Children's home run by Lincolnshire County Council

Inspection report children’s home: SC043732 1 SC043732 Registered provider: Lincolnshire County Council

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This local authority home looks after children on a long-term basis. All the children accommodated have an identified disability and/or a complex health or medical need. The children are usually aged between nine and 18 years, although they can stay beyond their 18th birthday for a short period when necessary. The home, which is a single-storey new building, can accommodate up to 11 children in two wings.

p.1

Information about this children’s home

There is an appropriately qualified registered manager in place.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

good

How well children and young people are helped and protected good

p.1

good

The effectiveness of leaders and managers requires improvement to be good

p.1

good

The children’s home provides effective services that meet the requirements for good.

p.1

good

Overall judgement at last inspection: good

p.1

good

Enforcement action since last inspection: none Inspection report children’s home: SC043732 2

p.1

Inspection date Inspection type Inspection judgement

09/04/2018 Full Good 06/09/2017 Full Good 07/02/2017 Interim Sustained effectiveness 19/09/2016 Full Good Inspection report children’s home: SC043732 3

p.2

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.

p.3

Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home

p.3

Requirement Due date

the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’)—

p.3

Requirement Due date

has spoken to the user about the measure; and

p.3

Requirement Due date

has signed the record to confirm it is accurate; and

p.3

Requirement Due date

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 (3)(b)(i)(ii)(c)(iv)) 25/10/2019

p.3

Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety. The registered person may only—

p.3

Requirement Due date

employ an individual to work at the children’s home; or

p.3

Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3).

p.3

Requirement Due date

the individual is of integrity and good character;

p.3

Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform; 25/10/2019 Inspection report children’s home: SC043732 4 the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and

p.3

Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2.

p.4

Requirement Due date

For the purposes of paragraph (3)(b), an individual who works in the home in a care role has the appropriate qualification if, by the relevant date, the individual has attained—

p.4

Requirement Due date

the Level 3 Diploma for Residential Childcare (England) (‘the Level 3 Diploma’); or

p.4

Requirement Due date

a qualification which the registered person considers to be equivalent to the Level 3 Diploma. (Regulation 32 (1)(2)(a)(b)(3)(a)(b)(c)(d)(4)(a)(b)) The registered person must ensure that all employees—

p.4

Requirement Due date

undertake appropriate continuing professional development;

p.4

Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

p.4

Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(a)(b)) 25/10/2019

p.4

Requirement Due date

The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once every 6 months.

p.4

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—

p.4

Requirement Due date

the quality of care provided for children;

p.4

Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

p.4

Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

p.4

Requirement Due date

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review (‘the quality of care review 25/10/2019 Inspection report children’s home: SC043732 5 report’).

p.4

Requirement Due date

supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed; and

p.5

Requirement Due date

make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home.

p.5

Requirement Due date

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 (1)(2)(a)(b)(c)(3)(4)(a)(b)(5)) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

p.5

Requirement Due date

helps children aspire to fulfil their potential; and

p.5

Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

p.5

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. (Regulation 13 (1)(a)(b)(2)(f)) 25/10/2019

p.5

Recommendations

 Ensure that staff follow ‘Managing medicines in care homes (March 2014)’. This is with particular reference to taking and recording the temperature of the medication rooms and medication refrigerators. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.17)  The registered person should monitor and review the patterns and trends of turnover of staff, whether agency or directly employed, and be able understand and where possible address, any negative trends. (‘Guide to the children’s homes regulations including the quality standards’, page 54, paragraph 10.19)  Registered persons have a key role in seeking to develop the home’s effective working relationships with each child’s placing authority and with other relevant Inspection report children’s home: SC043732 6 persons which may include services, individuals (including parents), agencies, organisations and establishments that work with children in the local community,

p.5

Recommendations

e.g. police, schools, health and youth offending teams (regulation 5 – engaging with the wider system to ensure children’s needs are met). These working relationships will also be key to success in delivering the care planning standard (regulation 14). (‘Guide to the children’s homes regulations including the quality standards’, page 52, paragraph 10.3)

p.6

Overall experiences and progress of children and young people: good

Children are well cared for and their needs are met. They have formed trusting relationships with staff, and there are a lot of warm and positive interactions. Consequently, children are happy, settled and secure.

p.6

Overall experiences and progress of children and young people: good

A strength of this home, and an area that has improved since the last inspection, is the emphasis on planned and structured activities. Children are going out into the community and accessing facilities such as leisure centres and horse riding. They also do planned activities at the home such as arts and crafts, they use the soft play and sensory rooms and they play in the garden. Their achievements, however small, are celebrated. Children are benefiting from these positive experiences as they are developing skills and confidence as well as having a good time.

p.6

Overall experiences and progress of children and young people: good

Children’s participation is another area of strength. Children are respected, and their views are taken into account both in the day-to-day running of the home and in the provision of their individual care. Care plans are written in the voice of the child, which helps staff retain a focus on child-centred care and support. An advocate visits the home regularly, and this provides an additional opportunity for children to share their views.

p.6

Overall experiences and progress of children and young people: good

Family contact is supported well. Family members are welcomed and encouraged to spend time with their child in the home. A room has been made available for this purpose so that this can be more private. Staff also support visits to see family members away from the home. Relationships between children and their families have improved as a result of this support.

p.6

Overall experiences and progress of children and young people: good

All the children attend school, and education is given a high priority to ensure that children fulfil their potential. Children’s health needs are well met. They are encouraged to eat healthily and they all attend routine and specialist health appointments. Staff have had training to ensure that they can meet the complex health needs of the children. There is good use of the child and adolescent mental health service (CAMHS) to support children and staff.

