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

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 Children and young people enjoy staying in this home and are always happy to arrive. The environment is calm, friendly and welcoming  Young people have safe and trusted relationships with staff who know them well and can anticipate their needs. Every opportunity is given to young people to express their views and make choices  Parents speak highly of and trust the manager and staff. They are confident their children enjoy their time in the home  Activities, trips and social opportunities offered enable young people to enjoy and benefit from experiences that they would not ordinarily have. Staff work hard to meet young people’s emotional, social and health needs during their stay  The manager and staff work closely with families and other professionals, considering young people’s needs at all times, not just while they are enjoying short breaks  Staff receive both individual and group supervision regularly and have close

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The children's home provision is good because:

links with CAMHS (Children and Mental Health Services) to ensure young people receive any therapeutic input they need  Physical intervention is used as a last resort to keep young people and other safe and therefore occurs infrequently. Recording of restraint is not in line with regulations  The home is comfortable and well-decorated. The bedrooms have very large institutional type frames to display young people’s photographs and information, which detract from an otherwise homely feel  Young people do not have visual images or unique information to help them understand what staff are helping them to achieve. Young people’s progress and experiences are not always evidenced and reviewed in line with the procedure set out in the home’s statement of purpose.  Managerial attention and processes in some areas are lacking, such as detailed written child protection procedures, training in relation to specific

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The children's home provision is good because:

diagnoses and independent visitor reports are not always sufficiently robust to support improvement in the home.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

12. The protection of children standard: In order to meet the protection of children standard with particularly reference to completing clear written child protection procedures that staff fully understand and implement, the registered person must ensure that: (2)(e) the effectiveness of the home's child protection policies is monitored regularly 10/10/2015

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Requirement Due date

13. The leadership and management standard: In order to meet the leadership and management standard with particular reference to ensuring staff have up to date training in autism, young people have user friendly tools to understand their plans which are reviewed in line with the statement of purpose and independent visitor reports are robust, the registered person: (1)(a) enables, inspires and leads a culture in relation to the children's home that— (a) helps children aspire to fulfil their potential; and ((2) In particular, the standard in paragraph (1) requires the registered person to— (a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home's statement of purpose; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (f) understand the impact that the quality of care provided in the

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Requirement Due date

home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; (g) demonstrate that practice in the home is informed and improved by taking into account and acting on— (i) research and developments in relation to the ways in which the needs of children are best met; and (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home 10/11/2015 The registered person must ensure that- (a) within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes— (i) the name of the child; (ii) details of the child's behaviour leading to the use of the measure; (iii) the date, time and location of the use of the measure; (iv) a description of the measure and its duration; (v) details of any methods used or steps taken to avoid the need

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Requirement Due date

to use the measure; (vi) the name of the person who used the measure ("the user"), and of any other person present when the measure was used; (vii) the effectiveness and any consequences of the use of the measure; and (viii) a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure. (Regulation 35(3)(a-e)) 30/09/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation:  Ensure homes should seek as far as possible to maintain a domestic rather than 'institutional' impression. (The Guide to the Quality Standards, page 15, paragraph 3.9)

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Information about this children's home

The service provides short-breaks care for up to two children each night. Children referred to this service live with their parents but have learning disabilities and challenging behaviours and may also have some on-going health care needs. The service is managed by a NHS Foundation Trust.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

11/03/2015 CH - Interim Sustained effectiveness

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Good

Children and young people love coming to stay in this home and really enjoy their time here. They benefit from trusted and longstanding relationships with the registered manager and staff, many of whom are long-standing. Staff say all the children are very happy to come to the home and parents confirm this whole- heartedly. One parent said ‘even though my son does not like change, he is always very excited about going for his short break and never complains.’

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Good

Young people who stay in this home have a range of highly complex and diverse needs that require staff to meet these needs with precision, sensitivity and respect. With careful planning and enthusiasm, staff ensure that young people’s medical, social and emotional needs are met by introducing young people to many different experiences. Health and medication needs and behaviours which carry risks are not barriers to staff who ensure young people have equal opportunities to do everything they want to do. One parent said ‘He gets all of his needs met there. They do things I would never have dreamed of being possible, like taking him on the train and playing golf.’ As well as enjoying trips to leisure parks and adventure centres, young people have also a variety of activities in the home, such as trampolining, planting and arts and crafts. Young people take turns to paint panels of the garden fence each in a choice of their own colour, making for a colourful

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Good

garden. The home displays photographs and young people have books with pictures and photographs of experiences and activities they have enjoyed. Staff provide sensory opportunities for young people, and will source specific resources, such as a chewy tube for young people who seek to place inedible objects in their mouth.

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Good

A strength of the home is how well staff support young people to exercise choice. Staff use a variety of methods such as talking mats and yes/no cards to name just a few. The staff’s knowledge and commitment to young people, through taking time to understand their views and encourage two way communication, significantly increases their ability to make choices. The strategies staff use do not pressure young people and young people feel in control and confident as a result. Staff respond quickly and calmly to young people when they make choices so they are not left feeling anxious or uncertain. For example, a young person made a last minute request to change an activity from golf to football which staff flexibly responded to.

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Good

Independent living skills are encouraged within the home. One young person has learned how to make their own bed which is a big achievement. Staff prepare bedrooms for young people when they come to stay with their belongings, photographs and other personal items. Preparation usually includes making up the bed but one young person enjoys doing this himself when arriving at the home. This routine prepares him for the transition of coming to stay. His parents are delighted their young person has learnt this skill especially as he continues to use it at home too. The skills and experiences that young people gain in the home are transferred to all aspects of their lives.

