Statement of Purpose - nestlingscare.co.uk … · Web viewBest Practice guidelines (e.g. NICE)...

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Higher Tunshill Farm

Specialist therapeutic and rehabilitative placements for Children (10-18)

Statement of Purpose“Safety, empowerment and independence achieved by opportunity and choice, facilitated in a homely environment with excellent standards of care and committed staff team”

Registered Provider Nestlings Care Ltd

Responsible individual Anthony Thompson

Manager Jenny Thompson Kavanagh

Date of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations

© Nestlings Care Limited

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CONTENTS:

QUALITY AND PURPOSE OF CARE

1. The range of needs of the children for whom service is intended to provide care and accommodation

2. Aims, Objectives, Philosophy, Ethos and Vision

3. Location and Facilities To Be Provided by Nestlings Care LTD

4. Arrangement For Children to Attend Cultural, Religious and Linguistic needs of Their Choice

5. Arrangement for Dealing with Complaints

6. Safeguarding Children Policy

7. Behaviour Management Policy

VIEWS, WISHES AND FEELINGS:

8. Consultation Procedure Regarding Operation of Higher Tunshill Farm

9. Diversity and Inclusion including Advocacy Services

10. Privacy and Dignity

11. Equalities Policy.

12. Personal Belongings

EDUCATIONS:

13. Promoting educational attainment & Supporting Service Users with Special Educational Needs

ENJOYMENT AND ACHIEVEMENT:

14. Arrangements For Educational, Creative, Intellectual, Physical Social Activities, Hobbies & Leisure Interests

HEALTH:

15. Health and Wellbeing

16. The Mental Health Team

17. Medications

POSITIVE RELATIONSHIPS:

18. Arrangements for contact between Service Users and Carers and Friends

PROTECTION OF CHILDREN:

19. Monitoring

20. Sanctions/Consequences

21. Approaches to Physical InterventionDate of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations


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LEADERSHIP ANF MANAGEMENT:

22. Relevant Qualifications And Experience Of The Registered Manager

23. Relevant Qualifications and Experience of Responsible Individual / Nominated individual

24. The Number, Qualifications and Experience of Staff Employed in The Home

25. Organisational & Governance Structure

CARE PLANNING:

26. Range of Needs that Nestlings Care Ltd is intended to Meet

27. Referral and admission Criteria and Process

28. Arrangements for Dealing With Review of the Service User’s Plan



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1. Range of needs of children intended to provide care and accommodation:

Higher Tunshill Farm is part of Nestlings Care LTD, organisation-offering specialist therapeutic and

rehabilitative residential placements for young people with complex mental health problems and

challenging presentations with risks to self and others.

Higher Tunshill Farm will offer placements for young people of mixed gender, aged between 10-18

years. The placements aim to offer specialist care and treatment and management by a highly skilled

team made up of a Registered Manager, Registered Mental Health Nurses, Residential Support

Workers, Clinical psychologist, Psychodynamic Psychotherapist and Consultant child and adolescent

psychiatrist. The service aims to offer safe and comprehensive care in the community in partnership

with carers, stakeholders and other agencies. The team has specialist expertise and skills in

Depressive Disorders, Psychotic illness, neurodevelopmental disorder; Autistic spectrum disorders,

Attachment problems and Emerging Emotionally unstable personality disorders with complex co-

morbid challenging presentations; risk of aggression and self-harm.

The team at Higher Tunshill Farm has extensive social care, clinical, operational and management

experience in the provision of mental health care in children and adolescents in inpatient settings

and residential care. Through these strengths Nestlings Care LTD aims to become the leading

provider of specialist residential placements for young people in the North West.

Higher Tunshill Farm is registered with Ofsted and CQC in order to promote and provide evidence

based high standards of mental health and social care for young people in a homely environment,

which offers emotional, relational and environmental security.

2. Aims, Objectives, Philosophy, Ethos and Vision:

Provision of specialist residential care service working in partnership with young people and all

relevant agencies with 24 hour support from consultant psychiatrist and registered mental health

nurse, providing a level of comprehensive care which will differentiate Nestlings Care LTD from

other providers.



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The aim is to comply with and exceed all regulatory and statutory requirements and standards,

which are achieved through the core objectives identified by the company are as follows:

To provide specialist multidisciplinary holistic assessment and management of young person’s

needs and risks with comprehensive care planning, key working and specific interventions suited to

individual needs, diversity and risks.

All relevant care plans will be individualised and will be developed in conjunction with young people

and carers.

Each young person will have a identified key worker from the staff team to develop trusting

relationships centred on the needs of the young person, their hopes and aspirations, to ensure a

high quality, holistic and consistent approach.

Facilitating optimal recovery with young person and carer, measured through young person and

professional rated health outcomes.

Achieve an excellent standard of care for young people by receiving feedback from young people,

carers/parents and stakeholders through questionnaires and feedback developing innovative ways

of working to facilitate rehabilitation.

To foster independence by being responsive to the young person’s ideas, views, wishes and

respecting their potential.

Working closely with parents / carers to build on protective factors, strengths and potential for

improvement. A great emphasis is placed upon the involvement of family, other carers and

significant people in the life of the young person. Key workers will establish and maintain regular

contact with family, carers or any other significant relationships and offer support and psycho

education with a view to rebuilding their relationships in order for the young person to return home.

Working in collaboration with local authorities, CAMHS, commissioners and relevant agencies in

order to offer seamless, timely and comprehensive packages of care for young person into early

adulthood. To seek advice or support, when necessary, from Educational Welfare Officers, the

Police, the Youth Offending Service, Community Projects which support Black and Minority Ethnic

People, Youth Link, the Voice of the Child in Care, MASH and others.

To encourage young people and enable them to access full time education or vocational placement

including monitoring attendance and achievement. Also we provide Homework facilities on site and

promote a sense of achievement within the young person’s Personal Education Plan.

Standard of care and provision of individualised care to be regularly assessed and reviewed through

Governance framework and audits to ensure that regulatory standards and organisations aims are

maintained through robust clinical governance structure.



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Within the Governance framework the team takes “reflective and learning approach” toward any

incidents that may occur or any complaint. Any further training or development if highlighted will be

provided.

To ensure that the young people are protected under safeguarding policy and every staff working

will have safeguarding training. The staff will be provided with guidance regarding reporting and

safeguarding concerns.

