SC 040491

Unique reference number SC040132 Inspector Guy Mammatt Type of inspection Full Provision subtype Children's home

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Registered person Cornwall Council Registered person address County Hall TRURO Cornwall TR1 3AY

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Responsible individual Katherine Margaret Brown Registered manager Jennifer Jean Massey Date of last inspection 18/03/2014 2 of 11 Inspection date 29/01/2015

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Previous inspection satisfactory progress Enforcement action since last inspection There has been no enforcement action since the previous inspection.

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Overall effectiveness inadequate

Outcomes for children and young people adequate Quality of care inadequate Keeping children and young people safe inadequate Leadership and management inadequate

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Overall effectiveness

The quality of care for children is inadequate because staff have not ensured that all children have comprehensive care plans and up-to-date individual risk assessments. As a result, children are exposed to an increased risk because the staff, including a high proportion of agency and temporary staff, are not supplied with current information about how to meet children’s needs.

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Overall effectiveness

The leadership and safeguarding arrangements of the home are inadequate. Staff do not have formal training to support the health needs of all the children. The manager is not assured that all staff who work in the home are properly vetted and have the necessary experience and skills to care for the children. The manager does not maintain recruitment checks for all agency staff or provide them with appropriate, professional supervision.

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Overall effectiveness

The Registered Manager has not ensured that practice in the home complies at all times with the Children’s Home regulations and does not pick up or correct weaknesses in the running of the home. The Statement of Purpose is not up-to- date. Not all complaints are notified to safeguarding agencies as required and the home does not have the necessary procedures in place to ensure that all children know how to exit the home in the event of a fire or a fire evacuation practice. 3 of 11 Following this inspection, Ofsted has taken enforcement action with regards to the failings identified in staff training and children’s individual care plans.

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Overall effectiveness

The children have a good time when they visit the home. They are entertained and cared for by a committed staff team. Many children have been attending the service for a number of years. They continue to do well and take up opportunities that they and their family may find too difficult to attempt outside of this home. The majority of feedback Ofsted has received from families and local authorities is positive. Families have said that the home benefits their child and staff provide good communication about each stay. The home has been renovated since the previous inspection and provides a well-resourced facility for the children. 4 of 11

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Information about this children’s home

This children's home is run by a local authority and provides short breaks for children with autism. At any one time it provides regular, short-break care facilities for a maximum of four children. Children stay for varying lengths of time and frequency, depending on their assessed needs.

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Inspection date Inspection type Inspection judgement

18/03/2014 Interim satisfactory progress 29/04/2013 Full good 18/12/2012 Interim satisfactory progress 17/07/2012 Full good

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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

5 (2001) review, and where appropriate, revise the Statement or Purpose and the children's guide and notify HMCI of any such revision within 28 days (Regulation 5 (a) & (b)) 27/02/2015

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Reg. Requirement Due date

(2001) ensure that the children's home is conducted so as to make proper provision for the care, education, supervision, support and, where appropriate, treatment, of children accommodated there (Regulation 11 (1) (b)) * 27/02/2015

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Reg. Requirement Due date

(2001) ensure that the children's home is conducted so as to promote and make proper provision for the 27/02/2015 5 of 11 safeguarding and the welfare of children accommodated there; with particular reference to ensuring that individual risk assessments are kept up to date with the child's setting and the child's perceived risk to others (Regulation 11 (1) (a))

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Reg. Requirement Due date

(2001) ensure that the employment of any persons on a temporary basis at the children's home will not prevent children form receiving such continuity of care as is reasonable to meet their needs; with particular reference to reducing the amount of agency staff used (Regulation 25 (2)) 23/03/2015

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Reg. Requirement Due date

(2001) ensure that full and satisfactory information is available in relation to staff in respect of each of the matters specified in Schedule 2; with particular reference to agency staff (Regulation 26 (3)(d)) 23/03/2015

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate training, supervision and appraisal (Regulation 27 (4)(a)) * 27/02/2015

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate training, supervision and appraisal; with particular reference to the professional supervision of agency staff (Regulation 27 (4)(a)) 23/03/2015

