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

Inspection report children’s home: SC432404 1 SC432404 Registered provider: Cornwall Partnership NHS Foundation Trust

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

The children’s home provides a short-breaks service for up to two children who have disabilities, complex individual needs and fragile health. This service is managed by an NHS foundation trust.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

good

How well children and young people are helped and protected requires improvement to be good

p.1

good

The effectiveness of leaders and managers requires improvement to be good

p.1

good

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

p.1

good

Overall judgement at last inspection: declined effectiveness Inspection report children’s home: SC432404 2

p.1

Enforcement action since last inspection

At the previous inspection on 21 March 2017, this home was judged to be declined in effectiveness. A compliance notice was issued because of the failure of the home to comply with the protection of children standard. A monitoring visit took place on 4 May 2017 when the compliance notice was judged to be met.

p.2

Key findings from this inspection

 Young people have excellent relationships with staff who are committed and caring. Staff take great pleasure in looking after young people who enjoy their short breaks and have fun.  Staff communicate well with young people and help them to make choices during their stays.  The team supports young people well when they start using the service and also those who move on because they reach adulthood.  Leadership and management arrangements have strengthened since the previous inspection.  Staff receive regular and effective clinical and management supervision.  Parents praise the staff and their commitment to young people.  The manager and staff communicate well with professionals to ensure that there is consistency and good care for young people.  Staff plan fun activities and experiences for young people in advance and prepare memory books of their time in the home.

p.2

Key findings from this inspection

The children’s home’s areas for development:

p.2

Key findings from this inspection

 Not all young people have taken part in fire drills and the times that they took place were not recorded.  Care plans do not reflect safeguarding practice that happens in the home or the complex supervision arrangements for young people accurately. Care plan reviews, although they take place, are not carried out as described in the statement of purpose. Management audit has improved, but did not capture these areas for improvement.  The home’s development plan is not detailed enough and does not include who will do what, when and why.  A requirement from the previous inspection relating to providing adequate sensory and play equipment in the garden is not met.  Staff have not thoroughly considered the benefits of sitting down with the Inspection report children’s home: SC432404 3 young people for a sociable mealtime experience.  Autism training is identified as a need, but is not yet arranged.  Fire signage in the home has increased in the otherwise homely environment.

p.2

Inspection date Inspection type Inspection judgement

21/03/2017 Interim Declined effectiveness 26/10/2016 Full Good 22/02/2016 Interim Sustained effectiveness 16/11/2015 Full Good Inspection report children’s home: SC432404 4

p.3

Statutory requirements

This section sets out the actions that the registered person(s) must take to meet 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.

p.4

Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who— take their views, wishes and feelings into account in relation to matters affecting the children’s care and welfare and their lives. In particular, present young people’s goals in a format that they can understand. (Regulation 7(1)(c)) 27/09/2017

p.4

Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— helps children aspire to fulfil their potential; and promotes their welfare. 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; (d) ensure that the home has sufficient staff to provide care for each child; (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; (g) demonstrate that practice in the home is informed and

p.4

Requirement Due date

improved by taking into account and acting on— (ii) feedback on the experiences of children, including complaints received; (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(2)(a)(c)(d)(f)(g)(ii)(h)) 27/09/2017 Inspection report children’s home: SC432404 5 In particular:  Ensure that there is sufficient management monitoring and oversight of care plans and care plan reviews to ensure children’s needs are met and that safeguarding and supervision arrangements are clear.  Ensure that care plan reviews focus on children’s experiences and achievements. Additionally, ensure that care plans are updated when necessary.  Ensure that communication takes place with social workers and other relevant professionals, prior to all care plan reviews.  Ensure that enough staff are available so that all young people who are able can go out on trips or activities.

