Achieving for Children Community Interest Company

The care delivered by the service was evidence based and reflected national and best practice guidance. This meant that Children and Young Persons (CYP) were receiving care that was deemed safe, well-led and appropriate to their needs.

The Care Quality Commission (CQC) undertook an unannounced focused inspection of AfC on 26 September 2018. Focused inspections do not usually look at all five key questions; they focus on the areas indicated by the information that triggers the focused inspection. Although they are smaller in scale, focused inspections broadly follow the same process as a comprehensive inspection. We carried out the focused follow up inspection to ensure the provider had taken action to comply with the regulations in the safe and well-led domains in community children’s and young person’s service.

The purpose of this was to follow up on the actions the provider had told us they had taken in relation to Regulation 13(2) Requirement notice served with the comprehensive report in February 2017.

CQC will not be providing a rating for this inspection. The reason for not providing a rating is because this was a focused / follow up inspection carried out to assess whether the provider had made improvement to services within the required time frame. During the focussed / follow up inspection we only reviewed the safeguarding in the safe domain and leadership / governance in the well-led domain of the community CYP core service.

At the inspection in February 2017 we found:

• There were serious weaknesses in safeguarding processes in relation to health staff: managers and some frontline heath staff did not have an overview of children in ISCD known to children’s social care.
• Child safeguarding supervisors were not trained to deliver this role in line with national guidance.
• Safeguarding supervision was not evidenced in child health records and we were not assured all staff, particularly those delivering sessional care staff had been trained in child safeguarding to level 3
• The pace of implementing learning from serious case reviews was slow.
• Child health records were fragmented and stored in various locations which meant health staff did not have access to a child’s complete record; the quality of record keeping was variable and did not always achieve expected professional standards.
• In some services such as short breaks, the consultation and involvement of parents had been less timely and effective.

At this inspection we found:

• The service has better oversight of staff training including child safeguarding training. In August 2018 a training needs analysis was undertaken that sets out core training and additional training requirements for health and therapies staff. It is too soon to evaluate the impact of this.
• Data about health staff child safeguarding training indicates there are gaps in level three training. One out of 31 staff required their three yearly safeguarding training updates.
• The advanced care record has a dedicated child safeguarding tab but this was not consistently used to record child safeguarding information.
• The standard of record keeping was variable in the advanced care notes sampled. There were gaps in recording the family composition in the demographics part of the record and the name and relationship of adults accompanying children to appointments were partially recorded.
• In case records we could see evidence of good information sharing which aids more effective joint working to meet children’s needs.