Children's Home run by Action for Children in Surrey

Inspection report children‟s home: SC013743 1 SC013743 Registered provider: Action for Children

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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 home offers long-term care for up to 16 children who have profound and multiple disabilities, including communication difficulties, sensory impairment, complex health needs and challenging behaviour. The home is made up of three separate residential units which cater for particular groups of children. There is currently no registered manager at the home.

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Information about this children’s home

The last registered manager left in July 2018. The provider has recruited to the post.

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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 inadequate

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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: 13 February 2018

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requires improvement to be good

Overall judgement at last inspection: improved effectiveness

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: SC013743 2

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Inspection date Inspection type Inspection judgement

13/02/2018 Interim Improved effectiveness 08/08/2017 Full Requires improvement to be good 22/02/2017 Interim Sustained effectiveness 14/09/2016 Full Requires improvement Inspection report children‟s home: SC013743 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. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) 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; (d) that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child‟s health; (Regulation 12 (2)(a)(i)(d)) In particular, the registered person must ensure that:  risk assessments are reviewed, and, if necessary, updated in an appropriate timescale following any incident;  any actions required following a health and safety check are completed in appropriate timescales;  their development plan improves the environment so that

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Requirement Due date

this is well maintained in all areas. 03/09/2018

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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— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) 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; 03/09/2018 Inspection report children‟s home: SC013743 4 (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(a)(h)) In particular, the registered person must ensure that the interim management arrangements effectively monitor all aspects of the operation of the service and that appropriate action is taken when a concern arises. The registered person must ensure that all staff across the

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Requirement Due date

organisation are clear about:  their roles and responsibilities  escalation processes for concerns about any aspect of the service, to ensure that they are known and used appropriately to identify and rectify issues, especially in relation to health and safety matters. The registered person must— (4) ensure that all employees— (b) receive practice-related supervision by a person with appropriate experience (Regulation 33 (4)(b)) In particular, the registered person must ensure that the supervision meetings are sufficiently frequent. The registered person must also ensure that:  the quality of supervision meetings support staff development and cover poor performance  records provide full detail of meetings undertaken, including the date and full names of supervisor and supervisee. 03/09/2018

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out— (a) how appropriate behaviour is to be promoted in the children‟s home; and (b) the measures of control, discipline and restraint which may be used in relation to children in the home. (2) The registered person must keep the behaviour management policy under review and, where appropriate, revise it. (3) The registered person must ensure that— (a) 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— (i) the name of the child; 03/09/2018 Inspection report children‟s home: SC013743 5 (ii) details of the child‟s behaviour leading to the use of the measure; (iii) the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the

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Requirement Due date

need to use the measure; (vi) the name of the person who used the measure (“the user”), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; (b) within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)— (i) has spoken to the user about the measure; and (ii) has signed the record to confirm it is accurate; and (c) within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (1)(a)(b)(2)(3)(a)(i)(ii0(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)) The quality and purpose of care standard is that children

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Requirement Due date

receive care from staff who— (a) understand the children‟s home‟s overall aims and the outcomes it seeks to achieve for children; (b) use this understanding to deliver care that meets children‟s needs and supports them to fulfil their potential. (2) In particular, the standard in paragraph (1) requires the registered person to— (b) ensure that staff— (ii) protect and promote each child‟s welfare; (Regulation 6 (1)(a)(b)(2)(b)(ii)) In particular, the registered person must ensure that staff keep an accurate and up-to-date chronology of how any safeguarding concern is managed. 03/09/2018 Inspection report children‟s home: SC013743 6 The registered person must also ensure that all staff know about the local agencies who are responsible for safeguarding and which of the agencies they would refer different safeguarding concerns to.