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Good

The manager and staff carefully plan which young people stay together at the same time, so that young people have the opportunity to learn about friendships. When there are difficulties, staff support young people to resolve any potential conflicts or make necessary changes. Two new young people visited the home for short breaks since the last inspection and have benefitted from well thought out introductions, which helped them to settle in well. The manager and staff advocate for young people well and agencies report that staff always attend multi- agency review meetings. When young people prepare for adulthood and moving on to adult resources, the manager and staff are in regular contact with professionals to ensure there is no delay in planning.

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Good

Since the last inspection, the registered manager has recruited a lead nurse. This appointment has enabled the home to further develop in the areas of medication systems and individual care plans. Documents entitled Positive Behaviour Support Plans are gradually being re-written for each young person. These documents are well thought out and thorough, and provide all the important detail necessary for staff to care for each child uniquely. These plans are compiled by staff in conjunction with young people, families and other professionals. Consequently, the likelihood of incidents are reduced, because staff know young people’s triggers, however small, and how to respond.

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Good

A social worker said ‘this is a good and safe place for children to be.’ The manager and staff work hard to ensure young people’s safety is prioritised in the home, by regularly reviewing and improving standards of care. The lead nurse has revamped the young people’s medical files to ensure medication is managed and administered as efficiently as possible. Each medical folder includes up to date information and research, individual to each young person, for staff to easily refer to. Support workers have welcomed the changes and feel that they have more time to focus on young people, while safe systems for young people’s health remain in place.

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Good

Young people do display challenging behaviours at times but staff respond effectively to manage young people’s behaviour and de-escalate difficult incidents, so minimising the need for restraint. Staff have physically intervened on seven occasions since the last full inspection and will only do so as a last resort to keep young people or others safe. Staff train in the system of MAPPA (Management of Actual or Potential Aggression). Young people’s positive behaviours support plans identify the types of physical intervention to be used and the manager reviews whether these have been effective. When staff record such episodes, the required information, such as incidents leading up to the restraint, is not always included. This missing information does not assist the manager when reviewing trends and effectiveness of physical intervention in the home.

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Good

Staff effectively follow up upon safeguarding incidents under the guidance of their manager. The manager works transparently by acknowledging lessons learnt with staff, professionals and families and as a result, people have confidence in the manager dealing with such issues.

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Good

Staff receive training in child protection and child sexual exploitation. They attend and advocate for young people in all meetings that relate to the safety and protection of children and engage in multi-agency meetings.

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Requires improvement

The home’s written child protection procedures are minimal. The procedures do not take into account the complexities the young people face, or their particular vulnerabilities and challenges. Therefore the potential is reduced for staff to initially recognise a safeguarding issue and confidently challenge professionals to ensure young people’s safety. Regular team meetings do include some discussion about safeguarding but team learning in this area is not a priority. Despite this shortfall, the manager’s oversight enables all incidents to be dealt with properly so that young people’s safety is not compromised.

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Requires improvement

Monthly reports by the independent visitor do not always provide enough scrutiny to support the manager to improve the home. Views of families and relatives are not sought on a regular basis to inform the independent reports.

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Requires improvement

While staff receive a variety of training which is recorded on individual files, a collective workforce plan which highlights training needs and when training is due, is not available. Staff have not benefitted from recent training in autism to assist their care of young people.

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Requires improvement

Two recommendations were made at the last inspection. Body maps have been reviewed and changed. The second recommendation relates to making the environment homely. The manager continues to make improvements to the home which is generally warm and inviting. However, large brown frames with safety glass are hung in the bedrooms which display young people’s photographs and safety information. They give an institutional feel and have not been replaced with modern alternatives. The home’s statement of purpose refers to a play shed in the garden, but this is used now for storage of ball pool and other items. The manager would like to develop the shed into another usable space for young people.

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Requires improvement

Young people do make progress in the home and reach targets. These may be physical, such as learning to use a spoon, or emotional, increasing in confidence. Staff are clear about what targets they need to help young people to succeed in and do support young people throughout the stay to do this. However, young people do not have pictorial images or user friendly plans to look at to help them understand clearly. The manager and lead nurse have identified team members who are developing and improving communication tools to build upon young people’s understanding. The home has a system in place to regularly review plans for young people which incorporates views of young people, family, professionals.

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Requires improvement

Not all internal reviews happen in accordance with the statement of purpose. The reviews do not clearly evidence the experiences that young people have and the progress they are actually making in practice. Therefore the manager’s overview of the progress young people make is hampered.

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Requires improvement

Staff have confidence in the registered manager who has been in post for two years. They greatly benefit from the manager’s knowledge and experience of many years in caring for young people with complex needs. The manager leads a committed and strong staff team, who work closely together. Staff feel supported by the manager and their peers and say ‘I really enjoy working here. The team is really supportive and we are confident in raising issues with each other.’

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Requires improvement

The manager provides regular supervision to all the support workers in the team and addresses performance issues. The lead nurse receives supervision from the responsible individual and works closely with the manager. The manager and staff work closely together with other agencies to achieve the best care for young people. A mental health therapeutic agency worker stated that ‘communication is good. We work closely together with young people who are linked in with the community team. The lead nurse attends team meetings and vice versa and we have multi-disciplinary discussions.’ Staff also visit young people in their homes with other professionals, such as social workers and occupational therapists, to holistically assess young people’s needs.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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