Children's Home run by My Choice Children’s Homes Limited in West Sussex

Unique reference number SC364812 Inspector Stephen Collett Type of inspection Full Provision subtype Children's home

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Registered person My Choice Children's Homes Limited Registered person address My Choice Childrens Homes Ltd, Unit 3/A Mill Green Business Estate, Mill Green Road HAYWARDS HEATH West Sussex RH16 1XQ Responsible individual Peter Christopher Kazmarski Registered manager Georgios Vramis Date of last inspection 06/11/2013 2 of 11 Inspection date 27/05/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness adequate

Outcomes for children and young people adequate Quality of care good Keeping children and young people safe adequate Leadership and management adequate

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Overall effectiveness

In recent months the home has had to manage some difficult situations, and there has been some variation in the quality of outcomes for young people. The Registered Manager and staff are clearly committed to supporting young people and encouraging them to achieve well, and there is evidence that for some young people this has worked well, with significant progress being made in terms of educational engagement and family contact. The home does well in identifying the needs of the young people living there, and staff are proactive in accessing support to meet these needs.

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Overall effectiveness

Some of the young people have needed very high levels of support to manage their behaviour, and the use of sanctions and restraint has been appropriately applied as part of this package of support. However, some shortfalls were identified, and recommendations regarding the recording of sanctions and the need to offer medical examinations following the restraint of a young person, have been made.

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Overall effectiveness

Young people receive a good quality of care, and staff were observed to be patient, sensitive and caring in their interactions with young people. Staff are able to quickly assess the emotional state of the young people, and adapt their communication style so the young person feels supported when they are at their most vulnerable. Key working sessions with young people are a strength and recordings demonstrate that 3 of 11 staff have good working relationships with the young people they support.

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Overall effectiveness

The home is a safe, comfortable environment and the staff access comprehensive training which enables them to care for the young people well. However, the high levels of risk taking behaviour displayed by some young people are not always managed in a way that leads to a reduction in the frequency or seriousness of incidents. A requirement has therefore been made that the effectiveness of behaviour management plans and risk assessments for young people are reviewed.

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Overall effectiveness

The staff team are supportive of one another. Any concerns that may arise regarding the practice of staff are quickly identified and investigated. An examination of documents identified a significant omission in a serious incident report. A recommendation has therefore been made in relation to the need for records to be clear. 4 of 11

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Information about this children’s home

This privately run children's home offers accommodation for up to two young people with emotional or behavioural difficulties.

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Inspection date Inspection type Inspection judgement

06/11/2013 Interim good progress 16/04/2013 Full good 29/11/2012 Interim good progress 12/06/2012 Full good

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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) 11 (1) (a) The registered person shall ensure that the children's home is conducted so as to promote and make proper provision for the safeguarding and welfare of children accommodated there. This specifically relates to need to review behaviour management strategies and risk assessments to ensure they are effective in keeping young people safe and reducing the number of serious incidents 31/08/2014

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Recommendations

To improve the quality and standards of care further the service should take 5 of 11 account of the following recommendation(s):

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Recommendations

 Standard 3.16. Where there has been a physical restraint, children's homes m be able to call on medical assistance as required and children are always give the opportunity to be examined by a registered nurse or medical practitioner.  Standard 3.18. Where any sanctions, disciplinary measures or restraint are us children are encouraged to have their views recorded in the records kept by t home.  Standard 22.5. Information about the child is recorded clearly and in a way w will be helpful to the child when they access their files now or in the future. Children are actively encouraged to read their files, other than confidential or third party information and to correct errors and add personal statements. Th specifically relates to the omission of significant information when recording serious incidents in the home. 6 of 11

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Outcomes for children and young people adequate

Since the last inspection one young person has left the home, and there has been a recent admission of a young person from another My Choice home. All the young people concerned have complex needs and display high levels of vulnerability. There has been some variation regarding outcomes for these young people. For one young person this has been a stable home, where significant progress has been made in terms of college attendance and improved contact with family. This stability has enabled the young person to increase levels of self confidence and wider social interaction.

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Outcomes for children and young people adequate

This level of progress for young people has not been achieved consistently, and some young people have engaged in dangerous behaviours which have placed themselves and others at risk. Management and staff have been consistent in offering good levels of support and guidance to the young people to try and minimise the frequency and seriousness of these events.

