Children's Home run by Worcestershire Children First in Worcestershire

Inspection report for children's home: 2548571 1 Registered provider: Worcestershire Children First Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home was previously owned by the local authority. It was re-registered in October 2019 when the local authority moved to be a wholly owned limited company. It is registered for up to four children with learning disabilities, including autism spectrum disorder.

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Information about this children’s home

The registered manager left the home in December 2021. A new manager was appointed in December 2022. He is working towards his level 5 qualification and is due to submit his application to register with Ofsted.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 16 November 2021

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report for children's home: 2548571 2

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Inspection date Inspection type Inspection judgement

16/11/2021 Full Good 03/08/2021 Full Inadequate Inspection report for children's home: 2548571 3

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improvement to be good

Children have built positive relationships with a small number of staff who know them well. The inspector observed positive interactions between children and staff during the inspection. Children approached staff with confidence and ease and responded well when boundaries were put in place. Staff were observed to be calm, patient and understanding of children’s complex needs and emotions.

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improvement to be good

Children living in the home do make some progress, but more action is needed to monitor, review and track their progress. For example, one child has made progress around his emotional regulation and independence in the community. However, this journey is not reflected clearly in his plans. The child is due to move from the home as part of his care planning for adulthood. More detailed records about the progress he has made could help to inform these next steps.

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improvement to be good

Although children’s general health needs are met, one child has recently refused to wear their visual and hearing aids. Records do not show what action has been taken to support the child to explore the reasons for this and to find an appropriate solution.

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improvement to be good

Overall, children make progress with their education. Two children are regularly attending educational provisions in line with their plans. One child is not attending education. In the absence of this, he is being provided with structured routines and activities at home. When there are concerns that a provision is not meeting the needs of a child, action is taken to ensure that appropriate assessments are undertaken. However, the outcome of these assessments is not incorporated effectively into children’s plans. For one child, this means that not all actions are fully understood and followed by the staff caring for him.

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improvement to be good

Overall, the home is clean, welcoming and friendly. Two children’s bedrooms are personalised to their likes and preferences. The other child’s bedroom has recently been redecorated. This child struggles with change, and a plan is in place to make his bedroom more homely, while balancing the need to keep him safe. There has been some damage caused to the home as a result of incidents, and the garden has been uncared for through the winter. This can take away from the otherwise homely environment.

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improvement to be good

Children are provided with opportunities to express their wishes and feelings through their day-to-day care. However, the responsible individual identified that in the absence of a consistent manager there has been a decline in regular consultation with children. This means that children are having less input into decisions that affect their daily lives. There is a plan in place to address this and ensure that children have opportunities to express their views in line with their preferred communication styles. Inspection report for children's home: 2548571 4 Professionals and parents have mixed views about the running of the home and children’s experiences. Positive aspects were noted in respect of relationships between children and particular members of the staff team. In addition, one social worker reported that staff knew her child’s needs and are able to anticipate and manage his behaviours. A common theme raised is the high turnover of staff and

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improvement to be good

the impact on the continuity of care for children.

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improvement to be good

Children spend time with those important to them, encouraged and supported by staff. Staff generally build positive relationships with children’s families. This helps children retain a sense of identity and belonging. However, one family member said that effective communication had declined in recent months. The manager and deputy manager recognise that building relationships with family members will need to be an essential focus moving forward.

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improvement to be good

Core staff understand the children’s historical experiences, their behaviours and vulnerabilities. Risk assessments document some of this information, but they are not always regularly updated and do not clearly identify all known current risks. Due to some staff’s knowledge of the children, this has not compromised their safety. However, these shortfalls may compromise the quality of care the children receive from staff who do not know them as well.

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improvement to be good

Medication is not well managed. Medication errors have the potential to compromise children’s health. Investigations into medication errors are undertaken, and learning and actions have been identified. This shows that concerns relating to medication are being taken seriously.

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improvement to be good

Children develop positive relationships with some staff but not all. When children raise issues about staff, these are looked into. The responsible individual told the inspector that staff do not always work consistently, and this makes it difficult for children to understand the rules and boundaries in place and to know what is expected of them. The new management team is addressing this.

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improvement to be good

On occasion, physical restraint has been used as a last resort to keep children safe. However, it is not always clear which members of staff have carried out a restraint. In addition, records do not always include the responses that children and staff make when they are spoken to about what happened. A manager did not review one serious incident. This was a missed opportunity to reflect and learn and develop better ways of supporting a child.

