Children's home run by Courtyard Care Limited

Inspection report children’s home: 1231404 1 Registered provider: Courtyard Care Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately run children’s service may provide care and accommodation for up to four children who have physical disabilities and learning disabilities. This may include care and accommodation for children who have sensory impairment. The home may only provide care and accommodation for up to two children under short-break arrangements and may only provide care and accommodation for up to two children to live permanently at the home.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

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

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good

Date of last inspection: first inspection since registration

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good

Overall judgement at last inspection: not applicable

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Enforcement action since last inspection

None. Inspection report children’s home: 1231404 2

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Key findings from this inspection

 Young people have unique ways of communicating their views, wishes and feelings. Members of staff know and understand these forms of communication very well. Therefore, young people are able to express their opinions of their care.  Young people have complex medical needs. They require medical equipment and assistance to support them throughout their lives. Professionals and parents say that young people receive high-quality care from a staff team that is trained to the highest standards.  Young people make progress because members of staff work closely with their parents, schools and medical professionals. Peer and social play enhances their quality of life.  Parents say that their children are happy, well cared for and enjoy a range of activities that they may not have experienced before. Parents say that family life has improved due to the service that they receive.  Transitions into the home are very well planned. The manager and a specialist

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Key findings from this inspection

nurse work closely with parents, schools and medical professionals prior to admitting a young person to the home. Members of staff work alongside teachers and parents to gain a full understanding of the young person’s needs.  The manager monitors the home extremely well. She is proactive and uses consultation with a range of people, as well as staff meetings and monthly monitoring systems, to identify areas in which the service can improve.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 If a sanction were imposed on young people, the current method of record would not capture all the information required by the Children’s Homes Regulations 2015.  Members of staff need to ensure that all visitors to the home have the fire evacuation procedure explained to them. This will help to ensure visitors’ safety.  The social worker, parent and manager have not signed one young person’s local authority documentation. This does not show that everyone is in agreement with the plans.  There are excellent arrangements for young people to transition into the home. However, this could be further enhanced by using the location risk assessment to ensure that young people are suitably placed.

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Inspection date Inspection type Inspection judgement

Inspection report children’s home: 1231404 3

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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.

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Requirement Due date

The registered person must ensure that 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-

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Requirement Due date

details of any methods used or steps taken to avoid the measure. Also, the name of the person who used the measure and the effectiveness and any consequence of the measure used. (Regulation 35(3)(a)(v)(vi)(vii))

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Requirement Due date

This is specifically in relation to the sanction record. 30/10/2017

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Recommendations

 Ensure that case records are signed and dated by the author of each entry. (‘Guide to the children’s homes regulations and quality standards’, page 62, paragraph 14.3) In particular, ensure that professionals and parents have signed the necessary documentation.  The registered person should review the appropriateness and suitability of the location and premises of the home at least once a year. (‘Guide to the children’s homes regulations and quality standards’, page 64, paragraph 15.1) In particular, evaluate the crime statistics for the area in order to address any known risks that may have the potential to impact upon young people. Furthermore, consider the location review when completing impact risk assessments for young people who are to be admitted to the home.  The registered person should build a strong safeguarding culture in the home. (‘Guide to the children’s homes regulations and quality standards’,

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Recommendations

page 43, paragraph 9.8) In particular, ensure that all visitors are taken through the emergency evacuation procedures. Inspection report children’s home: 1231404 4

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Overall experiences and progress of children and young people: good

Three young people currently receive short breaks at this home. Two other young people are currently being supported to move into the home on a permanent basis. All of the young people have complex disabilities that require a high level of care, supervision and medical assistance.