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Outcomes for children and young people adequate

Young people's physical and psychological health needs are recognised by staff and there is good communication with health care providers, such as CAMHS, to ensure young people's needs are reviewed and responded to. Arrangements are in place for young people to have their psychological needs assessed, and appropriate treatment is accessed. Despite this proactive approach by staff a young person has not always followed advice to seek necessary medical attention.

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Outcomes for children and young people adequate

Where sanctions are used, young people do not have the opportunity to record their views on the matter. Enabling young people to do so in the future will further enhance the homes approach to listening to the views and wishes of young people, which in other respects, are positive.

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Outcomes for children and young people adequate

Young people receive good support and encouragement to succeed in education. When appropriate, staff are present, or remain in the vicinity of the young persons educational placement, to provide support when needed. This arrangement has enabled one young person to make a successful transition to a college some distance away form the home. The on site educational facility has also enabled a young person who was struggling in mainstream school to re-engage with learning.

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Outcomes for children and young people adequate

Arrangements, such as young people's meetings, are in place so that young people can contribute ideas relating to how the home is run. One member of staff commented that the young person recently admitted from another My Choice was already starting to think of the house as home. Young people are encouraged to aquire age appropriate practical skills, and staff take into the account the abilities of each young person so that expectations are realistic but challenging. 7 of 11

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Quality of care good

The home is clean and tidy, well furnished and provides a warm comfortable environment for the young people. All maintenance requirements are actioned quickly and health and safety requirements are met. Young people are able to personalise their bedrooms, and one young person's bedroom seen during the inspection had posters, family photographs and the young person's art work displayed. The home is located near a park and has easy access to local open spaces and leisure activities, and young people are encouraged to make use of these. Staff were observed to interact well with young people, and were sensitive, warm and friendly in conversation.

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Quality of care good

During mealtimes the young people were relaxed together and with the staff, and chatted enthusiastically about their interests and plans for the half term school break. The food served at lunch time was seen to be healthy and nutritious, and the young people were encouraged to participate in the preparation and clearing away.

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Quality of care good

Staff take a consistent approach in setting boundaries and ensure young people understand why these are in place. When communicating with young people staff are patient and use language which takes account of the young person's additional needs and level of understanding. Young people are also encouraged to develop a strong sense of identity and recognition of their individuality. A Social Worker commented "staff will go out of their way to make sure their needs are met".

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Quality of care good

The staff are supportive of one another and communicate well. The three members of care staff spoken to during the inspection had a good knowledge of the individual needs of the young people and were familiar with the young people's behaviour management plans and risk assessments.

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Quality of care good

A key worker system is in place and regular key work sessions with the young people take place. These provide young people with an opportunity to express their views on a range of issues, relating to both the home and their care plan. These sessions are well recorded, and demonstrate that young people are listened to and are given full information when it is not possible to act on their wishes.

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Quality of care good

Young people's care plans and placement plans are detailed and reviewed regularly. The individual needs of the young people are identified and strategies for supporting them are thorough. This means that staff coming into the home who have not worked with the young person before has the information needed to provide effective care and support. The Registered Manager is proactive in obtaining the required documentation from placing authorities when required.

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Quality of care good

Staff encourage young people to engage in a range of activities, and are pro-active in identifying opportunities for young people to engage in community events. During 8 of 11 the inspection young people went swimming, played board games with staff and went shopping for art and craft materials. Outings are also arranged, such as a trip to Chessington, and walks on the South Downs and nearby forest.

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Quality of care good

No young people have made complaints since the last inspection. The two young people spoken to during the inspection were aware that they could make a complaint, but were not immediately familiar with the process. However, the process is explained in the young people's information pack, given to young people when they move into the home.

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Quality of care good

Medication is appropriately stored, and the system for administering and recording stock levels is effective.

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Keeping children and young people safe adequate

A young person who has lived at the home for an extended period reported that they felt safe within the home, but his was not the case for a young person more recently admitted, and the use of restraint was the issue identified. Restraint is used in the home strictly in accordance with the legislative framework, and all incidents are appropriately recorded. All staff have been trained in appropriate techniques and instructed to use restraint only as a last resort. Records indicate that this approach is embedded.

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Keeping children and young people safe adequate

Restraint reports demonstrate that young people are given the opportunity to talk to staff about a restraint and reflect on the circumstances leading to restraint being used. However, young people are not being asked if they require a medical examination following a restraint. This would provide the young person with a further opportunity to report any injury or discomfort they felt after being restrained. All young people should therefore be asked if they require a medical examination following a restraint, and their response should be recorded.