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Reg. Requirement Due date

(2001) ensure that if, in relation to a children's home, any of the events listed in column 1 of the table in Schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table (Regulation 30 (1)) 23/03/2015

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Reg. Requirement Due date

(2001) ensure that by means of fire drills and practices at suitable intervals, that the persons working at the home and, so far as practical, children accommodated there, are aware of the procedure to follow in case of a fire (Regulation 32 (1) (e)) 23/03/2015

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Reg. Requirement Due date

(2001) ensure that visits by the independent person take place at least once a month and may be unannounced; with particular reference to ensuring that the visits are robust and effectively monitor the safeguarding of children at the home (Regulation 33 (7)) 23/03/2015

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Reg. Requirement Due date

(2001) establish and maintain a system for improving the quality of care provided in the children's home, the system shall provide for consultation with children accommodated in the home, their parents and placing authorities. (Regulation 34 (1(b)) & (3)) 23/03/2015

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Reg. Requirement Due date

*These requirements are subject to a compliance notice

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Recommendations

6 of 11 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 the registered person has 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 15.1)  ensure that all people working in or for the children's home are interviewed as part of the selection process and have references checked to assess suitability before taking on responsibilities. Telephone enquiries are made as well as obtaining written references. (NMS 16.1) 7 of 11

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Outcomes for children and young people adequate

The promotion of the children’s health requires improvement. Staff use out of date and incomplete care plans that do not identify how they should manage children’s personal care needs. In addition, staff do not have the health training that they require to support their work with children, placing young children’s welfare at risk.

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Outcomes for children and young people adequate

The majority of children have positive experiences during each stay. They take up a range of activities that they would not normally participate in. In many cases, the children’s attendance at the home also ensures that they continue living with their family rather than moving into full-time residential care.

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Outcomes for children and young people adequate

The children have complex needs and use specialist health services, for example, hydrotherapy, a dietician and occupational therapy. These services benefit children’s health. Children who have an autistic spectrum disorder benefit from the staff team’s support. As a result, these children learn to better manage their own emotions and build positive relationships.

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Outcomes for children and young people adequate

Children make good progress in developing friendships. They look forward to attending the home and enjoy mixing with their friends. Often this is the only opportunity that the children have to spend time with their friends outside school.

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Outcomes for children and young people adequate

Children develop good skills of independence. For example, they learn how to cook and manage their personal hygiene. Children also develop their self-confidence during their stays at the home. They feel that they are enjoying the same experiences as children without disabilities, such as sleepovers and the use of leisure facilities in the community; this promote their self-esteem and sense of inclusion.

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Outcomes for children and young people adequate

One parent states that it is an ‘amazing place’ and another would ‘highly recommend the home to other families.’

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Quality of care inadequate

Staff do not have proper written guidance to inform them how to manage children’s personal care needs. They do not have an ‘intimate care’ procedure for each child and care plans do not provide enough information about how these needs should be met.

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Quality of care inadequate

Staff are not clear about how to manage the actual and potential risks that affect the children. Although individual risk assessments are in place for each child, some of these documents relate to previous settings and, as such, are not current. Other risk 8 of 11 assessments do not include the risk that children may pose to others. Consequently, staff do not understand the reasons for the need for constant supervision when children are together.

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Quality of care inadequate

Staff and children get on well together because the staff are enthusiastic and energetic. They make sure that children are involved in decisions about their stay and can make their own choices about, for example, the food they wish to eat and the activities that they wish to take part in. Staff respect children’s views and opinions; this makes them feel valued.

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Quality of care inadequate

The staff engage appropriately with all the children and interpret children’s non- verbal communication well. They provide a stimulating and fun environment for each child. As a result, children look forward to their short-break visit and also learn new skills.

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Quality of care inadequate

The children benefit from a home that is decorated and furnished to a good standard. Children have personalised their bedrooms and use a wide range of play equipment, for example, an outdoor play park, board games, musical instruments, books and interactive electronic games. Staff also take children on a variety of trips in the local area, such as bowling, ice skating and swimming. Staff promote children’s physical development well and children benefit from opportunities to take part in activities with each other.

