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

Unique reference number SC361090 Inspection date 23/10/2013 Inspector Kevin Whatley Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 16/08/2013 Website: www.ofsted.gov.uk

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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 adequate .

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Overall effectiveness

Young people receive personalised care which in general enables them to make adequate progress in their lives; in some cases individual progress is good. Other young people have made less progress and have engaged in negative and potentially dangerous behaviour within the home. This has led to some young people being charged with serious offences.

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Overall effectiveness

A key strength of the home is the positive and meaningful relationships shared between young people and staff. These have allowed young people to safely explore their own identities and sexuality and as a result improve feelings of self-worth and confidence.

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Overall effectiveness

Young people expressed positive views regarding living at the home; some of them described the home as, 'superb and excellent'. They also said they felt safe living at the home and noted there were always staff around who they felt able to talk to and gain support from.

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Overall effectiveness

The home has experienced a period of transition with the Registered Manager moving into another position within the organisation. The deputy manager who has taken over this role is suitably experienced and displays appropriate aspirations to improve the home further. Parents, social workers and staff generally speak positively of the new appointment, the efforts of staff and the way in which the home is run. Three requirements and two recommendations are made as a result of this inspection. The requirements relate to ensuring risk assessments and behaviour management plans accurately reflect the risks young people pose to themselves or others. To ensure incidents that are required to be notified are forwarded to Ofsted; and for an application be sent in for the acting manager to be registered as manager for the home. The recommendations concern the need to regularly record the temperature of the medicines fridge and to continually assess and review the

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Overall effectiveness

routines of the home, notably in respect of fire safety.

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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) appoint an individual to manage the home; in particular ensure if a new manager is in post and is not registered, there is an application in process, received by Ofsted, within 28 days of the appointment (Regulation 7 (1)) 30/11/2013

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Reg. Requirement Due date

(2001) prepare and implement a written policy which is intended to safeguard children accommodated in the a children's home from abuse or neglect; in particular ensure that care plans and assessments accurately reflect the risks young people pose to themselves or others and how staff can reduce such risks (Regulation 16 (1) (a)) 30/11/2013

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Reg. Requirement Due date

(2001) ensure if, in relation to a children's home, any of the events listed in column 1 of the table in Schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table; in particular any serious complaint about the home or persons working there. (Regulation 30 (1)) 30/11/2013

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Recommendations

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

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Recommendations

 ensure risk assessments of the whole children's home environment are carried out, to identify any potential sources of harm to the children are recorded in writing and regularly reviewed; in particular those relating to fire safety and the locking of some internal doors at night (NMS 10.8)  ensure there is a written record of all medication, treatment and first aid given to children during their placement; in particular record the temperature of the fridge used for the purpose of storing prescribed medication. (NMS 6.15)

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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

Outcomes for young people are adequate. Some young people make good progress at the home given their poor starting points. Other young people make less progress and have been involved in potentially dangerous incidents since moving in. Young people are supported to value the importance of a positive self-view with some benefitting from substantially increasing their levels of confidence and self-esteem.

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Outcomes for children and young people

Young people say they like living at the home, with some commenting that it is a 'superb' place to live.

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Outcomes for children and young people

Young people have their health care needs met with additional support provided to them to address their emotional wellbeing. All young people are registered with local doctors, dentists and opticians and are helped to attend all medical appointments. Young people are encouraged to eat healthily and to consider the importance of limiting junk foods which may impact negatively on their existing health conditions. The emotional needs of young people are considered as part of overall care planning. The organisation employs the service of a child psychologist who provides expert advice, guidance and intervention. This ensures young people have appropriate programmes put in place, such as cognitive behavioural therapy to address anger management issues.

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Outcomes for children and young people

Young people are given good support to keep in contact with family, friends and those important to them. Arrangements are made clear within care planning with parents noting that communication from the home is generally good. Young people are encouraged to maintain appropriate friendships with their peers outside of the home which includes having them visit them in the home. This approach supports young people to feel comfortable about living at the home, develops relationships and promotes normality.

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Outcomes for children and young people

Young people have opportunities to address their independent living needs. This includes programmes where they are supported to live on a budget, go food shopping and cook for themselves. Young people say this allows them to learn self- care skills, to take responsibility for themselves and to consider their move away from care.

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Quality of care

Young people share positive relationships with staff and generally make adequate progress as a result; for some young people progress is good. Young people spoke most positively about staff and the care they receive from them. They said staff are, 'caring and thoughtful' and are, 'always around when they need them.’ Meaningful relationships with staff have enabled young people to explore their own, often complex issues, attitudes and behaviours. For some this has significantly improved their levels of self-esteem and self-worth and has allowed them to safely explore issues of personal identity and sexuality. Interactions between staff and young people were relaxed and respectful.

