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

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Inspected under the social care common inspection framework

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Information about this children’s home

This 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 nurse. She registered with Ofsted in January 2025.

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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

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: 2516984 2

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Inspection date Inspection type Inspection judgement

20/03/2024 Full Good 28/02/2023 Full Good 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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improvement to be good

At the time of this inspection, four children were having a short break. All these children were seen.

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improvement to be good

Since the last inspection, there have been a lot of changes at the home. The previous manager and some established staff have left. A new manager has been recruited and has registered with Ofsted. The changes have had some impact on staffing levels at the home, which has meant that on occasions children’s stays have been cancelled and trips out into the community have been limited.

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improvement to be good

Despite the changes, staff are committed to providing children with the best possible care. Children are cared for by staff who know them well and they enjoy their stays. Children and their parents say that children look forward to coming and seeing their friends and that they have lots of positive experiences.

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improvement to be good

On one occasion, a child remained at the home longer than expected for a short break. This decision was made as the child knew the home and staff well, so it was in their best interests. Staff helped the child to understand what was happening and involved them in discussions about their future. Staff advocated for the child when plans were made to move the child from the home, due to them being settled there. This meant that when the child did move, the planning was child centred and at the child’s pace. This helped the child settle into their new home quickly.

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improvement to be good

Staff help children to take part in activities in the home and garden. These include arts and crafts, watching favourite television programmes, music, dance and cooking. At Christmas, Santa visited the home, and the manager arranged for a theatre company to come to the home and present a panto for children and their families.

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improvement to be good

Staff have developed plans for children which help others understand their needs and how best to care for them. Staff listen to families and update children’s plans as their needs change. However, staff have not fully explored with parents how children’s cultural or religious needs can be supported.

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improvement to be good

Staff have positive relationships with other professionals, including education staff. Staff visit children in school to gain insight into how best to support their learning needs, such as communication. This helps with providing consistent care to children when they visit the home.

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improvement to be good

The home is well maintained and when equipment breaks, this is reported promptly. However, there has been a long wait for a new specialist bath and a new kitchen, despite repeated requests by the manager. Inspection report for children's home: 2516984 4

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improvement to be good

Managers carefully consider which children visit together. There are few incidents and staff have not needed to use physical intervention to keep children safe.

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improvement to be good

Children’s health is prioritised. Only nursing staff and qualified workers administer medication and undertake tasks such as PEG feeds. There have not been any errors in the administration of medication.

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improvement to be good

Since the last inspection, new permanent staff have been recruited and there has been an increase in the use of bank staff, who are also used across the wider organisation. The manager has made sure that safer recruitment checks are carried out before new permanent staff are recruited. However, she has not checked that the same level of safer recruitment checks have been carried out for bank staff. This fails to ensure that all staff working with children are appropriate to be doing so.

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improvement to be good

On one occasion, a staff member did not follow the home’s safeguarding policy when a concern was raised by a parent about their child. There is no evidence the child came to any harm. This issue was identified during the inspection and the manager took prompt action. She carried out initial fact-finding, recorded the concern and reported it to those who needed to know.

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improvement to be good

Staff have developed plans to help others understand the risks to children. However, for one child, not all the known risks had been added to their plan. This could mean not all staff are aware of identified risks or the action staff need to take to manage these.

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improvement to be good

The manager has made changes to the way staff visually check children, during the day and at night. However, the approach taken is not individualised to children’s needs, meaning that, for some children, the frequency of that monitoring may not be necessary. However, records have not always been completed for those who do need frequent checks.

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The effectiveness of leaders and managers: requires improvement to be good

The manager has used her monitoring systems to identify areas where change or improvement are needed, which will enhance the care of the children and the environment. However, these changes have not always been well received by staff and as a result, morale has dipped and some staff have left. The manager and leaders are aware of the challenges and have plans to organise team-building days with an independent person.

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The effectiveness of leaders and managers: requires improvement to be good

The manager is continuing to recruit new staff so that there is less reliance on bank staff and future cancellations of children’s stays are minimised. New permanent staff receive a comprehensive induction which includes shadowing opportunities. However, there is no clear and consistent programme of induction in place for bank staff. This means that Inspection report for children's home: 2516984 5 some staff working with children are not being provided with the knowledge that they need.

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The effectiveness of leaders and managers: requires improvement to be good

Not all staff feel well supported. Supervisions have not been held in line with the organisation’s policy, and bank staff have not had any supervision. This means not all staff are being given the opportunity to discuss their feelings or reflect on their practice.

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The effectiveness of leaders and managers: requires improvement to be good

Staff receive a variety of training and most have completed all the organisation’s mandatory training. More specialist training is provided by external professionals who have specific knowledge, for example, individual children’s epilepsy nurses. However, staff have not undertaken training in working with children with learning disabilities or who have attention deficit hyperactivity disorder. This could mean not all staff have all the skills and knowledge they need to care for the children.

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The effectiveness of leaders and managers: requires improvement to be good

Feedback from families and professionals was positive. Some acknowledged there had been staffing challenges but understood why their stays were changed. All said how much children enjoyed their stays and that children were well cared for and kept safe. Inspection report for children's home: 2516984 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, The 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 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— that staff—

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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

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. (Regulation 12 (1) (2)(a)(i)(v)(vi)(vii))

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Requirement Due date

This relates to staff understanding the home’s child protection policy and taking the correct action when concerns are raised, that staff record monitoring checks as per children’s plans and that all risks are included in children’s plans, along with the action staff need to take to keep children safe. 11 April 2025

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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, 11 April 2025 Inspection report for children's home: 2516984 7 if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

the individual is of integrity and good character;

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform;

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Requirement Due date

the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and

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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)(a)(b) (3)(a)(b)(c)(d))

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Requirement Due date

Specifically, that staff from the NHS internal bank system who work at the home have been recruited as per this regulation.

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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. (Regulation 33 (4)(b)) 11 April 2025

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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. (Regulation 13 (1)(a)(b) (2)(c))

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Requirement Due date

Specifically, that staff have training in working with children with learning disabilities and those who have attention deficit hyperactivity disorder. 11 April 2025 Inspection report for children's home: 2516984 8

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Recommendations

 The registered person should ensure that children are able to maintain and develop their cultural or religious beliefs as far as practicable and where appropriate, through participation and instruction and by observing religious requirements, including dress and diet. Specifically, that staff consult with parents on how they can support children when they are on their short break. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 17, paragraph 3.22)  The registered person should continually and actively assess the risks to each child and the arrangements in place to protect them. Specifically, that frequent visual checks on children are still necessary. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 42, paragraph 9.5)  The registered person should ensure that external staff, such as agency or bank staff, have had the necessary induction when they start work in the home. (‘Guide to the

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Recommendations

Children’s Homes Regulations, including the quality standards’, page 54, paragraph 10.16)

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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 9

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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: 2516984 10 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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