Children's Home run by Turning Point Care Limited in Enfield

SC010699 Unique reference number 6 July 2010 Inspection date Sandra Jacobs-Walls Inspector Key Type of Inspection

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23 November 2009 Date of last inspection .

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 9 Inspection Report: SC010699

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Brief description of the service

This children's home is registered to provide care, support and accommodation to five young people of either gender between the ages of 12 and 16 years old. The home is owned by a private provider and is a family-run business. The Registered Manager is also the registered provider.

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Brief description of the service

The house has a kitchen/diner, lounge, meeting room, bathroom, five en-suite first floor bedrooms and a garden to the rear of the premises. At the time of the inspection, four young people were in placement at the home.

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Summary

The purpose of the unannounced key inspection was to assess the home against all key national minimum standards and gauge the home's success in addressing weaknesses identified at the last inspection. All outcome areas were assessed.

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Summary

The service offers young people a satisfactory level of care. Young people comment that relationships with staff are very positive and they feel well cared for. Staff encourage young people to live healthy lifestyles while living at the home and promote their well-being. All current residents are aged 16 years and most are participating in the home's semi-independent programme.

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Summary

This inspection notes weaknesses in staff training for first aid and physical intervention. Staff appraisals are overdue and staff vetting practices are in need of improvement. Some young people's files are missing key documentation. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The previous inspection noted weaknesses in staff's documentation of residents' meetings and inaccurate information contained in the home's Statement of Purpose document. These issues have since been resolved satisfactorily.

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Helping children to be healthy

The provision is good. Staff encourage young people to eat healthily while living at the home. Staff provide young people with varied, nutritious and well-balanced meals in accordance with their food preferences and religious needs. Young people indicate that meals provided are to their liking. Staff are aware of young people's culinary preferences and encourage them to shop, prepare and cook for themselves, with support if necessary. The staff group routinely discuss meal planning at residents' meetings and young people always have a choice at meal times. Snacks are readily available and meal times are flexible. The home's kitchen and dining area is well equipped and appropriate to meet the needs of young people. All staff receive food hygiene training.

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Helping children to be healthy

Young people's health care needs are well met by the service. Young people's files contain good background information about young people's health care issues and staff encourage 4 of 9 Inspection Report: SC010699 young people to register with primary health care services. Young people's files contain health care plans and young people have good access to specialist health care workers who address issues such as smoking, substance misuse and sexual health. The home openly displays relevant health care information on its notice boards. Young people routinely participate in sporting activities and belong to football clubs and hold gym membership. Staff record all accidents and injuries, however, records are not comprehensive. Staff have received first aid training, but certificates are outdated. Senior staff acknowledge that staff need to attend refresher first aid training as this poses some risk to the well-being of young people if they are in need of

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Helping children to be healthy

Staff practices with regard to the administration of young people's medication are sound. Staff have access to comprehensive medication policies to support their practice. The home's medication cabinet is secure in the staff office and is kept locked. Staff maintain good records of the administration of young people's medication and monitoring systems are good. Staff receive periodic training in the safe handling and management of medication and this features in newly appointed staff inductions.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Staff respect young people's privacy and their information is handled confidentially. Staff have access to relevant written guidance and sign a confidentiality agreement upon appointment. Young people's files are securely locked in the staff office and all electronically held information is password protected. Staff practices encourage confidentiality and this includes interviewing young people in private and not inappropriately disclosing young people's information. Staff are familiar with data protection and access to files protocols. When necessary, staff conduct the searching of young people's rooms in accordance with written guidance that promotes confidentiality. Young people can wash in private as all young people's bedrooms have en-suite facilities.

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Protecting children from harm or neglect and helping them stay safe

Young people benefit from the home's robust complaints policy. Young people and staff are familiar with the home's complaints procedure as written guidance is made available to both. Young people are able to comment on their dissatisfaction with the home's services through residents' meetings and during looked after children reviews. Staff maintain a centralised record of all complaints made against the service; there have been none recorded since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Young people indicate that they feel safe while living at the home. Staff have access to comprehensive child protection policies and their relationship with the host local authority is good. Staff are familiar with the home's whistle-blowing policy. Staff have access to regular safeguarding training and this features in new staff's induction. Staff maintain good records of significant incidents. Since the last inspection, there have been no allegations or incidents of a child protection nature.

