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:

 Young people enjoy their short breaks in this home. They have good relationships with the caring manager and staff, and experience a variety of activities and trips out.

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The children's home provision is good because:

 The manager and staff communicate closely with families and other professionals so that their approach and care of young people is coordinated and meets young people’s needs.

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The children's home provision is good because:

 The manager and staff advocate for young people and recognise their vulnerability due to their complex needs. They raise safeguarding concerns, where appropriate, and challenge social workers’ actions to ensure that young people are protected and well looked after.

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The children's home provision is good because:

 The team meets together regularly and discusses safeguarding issues with the children and adolescent mental health team coordinator to analyse their strategies for managing incidents that occur. This work has impacted positively on how staff support young people in accordance with their diagnoses.

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The children's home provision is good because:

 Young people have personalised memory books that include photographs.

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The children's home provision is good because:

 Young people have meaningful goals which have supported their progress.

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The children's home provision is good because:

 Not all supervision takes place at the agreed frequency. The manager does not have a structured system in place to ensure that she formally reviews the implementation of care plans to ensure that young people’s needs are being met. This shortfall impacts on the effectiveness of management monitoring.

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The children's home provision is good because:

 The home is generally warm and welcoming but there are aspects of the home that give an institutional appearance. Play facilities for the garden are agreed but have been delayed.

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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 within the given timescales.

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Requirement Due date

13. The leadership and management standard

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Requirement Due date

(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children's home that:

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Requirement Due date

(a) helps children aspire to fulfil their potential (b) promotes their welfare.

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Requirement Due date

(2) In particular, the standard in paragraph (1) requires the registered person to:

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Requirement Due date

(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; in particular, ensure that the home is registered to reflect the service it provides in relation to those young people who receive more than 75 days of short breaks in any 12-month period

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Requirement Due date

(f) understand the impact that the quality of care provided in the 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; in particular ensure that supervision takes place at agreed frequency and is recorded as such

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Requirement Due date

(h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home; in particular ensure that the manager has robust and clearly set out systems in place to review care plans, medication administration, incidents and body mapping; and that dates for upcoming external meetings are widely known to ensure that staff are meeting the needs of young people. 31/01/2017

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendations:

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Recommendations

 Ensure that the home seeks as far as possible to maintain a domestic rather than 'institutional' impression. (‘Guide to the children's homes regulations including the quality standards’, page 15, paragraph 3.9) In particular, review the suitability of furniture and fixtures with staff and children to ensure that the environment is as homely as possible, and ensure that there is no further delay for garden plans.

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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/or challenging behaviours and may also have some ongoing healthcare needs. The service is managed by an NHS Foundation Trust.

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Information about this children's home

Inspection date Inspection type Inspection judgement 24/02/2016 Interim Sustained effectiveness 29/07/2015 Full Good 11/03/2015 Interim Sustained effectiveness 16/12/2014 Full Good

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Good

Young people enjoy their short breaks at this home. The caring and dedicated staff team works hard to support and protect young people during their stays and in their day-to-day lives.

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Good

Young people take part in a variety of activities. Staff are keen to ensure that young people enjoy experiences that they do not have on a regular basis. These experiences include swimming, climbing, soft play and trips to local attractions, beaches and parks. The manager encourages links in the community and has been successful in enrolling one young person into a local football club, which they enjoy. In the home, young people are encouraged to do art and crafts, play with toys, cook and, importantly, relax and enjoy the company and attention of staff members. Staff members ensure that young people have familiar routines, such as bath then story time, and have an agreed approach that is consistent with care that they receive elsewhere. Parents and family members praise the home, and one parent said, ‘He enjoys going; they give him choices and they take him wherever he wants to go.’

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Good

Young people make progress in this home. Staff members have spent much time planning targets with young people. Young people know what these targets are and how to achieve them. The goals are achievable but also stretch young people to help them increase in confidence. Goals can have a practical focus, for example eating vegetables and fruit. Additionally, in response to a young person’s expressed wish for love during a school activity, the goal is building on relationships and increasing quality time with staff. Every three months, staff members review young people’s plans to ensure that young people’s needs are being met.

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Good

All young people have personal, colourful books with photographs, written information and drawings about their time in the home, which they enjoy looking at. Staff analyse individual responses to different activities and have started a consultation process with young people using visual aids. Staff are yet to embed this process to ensure that it happens regularly and with all young people so that responses can be collectively analysed.

