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Monitoring questions for children’s homes

Categories:
  • Organisations we regulate

During the monitoring call our inspector will focus on these specific key lines of enquiry. You can open the questions to see the type of detail they will be interested in.

Safe

S1: How do systems, processes and practices safeguard people from abuse?
  • How are you managing risks to safeguard children from abuse?
  • What is in place to ensure children receive timely care and treatment that respects their dignity?
  • What action are you taking to ensure children who use the service are protected from abuse; and to support them to understand their rights?
  • How do you ensure that staff know how to safeguard children from abuse?
  • How do you assure yourself that staff report concerns immediately and appropriately to the right person/people?
S2: How are risks to people assessed, and their safety monitored and managed so they are supported to stay safe and their freedom is respected?
  • How are risks to children assessed, reviewed and monitored?
  • What arrangements are there to manage risks appropriately, and to make sure that children are involved in decisions about any risks they may take?
  • How do you share information about risks with staff, children using your service and visitors?
  • How do you ensure staff, children using your service and visitors understand the arrangements (For example, signage, accessible information, information on your website)?
  • What lessons have you learned or actions have you taken to reduce or minimise the risk of accidents and incidents from happening in the future?
S3: How does the service make sure that there are sufficient numbers of suitable staff to support people to stay safe and meet their needs?
  • How has the pandemic affected your ability to staff the service, including their management, safety, wellbeing and deployment? For example have you used agency staff?
  • What action have you taken to manage this and ensure children’s needs continue to be met?
  • How have you been able to make sure children get care and support from workers with the right knowledge and skills? Is all the information required to deliver safe care and treatment made available to relevant staff in a timely and accessible way?
  • Are working arrangements clear and accessible to staff, children who use the service, their supporters and visitors?
S4: How do you ensure the proper and safe use of medicines?
  • How have you ensured the right medicines in the right doses and quantities are available to children, at all times?
  • How have you ensured medicines are stored and transported safely? For example how are they delivered to the home, any returns?
  • How have you ensured any errors are noted, addressed and learned from? Have you any examples?
  • How have you ensured children who administer their own medicines can continue to do so safely?
  • How do you ensure staff are competent in the safe administration of medicines? Have staff been asked to complete delegated duties in relation to medicines and was training provided?
  • How have you managed any challenges when working with your local healthcare professionals, including community pharmacies?
S5: How well are people protected by the prevention and control of infection?
  • How have you reviewed and developed your IPC arrangements in response to the pandemic – have you made any changes?
  • How are infection risks to children using the service being thoroughly assessed and managed so that the service could provide care to people both with and without COVID-19 symptoms or confirmed diagnoses?
  • How effective are your resources to obtain and access all necessary supplies, personal protective equipment and COVID-19 testing, for both staff and children using the service?
  • What changes have you made to staff working practices, for example changing facilities, break times, meals and drinks?
  • How is IPC-related training and support being provided?

Effective

E7: How do you ensure consent to care and treatment is always sought in line with legislation and guidance?
  • How are you managing social distancing, and ensuring least restrictions on children’s liberty or using seclusion/segregation during the pandemic period?
  • How does the service promote supportive practice that avoids the need for physical restraint? For example, are positive behaviour support plans in place? Are staff trained in this?
  • Where physical restraint may be necessary, how does the service ensure that it is used in a safe, proportionate, and monitored way as part of a wider person-centred support plan?
  • How are you ensuring that MCA Code of Practice requirements continue to be met and that children are given opportunities to provide consent
  • How are you protecting children’s human rights, including consent about health treatment, particularly about involvement in advance care plans/DNACPR decisions?
  • How does the service ensure staff are able to identify the deteriorating physical health of children who may not be able to communicate their needs?

Caring

C1: How do you ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed?
  • How are children treated with kindness and compassion in their day-to-day care, support and treatment?
  • How do staff show they know and respect the children they are caring for and supporting, including their preferences, personal histories, backgrounds, potential and human rights?
  • How are you supporting staff, relatives and children who use the service to raise any concerns and give feedback?
  • How have you supported children’s emotional wellbeing to maintain important relationships, including family/friends/advocates visits?
  • How have you supported children to adjust to changes and restrictions to their social life and routines due to COVID-19? What has worked well in supporting children’s emotional and spiritual needs during COVID-19; and how will learning be embedded?
C2: How does the service support people to express their views and be actively involved in making decisions about their care, support and treatment as far as possible?
  • How do staff recognise when children need and want support from their carers, advocates or representatives to help them understand and be involved in their care, treatment and support?
  • the service give staff the time, training and support they need to provide care and support in a compassionate and personal way? Are rotas, schedules and practical arrangements organised so that staff have time to listen to children, answer their questions, provide information, and involve people in decisions?

Responsive

R1: How do people receive personalised care that is responsive to their needs?
  • How does the service meet the Accessible Information Standard?
  • What impact has the increased PPE had on children’s ability to access information, for example hearing impairments?
  • How do you ensure that you make other reasonable adjustments for disabled children?
  • How do you ensure that you can meet the range of individual needs for children using the service, for example cultural or religious needs?
  • How have you changed the way children’s care has been planned since the start of the pandemic?
  • How have children’s involvement, or those who are involved in their decision making, been affected by COVID-19?
  • How well do children using the service know how to make a complaint or raise concerns?
  • How comfortable do they feel to do so in their own way; and how confident are they to speak up?
  • How easy and accessible is it for children to use the complaints process or raise a concern?
  • How are children who raise a complaint or concern protected from harassment, discrimination or disadvantage?
  • How is the service supporting people to follow their interests and take part in activities that are socially and culturally relevant and appropriate to them, including in the wider community and, where appropriate, to have access to education and work opportunities?
R3: How are people supported at the end of their life to have a comfortable, dignified and pain-free death?
  • What, if any, changes have you made to arrangements for supporting children at the end of their lives? In relation to family and friends, and working in partnership with health care professionals?

Well-led

W2: How does the governance framework ensure that responsibilities are clear and that quality performance, risks, and regulatory requirements are understood and managed?
  • How are you supporting services to ensure safe care and treatment is maintained for children during the COVID-19 pandemic?
  • What arrangements are in place to ensure transparency about COVID-19 risks, infections, other safety risks and deaths with staff, children using the service and their representatives?
  • Is there a registered manager at the service? Where there is no registered manager, how has the service been managed?
  • How are you meeting all relevant legal requirements, including CQC registration requirements, safety and public health obligations and sending notifications?
  • How are you keeping up to date with, for example, changing guidance?
  • What support networks have you created/accessed and how have they supported your service?
W4: How does the service continuously learn, improve, innovate and ensure sustainability?
  • What systems and methods for monitoring the overall quality of the service are in place for responding to business risks and issues as they arise? For example, quality assurance, information and clinical governance systems and evaluating learning from current performance?
Last updated:
22 February 2021