Children's Home run by Nottinghamshire County Council in Nottinghamshire

Inspection report for children’s home - monitoring visit: SC036726 1 SC036726

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Nottinghamshire County Council

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This home is operated by the local authority. It provides a residential service for seven children and a short-break service for up to five children. All the children have moderate to severe learning disabilities.

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This monitoring visit

This monitoring visit took place in response to an anonymous complaint about the service. The complainant gave several examples of poor practice, including serious medication errors. The complainant also stated that there are often not enough staff on duty to provide safe care to residents or children receiving short breaks.

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This monitoring visit

At the last inspection, the home was required to ensure that sufficient staff are available to provide good-quality care to each child. Although managers are actively recruiting new staff, the service continues to operate with staff vacancies and a high level of sickness absence.

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This monitoring visit

Over the last month, the number of staff on duty has fallen below the expected level on approximately half of all shifts. This increases the risk of mistakes such as errors in the administration of medication. Staff shortages also affect the quality of care and have an impact on the capacity of staff to spend one-to-one time with children. The short-breaks service has been particularly affected, with seven planned breaks being cancelled in the last month.

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This monitoring visit

The interim manager and assistant managers have covered staff vacancies by regularly placing themselves on the rota. Managers have stepped in at short notice to cover last-minute notifications of absence. This has eased pressure on shift leaders but has had an effect on the quality of essential management tasks.

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This monitoring visit

At the last inspection, weaknesses in the service’s risk assessment and risk Inspection report for children’s home - monitoring visit: SC036726 2 management systems were identified. These shortfalls continue. For example, children have access to a kitchen in the residential area, but staff and managers are not clear about whether children must be supervised at all times when using the kitchen. This inconsistent approach has the potential to confuse children. Also, children might be allowed to take risks that have not been subject to rigorous assessment.

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This monitoring visit

There has also been a lack of clarity over the decision to replace a small number of bedroom light switches with switches that can only be operated by staff. Although well intentioned, it is not clear that the change is necessary or proportionate in every case, or that it has been agreed by managers, parents or social workers.

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This monitoring visit

It was identified at the last inspection that there had not been a robust response to medication errors by managers. Unfortunately, there have been a small number of errors in administering medication in recent weeks. One error was potentially serious. A number of changes have now been made to improve practice. All staff are in the process of receiving more rigorous training that includes an assessment of competencies.

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This monitoring visit

There continues to be a need for effective quality assurance of practice by managers. This includes rigorous review of incidents to identify any patterns or themes which may be linked to staff shortages or staff competencies. It also includes the need to evidence progress made by children from their starting points, and to evidence how the home is supporting them to reach their potential. The interim manager recognises this. She has plans to improve quality assurance. However, because managers have been covering for staff absence, progress has been slower than anticipated.

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This monitoring visit

Despite the pressures placed on staff and managers by staffing shortages, the team remains committed to the service and committed to the care of the children. Interactions with children continue to be caring and nurturing. Staff have not allowed the staffing pressures to affect the way that they communicate with children.

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This monitoring visit

The interim manager has liaised with appropriate services to ensure that staff returning to work are given the support that they need. Staff reported that managers are accessible and visible.

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This monitoring visit

The requirements made at the last inspection are repeated. It is essential that an updated action plan is implemented.

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Recent inspection history

Inspection date Inspection type Inspection judgement 01/08/2018 Full Requires improvement to be good Inspection report for children’s home - monitoring visit: SC036726 3 30/01/2018 Full Outstanding 01/02/2017 Interim Improved effectiveness 01/09/2016 Full Outstanding Inspection report for children’s home - monitoring visit: SC036726 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— 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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies.

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Requirement Due date

(Regulation 12 (1)(2)(a)(i)(ii)(iii)(vii)) 29/03/2019

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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 the effectiveness of the home’s child protection policies is monitored regularly.

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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— 29/03/2019 Inspection report for children’s home - monitoring visit: SC036726 5 helps children aspire to fulfil their potential; and

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Requirement Due date

In particular, the standard in paragraph (1) requires the 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;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child;

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Requirement Due date

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home;

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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.

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Requirement Due date

(Regulation 13 (1)(a)(b)(2)(a)(d)(f)(h))

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Requirement Due date

33: Employment of staff 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.

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Recommendations

 Children should be supported to express themselves as individuals and should be given an appropriate degree of freedom and choice in relation to day to day arrangements for their care. (‘Guide to the children’s homes regulations including the quality standards’, page 17, paragraph 3.21) This is with specific reference to consulting with children regarding preference of gender to provide personal care, if this is required.  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. 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) Inspection report for children’s home - monitoring visit: SC036726 6 This is with reference to reviewing the practice of use of walkie talkies by

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Recommendations

staff while caring for children.  Children must be consulted regularly on their views about the home’s care, to inform and support continued improvement in the quality of care provided. Due consideration should be given to the child’s cognitive ability in the development and implementation of any consultation processes. Children should be able to see the results of their views being listened to and acted upon. (‘Guide to the children’s homes regulations including the quality standards’, page 22, paragraph 4.11)

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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: Nottinghamshire County Council

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Children’s home details

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

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Inspector(s)

Cathey Moriarty, social care inspector Philip Cass, social care inspector Inspection report for children’s home - monitoring visit: SC036726 7 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(s)

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Inspector(s)

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Inspector(s)

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