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Overall experiences and progress of children and young people: good

On receipt of a referral, the manager and specialist nurse meet with the relevant social care professionals, medical professionals and parents to discuss and assess the young person’s care needs. All medical information is obtained. Members of staff go into young people’s schools and parental homes to work alongside and come to know the young people. As a result, members of staff can mirror the care that young people receive. Members of staff receive additional training if a young person has a medical condition that they are not familiar with. Young people and their parents visit the home, stay for tea and have planned overnight stays prior to coming into the home. Consequently, transitions into the home take between three to six months. However, professionals and parents say that these excellent practices have ensured that young people settle into the home extremely well. A professional said: ‘The transition was fantastic. Due to the

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Overall experiences and progress of children and young people: good

amount of work undertaken and discussions, we were able to iron out any small issues before she came here.’ Each young person’s transition plan information and all of the meetings and arrangements in preparation for their move into the home are well documented. The home has a location risk assessment in place, but the manager has not used this document when assessing the suitability of the young people being placed at the home. This minor shortfall has not affected the safety of the young people.

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Overall experiences and progress of children and young people: good

The home has looked to develop innovative, child-centred ways to introduce young people to the home, especially given their varying levels of communication. As a result, a member of staff has created a video to show young people. This means that young people can see what the home looks like and can begin to familiarise themselves with its layout prior to visiting for the first time. In addition, a sensory booklet is being developed for young people who have a visual impairment.

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Overall experiences and progress of children and young people: good

The manager ensures that she has all the documents that are required to care for young people well. Detailed care plans show the young person’s history, health needs, school attainment and communication needs, as well as other services that are involved in each young person’s care. The plans also chart young people’s progress and set out the plans for their future. However, the social worker, parent or manager did not sign one young person’s local authority documentation. This does not show that everyone is in agreement with the plan.

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Overall experiences and progress of children and young people: good

Most of the young people communicate in a non-verbal way. They use facial expressions, body language or noises to indicate how they are feeling. One young person had very limited communication prior to coming to this home. Members of staff have worked extremely hard to help the young person to use eye pointing to communicate. Staff hold up picture cards or items of clothing for the young person to Inspection report children’s home: 1231404 5 choose. The young person then uses her eyes to indicate what she wants. For example, on the morning of the inspection, the young person chose her own ribbons and hairstyle. A professional said: ‘The progress in her communication is fantastic. We now know that she understands a lot more than we first thought.’ This progress has allowed the young person to have her views, wishes and feelings heard.

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Overall experiences and progress of children and young people: good

All the young people have complex health needs and require medical equipment to support them every day. For example, some young people have tracheostomies, ileostomies, gastrostomy tubes and oxygen support. This equipment needs cleaning and changing regularly. The company employs a specialist nurse who attends the home three days a week. She undertakes training with members of staff in all areas of care, and this is refreshed regularly. She draws up the young person’s health plan, which includes information on their condition, the medication required and the cleaning, maintaining and changing of medical equipment. Young people often require overnight hospital treatment. Young people have a hospital support plan that gives nursing staff information about their care, as well as their communication skills and medical needs. Members of staff also support the young people when they are in hospital. This means

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Overall experiences and progress of children and young people: good

that young people receive good continuity of care. Recently, there was a mix-up over a specific element of a young person’s care while in hospital. This was fully investigated and, as a result, a protocol has been put in place to clarify whose responsibility it is to oversee different aspects of medical care when young people are in hospital.

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Overall experiences and progress of children and young people: good

Young people have separate medication cabinets in which to store their medication. This reduces any opportunity for mistakes. Medication administration sheets are detailed and close attention is paid to ensuring that all medication is accounted for and safely administered in line with the prescription. All members of staff have received training in administering medication and they all have a first-aid certificate. This means that young people are well supported with their medication needs.

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Overall experiences and progress of children and young people: good

Young people enjoy the opportunity to try new activities, and staff work creatively to provide them. The home purchased tickets for the young people to enjoy a zoo ‘dream ticket’ experience, whereby they have the opportunity to interact with the animals. Staff reported that the young people had an ‘amazing time’, thoroughly enjoying the range of sensory experiences. Staff ensured that plenty of photographs were taken for inclusion in each young person’s memory book. Young people also enjoy spending time in the sensory room or having messy play, as well as going to the cinema and to the park. One young person, who had been socially isolated from her peers prior to coming to spend time at the home, is now having different experiences and has made friends with another young person at the home. They like similar things such as having their nails and hair done.