Safe recruitment with robust recruitment and vetting processes to be in place.

The new staff will be offered induction programme prior to undertaking any duties and will have an

identified Mentor from the staff team.

To ensure right staff skill mixes are available to meet young people’s needs by investing in staff

development to provide a progressive and expert workforce. To value each of our staff equally for

their expertise and experience they bring to the team and to provide our staff with a working

environment within which effective teamwork, where appropriate, and personal and group

development are actively encouraged and supported.

Team will work cohesively to maintain and improve standard of care for the young people through

staff meetings, training and supervisions.

Our Ethos and Vision is:

To protect young people from any harm

To offer loving, consistent and thriving environment.

To value young people and nurture each young person individually with their strengths and

capabilities.

Attentive to children’s need, supporting emotional, mental and physical health needs, including

repairing earlier damage to self-esteem and encouraging friendships.

To meet additional standards of quality assurance and other specialist accreditations.

To treat service users with dignity and respect at all times.

To provide a safe and therapeutic environment and bespoke model of care.

To use evidence based treatment and individualised care plans.

To understand and meet young people’s, carer’s and stakeholder’s needs on a timely basis.

To consult with young people about decisions which affect them and keep carers, staff and

purchasers informed of decisions in an open and honest way.

To comply with and exceed all regulatory and statutory requirements.



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To offer value for money services and offer competitive terms and conditions to our staff.

Encourage teamwork, personal growth and development to our staff through training and

supervision and opportunities to progress.

To enrol with Apprenticeship Programme to transfer skills and offer opportunities to engage

local youth and individuals to develop career choices.

Increase the provisions of specialist healthcare services in the community for young people

across the UK.

To develop further services for 18-21years old young adults to have seamless transition in

community.

3. Location and Facilities To Be Provided by Nestlings Care LTD

Higher Tunshill Farm is a spacious dwelling set in a remote yet idyllic location, with secure gated

entrance with private garden and with the addition of private secure land. There are 4 bedrooms offering

maximum of 3 placements for young people depending on their needs. Tunshill Farm offers modern

accommodation whilst retaining a homely appearance that retains character; the home has been built to

the highest standards. The facilities also include a large living and dining area, a separate small

office/Store, and a large and bespoke modern kitchen with dining facilities, away from the kitchen is a

separate office area. There are 2 large en-suite bedrooms, and a further large bedroom, which is

accommodated by a large and modern bathroom, that is accessed via the main landing. All rooms are

tastefully furnished to a high standard, providing television point and computer access points with WIFI

available throughout the home.

All exits from the house are monitored in order to safeguard young people. The local amenities and

facilities within the local town of Milnrow town centre are within a five minute drive, with the larger towns

of Oldham and Rochdale close at hand, slightly further afield the city of Manchester is less than thirty

minutes away.

Each young person has their own private bedroom, and will be given a key to that room depending on

risks assessment and agreement with young person. Spare keys will be kept by staff in a key safe in

the Manager’s office and would only be used in an emergency. Young people will have free access to

all communal areas of the home.



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We will always try to allocate the room that each individual has expressed a preference for, although

this is largely dependent on availability at the time of admission and subject to any specific risk

assessment etc. Should an individual wish to change rooms at a later date, or a room which is more

suitable becomes vacant it is possible to relocate at that time.

Higher Tunshill Farm provides extensive accommodation including:

A lounge and reception area

3 double bedrooms (2 en-suite)

Main bathroom

Downstairs cloakroom

Secure gardens and land

4. Arrangements for Service Users to attend Religious Services of their Choice:

All young people have the opportunity to attend religious services of their choice. The religious beliefs of

a young person and their request to attend religious services will be respected and all young people will

be supported to attend to their religious or cultural needs within the home, as appropriate within a

communal residence or in the community.

5. Arrangements for Dealing with Complaints: The following guide is available to individual young people:

At Higher Tunshill Farm, the team strives to ensure that in your dealings with us, you will find our staff

and services meet with both your expectations and your approval.

If ever these standards fall below that which you find acceptable, or if there is anything else that you are

unhappy about, we would ask that you tell us as soon as possible.

If you wish to complain about anything that you are unhappy about (either a formal or informal

complaint), you should:



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1. Tell a member of staff that you wish to complain or, write your complaint either on a Complaint

Form (available from staff) or in a letter to Registered Manager.

2. The Manager will acknowledge your complaint within 2 days.

3. The Manager will inform you of how the complaint is to be handled and who will carry out

investigations into your complaint.

4. Your complaint will investigated and the findings reported back to you within 20 days from the

Manager receiving it.

5. If it is not possible to complete the report within 20 days, you will be kept informed of the

progress and the likely completion date.

Ofsted:Ofsted

Piccadilly Gate

Store Street

Manchester

M1 2WD

Telephone: 0300 123 1231

Email: [email protected]

Care Quality CommissionCity Gate

Gallowgate

Newcastle upon Tyne

NE1 4PATel: 03000 616161Fax: 03000 616171Email:[email protected]

6. When your complaint has been investigated you will be invited to meet with the Manager and /

or the investigating manager to discuss the findings of the complaint.

7. You have the right to appeal against the findings of the investigation.

8. You have the right to refer your complaint to the Responsible Individual, Ofsted and the Care Quality Commission at any stage of your complaint.



mailto:[email protected]

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6. Safeguarding Children Policy:

Nestlings Care is committed to effectively protect every young person who is cared in any of our

provisions. Child protection is a part of safeguarding and promoting the welfare of children. It refers to

any activity that is undertaken to promote welfare and protect specific children who are suffering, or are

likely to suffer, significant harm. Nestlings Care aims:

To ensure that young people cared for in any of Nestlings Care provisions are protected from

any significant harm.

To ensure that all young people cared for at Nestlings Care provisions are entitled to

unconditional right to be kept safe and free from Harm.

To ensure that Nestlings Care meets the expectations set out by of Children’s Act

1989 and 2004, Education Act, Working together to safeguard children 2013, The

United Nations ‘Convention of Human Rights of the child 1989, The Human Rights

Act 1988 Article 3 and Children’s home Regulations and Quality standards.

Nestlings Care is committed to safeguarding and promoting the welfare of children and young people

and vulnerable adults therefore recruitment and selection to be conducted in accordance with the

Safeguarding children: Safer recruitment and selection in education settings good practice guidelines.