p.4

Requirement Due date

 Ensure that all complaints and concerns are concluded with recommendations.  Ensure that staff record incidents in sufficient detail.  Improve the home’s development plan so it is sufficiently detailed.  Progress the home’s development plan so that young people have adequate play and sensory provision in the garden.  Review the opportunities given to all young people to enjoy regular sociable mealtimes every time they have a stay. After consultation with the fire and rescue authority, the registered person must— ensure, by means of fire drills and practices at suitable intervals, that persons working at the home and, so far as reasonably practicable, children are aware of the procedure to be followed in case of fire. (Regulation 25(1)(d)) 27/09/2017

p.5

Overall experiences and progress of children and young people: good

Young people continue to have excellent relationships with staff and enjoy their stays at this home. The young people have complex healthcare needs and staff attend to these with confidence and expertise. Staff are caring and committed. Young people and staff look forward to spending time with each other and having fun. Inspection report children’s home: SC432404 6 Since the previous inspection, one young person has joined the home and another has left. Planned introductions to the home went well and the young person’s experience has been very positive. Staff have adapted their responses well to the young person’s behaviour to ensure that their needs are met. The other young person who has left the home was well prepared and informed, and enjoyed a leaving party before moving on.

p.5

Overall experiences and progress of children and young people: good

Staff communicate well with young people and use a variety of methods to do so. Activities in and out of the home are planned in advance so that young people can enjoy experiences that they may otherwise not be able to have. These include trips to nearby attractions and parks, museums, garden centres and arts and crafts centres. Young people have memory books which contain photographs and information about what activities they have enjoyed.

p.6

Overall experiences and progress of children and young people: good

Staff communicate well with parents and social workers. After every short-break stay, staff provide a written overview for parents and social workers to keep them informed of how the stay went and what young people did. The manager and staff attend all relevant meetings to ensure that they are involved in planning, and can advocate for young people.

p.6

Overall experiences and progress of children and young people: good

Most parents are very happy with the service provided and describe it as ‘amazing’. They feel that the staff are caring and that young people really enjoy their short breaks. Two parents are unhappy with the arrangements regarding ambulance transport for young people; the manager cannot guarantee that a staff member can travel in an ambulance with young people in an emergency.

p.6

Overall experiences and progress of children and young people: good

Very few incidents have occurred in the home since the previous inspection. On very few occasions, recordings of incidents have not contained sufficient detail and the manager has brought this to staff’s attention.

p.6

Overall experiences and progress of children and young people: good

The home is well maintained and decorated. Young people have personalised bedrooms and photographs on their walls of people who are important to them. However, fire signage has increased, which detracts from the inviting atmosphere that the team is trying to create in order for young people to feel relaxed and ‘at home’.

p.6

Overall experiences and progress of children and young people: good

Young people each have a goal to achieve which is agreed at reviews. Staff know what these goals are and help young people to achieve them. Goals are in a written format for young people, and are not displayed in a way that all young people can easily understand. The young people’s goals and experiences are reviewed by the manager and staff every three months. Not all social workers and relevant professionals are contacted before reviews and recordings show more focus on medical issues and little on progress made with goals and experiences. These reviews do not happen in accordance with the statement of purpose for the home and therefore a requirement is made.

p.6

Overall experiences and progress of children and young people: good

Staff and young people do not always sit down altogether with young people at mealtimes. Therefore, some young people are missing out on this social and learning opportunity. Inspection report children’s home: SC432404 7

p.6

improvement to be good

Staff have not physically intervened as a way of managing the behaviour of young people, but they have received the necessary training. Young people’s plans do not state what types of intervention should be used in the event of it being used as a last resort. Some care plans are not explicit enough as to the supervision arrangements for young people or about what staff need to do in individual safeguarding situations. Therefore, staff, parents and professionals cannot rely upon care plans to clearly reflect what actions should be taken in particular situations. However, the manager is able to describe the way that staff work with young people and how they recognise and deal with safeguarding and child protection concerns. This practice is safe and meets the regulations.

p.7

improvement to be good

Three of the seven young people who use the service have taken part in two fire drills this year. Therefore not all of the young people have been part of the exercise, including those who have started having short breaks this year. Although the durations of the fire drills are recorded and they take place within the required time, the times of fire drills are not documented, nor are there written evaluations of these exercises. Consequently, the complexities involved in managing a fire evacuation have not been thoroughly tested or reviewed.