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Protecting children from harm or neglect and helping them stay safe

Young people benefit from the home's clear policy with regard to bullying. Staff have a 'zero tolerance' stance with regard to bullying and young people understand this. Staff and young people have access to literature that addresses anti-bullying. Similarly, staff and young people have a clear understanding of action to be taken when young people are absent from the home without permission. There is clear guidance about procedures and staff take action in accordance 5 of 9 Inspection Report: SC010699 with guidelines. Staff keep good records of incidents where young people are absent from the home without permission.

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Protecting children from harm or neglect and helping them stay safe

Young people and staff benefit from the home's comprehensive behaviour management policies. Staff are effective in addressing unacceptable behaviour through ongoing dialogue with young people. Staff sparingly impose sanctions to address poor behaviour and significant incidents. Staff maintain good records of all imposed sanctions, which comply with the home's written guidance. Young people receive rewards and incentives for sustained, acceptable behaviour. Staff have access to clear written guidance that addresses physical intervention, and confirm that these techniques have never been used. Written policies state that staff must receive training in physical restraint. However, most of the staff group have not. Staff acknowledge that this is a useful tool and strategy to adopt under some circumstances for the protection of young people and others.

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Protecting children from harm or neglect and helping them stay safe

The home provides young people with physical safety and security. The home has good fire equipment in place and staff appropriately check and monitor its functioning. Staff maintain consistent records of fire equipment checking and of the home's evacuation exercises. Staff have access to comprehensive health and safety policies and all staff receive appropriate training. Since the last inspection, staff have fitted new locks to all young people's bedrooms.

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Protecting children from harm or neglect and helping them stay safe

With reference to staff vetting, the home has a robust recruitment and selection policy. Staff personnel files evidence that the home's recruitment procedures are appropriate and protect young people from potential abuse. These files evidence full information as required, including written references, which are verified by managers, Criminal Records Bureau checks, positive proof of identification and confirmation of work histories. However, not all files evidence that managers obtain written references from the applicant's most recent employer as specified by the regulations. This poses some risk to the safety of young people in placement at the home if staff's recent work conduct and practices cannot be verified.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive very individual support when they need it. Young people indicate that they feel staff understand their particular placement issues and are effective in addressing them. Young people's case files evidence some very unique circumstances that staff are working effectively to address.

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Helping children achieve well and enjoy what they do

Staff place a high priority on educational achievement and encourage and promote young people to do well in school and college. Young people and staff are regularly engaged in discussions that address issues of education and training and staff have a very good working relationship with educational professionals. Staff are creative in promoting educational success and so, for example where young people are unable to attend mainstream education, staff facilitate alternative arrangements. During key examination periods staff, at the request of schools and young people themselves, are available to escort young people and stay at the school to maximise young people's examination success. Young people's files evidence staff's regular communication with educationl professionals and some files evidence young people's personal education plans. Young people have access to computers in the home to enhance their learning.

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Helping children achieve well and enjoy what they do

6 of 9 Inspection Report: SC010699 Young people have good opportunities to participate in leisure activities of their choice. Some hold gym memberships and play in local football teams. Staff routinely facilitate local recreational events such as cinema trips, picnics in the park and swimming activities. Staff also arrange special events and incentives such as paintballing and go-karting. Young people and staff are currently in discussion about the home's annual summer holiday trip.

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Helping children make a positive contribution

The provision is good. Some young people's files evidence very comprehensive needs assessments and care plans. The placing authority devise these plans and the home supplements existing care plans with the home's support plan. These plans outline the placement objectives and how staff are to address identified needs. Most young people's files contain all required information, with the exception of one. Needs assessments are throughout and address all aspects of the young people's lives as required and explore issues of identity well. Both the local authority and staff of the home complete comprehensive risk assessments.

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Helping children make a positive contribution

Staff have good systems in place to ensure that young people's needs and developments are regularly reviewed. These include staff's completion of monthly summaries that explore placement progress and issues. Individual key work sessions explore similar issues with young people. All young people's files evidence relevant review documentation with the exception of one. In this file no monthly summaries of key work sessions are evident. Managers indicate that staff had completed the necessary review work, but had failed to place the information on the young person's case file. Looked after children's reviews were consistently held to review placement progress and issues.

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Helping children make a positive contribution

Staff encourage young people to maintain positive relationships with family and friends and young people are aware of the home's expectations with regard to visitors. Files evidence good information about young people's contact with their significant others and where there are restrictions, staff document these explicitly. Young people have the opportunity to discuss contact arrangements in key work sessions and looked after children's reviews.

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Helping children make a positive contribution

Young people indicate that their introduction and admission to the home was positive. Staff work hard to ensure young people settle and understand the purpose of the placement. Young people receive useful literature about the home's services and staff are sensitive to their circumstances. Young people leave the home in a planned and sensitive manner. There are protocols in place to ensure that staff offer good, consistent support to young people as they move on.

