24. Inspecting different types of homes
How inspections take account of the different types of children’s homes.
Each home is unique and, while all providers have to meet the requirements of regulations and take into account the Guide, there will be different ways that these are shown in different homes and for different groups of children and young people. Inspectors should use their pre-inspection planning time and the set-up meeting at the beginning of the inspection to understand the ethos and the approach or model of care used in a particular home.
Inspectors need to take the purpose of the home into account because this will influence:
- the specific needs of the children who come to live in the home and how these needs are made
- the physical environment
- the nature and extent of children’s progress
- the type of experiences that children can expect to have
- the training and development needs for staff
- how, as inspectors, they are able to understand the views and/or experiences of children
- the key stakeholders that they may try to contact
Some schools and children’s homes adopt a particular way of working or subscribe to a particular model of practice. It is not expected that inspectors have a detailed knowledge of all the theoretical models or approaches to residential care. However, it is important that they take the home’s approach into account and take opportunities to familiarise themselves with the principles of it wherever possible.
Where a home applies specific social work models, inspectors may ask staff if they have received training in these and to explain how the application of the models benefits children. Inspectors should not make judgements about the approach itself but should evaluate its impact on the children’s experiences and progress. If an inspector has any concerns about the efficacy or authenticity of a particular approach, they should seek advice from their manager.
24.1 Secure children’s homes
During inspections of secure children’s homes, inspectors should give careful consideration to:
- the quality and outcomes of education and related learning activities – separate and specific guidance is given for these aspects of the inspection of secure children’s homes
- for those children placed in secure children’s homes on justice grounds, the extent to which assessment and sentence planning is consistent with relevant legislation and guidance (National standards for youth justice services (2013)) and incorporated into the approved assessment and planning tools
- information provided to inspectors by the Youth Justice Board performance monitor
- the effective use and management of CCTV, security doors, locks and fences; escort arrangements to and from the secure children’s home; and management of movement around the building and outside the secure perimeter, including local emergency services’ access
- how effectively the use of restraint, single separation and searches of children are managed and minimised. Practice should take full account of relevant guidance and legislation, including the Youth Justice Board’s code of practice for behaviour management
- how well children’s outcomes are promoted through prompt and ongoing preparation for reintegration back into their community or a move to another secure setting, including resettlement or discharge planning arrangements
- the timeliness, quality and impact of health services provided for children, including specialist mental health and substance misuse services
When inspecting secure children’s homes, the United Nations Convention on the Rights of the Child (UNCRC) is taken into account.
All inspections carried out by Ofsted contribute to the UK’s response to its international obligations under the ‘Optional protocol to the UN convention against torture and other cruel, inhuman or degrading treatment or punishment’ (OPCAT).
OPCAT requires that all places of detention are visited regularly by independent bodies – known as the National Preventive Mechanism (NPM) – that monitor the treatment of, and conditions for, detainees.
24.2 Homes accommodating disabled children
When evaluating how well disabled children are helped and protected, inspectors should pay particular attention to how well staff understand the particular vulnerabilities of disabled children to abuse and neglect by taking account of:
- the effectiveness and impact of safeguarding training for all staff, including nursing staff where relevant, and how this has specifically raised awareness and understanding of the protection needs of disabled children
- whether children’s intimate care needs are met sensitively and their rights to privacy are respected
- the quality and effectiveness of the work to help disabled children keep themselves safe and, wherever possible, to develop an understanding of managing personal boundaries and developing appropriate relationships
- how staff respond to triggers or changes in behaviour for each child or unusual patterns of bruising or injury, including for those children with limited or no verbal communication, that may indicate that they may be at risk or have been subject to abuse
- how records of behaviour management and restraint confirm that staff use identified individual strategies that consider children’s communication, physical and learning needs to divert and minimise incidents and physical intervention
- whether staff administer pro re nata (PRN) or ‘as required’ medication appropriately and retain clear records of its administration
- whether children have access to advocates or independent visitors who spend enough time interacting with and observing children and staff to gather children’s views, wishes and feelings in order to reach a judgement about their safety and welfare
24.3 Short break services for disabled children
Inspectors should take the following into account.
