Children's home run by The Percy Hedley Foundation in North Tyneside

Information about this children’s home

The home accommodates up to 20 children or young people who have sensory impairment and/or learning disabilities and/or physical disabilities. The Percy Hedley Foundation operates the home.

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Information about this children’s home

Previous inspection date: 24 October 2018

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Information about this visit

Due to COVID-19 (coronavirus), Ofsted suspended all routine inspections in March 2020. As part of a phased return to routine inspection, we are undertaking assurance visits to children’s social care services that are inspected under the social care common inspection framework (SCCIF).

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Information about this visit

At these visits, inspectors evaluate the extent to which:

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Information about this visit

 children are well cared for  children are safe  leaders and managers are exercising strong leadership.

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Information about this visit

This visit was carried out under the Care Standards Act 2000, following the published guidance for assurance visits.

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Information about this visit

Her Majesty’s Chief Inspector of Education, Children’s Services and Skills is leading Ofsted’s work into how England’s social care system has delivered child-centred practice and care within the context of the restrictions placed on society during the COVID-19 pandemic. Assurance visit report: 1234323 2

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Findings from the visit

We identified the following serious and widespread concerns in relation to the care or protection of children at this assurance visit:

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Findings from the visit

 safeguarding arrangements are ineffective and do not protect children and young people from harm  staffing levels are insufficient to ensure the safety of children and young people and in some cases are not at the required levels  children and young people’s complex health needs have been significantly compromised due to inadequate medication procedures  staff do not fully understand children and young people’s complex health needs  children and young people are physically held by staff in response to crisis situations without appropriate records being completed and therefore the safety of such holds is not known  not all staff are trained to meet the complex needs of children and young people  leadership and management of the service is poor. Monitoring of the service is insufficient, resulting in poor-quality care for children and young people.

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The care of children

There are serious and widespread concerns in several areas of practice relating to the care that children and young people receive. This places them at serious risk of harm. Such practice has resulted in actual harm on one occasion and other practice has left some children at risk of loss of life.

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The care of children

The health of multiple children and young people has been compromised as they have not received the correct medication, including controlled medication prescribed for their enduring health needs. The manager was aware that there are medication errors, but has been ineffective in preventing further errors. Inspectors found a medication error during the visit that the manager was not aware of.

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The care of children

Not all staff are trained to administer the more complex health procedures, such as emergency rescue medication, to meet the needs of children who have epilepsy. This places children at serious risk of harm and in some cases, this could include loss of life.

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The care of children

A high turnover of staff means that some staff are not familiar with the emotional, behavioural and health needs of the children and young people, and therefore do not respond appropriately. A parent reported that staff ‘don’t pick up on seizures’ and that the ‘care he (his child) receives is lacking and concerning’. Assurance visit report: 1234323 3 The manager has failed to ensure that medical consent records for children and young people contain all their personal details and relevant health needs. This oversight may prevent children and young people from accessing emergency healthcare should this need arise.

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The safety of children

Children and young people are not safe in this home. There has been a serious incident in which a child suffered actual harm. This incident occurred despite a risk assessment being in place which detailed specifically the risks to the child and the supervision arrangements needed to militate against these risks. Staff did not follow this risk assessment.

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The safety of children

A further incident involving a fire occurred in the home due to a build-up of dirt in an oven. This was potentially harmful to the wider group of children and young people. This incident was not notified to Ofsted, preventing the regulator having oversight of the safeguarding measures to protect children and young people.

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The safety of children

Staff described working 15-hour shifts without a break. This presents the risk of further incidents occurring that may expose children to harm and impacts on the quality of care that children and young people receive. One family member commented, following injuries sustained, that her child was not listened to when the child tried to report being hurt by another child. This led to the child being further harmed.

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The safety of children

Children and young people are held by staff in response to displays of crisis behaviour. However, there are no individual records for each incident that detail the necessary information to determine if the hold was necessary and safe. There are no details of whether medical attention was needed or administered. There is evidence that children and young people have expressed unhappiness at being held during a crisis, but there are no records for the debriefs of children, young people or staff. The management oversight of such incidents is insufficient to ensure that the practice is safe and that the views of children and young people are heard and acted upon.

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The safety of children

A significant proportion of the staff team are not trained or up to date with their training in physical intervention. Staff showed a lack of understanding and knowledge about the use of physical intervention and restraint. These issues expose children and young people to a potential risk of harm. The manager confirmed that the accounts given by some staff following physical interventions change when they are questioned and records for such incidents are not kept. The lack of records prevents the manager from scrutinising this practice to ensure that it is safe, necessary, proportionate and protects children and young people from harm.

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The safety of children

There are incidents in which children and young people have become injured, such as when one child or young person attacks another. Body maps were not completed following these incidents. This shows that there is the potential for children and Assurance visit report: 1234323 4 young people, including those with additional communication needs, to have their medical needs left unattended.

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Leaders and managers

Leaders’ and the manager’s knowledge base and skills are ineffective in ensuring that children and young people are safe from harm as found in the shortfalls identified at this visit.

