Children's home run by Chailey Heritage Foundation

Inspection report for children’s home - monitoring visit: SC396813 1 SC396813 Registered provider: Chailey Heritage Foundation

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Inspected under the social care common inspection framework

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Information about this children’s home

The setting is owned by a charity and is registered to accommodate up to 27 children who have profound physical disabilities, sensory impairments and complex medical needs, including, in some cases, learning disabilities. On site is a non- maintained special school catering for children and young people aged three to 19 years. Adults receive residential care in Care Quality Commission-registered homes on the same site. A team of nurses, therapists and specialists, provided by Sussex Community Foundation Trust, is also based on site and provides medical support.

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Information about this children’s home

There is no registered manager at this home. The post has been vacant since 19 June 2021.

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This monitoring visit

This monitoring visit was conducted due to Ofsted being notified, by the provider, of several medication errors which were serious in nature. This was also identified as a shortfall at the recent full inspection which was conducted on 21 and 22 September 2021. A requirement, with the completion date of 5 November 2021, was made at the full inspection to address the shortfall.

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This monitoring visit

Prior to this monitoring visit, Ofsted wrote to the provider to gain further information regarding the circumstances of the medication errors that had occurred. The provider’s response to these concerns did not provide sufficient assurance. The monitoring visit took place so that the regulator could be satisfied that effective medication arrangements were in place. Some of the requirements from the last inspection were reviewed at this visit. Those which were not checked will be reviewed at a future inspection.

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This monitoring visit

Inspectors found that the medication processes continue to be ineffective. The medication errors that had taken place were due to staff failing to follow the correct Inspection report for children’s home - monitoring visit: SC396813 2 processes that are in place. This negatively affected two children who either missed prescribed medication doses or received medication they were not prescribed to receive. One of these children missed more than one dosage of medication in the same night. This meant that the child could have experienced pain or discomfort as a result of this significant error. Another child required close medical monitoring to ensure that they were not negatively impacted due to being given medication they should not have been given. These errors occurred over the same weekend period.

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This monitoring visit

The provider reported these medication errors to the relevant agencies in a timely way. This included the designated officer in the local authority who directed the provider to conduct internal investigations regarding the errors.

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This monitoring visit

The provider’s investigations failed to fully identify how these errors occurred and what strategies have been implemented to mitigate the risk of further errors occurring. Staff who had failed to follow process have not been held accountable. The provider failed to identify the circumstances which led to the errors. Any learning from these errors had also not been identified and therefore, not shared or reflected on. Some actions had been raised within the investigation outcome, but no timescales or details regarding how these actions would be implemented were included.

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This monitoring visit

The investigation failed to capture how these failings significantly affected the experience of the children involved. All the errors had occurred in the same bungalow and occurred while waking night staff had been on duty. Since the internal investigations were concluded, a further medication error, including similar circumstances, has occurred. This demonstrates that ineffective arrangements for the administration of medication remain.

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This monitoring visit

The current arrangements for administering medication are described by the manager and leaders as a two-step process. This is potentially ambiguous and open to interpretation. For example, the manager explained the process as one staff member preparing the medication and another staff member checking what has been prepared before administering and recording. However, staff explained that on rare occasions one staff member could complete both aspects of the two-step process. Guidance and oversight regarding who makes the decision for one staff member to prepare and administer medication is not clear. In relation to one of the notified medication errors, the same staff member completed both steps of the two- step process. Consequently, a child was given a medication that they were not prescribed to receive.

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This monitoring visit

Inspectors spoke to leaders, the manager and staff regarding staff sufficiency. The manager referred to the staffing at the home as a ‘staffing crisis’. Staff spoke about their concerns regarding staffing levels and told inspectors that it does not always feel safe. This was also identified as a shortfall at the full inspection and a requirement was raised to address this. The inspectors established that there are times when there is insufficient staff to fully meet the needs of children. This was raised with the manager and leaders during the monitoring visit. This resulted in Inspection report for children’s home - monitoring visit: SC396813 3 inspectors seeking further reassurance about staffing levels and the contingencies in place. Staff were reminded, by leaders, of additional staffing support they can access should they experience difficulties or require extra staffing support. The provider is actively taking measures to recruit more staff.

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This monitoring visit

Inspection report for children’s home - monitoring visit: SC396813 4

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Recent inspection history

Inspection date Inspection type Inspection judgement 21/09/2021 Full Good 13/08/2019 Full Good 30/10/2018 Full Good 01/11/2017 Full Good Inspection report for children’s home - monitoring visit: SC396813 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

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. (Regulation 10 (1)(a))

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Requirement Due date

This is with particular reference to ensuring that children receive the food specific to their needs, and that all necessary steps are taken to avoid delay in children receiving medical treatment. 12 December 2021

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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 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))

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Requirement Due date

This is with particular reference to ensuring that the strategies for keeping children safe, as specified in their plans, are implemented in practice. 12 December 2021

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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.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. (Regulation 23 (1) (2)(b)) 12 December 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— 12 December 2021 Inspection report for children’s home - monitoring visit: SC396813 6 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 the home has sufficient staff to provide care for each child. (Regulation 13 (1)(a)(b) (2)(d))

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendations

 The registered person should ensure that staff seek to identify and provide appropriate opportunities for children to develop themselves in accordance with their wishes and feelings and as part of the home’s plan for their care. In particular, ensure that any targets set in relation to a child’s development are clearly defined and progress is monitored. (‘Guide to the children’s homes regulations, including the quality standards’, page 31, paragraph 6.4)  The registered person should seek to involve the local authority and other relevant persons, including the designated officer, whenever there is a serious concern about a child’s welfare. (‘Guide to the children’s homes regulations, including the quality standards’, page 42, paragraph 9.4)  The registered person should have a system in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to

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Recommendations

reflect on their practice and the needs of the children assigned to their care. This recommendation was made at the last inspection and is restated. (‘Guide to the children’s homes regulations, including the quality standards’, page 61, paragraph 13.2)

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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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: SC396813 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: Chailey Heritage Foundation

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Inspectors

Kelly Marchmont, Social Care Compliance Inspector (Lead) Helen Simmons, Social Care Inspector Inspection report for children’s home - monitoring visit: SC396813 8 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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