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A copy of the LSCB, Safer Working Practice for Adults who work with Children & Young People is

available in the office, along with contact details for the LSCB. Staff will receive Child Protection

guidance and training at Induction, and will read and sign that they have read all the Policy &

Procedures for the home.

Links will be made with the Missing From Home Co-ordinator, and clear procedure guidelines in place

should a young person go MFH, will be displayed in the office.

A copy of Safeguarding Children & Young People from Sexual Exploitation supplement guidance for

Working Together to Safeguard Children is displayed in the home, along with telephone numbers for the

relevant CSE team.

Written records will be made of all circumstances of any children & young people who may abscond or

go missing from home, all action taken by staff, the circumstances of the return, any reasons given by

the young person, and any action taken.

Any notification of Significant Events will be made within 24 hours to all relevant parties.

7. Behaviour Management Policy:

Nestlings Care provisions aims to provide a sensitive, supportive environment for young people

described as having mental health, emotional and challenging behavioural difficulties. Our aim is

to engender equality of opportunity and maximise the potential for integration into mainstream

society.

Traumatic early life experience can lead to young people developing coping mechanisms, which

can present at times, in forms of anti-social and challenging behaviour.

In order to respond appropriately to young people who are looked after, exhibiting such

behaviours, staff need to understand their own emotional manifestations within the complex task

of caring for and controlling emotional and behavioural difficulties.

Staff will be skilled in self-awareness and evaluation, in order to deal positively and competently

with problematic situations. Every effort must be made to develop strategies for early



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intervention, in an attempt to de-escalate potentially violent incidents and positive methods of

control will be encouraged.

By providing a positive, supportive and safe environment, staff may be able to divert a young

person’s energies away from destructive and negative behaviour without the need for physical

intervention.

Staff at Higher Tunshill Farm will always ensure that young people understand the rationale for

any decision or intervention, so that they don’t feel disempowered, and are given equal

opportunity for change in their behaviour.

Higher Tunshill Farm has a Behaviour Management programme that incorporates having one to

one time with individual young people at the home. This is based on how, as a team, we can

come up with strategies to maintain a calm atmosphere; the young people have participated in

creating individualised Behaviour Management Plans which enable staff to understand the

young person’s behaviour, enabling them to deal with it more appropriately.

All staff at Nestlings Care Provisions will undergo Disclosure and Barring Checks.

Interview Process incorporates Value Based Questions in order to assess values, experiences

and attitude of potential employee.

Staff Team to have mandatory Safeguarding Children at induction training prior to

commencing any direct contact with young people in Nestlings Care provisions.

Staff will receive Team Teach training

Staff to adhere to safe caring policy and minimise physical contact with young people.

Each staff Member to have clear understanding of their responsibility in relation

reporting to any disclosure of abuse, documenting, reporting and to ensure that any

allegation is managed appropriately.

An Audit of Safeguarding processes will be carried out on all sites at least every 6 months.

The results of the Audit will be discussed at Integrated Governance meetings and an action plan

will be developed as required.

8. Consultation Procedure Regarding Operation of Higher Tunshill Farm:

Young People are expected and encouraged to participate in their individual therapeutic programme as

well as participating in the recreational activities of the home. The Team will encourage them to express

their views on the various aspects of living at Tunshill Farm through Key worker sessions and Children’s



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Meetings provide a forum for this which ensures that each individual has a “voice” on how their care is

provided. These meetings are documented and the records of such meetings posted in the home.

The meetings will be informal in nature to encourage young people to talk openly and freely, however

there are ground rules and a pre-identified agenda to ensure that there is productivity to the meetings.

Monthly Clinical Governance and Health and Safety meetings will be held at Higher Tunshill Farm, a

representative from young people (if appropriate and possible) will be invited to attend, where

individuals are able to represent the views of peers. Both Service Users and Carer can put forward

ideas and suggestions for improvement in services that we provide and these will always be given

consideration, and where possible these will be implemented. However, it may not always be possible

to respond positively to all suggestions made, in which case we will provide a reason why not.

A newsletter will be completed by the young people in the home where appropriate, this will be an

update of what the young people have been doing and it will be sent out to community, parents and

carers, local authority and to inspectorate bodies.

From time to time we will actively seek service users’ views on how we are providing for their needs.

This will be done by issuing a ‘feedback Questionnaire” that we will ask service user and carer, to

complete and return to us. Individuals may ask a member of staff to help them complete the form if they

wish.

The results of our service users surveys will be included with the Service Users Guide which is given to

every new service user and available from staff on request.

Each month an unannounced visit takes place by a member of the clinical or operational management

team, at which Residents are consulted regarding their views.

All such visits are documented and comments analysed to see if improvements to the service can be

made. The service will benefit from audits being examined by the Nominated Individual. This person will

visit regularly to ensure appropriate supervision and support is available to the manager and that the

Company is advised as to operational development.

9.Privacy and Dignity:Date of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations


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Each young person will retain the right to be treated: as an individual, with care, consideration,

dignity, courtesy and respect at all times, irrespective of ethnic origin, gender, sexual orientation

religious beliefs or the nature of any health problems.

No consultation or treatment will be carried out in a communal area and young person has the right to

choose to be accompanied at all consultations, examinations and treatments. This choice extends to

choice of gender of staff that carry out treatment or personal care, however young people are advised

that it may not always be possible to ensure that staff of a chosen gender are available at that time and

a period of delay might result.

It is the right of each young person to exercise their preference for privacy. This is acknowledged and

appropriate measures are implemented by staff in order that the Children wishes concerning their

privacy are respected. The home will not routinely restrain young people and has a “No Seclusion”

policy.

All our policies and procedures have been written to reflect current “best practice” and ensure that all

young people’s rights are observed and promoted. This includes respecting individual rights to privacy

and dignity.

Advocacy Services are provided in the home. This is done through ‘Real Advocacy’ based in

Manchester. Our representative is Sam Young. Sam has 10 years’ experience as a Specialist Advocate

and has an MSc Psychology. Children in the home will usually see Sam once a month and will

represent them at meetings when required.

10.Diversity and Inclusion:

Young people will be given the opportunity and encouraged to exercise their right to choose and be

involved in the planning of their care and to pursue activities both within the environment and outside in

the wider community.

