Children's Home run by Devon and Cornwall Autistic Community Trust (t/a Spectrum) in Cornwall

Inspection report children’s home: 1276719 1 Registered provider: Devon & Cornwall Autistic Community Trust (t/a Spectrum)

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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 children’s home was registered in May 2018 for three children. This is the first inspection.

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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: This is the home’s first inspection since it was registered.

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inadequate

Overall judgement at last inspection: not applicable

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inadequate

Enforcement action since last inspection: none

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Recent inspection history

This is the home’s first inspection. Inspection report children’s home: 1276719 2

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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

6: The quality and purpose of care standard

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The quality and purpose of care standard is that children receive care from staff who—

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

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

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

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understand and apply the home’s statement of purpose;

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understand and apply the home’s statement of purpose;

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protect and promote each child’s welfare;

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treat each child with dignity and respect;

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provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background;

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help each child to understand and manage the impact of any experience of abuse or neglect;

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help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult;

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provide to children living in the home the physical necessities 03/04/2019 Inspection report children’s home: 1276719 3 they need in order to live there comfortably;

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provide to children personal items that are appropriate for their age and understanding; and

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make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give the child an appropriate degree of freedom and choice; and

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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; and

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ensure that any care that is arranged or provided for a child that— relates to the child’s development (within the meaning of section 17(11) of the Children Act 1989) or health; and is not arranged or provided as part of the health service continued under section 1(1) of the National Health Service Act 2006, satisfies the conditions in paragraph (3).

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Requirement Due date

The conditions are— that the care is approved, and kept under review throughout its duration, by the placing authority; that the care meets the child’s needs; that the care is delivered by a person who— has the experience, knowledge and skills to deliver that care; and is under the supervision of a person who is appropriately skilled and qualified to supervise that care; and that the registered person keeps the child’s general medical practitioner informed, as necessary, about the progress of the care throughout its duration.

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(Regulation 6 (1)(a)(b)(2)(a)(b)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(ix)(c)(i)(ii))(d)(i)(ii) (3)(a)(b)(c)(d))

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12: The protection of children standard*

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The protection of children standard is that children are protected from harm and enabled to keep themselves safe. 03/04/2019 Inspection report children’s home: 1276719 4 In particular, the standard in paragraph (1) requires the registered person to ensure— that staff—

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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;

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help each child to understand how to keep safe;

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have the skills to identify and act upon signs that a child is at risk of harm;

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manage relationships between children to prevent them from harming each other;

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understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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take effective action whenever there is a serious concern about a child’s welfare; and

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

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that the effectiveness of the home’s child protection policies is monitored regularly.

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(Regulation 12 (1)(2)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(e))

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13: The leadership and management standard*

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The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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helps children aspire to fulfil their potential; and promotes their welfare.

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

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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;

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ensure that staff work as a team where appropriate; 03/04/2019 Inspection report children’s home: 1276719 5 ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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

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

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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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demonstrate that practice in the home is informed and improved by taking into account and acting on— research and developments in relation to the ways in which the needs of children are best met; and feedback on the experiences of children, including complaints received; and

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use monitoring and review systems to make continuous improvements in the quality of care provided in the home.

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(Regulation 13 (1)(a)(b)(2)(a)(b)(c)(d)(e)(f))(g)(i)(ii)(h))

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20: Restraint and deprivation of liberty

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Restraint in relation to a child is only permitted for the purpose of preventing—

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injury to any person (including the child); and

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serious damage to the property of any person (including the child).

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Restraint in relation to a child must be necessary and proportionate.

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The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. 03/04/2019 Inspection report children’s home: 1276719 6 In particular the registered person must ensure that—

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a record is kept of the administration of medicine to each child.

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33: Employment of staff The registered person must ensure that all employees—

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undertake appropriate continuing professional development;

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receive practice-related supervision by a person with appropriate experience; and

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have their performance and fitness to perform their roles appraised at least once every year.

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35: Behaviour management policies and records

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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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details of the child’s behaviour leading to the use of the measure;

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the date, time and location of the use of the measure;

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a description of the measure and its duration;

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details of any methods used or steps taken to avoid the need to use the measure;

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the name of the person who used the measure (‘the user’), and of any other person present when the measure was used;

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the effectiveness and any consequences of the use of the measure; and

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a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; 03/04/2019 Inspection report children’s home: 1276719 7 and

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within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (‘the authorised person’)—

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has spoken to the user about the measure; and

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has signed the record to confirm it is accurate; and

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within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure.

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(Regulation 35 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c))

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The registered person must complete a review of the quality of care provided for children (‘a quality of care review’) at least once every 6 months.

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In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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the quality of care provided for children;

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the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and

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any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children.

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After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review (‘the quality of care review report’).

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supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed; and 03/04/2019 Inspection report children’s home: 1276719 8 make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home.

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The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff.

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(Regulation 45 (1)(2)(a)(b)(c)(3)(4)(a)(b)(5))

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* These requirements are subject to a compliance notice.

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Overall experiences and progress of children and young people: inadequate

Children are not adequately protected by the practices staff use in the home. This has resulted in one child leaving the home in an unplanned way and another child feeling unsafe and dissatisfied with the quality of care that he receives.

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Overall experiences and progress of children and young people: inadequate

Children are not always treated with dignity and respect. Staff have sometimes used punitive practices. Leaders and managers have not carefully considered the impact these practices could have on a child’s sense of self-worth and belonging.