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Leaders and managers

The monitoring systems to review and evaluate the care that children and young people receive are not effective and, in some instances, do not exist. The manager was unaware of some errors in practice that could cause harm to children and young people. This means that there is no oversight and scrutiny to ensure the safety of children and young people.

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Leaders and managers

The manager and senior leadership team did not identify actions to sufficiently address all the issues raised. Additionally, they did not show an understanding of the seriousness of these concerns or of the risks to children and young people.

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Leaders and managers

When concerns were raised internally about a member of staff, the leaders and manager acted to protect the member of staff without initially taking into consideration the risk to children and young people.

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Leaders and managers

There are widespread concerns due to staff shortages, which increases the identified risks to children and young people, placing them at serious risk of harm. Insufficient staffing arrangements have resulted in children and young people receiving inadequate care and support from staff. Feedback from some parents, professionals and staff, including the manager, supported the evidence of shortfalls in staffing levels.

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Leaders and managers

The manager and deputies have taken on caring roles due to staff shortages. This has resulted in a lack of management oversight of practice, presenting further risks to children and young people.

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Leaders and managers

The manager said that at times she has shared concerns, including in relation to a lack of staff, with senior leaders. However, she has not always received a response to the concerns raised. The manager explained that in response to staff shortages she has arranged for staff to undertake overtime, yet they do not always turn up for work. This means that assurances that there will be adequate staffing in place to meet the needs of children and young people cannot be relied on. Inappropriate supervision levels for children and young people have resulted in harm to children and young people, and there is a risk of this happening again unless the issue is resolved.

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Leaders and managers

The manager was unable to provide inspectors with records to demonstrate which of the staff had attained or are working towards the qualification NVQ level 3 or equivalent. There were gaps in the knowledge and training of staff that have Assurance visit report: 1234323 5 resulted in harm, and have increased the potential for harm, within the group of children and young people.

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Leaders and managers

The home has been without a registered manager since March 2020. The current manager has been in post since May 2020 but is yet to submit a full application to register with Ofsted. The manager stated that she has only received one formal supervision since taking up her post. The responsible individual reported that further discussions had taken place but did not provide records to corroborate this statement. Senior leadership team has been ineffective in their oversight and support of the new manager and in ensuring that practice in the home is safe.

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Leaders and managers

Following this assurance visit, the service has been suspended. Additionally, five compliance notices are served to address areas identified as serious and widespread concerns. A further three requirements are issued to address other shortfalls.

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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, the 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 health and well-being standard is that— the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being; and children are helped to lead healthy lifestyles. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff help each child to— achieve the health and well-being outcomes that are recorded in the child’s relevant plans; understand and develop skills to promote the child’s well- being. (Regulation 10 (1)(a)(b)(c)(2)(a)(i)(iv)) * 11/10/2020

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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. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— 11/10/2020 Assurance visit report: 1234323 6 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; have the skills to identify and act upon signs that a child is at risk of harm; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; 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; 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.

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Requirement Due date

(Regulation 12 (1)(2)(a)(i)(iii)(v)(b)(d)) * The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— 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; ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home has sufficient staff to provide care for each child; 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; use monitoring and review systems to make continuous

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Requirement Due date

improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(a)(c)(d)(f)(h)) * 11/10/2020 Assurance visit report: 1234323 7 The registered person must compile in relation to the children’s home a statement (“the statement of purpose”) which covers the matters listed in Schedule 1. The registered person must keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (1)(3)(a)(b)) In particular, the statement of purpose must contain details of how a person, body or organisation involved in the care or protection of a child can access the home’s child protection policies and the behaviour management policy. 26/11/2020

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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. (2) In particular, the registered person must ensure that— (b) medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed. (Regulation 23 (1)(2)(b)) * 11/10/2020

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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— the name of the child; details of the child’s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; 11/10/2020 Assurance visit report: 1234323 8 within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered

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Requirement Due date

person to do so (“the authorised person”)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; and 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)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)) * The registered person must notify HMCI and each other relevant person without delay if— a child is involved in or subject to, or is suspected of being involved in or subject to, sexual exploitation; an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; there is an allegation of abuse against the home or a person working there; a child protection enquiry involving a child — is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(a)(b)(c)(d)(i)(ii) and (e)) 26/11/2020

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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. In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating— the quality of care provided for children; the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. After completing a quality of care review, the registered person must produce a written report about the quality of 26/11/2020 Assurance visit report: 1234323 9 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 report”). The registered person must—

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Requirement Due date

provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1)(2)(a)(b)(c)(3)(4))

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Requirement Due date

*These requirements are subject to a compliance notice.

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Children’s home details

Registered provider: The Percy Hedley Foundation

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Children’s home details

Registered provider address: Percy Hedley School, Forest Hall, Newcastle upon Tyne NE12 8YY

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Inspectors

Paula Kelly, Social Care Inspector Catherine Heron, Social Care Inspector Assurance visit report: 1234323 10 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 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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Inspectors

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