Gill Horrobin, 01962 847091 [email protected]

1 Summary

1.1 This report provides information regarding the performance of Hampshire's residential units, following inspections carried out by the Commission for Social Care Inspection (referred to as The Commission in the remainder of this report)) in the financial year, April 2005 to March 2006.

1.2 The report responds to a recommendation detailed in the report `Review of the Safety of Children's Homes Run by Hampshire County Council' written by Peter Wood (Independent Social Care Consultant) in August 2005. The recommendation concerned is as follows:

`That data on the performance of the department's children's homes with regard to compliance with the Children's Homes Regulations and National Minimum Standards is collated centrally and reported regularly to Members and managers at all levels within the organisation'.

1.3 The review was commissioned by the (then) Director of Social Services as a result of a briefing from The Commission, which formed part of Hampshire's Annual Performance Assessment (APA). A statement within the briefing reported that there appeared to have been no progress in relation to ensuring that Hampshire's residential units kept children safe. The statement was subsequently withdrawn to take into account improvements in the running of Hampshire's residential units.

1.4 Following the publication of Peter Wood's report, formal mechanisms have been put in place to strategically collate information from inspections. Formats for recording scores and work plans are consistently used in all residential units. The Commission have approved the systems put in place.

1.5 Provision of residential care for children and young people in Hampshire supports aims 1, 4 and 5 of the Corporate Strategy by:

· Maximising life opportunities;

· Building strong and safe communities;

· Improving services.

1.6 The service, by the very nature of the way in which it is delivered and inspected (see Section 3), supports the five outcomes of `Every Child Matters' and of the Children Act 2004.

2 Process for Inspection

2.1 The process for inspection changed in 2005/06. The `old' process for Hampshire comprised of announced and unannounced inspections. Specific standards would generally be inspected more than once within the year. It was easier to see if standards had been assessed as having improved or deteriorated over a relatively short period of time. The initial judgement made by the Commission (referred to in paragraph 1.3) was based purely upon announced inspections.

In 2004/5, of all the standards assessed as part of announced inspections in all units, 36% of standards failed, i.e. scored a 2 or 1 (minor shortfalls and major shortfalls respectively).

2.2 The new process comprises a `lighter touch', in line with Hampshire's current star rating. All inspections are now unannounced, carried out by one inspector per unit, with each standard generally being inspected at least once within the year. Less time is spent at the unit by the inspector, making it vital that supporting evidence is readily available.

2.3 In view of the revised process for inspection in Hampshire, work has been undertaken to respond to the increased risks that are associated with unannounced inspections, ensuring all units are prepared for inspection at all times. The residential training course has been amended to ensure all new staff are clear about their roles and responsibilities regarding inspection, the emphasis being on providing evidence.

2.4 The guidance provided on the training has also been shared with all registered managers, with a clear message that they are responsible for ensuring all their staff members are ready for inspection at all times.

3 Performance in 2005/06

3.1 This section provides a summary of feedback from inspections. It is broken down into six sections, five of which are in line with the Children Act 2004 outcomes, the format used for inspection. In addition, there is a sixth heading entitled `Management'.

3.2 Appendix One details the scores for all the units against the standards in relation to all inspections that have taken place in 2005/06.

3.3 Being Healthy: Of the forty four standards assessed, eight failed to meet the standard (all scoring a 2 - minor shortfall) equating to 18% (a reduction from 43% last year). Most of the shortfalls related to issues around the recording and administration of medication. Stonecroft accounted for half of the shortfalls and had two repeated requirements for Standards 12 and 13, one relating to an insufficiently detailed health care plan. The minor shortfall relating to The Green House referred to a written dosage on a prescription not mirroring the verbal guidance given by the GP to the young person. This resulted, in The Commission's view, as an inaccurate record.

3.4 Staying Safe: Generally a much improved picture this year compared to last with only nine standards failing (out of 108 assessed) equating to 8% (a reduction from 41% in 2004/05). There were no key themes in relation to the shortfalls in this section, but most issues related to lack of privacy (inadequate bedroom locks, lack of bathroom blinds, lack of telephone hood for the young people's telephone). Two units scored a 2 for lack of compliance regarding testing of fire equipment although, for Swanwick Lodge, a new system with minor problems was being addressed by the contractors. One requirement referred to a cleaner not having accessed child protection training and another, inadequate monitoring of the length of time a child was restrained. Other scores of 2 related to one young person stating she had not been given the opportunity to sign against her sanction and lack of explanation to children at one unit regarding the context within which they should contact the Commission regarding complaints.

3.5 Enjoying and Achieving: Of the 39 standards assessed only one failed to meet the standard, equating to 2.5% (a reduction from 14% last year). The score of 2 related to Stonecroft - no evidence was found in young people's files regarding efforts to promote education and increase school attendance. Godbey House scored a 4 due to the wide range of leisure activities that children have access to and Swanwick scored a 4 for the high priority that education is given.

3.6 Making a Positive Contribution: Of the 61 standards assessed four failed to meet the standard, equating to 6.5% (a reduction from 11.7% last year). Both Milesdown and Glendalyn failed to meet the standard relating to consultation. In respect of Milesdown this was regarding the recording of young people's meetings, including when residents refused to attend. As far as Glendalyn was concerned, the same standard scored 2 with no evidence to suggest why this was the case and no requirement against the standard. Stonecroft scored a 2 for each of their two inspections (different standards), both of which related to placement planning, i.e. no placement plan for one young person and lack of effective monitoring by the registered person.

