Children's Home, Residential special school run by SES Turnstone Limited in Norfolk

Unique reference number SC452461 Inspection date 15/10/2013 Inspector Stephen Halliley Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 21/08/2013 Website: www.ofsted.gov.uk

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Brief description of the service

The home is managed and run by a private company. It provides residential care for up to eight young people with emotional and behavioural difficulties. Education may be provided on the same site.

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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 good .

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Overall effectiveness

This home was judged to be inadequate at an Ofsted inspection in August 2013. Since that time the Registered Manager, manager designate, staff team, manager of the sister service and senior managers within the organisation have worked tirelessly to improve the quality of care provided. An extremely detailed action plan was provided following the last inspection. By robustly putting these plans into action; reducing the number of young people in placement, improving fire safety, having a consistent staff team, improving recording practices and more robust monitoring of the home among other things, the home has turned around and is once again providing a good quality service to young people. All six recommendations and two of the three recommendations made at the last inspection have been fully addressed. While there remains room for further improvement the huge progress already made must be recognised and this service is now judged to be a good home.

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Overall effectiveness

Young people have made clear progress in all areas of their lives since the last inspection. Staff have very high aspirations for young people and work very hard with them to ensure they achieve as much as possible during their time in the home. Attendance at the learning centre is much improved, young people are attending college courses, the use of restraint has dropped as young people find more appropriate ways to manage their emotions and relationships between staff and young people are much improved.

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Overall effectiveness

Young people say they get on well with staff and their only concern has been the amount of staff turnover to this point. This issue has been picked up by the new manager and she has plans in place to address this. Young people are developing strong relationships with all staff which is a big step forward as, for some young people, this has not always been the case. The increased trust in place between young people and staff is evident in all areas of the home.

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Overall effectiveness

Each young person has considerable input to their care and placement plans and they are fully aware of all updates made to their risk assessments. This ensures they are fully involved in the process of planning their care and are completely aware and accepting of decisions taken about their futures. Young people are taking much more of an interest in their own health needs. Risk taking behaviours such as self-harming and smoking are vastly reduced and some young people, where appropriate, are taking responsibility for self administering medication such as topical creams.

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Overall effectiveness

Young people all now report that they feel safe in the home. This is clear in the reduced number of restraints, unauthorised absences and sanctions being given. Young people are much more relaxed than at the time of the previous visit and this is evident in their relationships with each other and with staff.

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Overall effectiveness

The new manager is very aware of the strengths and weaknesses of the home. She has worked alongside the principal for some time and is now putting together an updated development plan to reflect her thoughts on how the home can continue to improve. This is an important aspect of the home at this time. While the progress made since the last inspection should be applauded managers are very aware that the challenge now is to maintain this level of service and their aim is to consolidate this good judgement at their next inspection.

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Overall effectiveness

Minor shortfalls were noted in respect of accurately recording the duration of physical restraints, ensuring all possible de-escalation techniques are used to prevent the need for restraint taking place and in the time taken by some staff to complete the children's workforce development council induction standards.

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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

 ensure methods to de-escalate confrontations or potentially violent behaviour are used wherever appropriate to avoid the use of physical restraint. Restraint is only used in exceptional circumstances to prevent injury to any person or to prevent serious damage to the property of any person. (NMS 3.13)  ensure new staff undertake the Children's Workforce Development Council's Induction standards, commencing within 7 working days of starting their employment and being completed within 6 months (NMS 18.3)  ensure the manager regularly monitors in line with regulation all records kept by the home to ensure compliance with the home's policies, to identify any concerns about specific incidents and to identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring; this specifically relates to staff recording clearly the duration of restraint separately from the duration of

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Recommendations

the incident (NMS 21.2)  ensure information about the child is recorded clearly and in a way which will be helpful to the child when they access their files now or in the future; this specifically relates to accurately recording information about lengths of incidents and restraints. (NMS 22.5)

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Outcomes for children and young people

Young people make very significant progress in all aspects of their lives while living in this home when compared to when they first arrived. All young people are fully aware of the reasons that have led to them living in this home and have a clear understanding of their personal backgrounds and family relationships. Young people have shown a great deal of emotional resilience to come through the unsettled period the home had prior to the last inspection and to make very positive progress in the last two months. Self-confidence and self-esteem has been improved through increased independence levels, active participation in a range of off-site clubs and activities and school work being displayed at the recent inspection of the learning centre attached to this home. One social worker said 'I last saw my young person two weeks ago and the continued improvement in him since then is clear'. This shows young people are making continual improvement in a home which is now

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Outcomes for children and young people

settled and able to provide consistent, quality care for young people.

