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

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Inspected under the social care common inspection framework

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Information about this children’s home

This home provides short breaks for up to four 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

Date of last inspection: 13 February 2024

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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: 2587315 2

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Inspection date Inspection type Inspection judgement

13/02/2024 Full Good 21/03/2023 Full Good 09/11/2021 Full Good Inspection report for children's home: 2587315 3

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improvement to be good

At the time of this inspection, two children were enjoying a short break. Both children were seen. Children enjoy their stays. Parents say children enjoy visiting and are happy to go to the home.

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improvement to be good

Staff carry out thorough assessments of children to make sure the home can meet their needs. One parent was complimentary about the home, the professionalism of staff and their attention to detail when developing care plans for children. However, staff have not always updated those plans when information has changed, for example, new social worker details.

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improvement to be good

Staff plan introductory visits well, at the child and their family’s pace. This means children get to know the home and staff before having overnight stays.

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improvement to be good

On one occasion, staff did not consult with a child’s family or placing authority when they felt a child would be better placed in this home instead of the sister home on the same site. The child had been visiting that home for some time and was moved without any discussion with the child’s family. This meant that the child’s family and placing authority were unaware of the change in care arrangements.

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improvement to be good

On occasions, children’s stays have been cancelled due to lack of staff. This has impacted on children. They have not been able to have regular opportunities to spend time with other children, socialising and developing their independence.

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improvement to be good

Staff are committed to making sure children have enjoyable stays. Staff know what activities children like to do and plan children’s visits so that they take part in things they enjoy doing. Children play outside and many love going on the trampoline. Staff also help children to do baking, arts and crafts, listen to music, play in the sensory room and go to the on-site hydrotherapy room. However, due to limited staff numbers, children have few opportunities to socially engage away from the home. This does not help develop children’s resilience or social skills, especially as some children visit when no other children are at the home.

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improvement to be good

Children are checked by staff during the night due to their health needs, and there has been a blanket approach to this. This has meant one child who does not have a concerning health condition is checked hourly throughout the night. This is despite parents requesting the child is not checked and it not being a proportionate approach to meeting the child’s needs. In addition, when checks are carried out for children, these are not always recorded by staff. Inspection report for children's home: 2587315 4 Staff are committed to the children. For example, when home-school transport was not available for one child, staff went to collect the child from school so that they did not miss out on their stay.

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improvement to be good

Staff keep children safe. However, some staff practice and shortfalls in records have the potential to put children at risk.

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improvement to be good

The home has nursing staff on site. The nurses support children during medical emergencies. On one occasion, parents were not given full details of how a child presented during a seizure. This meant the parents were not able to give the most up- to-date information to the child’s consultant.

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improvement to be good

There have some been medication errors at the home. Staff have not always followed the home’s procedures on checking medication correctly against pharmacy labels and on one occasion, they left a child’s medication in their drinks bottle. These errors have not caused harm to children but highlight the need to improve practice relating to medication.

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improvement to be good

Staff have developed plans which include risks to children and how to meet children’s health needs. However, staff have not always updated children’s risk plans promptly with new risks. In addition, staff have not always checked that all documents with guidance on what to do when a child is having a seizure are correct, or made sure that plans for what to do if a child was to go missing are sufficiently detailed.

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improvement to be good

Fire checks are carried out regularly. However, none of the children who currently visit the home have had an opportunity to practise an evacuation or been told what to do if there was a fire at the home.

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

Since the last inspection, there have been changes to the management team in the home and some staff have left. This has had an impact on staffing sufficiency and morale. Leaders are aware and have given additional support to the manager and the team. In addition, team-building sessions are planned.

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

Recruitment is ongoing and the manager is not using as many bank staff as previously. Despite all the changes, staff stay committed to the care of the children. New staff have come to work at the home, and they have brought new ideas and energy.

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

Managers’ monitoring systems are not as robust as they could be. Shortfalls have been found, for example, managers’ oversight of records such as risk assessments, not making sure all staff have had training they may need and that bank staff are safely recruited. Leaders are aware of the shortfalls and have put in place an action plan to make improvements to the home. Inspection report for children's home: 2587315 5 Not all staff feel well supported. Supervision has not always taken place in line with expectations and bank staff have not received any supervision. This does not give staff an 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. However, staff have not had training in working with children with learning disabilities, attention deficit hyperactivity disorder or supporting children with a visual impairment. This could mean not all staff have all the skills and knowledge they need to care for the children. 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, 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 health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being; and

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Requirement Due date

children are helped to lead healthy lifestyles.

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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

achieve the health and well-being outcomes that are recorded in the child’s relevant plans. (Regulation 10 (1)(a)(b)(c) (2)(a)(i)(ii)(iii)(iv))

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Requirement Due date

This relates to staff making sure children’s medication is given safely and in line with their prescription and that plans providing guidance to staff about when to give a child emergency medication are accurate. 25 April 2025

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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; 25 April 2025 Inspection report for children's home: 2587315 7 understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person. (Regulation 12 (1) (2)(a)(i)(v))

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Requirement Due date

This relates to staff making sure risk all risks to children are included in their plans, along with action staff need to take to keep children safe, and that when children are checked at night, this is recorded.

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Requirement Due date

After consultation with the fire and rescue authority, the registered person must—

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Requirement Due date

ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire. (Regulation 25 (1)(d))

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Requirement Due date

Specifically, that children are advised and given instruction on the action they need to take in the event of a fire at the home. 25 April 2025

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Requirement Due date

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans;

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5 (a)(d))

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Requirement Due date

Specifically, that staff share information with and consult with families and external professionals as necessary in relation to any concerns relating to children’s health or changes to their care arrangements. 25 April 2025

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if—

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children; 25 April 2025 Inspection report for children's home: 2587315 8 the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy. (Regulation 24 (1)(a)(b)(c)(d))

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Requirement Due date

Specifically, that staff do not visually monitor children at night when parents have requested this is not done.

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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

This relates to staff having training to meet the needs of the children staying at the home and that the manager’s monitoring systems are effective in identifying areas which need improvement. 25 April 2025

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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))

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Requirement Due date

This relates to all staff, permanent and bank staff. 25 April 2025

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Recommendation

 The registered person should ensure that short breaks play a role in extending and increasing the opportunities available to children to share, socialise with others and choose activities alongside their peers. This includes providing these opportunities to children away from the home. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 40, paragraph 8.21) Inspection report for children's home: 2587315 9

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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 10

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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 11 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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