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Overall experiences and progress of children and young people: good

The young people live in a well-equipped, purpose-built bungalow where they have specialised beds and medical equipment that is a replica of items from their own homes. This means that the home can accommodate young people who have a range of mobility needs, and that these are met sensitively and safely. The home is decorated and furnished to a high standard, and it is kept clean and tidy. Although there is a range of medical equipment in the home, the home retains a warm and welcoming feeling. Each Inspection report children’s home: 1231404 6 young person’s bedroom is decorated to their individual taste. For example, one young person likes princesses and another likes fantasy characters.

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How well children and young people are helped and protected: good

Professionals and parents say that young people are extremely safe at this home. Members of staff are highly trained to care for the young people well. There have been no safeguarding concerns to report. Staff demonstrate a thorough understanding of their roles and responsibilities in safeguarding young people. They receive regular training, including on safeguarding, child sexual exploitation and e-safety. This means that members of staff are able to identify and can take action if an incident was to occur or they had a concern.

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How well children and young people are helped and protected: good

Young people who have complex health needs and disabilities enjoy their time at this home. This is because there is a stable, knowledgeable and caring staff team that helps and protects them. Each young person has an identified key worker who liaises with parents, schools and medical professionals to ensure that risks are identified and minimised.

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How well children and young people are helped and protected: good

Members of staff know the young people extremely well and respond to any signs of distress. One young person has recently had a longer stay than normal. Members of staff noticed that she was more withdrawn than normal towards the end of her stay. A professional said: ‘We discussed ideas on how to let her know how long she was staying for and when it was time to go home. I am amazed that they took this on board so quickly, as we only discussed it last week. They have now put a countdown in to show her how many days. This has reduced her anxiety.’

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How well children and young people are helped and protected: good

Parents and professionals say that they have open and honest communication with the staff team and manager. They receive regular telephone calls and monthly reports about their children. All parties stated that they had no concerns about the home and that they were confident that they would be able to raise a concern, if necessary.

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How well children and young people are helped and protected: good

The home’s approach to managing behaviour and the support provided to young people is a strength of the home. Members of staff continue to find ways to support the young people to manage their anxiety and improve their communication skills, and to help them to interact with their peers and engage in wider social circles. Strategies to divert or de-escalate situations are agreed and highlighted in the young people’s support plans. This has been successful and has meant that young people have not needed to be held for their own or others’ safety. In addition, there has been no need to use sanctions as young people’s behaviour is well managed. However, the current recording log does not follow the Children’s Homes Regulations 2015. For example, it does not have a space for members of staff to identify what steps were taken to avoid using the measure, who gave the sanction or how effective it was. Therefore, the manager would be unable to

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How well children and young people are helped and protected: good

monitor the use of sanctions if they were to be imposed.

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How well children and young people are helped and protected: good

All health and safety aspects of the home are carefully monitored. Medical equipment, appliances and utilities are checked weekly and have the required certification for use. Inspection report children’s home: 1231404 7 This means that young people live in a safe environment. Young people and staff routinely undertake fire evacuations. This is important, as most young people are immobile. Because of this good practice, staff have identified and remedied any difficulties that they have encountered during evacuations, such as a fire door not closing. However, visitors are not routinely informed about the fire evacuation procedures and exits so that they know what to do in the event of an emergency.

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The effectiveness of leaders and managers: good

The manager was registered with Ofsted in May 2017. She has a number of years’ experience of working with young people with complex needs. She has progressed through the company to this position and is currently concluding her managerial award, which she expects to complete in December 2017. A deputy manager, a team leader and a stable staff team support the manager. All staff members say that the manager is approachable, fair and supportive. Professionals and parents commented on her excellent oversight, management and communication skills.

