Children's Home run by Praxis Care in Leicestershire

Inspection report for children’s home - monitoring visit: SC032069 1 SC032069 Registered provider: Praxis Care

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Inspected under the social care common inspection framework

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Information about this children’s home

This home is owned and operated by a voluntary sector organisation and provides short breaks for up to eight children with learning disabilities.

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Information about this children’s home

The registered manager has resigned, leaving the post vacant.

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This monitoring visit

This children’s home was judged inadequate at the full inspection on 29 and 30 November 2022. Following this judgement, Ofsted issued a restriction of accommodation notice, meaning that no children could be admitted to the home. The restriction notice was reissued for a second period, commencing 22 February 2023 and for a third period, commencing 18 May 2023.

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This monitoring visit

Four monitoring visits have been carried out on 10 January 2023, 17 February 2023, 3 April 2023 and 15 May 2023. This fifth monitoring visit was undertaken to ascertain whether the restriction notice is being adhered to and to evaluate progress against the provider’s action plan. The service is not currently operating and is complying with the restriction notice.

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This monitoring visit

Managers have developed an action plan that sets out the steps that they need to take to ensure children’s safety going forward. Senior leaders have taken the concerns about the quality of care provided seriously. The restricted period has been used by leaders as an opportunity to upskill staff, revise policies and protocols for the setting, and complete a comprehensive overhaul of children’s documents and records. This should allow for more-robust leadership oversight should children be permitted to stay at the service in the future.

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This monitoring visit

Internal investigations concerning the conduct of staff have now been completed. This was a slow response to the safeguarding concerns raised and it took the Inspection report for children’s home - monitoring visit: SC032069 2 provider five months to conclude. Some of these investigations have resulted in disciplinary action, and the resignation of some staff, including the home’s registered manager. The provider has a suitably qualified and experienced manager in post, who would apply to become the registered manager should the restriction notice be lifted.

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This monitoring visit

A significant number of historical safeguarding concerns have been escalated to placing authorities and to Ofsted during February and March 2023. A thorough evaluation of these concerns is being conducted by multi-agency safeguarding partners, including representatives from health, education, social care and the police. These safeguarding concerns are being looked at retrospectively as they were not reported at the time by the leaders and managers, who failed to follow safeguarding and child protection policies and procedures. Professionals share the view that disabled children have not received good enough care at the setting, and that a lack of professional curiosity has contributed to hidden harm. Institutional failings in the leadership and management of the service have added to this harm. These multi-agency investigations have now concluded with no further action deemed necessary.

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This monitoring visit

One of the two buildings covered by the registration, and where children are cared for, has been affected by subsidence. Building works have been agreed and have started. This currently limits the number of children that the provider would be able to care for.

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This monitoring visit

Following the full inspection in November 2022, the organisation has taken Ofsted’s concerns seriously. Sufficient progress has been made to rectify the areas of concern. Senior leaders now have better oversight of the service. They continue to regularly consult with local authority commissioners and the children’s carers and family members to ensure that they are kept informed and up to date during the restriction period. The restriction of accommodation notice can now be lifted.

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This monitoring visit

A number of statutory requirements have not been met and therefore remain. The provider has not been able to demonstrate sufficient improvements in order for these to be met during the restricted period. Progress against these requirements will be assessed when the home reopens. Inspection report for children’s home - monitoring visit: SC032069 3

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Inspection date Inspection type Inspection judgement

29/11/2022 Full Inadequate 08/06/2021 Full Good 09/04/2019 Full Good 23/05/2018 Full Good Inspection report for children’s home - monitoring visit: SC032069 4

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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 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

protect and promote each child’s welfare;

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Requirement Due date

treat each child with dignity and respect;

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Requirement Due date

provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

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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)(b)(ii)(iii)(iv)(c)(i)(ii))

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Requirement Due date

This relates to ensuring that children receive good-quality care that protects their welfare, in line with their care and support plans. This also relates to ensuring that the home is furnished to a good standard, with areas in need of repair and maintenance addressed swiftly. 18 May 2023

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who— 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 5 develop positive relationships with them;

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Requirement Due date

take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. (Regulation 7 (1)(a)(b)(c))

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Requirement Due date

This relates to ensuring that staffing provides consistency of care for children, so that they can develop positive relationships. Children’s views and feelings should be sought regularly to inform their care.