Swanwick Lodge scored two 4s in relation to placement plans and reviews

3.7 Achieving Economic Wellbeing: Of the 52 standards assessed, ten failed to meet the standard, equating to 19% (a reduction from 28% last year). Seven of the standards that failed relate to accommodation, with The Mead and Glendalyn both scoring a 1. Glendalyn required a considerable amount of work regarding refurbishment, which has now been completed. The Mead had a repeat requirement in relation to the provision of separate shower facilities for staff. This requirement remains unmet (due to the scale of works required), but work is in progress. The Mead also had requirements in relation to the environment, with the inspector stating that it looked shabby and uncared for. The latter requirements have all been met. Cypress Lodge has received a score of 2 against the same standard in both inspections this year, both in relation to required refurbishment of bedroom accommodation. There has also been a requirement in relation to the provision of hand washing facilities in the shower room,. However, almost all of the requirements in relation to the building have now been met. Crossways, Godbey House and Milesdown all received a score of 4 for their accommodation although Crossways received a 2 in their second inspection (uncomfortable lounge furniture) against the same standard.

3.8 Management: Of the 83 standards assessed, six failed to meet the standards, equating to 7% (a reduction from 30% last year). Cypress Lodge received a score of 2 against two standards, one being very unclear as it relates to the adequacy of staffing, but there is no mention of any shortfalls in the text of the report. There was also a requirement for the Regulation 33 visitor to monitor the complaints log. The Long House scored a 2 in relation to there being no permanent manager at that time (since rectified) and Milesdown scored a 2 in respect of missed supervision sessions. Godbey House scored a 2 which referred to children routinely being provided with information about accessing their files. Swanwick Lodge scored a 4 in respect of the unit being managed efficiently, providing a safe and stable environment for the young people.

4. Conclusions

4.1 Performance has improved significantly against the standards for 2005/6 in comparison to last year. This can be seen from the table below:

Standards	% of Standards Failed
	2004/5	2005/6
Being Healthy	52.4%	18.18%
Staying Safe	40%	8.33%
Enjoying and Achieving	23%	2.56%
Making a Positive Contribution	23.6%	6.55%
Achieving Economic Wellbeing	39.5%	19.23%
Management	38%	7.22%
Total	36%	9.8%

4.2 Three standards were assessed as having major shortfalls this year. Two of these related to the building. Registered managers are reliant on assistance from other parts of the County Council to meet standards that relate to the building, but are proactive in liaising accordingly, both flagging up requirements in a timely way and monitoring progress. The other shortfall related to one young person complaining about being overheard whilst on the telephone. The only outstanding requirements in relation to these scores are the shower facilities at The Mead.

4.3 There are no key themes as far as shortfalls are concerned, although there have been a number of outstanding requirements over the year in relation to building requirements that have not been met within timescales set by the Commission.

4.4 An issue that has been highlighted in two inspections (Swanwick and Godbey) has been young people's access to their records, with high priority given to The Freedom of Information and Data Protection legislation. The inspectors would like to see more open recording (children seeing and signing their contact sheets) and generally more information given to children and young people about their right to see their files.

4.5 On two recent occasions, units have received scores of 2 in relation to good practice recommendations as opposed to requirements. This has been followed up with the Commission and their response is as follows.......'where an element of any standard is not met and can be linked directly to a regulation, then this will result in a statutory requirement being made. Where it is not possible to link directly to a regulation then a recommendation will be made. In both instances the score for that standard will be affected'.

4.6 The change in process for inspection, which could result in much longer gaps between inspections, could lead to complacency. It could be a year or more between assessment against specific standards. It is therefore crucial to ensure developments continue to take place (both strategically and in-unit) and a very high emphasis given on evidencing for inspection, with constant staff briefing sessions about the type of evidence required against the standards. In some units audits are already taking place with key staff members taking leads on specific areas. This good practice has been shared with all registered managers at an away day in November last year. In addition, registered managers routinely feedback issues following inspections (both positive feedback and areas for development) as part of their monthly business meetings.

4.7 The hard work and substantial improvement in standards within the residential sector has been recognised. The Annual Performance Assessment (APA) letter (from CSCI/Ofsted) to the director in December 2005, acknowledged improvements in the care of children's health in children's homes and the fact that the units are being refurbished. Recent assessment from the Commission also identifies a number of areas of good practice within the children's residential sector.

4 Legal implications

5.1 None.

5 Financial implications

6.1 None.

6 Personnel implications

7.1 None.

7 Impact assessment

8.1 Race and equality impact assessment has been considered in the development of this report and no adverse impact has been identified.

8 Crime prevention issues

9.1 Not applicable.

9 Views of the Local County Councillor

10.1 Not applicable.

Recommendations

1 That the progress and improved performance within the children's residential sector is noted.

2 That a report on inspection of children's homes is brought to Members of this Committee on an annual basis.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB: the list excludes

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

All reports written by the Commission for Social Care Inspection following inspections of Hampshire's Children's residential units in the financial year 2005/06.