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Recommendations

 The behaviour management strategy should be understood and applied at all times by staff, and must be kept under review and revised where appropriate. In particular, the registered person should review the format of the restraint recording document. This review should assess whether the layout enables staff to properly include all relevant information about restraint incidents. The registered person should also consider whether it is appropriate to refer to mechanical and chemical restraint in the restraint record. („Guide to the children‟s homes regulations including the quality standards‟, page 46, paragraph 9.34)  Staff should be familiar with the home‟s policies on record keeping and should understand the importance of careful, objective, and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information

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Recommendations

about the child must always be recorded in a way that will be helpful to the child. („Guide to the children‟s homes regulations including the quality standards‟, page 62, paragraph 14.4) In particular, the registered person should ensure that all staff have the knowledge and ability to use the home‟s online recording system. Inspection report children‟s home: SC013743 7

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improvement to be good

Children‟s experiences are adversely affected by leaders and managers who have not effectively identified important gaps in practice. For example, leaders have not highlighted deficits in health and safety checks and they have not sufficiently overseen the remedial building works that have been needed. They have failed to appropriately monitor practice and records. Nevertheless, children thrive and have positive experiences here. Staff understand and manage children‟s health needs well. Children‟s education is promoted, and relationships between staff and children are good. Children enjoy spending time with staff and have fun in their company. The staff‟s nurturing, attentive and knowledgeable care of children is unbiased and non- discriminatory. Staff help children to be successfully involved in the local and wider community. Children attend a wide range of group and individual activities, local holiday clubs and

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improvement to be good

trips to places of interest. The staff find new experiences for children to try, as well as making sure that they attend the activities that they know children already enjoy. Plans to help children to move in and move and out of the home are carefully considered and are supported well. A child who recently came to live here has settled in well and her health is improving. Another young person successfully moved on to adult residential services. The pace matched his needs, and records show that his parents thanked the staff for their support in making the transition a success. The staff creatively reflect on which method of communication works best for each child. They consistently use a preferred system to support children to communicate their views; this has helped some children to make significant progress. For example, one child has increased the range of issues that they can express a view on, including

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improvement to be good

telling an inspector that „yes‟ he likes living here. Staff promote children‟s education through good partnerships with schools. The staff incorporate educational goals in each child‟s care plan and they liaise appropriately with education professionals to check that the care that children receive in the home complements and extends the work of the school. Care planning is not well organised, and some records are not well written. Managers have identified the shortfall and are working to improve this area of practice. In part, the issues are due to a new online recording system, as not all staff are confident in using this system and some are unclear about where records are stored. The standard of different parts of the premises is varied. Some areas have a positive and homely feel. The current refurbishment of all three kitchens will provide facilities that promote children‟s involvement in cooking meals and independence. Other areas

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improvement to be good

are worn and tired. The décor has been further damaged by works to the fire system Inspection report children‟s home: SC013743 8 and by difficulties in completing other ongoing maintenance work. Some areas, such as bathrooms and shower rooms, are in need of considerable attention. The responsible individual has extended the organisation‟s proposed programme of work in order to improve the facilities across the site.

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improvement to be good

Some aspects of safeguarding are managed well; staff understand the risks relating to each child and respond effectively to potential safeguarding concerns. The number of safeguarding referrals has decreased considerably over this year. Staff know how to refer safeguarding concerns within the organisation and are confident that managers deal with these appropriately. However, not all staff knew the procedures for referring safeguarding concerns to external bodies or who these agencies are. Managers did not keep a detailed chronology of the management of one serious safeguarding concern. This impeded their ability to maintain an accurate record of who completed each required action, or to check that all the relevant issues have been dealt with. This was a recommendation from the last inspection. Some health and safety assessments were not well evidenced, and some issues that were identified in these assessments had not been actioned. Immediate concerns were

