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

Inspection report for children's home - monitoring visit: 2495377 1 Registered provider: St Elizabeth’s Centre

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Inspected under the social care common inspection framework

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Information about this children’s home

This home is run by a large charitable organisation and provides care for up to 52 children and young people. The home cares for children and young people aged five to 19 with complex medical needs, autism spectrum disorders, epilepsy and associated learning disabilities. The home consists of eight individual houses. The children attend the on-site school.

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Information about this children’s home

The registered manager left in September 2021.

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This monitoring visit

The purpose of the visit was to assess the provider’s response to the steps set out in the two compliance notices that Ofsted served following the full inspection in October 2021. The compliance notices were in respect of the help and protection of children and the leadership and management of the home. This visit also monitored the provider’s adherence to the notice restricting accommodation that Ofsted served on 12 October 2021.

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This monitoring visit

This visit identified that the provider has addressed all the steps that were set out in the two compliance notices. The remaining seven requirements that were raised at the full inspection have not been assessed as part of this visit and will be reviewed at the next inspection. The provider has not admitted any children to the home since the last inspection.

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This monitoring visit

The senior leadership team has implemented a widespread safeguarding campaign. This has helped the staff to gain a better understanding of the safeguarding procedures and how to raise concerns quickly. The campaign includes a designated safeguarding champion in each of the houses. These safeguarding roles help the staff to understand the time frames and procedures for reporting concerns. Staff have recently reported potential concerns through the correct channels in Inspection report for children's home - monitoring visit: 2495377 2 accordance with the safeguarding policy. Line managers reiterate the importance of safeguarding in staff supervisions and staff team meetings. Revisiting these areas with regular questions and safeguarding scenarios helps the staff to remain vigilant.

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This monitoring visit

There are enough staff on duty, despite the staffing shortages. A duty manager provides a daily safety briefing to gain a picture of the staffing for the day. This briefing informs the effective deployment of staff to where they are needed most. The managers spread the staff’s skills and experience as well as they can. Some shifts are staffed well, and some are minimally staffed. However, core staff lead all shifts. Regular agency staff are used to provide consistent care for the children.

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This monitoring visit

The responsible individual and board of trustees have agreed a pay increase for every member of staff. This is to address the ongoing problem of retaining and recruiting staff. This pay increase is designed to attract new staff and provide existing staff with a sense of feeling valued.

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This monitoring visit

Managerial monitoring and oversight of staff practice concerns have improved. When there are concerns about staff practice, these are identified and followed-up by line managers. Medication administration, timekeeping and reporting have all been identified as recent practice issues. These concerns have been raised promptly and addressed without delay in supervision meetings. Senior managers provide further support to staff as required. This ensures that staff are supported to reflect on any mistakes and learn from these.

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This monitoring visit

New risks for children have risen following recent incidents. The risk assessments have been updated after incidents and include suitable risk-reduction strategies. This gives staff guidance on how to manage children’s behaviours and reduce the risks.

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This monitoring visit

Leaders have introduced several initiatives to address practice issues in respect of behaviour management. The staff have updated one child’s positive behaviour support plan. This plan has a clear structure to help the staff use consistent strategies and approaches. Positive behaviour support staff have an increasing presence at the home and give practice-based feedback to the staff. This provides effective support to the staff and encourages approaches that are well planned and consistent. The children are increasingly settled, and incidents have reduced significantly.

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This monitoring visit

The debriefs for children have improved following incidents. Sessions are child- centred and in line with children’s communication needs. For one child, the strategies outlined in an individualised social story helped the child to avoid a further incident.

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This monitoring visit

Good-quality updates have been provided to Ofsted each week since the full inspection. There are numerous examples of the home’s communication with the designated officer and the local placing authorities as ongoing allegations about staff are concluded. Inspection report for children's home - monitoring visit: 2495377 3 The efforts taken and the work to address the shortfalls raised at the full inspection are having a positive effect on the children’s welfare and safety. There are no further allegations about the staff. The environment has significantly improved, and refurbishment work is ongoing. Overall, in a short space of time there are better safeguarding systems and the quality of care has improved. Inspection report for children's home - monitoring visit: 2495377 4

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Inspection date Inspection type Inspection judgement

05/10/2021 Full Inadequate 28/01/2020 Interim Sustained effectiveness 24/04/2019 Full Requires improvement to be good 04/03/2019 Full Inadequate Inspection report for children's home - monitoring visit: 2495377 5

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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 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(d))

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Requirement Due date

In particular, ensure that the staff maintain effective and regular communication with the children’s social workers.

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Requirement Due date

This requirement was made at the last inspection and is restated. 1 December 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

ensure that the premises used for the purposes of the home are designed and furnished so as to—

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Requirement Due date

enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b) (2)(c)(i)(ii))

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Requirement Due date

In particular, ensure that all areas of the children’s accommodation are maintained to a good standard and that 1 December 2021 Inspection report for children's home - monitoring visit: 2495377 6 all children’s bedrooms are personalised and reflect their choices and requests.

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Requirement Due date

This requirement was made at the last inspection and is restated.

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due date

develop positive relationships with them;

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives.

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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

help each child to understand how the child’s views, wishes and feelings have been taken into account and give the child reasons for decisions in relation to the child. (Regulation 7 (1)(a)(b)(c) (2)(a)(iii))

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Requirement Due date

In particular, ensure that the staff use children’s individual communication aids and that they seek the children’s views and wishes.

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Requirement Due date

This requirement was made at the last inspection and is restated. 1 December 2021

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

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. (Regulation 10 (1)(a)(b)(c))

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Requirement Due date

In particular: 1 December 2021 Inspection report for children's home - monitoring visit: 2495377 7 ensure that children are provided with healthy snack choices between meals and that they have a stimulating routine that includes physical activity;

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Requirement Due date

ensure that communication between the health team and external agencies enables a clear understanding of children’s health needs.

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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

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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

ensure that staff have the experience, qualifications and skills to meet the needs of each child. (Regulation 13 (1)(a)(b) (2)(c))

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Requirement Due date

ensure that all staff have completed all mandatory training;

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Requirement Due date

ensure that staff receive training to meet the individual needs of the children they are allocated to work with. 1 December 2021

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Requirement Due date

keep the statement of purpose under review and, where appropriate, revise it; and

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Requirement Due date

notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)(b))

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Requirement Due date

This requirement was made at the last inspection and is restated. 1 December 2021

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Requirement Due date

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. (Regulation 33 (4)(b)) 1 December 2021 Inspection report for children's home - monitoring visit: 2495377 8 This specifically relates to the provider ensuring that the staff receive supervision in line with the home’s policy.

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Requirement Due date

This requirement was made at the last inspection and is restated.

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Information about this inspection

The purpose of the visit was to assess the provider’s progress towards meeting the steps set out in the two compliance notices that Ofsted served following the full inspection and the provider’s adherence to the restriction of accommodation.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children's home - monitoring visit: 2495377 9

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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: South End, Much Hadham SG10 6EW

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Inspectors

Deirdra Keating, Social Care Inspector Mark Anderton, Social Care Inspector Amanda Start, Social Care Inspector Inspection report for children's home - monitoring visit: 2495377 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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