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

Inspection report for children's home: 2587315 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 four children who may have sensory impairment, physical disabilities 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 the level 5 diploma in leadership and management of 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

Date of last inspection: 9 November 2021

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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: 2587315 2

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Inspection date Inspection type Inspection judgement

09/11/2021 Full Good Inspection report for children's home: 2587315 3

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Overall experiences and progress of children and young people: good

This home is one of two homes on the same site. Children accessing this service do so on a short-break arrangement. Currently, eight children are using the service, either as part of a small group or individually, dependent on need.

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Overall experiences and progress of children and young people: good

Children using the service are cared for by committed staff who know them well. Staff have developed plans which set out how to support children in all aspects of their daily lives, along with targets that they are helping children to achieve. However, these plans are not regularly reviewed or updated. Other records do not fully show what children have eaten, which is especially important for children on restrictive diets or weight reduction programmes. As a result, managers are unable to monitor children’s progress and ensure they are getting a varied and healthy diet.

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Overall experiences and progress of children and young people: good

Despite the shortfalls in plans, some children progress well. For example, children who have visited on their own have, over time, been helped by staff to reintegrate back into the larger groups. This has meant they have opportunities to spend time with peers at the home and on trips out into the community.

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Overall experiences and progress of children and young people: good

Children have lots of fun when they visit, even those who come on their own. Some children come as part of a regular group. This has meant they have started to develop friendships. The high level of staffing means children can have trips out into the community either on their own or with other children. Children have been on train rides and gone shopping, and to cafes and popular fast food outlets. Children go to the local parks for walks and to local farm attractions

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Overall experiences and progress of children and young people: good

Parents spoke highly of the service and those caring for their children. They felt their children enjoyed their stays and participated in lots of activities and that having the break made a difference. One parent spoke about the flexibility of the service and that managers would change the dates of children’s stays when possible .

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Overall experiences and progress of children and young people: good

External professionals also spoke highly of the service, saying children enjoyed visiting and staff helped children to develop their social skills and independence.

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

Children are kept safe by a staff team who know them well. Staff can pre-empt behaviours and use effective strategies to prevent behaviours from escalating. As a result, there are few incidents at the home and staff have not needed to use physical intervention to keep children safe.

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

On occasions, staff have noted that children have marks and bruises. Staff record what they have seen on body maps. However, records do not show what action they have taken to find out where the marks or bruises have come from or if they have discussed their concern with a more senior person. Staff told the inspector what Inspection report for children's home: 2587315 4 they would do if there was a concern. This lack of recording means others may not be aware if there is a concern or what action has been taken.

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

High levels of staffing mean children are closely monitored in the home and when out in the community. This reduces the risks of children wandering off without staff knowledge. No children have gone missing. However, if they were to wander off there are plans which tell staff clearly what they should do and who to contact.

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

Managers have made sure staff recruited to the home are done so following safer recruitment practices. This reduces the risk of those who should not work with children doing so.

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

Staff and managers make sure the environment and the equipment used are safe. Equipment is regularly serviced and faults are reported. Fire risk assessments are completed and shortfalls rectified.

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

The manager has reviewed the location assessment. This assessment now considers risks to children due to other services on the same site, for example, the adult short- break provisions, offices and a hydrotherapy pool. This assessment means staff are now aware of all the risks posed to children from others on or visiting the site.

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The effectiveness of leaders and managers: good

Leaders and managers have made sure the requirements from the last inspection have been met. They have also begun to act following feedback from Ofsted’s inspection of the other short-break home on the same site, to make improvements to this home. This shows a commitment to making improvements to the care of children.

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The effectiveness of leaders and managers: good

Managers’ oversight and monitoring has not been as robust as it could have been, for example, not having oversight of body maps and making sure records clearly showed what action staff had taken and if concerns had been raised with other Managers have started to make changes to improve the overall quality of care given.

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The effectiveness of leaders and managers: good

Since the last inspection, some staff have left and new staff have started work at the home. However, recruitment remains a challenge for the organisation, which has meant the manager has had to work on shift more than usual. The organisation is working hard to try and recruit sufficient suitable staff. Until then, the service is running at a reduced capacity and is not open every day of the week.

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The effectiveness of leaders and managers: good

Staff speak positively about the home and the support given by managers. Staff receive regular reflective supervision sessions and a variety of training and learning opportunities. However, there is a reliance on staff having previous knowledge about children’s communication systems, autism spectrum disorder and learning disability. As a result, not all staff have the same level of knowledge and competency.

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The effectiveness of leaders and managers: good

Managers plan moves to the home well. Information about children is gained from those who know them, such as parents, education professionals and social workers. Inspection report for children's home: 2587315 5 Children have tea visits, when they are introduced to other children and staff. Managers appropriately match children to ensure they have the best possible stay. This is regularly reviewed to have the least impact on children already accessing the service. Inspection report for children's home: 2587315 6

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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 is with regard to management oversight of children’s plans and that records are reviewed and kept up to date. In addition, that children’s targets are reviewed and how staff are supporting children’s progress. 21 May 2023

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Recommendations

 The registered person should ensure children have a clean environment, continuous access to drinking water, varied and nutritious food, clothing, hot water, bedding and so on. Specifically, records should show how staff are helping children who have restricted diets to try new foods, that children who are on healthy eating programmes are being given healthy options and that children are offered a varied, healthy diet. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 14, paragraph 3.3)

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Recommendations

 The registered person should ensure that staff have the knowledge and skills to recognise and be alert for any signs that might indicate a child is in any way at risk of harm. Specifically, staff should record the action taken when children are Inspection report for children's home: 2587315 7 found to have marks and bruises. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 43, paragraph 9.12)

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Recommendations

 The registered person should support staff to be ambitious for every child in the home and to gain skills and experience that enable them to actively support each child to achieve their potential. Specifically, that training is provided on the variety of communication methods children use, and on autism spectrum disorder and learning disabilities. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 52, paragraph 10.5)

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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: 2587315 8

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Children’s home details

Registered provider: Herefordshire and Worcestershire Health and Care NHS Trust

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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: 2587315 9 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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