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

Inspection report children's home: SC010699 1 SC010699 Registered provider: Turning point

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

A private provider owns and operates this home. The registered manager is also the registered provider. The home provides care for five young people who have emotional and/or behavioural difficulties.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 5 September 2016

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requires improvement to be good

Overall judgement at last inspection: Sustained effectiveness

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Key findings from this inspection

This children’s home requires improvement to be good because Inspection report children's home: SC010699 2  Poor staff retention has unsettled young people.

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Key findings from this inspection

 Inconsistent behavioural management fails to offer structure and routine to young people.

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Key findings from this inspection

 Poor succession planning in the management team has caused drift, delay and uncertainty in the home.

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Key findings from this inspection

 Poor record-keeping and a lack of thorough risk assessment mean there is a failure to chart the progress and welfare of young people.

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Key findings from this inspection

 Managers have failed to update key policies and guidance. This results in limited information for staff and placing professionals.

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Key findings from this inspection

 A warm friendly, family-style environment where staff strive to support young people.

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Key findings from this inspection

 Young people reduce risk-taking behaviour, such as offending and absconding from the home.

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Inspection date Inspection type Inspection judgement

05/09/2016 Interim Sustained effectiveness 11/04/2016 Full Good 02/12/2015 Interim Declined in effectiveness 07/07/2015 Full Good Inspection report children's home: SC010699 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. (Regulation 12(1) and (2)(a)(i))

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Requirement Due date

In particular, in relation to the lack of specialist risk assessments relating to young people at risk of child sexual exploitation. 16/06/2017

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Requirement Due date

The registered person must maintain records (‘case records’) for each child which— are kept up to date. (Regulation 36(1)(b)) 16/06/2017

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Requirement Due date

The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard, the registered person must ensure— that the premises used for the purposes of the home are designed and furnished to meet the needs of each child. (Regulation 6 (2)(c)(i))

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Requirement Due date

In particular, the damage to the living-room ceiling and the hallway wall 16/06/2017

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system of monitoring, reviewing and evaluating— the quality of care provided for children; 16/07/2017 Inspection report children's home: SC010699 4 the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and any actions that the registered person considers necessary in order to improve or maintain the quality of care provided to children. (Regulation 45(2)(a)(b)(c)(d)) Behaviour management policies and records

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out— how appropriate behaviour is to be promoted in the children’s home. (Regulation 35(1)(a))

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Requirement Due date

In particular, the need for staff to have clear guidance concerning room searches. 16/07/2017

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Requirement Due date

The registered person must review the appropriateness and suitability of the location of the premises used for the purposes of the children’s home at least once in each calendar year, taking into account the requirement in regulation 12(2)(c) (the protection of children standard). (Regulation 46 (1)) 16/07/2017

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Requirement Due date

The registered person must give notice in writing to HMCI, as soon as it is reasonably practicable to do so, if any of the following events take place or are expected by the registered person to take place— a person other than the registered person carries on or manages the children’s home. (Regulation 49(a)) 16/07/2017

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Requirement Due date

The independent person must produce a report about a visit (‘the independent person’s report’) which sets out, in particular, the independent person’s opinion as to whether— children are effectively safeguarded; and the conduct of the home promotes children’s well-being. (Regulation 44(a and b)) 16/07/2017

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Recommendations

 Staff should continually and actively assess the risks to each child and the arrangements in place to protect them. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)

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Recommendations

 Devise a workforce plan which can fulfil the workforce-related requirements of Inspection report children's home: SC010699 5 regulation 16, schedule 1 (paragraphs 19 and 20). The plan should: detail the necessary management and staffing structure (including any staff commissioned to provide health and education), the experience and qualifications of staff currently working within the staffing structure and any further training required for those staff, to enable the delivery of the home’s statement of purpose; detail the processes and agreed timescales for staff to achieve induction, probation and any core training (such as safeguarding, health and safety and mandatory qualifications); detail the process for managing and improving poor performance.

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Recommendations

The plan should be updated to include any new training and qualifications completed by staff while working at the home, and used to record the ongoing training and continuing professional development needs of staff – including the home’s manager. This is also with reference to ensuring staff are trained in the risk posed by radicalisation and refresher training in safeguarding. (‘Guide to the children’s homes regulations including the quality standards’, page 53, paragraph 10.8)the risk

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Recommendations

 Ensure that the registered person and staff work closely with the placing authority so that the young people are supported and enabled to resume full-time education as soon as possible. The focus should be on the provision of support to sustain or regain young people’s confidence in education and engagement in suitable structured activities (‘Guide to the children’s homes regulations including the quality standards’, page 27, paragraph 5.5)

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Recommendations

 Demonstrate that every effort is made to achieve continuity of staffing to prevent disruption to children’s attachments (‘Guide to the children’s homes regulations including the quality standards’, page 51, paragraph 10.1)

