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

Unique reference number SC010699 Inspection date 02/06/2011 Inspector Sandra Jacobs-Walls Type of inspection Full Provision subtype Children's home

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Date of last inspection 10/02/2011 Website: www.ofsted.gov.uk

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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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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 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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The inspection judgements and what they mean

Outstanding : a service that significantly exceeds minimum requirements Good : a service that exceeds minimum requirements Satisfactory : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Brief description of the service

This children's home is registered to provide care, support and accommodation for 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. 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.

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Overall effectiveness

The overall effectiveness is judged to be satisfactory .

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Overall effectiveness

Young people clearly enjoy living at this home and they talk candidly about the staff group genuinely caring for them in a way that makes them feel valued. Young people are well protected by the home's practice, policies and procedures, live in a nurturing environment and feel staff are committed to their well being. The staff group in turn enjoy caring for the young people, take an interest in all aspects of their lives and actively encourage positive outcomes for young people. The home's promotion of equality and diversity is good.

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Overall effectiveness

However, significant shortfalls are noted in the management of the service, in particular the managers' ability to effectively monitor the home's functioning and have a positive influence on the capacity to improve the service provision. This would essentially further improve the outcomes for young people.

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Overall effectiveness

The home's monitoring systems are poor. Managers do not make use of effective systems to review the functioning of the home and as a result the home's capacity to improve is compromised. For example, there have been no regulation 33 visits conducted since the last inspection. Managers' regulation 34 monitoring systems are sporadic, uncoordinated and poorly conducted. The process lacks the vigour to ensure that young people's records for example, are satisfactorily maintained.

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Overall effectiveness

There are clear areas for development. These include the robust monitoring of key records such as young people's case files, medication records, the accuracy of staffing rotas etc. Staff's partnership working with placing authorities is in need of improvement to ensure that young people's case files contain comprehensive information as outlined in the regulations. Managers do not ensure that relevant bodies, including Ofsted are informed of all significant events as outlined in the regulations. Staff's consultation with young people is poorly evidenced. These shortfalls have not directly impacted on outcomes for young people. However, the management of the home lacks insight into the home's weakness, particularly in relation to compliance with the regulations. These issues will need to be effectively addressed if the home is to provide young people with a service of excellence and satisfy legislative requirements.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) promote the educational achievement of young people in particular by ensuring that the routine of the home is organised so as to further young people's participation in education (Regulation 18(1)(b)) 01/09/2011

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Reg. Requirement Due date

(2001) promote and make proper provision for the welfare of children accommodated, in particular, in relation to the development of independent living skills (Regulation 11(1)(a)) 01/09/2011

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Reg. Requirement Due date

(2001) make suitable arrangements for the recording of any medicines received into the home (Regulation 21(1)) 01/09/2011

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Reg. Requirement Due date

(2001) ensure that regulation 33 visits take place at least once a month (Regulation 33(3)) 01/09/2011

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Reg. Requirement Due date

(2001) supply a copy of the regulation 33 report to the HMCI (Regulation 33(5)(a)) 01/09/2011

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 and improving the quality of care provided in the home (Regulation 34(1)(a)&(b)) 01/09/2011

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Reg. Requirement Due date

12A (2001) co-operate with the young people's placing authority in agreeing the plan for the child's placement (Regulation 12A(1)) 01/09/2011

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Reg. Requirement Due date

(2001) notify Ofsted without delay, of all significant events as outlined in Schedule 5 of the regulations. (Regulation 30) 01/09/2011

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 submit the home's child protection procedures for consideration and comment to the Local Safeguarding Children's Board and the Local Authority Designated Officer for child protection (NMS 20.4)  contribute to the development of young people's pathway plan and work collaboratively with social workers in implementing the plan (NMS12.2)  include in the children's guide information about securing access to an independent advocate (NMS 13.5)  provide accurate records of staff working in the home that demonstrate the staffing level (NMS 17.2)

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Outcomes for children and young people

Outcomes for children and young people are satisfactory . The inspection notes that the outcomes for young people in placement at the home significantly improve from the point that they are first admitted to the home. The exception to this however, is outcomes related to young people's educational achievements.

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Outcomes for children and young people

Staff encourage young people to take pride in themselves, their ethnic, religious and cultural identity. Staff ensure that young people's differences are embraced by all and young people are appreciative of staff efforts to understand them and what is important to them. Staff pay good attention to young people's identity needs and ensure these are well addressed. Young people enjoy staff's participation and genuine interest in cultural events and activities that are of interest to residents. Staff encourage young people's participation in religious worship; where language is an issue, staff work effectively with interpreting services and young people have good access to culturally appropriate meals and self care products.

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Outcomes for children and young people

The service ensures that young people are aware and are interested in maintaining a healthy lifestyle. For example, staff encourage young people to register with primary care services soon after the placement starts. Staff document well young people's health care and medical needs and how these are to be met. Staff have effective working relationships with health care professionals such as the looked after nurse, who is available to young people on site for advice and support. Young people also have access to mental health services where this is deemed necessary. Accidents at the home are rare. Young people enjoy varied and nutritionally balanced meals that meet their dietary needs. Staff encourage young people to participate in activities that facilitate physical exercise. For example some young people swim frequently during the week as a feature of their placement plan.