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improvement to be good

When safeguarding concerns arise, these are responded to promptly. Managers work collaboratively with a range of safeguarding agencies. When allegations are made, appropriate action is taken to safeguard children. Inspection report for children's home: 2548571 5

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good

The home has been without a registered manager since January 2022. Attempts have been made to recruit to this post permanently, and an interim manager was appointed for a three-month period between May and July 2022. The provider initiated two further recruitment drives following the interim manager’s departure. In December 2022, a new manager was appointed. A new deputy has also been appointed to support the manager.

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good

Leaders and managers have not ensured consistent and effective oversight of the service. The responsible individual has worked hard to maintain some oversight but she does not have capacity to undertake the day-to-day management of the home in the absence of a registered manager. Because of issues associated with staff retention and recruitment, she has also been heavily involved in managing the children’s day-to-day care. This impacts the quality of leadership in the home and limits effective review of the quality of care children receive.

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good

The home has been affected by staffing shortages. Five staff have left the home since the last inspection. New staff have joined from elsewhere in the organisation and the home uses regular agency and relief staff to fill gaps on the rota. The home has a core team of regular staff, who provide consistent care for children. A review of pay for staff overtime has taken place to encourage consistency of care. This has reduced the need for the use of unfamiliar agency staff and means that the continuity of care provided to children is improving.

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good

Staff have completed mandatory training. However, records in the home do not always reflect the most up-to-date training undertaken by staff. Managers were unable to determine if staff have had essential training that helps them to understand and respond to children’s individual needs.

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good

Staff have not received consistent supervision that promotes their development and allows them to reflect on the care they provide to children. Furthermore, managers were unable to find records to evidence that staff appraisals had taken place. This means that staff do not fully understand their own progress and areas for development or receive adequate guidance to support them in caring for the children.

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good

The most recent quality of care review report for the home has not been completed. This a missed opportunity to review the care provided to children through what has been a challenging time for the home. Although managers demonstrated a good understanding of the shortfalls during the inspection, they have not yet had the opportunity to devise an action plan. A meeting is planned to ensure this is done.

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good

Managers have been unable to locate some documents that they are required to keep for children. For example, the home’s register, which details admissions and discharges from the home, could not be found. A requirement was raised in relation to this shortfall at the last inspection and has not been met. Inspection report for children's home: 2548571 6 Leaders and managers show good intentions and want the best for children in their care. They have recognised the shortfalls in practice and are working hard to address these. The responsible individual has a good understanding of the children’s needs, experiences and plans moving forward. Inspection report for children's home: 2548571 7

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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 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;

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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)(c)(h))

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Requirement Due date

In particular, that staff receive training to meet children’s complex needs, and that managers have systems to oversee training and they effectively monitor the quality of care provided to children.

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Requirement Due date

This requirement was raised at the last inspection and is restated. 21 February 2023

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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)) 21 February 2023 Inspection report for children's home: 2548571 8 Specifically, ensure that all staff administer medication safely, and maintain clear and effective oversight of the storage, administration and recording of medication.

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Requirement Due date

ensure that each employee completes an appropriate induction;

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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; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (1)(a) (4)(b)(c))

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Requirement Due date

This specifically relates to all employees receiving practice- related supervision and a review of their performance at least once a year. In addition, the registered manager must ensure that each staff member receives an induction into the home. 21 February 2023

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children’s home.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1) (2)(a)(b))

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Requirement Due date

This specifically relates to point 1 in schedule 4.

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Requirement Due date

This requirement was raised at the last inspection and is restated. 21 February 2023

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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. (Regulation 45 (1)) 21 February 2023 Inspection report for children's home: 2548571 9

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Recommendations

 The registered person should ensure that children’s needs are met in a homely, domestic environment. This specifically relates to ensuring that the home is well maintained and decorated throughout. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 15, paragraph 3.9)  The registered person should ensure that children are consulted regularly on their views about the home’s care, to inform and support continued improvement in the quality of care provided. Due consideration should be given to the child’s cognitive ability in the development and implementation of any consultation processes. Children should be able to see the results of their views being listened to and acted on. This specifically relates to improving the quality of consultation with children. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 22, paragraph 4.11)  The registered person should ensure that they continually and actively assess the

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Recommendations

risks to each child and the arrangements in place to protect them. Where there are safeguarding concerns for a child, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any assessed risks on a day-to-day basis. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 42, paragraph 9.5)  The registered person should ensure that records of restraint are kept that 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. The review 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

Inspectors have looked closely at the experiences and progress of children and young people, using the social care common inspection framework. This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the Children’s Homes Regulations, including the quality standards’. Inspection report for children's home: 2548571 10

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Children’s home details

Registered provider: Worcestershire Children First

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Children’s home details

Registered provider address: County Hall, Spetchley Road, Worcester WR5 2NP

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Inspector

Natasha Skinner, Social Care Inspector Inspection report for children's home: 2548571 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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