Children's home run by Cornwall Council in Cornwall

Inspection report children’s home: SC361789 1 SC361789 Registered provider: Cornwall Council Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is registered to provide care and accommodation for up to nine children who have emotional and/or behavioural difficulties and learning difficulties. The home is owned by a local authority. It is situated near a school for children who have additional needs and a children’s home that offers short breaks. Some facilities and resources are shared between these three services.

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Information about this children’s home

Inspection dates: 29 to 30 November 2018

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Date of last inspection: 15 November 2017

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report children’s home: SC361789 2

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Inspection date Inspection type Inspection judgement

15/11/2017 Full Good 16/02/2017 Interim Sustained effectiveness 13/10/2016 Full Good 21/03/2016 Interim Sustained effectiveness Inspection report children’s home: SC361789 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 quality and purpose of care standard is that children receive care from staff who—

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Requirement Due Date

understand the children’s home’s overall aims and the outcomes it seeks to achieve for children;

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Requirement Due Date

use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential.

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Requirement Due Date

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

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ensure that the premises used for the purposes of the home are designed and furnished so as to—

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enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b)(2)(c)(i)(ii))

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Requirement Due Date

 Ensure that young people have a sensory room or space to go to that meets their needs.  Review any restrictive or institutional areas of the home, so that children can live in a homely environment. 02/01/2019

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Requirement Due Date

The children’s views, wishes and feelings standard is that children receive care from staff who—

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Requirement Due Date

develop positive relationships with them;

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Requirement Due Date

take their views, wishes and feelings into account in relation to 02/01/2019 Inspection report children’s home: SC361789 4 matters affecting the children’s care and welfare and their lives.

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Requirement Due Date

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

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Requirement Due Date

regularly consult children, and seek their feedback, about the quality of the home’s care. (Regulation 7 (1)(a)(b)(c)(2)(a)(iv))

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Requirement Due Date

The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills.

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Requirement Due Date

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

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Requirement Due Date

that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1)(2)(b)) 02/01/2019

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Requirement Due Date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due Date

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

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Requirement Due Date

are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due Date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1)(2)(a)(vii)(b))

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Requirement Due Date

 Ensure that placement plans, risk assessments and positive behaviour plans give staff precise guidance to ensure that they can be confident in consistently delivering the best care to young people.  If an allegation or concern is raised, ensure that it is investigated in accordance with safeguarding and child protection procedures.  Ensure that the needs of one young person do not impact negatively on the welfare of other young people in the home. 02/01/2019

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Requirement Due Date

The leadership and management standard is that the registered 02/01/2019 Inspection report children’s home: SC361789 5 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 work as a team where appropriate;

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Requirement Due Date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due Date

ensure that the home has sufficient staff to provide care for each child;

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Requirement Due Date

ensure that the home’s workforce provides continuity of care to each child;

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Requirement Due Date

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;

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Requirement Due Date

demonstrate that practice in the home is informed and improved by taking into account and acting on— use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(a)(b)(c)(d)(e)(f)(h))

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Requirement Due Date

In particular:  Ensure that young people have, during the day and night, sufficient staff to look after them, with the right balance of experience and qualifications based on assessment of young people’s needs.  Ensure that all concerns and complaints are recorded and responded to in a transparent way.  Ensure that there is effective communication between the home and school on a daily basis.  Review incident and physical intervention reports to ensure that they reflect the practice in the home and that they contain all of the required information.  Analyse incidents and review data available to help Inspection report children’s home: SC361789 6 identify patterns and triggers.  Ensure that staff receive training about autism at a specialist level, as required in their roles.

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Recommendations

 Any home using CCTV or other monitoring equipment should have a written policy describing how this will support the safeguarding and well-being of those living and working in the home in accordance with Regulation 24. Homes must gain consent to any monitoring or surveillance from the placing authority in writing at the time of placement. (‘Guide to the children’s homes regulations including the quality standards’, page 16, paragraph 3.16) In particular, ensure that any person with parental responsibility is aware of the use of door alarms for young people.

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Overall experiences and progress of children and young people: inadequate

Young people’s welfare is not safeguarded due to serious failures in the home. Six young people who have complex needs live together. They require significant levels of care and support to keep them safe and to promote their well-being. Currently, young people are not receiving the levels of care and support that they need.

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Overall experiences and progress of children and young people: inadequate

Young people are not provided with sufficient staff to look after them. A third of the staff team, including the registered manager, have left the team in the last year and more staff have since handed in their notice. Difficulties created by staff shortages are further compounded by incompatibility between the young people. Some young people are based in different parts of the building for their own safety. When the needs of one young person are so great that they require the attention of several members of staff, the care of the other young people is neglected by the reduction in available staff members.

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Overall experiences and progress of children and young people: inadequate

Some relationships between young people and staff have significantly deteriorated. At times, staff feel anxious and lack confidence about how to look after the young people and how to keep themselves safe. This impacts negatively on the staff team’s ability to give safe and effective care to the young people.

