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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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This home is a short-break service that provides care 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 home is run by a combined healthcare NHS trust. It is 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 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: 25 February 2025

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requires improvement to be good

Overall judgement at last inspection: requires improvement to be 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

25/02/2025 Full Requires improvement to be good 20/03/2024 Full Good 28/02/2023 Full Good 08/06/2021 Full Good Inspection report for children's home: 2516984 3

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improvement to be good

At the time of inspection, five children were having a short break. All children were seen and appeared happy to be cared for by staff. The registered manager was absent during the inspection.

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improvement to be good

Staff demonstrate a clear understanding of individual children’s needs and support positive, nurturing relationships. Children appear happy during their stays, and positive peer interactions are encouraged. One parent said, ‘[Name of child] consistently enjoys attending the home and always wants to go back.’ Feedback overall has been positive, particularly noting how the short-break service has helped families manage care responsibilities at home.

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improvement to be good

Children are given opportunities to express their views and make choices, such as meal choices and activities. Children access some activities such as garden play, arts and crafts and sensory play. Staff supports these activities. Children’s views on what they would like to do next time are captured. However, the range of activities available does not consistently support children’s individual interests or development needs. Activity plans for children’s stay are not always in place, and their views are not always acted on for their stays next time. This lack of proactive creative planning limits children’s overall experiences. In addition, on occasions, constraints of staffing levels have meant that children’s stays have been cancelled and trips into the community have been limited.

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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. Communication systems are in place for children who cannot communicate verbally. However, there is an inconsistent approach to using these. For example, one child has had a new communication book introduced from school that is not being used. This inconsistent approach does not support children to develop their communication in a consistent way. In addition, the home has a staff picture board to support children’s understanding of staff members working during their stay. This was not updated accordingly throughout the inspection. This does not support children’s understanding and sense of security.

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improvement to be good

Since the last inspection, staff have developed more comprehensive care plans that clearly outline each child’s needs, including risks, health considerations and cultural or religious requirements. These plans now provide clear guidance for those supporting the children. However, in one instance, the transition of a child to adult services was not managed in line with the agreed care plan. A lack of multi-agency collaboration resulted in a missed opportunity to support the child’s move effectively.

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improvement to be good

The home environment is maintained. Some areas do require maintenance, such as painting and replacements of stained seatings. Despite this, living areas provide a warm Inspection report for children's home: 2516984 4 and homely feel. There has been a long wait for a new specialist bath and new kitchen, despite repeated requests by the manager. In addition, the garden is not well maintained for children. There are broken items and trip hazards. Leaders took immediate action to rectify this during this inspection. The play shed in the garden does not provide accessibility to children who use wheelchairs independently.

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

Since the last inspection, there have been improvements in planning stays for children who visit at the same time. Robust plans now provide clear guidance for staff. This reduces risks effectively, and there have been no incidents requiring physical intervention. Children remain safe throughout their visits.

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

Staff have demonstrated their understanding of children’s health needs, and children’s health is prioritised. Only nursing staff and qualified workers administer medication and undertake tasks such as percutaneous endoscopic gastrostomy feeds and oxygen suctioning. There have been some medication errors since the last inspection; however, these have not impacted on children. Staff and managers have taken appropriate actions to report and adapt practices to help prevent any further errors around recording and signing medication in and out.

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

Staff and managers have undertaken further learning about safeguarding practices since the last inspection. There is now a clear policy in place. In addition, staff have demonstrated a clear understanding of how to safeguard children and report any concerns. Furthermore, training has been identified for leaders and managers around the role of the local authority designated officer. This will help strengthen the safeguarding culture further in the home.

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

Risk assessments in place provide clear guidance for staff to follow. When risks are posed to specialist diets and sleeping, there are robust protocols in place that staff follow well. However, community-based activities for children are not risk assessed suitably. This does not provide staff with clear guidance around risk management out of the home while also considering health care risks. In addition, the restrictive access to the garden controlled by a keypad has not been risk assessed, which poses further concerns regarding inclusivity and safety.