Inclusive practice is a process of identifying, understanding and breaking down barriers to participation

and belonging. Inclusion is about ensuring that children and young people, whatever their background

or situation, are able to participate fully in all aspects of the life in community and educational

placements. Inclusive practices will ensure that everyone feels valued and has a sense of belonging.

Inclusion is not about viewing everyone as the same or providing the same work, but about providing

the same opportunities and access to a high quality of education. In an inclusive environment there is

recognition, acceptance and celebration of difference’s and similarities.Date of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations


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11.Equal Opportunity Policy:

Nestlings care Ltd is committed to promote equality for all by encouraging diversity and challenging and

eliminating discrimination in both its role as an employer and as a provider of services. Nestlings Care

Ltd aims to create a culture that respects and values each other’s’ differences, that promotes dignity,

equality and diversity, and that encourages individuals to develop and maximise their true potential. We

are committed wherever practicable to achieving and maintaining a workforce that broadly reflects the

local community in which we operate.

The purpose of this policy is to provide equality and fairness for all in our employment and in the

provision of services and not to discriminate on the grounds of gender, marital status, race, ethnic

origin, colour, nationality, national origin, disability, sexual orientation, religion or age. Nestlings Care

LTD opposes all forms of unlawful and unfair discrimination. None of these issues of difference will

effect an individual’s position within the home or their access to achievement.

Stereotypical thinking in relation to age, gender, sexual orientation and able-bodied status will be

challenged.

Sexism, racist attitudes and prejudices towards disability will be actively challenged.

In recognition that children and young people from minority ethnic backgrounds have particular needs

relating to their cultural differences, such as, personal care, diet, religion, language and education; there

will be measures in place in caring for children and young people from ethnic minorities so they feel

comfortable with the attention and care they are given.

Children are given skills to challenge discriminatory remarks themselves.

The above principles equally apply to children & young people who are placed in our care.

All employees, trustees and volunteers, whether part-time, full-time or temporary, will be treated fairly

and with respect. Selection for employment, promotion, training, volunteering or any other benefit will be

on the basis of skills and ability. All staff will receive training in Equality & Diversity issues, the manager

will ensure that staff have access to relevant information that assists them in understanding and

meeting the care needs of all the children & young people within our services.

We are committed to achieving equal opportunities in everything we do, and to meet these aims we will:

Treat all young people equally irrespective of their race.

Not tolerate Bullying, racist harassment or intimidation, and respond to all reports of this



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Combat prejudice and stereotyping, particularly in relation to heritage, ethnic origin, geographic

origin, race or religion.

Encourage all individuals to apply for employment without discrimination.

Responding to the needs of young people and staff from diverse community’s means having

robust systems, policies and procedures in place which support equality and diversity.

The manager has a responsibility to ensure that a culture is created in which the promotion of

race equality and race relations becomes an integral part of everyday work.

Both staff and young people are reminded that they have a duty to report any suspected racial

incident or racial harassment perpetrated by others.

12. Personal Belongings:

On admission, staff will record details of all clothing and personal belongings which young person brings

into the home. There is a banned items list, which would be discussed with young person, and if

necessary such items will be kept secure by staff. These records need to be updated when new items

are brought onto the premises or when old ones are discarded. This ensures, as far as possible, that

these items can be traced back to its rightful owner should they become lost. Young people will be

encouraged to notify staff of new items of clothing so that they can be properly labelled and recorded.

We strongly recommend that all clothing should have a label with the owners name on it.

Whilst young people will be encouraged to carry out their own laundry (under supervision initially), there

may be occasions where this is carried out by staff and labelling makes identification much easier.

The level of support required is identified through ADL assessment in order to maintain independence

and is reviewed regularly to track progress made.

Young people will be encouraged to bring photographs, favourite ornaments or other treasured

keepsakes or small items of furniture that may help to personalise their room and make it feel more

comfortable. There are, however, limits on some items either due to size or value or risk assessment.

While we will encourage Young People to bring personal items with them into the home to help feel at

home, we would suggest that because of the risk or damage or loss, these items should not be of a

valuable nature.



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All items of electrical apparatus over 12 months old must be PAT tested to ensure that they are in good

working order before they can be used. This can be arranged by the staff and there is no charge for

this testing.

Any items of furniture must be in good condition and must conform to current Fire Regulations for flame

retardancy.

There is of course suitable hanging and storage space for clothes.

We wouldn’t advise young people to keep cash (unless agreed with carer/ social worker), expensive

items of jewellery or valuable ornaments in their room. In case of loss, damage, or theft we cannot

accept responsibility. Young people will be supported and encouraged develop skills of budgeting and

saving by opening a personal bank account for the safe keeping and management of their finances.

13. Promoting Educational Attainment & Supporting Young People with Special Educational Needs

Nestlings Care LTD is committed to ensure that young people in care have access to education

Irrespective of age, gender, ethnic background, attainment levels and socioeconomic background.

Every Child placed at Nestlings Care will have a Personal Education Plan (or EHCP)- part of Care

Plan and a Placement Plan drawn up by social services as set out in legislation.

The PEP/EHCP should be agreed as soon as possible and at least within 20 school days of entering

care or of joining a new school. Thus in the case of a child entering care the PEP should be prepared in

time for the first review (the 28 day review).

At Nestlings Care LTD, young people to be able to access education in a local school setting however if

that is not possible then young people can have access to 1:1 education through National Training &

Advisory Services at home or in library.

Higher Tunshill Farm is not registered with the department of education as an education provider.



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Staff are committed to ensure that they attend parents’ evenings and other relevant meetings, such as

the annual reviews of a statement of special educational needs; other school events or activities at

educational placements are attended as appropriate.

Staff support young people ensuring regular school attendance, high quality homework and reading

support, robust monitoring of progress relating to the content of the PEP and effective liaison between

the home, the school and children’s services.

14. Arrangements for Social Activities, Hobbies & Leisure Interests:Young People referred to Higher Tunshill Farm with established activities will continue to be supported

to access such activities. All young people will be encouraged and supported to access a wide range of

activities designed to assess their level of functioning, offer therapeutic benefits within the home to help

with their rehabilitation programme and integrated community access as part of their progress along a

recovery pathway.

The MDT, including Occupational Therapy, will complete a holistic assessment, including identification

of the young peoples’ ADLs, strengths, interests, hobbies and unmet needs. Young people are offered

individualised activity planner, which is developed with young people.

