The Children's Trust - Tadworth

Updated 17 April 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. The purpose of this inspection was to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service under section 46 of the Act.

Inspection team

The inspection team consisted of three children’s services inspectors, one medicines inspector and a specialist advisor for children’s nursing.

Service and service type

The Children's Trust – Tadworth is a residential children's home for children and young people with profound and multiple learning disabilities and a residential rehabilitation unit for children and young people with acquired brain injury. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The Children's Trust can accommodate 38 children and young people with profound and multiple learning disabilities across four houses and 28 children and young people with acquired brain injury across three houses.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection.

What we did before inspection

We used a range of information to plan this inspection, including findings from our last inspection of the service, on-going monitoring information including complaints and concerns about the service, as well as information received from other stakeholders.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We spoke with two young people who used the service and two relatives about their experiences of the care provided. In addition, we spoke with 31 members of staff including the chief executive officer, registered manager, nominated individual (who is responsible for supervising the management of the service on behalf of the provider), doctors, registered nurses, therapists, children's support assistants, and the on-site pharmacist.

We reviewed a range of records. This included 18 children and young people’s care and medication records. We looked at three staff files in relation to recruitment, training, and supervision. We also reviewed a variety of records relating to the management of the service, including audits, complaints procedures, policies, and guidelines.

Updated 17 April 2024

About the service

The Children's Trust – Tadworth provides a residential children's home for children and young people with profound and multiple learning disabilities, a residential rehabilitation service for children and young people with acquired brain injury and a short breaks service. The Children's Trust offers a wide range of services, and at the time of our inspection 50 children and young people were in receipt of care. They can accommodate 66 children and young people across seven houses.

Ofsted are the lead regulator for The Children’s Trust as it is a children’s home. The service is also registered with the Care Quality Commission for the regulated activity of treatment of disease, disorder, or injury.

We expect health and social care providers to guarantee people with a learning disability and autistic people, respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people, and providers must have regard to it.

Right Support: Model of Care and setting that maximises people's choice, control, and independence.

Right Care: Care is person-centered and promotes people's dignity, privacy, and human rights.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive, and empowered lives.

People’s experience of using this service and what we found

We have recommended that the provider should strengthen the detail of description of one to one care and observations related to overnight care within children and young people’s care plans.

We have recommended that daily evaluations of the child or young person’s care is strengthened to include their voice, feelings and wishes.

We have recommended that the provider should ensure staff document checks of water temperatures across the houses during bathing and showering.

We have made recommendations about the management of medicines.

Staff enabled children and young people to have maximum choice and control of their lives and supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff understood how to protect children and young people from abuse and the service worked well with other agencies to do so. Staff had the appropriate level of training on how to recognise and report abuse, and they knew how to apply it.

Children and young people receiving intensive rehabilitation at The Children's Trust were supported by excellent staff who were committed to supporting achievement and success. The progress children and young people made was evident.

The service had enough staff with the right qualifications, skills, training, and experience to keep children and young people safe from avoidable harm and to provide the right care and treatment.

The Children’s Trust had up to date, comprehensive policies, and procedures to support effective practice.

All houses and communal areas were clean. Hygiene standards, infection prevention and control were maintained.

Staff gave children, young people and their families practical support and advice to lead healthier lives.

Staff supported young people to make informed decisions about their care and treatment. They knew how to support children and young people who lacked capacity to make their own decisions.

The service planned and provided care in a way that met the needs of children, young people and their families and the communities served. It also worked with others in the wider system and local organisations to plan care.

Leaders had the integrity, skills, and ability to run The Children’s Trust. They understood and managed the priorities and issues the service faced. Leaders were visible and approachable in the service and supported staff to develop their skills and practice.

Rating at last inspection

The last rating for this service was outstanding. (Published 27 March 2020). CQC do not currently rate services that are defined as being a children’s home and which are also registered with Ofsted.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted in part due to concerns received about monitoring of children and young people overnight. A decision was made for us to inspect and examine those risks. We completed a comprehensive inspection of The Children’s Trust.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.