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Outcomes for children and young people

Young people's health continues to be given a high priority and they have regular access to a range of health professionals to ensure their physical health needs are met. Young people are taking a more active role in being responsible for their own health and well-being. They have a clear understanding of a healthy diet and ensure, when planning the menu with the cook, there is a good balance of all five food groups. Young people are also encouraged to take part in activities which support their health. Young people's comments include 'I really enjoy roller skating and it helps me keep fit so I have also built this in to my PE lessons in the learning centre.' This increased awareness of their own health needs and what constitutes a healthy lifestyle represents a big step forward for young people. Risk taking behaviour is hugely reduced. Young people make regular use of e-cigarettes and as a result smoking has been drastically reduced. Ready access to a range of therapists

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Outcomes for children and young people

employed by the organisation supports emotional and psychological health and this has had an impact on the significantly reduced occurrence of self-harming behaviour. Young people also benefit from the home having good links with local child and adolescent mental health services and they can obtain additional support from this service if required.

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Outcomes for children and young people

Young people's attendance at the on-site learning centre is much improved. Staff, social workers and young people themselves comment on this and it is extremely encouraging that young people now see the importance of their education. The learning centre continues to offer a range of learning styles from the traditional academic approach to a more vocational style to support the diverse learning styles of all young people. As a result young people are undertaking courses which will lead to them sitting GCSE examinations in the coming year. Some young people attend local college courses one day each week. This also allows them to build friendships with a more diverse peer group. Young people will benefit from spending time with appropriate role models of a similar age to themselves, learn to manage themselves in a range of different social situations and work towards achieving nationally recognised qualifications.

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Outcomes for children and young people

Young people are fully involved in redecorating their bedrooms and changing the layout of communal areas so they are more to their liking, both as individuals and as a group. This shows that young people are now investing in the home and are showing greater awareness and appreciation of the wishes of others. With the support of the new handyman young people are also making good damage they have previously done to communal areas of the home. This restorative approach ensures young people are gaining an understanding of the impact their inappropriate behaviours have had on both themselves and others. Young people are actively involved in a number of community based activities and clubs. This shows significant progress as previous behaviours had made this extremely difficult to support and to manage safely. Activities include roller skating classes, attending the gym and swimming and there are plans to expand the range of activities undertaken to

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Outcomes for children and young people

include army cadets. Young people are also very good at supporting younger, less able children in some of these activities. This has been commented on very positively to staff by other parents who support these activities. This indicates young people are developing a sense of social awareness, can manage their behaviour well when in a range of social settings and are self-confident enough to offer this support to others without fear of failure or criticism.

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Outcomes for children and young people

Family contact continues to be an area of great strength for this home. All young people benefit from contact with a range of family members appropriate to individual needs and in line with any legal restrictions which may be in place. The homes unfailing support for this contact, whether providing transport, supervising the contact or making unusual arrangements to fit in with special requests for birthday and other family celebrations, ensures young people maintain the relationships which are important to them.

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Outcomes for children and young people

Independence plans are in place for all young people though they are at very different stages in their journey to independence. While some are trialling independent travel to home contact in a well managed and appropriately staggered manner others are talking proudly and positively of gaining independence in the local area having lost this due to previous behaviours. Young people are clearly able to relate the positive rewards of their good behaviour to the more negative, sanction led approach previously in place. There are clear plans to develop life skills for older young people including writing CV's, applying for college placements or apprenticeships, cooking, budgeting and shopping. These skills will be very beneficial to them in the future when they do not have the level of adult support they can currently rely on.

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Quality of care

The very significant change in the group of young people living in this home and the accompanying change in the group dynamic has allowed young people and adults to rebuild relationships which were previously very strained. Young people enjoy spending time with staff and clearly benefit from the time staff are able to give them. Individual activities based around young people's hobbies and interests are made readily available and young people engage in these with relish. Relationships within the group of young people are also very settled and this has allowed everyone to move forward in a very positive manner in recent months. Young people are very relaxed around staff, talk openly to them on a range of subjects and are happy in their placements. Staff comment on young people making incredible progress and there is a clear sense that staff are constantly trying to push young people forward and develop their life skills as they have high aspirations for all young people.

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Quality of care

Young people's views, thoughts and opinions are highly valued by the staff as a means of ensuring they are providing the right level and quality of care. House meetings are held regularly and records show a range of topics being discussed. Young people receive clear feedback and report that staff will always look into their requests and try to find ways to meet these. When this cannot be done a clear and reasoned explanation is given. This ensures young people know their requests are being given due consideration by staff and are not simply being refused. The access young people have to the complaints procedure is clear and, though some minor issues have been raised in house meetings, no complaints have been made.

