Children's Home run by Creating Care Choices Limited in Lewisham

Unique reference number SC025657 Inspection date 12/11/2013 Inspector Angus Mackay Type of inspection Interim Provision subtype Children's home

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Date of last inspection 06/06/2013 Website: www.ofsted.gov.uk

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Brief description of the service

This privately run children's home is registered to provide care and accommodation for up to three children on short break arrangements and no more than four young people resident in the home. The home is registered to care for children and young people who may have learning disabilities and/or physical disabilities. However, the building is not fully accessible or adapted, meaning that placement of children and young people with significant mobility problems would not be appropriate.

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The inspection judgements and what they mean

Good progress The children’s home has demonstrated continued improvement in quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the large majority of recommendations that were raised at the previous inspection. Satisfactory progress The children’s home has maintained quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the majority of recommendations that were raised at the previous inspection. Inadequate progress The children’s home has failed to address one or more requirements and/or has not met the majority of recommendations and/or the quality of care and outcomes for children and young people have declined since the last full inspection.

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Progress

Since their previous inspection the service is judged to be making good progress .

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Progress

At the last full inspection, carried out on 06 June 2013, the home was judged as adequate. There were four requirements and two recommendations for improvement made at that inspection. The home has successfully addressed the requirements and one of the recommendations that were set. In addition the home has made further progress in improving the internal décor, creating a reception point, continuing the revision of policies and procedures, improving communication with young people and getting young people involved in shopping, cooking and budgeting. The home has made good progress but some weaknesses in the service were identified.

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Progress

The manager has been in place for three months but has not completed her registration with Ofsted. She is in the process of leaving but is aiding the home in identifying a replacement manager. Recruitment procedures are appropriate and all required checks are in place to ensure safe appointments. Improvements in the home have resulted from the actions of the last two managers and their development of the staff team. The provider has commenced interviewing suitable candidates to maintain this improvement and provide a safe progressive environment for staff and young people.

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Progress

The manager has a good understanding of the strengths and weaknesses of the home. External monitoring reports have improved in quality and now provide a robust audit of the conduct of the home. Previous reports were irregular, inadequate and provided no helpful information. The manager uses these reports with the staff team to drive improvements in the service. Internal monitoring reports are basic but improving. The manager has not yet completed a full six month period of monitoring and consequently has not supplied a full report to HMCI. The care of young people is being enhanced by this more regular and comprehensive monitoring of the home.

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Progress

Young people are relaxed with staff and happy to see them. Staff are actively involved with young people at all times, playing games, singing songs and aiding in meeting basic care needs. Young people have a lot of fun but also focus on some learning activities. Staff use these social and play times to develop young people's use of language and to reinforce positive behaviours. Staff are knowledgeable about young people and their presenting problems. Care and risk plans contain helpful information on working with young people which staff use in their interactions with them. Staff receive training to aid in working directly with young people. Staff have recently completed training in manual handling and moving, first aid and control of medication. All staff but one, now have a minimum of an appropriate level 3 qualification and many have more advanced qualifications. Young people benefit from the improved staff performance and knowledge this training brings.

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Progress

Young people have made progress in communication and behaviour management. There have been no restraints and no children missing since the last inspection. Staff have improved the range of communication available to young people aiding them in achieving improved involvement in their own care and increased opportunities to make choices. Consequently young people are more engaged with staff and this improved communication has resulted in fewer incidents and better outcomes for young people. One social worker commented, ' This good communication is key to improvements in the young person and reducing the number of incidents.'

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Progress

The home works well with external agencies such as social workers, child and adolescent mental health services and schools. Staff encourage parents to be involved in the home and welcome them to meetings and social visits. One social worker commented, 'Staff have really helped Mum develop her own style and encouraged her to get involved in doing activities with her child.'

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Progress

The provider has put in place a new fire prevention system including fire detection equipment, fire retarding measures, fire fighting equipment and emergency lighting. Staff have all been trained in the use of the new system and perform regular checks on all aspects of the system. Young people have their safety enhanced by these changes and by regular fire drills. Young people have pictorial emergency evacuation procedures aiding their understanding of how to safely leave the building. The home is well maintained and all areas are clean, bright and welcoming. Young people have some degree of personalisation in their rooms including pictures of family members. Young people have new mattresses and bedding making their rooms more comfortable and enjoyable spaces to be in. Young people are making progress with learning how to look after themselves including how to dress, use the toilet, tidy their rooms and to prepare meals. Staff have established budgets for

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Progress

young people and they now enjoy shopping for their own clothes and toiletries. Young people require staff assistance in these tasks but can exercise choice and learn social skills in public places.

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Progress

The home now has dedicated budgets for young people, activities and food. Staff say this has completely changed the way of working in the home improving the quality of care provided to young people. Young people and staff create the menu through discussion and choosing images. Some assistance from parents refines the range of images available to choose from. Young people now enjoy choosing, purchasing, cooking and eating meals. The establishment of a food budget allows young people to shop at local shops, markets and supermarkets. This allows them to purchase fresh produce and items such as yams and difficult to obtain herbs and spices. Young people are now gaining in confidence in public places, improving social and life skills, as well as enjoying healthy, culturally appropriate meals.

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Progress

The manager has revised the management of controlled drugs. Controlled medication is appropriately stored and recorded in a separate bound and numbered log book. Staff have completed training in medication administration and first aid. Staff maintain young people’s health care plans effectively, recording all appointments and outcomes from these. Consequently young people are safely cared for and receive good medical care. Child protection procedures are comprehensive and benefit from comment from the Local Authority Designated Officer and the Local Safeguarding Children Board. Staff are use the guidance contained in the procedures to enhance their safe working practice with young people. The home responds appropriately to complaints and to child protection investigations. Notifications are made to relevant parties immediately and followed up in writing. Sometimes the written confirmations are not done in a timely manner. The home responds positively

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Progress

to feedback from complaints and has recently revised policies, procedures and training following an incident. This ensures that young people receive safe care in a safe environment.

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Progress

The manager has revised policies on personal and intimate care and manual handling to improve the care of young people. Staff now complete body maps of young people on arrival at the home and on leaving to ensure the early identification of any accidents, injuries or abuse. Staff actively encourage young people to identify any situations where they are unhappy or wish to complain which improves their safe care. Care plans include a version in a pictorial form allowing young people to engage and comment on their plans. Young people’s safe care is enhanced by these measures.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) appoint an individual to manage the children's home if the registered provider is not, or does not intend to be, in full-time day to day charge of the children's home (Regulation 7(1)(b)(iii)) 12/12/2013

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Reg. Requirement Due date

(2001) ensure that visits in accordance with this regulation occur at least once a month and that a written report on the conduct of the home is sent to HMCI. (Regulation 33(1-5)) 12/12/2013

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Recommendations

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

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Recommendations

 ensure that there is a system in place to notify Ofsted within 24 hours of any significant events in accordance with Regulation 30 (NMS 24.1)  ensure that an evaluation of the monthly monitoring of matters set out in Schedule 6 is sent to HMCI at six monthly intervals. (Volume 5, statutory guidance, paragraph 3.14)  ensure that all existing care staff attain a minimum level 3 qualification or are working towards the level 3 Children and Young People's Workforce Diploma within 6 months of conformation of employment. (NMS18.5)

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the progress made by the provider since the last full inspection, identifies any further strengths, any areas for improvement and makes judgements as outlined in the Inspection of children’s homes – framework for inspection.

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