Children's home run by Action for Children in Watford

Inspection report for children’s home - monitoring visit: SC013402 1 SC013402

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Action For Children

Monitoring visit Inspected under the social care common inspection framework

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Information about this children’s home

This children’s home is run by a registered charity. Care and accommodation are provided in two separate houses. One home provides care and accommodation for up to four children under short-break arrangements and up to two children to live permanently. The other house provides care and accommodation for up to five children to live permanently. Children may have learning disabilities and/or a physical disability.

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Information about this children’s home

The home has been without a registered manager since January 2020.

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This monitoring visit

Ofsted had received information that highlighted concerns about this children’s home. The main purpose of this visit was to check if the home was run in line with The Children’s Homes (England) Regulations 2015. The inspector looked at the quality of care provided to children and the impact of the service on children’s health and welfare.

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This monitoring visit

The main outcome of the visit is that there are widespread failures in the service provided to children. Twelve breaches of regulations were identified. Many aspects of the care are poor. Some practices in the home do not adequately protect and promote the health and welfare of children.

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This monitoring visit

Following the visit, Ofsted has served a notice restricting accommodation at this children’s home under section 22B of the Care Standards Act 2000. Ofsted will carry out further monitoring visits and take further actions as necessary.

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This monitoring visit

There has been a high level of instability in the leadership and management at every level. This has had a negative impact on the guidance and support provided to staff. Inspection report for children’s home - monitoring visit: SC013402 2 This, in turn, has affected their ability to provide safe care or to look after children well. Many staff have not had formal supervision since February 2020.

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This monitoring visit

There is a culture of staff working in isolation rather than in partnership with other professionals to promote the health and welfare of children. This approach to providing care is limited and unsafe. Staff do not always seek health advice in a timely manner and do not always follow the advice given. An example of this is staff not seeking medical advice after the school nurse raised concerns that may involve medical treatment.

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This monitoring visit

There is a high level of referrals to the local authority’s designated officer. The allegations include serious malpractice and neglect. A child protection investigation is in progress. Despite this, staff delayed following up on the actions agreed at a multi- agency safeguarding meeting.

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This monitoring visit

The medication practices at the home are poor and increase the risk of harm to children. There have been several errors relating to administering medication to children since the last inspection. The errors included incorrect amounts of medication given and delays in administering medication to children. It was noted at this visit that the home did not have any record of the medicines that waited for disposal. These medicines were unsuitably stored together with the controlled drugs.

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This monitoring visit

In addition to concerns relating to children’s medication, there are concerns about staff’s ability to meet children’s basic needs for nutrition and hydration. For example, a child was sent to school without the equipment that enables them to receive their food, drink and medication.

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This monitoring visit

The care planning is poor. This increases the risk of children not receiving care that meets their needs and promotes their welfare. Examples include out-of-date information about one child’s education and family contact, and limited information regarding their personal care, identity, cultural and faith needs, and social integration.

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This monitoring visit

The poor record-keeping undermines any monitoring that takes place. There is no separate record of when staff have used physical intervention to manage children’s behaviours. The inspector was provided with contradictory information regarding whether physical interventions have taken place or not since June 2020. Without records, it is impossible to know what happened or to check if correct processes were followed. Staff do not maintain the records of incidents.

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This monitoring visit

The management monitoring is poor. The last six-monthly review of care that was completed by the home’s management was for the period that ended in September 2019.

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This monitoring visit

Leaders and managers do not act swiftly on the recommendations given by the independent visitor to the home. For example, the recommendations relating to improving records on children’s files go back to January 2020. Inspection report for children’s home - monitoring visit: SC013402 3 Ofsted is not always notified of significant events as required. This limits its ability to monitor the service on a basis of information shared with it by the home.