A process of collaborative working will ensure that treatment and care is directed towards achievement

of mutually agreed goals, including accessing any educational/ vocational, social activities, hobbies and

leisure interests.

Ideas for potential activities will be encouraged from a range of sources:

Residents

Vocational support agencies

Newspapers

Posters

Course information booklets

Primary Nurse / staff team

Clinical Team meetings

Community meetings



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Gathering information about activities is seen as an equally valid exercise as the activity itself; providing

opportunities for social integration, problem-solving, and personal development.

Funding for activities will come from a variety of sources:

Vocational services

Social services

Local education Authority

Allocated budget from Higher Tunshill Farm

15. Health and Well-being:

In addition to our experienced staff members who will look after young people’s care and welfare,

further support is provided by a number of other healthcare professionals from a variety of disciplines to

ensure that we are able to provide a comprehensive care and treatment rehabilitation package.

All young people will be registered with a local GP practice or Health Centre to ensure continuity of

medical treatment. For some Residents this means that they may be able to retain their own family GP,

whilst for others it may mean registering with a new GP.

The young person will be registered to GP, local dentist and optician, as soon as agreement and

funding to transfer is in place.

The home will provide access to a range of advocacy services which may be useful where an individual

wishes to make their views ad wishes expressed through an independent person.

16. Medication:

The Young People admitted to Higher Tunshill Farm may already be on medications, which would

require supervision, and the visiting Consultant psychiatrist may prescribe medication as part of the

young person’s treatment plan. If the young person requires any facts about their medication are other

aspects of their care, they can ask the staff, the MDT, or pharmacist. There will be leaflets available for

mental health information from Royal College of Psychiatrist.

Staff on duty will ensure the safe and timely administration of all Young people’s medication. It the aim

of the clinical team that services are supported to self-administer medication, but this may be easier to

achieve for some than others. There is a self-medication policy / procedure which may be implemented Date of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations


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following detailed risk assessment by the members of MDT involved depending on young people’s age

and risks.

17. Arrangements for Contact between Service Users Family/Carers& Friends:

Young People are supported to make, and to maintain contact with family/ carer, including involving

them in decisions about their care and treatment, its application, and review, including attendance at

CPA meetings etc, where clinically appropriate to do so.

Staff gather all relevant family history, information regarding the nature of relationship the young person

has with parents/carers, and any safeguarding concerns, which would be relevant. This information will

be incorporated in young person’s placement care plan, contact list, and if there are any ongoing

concerns, clarification will be sought from the Social Worker and young person’s protection will be

paramount. If indicated, young people will be supervised during contact visits.

During the introductory visit to the home, young people will be able invite a family member or a

representative with them.

The views of family/ carers will be sought through “Feedback Questionnaires” when reviewing the

achievement(s) of the home in meeting the needs of the individual.

Family/ carer are always welcome to visit young people at the home.

18. Monitoring

At Higher Tunshill Farm young people will be regularly supervised and safety will be ensured by support

staff on duty. The staff team will ensure that the level of monitoring is proportionate to the level of risk

presented by the young person. All risk assessments and levels of monitoring will be agreed as part of

the young person’s care planning on admission and will be regularly revisited by all professionals Date of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations


21

involved in the decision making process relating to that child as well as the social workers consent

being sought.

The home does not make use of any electronic recording devices. The doors can be fitted with alarms

to alert staff to anyone entering or leaving the home as a safeguarding measure.

19. Sanctions and Consequences:

At Higher Tunshill Farm we believe in positive reinforcement through praise, non-verbal

communication, and incentives. Consequences must be used cautiously for dealing with difficult

behaviour, as they can lead to resentment from the young person. However, whenever there is a

need for a consequence to any given situation, it is vital that the consequence is:

a. Understandable to the individual concerned;

b. Directly related to the incident;

c. Individualised – relevant to age and understanding; there should not be a prescribed tariff of

behaviour and consequences (blanket rules);

d. Timely – as close to the episode as possible;

e. To be realistic, sensitive, enforceable and achievable, and seen to be proportionate to the

behaviour in consideration;

To be non-disruptive to other residents;

No consequences should involve, or lead to the humiliation of a young person, and staff should

ensure that the young person is able to retain their dignity and self-respect after the imposition of

any consequences.

Whenever a consequence has been applied, it is important that it is discussed fully with, and is

as far as possible, understood and agreed by the young person.

All consequences will be recorded in the specific consequence book to make sure that they are

fair, effective and time limited. The manager will keep a check on the consequences being made

to ensure that consequences put in place are reasonable and effective.

Nestlings Care LTD employ Team Teach as the chosen method of Physical Interventions. All

staff receive training when commencing employment and then on an annual basis for refreshers.

The intention for Physical intervention should only be as a last resort and for a minimal time to

ensure the safety of the young person or staff present. Physical Intervention will only be used

when all other courses of action have failed.



22

20. Relevant Qualifications And Experience Of The Manager:Jenny Thompson Kavanagh is an experienced and suitably qualified Manager with experience of Ofsted and CQC regulations. Working in the social Care sector since 1998 Jenny has risen through the ranks from Support worker to Registered Manager. Jenny has worked in a variety of settings that include working with young people who have learning disabilities and complex needs, Autism, and Mental Health difficulties. Jenny has a passion for the social care arena and is keen to improve and develop the lives of some of societies more vulnerable individuals. Jenny has a proven track record for achieving good outcomes for staff and young people. Employing a good sense of humour, empathy, understanding and good listening skills. Qualified to NVQ Level 5, Jenny also holds qualifications in Counselling Skills, Management and Assertive skills, and Safeguarding as well as comprehensive mandatory training courses.

21. Relevant Qualifications and Experience of the Responsible Individual/ Nominated Individual:Mr Anthony Thompson holds extensive experience in representing mental health and learning disability

services within the public and Independent services. He has published and edited numerous

professional textbooks and journal articles, particularly within the area of inter-professional working and

education.

His career has spanned decades in the statutory services domain. This includes positions held as

Senior Inspector of Training schools (General Nursing Council for England and Wales).He is the former

Education officer and Professional Advisor the English National Board for Nursing, Midwifery and Health

Visiting. He has held senior lectureship in Higher Education and appointment as external examiner to

Universities including, Dundee, Queens Belfast, Ulster, Sheffield and the South West.