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Quality of care

Young people have detailed daily living plans which are informed by the care and placement plans in place. Young people state that they 'sit in on reviews, planning meetings, portfolio of achievement and needs (PAN) meetings and read and sign all updates to paperwork. This includes risk assessments so 'I know what these say about me.' This open approach ensures young people are fully aware of decisions being made about their lives and have the opportunity to comment on these plans in a proactive manner. Involvement in updating risk assessments also allows young people to be aware of how their behaviours and attitudes have changed. Recently these risks have become much lower in a number of areas and this understanding of how they are better able to manage their behaviour has also led to improved levels of self-esteem and pride in their achievements.

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Quality of care

Young people's health and well-being are given a high priority in this home. Young people are involved in producing a well-balanced diet, they participate in a range of stimulating and challenging physical activities and are aware of their own health needs. Staff ensure all young people regularly attend appointments with a range of health professionals which ensures their physical health needs are well met. There is a clear system in place for the administration of medication and, where appropriate, young people are encouraged to take responsibility for self-administration of their medication. Young people's psychological health needs are addressed through a range of different therapeutic approaches available within the organisation. Staff take great care to ensure the correct approach is used for each young person. This highly individualised approach ensures that young people's psychological health

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Quality of care

Young people are unfailingly encouraged to attend the learning centre. Links between the pastoral and educational teams are very strong and this ensures a consistent approach to working with young people. Attendance levels have improved dramatically since the summer. Social workers comment on attendance at the learning centre increasing, attendance on college courses, young people planning work experience and having clear aspirations and goals. This shows a complete change in attitudes towards education being exhibited by young people and the progress they have made must be commended. In some cases attendance levels at the learning centre have almost doubled as a direct result of staff providing constant encouragement and support to young people to access their education.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people say they feel safe in this home and this is echoed by their social workers. This is a due to the much improved group dynamics, more consistent staffing in place and the much more settled feel to the home. As a direct result of feeling safe and looked after by staff young people have begun to engage in education and to invest in the home once again.

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Safeguarding children and young people

A range of health and safety checks are carried out regularly to ensure young people remain safe from accidental injury while at the home. At the time of the last inspection there were significant gaps in the fire checks and some young people had not been involved in fire drills since moving to the home. This has been robustly addressed and all checks are now carried out at the required frequency and all young people and staff have been involved in fire drills. This ensures young people will know what to do should there be an emergency situation in the home. The home has also been visited by the fire safety officer who was happy at the comprehensive action plan put in place to address the shortfalls noted.

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Safeguarding children and young people

There have been two incidents of young people going missing from this home since the inspection in August 2013. Both of these were related to young people wanting to visit friends but not being able to and taking inappropriate action to try and get their own way. The home followed the clear protocols they have in place and liaised well with the police when necessary. There was clear work done with the young people following their return to the home including discussing reasons for going missing. The fact this behaviour has not been repeated in over a month indicates they have listened to staff and thought about how to ensure their needs and wishes are best met by staff.

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Safeguarding children and young people

Staff continue to work hard to role model appropriate behaviour for young people. In response young people are now clearly demonstrating they have the ability to behave appropriately both in individual and group situations. There have been 30 restrictive physical interventions since the last inspection. This represents an almost 40% reduction in the average weekly frequency of restraint in this time. A small minority of these restraints were possibly a result of staff anticipating situations due to previously witnessed behaviours rather than being a direct response to the situation at hand. Managers have picked up on this and led some role-play based training around the use of restraint in order for staff to fully understand appropriate responses to young people's behaviours. This ensures young people are only restrained as a last resort when all other intervention methods have proved unsuccessful. There is a vast improvement in the quality of the recording of

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Safeguarding children and young people

restraints and serious incidents and staff have again been provided with additional training to understand their role and responsibilities in this area. More rigorous monitoring has led to issues with recording being picked up. However, some restraint records show the duration of the incident itself rather then the duration of the actual restraint. This lack of accuracy can lead to questions about the suitability and length of the restraint and would also lead to questions being asked by young people if they were to read their files at some point in the future.

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Safeguarding children and young people

Young people are kept safe from possible harm or abuse by adults who work with them and those who visit the home. New staff undergo rigorous and robust checks before starting employment. Visitors are required to sign the visitors book, carry a pass and are escorted by staff at all times when young people are in the home.

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Safeguarding children and young people

There has been one incident of a serious nature since the last inspection. This was reported promptly to outside agencies including Ofsted, social workers and safeguarding teams. The social worker of the young person who made the disclosure is very happy with the way it has been handled and resolved. She said 'I believe this situation has been handled appropriately and that my young person is not at risk. I am confident she is safe within this placement and it remains the right placement for her and is the best placement she has had.' This clearly shows this home take allegations and disclosures from young people seriously and respond appropriately to ensure their ongoing safety and well-being.

