DrPA Secure - Oakhill Secure Training Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked at 4 quality statements in this key question.

Children in the STC did not consistently receive timely or comprehensive health assessments, and some records lacked critical information or updates when needs changed. Additional assessments, while valued, were non-clinical and could not compensate for incomplete CHAT assessments. Care records were often fragmented, and handover processes failed to capture essential tasks, resulting in missed interventions. Substance misuse cases were not managed in line with national guidance due to insufficient training and policies. Despite these shortcomings, staff demonstrated commitment to health promotion, and children had access to routine services such as vaccinations, though uptake remained below average.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

Children did not always receive a comprehensive health assessment of their care needs. Upon admission to the STC all children should complete an assessment (CHAT) with a nurse which explores all needs and identifies any treatment requirements. However, some children did not receive an assessment or waited too long for an assessment.

Where assessments were completed, they did not always identify all of the child’s needs. For example, one child’s CHAT assessment did not include any information regarding a known healthcare condition.

CHAT assessments did not always include historic information from community care providers involved in children’s care prior to admission to the STC. In addition, the views of the child’s family or carers were not always sought.

An additional assessment known as ‘My story’ was completed following admission. These assessments were completed by AP’s and factored in all children’s care needs. These assessments were designed to inform a centre wide approach to care for the child including guidance for operational staff. Children we spoke with who were involved in the assessment process told us they found them valuable. Care and operational staff told us they found them beneficial and underpinned their work with the child.

However, these assessments were not a clinical assessment of each child’s needs. Therefore, should a child’s CHAT assessment not be completed or not sufficiently detailed, they were at risk of receiving inappropriate care.

Where children’s care needs changed, care records were not always updated. For example, one person developed a healthcare condition when in the STC. Records relating to the condition were not updated to inform staff.

A speech and language therapist (SALT) screens all children in the STC. Should further work be required, children are given the opportunity to complete a programme of tailored interventions with the SALT.

Although rare, the STC was supporting children with clinical substance misuse needs. During this inspection we found their care did not reflect national guidance. Staff had not been trained to care for children with such needs and clinical policies were not in place. We spoke to the provider about this during our inspection who assured us this would be addressed.

A handover occurred daily for staff to share information and allocate tasks. We were told this was the mechanism for ensuring all children’s care needs were allocated to a named member of staff. We saw too many examples where key tasks were not included in the meeting leading to children not receiving the care they required. For example, one child needed a particular clinical intervention completing as per a doctor’s request. This task was not taken to the handover meeting and therefore was not completed.

Children’s care records lacked clarity and were not always contemporaneous. In some cases, key information was held on a separate system or email correspondence was not uploaded to care records. This meant staff did not always have the required information to make informed decisions on children’s care.

During our inspection we saw good working relationships between healthcare staff and the STC’s operational staff. Regular joint meetings were held where individual children’s care was discussed in a multidisciplinary setting. Staff told us these meetings were beneficial.

During the inspection, all children we spoke with told us care staff were supportive and put their health needs first. Staff we spoke with knew how to look after children and were passionate about their role in doing so.

Health promotion was a priority with children given important messaging about their health throughout their stay in the STC. Children were encouraged to make healthier choices in every aspect of their care.

Children had good access to routine health monitoring services where available. For example, the provider had organised for community services to undertake vaccination clinics within the STC. Although uptake was below average, the provider was doing all that was practicable to address this and working with the children to help them understand the importance of vaccines.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.