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Overall experiences and progress of children and young people: inadequate

Children know how to complain but they are not sufficiently helped to understand what has happened because of their complaint.

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Overall experiences and progress of children and young people: inadequate

Children are not able to build trusted and secure relationships with many of the adults who care for them, due to the high level of staff turnover.

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Overall experiences and progress of children and young people: inadequate

Staff have failed to provide a child with an adequately furnished, personalised and well- presented bedroom. For example, following an incident, a child was without any form of window dressing to his bedroom window for 21 days prior to the inspection. The rest of the environment is devoid of playthings, and it is not apparent that a child lives there.

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Overall experiences and progress of children and young people: inadequate

A child who lived in the home was asked to leave as staff could not meet his needs or keep him safe. Due to a serious incident, he left the home in an emergency and before his placing authority had found a suitable alternative home. Leaders and managers have reflected on what happened and considered how improvements can be made. The assessment and admission of the current child were more thorough.

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Overall experiences and progress of children and young people: inadequate

The current child is enjoying school and feels he can do well there. His attendance has improved significantly. He has an advocate and sees his family regularly. Leaders and managers are working with his social worker to help the child to develop more independence in keeping with his age and ability. Inspection report children’s home: 1276719 9

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

Safeguarding procedures have not been followed, placing the child at risk of harm. Leaders and managers failed to report a serious child protection concern promptly to the local authority, which led to unacceptable delays in investigating this concern.

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

The home does not maintain accessible safeguarding records, and leaders and managers were unable to provide accurate and detailed information about the number of concerns that had occurred since opening in May 2018.

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

Children’s behaviour is not managed well. Physical restraints have been inappropriate. Too many staff are involved in restraining a child, and staff respond to children in a way that escalates a situation. Sometimes, children are restrained on the ground, a practice that can increase the risk of harm to the child and staff. Physical restraint records are inadequate. Essential information, such as a body map detailing the injury a child has sustained during a physical restraint, has not been recorded. Risk assessments and safety plans are not in place and leave children and staff at risk of harm. Consideration has not been given to the child’s physique or the risks of restraining a child in a confined and personal area, such as their bedroom.

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

Staff have sometimes used punitive practices. This has led to the child feeling upset and unsafe. On six occasions, the police have been called to support staff because staff have been unable to manage children’s behaviour effectively and safely.

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

There have been two incidents of children going missing from the home. Leaders and managers could not find the record relating to one incident. Independent return home interviews were carried out, but these were not within 72 hours as required, and leaders and managers did not ensure that they received a copy of the interview notes. This has meant that opportunities have not been taken to learn from the incidents to help children become safer.

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

Omissions of staff signatures on some medication administration records have not been investigated. This poor practice places children at risk of harm as they may not have received the correct amount of medication prescribed for them, and staff who need additional training and support have not been identified. In-house guidance on homely remedies has not been agreed by the child’s general practitioner (GP). This also places the child at risk of harm.

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The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to ensure that the manager swiftly applied to register with Ofsted. The home has been without a registered manager since August 2018. A Inspection report children’s home: 1276719 10 new manager has recently been appointed and is aware of the importance of applying to Ofsted as soon as possible.

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The effectiveness of leaders and managers: inadequate

Staff have not been effectively led, managed, supported or supervised. There have been three different managers since the home opened 10 months ago, and this has resulted in inconsistent and poor leadership.

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The effectiveness of leaders and managers: inadequate

Staff retention is inadequate. Since opening, 23 staff have been appointed, 12 of whom have left. Staff turnover has led to children receiving inconsistent and inadequate care. These arrangements do not support children to make positive attachments and develop trust with the adults caring for them.

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The effectiveness of leaders and managers: inadequate

Staff are insufficiently qualified and experienced. Of the 11 members of staff in post, only one has the required level 3 diploma in residential childcare. Additionally, four of the 11 staff are still in their probationary period of employment.

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The effectiveness of leaders and managers: inadequate

Staffing arrangements do not provide enough leadership and structure when the manager is not in the home. There is no formal arrangement in place for designating who is leading a shift or deputising in the absence of the manager. This also means that inexperienced staff are not being fully supervised or supported while on duty.

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The effectiveness of leaders and managers: inadequate

Practice-related supervision has not been provided regularly. Team meetings have also been sporadic. These arrangements do not adequately support a new and inexperienced staff team.

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The effectiveness of leaders and managers: inadequate

Leaders and managers do not sufficiently understand the difference between managing a children’s home and an adult’s home. For example, in documentation, children are referred to as service users. Some institutional practices, such as locked kitchen cupboards are used. A safeguarding and fire document given to visitors uses language that is discriminatory.

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The effectiveness of leaders and managers: inadequate

A manager’s review of quality of care, which should be submitted to Ofsted every six months, is overdue by three months.

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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. Inspection report children’s home: 1276719 11 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

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Information about this inspection

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: 1276719 12

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Children’s home details

Registered provider: Devon and Cornwall Autistic Community Trust (t/a Spectrum)

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Children’s home details

Registered provider address: Lakeside Offices, The Old Cattle Market, Porthleven Road, Helston, Cornwall TR13 0SR

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Inspectors

Norma Welsby, social care inspector Polly Soper, social care inspector Inspection report children’s home: 1276719 13 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 children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

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