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

At the time of inspection, the registered manager has been absent for 28 days. The home has been managed by a senior leader during this time. She is enthusiastic about driving improvements forward. She has a clear understanding of the home’s strengths and areas for development. A new responsible individual has been appointed since the last inspection in March 2025. However, she has had little oversight during this time. Despite this, she was able to demonstrate a clear understanding of areas for development and strengths since the last inspection. In addition, the new responsible Inspection report for children's home: 2516984 5 individual has not notified Ofsted of her appointment. Therefore, her suitability has not been assessed.

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

There continue to be changes to the staffing team, with staff leaving the home. However, leaders and managers have worked hard to boost staff morale during this time. In addition, previous permanent staff have supported gaps in the rota. This helps children to have continuity of care while also providing experience and skilled staff each working day.

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

Staff are now receiving regular supervision and an annual appraisal. However, it is not clear if these are always conducted by experienced, suitable people. Staff say they enjoy working in the home and feel well supported. There is a keen sense of teamwork in the home. This helps to drive improvements in the quality of care that children receive.

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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. Staff have not undertaken training in working with children with attention deficit hyperactivity disorder. This is a missed opportunity to ensure that all staff have the skills and knowledge to support the specific needs of children who access the short-break service.

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

Safer recruitment checks have now been conducted on bank members of staff. However, information of these checks has not been shared with the registered person. This does not allow the registered person to be satisfied that these staff members have been safely recruited. The manager has taken appropriate action, and these staff are not working in the home while a resolution is being considered.

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

Managers’ and leaders’ oversight requires improvement. Monitoring systems are not always effective. The registered manager has not met all the previous requirements from the last inspection. Managers’ review of accident forms does not pick up shortfalls in recordings of language used about the child. In addition, there is a lack of professional curiosity about how accidents have happened. Furthermore, the registered manager has not ensured that all relevant care planning recordings are obtained for children who are looked after. Some children’s records have outdated information about their allocated social workers. 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 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

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

provide to children living in the home the physical necessities they need in order to live there comfortably;

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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) (2)(b)(vii)(c)(i)(ii))

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Requirement Due date

In particular, ensure that specialist equipment is available and accessible to children to meet their individual needs. Areas of the home are designed to promote inclusivity and independence for children in the home and garden areas. Risk assessments specific to environmental restrictions should be kept under review.

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Requirement Due date

Additionally, the registered person must ensure that the home and garden environment is maintained and safe for children. 20 July 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. 20 July 2025 Inspection report for children's home: 2516984 7 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. (Regulation 12 (1) (2)(a)(i))

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Requirement Due date

This requirement was raised at the last inspection and is reinstated.

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Requirement Due date

In particular, the registered person must ensure that children’s risks are suitably assessed when children are accessing community-based activities. Ensure that risk assessments provide clear guidance around steps to take to safeguard children from harm, including risks relating to children’s complex health needs.

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

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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; 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)(d)(f)(h))

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Requirement Due date

This requirement was raised at the last inspection and is reinstated. 28 September 2025 Inspection report for children's home: 2516984 8 In particular, the registered person must ensure that they use monitoring and review systems to review and improve practice. Children’s records must be kept up to date. Staff should receive training to meet the individual needs of children who access the short-break service.

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home.

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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

plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority. (Regulation 14 (1)(a) (2)(iii))

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Requirement Due date

In particular, the registered person must ensure that children have access to a variety of enjoyable, planned activities that reflect their interests and developmental needs. Children’s views must be considered in planning activities in the home and community. When children leave the home, care planning must be effective to support a smooth transition. 28 September 2025

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Requirement Due date

An organisation may only carry on a home if—

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Requirement Due date

the organisation has notified HMCI of the name, address and position in the organisation of the responsible individual. (Regulation 26 (4)(ii))

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Requirement Due date

This specifically relates to the responsible individual informing Ofsted at point of appointment. 29 June 2025

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Recommendation

 The registered person should ensure that staff record information on individual children in a non-stigmatising way. Information about the child must always be recorded in a way that will be helpful to the child, in particular the recording of children’s incidents. (‘Guide to the Children’s Homes Regulations, including the quality standards’, page 62, paragraph 14.4) Inspection report for children's home: 2516984 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: 2516984 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

Joanne Humphreys, Social Care Inspector Inspection report for children's home: 2516984 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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