- There is likely to be a greater emphasis on experiences for children than on progress, although the service should still focus on working with others to support progress where it can. The impact of the service on children’s progress is likely to be influenced by the frequency and length of the short-break stays. Children should be supported to enjoy experiences that may not be available to them otherwise
- The quality of introductions to the service and the level of engagement with the family and with other professionals to provide consistent and safe care and minimise disruption in children’s lives are critical
- Parents/carers are likely to hold the central role in relation to many aspects of the care of the child. Therefore, inspectors should place particular emphasis on evaluating the quality of these relationships and how they support the best possible experience for children
- Particular importance should be placed on the planning of stays; how decisions are made about the groups of children who visit together; how friendships are supported; and the experiences that children are offered and how these add to their lives
24.4 Residential special schools also registered as children’s homes
Inspectors should take the following into account.
- Larger group-care settings may look and feel different to a family home. Inspectors should evaluate how the organisation of the home meets the needs of the children who live there. Children living in these homes may live within larger groups, spread across a number of sites or houses. For some children, being able to socialise in large groups is an important element of their experience and learning. However, this may not be the desired experience for all children. Inspectors should evaluate how the organisation can meet the needs of all children living there
- The building and private and communal areas may need to be adapted to meet the needs of individual children. Inspectors need to take time to understand this and ask for explanations where they are unsure. Equally, inspectors should, when necessary, challenge ‘custom and practice’ to determine that services continually adapt and evolve to meet the needs of children
- Parents/carers may hold the central role in relation to many aspects of the care of the children. Children will be living in the residential special school (RSS) for different amounts of time. This is likely to influence the role that the RSS has in the child’s life. Inspectors should take this into account
- While attendance at school is much less likely to be an issue, how the home manages transitions from home to school and consistency of care between home and school are very significant and must be considered
- Educational curriculums may be developed to support children over a 24-hour period. Inspectors need to understand how opportunities for learning are used to help children progress and feel safe. Structure may be more important for some children. Inspectors need to question and challenge the structure that they see so that they can evaluate how practice is in the best interests of children
- Residential special schools offer a 24-hour environment and can be situated away from communities. This means that external scrutiny and links with the local community are important in supporting children’s experiences and safeguarding their welfare
- Particular attention must be given to the arrangements for children to complain, to tell someone they are being bullied and for them to contact their families or a trusted adult away from the school
24.5 Assessment homes/refuges
Where a home is a refuge or provides short-term assessment placements, inspectors should focus especially on how well children are welcomed into the home, how they are helped to feel safe and how they are helped to move on to the next stage of their lives.
24.6 Where health professionals provide services on site
Inspectors should take the following into account.
- Nursing and health professionals should be registered with the relevant professional body, such as the Nursing and Midwifery Council. They should be able to demonstrate to Ofsted that this is the case. Nurses are required to undertake specific safeguarding training to comply with their own code of practice. While inspectors are not expected to know the detail of individual codes of practice for health professionals, it is reasonable to ask for evidence of how these requirements are met
- Nurses should receive regular clinician supervision from a qualified professional. Inspectors should examine how nurses’ practice is subject to monitoring, supervision and external professional scrutiny to promote and safeguard the welfare of children. This includes looking at the systems in place for external scrutiny following an injury, particularly if the injury was sustained as a result of a physical restraint, a possiible non-accidental injury, or an injury from another child
- The working hours of nursing and medical staff and the procedures for administration of drugs should meet the individual needs and routines of children
- Inspectors should consider the quality of the arrangements for the secondary dispensing of drugs by medical staff, the management of changes of prescribed drugs, the systems in place to audit the drugs held on site and the procedures in place in the event of mal-administration of medication