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improvement to be good

rectified during the week of the inspection, but ongoing plans to ensure that health and safety matters are acted on appropriately are not sufficiently robust. Children‟s risk assessments reflect their needs. The assessments provide staff with good advice on how to reduce the likelihood of risk and guide staff on how to manage children‟s behaviour and health needs. Staff understand the risks relating to each child and act in accordance with the risk assessment. However, after one serious incident, the risk assessment was not updated quickly enough. The risk assessment did not include a record of all the actions that staff should undertake. Staff rarely restrain children, and have only done so on three occasions since the last inspection in September 2017. Staff are trained appropriately in the home‟s restraint methods and two staff have recently become the home‟s restraint trainers. Plans are in place to review de-escalation strategies to reduce the number of restraint incidents still

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improvement to be good

further. The recording of restraints is poor. Managers have not met the previous recommendation to monitor restraint records. A senior manager was unaware that this was her responsibility. All three restraint records viewed by inspectors lacked information, and many of the sections were left blank. The template that staff use to record restraint incidents includes sections about whether „chemical‟ and „mechanical‟ restraint has been used. Although managers confirmed that these restraint methods are never used, the inclusion of these terms in the document is confusing and might suggest to staff that these methods are permissible. Behaviour management is effective. The staff nurture and encourage children to behave well. The staff regularly praise children and spend meaningful time with them. Inspection report children‟s home: SC013743 9 Staff understand children‟s needs, likes and dislikes, and carefully consider what each

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improvement to be good

child is feeling and thinking. This is important because most of the children communicate through actions rather than verbally.

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The effectiveness of leaders and managers: inadequate

Leadership and management of the home is poorly organised and largely ineffective. Poor structure and a lack of accountability between the wider organisation and the managers of the home mean that health and safety is not properly overseen, and the standard of décor has deteriorated significantly. There has been a serious lack of urgency in ensuring that issues relating to the property are addressed in good time. For example, the actions that were agreed following fire safety audits undertaken in February 2018 were not progressed. The current interim management arrangements are weak. Oversight of practice is not sufficient to identify and rectify issues effectively; for example, managers have not ensured that an up-to-date legionella assessment is in place. Interim managers are not fully aware of their roles and responsibilities and are struggling to meet these. There are sufficient numbers of staff on duty to meet children‟s needs. Managers

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The effectiveness of leaders and managers: inadequate

continue to use long-term agency staff, some of whom have worked at the home for over a year, to support stability for children. However, there has been an improvement in the retention of staff, with fewer leaving. The organisation continually tries new approaches to improve recruitment and to encourage staff to stay. Staff training programmes are adequate. Courses are mainly delivered online through a national programme. There is a limited annual budget for bespoke training and the availability of face-to-face training courses is sometimes negatively affected by demand across the organisation. There is a good system for monitoring which members of staff have completed necessary training. Records demonstrate that most staff have completed the organisation‟s required training within the expected timescale. This is an improvement. However, concerns about non-completion of training have not been escalated

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The effectiveness of leaders and managers: inadequate

appropriately. Staff supervision is not sufficiently frequent for all staff. Importantly, this includes a member of staff whose performance is being monitored. Supervisors do not follow the home‟s supervision format and the quality of records viewed was generally poor. Nevertheless, the staff spoke positively about the support that they receive and say that it helps them to reflect on and develop their practice. Professionals are positive about how the staff work with them. Even where there are difficulties, they consider the staff responses to issues to be appropriate. Professionals feel welcomed when they visit the home and staff provide them with good information about how a child is progressing or any concerns that the staff may have. The staff promote equality and diversity. They help children to develop a sense of equality and tolerance of others. Staff practice towards children reflects these values.

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The effectiveness of leaders and managers: inadequate

Inspection report children‟s home: SC013743 10

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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: SC013743 11

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Children’s home details

Registered provider: Action for Children

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Children’s home details

Registered provider address: 3 The Boulevard, Ascot Road, Watford WD18 8AG

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Children’s home details

Responsible individual: Shelagh Frankcom

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Inspectors

Ruth Coler, social care inspector Liz Driver, social care inspector Inspection report children‟s home: SC013743 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 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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