Monitoring Quality

The Authority will arrange for all of its children's homes and residential family centre to receive monthly visits from an Independent Person. These visits are an on-going process that identifies where you are at any given point in time and provides a potential basis in moving forwards. This is only a small element of this process. The visits should usually be unannounced but can be announced if it is necessary to arrange to meet a particular person.

For more information on who can be appointed as an independent person, see Children's Homes Regulations Amendments 2014: Advice for Children's Homes Providers on New Duties under Amendments to Regulations that came into Effect in January and April 2014.

The visit will be for a minimum of one hour. The person should complete a written report of the visit. This may include recommendations for improvement, with timescales.

The report should be shared with the Registered Manager and Responsible Individual, with the opportunity to make comment e.g. if there is disagreement with the comments and recommendations.

The report should be lodged with the home for the Manager and staff to read and respond to.

A copy of this report is sent to the Regulatory Authority in the following month after the visit.

The independent person, when carrying out a visit, shall:

• Interview, with their consent and in private, such of the children accommodated there, their parents, relatives and persons working at the children's home as appears necessary in order to form an opinion as to whether:
  • Children accommodated at the children's home are effectively safeguarded;
  • Parents accommodated at the residential family centre are appropriately supported;
  • The conduct of the children's home promotes the wellbeing of the children accommodated there;
  • The conduct of the residential family centre promotes the wellbeing of the families accommodated there.
• Inspect the premises of the children's home, and such of the children's home's records, as the independent person requires (children's case records may only be inspected with the consent of the child and the child's Placing Authority);
• Inspect the premises of the residential family centre and such of the family centre's records, as the independent person requires (children's case records may only be inspected with the consent of the child and the child's Placing Authority).

This may include the following:

1. Meet and talk to children and staff of the home to ascertain their views, comments and any complaints about the running of the home;
2. In the case of the residential family centre, also meet and talk to the parents being accommodated at the centre to ascertain their views, comments and any complaints about the running of the centre;
3. Read the Daily Log, records of restraints, incidents, reports of notifiable events;
4. Read the records of Comments, Representations and Complaints and (Child Protection Referrals), commenting on the frequency and type made and whether they appear to have been dealt with adequately;
5. Read and comment on the record of Children's and Staff Meetings, or other methods used by the manager to consult the children and staff, held in the home. The person should also check that staff supervision have taken place as required;
6. Check on the physical condition and decoration of the home, including the children's bedrooms and families bedrooms in the case of the residential family centre.

Each site used by the scheme must be visited by either the responsible individual or another of the directors or partners or other persons responsible for the management of the organisation. A visit must take place at least once in every 12 month period at a time when children are being provided with care and accommodation there. The person carrying out the visit must interview, with their consent and in private, the children who are accommodated by the scheme and staff members in order to form an opinion of the standard of care provided by the scheme. The person carrying out this visit must inspect the premises and sites used by the scheme to provide care and accommodation for the children and inspect the records of any complaints. The person must prepare a written report on the conduct of the scheme and the report must be supplied to OFSTED; the registered manager and the directors responsible for the management of the organisation.

As identified earlier, the formal Review of Quality of Care (Regulation 45 for Children's Home/Regulation 23 for Residential Family Centres) completed by the Registered Manager must be submitted to HMCI at least once every 6 months which is sent within 28 days of the completion of the review.

It is the expectation of the Responsible Individual that these reviews are completed at least twice per year. The registered Manager may assess that due to events in the home, changes in residents or significant changes in staff for example it may be helpful to review outside of these timescales.

In order to complete a review of the quality of care the Registered Manager must establish and maintain a system for monitoring, reviewing and evaluating:

1. The quality of care provided for children;

2. The quality of support provided for families in the case of the residential family centre;
3. The quality of assessment in the case of the residential family centre: how robust, fair and evidence-based the assessment is and how much it is based on the family's individual needs;
4. The feedback and opinions of the children about the children's home, its facilities and the quality of care they receive in it;
5. The feedback and opinions of the parents about the residential family centre, its facilities, the quality of the assessment process as per (c) above and the quality of the support they receive from the staff team;
6. Any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children;
7. In the case of the residential family centre, any actions that the registered person considers necessary in order to improve or maintain the quality of assessment and the quality of support provided for the families;
8. The feedback and opinions of the parents, placing authorities and other significant stakeholders in the care of the children and in the home such as the staff working there;
9. In the case of the residential family centre, the feedback of the placing authorities and other significant stakeholders (including the Guardians where children are subject to care proceedings).

The Registered Manger should make available their schedule of monitoring to ensure that in their absence monitoring will continue.

Whilst it is the responsibility of the Registered Manager to establish and maintain their system of monitoring for the home, the expectation is that that the following are monitored:

Minimum of weekly:

1. Incidents including:
   1. The use of restrictive physical interventions;
   2. Episodes of missing from home;
   3. Accidents and injuries;
   4. Safeguarding or Child Protection;
   5. Notifications under Regulation 40 (Children's Homes Regulations);
   6. Notifications under Regulation 26 (Residential Family Centre Regulations 2002).
2. Daily notes / recordings;
3. Complaints log;
4. Fire log;
5. Day planner;
6. 1:1 consultations or debriefs following incidents;
7. Medication records;
8. Sanctions;
9. Daily log book.

