the home‘s supervision agreement. 30/09/2018

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Requirement Due date

The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes all required information. (Regulation 35(3)(a)(i-viii))

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Requirement Due date

This is in relation to ensuring that all records of single separation are kept up to date in the appropriate book so that managers can monitor them effectively, and so that young people‘s views are recorded. 30/09/2018

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Requirement Due date

The registered person must establish a procedure for considering complaints made by or on behalf of children. 30/09/2018 Inspection report secure children‘s home: SC036740 5 In particular, the procedure must provide that no person who is the subject of a complaint takes any part in its consideration or investigation, except at the informal resolution stage if the registered person considers it appropriate.

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response, and the outcome of any investigation.

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Requirement Due date

The registered person must ensure that no child is subject to any reprisal for making a complaint or representation.

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Requirement Due date

The registered person must supply to HMCI, at HMCI‘s request, a statement containing a summary of any complaints made during the preceding twelve months and the action that was taken in response to each complaint. (Regulation 39 (3))

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Requirement Due date

This is relation to keeping a record of an issue raised by young people about a member of staff‘s comments to them, and for which no record outlining the investigation and resolution of the matter could be provided.

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Requirement Due date

The independent person must produce a report about a visit (―the independent person‘s report‖) which sets out, in particular, the independent person‘s opinion as to whether—

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Requirement Due date

children are effectively safeguarded; and

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Requirement Due date

the conduct of the home promotes children‘s well-being. (Regulation 44(4)(a)(b)) 30/09/2018

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. (Regulation 45(2)(c)) The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45(5))

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Requirement Due date

In particular it does not evaluate the effectiveness or impact of consultation with placing authorities, staff, children and families and whether further action may be required to improve the quality of care provided to children. 30/09/2018 Inspection report secure children‘s home: SC036740 6

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Recommendations

 When making a decision about arranging care for children in secure children‘s homes, it is good practice for all relevant people involved in the child‘s health care commissioned through NHS England to be informed so there is an integrated approach to health and wellbeing (‗Guide to the children‘s homes regulations including the quality standards‘, page 19, paragraph 3.38). This is with specific reference to carrying out an audit of the infection control measures in the medical room and increasing the number of defibrillators.  The ethos of the home should support each child to learn (‗Guide to the children‘s homes regulations including the quality standards‘, page 29, paragraph 5.18). Specifically, ensure that young people‘s written personal contributions to their independent learning plans are more detailed and do justice to the progress they have made.  The ethos of the home should support each child to learn (‗Guide to the children‘s

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Recommendations

homes regulations including the quality standards‘, page 29, paragraph 5.18). This is in relation to reviewing building arrangements to ensure that practical tasks in the science classroom can be undertaken more effectively.  The behaviour management strategy should be understood and applied at all times by staff, and must be kept under review and revised where appropriate (‗Guide to the children‘s homes regulations including the quality standards‘, page 46, paragraph 9.34). This is in relation to revising the clothes allowed in a young person‘s room when they are on bronze level of the reward system.

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Inspection judgements

Inspection report secure children‘s home: SC036740 7 Overall experiences and progress of children and young people: Good.

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Inspection judgements

Young people make very good progress in all areas of their lives. For many, the positive experiences they have during their time at this home are life changing. For example, a young person recently wrote, `I am unhappy with the life I had been living up to recently and I am looking forward to the chance to make a positive change. I believe I am ready to make the steps needed to make a change for the better and move on with my life.‘ Another young person reported that their key worker ‗is the best thing to have ever happened to me‘.

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Inspection judgements

Relationships are the key to success. Staff are skilled and resolute in the way that they develop relationships with troubled young people. The relationships are strong, trusting and often long lasting. They are robust enough to withstand challenging and disruptive periods. The strength of relationships between young people and staff underpins the way in which behaviour is managed in the home.

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Inspection judgements

Transition and re-settlement arrangements are good. Planning for transition commences when a young person is first admitted. Care plans, assessments of risk and strategies to manage behaviour are reviewed and updated regularly. This keeps them current. The plans to enable young people to move on successfully are clear and very well structured. The home has a strong record in advocating forcefully for young people, particularly when considering future placements.

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Inspection judgements

This is a home where young people have a voice. Levels of consultation are high, helped by the positive relationships between staff and young people. Staff listen to suggestions made by young people and, if appropriate, act on these quickly.