Previous service positions include Director in High Secure care and the Independent Sector. Currently

he is a senior associate of caring solutions UK Ltd specialising as an Independent Investigator of

Serious Incidents within the NHS and he is a Director of a non-profit organisation Bridge R&D UK. He

retains interest in the Independent Mental Health sector as RI for Roefield and Debdale Care Ltd and is

associate visiting manager (MHA) for Care UK and J. Munroe Hospital group.

22. The Number, Qualifications and Experience of Staff Employed in the Home:



23

Higher Tunshill Farm will ensure that at all times an appropriate number of suitably qualified, skilled and

experienced staff are employed.

The staffing numbers may be variable due to the number of children in residence at any one time as

well as the support needs of the children in placement altering at times of crisis. There will always be

one staff member on duty for each child. The home will always seek to have a gender balance on each

shift as well as a mix of ages, skills and experience.

Staff employed to work at Higher Tunshill Farm are offered regular Mandatory Training, Safeguarding

and CSE training, Mental Health training and supervision from the Registered Manager.

A list of the names, qualifications and experience of staff working in the home:

Name Position Qualifications Experience

Jenna Somerville

Deputy Manager

Working towards Diploma level 3 in Health and Social Care

Over 10 years’ experience of working with children from the age 0-18 in a number of different settings and has been with Nestlings care LTD for 3 years.

Danielle Horan

Acting Team Leader

L3 in Health & Social Care. Working towards L3 in children and Young people

Working with adults in their own home for 18 months. Worked for nestlings for 19 months. Has worked in Nestlings adult home (Lang Riggs) until October 2017

Charlotte Dudley

Acting Team leader

Currently completing diploma level 3 in health and social care following a successful probation period.

Over 6 years’ experience of working with adults who have disabilities and display challenging behaviour and working with Nestling Care LTD for nearly 2 years .

Andrew Hall

Support Worker

Safeguarding, CSE, PMVA, Medication Management

NVQ level 2 in supervisory Management

Joined Nestlings in 2017 and is currently completing Induction pack before beginning NVQ 3. 3 years’ experience working in a variety of residential Children's home supporting young people with challenging Behaviour and mental health diagnosis.



24

Jason

Nolan

Activity Coordinator

Level 3 diploma in health and social care complete.

Has been working with at Nestlings care for 3 years.

Alexandra Clarke

Shift Leader Degree in Psychology. Currently completing

L3 diploma

4 Years’ experience as a Teaching Assistant for children with Special Needs and has been working with Nestlings Care LTD for over a year.

Emma Cairns

Support worker

BA (Hons) Social work degree

* A level in psychology, Health and safety and Sociology

* Other training includes - Mental Capacity act, mental health act, Safeguarding, PMVA, Medication management

Has worked with young people for the last 3 years this has included working as a volunteer in a nursery and working in placements during University with young people with mental health diagnosis and their families.

Katie Davanna

Support worker

Proacscip, PMVA, MCA, DOLs, Working towards L3 in children and young people

Has over 7 years’ experience working with adults with LD, Autism, dementia, challenging behavior. Has trained in completing MCA reports and assessments. Has previously been a team leader with adult services.

Chelsea Toft

Support worker

Degree Psychology & criminology, Masters in Science

Has worked as a teaching assistant for 2 years with early years including challenging behavior.

Provision is made for Qualified Nurses to be available for consultation 24hrs per day 365 days per year.

The Mental Health Multi-Disciplinary Team:

The home incorporates a “Multidisciplinary Mental Health Team” consisting of:



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Consultant Child and Adolescent Psychiatrist – Dr Faeza Khan

MBBS DCP DPM MRC Psych

Lead psychiatrist for Adolescent Psychiatric Intensive Care unit at the Priory Hospital

Cheadle Royal for a 10-bedded national provision for 9 years.

19 years of experience in assessing and managing a wide range of psychiatric disorders and

14 years of experience in Child and Adolescent psychiatry with special interest in

Neurodevelopmental Disorders and Developmental Trauma with associated complex and

challenging presentations.

Counselling Psychologist – Dr Lynn Allen

Doctorate in Counselling Psychology, University of Wolverhampton (BPS DCoP Trainee Prize, 2010

runner up). Research: Practitioners’ Understanding of the Sociopolitical Context and its Role in

Psychotherapy.

PG Certificate in Social Science Research Methods, Open University.

Certificate in Counselling Skills, Level 3 ABC.

BSc Psychology (Honors), Open University (First) (Bruner Prize, 2007).

Certificate in Counselling Concepts, Level 2 ABC.

Certificate in Social Sciences, Open University.

Psychotherapist – Eunice Ayodeji

Diploma in Professional studies in Nursing (Mental Health)

Diploma in Child and adolescent psychiatry

Post Graduate certificate in cognitive behavior psychotherapy

PHD in Child & Adolescent Mental health

Occupational Therapist – Anne Lee

BSc (Hons) Occupational Therapy Registered with Health and Care Professions Council and British Association of Occupational Therapists.Parks Inner Child Therapy Practitioner (Advanced Practitioner Diploma) – Registered member of the National Council of Psychotherapists(Accredited) and The Penny Parks FoundationOccupational Therapist - Orthopedics Unit, Acute Medical and Surgical and Forensics – East

Registered Mental Health Nurses –

Beth Griffiths:

Diploma in Professional Studies in Nursing (Mental Health) University of Manchester 2010 – 20134 years as a Support Worker in Secure/Acute and CAMHs Psychiatric Hospitals2 years as a Registered Mental Health Nurse – Adolescent Psychiatric Intensive Care Unit.Registered Mental Health Nurse for Nestlings Care LTD since 2015.