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Quality of care

Young people say they are listened to and confirmed they are able to express their views easily. House meetings take place weekly, with menu and activity planning an obvious way in which young people contribute their opinions to the running of the home.

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Quality of care

An appropriate programme of care planning and review ensures that a vast majority of young people have their specific needs identified and planned for. Such plans generally match the overall aims of the placement and incorporate specific cultural needs which staff follow in practice. Working with families is deemed to be a core part of practice. This is seen in the recent improvements to the care planning process now involving parents in developing and agreeing behaviour management strategies. However, one plan did not confirm the nature of previous self-harmful behaviours and therefore written guidance as to how staff should respond to this issue was unclear. Reviews of care take place regularly, with reports being provided for statutory review meetings. Young people are supported to express their views, both through their attendance and written contributions. Parents and social workers stated that they are kept regularly informed of the progress of young people.

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Quality of care

Young people are offered a variety of activities which incorporate their positive involvement in the local community. These include visits to local places of interest and regular trips swimming which staff play an active role in. Young people with specific interests, such as football, have been encouraged and supported to join local football teams and are given good support to attend and participate. Young people clearly benefit from these activities, which promotes healthy living and aides community cohesion.

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Quality of care

The storage and administration of medication is appropriate, although recording procedures for the keeping of certain medicines could be improved. Young people, where appropriate and subject to risk assessment, are supported to self-administer which enables them to take responsibility for their own medical needs. Medicines are stored safely with administration records being accurate and up to date. The home keep a separate fridge for the storage of specific prescribed medicines. Clear guidance is available as to how these should be maintained including the appropriate temperature. However, there is no written record to confirm this temperature is being monitored.

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Quality of care

The home promote learning and provide a cohesive approach to supporting young people in their education. The organisation have a small independent school which is next to the home. The routines of the home and attitude of staff positively support attendance, with teachers and care staff working closely together to ensure a joined up approach. Young people who arrived at the home with previously poor levels of attendance have been able to considerably improve this. Good links with other educational establishments result in older young people moving onto college where they engage in vocational courses which matches their choices and future plans.

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Quality of care

Young people benefit from living in an environment that offers them a suitable standard of accommodation. Communal areas are comfortable being appropriately decorated and furnished. Young people are able to personalise their bedrooms and do so in choosing the colours of the décor, putting up posters and photographs. Since the last inspection improvements have been made with several areas being redecorated. Young people commented that the acting manager has introduced more pictures, shelving and ornaments which they feel is more 'homely'.

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Safeguarding children and young people

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

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Safeguarding children and young people

The home are adequate at keeping young people safe. Young people say they feel safe and confirmed they are provided with help to consider their challenging and risk taking behaviours. Staff promote appropriate behaviour and impose boundaries which are firm but fair. For some young people this has resulted in positive outcomes. However, other young people have displayed dangerous behaviours in the home leading to their arrest for serious offences.

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Safeguarding children and young people

The home has an appropriate recruitment process which includes completing the necessary checks for prospective employees before they commence work. Following the last inspection the recruitment policy has been updated to make the process more explicit, notably in regard confirming any gaps in employment. No new staff have been employed.

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Safeguarding children and young people

A suitable approach towards safeguarding ensures young people are protected when concerns arise. Staff receive training in child protection and display a sound understanding of safeguarding matters. When issues occur swift and appropriate actions are taken including notifying the relevant safeguarding agencies. One child protection concern arose since the last inspection which was unfounded. Interventions were appropriate and ensured the safety and wellbeing of all. However, this matter was not notified to Ofsted as required in relation to a serious complaint against a person working in the home.

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Safeguarding children and young people

Strategies to reduce the risks young people may present to themselves or others have a varied level of success. For some, programmes of intervention have led to improved outcomes, including considerably reducing the occasions they run away from care. However, for other young people the approach in managing their challenging behaviours has been less productive. In these instances they have engaged in offending behaviours including the setting of small fires in the home; this subsequently led to their arrest and charge. The home have acted swiftly in these matters and have involved the local fire safety service in providing young people with sessions to address the risks of fire setting. Young people attending this programme said it was, 'very helpful'; no further episodes of a similar nature have taken place. Despite the appropriate and supportive response to this incident, such behaviours must be seen as placing the safety of all those living and working at the home at risk

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Safeguarding children and young people

Young people are encouraged to treat each other with respect and understanding. Bullying is not identified as a problem in the home and no young person raised concerns that they were experiencing prejudice or intimidation. Suitable staffing levels further reduce the risks that any incidents would go unnoticed.

