Children's Home run by Tulip Care One Limited t/as TulipCare in Kent

Unique reference number SC361090 Inspection date 16/08/2013 Inspector Keith Riley Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 14/03/2013 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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Brief description of the service

This privately owned children's home provides residential care and support for up to five boys. The home adjoins an independent school, registered for seven male pupils. The school is included in the resources available to young people placed at the home.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be inadequate .

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Overall effectiveness

A stable and motivated staff team support young people to make progress in their educational attendance and achievement and in modifying some behaviours. The home is partly successful in working with health professionals to ensure the best possible health outcomes for young people. Medical issues, that young people came to the home with, are addressed thoroughly. However, some young people do not engage with the strategies put in place to improve their health such as recommendations by a dietician or smoking cessation nurse.

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Overall effectiveness

The views of young people are important and regularly sought on the quality of care and activities they want to pursue, such as ice-skating or swimming. Young people, currently placed in the home speak positively about the care they receive and say they feel safe most of the time.

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Overall effectiveness

However, there is not always a calm and positive environment in the home. For some young people, staff use high risk behaviour management strategies. In spite of a warning from another professional of the dangers of such strategies, they continue to be used. The consequences of such interventions are not fully assessed, interventions are not always recorded in line with the regulations and the use of physical intervention is excessive. Such interventions, as well as more established day-to-day care, are not clearly signed and agreed in the placement plan. The independent visitor does not always monitor the use of restraint. Young people are not always offered the chance to see a medical practitioner after a physical intervention. On occasion, the police are called to the home to assist in managing behaviour. Young people are arrested and charged with assaulting staff or criminal damage.

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Overall effectiveness

The Registered Manager understands the strengths of the home. However, the weaknesses around behaviour management are not identified.

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Overall effectiveness

Other shortfalls were around the recruitment process, in particular establishing satisfactory information about gaps in employment and making further checks for staff who have worked overseas.

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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) ensure no measure of control or discipline which is excessive or unreasonable is used at any time on children accommodated in a children's home (Regulation 17 (1)) 16/09/2013

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Reg. Requirement Due date

17B (2001) revise the behaviour management policy, in particular the use of high risk interventions (Regulation 17B(2)(a)) 16/09/2013

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children's home, a written record is made in a volume kept for the purpose (Regulation 17B (3)) 16/09/2013

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Reg. Requirement Due date

17B (2001) ensure that written records include the consequences of the use of the measure, in particular the effect on breathing (Regulation 17B (3)(f)) 16/09/2013

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Reg. Requirement Due date

12A (2001) agree and sign the plan for the child's placement prepared in accordance with the provisions in regulation 9 of the Care Planning, Placement and Case Review (England) Regulations 2010 (Regulation 12A (1)) 16/09/2013

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Reg. Requirement Due date

(2001) ensure full and satisfactory information is available in relation to a person working at a children's home in respect of each of the matters specified in Schedule 2, in particular a full employment history, together with a satisfactory written explanation of any gaps in employment (Regulation 26 (3)(d)) 16/09/2013

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  ensure, where there has been physical restraint, that children are always given the opportunity to be examined by a registered nurse or medical practitioner (NMS 3.16)  ensure visits of the home carried out under Regulation 33 include checks of the use of restraint (NMS 21.7)  ensure records are clear, up to date and contribute to an understanding of the child's life (NMS 22.1)  consider, where the person has lived outside of the UK, what further checks are considered appropriate to establish suitability to work with children. (NMS 16.3 (f))

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Outcomes for children and young people

Outcomes for young people are adequate .

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Outcomes for children and young people

Staff provide a caring, open and homely environment where young people are supported to work on their self-esteem, behaviour, independent living skills and focus on the future. There are some good outcomes, such as young people engaging with their education and making progress with their health. However, some young people are not dis-engaging from their destructive behaviours and finding other ways to manage their difficult and challenging emotions. Behaviour, such as violence toward carers, fluctuates. On some occasions the police are called. This results in young people being arrested and charged with offences that happen in the home. Some young people are at risk of having a criminal record which jeopardises their future life chances. On occasion, there are conflicts with other young people in the home. Staff use physical intervention techniques to separate young people. However, these are not recorded in line with regulation.