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Inspection judgements

Following assessment, young people benefit from participating in targeted group and individual work. This is an area of strength, with high engagement levels. Young people are able to explore their past behaviour and understand the impact it has on others. As a result, many change their outlook on life and start to make more positive plans for their future.

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Inspection judgements

A new living unit recently became operational. A rolling programme of refurbishment is improving the appearance and facilities in the other living areas. The campus is clean, tidy and fit for purpose.

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Inspection judgements

Healthcare staff provide a good level of physical and mental healthcare to the young people. They are enthusiastic and dedicated to providing good outcomes for those they care for. An appropriate range of primary care services are delivered, without delay, on and off site. Consequently, young people feel well supported by health staff.

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Inspection judgements

Health and well-being needs are identified promptly through the children‘s health assessment tool. A large number of young people are diagnosed with attachment and developmental trauma. These young people receive very good support. Inspection report secure children‘s home: SC036740 8 Specialist staff provide good psychosocial support to all young people and deliver a good-quality programme of education and awareness about substance misuse.

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Inspection judgements

There is good and detailed recording of healthcare needs. Health plans are reviewed appropriately. However, medicine management is of concern. There have been mistakes in the recording and timing of medication administration. Nursing staff have highlighted these issues. However, the concerns remain. Those responsible for administering medication often have other duties that distract them from this key task. The potential for mistakes is high.

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Inspection judgements

The medical room has not had an infection control audit carried out recently. This means that the infection control measures in place may not be effective.

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Inspection judgements

The multi-disciplinary mental health team members work well together. They offer a wide range of interventions, which are individually tailored to improve the mental and emotional well-being of young people. The provision of emotional support and promotion of psychological well-being are strengths in this service.

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Inspection judgements

There is a lack of defibrillators in the home. There is only one defibrillator, located in the education area. This means that there could be an unacceptable delay if it was needed in other parts of the establishment. The defibrillator needs to be maintained regularly, and staff need to be trained to use it.

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improvement

Close multi-disciplinary working enables staff to understand the vulnerabilities that the young person may have. Clear and explicit plans are made so that staff know what they need to do to keep young people safe. While general safeguarding practice is good, there have been occasions when members of staff have not followed the procedures identified in risk assessments to keep young people safe. Although young people came to no harm in these instances, they were nevertheless not as closely supervised as they should have been. Records of observations of vulnerable young people were found to be inaccurate and are now the subject of management review and investigation.

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improvement

Wider safeguarding practice is diligent and thorough. Managers identify any trends or issues and follow them through conscientiously. The sharing of information with wider safeguarding agencies is good. This means that plans are put in place to promote the young people‘s safety.

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improvement

Young people‘s views are valued and encouraged. Young people have a number of ways to raise any issues regarding their treatment. Generally, complaints are appropriately investigated and resolved. However, actions taken in response to a particular young person‘s concerns have not been clearly recorded.

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improvement

Positive behaviour is celebrated and rewarded. Young people are able to earn extra privileges by behaving well. This practice complements the individual programmes which Inspection report secure children‘s home: SC036740 9 enable young people to reflect on their behaviours. However, one feature of the reward system has been questioned by some young people. They believe that a restriction on the number of clothes they can keep in their rooms should be the subject of risk assessment rather than a matter of privilege. Managers have agreed to review this.

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improvement

Single separation and the management of young people away from their peers are appropriately used. Records of these situations are, on the whole, clear and justify the measure taken. However, on one occasion, the measure was recorded in the wrong book and therefore managers did not have an opportunity to monitor the measure. This was a missed opportunity to assess a disciplinary control measure, examine it for fairness and effectiveness, and ascertain the young person‘s views on the issue.

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improvement

Incidents of physical restraint are thoroughly assessed and reviewed by an independent person. Any training needs are identified during these reviews. All young people are offered medical advice and support after an incident of restraint. Debriefing sessions for the young people and members of staff enable everyone to reflect on the incident and learn from it. Consequently, practice in this area is strong.

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The effectiveness of leaders and managers: requires improvement

Independent visitors complete monthly monitoring visits. They provide an overview of care quality and identify shortfalls. However, the independent visitors do not give their view of the safeguarding arrangements or report on young people‘s overall well-being.