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Safeguarding children and young people

Risk assessments are regularly updated and signed off by staff and young people. There is a system in place for staff to sign a log when they go off site with young people. Implicit with signing this is the understanding that staff have read and understood the latest risk assessment for the young person they are working with and for the activity they are undertaking. This is a far more proactive risk management strategy to that which was previously in place and ensures young people can participate safely in a range of age appropriate activities in a safe manner. This has also led to staff being more aware of young people's potential behaviour and consequently there has been an almost complete reduction in the risk taking behaviour of young people when they are out with staff.

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Leadership and management

The leadership and management of the children's home are good . The Principal, manager designate and senior colleagues within the organisation have worked tirelessly to manage this home effectively and to turn it around from the previous inspection judgement. The decision to find more appropriate placements for some young people has led to a much better atmosphere within the home. Staff have been able to work well with young people without the need for constant senior staff support and guidance. This has allowed time for managers to undertake management tasks and this is evident in the much improved monitoring, frequency of supervision and additional training staff have received.

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Leadership and management

There has been very significant improvement in all areas of this home since the last inspection. The home is now being conducted in a manner which promotes and makes proper provision for the welfare of young people. The impact of this can be seen in the stability of young people, the ready smiles they now have for staff and each other and their investment in the home and in their education. The most significant improvement since the last inspection is that the manager designate has now completed the registration process with Ofsted. This will ensure that the Principal can focus on the management of the service as a whole while she takes over day to day responsibility for the running of the home. She feels the key strength of her team is that they are all 'fully on board with the no limits ethos to young people's achievements championed by this organisation.' The key weakness she has identified is staff retention and she will be working on a new tapered induction

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Leadership and management

programme and professional development plans to try and address this. She is aware of the impact this can have on young people in terms of stability and confidence in staff. She has measured progress against the development plan previously in place and is currently developing a plan based around her thoughts for continuing to drive the home forward.

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Leadership and management

There were six requirements and three recommendations made at the last inspection. The action plan put together by the home addressed all of these and with the exception of one recommendation these have now all been fully addressed. With just four recommendations being made at this inspection visit it is clear that the improvements made in recent months have had a great impact on the work of staff and the outcomes for young people.

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Leadership and management

As a direct result of the changes made to the residential group and the consistency of staffing this home are now providing a service which once again fully meets the aims and objectives they have set out in their statement of purpose. Social workers are very clear on what the home intends to offer to young people and are encouraged that in the last two months they have been able to focus more fully on this and to provide an improved level of care and support to young people compared to the early summer.

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Leadership and management

Monitoring of the home continues to be carried out on a monthly basis by the external visitor with reports being sent to Ofsted in a timely manner. Managers monitoring has been handed to the manager designate and she has made a decision to carry this out on a monthly rather than bi-monthly basis. This will ensure any issues are picked up more quickly and can be addressed immediately ensuring prolonged, repeated omissions or errors in recording are avoided.

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Leadership and management

All staff continue to receive regular training in all mandatory areas; behaviour management, safeguarding, fire safety and first aid among others. Staff have also been given additional training in responding to inappropriate behaviour and the recording processes they are required to follow which they have found to be beneficial. This approach to training ensures staff are well-equipped to deal with situations and that all staff work with young people in a consistent manner.

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Leadership and management

The staff rota shows a good mix of experienced and newer staff. The recent recruitment of three new staff will bring the staff team to capacity, with the continued use of two agency staff who are assimilated into the rota and work full time hours to ensure consistency of care to young people. This recruitment drive, which also included the appointment of a new handyman suggests that there are no concerns regarding the financial viability of the provider. All staff receive regular supervision and appraisals have been held for those staff who have been in post more than six months. Stretching professional development targets were set during these meetings and they are regularly reviewed in supervision to ensure staff continue to develop in their roles and to provide a high quality service. All new staff are undertaking the children's workforce development council's induction standards. Some staff have not completed this within the anticipated six month time frame for a

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Leadership and management

variety of reasons; personal, long term sickness or due to the pressure they have been working under until recently. It is an expectation that all staff will complete this as soon as possible and that all new staff will complete it within six months of taking up employment.

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Leadership and management

The number of notifications of significant events sent to Ofsted has reduced dramatically since the last inspection. This shows that young people have developed techniques to better self-regulate their behaviour and that staff are handling difficult situations much more effectively. There have been no delays in sending through notifications and they have included clear action plans or risk assessment modifications to respond to the behaviours seen. This is another indication that young people are feeling safe, settled and well cared for and that the hard work carried out since the last inspection is having a very positive impact on young peoples lives.

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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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