Children's home run by Chailey Heritage Foundation

Inspection report for children’s home - monitoring visit: SC396813 1 SC396813

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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 with 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 on the same site, in homes that are registered by the Care Quality Commission. 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 has been no registered manager at the home since 19 June 2021.

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Information about this children’s home

This monitoring visit was conducted remotely due to the COVID-19 circumstances in the home at the time that the visit was scheduled to take place.

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This monitoring visit

Following a monitoring visit to the home on 19 November 2021, Ofsted issued two compliance notices on 29 November 2021. These notices were in respect of regulation 13, due to concerns about the sufficiency of staffing, and regulation 23, regarding the safe administration and recording of prescribed medication. The purpose of this monitoring visit was to assess whether the steps specified in the compliance notices had been met.

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This monitoring visit

The compliance notice under regulation 13 required the provider to ensure that there are sufficient staffing levels in each of the three residential bungalows, and that records of the deployment of staff demonstrate how each child’s individual staffing ratio will be achieved. The provider was also required to undertake a review of the staffing situation, identify the number of staff vacancies, and assess how many children the home could look after safely. Inspection report for children’s home - monitoring visit: SC396813 2 Since the monitoring visit on 19 November 2021, leaders and managers have reduced the demand on the number of services available in the home. Consequently, the number of staff needed to provide safe care to children at all times has reduced. Well-developed contingency plans for covering staff shortages have been implemented and suitable staff from other services that are provided on site are now

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This monitoring visit

supporting the residential care staff when needed. Agency care staff are also being used to cover staff shortages.

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This monitoring visit

New initiatives have been taken regarding the recruitment and retention of residential staff. The terms and conditions for staff have been reviewed and changes are being made to ensure that the role becomes more attractive. A new United Kingdom and overseas recruitment adviser has been appointed, and specialist advice is being taken on overseas recruitment procedures. Recent recruitment activities have resulted in new staff being appointed.

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This monitoring visit

A detailed report regarding the staffing situation was submitted to Ofsted prior to this monitoring visit taking place. This contained an analysis of the optimal and minimum numbers of staff needed to provide safe care to the children. The individual needs of each child were considered during this process. This has enabled leaders and managers to identify how many staff will be required on each shift, and ensure that there is a sufficient level of experience and expertise at all times.

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This monitoring visit

The residential staff rotas covering the period from the end of November 2021 to the end of December 2021 are clearly recorded. They identify where there are staff shortages and how this has been, or will be, covered. All shifts are staffed to at least the minimum level, and, in many cases, the minimum number of staff required was, or will be, exceeded.

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This monitoring visit

Leaders and managers are monitoring the staffing situation closely. Weekly management meetings are used to monitor the accuracy of the staff rotas and plan ahead for potential shortfalls in the sufficiency of staffing. The impact of staff shortages has been risk assessed and there are contingency plans in place to mitigate against the identified risks.

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This monitoring visit

The steps in this compliance notice have been met.

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This monitoring visit

The compliance notice under regulation 23 required the provider to develop, implement and maintain improved systems for the safe administration and recording of medication. The provider was to ensure that these systems ensure that medicine is only administered to the child it is prescribed for, and that all staff undertaking medication duties are suitably trained and assessed as competent to do so.

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This monitoring visit

The systems for administering and recording medication have been reviewed and amended to promote safe and effective practice. There is a new medication handover form, which ensures that verbal handovers to staff coming on shift are reinforced by a visual checklist. This is in addition to the electronic recording system. Inspection report for children’s home - monitoring visit: SC396813 3 Daily medicine checks have been adjusted so that staff are now cross-checking medication administration at least twice a day. Shift plans now name a lead person for ensuring that the checks are completed, and day and night staff now share equal responsibility for ensuring that the checks are completed on all shifts.

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This monitoring visit

Staff speak favourably of these changes and report that morale has improved. Managers keep staff fully informed of the changes to the medication system and provide explanations as to why the changes are necessary.

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This monitoring visit

An effective system for identifying medication errors has been implemented. Since the monitoring visit was conducted on 19 November 2021, two medication errors have occurred. Both errors were identified promptly and managed appropriately. This can be attributed to the process for detecting medication errors quickly, establishing the root cause of what happened and ensuring swift and appropriate actions were taken to address the issues. No children came to harm because of these errors and clear learning was identified and shared with the whole staff team.

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This monitoring visit

The changes to the systems for administering and recording medication are being closely monitored by the management team. Shift audits are being undertaken to ensure that those with responsibilities for preparing and checking medication are clearly identified. ‘Trends meetings’ have been introduced so that themes and patterns can be identified and explored. This has enabled leaders and managers to get to the root causes of errors and to take action to ensure that they are not repeated.

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This monitoring visit

A new bespoke medication training package has been developed by the clinical quality assurance lead person. The training is designed to ensure that staff are competent in all aspects of the medication administration process. Face-to-face training in cohorts of seven to eight staff at a time is being delivered, and it is planned that all relevant staff will receive this training.

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This monitoring visit

In addition, all staff in the night team have undergone training in the principles of administering medication. Leaders and managers also held a meeting with night staff to explore any issues and concerns relating to the safe administration and recording of medication during the night.

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This monitoring visit

Practice observations are being conducted for all staff. This includes observations of staff preparing and/or administering medication. These observations are being completed by members of the management team, who have also had their competencies to observe practice reviewed. Positive observations are recorded and there is a focus on children’s experience of receiving the medication and the interactions with staff.

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This monitoring visit

The steps in this compliance notice have been met.

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This monitoring visit

At the last full inspection in September 2021, a requirement was made under the protection of children standard. This was in relation to staff needing to follow the Inspection report for children’s home - monitoring visit: SC396813 4 strategies specified in children’s plans. Effective action has been taken to address this matter. However, a further shortfall in relation to the protection of children was identified at this monitoring visit.

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This monitoring visit

In response to a comment made by a parent, an undertaking was given to investigate a potential safeguarding matter. Although leaders and managers provided assurances that enquiries had been made regarding this matter, no audit trail was kept of the actions taken, any consultation with relevant professionals, or the outcome of the investigation. Consequently, the inspectors were not able to judge how effectively this matter had been responded to.

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This monitoring visit

A shortfall was also identified in relation to establishing the fitness of agency staff to work at the home. Records indicate that none of the agency staff currently hold a relevant qualification and there is nothing to indicate that these staff are currently working towards obtaining a relevant qualification.

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This monitoring visit

The response to one requirement and the recommendations made at the full inspection in September 2021 were not reviewed at this monitoring visit. Therefore, the requirement and recommendations are repeated in this report and will be reviewed at the next inspection.

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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 specified for their consumption and that all necessary steps are taken to avoid delay in children receiving medical treatment. 31 January 2022

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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 that staff—

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare. (Regulation 12 (1) (2)(a)(vi))

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Requirement Due date

This is with particular reference to ensuring that concerns for a child’s welfare are appropriately investigated and a clear audit trail is kept of the decisions made and actions taken. 31 January 2022

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Requirement Due date

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

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform. (Regulation 32 (2)(a)(b) (3)(b)) 31 January 2022 Inspection report for children’s home - monitoring visit: SC396813 6

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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)

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Recommendations

 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)

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Recommendations

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

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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.

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Children’s home details

Provision sub-type: Residential special school

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Inspectors

Stephen Collett, Social Care Inspector Kelly Marchmont, Social Care Inspector Inspection report for children’s home - monitoring visit: SC396813 7 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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