Children's Home run by Cornwall Partnership NHS Foundation Trust in Cornwall

Unique reference number SC432404 Inspection date 17/07/2012 Inspector Guy Mammatt Type of inspection Full Provision subtype Children's home

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Date of last inspection 21/03/2012 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Brief description of the service

This children’s home is part of a local authority short breaks service for up to two children with disabilities, complex individual needs and fragile health.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be adequate .

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Overall effectiveness

The service provides a good quality of care with personalised plans for each child and young person. The staff have an excellent relationship with the children and young people and show a great understanding of their communication needs. Children and young people are able to interact with others with similar health needs and abilities. This promotes good outcomes for them; for example, they enjoy attending the service and they develop confidence in social situations.

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Overall effectiveness

Children and young people using the service feel safe. They benefit from staying in a spacious modern environment which is designed to help staff meet their health needs. The environment also provides a relaxing, fun time away from their family home. Parents speak very highly of the service offered and say that the staff team is ‘absolutely brilliant’.

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Overall effectiveness

The management team is knowledgeable and has great experience; it shows good intention to learn the necessary legislative framework to ensure that the overall rating of the service improves to match the excellent standard of care provided. However, managers are still developing an understanding of the Children’s Home Regulations and have not fulfilled all the requirements and recommendations set at the previous inspection. These include developing an effective monthly Regulation 33 monitoring system, involving families and placing authorities in the monthly monitoring systems and submitting a current statement of purpose to Ofsted. The service has also not yet implemented a development plan to show the strengths and weaknesses of the service and to complete regular supervisions of the staff team.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that the registered person provides a copy of the statement of purpose to the HMCI (Regulation 4 (2)) 31/08/2012

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Reg. Requirement Due date

(2001) ensure that the home shall be visited in accordance with this regulation by the responsible individual or one of the partners; the visits shall take place at least once per month and may be unannounced (Regulation 33 (2) (a) & (3)) 31/08/2012

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Reg. Requirement Due date

(2001) ensure that the person carrying out the visits shall interview, with their consent and where appropriate, such of the children accommodated there, their parents, relatives and persons working at the home as appears necessary in order to form an opinion of the standard of care provided at the home (Regulation 33 (4) (a)) 31/08/2012

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Reg. Requirement Due date

(2001) supply a copy of the report required under paragraph (4) (c) to the HMCI and the Registered Manager of the children's home (Regulation 33 (5) (a) and (b) 31/08/2012

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Reg. Requirement Due date

(2001) ensure that the system referred to in paragraph 1 (Regulation 34) shall provide for consultation with children accommodated in the home where appropriate, their parents and placing authorities. (Regulation 34 (3)) 31/08/2012

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure that there is a written development plan, reviewed annually, for the future of the home either identifying any planned changes in the operation or resources of the service, or confirming the continuation of the home's current operation and resource (NMS 15.2)  ensure that all staff are provided with regular supervision and that a signed record is kept of these. (NMS 19.4 & 19.5)

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Outcomes for children and young people

Outcomes for children and young people are good .

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Outcomes for children and young people

Children and young people are confident and secure while they attend the service. They enjoy interacting with peers and staff members away from their family home. This builds confidence and their sense of achievement.

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Outcomes for children and young people

Children and young people have good attendance at school and make good educational progress. This ensures they make comparable progress with peers who do not have a disability.

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Outcomes for children and young people

Children and young people’s participation in activities both inside the service and outdoors is good. They have access to opportunities that may not have otherwise been available to them, because of the high level of staff support and the resources offered by the respite care. For example, they enjoy outdoor trips to the seaside, the zoo and to local parks.

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Outcomes for children and young people

Children and young people enjoy the environment inside the service. They make the most of opportunities to watch TV, listen to music and be creative with art materials. They also make good use of a wide range of sensory equipment.

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Outcomes for children and young people

Children and young people receive excellent health care while using the service. The service makes every effort to ensure that it manages health conditions well in order to improve the quality of children’s lives. Although health conditions sometimes deteriorate over time, this is not a reflection of the care received from the service.

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Outcomes for children and young people

Children and young people benefit from being cared for by a staff team that is always open to trying new ideas and opportunities with them. Children do not communicate verbally and many are visually impaired, but they are still able to contribute in some decisions about their daily lives. Through understanding, experimentation and the ability to interpret body language, staff can see whether children are enjoying themselves and whether they would like to do an activity again.

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Quality of care

Staff provide a short break service for children and young people with profound multiple learning disabilities who have associated severe, complex and high health needs. Staff build strong relationships with children and show an excellent understanding of their daily needs. They are experienced and well trained to ensure that they can respond to children and young people’s requests.

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Quality of care

Staff treat those who use the service as children first, irrespective of any disability or difficulty. Children and young people are valued as unique individuals in their own right, with access to the same opportunities as children and young people who do not have the same level of disability.

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Quality of care

There is excellent, individualised care planning in place to help the staff to promote children’s health and well-being. Children’s views are gathered over time, by getting to know them and from listening to family members. This means that children and young people can contribute to their care plans and take part in activities that they enjoy. Children and young people’s communication needs are clearly identified in the care plan and through communication passports. This enables all settings who work with them to ensure that children’s wishes are known.