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Outcomes for children and young people

The home is less successful in ensuring the educational success of some young people in placement. Whilst staff do work closely with educational professionals to secure school/college placements for young people, where this fails, there is little evidence of the home offering opportunities for structured home based learning. Some young people have been out of mainstream and alternative schooling for a significant length of time and this situation continues while in placement at the home. This is unacceptable and young people will benefit from staff's exploration of alternative educational resources such as home tuition or structured home based learning.

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Outcomes for children and young people

Young people benefit from the home's welcoming ethos and attitude towards visitors to the home. Young people are clear that their friends and family members are welcome to visit them at the home in accordance with the home's boundaries and expectations with regard to visitation. Staff ensure these are well known to young people. Staff make good efforts to ensure there is clear understanding of young people's contact arrangements at the outset of the placement. Staff record clear information about these arrangements on file, and pay good attention where contact with individuals is prohibited. Young people comment that arrangements are very flexible and that they enjoy the home's practice of making friends and family members feel welcome. Young people benefit from the home's efforts to assist them develop practical skills that prepare them for independence. Staff monitor and support older young people

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Outcomes for children and young people

with life skills as they approach the transition to leave local authority care. Staff assist young people to develop skills in shopping, budgeting, meal preparation, laundry, saving, and preparing for employment. While young people confirm staff support the development of life skills, case files do not evidence that this is a routine feature of the weekly planner and pathway plans are incomplete. Staff's support and monitoring of the development of these skills are sporadic. Young people do not benefit from a structured semi independence programme tailored to meet individual needs.

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Outcomes for children and young people

Feedback from placing authorities with regards to the home's ability to improve outcomes for young people is positive. One placing authority comments 'I can't say enough about (the home). They are an excellent service, very helpful with the most difficult of young people. They manage to hold on to them and placements are successful. I'm very pleased with the staff's performance and I am pleased with what they do'.

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Quality of care

The quality of the care is satisfactory . Young people speak enthusiastically about the positive relationships they share with staff of the home. One young person comments, 'if I could live here after 16, I would'. Staff are equally positive, when asked to comment upon the best thing about their role, staff indicate this is spending time with young people. One staff member comments 'they give you jokes all the time'. The management team encourages and fosters positive relationships between staff and young people and all parties clearly benefit from this.

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Quality of care

Young people are appreciative of the home's openness with regard to soliciting their views. Young people indicate that staff and management are interested in their opinions and what they have to say about the service and more general issues. Young people have ample opportunity to share their views and staff feel they do so very confidently. Young people's key work sessions routinely explore placement issues as does statutory review meetings. The home's records of residents meetings, a formal collective forum to air views, is not well documented and does not support the view that consultation in the home is robust. The issue of inadequate recording is explored in greater detail elsewhere in this report.

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Quality of care

Young people comment that they have never known a complaint to have been made against the service, however they are confident that in this event staff would act appropriately. Young people are aware of the home's comprehensive complaints procedure as they confirm receipt of this information at placement start via the home's children's guide. Young people also confirm that staff routinely advise them to consider making a complaint when they appear dissatisfied with events. The home's record of complaints confirms that none have been received since the last inspection. Newly recruited staff demonstrate an awareness of the home's complaints procedures, they confirm this issue features as part of their induction.

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Quality of care

The home has medication policies in place and these feature in newly recruited staff's induction. All staff receive medication training. Despite this however, staff are not consistent in their record keeping of young people's medication regimes. This inspection notes documented medication errors on file. This potentially places young people at some risk and is evidence of poor medication practices.

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Safeguarding children and young people

The service is good at keeping children and young people safe and feeling safe. Young people are clear that they feel well protected by staff while in placement at the home. Staff have access to comprehensive child protection training that is ongoing throughout their employment with the provider. The service has good safeguarding and child protection policies and procedures in place, however these are yet to be shared with the Local Safeguarding Children's Board as outlined in the national minimum standards. Staff are knowledgeable about relevant procedures, there have been no allegations or incidents of a child protection nature at the home for a significant length of time.

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Safeguarding children and young people

A clear strength of the service is their ability to engage effectively with young people. As a direct result, young people, even those known to have histories of being persistent absconders from residential care settings, do not do so at this home. Staff have access to good policies and procedures that address unauthorised absences and young people who are deemed missing. Young people are also aware of the effective protocols in place with regards to reporting those absent or missing. The home's records evidence that unauthorised absences and young people who go missing is a rare occurrence at the home. This is an unusual trend for urban residential childcare settings. Young people are clear and appear proud that they have a home that they enjoy and want to live in. This, they comment prevents them from absconding frequently as they did formerly at previous placements. This ethos is to the credit of staff of the home. Young people comment that on the rare

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Safeguarding children and young people

occasion where they do go missing, staff are genuinely pleased that they are safe when they return. Young people comment that once back at the home, they are disappointed in themselves for causing staff to worry.