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Recommendations

 Monitor and review the patterns and trends of turnover of staff, whether agency or directly employed, and be able to understand and where possible address any trends. (‘Guide to the children’s homes regulations including the quality standards’, page 54 paragraph 10.19)

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Recommendations

 Ensure that staff make a full and valuable contribution to the pathway planning process. They should actively seek to make the fullest contribution by working with relevant persons. (‘Guide to the children’s homes regulations including the quality standards’, page 17, paragraph 3.28)

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Recommendations

 Ensure the children’s guide contains contact details for the Office of the Children’s Commissioner. (‘Guide to the children’s homes regulations including the quality standards’, page 23, paragraph 4.23)

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Recommendations

 Challenge the child’s education provider if the child does not receive sufficient support to progress as outlined in their relevant plans. Act as effective advocates for or on behalf of a child who may be experiencing difficulties with education, as a good parent would do. (‘Guide to the children’s homes regulations including the quality standards’, page 27, paragraph 5.12) Inspection report children's home: SC010699 6

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improvement to be good

Young people are happy in their home. One commented, ‘The staff are cool here.’ Young people also feel that the home is well situated, offering good transport links and a suitable distance from ‘bad people from the past’. Young people report that there are good levels of staff support and proactivity. Staff recently supported a successful application for employment for a young person. Despite recent staff upheaval, young people build trust with staff and are able to express their feelings in an open and honest fashion. Staff engage young people in shared entertainment, such as card games, to promote a family-style atmosphere. Young people report that there are a good range of activities and recently enjoyed a three-night holiday at the seaside with the staff team.

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improvement to be good

Feedback from placing professionals is positive. They report that young people make progress in developing their social skills and begin to ‘come out of their shell’. Young people learn new skills, for example, an improved awareness of consequences. Case records show some young people learning to remove themselves from potentially risky situations and encouraging their peers to follow staff direction, where previously they would have placed themselves at risk.

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improvement to be good

Professionals refer to the ‘stickability and persistence’ of the staff and their passionate desire to improve outcomes for young people. This is reflected in improved outcomes for young people. Two moves, including a young person’s successful rehabilitation home, have occurred since the last inspection. One of these young people remains in contact with the staff team.

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improvement to be good

Educational attainment is mixed. Staff strive to offer a range of educational opportunities and mentoring provision with limited success. Despite tutors visiting the home, some young people do not engage on a sustained basis. The allocated tutor reports that one young person only attends 40% of planned sessions.

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improvement to be good

Behavioural expectations are not consistently enforced. During the two days of the inspection, young people were in their rooms playing on games consoles while their tutors were on-site waiting for them too engage in education. Furthermore, young people were given pocket money from staff during the same period and then returned directly to their rooms without prompting from staff to attend education.

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improvement to be good

Behavioural management is ineffective. Despite not being in full-time education, some young people lack structure and routine to their day. Young people do not take regular exercise. Staff do not provide daily planners or effectively incentivise engagement. This limits the breadth of experience and stimulation offered to young people. Young people are open and candid about their cannabis misuse. Staff do not challenge this effectively and there is no guidance offered as to the potential use of room searches. As a result, the progress of young people is limited. Inspection report children's home: SC010699 7 Independence planning is inconsistent. Some young people lack structured work around budgeting and cooking. In addition, staff do not challenge placing authorities effectively when delays occur in the pathway planning process. This means that young people are not effectively prepared for transition from the home.

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improvement to be good

The voice of young people is heard. Residents’ meetings occur regularly and young people support staff in planning activities and the weekly menu. When complaints occur, managers investigate thoroughly and take the time to write formal responses. This promotes a climate of mutual respect and ensures that young people feel listened to. However, the young person’s guide does not contain the contact details for the Children’s Commissioner. Therefore, an opportunity to promote increased independent support and advocacy for young people is lost.

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improvement to be good

Staff ensure young people have access to healthcare services and promote the importance of sustained engagement. Young people recognise this and participate well. Referrals to child and adolescent mental health services are made in a timely fashion. Specialist help comes from professionals, such as a drugs counsellor and a sexual-health nurse, who support staff in offering a holistic range of support options to young people.

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improvement to be good

Young people’s culture and difference are supported by life story work. Staff encourage young people to maintain close relationships and direct contact with friends and family, where appropriate. Visitors are encouraged to attend the home. This helps to limit levels of missing behaviour and helps young people to make sense of previously difficult life histories.

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improvement to be good

Young people feel safe in their home. There are no reports of bullying. When in distress, young people feel able to communicate with and confide in staff members. Staff follow the correct safeguarding procedures promptly and liaise effectively with the wider professional network. This ensures the safety of young people.

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improvement to be good

Staff do not advocate consistently for young people. They do not offer effective challenge to placing local authorities when care planning is considered not to be meeting the needs of young people. For example, there is no record of challenge when tuition support levels commenced at four hours per week for one young person. This limits the scope of the placing authority to take effective action and the progress achieved by young people.