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Recent inspection history

Inspection date Inspection type Inspection judgement 07/01/2020 Full Good 19/03/2019 Interim Sustained effectiveness 16/07/2018 Full Good 20/02/2018 Interim Improved effectiveness Inspection report for children’s home - monitoring visit: SC013402 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

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans;

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Requirement Due date

seek to secure the input and services required to meet each child’s needs;

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Requirement Due date

if the registered person considers, or staff consider, a placing authority’s or a relevant person’s performance or response to be inadequate in relation to their role, challenge the placing authority or the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans; and

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5 (a)(b)(c)(d)) 01/01/2021

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who—

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Requirement Due date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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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

understand and apply the home’s statement of purpose; 01/01/2021 Inspection report for children’s home - monitoring visit: SC013402 5 ensure that staff—

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Requirement Due date

understand and apply the home’s statement of purpose;

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Requirement Due date

protect and promote each child’s welfare;

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Requirement Due date

treat each child with dignity and respect;

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Requirement Due date

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background. (Regulation 6 (1)(a)(b) (2)(a)(b)(i)(ii)(iii)(iv))

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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;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being; and

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Requirement Due date

children are helped to lead healthy lifestyles.

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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

achieve the health and well-being outcomes that are recorded in the child’s relevant plans;

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Requirement Due date

understand the child’s health and well-being needs and the options that are available in relation to the child’s health and well-being, in a way that is appropriate to the child’s age and understanding;

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Requirement Due date

take part in activities, and attend any appointments, for the purpose of meeting the child’s health and well-being needs; and

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Requirement Due date

understand and develop skills to promote the child’s well- being;

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Requirement Due date

that each child has access to such dental, medical, nursing, psychiatric and psychological advice, treatment and other services as the child may require. (Regulation 10 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv)(c)) 01/01/2021 Inspection report for children’s home - monitoring visit: SC013402 6 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 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. (Regulation 12 (1) (2)(b)) 01/02/2021

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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 aspire to fulfil their potential; and promotes their welfare.

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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 staff work as a team where appropriate;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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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

ensure that the home’s workforce provides continuity of care to each child and

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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. (Regulation 13 (1)(a)(b) (2)(a)(b)(c)(d)(e)(h)) 01/01/2021

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Requirement Due date

The care planning standard is that children— receive effectively planned care in or through the children’s home; and

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Requirement Due date

that each child’s relevant plans are followed. (Regulation 14 (1)(a) (2)(c)) 01/01/2021 Inspection report for children’s home - monitoring visit: SC013402 7 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)) 01/01/2021

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development;

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Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(a)(b)) 01/01/2020

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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, a record is made which includes—

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Requirement Due date

details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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a description of the measure and its duration;

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details of any methods used or steps taken to avoid the need to use the measure;

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the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

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”)—

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Requirement Due date

has spoken to the user about the measure; and 01/01/2021 Inspection report for children’s home - monitoring visit: SC013402 8 has signed the record to confirm it is accurate; and

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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)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(iv)) The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

there is an allegation of abuse against the home or a person working there;

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Requirement Due date

a child protection enquiry involving a child —

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Requirement Due date

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)(c)(d)(i)(ii)(e)) 01/01/2021

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Requirement Due date

The independent person’s report may recommend actions that the registered person may take in relation to the home and timescales within which the registered person must consider whether or not to take those actions. (Regulation 44 (5)) 01/01/2021

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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.

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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—

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Requirement Due date

the quality of care provided for children;

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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

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. 01/01/2021 Inspection report for children’s home - monitoring visit: SC013402 9 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 report”).

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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

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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.

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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))

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Information about this inspection

The purpose of this visit was to monitor the home’s compliance with regulations. The visit was undertaken during the second COVID-19 (coronavirus) national lockdown and included on-site and off-site activities. The inspector spent a significant amount of time on-site at the long-term house. The off-site activities included communications with the social workers for all children who live at the home, the school nurse and the local authority’s designated officer for dealing with allegations.

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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: Action For Children

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Children’s home details

Registered provider address: 3 The Boulevard, Ascot Road, Watford, Hertfordshire WD18 8AG Inspection report for children’s home - monitoring visit: SC013402 10 Responsible individual: Bethan Davies

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Inspector:

Seka Graovac, Social Care Inspector Inspection report for children’s home - monitoring visit: SC013402 11 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:

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Inspector:

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Inspector:

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