Children's home run by Herefordshire and Worcestershire Health and Care NHS Trust

Inspection report for children’s home: 2516984 1 Registered provider: Herefordshire and Worcestershire Health and Care NHS Trust Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The service provides short breaks for up to six children who may have sensory impairment and/or physical disabilities and/or learning disabilities.

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Information about this children’s home

The service is dual registered with Ofsted and the Care Quality Commission.

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Information about this children’s home

The registered manager is a qualified learning disability nurse and holds a level 5 diploma in leadership and management for residential childcare.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Overall judgement at last inspection: good

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good

Enforcement action since last inspection: none Inspection report for children’s home: 2516984 2

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Inspection date Inspection type Inspection judgement

08/06/2021 Full Good 04/02/2020 Full Requires improvement to be good Inspection report for children’s home: 2516984 3

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Overall experiences and progress of children and young people: good

Children accessing this service do so as part of a short break. The service currently offers care to over 40 children, many of whom have been coming for several years. Managers do their best to make sure that children are matched with other children so that they have the best possible experience when they stay.

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Overall experiences and progress of children and young people: good

Staff are passionate about the care they provide. They are committed to making sure that children have lots of activities and social opportunities, such as karaoke nights, enjoyable times in the garden and trips to the local parks and shops. There is an on-site hydrotherapy pool which children enjoy using with support from staff.

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Overall experiences and progress of children and young people: good

Staff listen to children and take on board their requests. Nothing is too much trouble. For example, one child wanted to go on a train ride. This was planned and facilitated and all had a good time. Another child likes to visit when their friends do. During their stay, the friends have had cooking evenings and shared meals together. This helps children to have the same opportunities as any other child and develop friendships and confidence. Children say that they enjoy their stays. One child said, ‘I would live here if I could.’

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Overall experiences and progress of children and young people: good

Staff know the children well and have developed plans to support their care. However, these records are inconsistent. Some records showing children’s targets have not been regularly reviewed or linked to other plans, such as their education, health and care plans or child-in-need plans. This is a missed opportunity to have a joined-up approach to help children make progress.

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Overall experiences and progress of children and young people: good

Staff have positive relationships with families. Those who gave feedback said that they feel listened to and that staff take on board what they want for their child. As a result, parents say that they feel confident leaving their child in the knowledge that they are safe, well cared for and have a good time.

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How well children and young people are helped and protected: good

Staff know children well and use their knowledge to increase children’s safety. Staff have also developed plans which include instructions and photos of how to keep children safe, for example in the case of children who sleep in a specific position and may require additional equipment. This means that staff have a point of reference to ensure that children are kept safe and are not in pain.

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How well children and young people are helped and protected: good

Managers carefully consider children’s needs and risks and how these may impact on other children. This considerate approach means that children who are more vulnerable do not have overnight stays with children who may pose a risk to them. As a result, children have positive stays, and incidents between children are rare. Inspection report for children’s home: 2516984 4 There are few incidents at the home and children do not go missing. Staff use their knowledge of children to defuse and distract children from situations. As a result, staff have not needed to use physical intervention techniques.

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How well children and young people are helped and protected: good

The home has doors with high handles, which restricts children’s movement around the home when it may be unsafe for them. However, managers have not provided guidance to staff about their use. This has the potential for restrictions being used unnecessarily.

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How well children and young people are helped and protected: good

When staff are aware that children have marks and bruises, they record this information on a body map. Staff were able to tell the inspector what they would do if they had concerns. However, records are not always updated effectively. For example, it is not always clear what action staff take in response to concerns. This lack of recording does not demonstrate staff’s professional curiosity or management oversight to ensure that children are not being harmed.

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How well children and young people are helped and protected: good

Staff have completed personal emergency evacuation plans (PEEP) for children. These detail the staffing levels and equipment needed to safely evacuate a child in the event of a fire. However, plans for children who use specialist beds do not have this information included. These are beds which children cannot freely exit from. As an emergency plan, all barriers to speedy evacuations should be included.

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The effectiveness of leaders and managers: good

Leaders and managers are committed to children having the best possible stays. They ensure that children have the chance to be as any other child, for example seeing friends, going out on trips, socialising and generally having lots of fun.

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The effectiveness of leaders and managers: good

Managers provide staff with regular supervision and training. Training has included learning about autism spectrum disorder and the different communication methods children may use. This means that staff have had the opportunity to reflect on their practice and develop the skills they need to care for children.

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The effectiveness of leaders and managers: good

Since the last inspection, there have been some changes in the staff team. Several members of staff have left to take up other opportunities. This has reduced the number of staff. The challenges of recruiting suitable staff have impacted on the manager’s time and she has needed to work on shift more. When there have been staff shortages, managers have made the difficult decision to move children’s visits to other days or cancel stays as a last resort. Managers do not do this lightly as they understand how much children enjoy their stays and the need for parents to have a break from their caring role.

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The effectiveness of leaders and managers: good

As the manager has needed to be on shift more often, some of her monitoring systems have not been as robust as possible. This includes checking that all documents have been received in a timely manner from children’s placing authorities, that children’s plans are always promptly reviewed, that targets are always in line with other placing authority plans and that there is effective oversight of body maps. Inspection report for children’s home: 2516984 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 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

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(f))

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Requirement Due date

This relates to management oversight of children’s plans. Records must be reviewed and kept up to date, and targets must be reviewed and show how staff are supporting children’s progress. 28 April 2023

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Recommendations

 The registered person should ensure that the home plays a full part in promoting the best interests of the child, proactively advocating for the child to ensure that others play their role and deliver the high-quality support that is needed. Specifically, when information from others is not received, such as minutes from child-in-need meetings or looked after reviews, a system should be in place to escalate this promptly. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 11, paragraph 2.4)  The registered person should ensure that staff continually and actively assess the risks to each child and the arrangements in place to protect them. Specifically, when children use specialist beds that are enclosed during the night, this information should be included in the child’s PEEP. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 42, paragraph 9.5)

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Recommendations

Inspection report for children’s home: 2516984 6  The registered person should ensure that staff have the knowledge and skills to recognise and be alert to any signs that might indicate a child is in any way at risk of harm. Specifically, staff should use professional curiosity when children have marks and bruises. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 43, paragraph 9.12)  The registered person should ensure that there is guidance for staff to know when it is acceptable to restrict a child’s liberty of movement, such as when the home uses high door handles. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 47, paragraph 9.42)

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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: 2516984 7

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Children’s home details

Registered provider address: Unit 2, Kings Court Business Park, Charles Hastings Way, Worcester, Worcestershire WR5 1JR

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Inspector

Debbie Bond, Social Care Inspector Inspection report for children’s home: 2516984 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 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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