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The effectiveness of leaders and managers: good

The home was registered in February 2017 with a full complement of staff. Due to the stability of the staff team, there have been no new staff recruited since registration. The home is due to take two young people on a permanent basis. Therefore, recruitment and interviews have been conducted for four additional staff members. The manager is waiting on disclosure checks and references prior to offering them employment. These good practices will ensure that suitable adults care for young people.

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The effectiveness of leaders and managers: good

The home’s statement of purpose clearly sets out the ethos of the home. Young people receive high-quality care and their uniqueness is valued. Members of staff speak proudly of the young people and fully understand their complex needs. More importantly, staff have ambitions for the young people and help them to progress. One member of staff said: ‘Progress for our children can be slight, but is massive for them. We are able to do this as we work closely with parents and professionals to ensure that they receive the care they need. The company supports us to do our job extremely well through excellent training opportunities that are designed to meet each individual’s needs.’ She continued: ‘I am proud to work here and be able to assist young people to grow.’

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The effectiveness of leaders and managers: good

The home’s training matrix identifies when staff require updated training. Staff receive a wide range of training regarding young people’s health needs, as well as mandatory training. The specialist nurse is currently liaising with medical professionals regarding the best option to meet the medical needs of a recently referred young person. This includes considering whether training staff would be appropriate or whether a community nurse is needed. Four members of staff have a qualification in caring for young people. Seven members of staff are currently undertaking this award and they are all on target to complete it in a timely manner.

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The effectiveness of leaders and managers: good

Members of staff receive monthly supervision, when their practice and development opportunities are discussed. This ensures that they receive good support with caring for young people. The manager is currently developing the supervision process to capture members of staff’s understanding and retention of the knowledge gained from training. Inspection report children’s home: 1231404 8 She said that this would assist her in identifying whether staff require additional support or a different method of learning. In addition to this, staff have monthly staff meetings. They discuss the progress of young people, company policies and procedures, and the running of the home. The manager identifies points of learning and aspects of research that are discussed at these meetings. For example, the staff team has recently explored court orders. As a result, members of staff understand whose responsibility it is to make

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The effectiveness of leaders and managers: good

The home’s workforce plan outlines each member of staff’s qualifications, training and experience. It also details management’s expectations of staff conduct, and provides a schedule of their supervisions and appraisals, and the dates of staff meetings. This is updated regularly to ensure that it is current.

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The effectiveness of leaders and managers: good

The manager works closely with a range of professionals to ensure that young people receive high-quality care. She is confident to challenge other professionals, and regularly seeks professionals’ and parents’ views about the way that the home operates and how it could be improved. However, no concerns or improvements were identified during the consultation process. On the contrary, the manager and staff receive high acclaim for their work and practice.

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The effectiveness of leaders and managers: good

An independent visitor monitors the home on a monthly basis. The report includes consultations with young people, parents and professionals, therefore an all-round view of the home’s practice is given. The manager quickly addresses any areas identified for improvement. These are taken forward to her monthly monitoring report and home development plan. For example, the independent visitor felt that the garden could be improved. The garden has been redesigned and the young people have helped to paint tyres. The next step is for young people to choose and buy plants for the garden, and to plant them. The manager said that, to keep the young people interested in this, they would have a competition for whose plants grow the fastest. Members of staff said that they were fully included in developing and improving the home. One member of staff is putting together a touch sensory book for new referrals in a format that is more easily

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The effectiveness of leaders and managers: good

accessible. This shows that the manager takes on board, reflects on and puts things into action in order that the home continues to develop. Inspection report children’s home: 1231404 9

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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 whom it is trying to help, protect and look after.

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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: 1231404 10

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Children’s home details

Registered provider: Courtyard Care Limited

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Children’s home details

Registered provider address: Optima House, 100 Manchester Road, Denton, Manchester M34 3PR

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Inspector

Pam Nuckley, social care inspector Inspection report children’s home: 1231404 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 looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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