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Safeguarding children and young people

Staff of the home actively encourage positive behaviour and young people confirm that generally, poor behaviour is not an issue at the home. Staff have access to good behaviour management policies and procedures, including a control and sanctions policy. Young people are well aware of staff expectations with regards to behaviour. Staff rarely make use of sanctions, but prefer to counsel young people to reflect on the consequence of their actions. Young people indicate that this is an effective approach and accept it as fair that damage to property is always paid for. Young people's relationships with staff are based on trust and mutual respect; residents are appreciative of the opportunity to reflect on their behaviour as opposed to immediate reprimand. This young people say, is common to their experience at other residential settings. The home's successful approach to behaviour management is a clear

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Safeguarding children and young people

Young people indicate that bullying is not an issue for the home and is a rare occurrence. Asked about the experience of bullying at the home, one young person comments 'no way, never - staff would take care of it'. Young people's case files all evidence a bullying risk assessment used to alert staff to the potential for such behaviour. There are sound policies in place that support the home's zero tolerance stance for bullying.

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Safeguarding children and young people

With regards to physical intervention, managers confirm that whilst the entire staff group have completed this training, it is still the home's stance that restraint be used in the most exceptional of circumstances. Staff records confirm that restraint is yet to used in the home. Young people indicate they would be shocked if such action was taken by staff as the relationship between staff and residents is so positive. One young person commented about staff's use of restraint 'never in my lifetime at this home, never'.

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Safeguarding children and young people

Young people benefit from the robust selection and vetting of staff for the home. The home's recruitment practices are conducive with the regulations and the home's own policies and procedures. Staff personnel files evidence full and comprehensive information as required. Staff confirm their recruitment process was thorough, with all completed checks including Criminal Record Bureau checks prior to them resuming duties at the home.

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Safeguarding children and young people

The home's premises is physically safe and appropriately secure and young people feel safe in their surroundings. Staff address well general health and safety issues and there are relevant risk assessments in place. Fire precautionary measures are sound and appropriate service contracts are in place for fire, gas and electrical equipment. Staff conduct routine building checks regularly and CCTV monitors the home's external perimeters for unwarranted activity.

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Leadership and management

The leadership and management of the children's home are inadequate . Management of the home fails to effectively monitor the functioning of the service and this is a major weakness of its service provision. As a direct result, the home is unable to demonstrate a capacity for continuing improvement or evidence the impact of recent improvements. While all requirements and recommendations from the last inspection have been addressed, actions made as a result of this inspection are sometimes repeat actions from inspections prior to the last. This is indication that the leadership of the home have poor insight into measures necessary to sustain service improvement.

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Leadership and management

The home's Statement of Purpose document is comprehensive and outlines well the aims and objectives of the service. These are generally well met by the provider. Where necessary, the Statement of Purpose document is made available for translation if English is not the young person's preferred language. The home's children's guide is graphically creative, well written, age appropriate document. It contains a good summary of services and facilities provided by the home. The document's graphics portray positive images of multi-cultural life. The document does not however contain details of how to contact an independent advocate as the national minimum standards recommend. This is important since some young people feel their placing authority are not acting in their best interest and other advocacy options should proactively be made available to them.

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Leadership and management

Young people and staff will benefit from improved monitoring systems that are consistent, robust and effective. No regulation 33 visit has been conducted for several months. Equally new systems are currently being introduced to ensure regulation 34 monitoring is effective. In conducting the review of a number of the home's records, this inspection finds significant shortfalls in the accuracy of staff's documentation of often routine records. This inspection finds evidence of poor record keeping in relation to written care and placement plans for some young people, documents have the very basic of required information. This is despite managers' completion of case file audits. Some young people's files do not evidence that placement planning meetings have been convened. Staff confirm that not all placements are negotiated with this process executed. This is a significant shortfall. The failure to complete the placement planning process acts to compromise staff's

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Leadership and management

knowledge of young people's specific needs and how the service is to address individual need.

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Leadership and management

The review of medication records illustrate that despite management monitoring, errors in recording of young people's medication regime are still evident. Effective, robust monitoring would act to reduce or eliminate such errors. The home's record of residents' meetings is irregular and does not support the view that as a collective, young people are effectively consulted. The home's record of staff hours actually worked is vague and on some occasions, inaccurate. Staff of the service do not consistently inform Ofsted of significant events as outlined in Schedule 5 of the regulations. The home's lack of effective monitoring and poor record keeping is a clear weakness of the service that impacts on its capacity to drive service improvement.

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Leadership and management

The home is financially viable and well resourced to meet the needs of young people in placement. Young people indicate that they receive adequate funds and there are records in place to support this view. Managers ensure the home's health and safety requirements are well met.

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Leadership and management

The staff group are sufficient in numbers and have access to relevant and quality training opportunities. These assist inform and support their practice. The home provides training that is both internal and externally facilitated, staff have access to local authority safeguarding training and this is high on the home's team meeting agenda. The home's registered manager is very well qualified and experienced. The home employs a sufficient number of staff who receive adequate support to enable them to meet the needs of young people. Staff comment that support and supervision is regular, relevant and meaningful. The staff team appreciate the 'hands on' management style of the provider which allows them greater access to practice and procedural support.

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Leadership and management

Equality and diversity practice is good .

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