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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—

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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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

have the skills to identify and act upon signs that a child is at risk of harm;

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Requirement Due date

manage relationships between children to prevent them from harming each other;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare; and

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

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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; 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 6 that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health; and

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Requirement Due date

that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (1) (2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(b)(d)(e))

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Requirement Due date

This relates to ensuring that children’s care plans and risk assessments are adequately informed to keep children safe. This also relates to staff having the skills to identify and act on child protection concerns, follow relevant safeguarding policies and take effective action. All significant incidents and recordings should be clear, detailed and demonstrate evaluation and management oversight, reflection and learning. Staff should be skilled in completing body maps when injuries to children are present, and they should know how to evaluate such records and act accordingly to ensure that children are safeguarded from risk of harm.

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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 work as a team where appropriate;

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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

ensure that the home has sufficient staff to provide care for each child;

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Requirement Due date

ensure that the home’s workforce provides continuity of care to each child; 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 7 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;

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Requirement Due date

demonstrate that practice in the home is informed and improved by taking into account and acting on—

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Requirement Due date

research and developments in relation to the ways in which the needs of children are best met; and

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Requirement Due date

feedback on the experiences of children, including complaints received; 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)(b)(c)(d)(e)(f)(g)(i)(ii)(h))

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Requirement Due date

This relates to the manager showing effective leadership skills to continually review and evaluate the quality of care for children. Robust quality assurance and monitoring systems need to be in place. It also relates to having concise and accurate record-keeping in order for the progress of children to be evaluated by the manager.

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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; and

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Requirement Due date

a record is kept of the administration of medicine to each child. (Regulation 23 (1) (2)(b)(c))

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Requirement Due date

This relates to ensuring that medication errors are evaluated effectively and relevant policies are followed. Records of such errors should be accurate and contain all the necessary information. 18 May 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 not prevent children from receiving such continuity of care as is reasonable to meet their needs. 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 8 (Regulation 31 (1))

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Requirement Due date

This relates to consistency of care for children with complex needs and the impact on them of having temporary staff in the home on a daily basis.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

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

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Requirement Due date

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,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (2) (3)(d))

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Requirement Due date

This relates to ensuring that full information is available for each employee in respect of Schedule 2. 18 May 2023

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Requirement Due date

ensure that each employee completes an appropriate induction. (Regulation 33 (1)(a))

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Requirement Due date

This relates to ensuring that all staff, including those who are temporary, receive a sufficient induction to meet the needs of disabled children with complex health and care vulnerabilities. 18 May 2023

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Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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Requirement Due date

the name of the child; 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 9 details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”)—

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii) (c)(iv))

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Requirement Due date

This relates to ensuring that accurate records are kept of any incident of restraint and that these are properly evaluated by the manager.

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if—

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Requirement Due date

an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious;

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Requirement Due date

a child protection enquiry involving a child— 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 10 is instigated; or concludes (in which case, the notification must include the outcome of the child protection enquiry); or

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4)(b)(d)(e))

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Requirement Due date

This relates to serious incidents not being notified to the regulator, which prevents a thorough evaluation of the care provided to children.

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Requirement Due date

The registered person must ensure that an independent person visits the children’s home at least once each month.

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Requirement Due date

When the independent person is carrying out a visit, the registered person must help the independent person—

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Requirement Due date

if they consent, to interview in private such of the children, their parents, relatives and persons working at the home as the independent person requires. (Regulation 44 (1) (2)(a))

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Requirement Due date

This relates to the independent person visiting the home when children are present and seeking their views on their care. 18 May 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.

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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Requirement Due date

any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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Requirement Due date

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person 18 May 2023 Inspection report for children’s home - monitoring visit: SC032069 11 intends to take as a result of the quality of care review (“the quality of care review report”).

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Requirement Due date

supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed; and

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Requirement Due date

make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home.

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Requirement Due date

The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (1) (2)(a)(b)(c) (3) (4)(a)(b) (5))

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Requirement Due date

This relates to ensuring that there is a robust system in place for monitoring, reviewing and evaluating children’s care. The manager must ensure that this considers the opinions of children, families, staff and placing authorities.

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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: SC032069 12

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Children’s home details

Registered provider address: 25 Lisburn Road, Belfast BT9 7AA

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Children’s home details

Responsible individual: Richard Broughton

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Inspector

Rachael Sprigg, Social Care Inspector Inspection report for children’s home - monitoring visit: SC032069 13 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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