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Member of RCN

BTEC L3 advanced restraint instructor

Samantha Wrigley:

Registered Mental Health Nurse – Sam WrigleyDiploma in Nursing (Mental Health), Edge Hill University 2010 - 2013BSC (hons) in Psychology in Education, Lancaster University 2006-20092 years as Registered Mental Health Nurse – Adolescent Psychiatric Intensive Care Unit1 year as Clinical Lead – Adolescent Psychiatric Intensive Care Unit1 year as Specialist Mental Health Nurse – Tier 3 Community CAMHS TeamRegistered Mental Health Nurse for Nestlings Care LTD since 2016.BTEC L3 advanced restraint instructor

Member of RCN

23. Organisational Structure:Date of Issue: July 2013 SOP: 006Date of Review: October 2017 Department: Operations


27

Governance Structure and Processes:



Director Responsible Individual/Nominated individual

Shift LeadersResidential Support workers

Team Leaders

Registered Manager

MDT

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Statement of Purpose

Date of Issue: July 2013 SOP 004Date of Review: October 2016 Department: Operations


Staff Meetings, Supervision, Safeguarding,AppraisalStaff Survey Feedback from Multidisciplinary team

Registered ManagerInternal & External Audits and Safeguarding, Complaints

Ofsted & CQCDirectors Anthony Thompson( RI/NI)

Young peoples' involvement in service

provisions, care planning, feedback from Young

People & Cares/parent, external Professionals &

complaints

Response to Young people, feedback

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24. Range of Needs that Higher Tunshill Farm is intended to Meet:

The team identifies young people can pose ongoing risks to self or others which can be a barrier

to their integration in community. One of the limiting factors is limited resources or provision of

expertise to manage such presentation through positive therapeutic risk management in the

community in collaboration with carers, local authorities and professionals.

The placements offer therapeutic milieu underpinning attachment theory, theory of mind,

mentalising approaches and social and interpersonal skills training with structured and consistent

behavioural approaches. The team recognises that young people require help to put their

experiences into perspective.

The placements will offer planned admissions from inpatient hospital settings due to complexity of

presentation requiring a tailor made package, delayed discharges due to limited local resources or

lack of specific provision in the community or as step down from secure inpatient services.

Admission to young people with history of readmissions or deterioration in community due to non-

adherence to treatment, non-engagement and admission to inpatient setting is not indicated or

has limited interventions to offer or deemed to be counterproductive. Admissions will be offered to

young people from social services placements and community through CAMHS following a

detailed review of case and risk assessment.

Communication:

The team identifies the importance of simple, open, honest and non-challenging communication

with young people according to their understanding, experiences and level of emotional and

cognitive development. Young people mental health problems and complex challenging needs

struggle to trust adults due to their authoritative role, perceiving the professionals and adults in

their life taking control away and disempowering then which in turn has significant impact in

building therapeutic relationships. We recognise adolescence to be an important stage of

development of identity and self-control, which can only be achieved in collaboration with young

people.



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Individualised Care:

The team identifies that young people are a unique individual with a distinctive life story and set of

events (internal and external) that have led them to have complex difficulties. Each young person

is entitled to have support and guidance in order for them to feel secure, trust others, develop self-

confidence, feel empowered and achieve their full potential. Each young person is considered

and treated as a whole person within the context of their current situation. The placements will

care plan individual’s needs, facilitate recovery to their optimal functioning level. This in turn

enables them to progress along the pathway of recovery, ultimately enabling the successful return

home or to independent community living.

Giving Chance for Independence:

Young People with mental health problems and complex needs don’t always have opportunity and

chance to live in positive and emotionally safe environments in community with holistic view of

their needs. The team recognises the needs for therapeutic risk taking by having intensive care

package in community in order to facilitate transition into adulthood.

Equality and Inclusion:

We recognise that this particular group of young people are faced by several emotional,

psychological and cognitive challenges. We have identified these young people as having right to

be respected, treated equally and valued. We will take innovative and creative approaches to

enable them to overcome barriers and integrate these young people to be part of community. It is

the policy of Nestlings Care placements to provide residents with a homely environment in which

the principles of individual rights, including privacy, choice, safety, equality, diversity and freedom

of choice are respected and actively encouraged by every staff member.



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Activity: How Delivered Approved by:Delivered by:

Psychiatric input

Psychiatric assessment

Mental State Examination

Examination/Ongoing Reviews

Medication Review

Monitoring and Prescribing

Treatment Plan

MDT Meetings& Risk

assessments and management

Psychiatric Reports

1:1 assessment by Consultant

psychiatrist on weekly basis to

offer assessment, review primary

diagnosis or current mental state

or changes from last

assessment.

1.2 Implementation and review of

management plan.

Consultant Psychiatrist

Rationale : To identify and confirm diagnosis of mental illness and assess mental state for

treatment in a community rehabilitation setting. Regular review of progress and mental state

allows the Consultant Psychiatrist to tailor medication to be optimally effective, appropriate to

their condition and within BNF limits.

Psychological input

Psychological Assessments

Cognitive Assessments

Psychological Interventions

Multi-Disciplinary Team

Attendance

Staff Liaison

Teaching and Training

Supervision

Service Development

1:1 assessment (with staff and

Service Users)

Indirect Assessment

Observation

1:1 Intervention

Group Intervention

Indirect Intervention

Contribution to MDT

Behavioural Management Plans

Supervision of other Clinical Staff

Formulation Meetings

Teaching and Training Sessions

Service Audit, Review and

Modifications

Consultant Psychiatrist

Clinical Psychologists( via

MDT)



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Rationale: As a result of the structure of psychology services, all young people will receive direct

and/or indirect psychological input into their care, both in terms of assessments and interventions.

On an individual basis, individuals have access to a range of psychological assessments and

interventions to help them to identify their psychological difficulties and work on overcoming them.

All psychological input into an individuals care is agreed and co-ordinated by the MDT and CPA

process.

Activity: How DeliveredApproved by:

Delivered by:

Nursing Input

Holistic Assessment of Needs

Risk Assessment

Care Planning

Active Interventions

On-going monitoring and

evaluation

Collaborative working

Administration of medication

Relapse Prevention

Psycho-Social Interventions

Recovery Model

Individualised Care Planning

Collaboration

24hr Care

Registered Nurses (via

MDT)

Residential

Support Workers

Rationale: To work collaboratively with young people to promote self management. To support

individuals over 24-hours in meeting their needs and to provide a systematic approach towards

regaining their independence and achieving social inclusion.

Occupational Therapy input

Personal independence and

social skills. Domestic and

community living skills. Leisure.

Work/Occupation.