p.7

improvement to be good

Staff administer medication safely to young people. The manager and a nurse carefully audit medication records on a regular basis. Mistakes are now fewer, and are dealt with quickly. Errors made are investigated and the team reflects on any learning as a result, to prevent future mistakes.

p.7

improvement to be good

Leaders and managers ensure that new staff recruited have suitable training, experience and are safe to work with young people.

p.7

The effectiveness of leaders and managers: requires improvement to be good

The manager has been running this home since March 2017, and has applied to Ofsted to be the registered manager. Since the previous inspection, further arrangements have been made to strengthen the oversight and running of the home. This includes the appointment of a part-time team coordinator whose role is to lead on areas such as training, rotas and keeping up to date with research and practice. Managers from the organisation’s neighbouring homes also meet monthly to review incidents and practice, and share learning.

p.7

The effectiveness of leaders and managers: requires improvement to be good

The manager has a development plan in place, but it is not detailed enough. It does not describe all of the improvements that the manager and staff have discussed, how they will be achieved, or clear targets or timescales for action. For example, the manager has funding for sensory and play equipment. The exact equipment has not been decided Inspection report children’s home: SC432404 8 upon or purchased and this information is not included in the plan. Therefore the manager cannot easily review the progress being made with the home’s development and how timely this is.

p.7

The effectiveness of leaders and managers: requires improvement to be good

The garden is picturesque and of a good size, and is surrounded by attractive plants with well-maintained grass. A ramp with recently painted colourful rails enables young people who use wheelchairs to easily access the garden. With the funding available, staff have improvised and made some changes. This includes trugs which young people use when they help to plant and water flowers and herbs. Also, staff have built an innovative tunnel made out of wooden sticks, with sensory items for young people to touch and see. However, no play equipment or furniture is available for young people to enjoy with staff. The manager states that funding applications have been unsuccessful. Consequently, young people rarely use the garden. Sometimes young people are not well enough to travel in the car or not enough staff are available to take young people out. Therefore, this is a missed opportunity for young people to benefit from fresh air, a

p.8

The effectiveness of leaders and managers: requires improvement to be good

change of scenery and a stimulating experience which is easily accessible outside of the home.

p.8

The effectiveness of leaders and managers: requires improvement to be good

A variety of activities and trips take place that the manager, staff and parents state happen regularly. However, it is not clear how often, as this information is not consistently and collectively recorded. One young person has not been able to leave the home for the last three months. Due to insufficient levels of staffing, other young people have often not been able to go out when having stays at the same time. The manager has recognised this problem and is increasing staffing to resolve it.

p.8

The effectiveness of leaders and managers: requires improvement to be good

The manager has developed a system to ensure that they have oversight and review of care planning, medication and supervision. All young people have care plans and the quality of these plans has improved. However, some aspects are not detailed enough, nor do they fully reflect how staff care for young people. The manager’s regular audits of care plans have not identified this or shortfalls in care plan reviews.

p.8

The effectiveness of leaders and managers: requires improvement to be good

All staff receive regular, effective supervision and appraisal and so this requirement from the previous inspection has been met. Nursing staff have additional monthly supervision by the nurse consultant in addition to supervision by the manager. Staff have regular training, but the manager has identified a need for staff to have training to support them to care for young people who have autism. This training has not yet been arranged.

p.8

The effectiveness of leaders and managers: requires improvement to be good

The manager ensures that regular team meetings take place, and has arranged a team- building day to help further develop team morale. Staff feel supported by the manager, who is clear about expectations in relation to roles and responsibilities, and is committed to providing a good service to young people. Inspection report children’s home: SC432404 9 Communication and relationships with social workers are much improved. A headteacher reported that ‘staff support and represent children well and that communication is effective’.

p.8

Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

p.9

Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC432404 10

p.9

Children’s home details

Registered provider address: Fairview House, Corporation Road, Bodmin, Cornwall PL31 1FB

p.10

Inspector

Sarah Canto, social care inspector Inspection report children’s home: SC432404 11 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

p.10

Inspector

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, 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 http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.11

Inspector

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.11

Inspector

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

p.11