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Outcomes for children and young people

Staff have high aspirations for all young people, irrespective of their initial educational starting points. Young people who have struggled historically with the education environment before coming to the home are able to attend school or college. Although behaviour has affected academic progress prior to placement in the home, staff work hard to encourage young people to reach their full potential. Young people above school leaving age speak positively of their education and their ambition to continue at college to gain further qualifications. Young people have every opportunity to succeed with their education.

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Outcomes for children and young people

Young people benefit from carefully planned health care and staff work well with other professionals, for example specialists in specific medical conditions. Young people's emotional well -being is promoted to an acceptable standard, with the staff arranging and facilitating contact with other professionals such as child and adolescent mental health services. Young people are able to address some of the difficult emotional issues they experience.

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Outcomes for children and young people

Contact with family members and other people important in young people's lives is fully supported. Staff demonstrate a clear commitment to facilitating contact. Staff convene multi-disciplinary meetings to discuss and agree how young people are to be kept safe when there are any concerns identified.

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Outcomes for children and young people

Staff set clear targets to support young people to develop their independent living skills. Young people have the opportunity to increase their life skills such as cooking or managing their own budget. Young people are prepared for work, for example, by doing voluntary work in the local community. However, there are no formal pathway plans in place. This means that young people are at risk of not being fully prepared for adult life.

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Quality of care

Young people have supportive relationships with staff who are empathetic to the range of emotions the young people in their care go through. Young people describe the staff in positive terms. Although there is an environment to support positive behaviour not all young people interact positively with staff and each other. Regular key work sessions and young people meetings ensure the views of young people are known. There is little need for young people to access the formal complaints procedure. When they do, their concerns are taken seriously and adequately addressed.

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Quality of care

Placement plans give staff an overall understanding of each young person's life, background and needs. However, some specific known behaviours and strategies that are in place are not documented in the plans. This means that there is not clear written agreement or review.

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Quality of care

Young people have a range of support services they access and have an understanding of their behaviours requiring support and intervention. Support is given by staff and other professionals to help young people develop emotional resilience. Young people gain an understanding of their background and their cultural heritage and have a sense of their own identity.

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Quality of care

Young people's physical health needs are identified and met. Staff ensure that they know the young people's health needs and seek professional advice when necessary. Young people have access to a range of information and advice on health issues. Consequently issues such as alcohol misuse are diminishing or eliminated.

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Quality of care

Young people are learning to understand the nutritional value of eating a good diet. They have an appreciation of different cultures and a range of international cuisine. Needs relating to young people's cultural background and personal identity are positively addressed in both daily living and care planning by a diverse staff team. For example, young people are encouraged to talk about their understanding of different religions.

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Quality of care

Staff have close links with the home's adjoining school. There is a plan in place for each young person to provide them with the maximum opportunity to learn. Young people, above school leaving age, are able to gain college placements.

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Quality of care

The home is decorated and furnished to a good standard which creates a pleasant domestic environment. Young people are able to personalise their bedrooms to reflect their hobbies and interests. This gives them a sense of identity and belonging.

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Quality of care

Young people are encouraged to be part of the local community and take advantage of local facilities. Activities such as swimming, ice-skating or walking are offered. Young people benefit from a staff team who are committed to supporting them in stimulating and meaningful pursuits.

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Safeguarding children and young people

The service is inadequate at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

All members of staff receive training in child protection and safeguarding. They know what to do and who to inform in the event that they have concerns about a young person's well-being. The manager ensures that all the relevant agencies are informed promptly of any safeguarding issues such as an allegation being made against staff. This ensures that strategies and plans can be developed in the event of any concerns being identified.