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improvement to be good

Behavioural goals are not reviewed regularly and do not reflect the high risk posed by cannabis misuse in the home. In addition, key risk assessments, such as those referring to the risk of child sexual exploitation, are not completed. This limits key information for all of the relevant professionals and means the progress of young people is difficult to chart. Inspection report children's home: SC010699 8 Young people reduce risk-taking behaviour. They learn to manage their own anger through simple and effective techniques, such as changing their breathing patterns when they feel stressed or upset. Case records show young people recognising the effect of their own actions, apologising to staff and proposing to help repair any damage caused to the home.

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improvement to be good

Levels of missing behaviour have reduced. Young people receive help from staff to develop an understanding of the dangers posed by spending time away from the home. Local police report that they have close liaison with, and confidence in, the staff team. When young people leave the home they remain in consistent phone contact with staff. Staff are attentive to their whereabouts. Their location is monitored through effective liaison with family members. When missing behaviour occurs, staff ensure that young people receive an independent return to care interview and any resultant information is shared with key professionals.

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improvement to be good

Staff strive to consistently manage the behaviours of young people when they struggle. There is no restraint use in the home. Staff attempt to celebrate good behaviours by the giving of certificates. Conflict management works well. Staff focus on limiting the use of police as a behavioural management tool and thus avoid the unnecessary criminalisation of young people. This promotes trusting relationships in the home.

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improvement to be good

The young people have use of the internet at the home. E-safety is provided through parental controls and filters, which protect the young people’s associated online risks.

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The effectiveness of leaders and managers: requires improvement to be good

Succession planning in the management team is poor. The registered manager is also the owner of the home. Two years ago, the plan was for her to retire and pass management control to her son. She will remain as the responsible individual. In April 2017, she passed direct management of the home to her daughter and installed her as interim manager. Ofsted was not notified of the change of management and she remains as the registered manager. This results in confusion for young people and a lack of clear direction for staff.

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The effectiveness of leaders and managers: requires improvement to be good

Effective scrutiny from the independent visitor is lacking. Recent reports do not evaluate the safety of young people and the impact of the home on their progress. This limits the development and progress of the home.

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The effectiveness of leaders and managers: requires improvement to be good

The home environment is poorly maintained and unsafe. A corner patch of the living- room ceiling is missing and damage to the main hallway wall presents a health and safety risk to young people. This offers a poor impression of the home to young people.

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The effectiveness of leaders and managers: requires improvement to be good

Management oversight of case files is poor. The case recordings in the home are often absent and lack analysis and depth. The case filing system does not allow for easy access to information. This means that the progress of young people is difficult to assess Inspection report children's home: SC010699 9 and that important information may be lost.

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The effectiveness of leaders and managers: requires improvement to be good

Key management documents are missing. This includes a workforce development plan, a behavioural management policy and a management review of care arrangements. In addition, the assessment of the risk of the local community lacks evaluation and key information regarding areas of concern. The behavioural policy is out of date and requires revision. These documents are integral to the future development of the home, as they offer guidance to staff and promote the safety of young people.

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The effectiveness of leaders and managers: requires improvement to be good

The interim manager has over 21 years of experience in residential care and is due to complete the relevant level 5 qualification in December 2017. She has updated the statement of purpose during the course of this inspection. The interim manager is committed to addressing the homes shortfalls and regrets the re-emergence of previous concerns relating to issues such as the lack of independence planning.

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The effectiveness of leaders and managers: requires improvement to be good

The staff team is new and inexperienced. Only two permanent staff members remain from the last full inspection, with a large staff turnover having occurred. In the intervening period, managers have taken strong action to address performance-related issues within the staff team. Despite the safe and well-planned recruitment of four new permanent staff members, young people report feeling confused and disorientated by the loss of key professionals and key workers. Managers have failed to fully evaluate the reasons behind the staff turnover and exit interviews were not completed.

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The effectiveness of leaders and managers: requires improvement to be good

The interim manager is popular with the staff team and young people. She consistently interacts well with young people and has a clear grasp of their needs and their relationships with the staff team.

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The effectiveness of leaders and managers: requires improvement to be good

Staff report good levels of management support and a well-planned induction process Extra support is provided to staff in key areas such as report writing. Training is sourced from both the host local authority and a private provider. Training is described by staff as ‘really good and interactive’ and supervision is described as being both regular and effective.

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The effectiveness of leaders and managers: requires improvement to be good

Admissions are well handled. The home has not admitted any young people for six months and has continued with two vacancies. Risk assessments carefully match the needs of prospective new young people to the needs of young people already resident in the home. Careful thought is given to age and previous care history. Despite the staffing upheaval, this offers a degree of stability for young people.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In Inspection report children's home: SC010699 10 addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children's home: SC010699 11

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Inspector

Barnaby Dowell: social care inspector Inspection report children's home: SC010699 12 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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