Oakhill Secure Training Centre

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We inspected 3 quality statements for this key question. We found staff had been working incredibly hard to help improve the outcomes for children. Staff we spoke with were positive about the changes that have been made since our previous inspection. This included having more support and direction from healthcare managers and additional staffing on the majority of shifts. We found that significant improvements had been made as detailed in this report. However, there were still some breaches of regulations which had not been fully complied with. We found care plans did not always reflect a child’s current need and care had not always been carried out in line with care plans. In addition, information from children’s initial assessments and community services had not been fully utilised to inform care.

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

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

During the previous inspection we found concerns with care planning and that not all information obtained by the healthcare provider had been acted upon to help support the child. In addition, we found that not all records were kept on the electronic clinical record system.

During this inspection, we have found significant improvements in children’s health care plans. Where a specific need had been identified we found care plans were in place to inform staff. However, some care plans had not been reviewed to reflect children’s changing care needs. In addition, not all actions had been carried out in line with the care plan. For example, one child required a specific healthcare treatment. Care records failed to demonstrate treatment had taken place. This increased the risk of children receiving care which did not meet their current needs.

We found information from children’s assessments and community services had not always been used to inform their care. For example, one child was admitted with a known healthcare condition. We found no attempts had been made by the provider to liaise with community services ensuring continuity of care for the child.

We found evidence children were reviewed by healthcare staff after any injuries or episodes of self-harm to address any immediate concerns. In addition, we found processes in place for a child to be reviewed regularly by clinicians if they were removed from association with their peers.

Children had good access to clinicians, we saw many examples of timely access to relevant healthcare professionals such as the GP and psychiatrist.

During this inspection we identified updates about some children from the daily clinical team meeting had not always recorded in their clinical record. The provider took immediate action to address this during the inspection. However, we found meeting minutes and actions arising from a weekly staff multidisciplinary meeting were now recorded in clinical records. This helped ensure all staff could access the notes and were aware of the health needs of each child.

The introduction of a named officer to help facilitate children’s appointments in healthcare had improved attendance and increased positive healthcare outcomes.

Additional resuscitation and first aid equipment had been procured to help ensure timely responses to medical emergencies. Staff had received training to access resuscitation bags and the staff member we observed was able to do so quickly.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe and effective staffing is based on the latest evidence we assessed for the Safe key question.

During this inspection we found infection, prevention and control practices (IPC) had improved significantly. This meant children were no longer at increased risk of infection. An audit had been completed by an external provider. The provider used this information to develop an action plan to drive improvements. There was now an identified lead for IPC who had attended additional training to further increase their knowledge and improve IPC practices in the centre. Cleaning schedules were now in place for nurses which were monitored by managers. The provider had worked well with the facility management team at the centre to ensure that cleaning in healthcare environments was completed to NHS IPC standards.

At our previous inspection in October 2024, we identified concerns in the management of medicines including the identification of out-of-date immunisations and vaccines.

During this inspection, we found medicines processes had improved. This meant children were no longer at risk of receiving unsafe medicines. Audits had been completed by the chief pharmacist and there was evidence that appropriate action had been taken as a result of these. Additional training had been provided and briefings developed for staff to ensure the safe administration of medicines.