Children's Home, Residential special school run by St Elizabeth’s Centre in Hertfordshire

Inspection report children's home: 2495377 1 Registered provider: St Elizabeth’s Centre Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This service is run by a large charitable organisation and is registered to provide accommodation for up to 58 children who have special educational needs and/or disabilities. Children attend St Elizabeth’s School, which is on the same site. It caters for pupils aged five to 19 who have complex medical needs, autism spectrum disorder, epilepsy and associated learning difficulties. The home was registered with Ofsted in September 2018. The manager registered at that time.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and/or widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: not applicable

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inadequate

Enforcement action since last inspection: not applicable Inspection report children's home: 2495377 2

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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;

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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

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(1)(2)(a)(i)(b)(d))* 19/04/2019

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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 to aspire to their full potential and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13(1)(a)(b)(2)(h)) 19/04/2019

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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. (Regulation 23(1))

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Requirement Due date

In particular, keep an up-to-date record of medication stock. 01/04/2019

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Requirement Due date

The registered person must ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 and any regulations 01/04/2019 Inspection report children's home: 2495377 3 made under it, except for article 23 (duties of employees), are complied with in respect of the home. (Regulation 25(2)(b))

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Requirement Due date

In particular, ensure that all fire doors meet fire safety regulations.

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Requirement Due date

* These requirements are subject to a compliance notice.

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Recommendations

 The registered person should review the appropriateness and suitability of the location and premises of the home. The review should include the identification of any risks and opportunities presented by the home’s location and strategies for managing these. (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.1)  Any individual appointed to carry out visits to the home as an independent person must make a rigorous and impartial assessment of the home’s arrangements for safeguarding and promoting the welfare of the children in the home’s care. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.5)

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Overall experiences and progress of children and young people: inadequate

This is the first inspection since the home was registered on 26 September 2018.

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Overall experiences and progress of children and young people: inadequate

Significant shortfalls in behaviour management, risk assessment, managerial oversight of practice and internal and external monitoring have resulted in a judgement of inadequate. At times, behaviour management techniques do not respect children’s rights and dignity. Staff have deprived children of their liberty as a means of managing behaviour.

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Overall experiences and progress of children and young people: inadequate

Although children are attending education, have their medical needs met and have positive experiences, this is seriously undermined by the shortfalls in the help and protection that children receive and the leadership and management of the home.

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Overall experiences and progress of children and young people: inadequate

Medication is stored appropriately and administered by trained staff. However, there have been two incidents of staff failing to administer children’s medication correctly. Additionally, on another occasion, staff administered medication that was out of date to a child. Although children have not been harmed, lack of clarity in the records of medication stock means that errors cannot be easily identified and avoided.

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Overall experiences and progress of children and young people: inadequate

Staff encourage children to attend a wide variety of activities at the home, which children enjoy. Children also enjoy activities in the community, such as swimming, bowling, going to the cinema and having meals out. The children learn social skills and have opportunities to mix with their peers. Inspection report children's home: 2495377 4 Staff understand the importance of children attending education. The staff encourage and support children to attend. There is good communication between school staff and residential staff.

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Overall experiences and progress of children and young people: inadequate

The houses have recently been redecorated to a good standard. Many of the children’s ensuite bathrooms have been upgraded. Children are encouraged to personalise their bedrooms. Children are involved, through regular house meetings, in choosing furnishings for their house. Staff listen to and act on children’s wishes and feelings. This helps children to feel settled.

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Overall experiences and progress of children and young people: inadequate

Staff help children to see their families. Parents said that they can contact or visit the home at any time and are always made to feel welcome. Parents and professionals gave positive feedback about the care that children receive.

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How well children and young people are helped and protected: inadequate

Staff have shut children in their rooms as a means of managing aggressive behaviour. There have been incidents in which a child has been physically moved from the lounge into their bedroom, where the door was held shut and, in one case, locked. The training provider for physical intervention confirmed that these techniques are not taught or condoned, as they restrict children’s liberty and are unsafe.

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How well children and young people are helped and protected: inadequate

Risk assessments are not always updated following a serious incident. This does not help staff to understand the current risks and how to manage them safely in accordance with regulations.

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How well children and young people are helped and protected: inadequate

The main grounds of the home are well kept and include a large, well-equipped playground. However, areas immediately outside some of the houses and in some courtyard areas contain broken equipment and rubbish. Items included an upturned picnic bench with protruding screws, piles of wood and roof tiles. Given the limited mobility of some children, this may cause a hazard. The manager made arrangements to clear the rubbish at the time of the inspection.

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How well children and young people are helped and protected: inadequate

The houses are clean and furnished to a good standard. However, during the inspection, not all the fire doors closed tightly. The manager arranged immediate checks and repairs of fire doors because this was raised by an inspector. The lack of effective fire safety checks means that shortfalls and faults may not be identified, which puts children at risk of harm.

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How well children and young people are helped and protected: inadequate

Children have not gone missing from the home. Risk assessments for children who present with low-level behaviours are adequate. However, staff have failed to update some risk assessments for children for whom the risks are more significant. Consequently, these assessments do not reflect current behaviours or equip staff to manage them effectively. Inspection report children's home: 2495377 5

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The effectiveness of leaders and managers: inadequate

Internal monitoring lacks the rigour to identify shortfalls. Managers had not identified a number of the shortfalls that were apparent at this inspection. As monitoring systems are devolved to the staff and managers, leaders have failed to provide oversight and checking. Consequently, there is a lack of accountability. This has led to serious shortfalls in the help and protection of children.

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The effectiveness of leaders and managers: inadequate

External monitoring has identified that staff have shut children in their rooms to manage behaviour. However, this has been reported as an appropriate response and has not been challenged by the independent visitor. A lack of robust challenge when shortfalls are identified means that children do not benefit from the additional safeguard that external monitoring should provide. Additionally, the independent visitor’s reports are not submitted to Ofsted in a timely way.

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The effectiveness of leaders and managers: inadequate

The manager has failed to notify Ofsted of two safeguarding concerns. These include a serious incident in which the police were called. The other incident was an allegation against a staff member. Although managers made sure that children were safe because they referred the concern to the designated officer and followed the officer’s guidance, they did not notify Ofsted as required. Consequently, Ofsted was not able to check the actions that staff took to keep children safe.

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The effectiveness of leaders and managers: inadequate

Staff do not consistently make full and accurate records of physical intervention. They do not always detail the type of hold that was used. This is mainly in relation to incidents of staff using ground holds to manage behaviour. The failure to provide records that are full and accurate hinders effective monitoring to ensure children’s safety.

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The effectiveness of leaders and managers: inadequate

Staff receive regular, supportive supervision that is recorded in detail. All of the staff, including agency staff, have undertaken foundation training in restraint. However, not all staff who require it have been trained in ground-hold restraint. This does not protect children who have to be physically held in this way and could put them at risk of harm.

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The effectiveness of leaders and managers: inadequate

The manager has updated the location risk assessment. However, the assessment lacks depth in respect of the risks posed by the 65-acre grounds. The failure to provide a location risk assessment that includes risks in the immediate vicinity means that staff do not have the comprehensive guidance that they need to keep children safe. Inspection report children's home: 2495377 6

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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: 2495377 7

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Children's home details

Provision sub-type: Residential special school

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Children's home details

Registered provider: St Elizabeth's Centre

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Children's home details

Registered provider address: The Provincialate, 29 Tite Street, London SW3 4JX

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Inspectors

Trish Palmer, social care inspector Ricky D'Arcy, social care inspector Inspection report children's home: 2495377 8 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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