5 Carrwood Park is operated by Yorhealth Limited. The service provides nurse-led complex care services for children and young people aged 0-25 in the community; this includes access to care provision 24 hours a day, seven days a week, and care staff accompany children and young people to school and hospital when required. Children cared for have a range of conditions and needs.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 6 March 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

This was our first inspection of this service. We rated it as Good overall.

We found the following areas of good practice:

• The service kept premises and equipment clean and well maintained, and managed medicines safely.

• Care plans and risk assessments were completed thoroughly and reviewed regularly, and staff worked alongside families to recognise changes in a child’s condition.

• Records were stored safely and incidents managed appropriately, with clear implementation of lessons learned.

• Policies and procedures were up to date, based on evidence and national guidance, and could be accessed easily by staff and families. There were clear policies regarding consent, mental capacity and Deprivation of Liberty Safeguards.

• Care was monitored and audited: feedback was gathered from staff, children, families and stakeholders, and all were involved in decisions about care.

• Staff cared for children and families with compassion, kindness and respect. They were passionate about providing high quality, family-centred care and were always mindful of people’s needs.

• The service met children’s needs well, including those in vulnerable circumstances and with communication difficulties.

• Managers were experienced, approachable and visible; staff told us they felt listened to and supported.

• The service promoted an open culture with a focus on effective communications. Staff and families told us they felt confident that they could speak honestly and any concerns they had would be addressed appropriately.

However, we also found the following issues the service needs to improve:

• At the time of our inspection Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) mandatory training levels did not meet the service’s 80% compliance target. However, following our inspection, the service lead told us that this had improved when the next quarterly report was created and the compliance was 97%.

• The service found short-notice shift cover was sometimes difficult to provide and some families felt this was a concern. However, information provided by the service showed 0.99% of hours were missed against an overall target of 1.0%.

Following this inspection, we told the provider that it should make one improvement.

Name of signatory

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)