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Quality of care

Children and young people are assessed when they enter the service and there is a comprehensive record of their health during their stay. This ensures that children and young people receive the appropriate responses to any complex health needs.

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Quality of care

Staff follow clear instructions to ensure that they receive adequate nutrition and that their personal hygiene needs are met. Staff follow a clearly detailed daily routine and night time monitoring procedure. This ensures that all of the children and young people’s daily needs are met and that they are safe and comfortable overnight.

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Quality of care

The facilities for storing and dispensing medication are secure. Medication administration procedures are clearly detailed for staff to follow. Staff are well trained in the medication procedures for specific conditions; for example, epilepsy.

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Quality of care

Staff support school attendance every day to ensure that there are no barriers in place to full time education. For example, staff provide transport to school, communicate well with education staff and help children and young people to pursue learning objectives after school. This means that children and young people benefit from a consistent, joined-up approach to their educational progress.

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Quality of care

Staff provide and support an extensive range of purposeful, suitable and enjoyable activities, including experiencing stimulating environments. For example, children and young people have experienced the sea, the air, putting their toes into a freshwater stream and visiting sensory gardens. Staff and children collect artefacts from activity days in order to make tactile booklets and collages. This helps children and young people to remember their experiences of the day and enjoy their interests.

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Quality of care

The service is well resourced. Children and young people stay in modern, spacious buildings that provide a great deal of space for them to express themselves, pursue their interests and remain safe. The service provides a good balance between the need for clinical and lifting equipment and providing an enjoyable environment, including sensory equipment and plentiful space for play. The service has renovated an outside building to become an arts and crafts room for the children and young people, which further enhances their experiences.

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Safeguarding children and young people

The service is good at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Parents say that their children and young people are safe attending the service. Families have used the service for a number of years and they trust the staff implicitly.

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Safeguarding children and young people

Children and young people do not experience bullying, because of their communication needs and the high levels of staff monitoring. Staff monitoring also ensures that children and young people do not go missing from the service.

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Safeguarding children and young people

The environment is physically safe and secure. All visitors to the service are appropriately checked and monitored to ensure that only authorised persons have access to the property. This ensures children and young people stay in a safe environment and are protected as far as possible from harm.

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Safeguarding children and young people

Staff promote positive behaviour through constant communication and encouragement. The service does not use disciplinary measures or sanctions. The use of restrictive physical intervention is minimal. Families receive guidance on the need for restraint when they first start using the service and they are also notified after any use of restraint.

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Safeguarding children and young people

There have been no safeguarding concerns or investigations since the last inspection. Policies are in place to ensure all safeguarding concerns are handled correctly and any staff that are recruited are carefully selected. This means that children and young people are protected from as far possible from unsuitable people having the opportunity to harm them.

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Safeguarding children and young people

Good procedures are in place to ensure that children and young people stay in a well-managed environment in the event of an emergency evacuation. The service is equipped with a modern fire alarm system and all the rooms are monitored for fire either using smoke or heat alarms. Fire drills with evacuation have been carried out with children and young people. The Registered Manager has ensured that the difficulties encountered during one of the evacuations have been resolved. As a result of this children and young people now stay at a service that has sufficient procedures in place to ensure their safe and prompt evacuation in the event of a fire.

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Leadership and management

The leadership and management of the children's home are adequate .

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Leadership and management

The home’s Registered Manager has a vast amount of experience in looking after children and young people with severe learning disabilities and complex health issues. The Registered Manager, with the support of the senior management, has taken action to ensure that complaints received from parents are resolved. The majority of parents are very happy with the quality of care provided at the service and say that they would ‘wholeheartedly’ recommend the service to other families. The only negative aspect described by parents is the decrease in the home’s capacity since the re-development of the building two years ago.

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Leadership and management

The management team has not fully met all the requirements and recommendations from the last inspection. The Registered Manager carries out Regulation 34 monitoring over an appropriate timescale to cover all the matters specified in Schedule 6. However, monitoring does not include consultation with children and young people, their families and placing authorities.

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Leadership and management

The Responsible Individual has completed one Regulation 33 visit since the last inspection, whereas these are required monthly. The Regulation 33 visit covers the same information as the Registered Manager’s monitoring and does not provide an evaluative report of the standard of care provided at the service. The Regulation 33 inspection also does not include consultation with children and young people, where appropriate, and their families. This means that those using the service and outside stakeholders do not have the opportunity to contribute to the progress and improvement of the service.

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Leadership and management

In addition, both monitoring inspections lack action plans to drive the quality of the service forward. The management team has not implemented a written development plan in response to a recommendation made at the last inspection. Therefore, managers cannot demonstrate that they understand the strengths and weaknesses of the service.

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Leadership and management

Staff receive good levels of training and annual appraisals to promote their professional development opportunities. This means children and young people are looked after by a well-trained staff team. However, staff receive infrequent supervision to support and monitor them in their roles. This has the potential to impact on the quality of service provided to children and young people.

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Leadership and management

The Registered Manager has notified the appropriate parties in relation to significant events for the protection of children and young people.

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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