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Overall experiences and progress of children and young people: inadequate

Young people’s plans do not set out their specific targets and how these can be achieved and measured. Some young people have made progress in the home, but others have not and are increasingly vulnerable. They came to the home with a high risk of causing injury to themselves, and this behaviour has dangerously increased.

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Overall experiences and progress of children and young people: inadequate

In the two weeks before this inspection, new staff had been seconded to the home. Inspection report children’s home: SC361789 7 These staff are experienced and competent, and some know the young people from previous times. However, due to the crisis in staffing, they have not had an adequate induction and so they do not know exactly what the young people’s needs are.

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Overall experiences and progress of children and young people: inadequate

Young people do not get enough social stimulation outside of the home, such as outings, clubs and activities. None of the young people went on holiday this year unless this was facilitated by their own families. Managers report that this is due to low staffing levels. In addition, young people’s health, social and identity needs can be overlooked, because staff are occupied in managing risky and sometimes volatile situations.

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Overall experiences and progress of children and young people: inadequate

Daily handovers between school and the home are not sufficient. Both teachers and staff do not pass on enough information about each young person’s day or night, so that they can be aware of any concerns. However, staff attend all other relevant meetings and support young people with education, including transport to school.

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Overall experiences and progress of children and young people: inadequate

A social work team manager praised the staff team for the commitment that they have to the young people. Parents also recognise this. One parent, despite their significant concern about their child’s progress and experience in the home, recognised how staff continually go ‘over and above’ to do their best for young people.

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

Leaders and managers do not ensure that young people are safe, particularly at night. Staffing levels are insufficient to ensure that young people’s well-being is protected. At night, less qualified waking night staff members often work alone, while three other staff members sleep. When staff are woken to assist the lone worker, they have, on occasions, continued to work for a full day. This includes the manager as well as staff.

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

Staff do not always consistently apply boundaries for young people. For example, placement plans do not give sufficient guidance to staff on young people’s daily routines. As a result, young people’s routines have been needlessly disrupted, causing them to become upset and incidents have occurred.

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

The approach to protecting young people from each other’s behaviour is unclear. For example, at night, a young person who requires two to one support has entered another young person’s bedroom on several occasions. Strategies to protect the young person are not clearly outlined or consistently followed.

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

There is insufficient consideration of means of de-escalating young people’s behaviour without resorting to high level physical intervention. Serious incidents have occurred, involving young people hurting themselves, and staff have been assaulted on a regular basis. In response, managers arranged for staff to be trained in ground holds, an extreme form of physical intervention, which involves at least four staff holding a young person to the ground. Staff have not yet carried out ground holds, largely because they have not had enough staff available to do so. In addition, guidance on when and how to use physical intervention is not clear enough. When physical intervention does occur, the required detail is not always recorded. Inspection report children’s home: SC361789 8 Although a child protection and safeguarding policy is in place, managers do not always implement it. An allegation was made, but managers did not recognise it as such. They

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

did not act to fully investigate the concerns raised, which potentially leaves young people at risk.

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

All young people have alarms on their bedroom doors, but the rationale for this is not recorded on plans. The necessary consent from the local authority and those with parental responsibility is not documented.

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The effectiveness of leaders and managers: inadequate

The previous registered manager for this home resigned in November 2018. A new manager has been appointed and plans to make urgent improvements.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have not ensured that routines and safe practice are consistently implemented across the home. Oversight and monitoring of the home has been insufficient in areas such as incidents, medication, plans and the development of the home. Managers have not analysed incidents collectively in recent months. This has not helped them to learn what may have triggered and increased their frequency and severity. Concerns and complaints are not collated or properly recorded, so the manager cannot identify themes for improvement.

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The effectiveness of leaders and managers: inadequate

Staff have not completed all the necessary training, such as fire safety and advanced strategies on de-escalating situations. Specialist autism training has not been arranged for the staff, which is a concern as most young people have autism.

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The effectiveness of leaders and managers: inadequate

The home is clean and has toys and games in all parts, where appropriate. Some rooms have a homely appearance, but areas of the building need repair and updating. The home has not been sufficiently adapted to meet young people’s needs. For example, a sensory room has been identified as a necessity but has not yet been installed, although plans are in place. The home is institutional in parts. For example, young people cannot switch on the lights in the lounge, as staff need to use a key to do so.

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The effectiveness of leaders and managers: inadequate

Staff have monthly supervision with the manager and senior staff members. This is generally reflective, supportive and research based. Team meetings take place on a regular basis.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have identified and acknowledged shortfalls in the home and express commitment to making improvements. Inspection report children’s home: SC361789 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 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: SC361789 10

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Children’s home details

Registered provider address: Cornwall Council, Accounts Payable, PO Box 727, Truro TR1 9GP

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Children’s home details

Responsible individual: Tony Phillips-Jones

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Inspector

Sarah Canto: social care inspector Inspection report children’s home: SC361789 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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