Minimum of monthly:

1. Cleaning rota;
2. Fridge/freezer temps;
3. Menus (quality and evidence of child involvement);
4. Communications book;
5. Rotas and timesheets;
6. Visitor's book;
7. Staff supervision records;
8. 1:1 work/keyworker sessions;
9. Maintenance log;
10. Health records;
11. Monetary records;
12. Meetings – staff and children's; families in the case of the residential family centre;
13. Children's Files including:
    1. Placement Plans / Care Plans;
    2. Risk assessments;
    3. Individual Behaviour Support Plans;
    4. Monthly reports/summaries;
    5. Contacts with Parents/Social Workers/others;
    6. Education attendance and attainment.
14. Case management meetings;
15. Training matrix;
16. First aid boxes;
17. Contents of fire box;
18. Legionnares testing;
19. Families Files including:
    1. Family Placement Plan (See Residential Family Centres National Minimum Standards : Standard 9: Family Placement Plan);
    2. Risk Assessments;
    3. Daily Progress Notes;
    4. Fortnightly Summaries;
    5. Records of learning activities conducted with parents as part of the assessment process;
    6. Review and Final Assessment Reports;
    7. Contacts with Social Worker/Guardians/Health Visitors/others;
    8. Education attendance if children are of school age.

Minimum of Quarterly (Children's Homes)

1. LAC Reviews;
2. Education paperwork (plans and targets).

For Guidance on what should be included within the report see Appendix 1: Regulation 45 Report on Review of Quality of Care: Children's Homes.

See Regulation 45 Report (Children's Homes)/Regulation 23 Report (Residential Family Centres) – Review of Quality of Care.

The manager must establish and maintain a system for improving the quality of care provided by the scheme and monitoring the following matters:

• The deposit and issue of money and other valuables handed in for safekeeping;
• Accidents involving and injuries to persons in premises or sites used by the scheme to accommodate children;
• Illnesses of children accommodated by the scheme;
• Complaints in relation to children accommodated by the scheme and the outcomes of those complaints;
• Allegations or suspicions of abuse in respect of children accommodated by the scheme and the outcome of any related investigation;
• Visitors to premises or sites used by the scheme to accommodate children, including visitors to children accommodated;
• Notifications;
• The use of measures of control, discipline and restraint in respect of children accommodated by the scheme;
• Risk assessments for health and safety purposes and subsequent action taken;
• First aid, medical treatment or medicines administered to a child accommodated by the scheme;
• Fire drills and tests of alarms and of fire equipment.

1. Any safeguarding concerns or incidents in respect of a child accommodated at the children's home and the measures taken by the persons working at the children's home to respond effectively to these to ensure the safeguarding and welfare of the child. What has been learnt from these incidents?
2. The arrangements for children coming to and leaving the children's home. Impact on the home?
3. The arrangements for monitoring the quality of care provided by the children's home's, including the actions taken in response to recommendations made by the independent person or, as the case may be, the reasons why the registered person did not consider it appropriate or necessary to take any such actions;
4. In respect of each child accommodated in the children's home, compliance with the Placing Authority's care plans and placement plans;
5. The arrangements for:
   1. Consulting children about the quality of the children's home's care and for acting on the results of such consultation;
   2. Involving children in decisions about:
      1. Their own care; and
      2. The day to day running of the children's home.
6. Complaints in relation to the children's home or children accommodated in it, including any actions taken in response to such complaints and how complaints were resolved;
7. Notifications of the events under Regulation 40 (see Notification of Serious Events Procedure).

8. The effectiveness of the children's home is not dually registered as a school, the effectiveness of the children's home in promoting the educational attainment of children in its care and the quality of relationships between the children's home and local schools.

9. The arrangements for promoting and supporting the positive behaviour of children accommodated in the children's home;
10. The effectiveness of the children's home's approach to behavioural support, including arrangements for commissioning training for staff in behaviour management and restraint;
11. The number of times that children accommodated at the children's home are restrained and the steps taken by the children's home to minimise the use of restraint;
12. Whether there have been any occasions when children accommodated in the children's home have been charged with a criminal offence.

13. The arrangements, if any, for commissioning therapeutic services appropriate to the needs of children accommodated by the children's home and the effectiveness of any such arrangements in achieving health outcomes for the children accommodated by the children's home;
14. The arrangements for children to be provided with general medical practitioner and other primary health care services, including access to preventive and screening services in the local community;
15. Details of children requiring accident and emergency treatment and other hospital services;
16. Illnesses of children accommodated in the children's home.

17. Risk assessments for health and safety purposes and subsequent action taken;
18. Fire drills and tests of alarms and of fire equipment.
19. The arrangements for the management and supervision of staff working at the children's home, including duty rosters and staff deployment in relation to incidents at the children's home;
20. The arrangements for continuing professional development, recruitment and training of staff working at the children's home;
    
    Details of:
    1. Disciplinary action concerning persons working at the children's home;
    2. Staff grievances.
       
       The reasons for staff ceasing employment at the children's home.
21. The arrangements for consultation with placing authorities, the local authority in whose area the children's home is located and other community services used by children accommodated at the children's home;
22. The effectiveness of the children's home's guidance and procedures concerning police involvement in the children's home.

On an annual basis, the managers must also review the Home's Statement of Purpose, and make necessary improvements, which should be approved by the Regulatory Authority.

23. The number of reports of children accommodated at the children's home being absent without permission;
24. The measures taken by staff:
    1. To prevent children from being absent from the children's home without permission; and
    2. In response to a child being absent without permission from the children's home.
25. The effectiveness of arrangements agreed between the children's home, local police and the local authority for responding to missing person incidents in relation to children accommodated at the children's home.