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

Inspection report children’s home: SC429523 1 SC429523 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

This service is provided by an NHS Foundation Trust and offers short-break care for up to four children at any one time. Children who have significant health needs and learning disabilities are cared for by a team of nursing and support staff. The manager has been registered with Ofsted since July 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 requires improvement to be 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: sustained effectiveness

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good

Enforcement action since last inspection: none Inspection report children’s home: SC429523 2

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Inspection date Inspection type Inspection judgement

23/03/2018 Interim Sustained effectiveness 03/10/2017 Full Requires improvement to be good 07/02/2017 Interim Sustained effectiveness 04/07/2016 Full Requires improvement Inspection report children’s home: SC429523 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 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.

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Requirement Due date

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

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Requirement Due date

ensure that staff have the experience, qualifications and skill to meet the needs of each child; 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; and use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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Requirement Due date

In particular, ensure that care plans contain important details about the aims and/or targets and progress that children make at the home. 13/08/2018

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Requirement Due date

If the Regulatory Reform (Fire Safety) Order 2005(a) applies to the home—

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Requirement Due date

the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home.

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Requirement Due date

In particular, ensure that exit routes between the home and assembly point do not include locked doors. 13/08/2018

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Requirement Due date

The registered person may only use devices for the monitoring 13/08/2018 Inspection report children’s home: SC429523 4 or surveillance of children if—

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Requirement Due date

the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children; the child’s placing authority consents in writing to the monitoring or surveillance; so far as reasonably practicable in the light of the child’s age and understanding, the child is informed in advance of the intention to do the monitoring or surveillance; and the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy.

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Requirement Due date

In particular, ensure that any night-time monitoring of children is recorded and regularly reviewed and reduced if children are safe, to avoid invasion of privacy.

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Recommendations

 For children’s homes to be nurturing and supportive environments that meet the needs of their children, they will, in most cases, be homely, domestic environments. Children’s homes must comply with relevant health and safety legislations (alarms, food hygiene etc.); however in doing so, homes should seek 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)  Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective, and clear recording. Staff should record information on individual children in a non-stigmatising way that distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the children’s homes regulations including the quality standards’, page

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Overall experiences and progress of children and young people: good

Children benefit from the short breaks offered at this home. The adults who work here are a good mix of qualified care and medical staff who understand the needs, likes and dislikes of the children they care for. Attention to providing new experiences and activities for children has improved. This Inspection report children’s home: SC429523 5 adds more opportunities for learning and making the most of stays in the home. The home is well resourced an additional garden space has recently been created with teenagers’ preferences in mind.

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Overall experiences and progress of children and young people: good

Careful care planning identifies the needs of each child and how these, including often complex medical needs, are to be met. Plans are agreed with the parents and other professionals on children’s admission to the home and at reviews.

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Overall experiences and progress of children and young people: good

All children attend full-time education provision. Communication is effective between the child’s home, education and the short-breaks services.

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Overall experiences and progress of children and young people: good

Reviews are attended by adults from this service to ensure that they are contributing to any planning. Memory books are created for each child, with photographs and other memorabilia of their time at the home. These are commonly presented at review meetings and are taken by children as a lasting memento’ .

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Overall experiences and progress of children and young people: good

Moves into and out of the home are planned in advance to allow children to become familiar with new services and to avoid anxiety. Two new children’s guides have been created these are child friendly and suited to different abilities. One includes photos of the home with an audio commentary and the other is paper based with lots of pictures and colour.

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

Children are safe in this home. The adults are clear about children’s needs and understand the particular vulnerabilities associated with their presenting needs and medical conditions.

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

Arrangements for the storage and administration of medication have been reviewed and amended following a medication error. Systems and checks are more robust and designed to prevent a recurrence of this mistake. All staff are assessed as suitable to administer medication by a health professional.

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

The manager tries to match the children staying together so that they have opportunities to make friends and to limit any conflict. Physical intervention does not feature as a means of controlling children. Behaviour is managed effectively because the adults know the children well and can anticipate any difficulties.

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

Children and parents know how to make a complaint. Complaints are dealt with fairly, in a timely way and to the satisfaction of those who complain. Adults will also advocate on behalf of children if they are dissatisfied about services outside of the home.

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

Risk is considered prior to children’s involvement in new experiences or activities. This avoids exposing children to unnecessary risk and makes sure the adults have all the equipment needed to help children if they become unwell.

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

All adults working in the home receive training so that they are able to recognise and Inspection report children’s home: SC429523 6 respond effectively to any signs of abuse. Safer recruitment practice is in place to prevent those who seek to harm children from working in the home. Many of the adults have worked in the home for a long time and the children know them well.

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

Early warning fire detection systems are fitted throughout the building and regular fire safety checks are competed on behalf of the NHS trust. The need to remove a lock from an external door fitted between an exit point and the assembly point has not been addressed. This may compromise the effective evacuation of the premises in the event of a fire.

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

A suitably qualified registered manager has been in place since July 2017. Her experience of the overall management of a children’s home is relatively limited and some shortfalls have yet to be fully understood and/or addressed.

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

Record keeping continues to be problematic. A dual system of keeping records on a computer system and handwritten notes lacks clarity. Staff do not fully understand this system, what records they need to retain or print off the computer, or where information needs to be stored.

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

In practice, it is clear to see the benefits to children of staying for short breaks. However, Children may be subject to unnecessary checks and it is not possible for the manager to accurately review these interventions. Care plans do not set out aims and objectives.Fire drill records do not readily demonstrate that all staff and children have been involved in an evacuation practice.

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

The environment and some practice require attention to avoid an institutionalised feel, for example, window restrictors have been fitted indiscriminately throughout the building, despite a lack of identified risk. Hospital-style health and safety checks continue to be applied, whether they are needed or not. The manager addressed some of the matters identified by the inspector during this inspection.

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

The NHS trust has struggled to recruit sufficient staff, particularly qualified nursing staff. On occasion, the home has had to close because of staff shortages. This can be disruptive for both children and parents.

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

The enthusiasm and dedication of the manager is not in question. The team members work closely together and they have a genuine affection and positive regard for the children they look after.

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

Supervision is provided on a regular basis and allows opportunities for staff to reflect on and learn from practice. Qualified nursing staff assess that all staff are competent to carry out non-regulated medical procedures, to make sure children are treated effectively. Inspection report children’s home: SC429523 7 Annual appraisals are completed for all staff, to encourage continuous personal development. The manager is currently undertaking a level 5 diploma to further enhance her management skills.

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

The manager has introduced several methods to include children in developing the home and the service provided. Staff are keeping records of children’s reactions to activities, likes and dislikes.. New activities and opportunities for each child are carefully planned and considered in team meetings and from feedback obtained from the children.

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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: SC429523 8

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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

Janice Hawtin, social care inspector Inspection report children’s home: SC429523 9 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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