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

Inspection report children’s home: SC428956 1 SC428956 Registered provider: Cornwall Partnership NHS Foundation Trust

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The service provides short-break 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 dates: 21 to 22 December 2017

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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

Overall judgement at last inspection: good

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Enforcement action since last inspection:

None Inspection report children’s home: SC428956 2

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Key findings from this inspection

 The children enjoy their visits and they do things that they can’t do when they are at home.  Children who start to use the service are introduced in a well-planned and sensitive way.  The manager and the staff continue to support young people who move on to receiving a service from adult care; this provides valuable continuity.  The manager and the staff advocate for the children and young people, challenging decisions made by other agencies, when required.  The staff understand the children, their moods and how their health needs affect their behaviour. Consequently, children go to events and places that they can enjoy safely.  Children are involved in day-to-day decisions about what they would like to do.  Children are safe when they visit.

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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

 There is evidence that decisions made about video surveillance of children are considered carefully. Parents and relevant professionals are involved in these decisions but relevant support plans are not updated in a timely way.  Children are not at the centre of reviews. They do not attend their meeting, and more thought needs to be given to how their wishes and feelings are captured in the review process.

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Inspection date Inspection type Inspection judgement

20/03/2017 Interim Sustained effectiveness 12/12/2016 Full Good 24/02/2016 Interim Sustained effectiveness 29/07/2015 Full Good Inspection report children’s home: SC428956 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 children’s views, wishes and feelings standard

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Requirement Due date

In particular the standard requires the registered person to— Ensure that staff help each child to express views, wishes and feelings; help each child to prepare for any review of the child’s relevant plans and to make the child’s views, wishes and feelings known for the purposes of the review. (Regulation 7 (2)(a)(ii)(vi))

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Requirement Due date

In particular, ensure that all reviews are constructed in a way that puts children’s wishes and feelings at the centre. The registered provider should develop more creative ways to capture the wishes and feelings of children in the review process. 30/03/2018

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Requirement Due date

The registered person must ensure that— the privacy of children is appropriately protected; any limitation on a child’s privacy or access to any area of the home’s premises— allows children as much freedom as possible when balanced against the need to protect them and keep them safe. (Regulation 21 (a)(c)(iv))

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Requirement Due date

In particular, the registered manager should ensure that, when decisions are made in relation to video surveillance of a child, parental consent is recorded and all relevant documents are updated. 02/03/2018 Inspection report children’s home: SC428956 4

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Overall experiences and progress of children and young people: good

The children enjoy the time they spend at the home and on their outings into the community. The children have clear goals to achieve that are challenging and realistic. These are captured and recorded in a way that celebrates the children’s progress, and that they understand.

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Overall experiences and progress of children and young people: good

The manager and the staff have worked in the home for a considerable length of time, and they know the children well. This results in a considered approach to risks that gives young people exciting and challenging experiences. For example, one young person was taken to a laser show at a nearby attraction. The staff researched the event carefully to ensure that the lights would not trigger seizures, watched videos of the previous year’s event with the young person and took him for a short visit. Knowing that he enjoyed the experience they took him again, for longer and to a more challenging experience involving live music.

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Overall experiences and progress of children and young people: good

Conversely, the staff understand the health needs of the children and the effect this can have on both mood and behaviour. The staff are led by the children and young people when they go out, and return to the home when they are tired or simply not enjoying experiences. Rooms are prepared in advance of overnight stays so that the children and young people are comfortable. The children and young people recognise their own belongings and are encouraged to bring with them whatever creates a sense of home.

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Overall experiences and progress of children and young people: good

When children are having difficulties at school, at home or because they are moving on the staff prepare them well and advocate on their behalf. The manager challenges delay and poor practice when necessary and builds up good relationships with families so that sensitive issues can be addressed and dealt with.

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Overall experiences and progress of children and young people: good

Families speak highly of the service that children receive and value the progress that children make.

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Overall experiences and progress of children and young people: good

When children start using the home, their introductions are well-planned and are sensitive to the timescales that the whole family need to make the stays a success.

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Overall experiences and progress of children and young people: good

Although children and young people are very much involved in day-to-day decisions about what to do and when, lesser thought is given to how they are involved in longer- term decisions. For example, reviews do not include children, and more consideration needs to be be given to how to include their wishes and feelings in creative ways. Inspection report children’s home: SC428956 5

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

The understanding and management of child protection issues has improved significantly. On the small number of occasions when safeguarding issues have been raised, the manager, in particular, has responded well. This extends to challenging other agencies and giving support to families where there are concerns over neglect.

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

The children often have complex health needs that include regular seizures. The staff have a good understanding of thresholds in terms of bruising and injuries. They recognise unusual and concerning injuries and record and report them accordingly. The staff team members are trained to the required level in safeguarding and put their training into practice.

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

When children communicate through their behaviours rather than through speech, the staff team is supported to observe and analyse patterns of behaviour. This is discussed in clinical supervision, and strategies are put into place that all key adults use to good effect.

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

The staff respond in a calm and informed way to behaviours that are potentially unsafe. For example, support plans clearly identify a strategy of when to wait and when to intervene with a child who has recently started coming to stay. Consequently, the number of restraints used is very low. On two occasions since the last inspection, children have been removed from situations where they were growing increasingly anxious. This was proportionate, reasonable and successful in calming the child. On both occasions, clinical support and supervision facilitated a discussion on how to prevent this anxiety in the future.

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

Since the last full inspection, there has been one medication error, which did not result in any harm to children. The situation was dealt with calmly and professionally, and the staff have been supported to understand the reason for the error.

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

Careful consideration has been given to the balance between safety and privacy for a child who requires video surveillance while in his room, due to his health needs. It is evident that this has been discussed with his family and relevant professionals, and the solution is both sensitive and appropriate. However, signed consent from a parent for the recently increased level of surveillance and updated assessments is required.

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The effectiveness of leaders and managers: good

The manager of this home has substantial experience and knowledge. She supports the staff well and trusts them to make independent decisions. The staff feel valued and receive regular, good-quality supervision from their manager, alongside clinical support from other professionals in the trust. Although it is not a requirement under the NHS policy on safeguarding, quarterly group supervision on safeguarding issues has resulted in an increased awareness of child protection issues. This has recently been suspended Inspection report children’s home: SC428956 6 due to resource issues but would further enhance the quality of the service if resumed.

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The effectiveness of leaders and managers: good

The independent person, who conducts monthly visits and produces reports for both the manager and the regulator, uses her own experience to identify issues that will enhance the experiences of the children.. The manager responds quickly to any recommendations that are made.

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The effectiveness of leaders and managers: good

Training is regular and covers both the mandatory elements that staff need to keep children safe and responds to the evolving nature of the personal and health needs of the children who come to stay.

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The effectiveness of leaders and managers: good

The manager shows strong leadership in terms of advocacy and encouraging the staff to see the children’s lives in a holistic way. This results in support for families outside of the home, including training for other agencies on the specific needs of the children. Staff are also made available to support those who move on to being cared for by adult services.

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The effectiveness of leaders and managers: good

The leadership team is aware that referrals to this service are dwindling, and the manager is fully involved in discussions about the future of the service.

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The effectiveness of leaders and managers: good

The one requirement made at the last inspection has now been met.

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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 differences 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: SC428956 7

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Children’s home details

Registered provider address: Trust Head Office, Carew House, Beacon Technology Park, Dunmere Road, Bodmin PL31 2QN

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Inspector

Steve Lowe, social care regulatory inspection manager Inspection report children’s home: SC428956 8 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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