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

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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 home is owned by 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.

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Information about this children’s home

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: requires improvement to be 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

21/08/2018 Full Requires improvement to be good 18/07/2017 Full Good 26/10/2016 Full Good 22/02/2016 Interim Sustained effectiveness 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

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

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. (Regulation 12 (1)(2)(a)(i))

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Requirement Due date

Individual manual handling risk assessments for each child must clarify the steps that staff are to take in the event of a fire. 29/05/2019

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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—

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child. Demonstrates 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 (2)(d)(g)(ii))

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Requirement Due date

Every shift must be staffed to meet the needs of each child. Parents’ views must be fully involved in their child’s care planning. Any complaints received must be formally managed and clarity provided as to any learning which has been taken. 29/05/2019

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. (Regulation 23 (1)(2)(b)) Medication handling and administration processes must be robust. Learning taken from any medication errors must be 29/05/2019 Inspection report children’s home: SC432404 4 clearly recoreded and effective actions taken to reduce the risk of any further errors.

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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 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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improvement to be good

The home is clean and well maintained, although the overall environment is more institutional than homely. The bedrooms do not provide vibrant and inviting spaces for children.

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improvement to be good

Planned stays for children have been cancelled on too many occasions due to staff shortages. This has had a negative effect on children and their families . New staff have been hired and, as a result, all planned stays are now taking place.

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improvement to be good

Children who are new to the home are supported to enjoy their time here. Staff are sensitive to the emotional needs of children who may not have previously stayed away from their parents. Staff have a good understanding of children’s diverse emotional and physical needs. Children who are predominantly non-verbal are helped to make choices and to demonstrate their feelings using pictures.

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improvement to be good

Children are supported to take part in varied activities and to enjoy new experiences, such as a recent cinema trip. Staff have compiled scrapbooks for each child which show the children enjoying these activities.

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improvement to be good

Proposed improvement work in the garden area has not been started. The garden provides limited sensory play opportunities for children. Inspection report children’s home: SC432404 5 Regular and meaningful consultation with parents is not taking place. This means that care planning and the development of the home are not fully informed by the views of parents.

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improvement to be good

Feedback received from professionals is positive overall. A social worker explained that they are looking to increase the number of stays for one child because he enjoys his visits so much.

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improvement to be good

A serious medication error occurred at the end of last year. The appropriate steps were taken to address the matter. However, systems in place for obtaining and sharing medical information continue to lack thoroughness.

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improvement to be good

Preparations to meet children’s complex medical needs, prior to stays, are not vigilant enough. For example, recording systems are confusing and cumbersome. This means that important information is not easily accessible to staff.

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improvement to be good

Staff do not always communicate effectively with each other. For example, a child’s finger was accidently cut at school. This information was shared with staff at the home when the child arrived. However, it was not shared with the night-time staff, who were concerned when a small amount of blood was seen on the child’s bed sheets.

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improvement to be good

Recruitment of staff is safe. Overall, staff are trained to the expected standard. Supervision of staff is regular, and any practice concerns are challenged effectively. Clinical supervision is now in place. This is supports the development of shared good practice within the nursing team.

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improvement to be good

Individual risk assessments for children do not provide important clarity for staff in the event of a fire. Most staff have attended a recent fire drill. However, a number are yet to receive the required up-to-date fire training.

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

The registered manager acts quickly when safeguarding concerns become apparent. She ensures that the appropriate authorities are contacted, which demonstrates important transparency.

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

The induction process for new staff is thorough and promotes the ability of staff to meet the complex needs of children. Supervision is regular and there is a focus on the ongoing ability of staff to meet children’s needs.

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

Leaders and managers have not ensured that every shift is staffed in line with children’s needs. This means that if a medical emergency were to occur, the ability of staff to meet the needs of each child would been reduced. Inspection report children’s home: SC432404 6 Three team meetings have not taken place in recent months. During these months, several incidents occurred which were not effectively explored with the staff team. This means that opportunities to promote shared good practice have been lost.

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

Complaints are not all well managed. Therefore, parents are not always confident in the standards of care provided to their children. In contrast, compliments from parents and professionals were seen by the inspector. These demonstrate how important the home is for children and their families.

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

Children’s case records are chaotic and confusing. This means that important medical information is not easily accessible to staff.

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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 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

Polly Soper, social care inspector Inspection report children’s home: SC432404 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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