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Safeguarding children and young people

The approach towards assessing the problematic or risk taking behaviours of young people is inconsistent. For the most part each young person has a detailed risk assessment and behaviour management plan which highlights their challenging behaviours. Reviews of assessments and their effectiveness occur regularly, while specific incidents are reviewed by the management team. However, risk assessments did not accurately reflect the levels of behaviour exhibited, notably the recent incidents of fire setting in the home. Similarly a behaviour management plan, although identifying a previous issue of self-harm, did not then confirm the context of what this actually concerned. Staff confirmed they were aware of the nature of these behaviours and how they are working to reduce the risks of them reoccurring. However, these shortfalls pose a risk that new or temporary staff would not be so informed as to how to meet all the challenging behaviours of young people.

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Safeguarding children and young people

All staff are trained in the use of physical restraint and have recently undertaken refresher courses. The number of occasions when staff use physical interventions has reduced to a low level. Records accurately reflect the nature of the incident and it's outcome. A new format has recently been introduced which provides an improved document for recording such events. This includes a section to confirm that medical assistance was offered to young people after each incident. Since the last inspection no physical interventions have involved the use of floor restraints. Staff display a clear understanding that restraints are only used as a last result. No young person raised concerns that physical interventions were inappropriately used.

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Safeguarding children and young people

A suitable sanctions policy and procedure is in place which is implemented in practice. Young people are made aware of the consequences of their actions and when appropriate are given sanctions for unacceptable behaviour. Records clarify the reasoning behind any sanction, including the views of young people.

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Safeguarding children and young people

Health and safety is given an appropriate priority, although the locking of some internal doors at night should be reviewed. The recent incident of fire setting confirmed that fire safety equipment works as required with the homes sprinkler system being activated to put out the fire swiftly. The local fire and rescue service praised the actions of staff during this incident with all evacuation procedures being effective and professional. The homes fire risk assessment confirms evacuation routes and that 'sleep in' staff must keep a key on them should they need to use the second route through the kitchen door; as this internal door is locked once young people settle to bed. The fire safety service acknowledged this was appropriate practice but noted further expert advice would be beneficial; an appointment was made for the local fire safety team to visit the home and assess this process. The servicing of gas and electrical appliances occur routinely.

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Leadership and management

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

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Leadership and management

The home is suitably run within an ethos that aims to meet the individual needs of young people. Since the last inspection the home has experienced a period of transition with the appointment of a new acting manager. The Registered Manager has recently moved to take up a more strategic role within the organisation. Although the process of obtaining all the necessary information is nearing completion, as yet the required application has not been received by Ofsted for the acting manager to be registered. The acting manager has considerable experience within the residential child care arena, notably at this home. She clearly understands the strengths and weaknesses of the service and displays appropriate aspirations to improve further. Shortfalls identified at this inspection relate predominantly to documentation and failing to follow due processes. This includes a failure to notify Ofsted of a serious complaint against a member of staff. Feedback regarding the

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Leadership and management

impact the acting manager has had on running the home from staff, social workers and young people is positive.

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Leadership and management

All requirements and recommendations made at the last inspection have been met and addressed. The use of restraint has significantly reduced, with staff receiving updated training in the model of physical intervention adopted by the home. Policies and procedures for restraint have been reviewed with staff displaying a clear and appropriate appreciation of when such measures can be used. Newly implemented documents provide an improved format for recording matters of restraint and sanctions; visits carried out in relation to Regulation 33 now include a review of these documents. Key documents have been amended to evidence that all those responsible for a young person’s care and wellbeing, agree with placement and behaviour management plans. The homes recruitment policy has been updated to reflect the need to capture all relevant information.

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Leadership and management

A suitable process of monitoring is in place to ensure standards of care are routinely assessed. These include the manager completing six monthly reviews of all areas of care provision and evaluating the impact this has on the progress made by young people. An experienced child care consultant completes monthly inspection visits as required. The inspections provide an appropriate critique of the home that includes consultation with young people and areas for improvement.

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Leadership and management

Young people are cared for by a suitable number of staff who are committed to meeting their individual needs. Many of the staff team have worked at the home for a number of years and are experienced in working with particularly challenging young people. Staff say they receive a good quality of training and formal supervision which assists them to work to the best of their abilities. Social workers and parents say staff are, 'lovely' and 'committed' in their approach to caring for young people. A majority of records are well maintained and present an accurate picture of the life of young people as they progress in their placement. However, a number of shortfalls, as previously noted, have resulted in gaps in care planning and assessment.

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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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