p.6

Overall experiences and progress of children and young people: good

Staff practice in relation to the safe administration and auditing of medication is good. However, one of the rooms where medication is stored was at a temperature above the recommended level and in another there was not a thermometer to record the Inspection report children’s home: SC043732 7 temperature. In addition, neither of the medication refrigerators were equipped with thermometers; therefore, the temperature for safe storage cannot be assured. These shortfalls have the potential to affect the effectiveness of the medication stored.

p.6

Overall experiences and progress of children and young people: good

Transitions into and out of the home are managed well. Children have planned admissions, including a number of visits to their current placement and visits to the new home. Staff also provide outreach support when children move on to ensure that they settle into the new provision.

p.7

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

Good staffing levels ensure that children are well supervised and well supported at all times, and this helps to keep them safe from harm. No child has gone missing since the last inspection, but staff know what to do if this were to occur.

p.7

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

When there have been safeguarding concerns, managers have cooperated with investigations and improved the practices in the home as a result. Staff have contributed effectively to mapping meetings, and they understand their roles and responsibilities in relation to safeguarding.

p.7

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

Risk assessments and behaviour-support plans are comprehensive, up to date and followed by staff. Staff know children’s vulnerabilities and triggers and they know how to help children to regulate their emotions. Regular consultations with CAMHS provide a further level of insight into how best to support children and provide them with a sense of safety and security.

p.7

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

Given the nature and complexity of children’s needs, on occasions it is necessary to use physical intervention for short periods of time. This is carried out in line with children’s support plans and in order to safeguard children from harming themselves and others. Records of these incidents are detailed. Debriefs with staff are undertaken; however, these are often conducted by a person who has been involved in the incident, rather than someone independent who can facilitate reflection. Children are also offered debriefs, but again this is often carried out by a member of staff who has been involved in the incident. As a result, children are less likely to want to share their feelings. These shortfalls lead to missed opportunities to learn from incidents and ensure that practice in this area remains good.

p.7

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

Although managers are aware of their responsibilities in relation to staff recruitment, documentary evidence to support this was not available on the day of the inspection. For example, not all gaps in employment have been explored, not all staff had two written references, and, where staff have worked with vulnerable adults or children in the past, the reason why that employment ended has not consistently been verified. Therefore, safe staff recruitment practices are not assured.

p.7

The effectiveness of leaders and managers: requires improvement to be good

Staff are very positive about working at this home, citing the supportive staff team as a Inspection report children’s home: SC043732 8 real strength. Staff spoke with warmth and affection about the children and clearly want the best for them. New staff have found the induction to be helpful in enabling them to get to know and understand the children’s needs before they work with them directly.

p.7

The effectiveness of leaders and managers: requires improvement to be good

However, there have been a number of challenges that have had an impact on the operation of the home and the consistency of care. There has been a significant turnover of long-standing, experienced staff in recent months. This coincided with an increase in the number of children accommodated at a pace that was less than ideal due to external factors. The appointment of enough staff to cope with the increasing numbers of children has been a challenge, so the home has been operating with a high number of agency staff on each shift. To mitigate the impact of this, a cohort of agency staff has been contracted to provide consistency. However, not all agency and relief staff have the required childcare qualification despite, in the case of relief staff, them having worked for the home for some years. In addition, managers should explore the reasons for the staff turnover so that they can focus more effectively on supporting staff retention to provide

p.8

The effectiveness of leaders and managers: requires improvement to be good

consistency of care. There has been recent improvement as more permanent staff have been recruited, and they are settling into their roles and building relationships with the children.

p.8

The effectiveness of leaders and managers: requires improvement to be good

Two requirements and two recommendations were set at the last inspection. The requirements, which related to activities and case records, have been met, but the two recommendations, which related to staff supervision and external feedback, have not been achieved. Staff have not been receiving regular, good-quality supervision from a person with appropriate experience. Not all supervisors have had appropriate training in supervision. Records of supervision are limited in scope and quality and do not reflect the importance of this managerial tool to improve practice and develop staff.

p.8

The effectiveness of leaders and managers: requires improvement to be good

Although the home receives some feedback from stakeholders and parents, this is on an ad hoc basis. For example, a compliments and comments book placed in the entrance hall does not facilitate meaningful comment and could breach confidentiality, as it is available for all to read. In addition, the review of the quality of care has not been sent to the regulator for over a year. Although there was evidence that it had been completed, the report did not use feedback from stakeholders and parents to drive improvement.

p.8

The effectiveness of leaders and managers: requires improvement to be good

There is evidence of good partnership working. However, some stakeholders and some parents were not satisfied with the level of communication that they have with the home. When this has been raised, it has improved, but more formal feedback mechanisms may identify this discontent at an earlier stage.

p.8

The effectiveness of leaders and managers: requires improvement to be good

Although children’s needs are met, the objectives and target setting lack timescales and are not detailed and specific enough to enable managers to have a realistic oversight of the progress that children are making. Consequently, managerial monitoring is limited. Monthly progress reports, when completed, give good information about children’s progress and experiences, but these are not completed as regularly as they should be.

p.8

The effectiveness of leaders and managers: requires improvement to be good

Managers are aware of some of the shortfalls identified in this report and they have Inspection report children’s home: SC043732 9 already started to address these, although changes were either in the process of being implemented or were not embedded enough at this stage.

p.8

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.

p.9

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: SC043732 10

p.9

Children’s home details

Registered provider address: Lincolnshire County Council, County Offices, Newland, Lincoln LN1 1YL

p.10

Inspectors

Ros Chapman, social care inspector Rachel Griffiths, social care inspector Inspection report children’s home: SC043732 11 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.

p.10

Inspectors

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.11

Inspectors

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.11

Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

p.11