Children's Home run by Lakeside @ Our Place Limited in Worcestershire

Inspection report for children’s home - monitoring visit: 2553111 1

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Information about this children’s home

A private company operates this children’s home. It provides care for 10 children with learning disabilities, including autism spectrum disorder and associated challenging behaviours.

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Information about this children’s home

A new manager has been appointed. He has applied to register with Ofsted.

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This monitoring visit

This home was judged as requires improvement to be good at the last full inspection. This inspection was undertaken following concerns raised with Ofsted about the quality of care provided to children and in response to escalating concerns arising from safeguarding notifications, related to the safe administration of medication.

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This monitoring visit

There are currently nine children living in the home. Since the last inspection, two children have moved in to the home and three have moved out of the home.

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This monitoring visit

Inspectors found serious and widespread failings regarding the administration of medication. This includes children not being given medication in line with their prescriptions and children being provided with double doses without sufficient reason. Managers told Ofsted, in response to the notifications, that they would complete internal investigations, review the home’s internal medication policy, complete weekly medication audits and complete refresher training with all staff members. Inspectors found that these actions have not taken place.

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This monitoring visit

Leaders and managers have failed to take effective action to address poor and unsafe practice. On 27 October 2022, managers found that a member of staff had signed off another member of staff’s medication competency assessment when this had not taken place. Inspectors found no record of managers formally addressing and investigating this poor practice. In addition, there was a delay in notifying Ofsted and the local safeguarding team about this concern. Furthermore, despite having concerns that the competency assessment may not have been completed, managers have failed to Inspection report for children’s home - monitoring visit: 2553111 2 reassess staff competencies and assure themselves that the member of staff is safe to administer medication. This lack of action leaves children vulnerable and compromises their safety and well-being.

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This monitoring visit

Managers have failed to ensure that the home’s medication policy is safe and implemented. Inspectors identified that the policy is not clear regarding the protocol for ensuring that children receive their medication when away from the home. In addition, despite the policy stating that investigations will take place after a medication error, this has not always happened. This means that leaders and managers are not identifying any patterns or trends from errors or identifying learning to reduce future occurrences.

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This monitoring visit

Managers have not ensured that all staff have the skills and training to meet the individual needs of the children. For example, not all staff have received training in managing pica, despite this being a known condition of some of the children. This places children at risk as staff do not have the suitable skills to respond to children’s needs, which may impact on the quality of care they receive.

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This monitoring visit

Managers have failed to ensure effective coordinated care. For example, when medication errors take place, children’s parents, social workers and safeguarding agencies have not always been notified. In addition, when teaching staff have raised concerns in relation to the lack of communication with the manager, this has not been addressed. This practice does not ensure that children’s well-being is promoted and leaves children vulnerable.

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This monitoring visit

The provider commissioned an external audit into medication administration that was carried out on the 20 October 2022. The audit identified unexplained gaps in children’s medication records and an occurrence where a child was not provided with their medication for two weeks. Inspectors found that there had been no action to address or investigate the shortfalls found. This demonstrates a failure by managers to ensure that sufficient timely action is taken to respond to concerns.

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This monitoring visit

Since the last inspection, there have been some improvements to the home environment and to the external grounds. However, managers do not consistently promote a homely environment. For example, inspectors found a large metal cabinet in the communal space labelled ‘pads’ and used to store incontinence products. This practice does not promote children’s dignity or provide a welcoming environment.

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This monitoring visit

Processes to support children to move out of the home are not effective. For example, inspectors found no transition plans for children who have left the home or records that indicate that children’s wishes had been considered. In addition, records were unclear when children had moved out of the home. The home’s admission and discharge register indicated that more children had been living at the home than it is registered to provide accommodation for. This means that managers had breached the home’s condition of registration. This practice fails to demonstrate child-centred practice and indicates poor management oversight. Inspection report for children’s home - monitoring visit: 2553111 3 As a result of shortfalls found at this visit, Ofsted issued a notice to restrict accommodation at the home along with a compliance notice issued under regulation 23, medicines. Ofsted will undertake a further unannounced visit to monitor the home’s

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This monitoring visit

Not all the requirements made at the last inspection were considered during this visit and have been restated. Inspection report for children’s home - monitoring visit: 2553111 4

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Recent inspection history

Inspection date Inspection type Inspection judgement 23/05/2022 Full Requires improvement to be good 27/05/2021 Full Good Inspection report for children’s home - monitoring visit: 2553111 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 involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans; and

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Requirement Due date

seek to secure the input and services required to meet each child’s needs. (Regulation 5 (a)(b))

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Requirement Due date

This specifically relates to ensuring that the manager works effectively with relevant professionals to support children. 2 January 2023

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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

The specifically relates to the home being appropriately decorated, maintained and clean.