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Helping children make a positive contribution

Young people feel that staff are interested in their views and opinions. Staff encourage young people to participate in making decisions about how the home is run. For example, young people's bedrooms are furnished and decorated to suit their tastes and young people are always involved in meal planning. Staff encourage young people to contribute to residents' meeting that explore the improvement of service provision.

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Achieving economic wellbeing

The provision is good. All current residents of the home are over the age of 15 years and so to varying degrees, staff are working with them to prepare for adulthood. Staff are working with young people to develop 7 of 9 Inspection Report: SC010699 independent living skills which include budgeting, saving, shopping, meal preparation, doing laundry and cooking. This is in accordance with local authority pathway plans that are evident on some young people's files.

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Achieving economic wellbeing

Young people indicate that they are happy with the home's environment. The home's premises are well decorated, and maintained to a high standard. Young people benefit from the home's rolling programme of repair and decoration, which includes vacant bedrooms each time there is a new admission. Staff encourage young people to personalise their rooms to their preferred tastes. The home's communal areas are very well equipped with big screen TV, free view cable channels, a home computer, DVD, books, magazines and so forth. The garden area to the rear of the building contains garden furniture. The area hosts basketball games and barbeques when the weather is good. Staff encourage the use of recycling programmes. The home has a laundry room for the washing, drying and ironing of young people's clothes. The building has a meeting room for private conversations and meetings; young people indicate that the lack of privacy is

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Organisation

The organisation is satisfactory. This inspection finds that the home's ability to keep young people safe is satisfactory. In accordance with Ofsted benchmarking guidance the outcome area organisation must therefore also be judged as satisfactory.

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Organisation

The home's promotion of equality and diversity is good. Staff and young people benefit from a clear equal opportunities policy and pay good attention in particular to religion, gender and issues of sexuality. Young people's identity needs are explored during the needs assessment and care planning process and staff review these issues. The home's Statement of Purpose is a revised comprehensive document that fully meets the regulatory requirements. Young people have access to a useful young people's guide.

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Organisation

Staff have access to good training opportunities. All new staff participate in an induction that has recently been revised by managers. The induction programme is extensive and includes a range of learning opportunities including shadowing and the review of key policies and procedures such as safeguarding and child protection. The home has a good working relationship with the host local authority and is able to readily access training facilitated by the department. Some new staff already hold relevant National Vocational Qualifications at level 3. Management support and supervision to staff are excellent; however, staff appraisals are overdue.

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Organisation

The home employs a sufficient number of staff; during the day there are two members of staff on shift, often three. Two staff members cover the night shift. Young people indicate that the staff group perform their duties well and that their relationships with staff are positive. The service is a family-run home and it operates as such, with clear family values in terms of care provided and the development of trusting relationships. Senior staff are well established in the home and feel that support staff complement their efforts well.

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Organisation

The home's monitoring systems are sound and managers ensure that the home operates in accordance with its Statement of Purpose. The home employs an external body to complete monthly monitoring visits. These are unannounced visits and review all aspects of the home's functioning as required. Subsequent reports are appropriately detailed and address identified weaknesses. 8 of 9 Inspection Report: SC010699 Staff maintain most young people's case files well. As mentioned elsewhere in this report the inspector notes one file reviewed had key information missing. Most files evidence good background and comprehensive current information as required. Staff maintain young people's information securely and confidentially and there are systems in place to facilitate young people's access to information.

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Statutory requirements

This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Due date Action Standard

1 September 2010 ensure staff record details of any accident or serious illness involving young people while accommodated in the home (Regulation 28(1)) 1 October 2010 ensure that at all times, at least one person on duty has a suitable first aid qualification (Regulation 20(2)(e)) 1 October 2010 ensure the home's behaviour management policy is implemented, specifically to ensure that staff are aware of and trained in the use and techniques of physical restraint and intervention (Regulation 17) 1 September 2010 obtain for all staff, before they start work at the home, all the information set out in Regulation 26 (Regulation 26(6)(a)) 1 September 2010 prepare a written plan, the placement plan, for each young person setting out how on a day to day basis he will be cared for (Regulation 12(1)(a)) 1 September 2010 keep under review and revise the placement plan as necessary (Regulation (12)((2)) 1 October 2010 ensure that all persons employed receive appropriate appraisal.

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • encourage key workers to contribute effectively to all reviews, by consistently convening key work sessions with young people that are fully documented on file. (NMS 3) 9 of 9 Inspection Report: SC010699

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