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Keeping children and young people safe adequate

Young people with complex emotional and behavioural difficulties, who frequently display high levels of dangerous behaviour, are placed at the home. Although individual behaviour management strategies and associated risk assessments are place for each young person, these are not always adequately reviewed and revised following a serious incident. The review process for these strategies is not evaluating how effective the measures are in terms of reducing the seriousness and frequency of dangerous incidents. Therefore, behaviour management strategies and risk assessments that are in place to keep young people safe should be reviewed to ensure they are consistently effective.

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Keeping children and young people safe adequate

Staff have a clear understanding of the needs and vulnerabilities of the young people and are able to assess when a young person's mood makes them more likely to go missing. Such incidents are therefore kept to a minimum. Protocols are in place with the Police for when young people do go missing, and arrangements for individual 9 of 11 young people which reflect their level of vulnerability have been agreed. The Registered Manager meets with the local PCSO each month to consider the vulnerability of the residents and highlight associated risks.

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Keeping children and young people safe adequate

Staff recognise the potential for bullying amongst young people, and where concerns have arisen, have taken steps to ensure a young person's safety. A Social Worker reported that staff are aware when two young people might not be getting on and felt confident that these situations are managed well.

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Keeping children and young people safe adequate

Procedures for investigating concerns about staff are robust. Two examples of potentially poor practice have been bought to the attention of management in recent weeks. Investigation reports demonstrate a thorough examination of the circumstances and facts relating to these incidents and conclude that concerns were unfounded. There have been no negative impacts on the wellbeing of the young people in relation to these matters.

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Keeping children and young people safe adequate

No new staff have been recruited to work in the home since the last inspection and consequently no new recruitment documentation to inspect.

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Keeping children and young people safe adequate

The home provides a physically safe environment for the young people. Alarmed sensors are used on the young people's bedroom doors and there is also a perimeter alarm around the property which is switched on at night. The perimeter alarm sounds in the staff sleep in room, and the bedroom door alarms sound throughout the house. Placing Authorities are made aware of these measures prior to a young person being admitted. Young people are informed about the alarms upon admission and there is information in the young people's information pack.

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Keeping children and young people safe adequate

Installation and appliance checks are undertaken and recorded appropriately, and health and safety risk assessment are in place. Fire drills are kept up to date and the Fire Service make the required visits to the home. Staff from the Fire Service have spoken with young people about the risks associated with fire when this has required.

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Leadership and management adequate

The Registered Manager has been in post since February 2012. He has obtained the NEBS Management/level 5 L&M & H&SC - Management and Professional and also holds an NVQ level 3 Health & Social Care - Management and Professional. The Manager has a clear understanding of the organisations and the homes statement of purpose. Services provided by the home are in accordance with those described in the document. No requirements or recommendations were made at the last full and 10 of 11 interim inspections.

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Leadership and management adequate

Records are kept up to date and provide an insight into the life of the young person. Records relating to a young person who left the home in April 2014 were found not to contain significant information regarding the circumstances of a fire in the young person's bedroom in December 2013. The relevant information was given verbally by a member of staff to inspectors during the inspection, and confirmed by the Registered Manager. The information had not been recorded in the incident report. The omission of this information could have impacted negatively on the planning for the young person's future and on other young people residing with the young person concerned. Records need to be clear and contain all relevant information known about the young person.

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Leadership and management adequate

The home employs sufficient staff to care effectively for the young people. Staff from other of the organisations homes, including bank staff, are used to cover staff absence. In addition, agency staff are also employed, but these are usually staff who have worked regularly at My Choice and consequently are familiar with policies and procedures in place and are known to the young people.

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Leadership and management adequate

My Choice provide a comprehensive training programme for staff. The risks associated with child sexual exploitation and internet safety are covered, enhancing the teams ability to keep young people safe. The staff spoken to during the inspection spoke favourably of the training available, and all were able to speak confidently about recognising the signs of abuse. Although all staff have personal development plans, not all were familiar with how these were relating to their personal and career development.

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Leadership and management adequate

Regulation 33 reports are completed and submitted on time, and are of a good standard. The reports contain a record of which young people were given the opportunity to speak to the Regulation 33 visitor, and a summary of their feedback. The appropriate authorities are notified of significant events, and in the majority of cases appropriate action is taken following the incident. However, as mentioned previously in this report, there is a need to review the effectiveness of behaviour management plans and associated risk assessments where a young person continues to place themselves at risk. Website: www.ofsted.gov.uk

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Leadership and management adequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information about this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the framework of inspection for children's homes.

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