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Safeguarding children and young people

Staff know and implement the procedure when young people go missing. Frequent attempts are made to contact the young person and messages left to encourage young people to let staff know they are safe. Young people will also contact other adults they trust such as a relative. Written records are kept detailing the action taken, the circumstances of the young person's return and possible reasons for their running away.

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Safeguarding children and young people

Staff are trained in the home's approved behaviour management techniques. Although de-escalation strategies are applied initially, any physical interventions used are primarily high risk interventions such as restraining young people on the floor. On occasion, this is for an extended period of time. The effect of this on young people is not recorded, for example, records do not evidence how young people are monitored for breathing. Young people are not offered the opportunity to see an independent medical practitioner after a restraint. Some young people are at risk of being exposed to excessive means of restraint without proper monitoring and review. This places them at risk.

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Safeguarding children and young people

Sanctions, that are fair and generally restorative, are used to address poor behaviour. They are regularly reviewed by the Registered Manager as to their appropriateness and effectiveness and adjusted if necessary. Young people have the opportunity to reflect on and improve their social behaviour.

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Safeguarding children and young people

The home ensures that all prospective members of staff have had a Disclosure and Barring Service (DBS) check completed before they commence work. Most recruitment records contain all the information required. However, in one case, full and satisfactory information in regard to the employment history was not available or evaluated. In addition, no further checks are considered for staff who have worked overseas.

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Safeguarding children and young people

The environment is appropriately safe and secure. The practice of locking the rear door at night is suitably risk assessed. External contractors certify the safety of the environment.

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Leadership and management

The leadership and management of the children's home are inadequate .

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Leadership and management

Staff work hard to encourage young people to reach their full potential. Young people benefit from a manager and staff team who are committed to their needs. The staff endeavour to enhance young people's quality of life and to make the right choices. However, not all young people engage with this.

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Leadership and management

The organisation demonstrates a commitment to staff training. Staff feel their training needs are met and they positively engage in the training on offer. Further training, such as obtaining formal qualifications in therapeutic communication, is promoted.

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Leadership and management

Staff are trained in the home's approved behaviour management techniques which includes de-escalation techniques. However, the vast majority of physical interventions are high risk, such as restraining young people on the floor. Such interventions are not clearly recorded and agreed in the placement plan. Young people live in an environment where they are at risk of being restrained on the floor when presenting with extreme challenging behaviours. Another professional has warned of the dangers of such interventions. The senior management do not recognise restraining to the floor, with only one other alternative, as a weakness. Not all incidents of physical intervention are recorded in writing in accordance with the regulations. This means that not all incidents requiring physical intervention are carefully analysed, monitored or reviewed.

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Leadership and management

The previous requirement to revise the Statement of Purpose has been met. However, the ethos and philosophy of the home is not understood by all authorities who place young people in the home. For example, the Statement of Purpose refers to a 'therapeutic living environment' but there is not a therapeutic model on which this is based. Although there is a thorough referral and assessment process there is a risk that young people are inappropriately placed.

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Leadership and management

The Registered Manager regularly considers the running of the home to maintain adequate care levels. Internal monitoring arrangements are in place such as visits by an independent visitor, who reports monthly on the service being delivered. However, such visits do not always monitor the physical restraint that is being used. This means that the physical intervention young people experience is not always scrutinised and challenged. The staff team are well balanced with staff of both genders. The deployment and numbers of staff on duty at any one time is indicative of the needs of the young people. The management team ensures that staffing levels take into account the needs of young people, for example, when young people are experiencing high levels of anxiety.

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Leadership and management

Records are generally clear and well kept. However, not all incidents involving physical restraint are recorded in line with regulation. Some placement plans do not identify the established support needed in the day–to-day care of some young people. Some young people say they do not contribute to their placement plan. Significant events are notified promptly to the appropriate authority. This means that incidents are dealt with appropriately and in consultation with other professionals.

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Leadership and management

The previous requirements to revise the Statement of Purpose and improve the Regulation 34 reports are met. The previous recommendations to conduct regular supervisions and appraisals are met.

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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 and the evaluation schedule for the inspection of children's homes.

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