ACTIVITIES:

Kitchen Assessment

Supported cooking sessions

ADL’s

Risk Assessments and individual

programme planning to include:

Therapy sessions

Individual sessions

Access to community

resources

Occupational Therapists

Registered Nurses

Residential

Support Workers



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Relaxation

Baking

Community skills

Facilitation of College and further

education courses

Budgeting and financial

management

Rationale: To enable and empower Service Users to meet the requirements of the transition to

community living. Supporting individuals to find and maintain positive community links, such as

paid employment or educational courses. This has a positive impact on self-esteem and coping

capabilities and is intended to reduce relapse rates. The main aim is to facilitate recovery that is

directed by the individual themselves.

Activity How DeliveredDelivered byApproved by



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Music Therapy

To encourage development of

a therapeutic relationship

between the client and the

therapist.

Allowing young people to

explore the world of sound and

to create a musical language

of their own.

Offer 1:1 or group session

using different instrumentsConsultant Psychiatrist

Music Therapist

Rationale: Music therapy has been evidenced as using music to explore and express emotions

and feeling for difficult engaged young people. It offers non challenging opportunity to develop

therapeutic relationships. It is also used for sensory integration of young people with Autistic

Spectrum disorders.

25. Referral and Admission Criteria and Process:Date of Issue: July 2013 SOP 004Date of Review: October 2016 Department: Operations


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It is anticipated that young people will be referred to Higher Tunshill Farm from a range of sources

including:

Step down from acute and low secure adolescent units( NHS and Independent sector)

CAMHS ( Child and Adolescent Mental Health Services)

Social care placements

Criminal justice system

Youth offending teams

Higher Tunshill Farm will offer specialist interventions for following:

Depressive disorders

Psychotic illnesses

Hyperkinetic conduct disorder

Autistic Spectrum Disorder with co morbidity or challenging presentation

Mild or Specific learning difficulties with co- morbid mental health problems

Challenging behaviour; aggression and self-harm; Emerging personality disorder

Forensic history with mental health problems (involvement with YOT or CJS) Other admission

criteria are:

All Residents must be regarded as capable of living in a communal living scheme

Residents must be assessed as capable of semi-supported independence as part of a

rehabilitation programme

All Residents must undergo a full assessment of their needs through preadmission

assessment.

The Registered Manager must agree that the individual will benefit from treatment

No Residents will be admitted whose presence would breach any condition of registration

from The Care Quality Commission

Residents must have been stable for a period of time prior to admission and not in an acute

phase of their illness

Residents should be considered capable of self-caring as far as possible

Residents should see the move as beneficial to themselves in their treatment plan.



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Residential placements can be short, medium or long term depending on the complexity of the

individual’s needs.

Short Term Care :

Short term placements typically range between 12 weeks -6 months. The aims is to

provide comprehensive assessment of the young person’s mental health, psychological,

educational/ vocational and social care needs and offer an appropriate care package with

interventions and anticipated outcomes agreed with young person and external agencies

to facilitate their recovery.

Medium Term Care:

Medium term placements range from 6 months to 18 months depending on age of young

person, complexity of needs and progress made through specilaist interventions. The

medium term care provided aims to provide ongoing specialist interventions, a positive

residential experience with consistent and safe care giving, prosocial environmentand

activities, social skills and intereprsonal training, behvaioural remodelling, psyhcological

therapies and famiy interventions which would enable young person to learn more

positive coping startegies in order to return home or live independently.

The care programmes aim to create real opportunities for young people to change and

take control of their lives to enable them to develop confidence, competence, self-esteem

and self -respect which will support them in gaining the interpersonal and vocational skills

to survive and succeed in life and the world beyond residential care.

Long term Care:

Long term care placement ranges from 18 months onwards when the young person’s

needs are such that they will require continuing care through early adulthood.

An admission of a young person is the start of a journey through the care pathway and it is

essential that pertinent information is gathered, in order to develop individual care plans for young



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person, which will address identified needs. This process will ultimately assist patients to achieve

outcomes specific to their own care pathway.

The admission criteria for accessing services at Tunshill Farm are clearly stated in our

policies and procedures manual. The criterion ensures that only those individuals who have

been fully and professionally assessed for their suitability for a community therapeutic and

Reliving scheme will be accepted.

ADMISSION PROCESS:

The care plans that are developed will assist our staff members to implement the appropriate care

and this will offer reassurance to the young people that use our service and there referring bodies

alike.Equality of access will be promoted for all young people.

All prospective young people will receive relevant information about the service to enable them to

make an informed choice about their treatment and care. The team at Tunshill Farm will ensure

that all admission procedures are carried out to the highest standards and in line with this policy.

Individual Placement plans are agreed with young people to meet their holistic needs. Best

Practice guidelines (e.g. NICE) always inform decision making, and a range of interventions are

offered through the MDT; including psychiatrist, psychology, psycho-social interventions, activity

therapy and social skills, as well as psychotropic medication. An underlying philosophy based on

“Recovery” ensures that individuals are empowered towards achieving their own goals. .

26. Arrangements in Dealing with Review of Young Peoples’ Plan:

Young People health care will be planned in consultation with our MDT, staff members, and

carers as appropriate. Other appropriate health care professionals are also involved in the

planning of young people’s health care.

Young people who will be referred to Higher Tunshill Farm will usually be under the Care

Programme Approach (CPA).



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It is expected that the community Care-Co-ordinator will continue to undertake this role throughout

the young People’s stay at Higher Tunshill Farm.

There are 4 main elements to CPA:

Systematic assessment of an individual’s health and social care needs

Development of an agreed care plan to meet those needs

Allocation of a “Named Nurse” (or other such name) to co-ordinate delivery of care

Regular review and monitoring of an individual’s progress and ongoing delivery of the care

programme to meet individual needs

The Registered Manager will regularly audit the effectiveness of the CPA process and invites

feedback from all parties.

To ensure that we provide the highest level of care to our Young People, our staff will prepare

various reports to inform the CPA review meetings; including psychiatric, psychological,

occupational therapy, music therapy and nursing perspectives.

Young People will be encouraged to be fully involved in the creation, documentation and review of

their care plan. Each individual will be encouraged to contribute and sign their care plan and a

written copy will be given to them.

Young People may request access to their Health Records under the Data Protection Act 1998.

The young people will be aware that their records contain the details of their care needs and the

services provided to them, and are updated regularly. They are strictly confidential and won’t be

seen by anyone who isn’t involved in their care. If young person would like to see their records

then they must write to Registered Manager, if they need help with this then they can ask a

member of staff.

Nestlings Care LTD



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