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 Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is owned by ‘The Cornwall Partnership NHS Foundation Trust’ and offers short breaks for up to two children who have complex health needs and have a learning and/or physical disability. Some children have life-limiting conditions which significantly affect their activities and daily living. The manager was registered with Ofsted in June 2018. The manager is also the registered manager of another children’s home in the locality.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

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

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children’s home: SC432404 2

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Inspection date Inspection type Inspection judgement

18/07/2017 Full Good 26/10/2016 Full Good 22/02/2016 Interim Sustained effectiveness 16/11/2015 Full Good Inspection report children’s home: SC432404 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

13: The leadership and management standard 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— 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; ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home has sufficient staff to provide care for each child; and demonstrate that practice in the home is informed and improved by taking into account and acting on— feedback on the experiences of children, including complaints received. (Regulation 13 (1)(2)(a)(c)(d)(f)(g)) In particular: Ensure that care plan reviews focus on children’s full

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Requirement Due date

experiences and achievements. Additionally, ensure that care plans are updated when necessary. Ensure that feedback from parents and children is included in the monitoring and review of the home. Ensure that sufficient staff are available so that all children receive the services as allocated. Ensure that all complaints and concerns are concluded with recommendations and review. 29/09/2018 Inspection report children’s home: SC432404 4 25: Fire precautions 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)) 29/09/2018

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Requirement Due date

12: The protection of children standard The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; have the skills to identify and act upon signs that a child is at risk of harm; understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; take effective action whenever there is a serious concern about a child’s welfare; and are familiar with, and act in accordance with, the home’s child protection policies; and that the effectiveness of the home’s child protection polices is monitored regularly. (Regulation 12 (1)(2)(a)(i)(ii)(iii)(v)(vi)(vii) and (2)(e))

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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)  Regulations 35–39 detail the records that must be kept in children’s homes. All children’s case records (regulation 36) must be kept up to date and stored Inspection report children’s home: SC432404 5 securely whilst they remain in the home. Case records must be kept up to date and signed and dated by the author of each entry. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.3)

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Recommendations

 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 62, paragraph 14.4)

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improvement to be good

Children mostly benefit from the short breaks provided in this children’s home.

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improvement to be good

A small number of issues have had a negative impact on children’s experiences. In addition, it has not been possible for staff to resolve some worries raised by a parent whose child has stopped coming after more than 10 years of short breaks. The manager has been working with stakeholders to try and resolve these issues.

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improvement to be good

Access to activities and the variety of activities available to children has improved since the previous inspection. Activities are now well documented in children’s individual story books, using both pictures and commentary. Staff complete an assessment of suitability following activities. They record indicators of the child’s likes and dislikes to inform future activity planning.

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improvement to be good

Moves into the home and on to adult services are sensitively managed by the staff. Children are able to undertake as many visits as needed so that when they stay overnight, they are familiar with the home and the staff. One parent described her son as getting very excited when he arrives at the home, adding, ‘He loves to stay, and is meeting all the targets we agreed. He is making choices and he doesn’t need to be with his Mum all the time now.’ Compliments have also been received from other families of children who have recently moved on to adult services.

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improvement to be good

Staff are attentive to the needs of the children they care for. Not all care plans have been kept up to date. They do not consistently reflect the positive quality of care that staff provide in practice.

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improvement to be good

The environment is suited to the needs of the children accessing short breaks. Home comforts such as rugs and cushions are just not practical for some children who use wheelchairs or have mobility issues but they are available if suitable. However, there is an abundance of notices around the home particularly related to fire safety which are Inspection report children’s home: SC432404 6 not necessary and add to an institutionalised feel.

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improvement to be good

Ofsted is aware of an ongoing investigation being conducted by the designated officer. This investigation is a result of several errors relating to the medical needs of children. Immediate risks have reduced. Leaders and managers are updating policies and guidance, and several additional monitoring systems have been established to avoid a repeat of mistakes.

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improvement to be good

Staff understand the needs of children using this short-breaks service. They are able to interpret often very limited communication and gauge the mood, comfort and needs of the children in their care. Most parents report that they feel that their children are safe in this home and benefit from spending time here.

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improvement to be good

Staff manage children’s behaviour well. They interpret all forms of children’s behaviour as a way of communicating. They do not use any form of physical intervention to manage behaviour and children do not go missing from this home. The majority of children require help to get out and about.

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improvement to be good

Most aspects of risk and risk management are understood by staff and implemented well to keep children safe. Staff have not completed individualised risk assessments for children who need surveillance or monitoring devices during the night. This may compromise children’s rights to privacy and dignity. The clinical lead nurse took action to address this shortfall during the inspection.

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improvement to be good

Complaints, although few, are not well recorded, and there is insufficient information in records about whether the complainant is satisfied with the outcome.

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improvement to be good

A previous requirement to ensure that all staff and children have had the chance to practice a fire drill is still not completed and has been repeated following this inspection.

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

Leaders and managers have not addressed all of the shortfalls identified at the previous inspection. Not all staff and children have been involved in a fire drill and care plans lack sufficient detail and clarity.

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

While some improvements have been made to the garden area, there is still a lack of suitable play equipment for children. Grant applications have been made to raise the funds needed to improve this area further.

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

A suitably qualified and experienced manager was recently appointed to the home. She has the confidence of and is respected by both staff and parents. Strengths and weaknesses of the home are known to her and she is already monitoring the home more effectively to ensure the quality of care. The progress of children and the activities that Inspection report children’s home: SC432404 7 they are involved in is now documented more thoroughly. Staff are also recording signs and indications that a child enjoyed or benefited from a particular activity to inform future planning.

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

Records are not always good-quality documents which demonstrate a detailed understanding of the children’s needs. It was only following an incident that staff recognised a child’s healthcare plan was disordered and lacked clarity. The manager has identified that other records need review and update, including children’s care plans and assessments to support the use of monitoring devices.

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

Work in collaboration with other stakeholders, particularly parents, adds to the quality of care provided. Consultation with other professionals aids understanding of children’s needs and helps to progress their identified targets. Regular formalised feedback from parents and children about developing the home is in the early stages of being introduced. The manager has recognised this as a point for improvement.

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

Supervision is provided consistently to staff. The majority of care staff have a suitable child care qualification and a number of qualified nurses provide clinical care in the home. Substantive training and induction programmes are effective. The frequency of induction programmes is causing some delay in appointed staff starting work in the home. Staffing shortages are beginning to have an impact on the provision to children and their families, with a number of arranged stays being cancelled.

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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: SC432404 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: SC432404 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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