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Quality of care inadequate

The manager pairs children together appropriately for each stay. They carefully consider the needs of each child to ensure they have a positive social experience. Children are prepared well for their short breaks in the home. During their admission, the children and their families visit regularly before moving onto overnight stays. Staff work closely with families during this period to ensure they gain the necessary information. As a result, children settle in well and most families are happy with the arrangements for children joining the home.

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Keeping children and young people safe inadequate

The safeguarding arrangements are inadequate because the manager cannot demonstrate that all staff who work with the children are carefully selected to do so. The manager does not assess the suitability of all the agency staff and she has also not verified the references of three new permanent staff.

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Keeping children and young people safe inadequate

The manager has not referred a complaint about a member of staff’s practice to the local area designated officer or Ofsted as required. Consequently, independent safeguarding agencies have been unable to examine the allegation. As a result, the manager has failed to ensure that each complaint is investigated correctly and staff have failed to protect children adequately.

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Keeping children and young people safe inadequate

The arrangements for ensuring that children are safe in the event of a fire are poor. 9 of 11 Some children have not taken part in a fire drill and not all children have a personal evacuation and emergency plan in place. Consequently, the manager and staff do not provide satisfactory protection for children in the event of an emergency.

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Keeping children and young people safe inadequate

Staff provide protection to children who leave the home without permission. All children have returned safely and have remained under a member of staff’s supervision whilst outside the home. The manager and staff respond appropriately to each incident to reduce any further occurrences.

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Keeping children and young people safe inadequate

The manager monitors the use of physical interventions to reduce their use. Children are involved in well-being checks throughout and following an incident of restraint to ensure their welfare is promoted. Restraint has been used appropriately by staff to keep children safe from harm. Some children show high levels of physical aggression. Staff manage these situations well and put in place positive support measures to reduce the need for physical intervention.

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Keeping children and young people safe inadequate

Staff support children’s individual communication needs well. They use specialist equipment and techniques such as, ‘social stories’, ‘talking mats’ and ‘sequencing strips’ to help the children understand expectations and timetables. As a result, children’s anxiety reduces and they are more able to deal with changes in their routine. Staff rarely use sanctions as they understand that children learn best from having matters explained to them. The manager monitors the effectiveness of sanctions to identify learning points about future practice.

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Leadership and management inadequate

The welfare of children is not safeguarded because systems in place to monitor the home are ineffective. The independent visitor has failed to identify many of the significant concerns identified at this inspection. The manager’s ability to improve the quality of care provided for children is weakened because her monitoring of the home does not evaluate the strengths and weaknesses or routinely seek feedback from the children, families and placing authorities. The manager has not updated the essential paperwork that supports the care of children. She does not have a development plan for the home, which in turn, limits her ability to prioritise areas for improvement. Despite senior managers being aware of some of the weaknesses, they have not been resolved.

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Leadership and management inadequate

The arrangements for staff training are inadequate. Staff who administer a ‘percutaneous endoscopic gastrostomy’ feeding procedure are not trained by an appropriately qualified health care professional and have not had their competency assessed. Staff have not had training in the delivery of intimate care. The manager’s records of staff training are incomplete. The records do not confirm that all staff have received training to support children with autism and epilepsy. In addition, the records do not show that all staff have received training in the safeguarding of children, manual handling and vehicle wheelchair clamping training. Consequently, 10 of 11 the manager cannot demonstrate that staff are suitably trained to meet the health needs of the children.

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Leadership and management inadequate

The staffing arrangements at the home are unsatisfactory. A high number of agency and temporary staff have been used in the home since it re-opened in April 2014. Despite the manager’s efforts to use the same staff regularly, and the staff team’s willingness to work overtime, the continuity of care for children is disrupted. The manager has also failed to provide adequate professional supervision for agency staff who regularly work at the home. As a result, they are not guided to fulfil their role properly and their performance is not monitored well enough by the manager.

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Leadership and management inadequate

The Registered Manager has been in post since the home was registered in 2007. She has the necessary qualifications and experience for the role. There were no actions for the manager to correct from the previous inspection. Website: www.ofsted.gov.uk

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Leadership and management inadequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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