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Requirement Due date

This was raised at the last inspection and has been restated. 2 January 2023 Inspection report for children’s home - monitoring visit: 2553111 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

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; and

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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)(a)(i)(b))

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Requirement Due date

In particular, the registered person should ensure that risk assessments contain up-to-date, clear and specific guidance for staff to follow.

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Requirement Due date

This requirement was raised at the last inspection, was not reviewed during this inspection and has been restated. 2 January 2023

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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

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 have the experience, qualifications and skills to meet the needs of 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)(c)(h)) 2 January 2023 Inspection report for children’s home - monitoring visit: 2553111 7 This relates to ensuring that staff have received training that is specific to meeting the needs of the children.

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Requirement Due date

Additionally, the manager must review and evaluate the quality of care and improve practice.

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Requirement Due date

This requirement was raised at the last inspection and has been restated.

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered to ensure—

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Requirement Due date

ensure the effective induction of each child into the home;

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Requirement Due date

manage and review the placement of each child in the home. (Regulation 14 (1)(a)(b)(i)(ii)(iii))

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Requirement Due date

This specifically relates to ensuring that managers demonstrate child-centred planning when children leave and enter the home. In addition, the manager should ensure that the home’s admission log is up to date. 2 January 2023

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Requirement Due date

The registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (5))

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Requirement Due date

This specifically relates to the statement of purpose being clear about the care provided in the home.

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Requirement Due date

This requirement was raised at the last inspection, was not reviewed during this inspection and has been restated. 2 January 2023

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Requirement Due date

*The registered person must make arrangement for 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— 4 December 2022 Inspection report for children’s home - monitoring visit: 2553111 8 medicine which is prescribed for a child is administered as prescribed to the child for who it is prescribed and to no other child; and

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Requirement Due date

a record is kept of the administration of medicine to each child.

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Requirement Due date

Paragraph (2) does not apply to medicine which —

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Requirement Due date

is stored by the child for whom it is provided in such a way that other persons are prevented from using it; and

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Requirement Due date

may be safely self-administered by that child. (Regulation 23 (1) (2)(b)(c) (3)(a)(b))

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Requirement Due date

In particular, the provider must take action to address the steps set out in the compliance notice.

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if—

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children. (Regulation 24 (1)(a))

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Requirement Due date

This specifically relates to ensuring that door alarms, CCTV and radios are only used as set out in a child’s agreed risk assessment.

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Requirement Due date

This requirement was raised at the last inspection, was not reviewed during this inspection and has been restated. 2 January 2023

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Requirement Due date

A person may only manage a children’s home if—

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Requirement Due date

having regard to the size of the home, its statement of purpose, and the number and needs (including any needs a rising from any disability) of the children—

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Requirement Due date

the person has the appropriate experience, qualification and skills to manage the home effectively and lead the care of children. (Regulation 28 (1)(b)(i))

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Requirement Due date

This requirement was raised at the last inspection, was not reviewed during this inspection and has been restated. 2 January 2023

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Requirement Due date

The registered person must ensure that the employment of any person on a temporary basis at the children’s home does 2 January 2023 Inspection report for children’s home - monitoring visit: 2553111 9 not prevent children from receiving such continuity of care as is reasonable to meet their needs.

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Requirement Due date

at all times, at least one person on duty at the home has a suitable first aid qualification. (Regulation 31 (1) (2)(a))

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Requirement Due date

This requirement was raised at the last inspection, was not reviewed during this inspection and has been restated.

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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 the review of the location includes the identification of any risks and opportunities presented by the home’s location and strategies for managing these. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 64, paragraph 15.1)

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Recommendations

 The registered person should ensure that restraint must be kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. Where trends are identified, this should provide the opportunity for amending practice to ensure it meets the needs of each child. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 49, paragraph 9.59)

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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: 2553111 10

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Children’s home details

Registered provider: Lakeside @ Our Place Limited

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Children’s home details

Registered provider address: Lakeside, Bransford, Worcester, Worcestershire WR6 5JE

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Inspectors

Sophie Hills, Social Care Inspector Lisa O’Donovan, Social Care Inspector Inspection report for children’s home - monitoring visit: 2553111 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 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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