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Good

Staff use the learning from incidents when young people become distressed to develop different strategies to help them manage their emotions and keep themselves and others safe. Staff create bespoke social stories to help young people and have seen positive outcomes as a result.

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Good

The manager and staff closely support young people when they leave the home. They help young people prepare, communicate with the relevant professionals, and visit new accommodation with young people so that they feel comfortable with the changes ahead.

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Good

Young people’s bedrooms are personalised with noticeboards, photographs and colourful pictures and toys that they enjoy. The home is warm and welcoming but some aspects of the home give an institutional appearance. The garden has a trampoline but lacks other play facilities. Plans for a new playhouse and paving to the garden are agreed but have been delayed.

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Good

The home now has a clear safeguarding and child protection document in operation and the manager monitors its effectiveness regularly. This requirement from the previous inspection is now met. The registered manager and staff members are robust at reporting safeguarding concerns to the appropriate professionals. They follow up these concerns and challenge practice decisions, where appropriate, to ensure that young people are safe.

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Good

The registered manager and the staff attend monthly clinical safeguarding meetings, led by a child and adolescent mental health service coordinator. Each young person’s needs are discussed, alongside various strategies to manage incidents effectively in line with the young person’s diagnosis. The learning from these meetings has led to improved behaviour management of young people.

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Good

Young people are rarely restrained. Since the previous interim inspection staff have used physical intervention on three occasions, which is a significant reduction. On each occasion, minimal intervention was used as a last resort to ensure young people’s safety. Young people were supported after the intervention. The manager reviewed each incident to ensure that the intervention was appropriate and to apply any learning, where appropriate.

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Good

The manager has investigated the reasons for two medication errors that have occurred and ensures that the learning is distributed to staff members to prevent this from happening in the future. The errors did not have any detrimental effects upon young people. Judgement grade

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Requires improvement

The registered manager now verifies references of staff members working in the home to ensure that they are safe to work with young people. This requirement made at the previous interim inspection is now met.

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Requires improvement

At monthly, well-planned team days, training and regular discussions take place to develop the progress of the young people. The registered manager has membership of professional organisations so that practice in the home is influenced by the latest research and information available. Staff receive regular and useful training to support their care of young people.

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Requires improvement

The manager is now clear about the legal status for all young people who use the service and knows what level of support young people should receive from children’s services. If young people are not visited by their social worker, the registered manager contacts the social worker to ensure that this happens. Staff members promote the use of advocacy so that young people have independent advocates to ensure that their views are represented.

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Requires improvement

The home works well with other professionals and families, so that young people receive a coordinated and integrated approach to their care. Social workers, school staff and parents state that communication with the manager and staff is very effective. A social worker said, ‘They support the young person well; they know him well, attend all meetings and have a multi-agency approach.’

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Requires improvement

The home has an independent visitor who provides regular reports to support the manager in continuing to improve the home. The home’s development plan lists all the improvements that the manager wishes to make with the team.

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Requires improvement

The registered manager tackles performance issues and supervises staff. However, documentation does not indicate that all supervisions for staff take place at the required frequency.

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Requires improvement

Not all minutes of meetings held for young people by children’s services are available, and their absence has not been followed up by the manager or staff. Staff do not routinely complete body maps for young people in accordance with their safeguarding procedures. However, staff have completed some body maps at the request of a social worker. Although these body maps have not raised concerns for staff, neither the manager nor staff are clear why they are completing them and, having completed the body maps, have not followed their usual process.

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Requires improvement

Some of the young people’s care plans are out of date, which the manager was not aware of, and incidents have not been collectively analysed for trends for the past three months. While the manager does review incidents and care plans, a systematic structure is not in place that informs analysis and the improvement of care for young people. These shortfalls indicate a lack of a structured system for management monitoring.

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Requires improvement

The registered manager is approachable, caring and has significant experience of caring for young people with disabilities. The manager and staff in this home work well as a team and provide a warm and welcoming environment for young people to enjoy their short break stays. A staff member said, ‘I really enjoy caring for the young people and I love to get out and about with them so they enjoy new experiences.’

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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 children looked after 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 that 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 that 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

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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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