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The effectiveness of leaders and managers: requires improvement

The managers conduct internal monitoring that assesses the strengths of the home. However, it fails to monitor the impact of consultation systems and does not indicate whether further action may be required to improve the quality of care. In addition, monitoring systems have not identified potential serious risks to children, for example that some staff have not consistently completed the required visual checks on high-risk children as stated in the child‘s risk assessment.

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The effectiveness of leaders and managers: requires improvement

For the most part, care staff receive regular reflective and structured supervision. However, waking night staff do not receive supervision with the same regularity.

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The effectiveness of leaders and managers: requires improvement

Training programmes reflect the children‘s needs. They provide staff with the skills and knowledge they need. Managers are proactive in seeking external training and providing opportunities for staff to broaden their experience. The majority of staff hold a relevant qualification or are undertaking the appropriate course. Some waking night staff have not been provided with this opportunity, and some have a lower-level qualification. Consequently, not all eligible care staff have the required qualification.

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The effectiveness of leaders and managers: requires improvement

Delegation of roles and responsibilities in the senior leadership team provides clear lines of accountability. As a result, delays in decision-making are avoided. Weekly management meetings between the multi-disciplinary teams ensure that children receive individually tailored packages of care.

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The effectiveness of leaders and managers: requires improvement

The manager notifies all appropriate agencies of significant events. His response to Inspection report secure children‘s home: SC036740 10 incidents is reflective and encourages transparency. As a result, staff have a willingness to learn from incidents and mistakes.

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Outcomes in education and related learning activities: Outstanding

Young people achieve well. They all make better than expected progress in their studies, including mathematics and English. Many gain GCSE qualifications, having had to undertake additional study and homework to do so.

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Outcomes in education and related learning activities: Outstanding

Young people become independent and inquisitive learners. They produce written work and portfolios of a high standard. Young people benefit from a broad and creative curriculum, including enrichment activities that stretch and challenge them. Their learning is managed flexibly, allowing them to cover core subjects and to pursue their own interests such as art or foreign languages. Learning resources are good and well used, but the science classroom is too cramped to allow for practical work.

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Outcomes in education and related learning activities: Outstanding

Young people‘s attendance is consistently good. In the few instances when they become disinterested or disruptive, constructive solutions are always found. Behaviour is very good and young people are respectful and tolerant. Weekly assemblies are used well to celebrate young people‘s achievements and promote the value of education. Young people who have left the home often return to sit external examinations.

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Outcomes in education and related learning activities: Outstanding

Education staff create a constructive and positive learning environment. This environment, combined with excellent relationships between young people and staff, means that young people are receptive to teaching.

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Outcomes in education and related learning activities: Outstanding

Teachers, supported by good teaching assistants, are highly skilled. They have good subject knowledge. They design activities that are enjoyable and enable young people to consolidate their previous learning. Teachers and teaching assistants manage challenging behaviour calmly and sensitively. Teachers cope very well with young people who are at very different levels in their education. Work is well marked with helpful annotations.

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Outcomes in education and related learning activities: Outstanding

Education managers are constructive and self-critical. They are ambitious for the young people and have worked diligently to maintain high standards. Teachers are well managed and supported. Good access to professional development ensures that they keep up to date with their subjects.

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Outcomes in education and related learning activities: Outstanding

Educational assessments, carried out when young people are admitted, are conducted in a positive and optimistic manner. The outcomes of these assessments are quickly conveyed to teachers. The resulting individual learning plans are detailed, and young people‘s progress is well monitored. Although teachers‘ written contributions to the plans are insightful, the personal reviews written by young people are too sparse.

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Outcomes in education and related learning activities: Outstanding

Education staff cooperate well with health, care and intervention teams. Consequently, young people have coherent support at the right time. Inspection report secure children‘s home: SC036740 11

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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 secure children‘s home: SC036740 12

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Children’s home details

Registered provider address: Nottinghamshire County Council, County Hall, Loughborough Road, West Bridgford, Nottingham NG2 7QP

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Children’s home details

Responsible individual: Shelagh Mitchell

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Inspectors

Paul Taylor, social care inspector Natalie Burton, social care inspector Graham Robinson, social care inspector Tony Gallagher, social care inspector Andrea Crosby – Josephs (Health and Justice Inspector – Care Quality Commission) Inspection report secure children‘s home: SC036740 13 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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Inspectors

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Inspectors

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Inspectors

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