Children's home run by My Choice Children’s Homes Limited in Mid Sussex

This monitoring visit

This monitoring visit took place following a Declined in effectiveness judgement made at the interim inspection on 27 January 2016. Seven requirements and four recommendations were made at the interim inspection. The date set for meeting the requirements was 22 February 2016. This monitoring visit focused on progress made since the interim inspection, and whether the home has met the requirements. Progress against the recommendations made at the interim inspection was not examined at the monitoring visit. These recommendations are repeated in this report, along with one new recommendation relating to policies.

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This monitoring visit

The organisation’s area manager took on the role of acting manager at the home, on 8 February 2016. Consistently strong leadership and management has not yet become established in the home. One team meeting has taken place since the interim inspection. This meeting did not focus on the weaknesses identified during the inspection, or on the organisation’s action plan to address these.

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This monitoring visit

An external agency has been commissioned to work with the staff to improve team dynamics. Staff have not yet fully engaged with the work. Some staff continue to feel unsupported and remain sceptical about the competence of senior managers. It is not apparent that staff have confidence in the organisation’s whistle-blowing procedures.

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This monitoring visit

Staff shortages and sickness have resulted in there being insufficient numbers of experienced staff on some shifts. On one occasion the staffing level fell below that described in the home’s statement of purpose. This meant young people could not be supervised in accordance with their risk assessments and behaviour management strategies, which state that they will be supervised on a one-to-one basis.

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This monitoring visit

Agency staff, along with casual staff and care staff from the organisation’s other homes, have been used to cover staff shortages. During February 2016, 14 different members of staff were used to cover gaps in the rota. Consequently, young people have not benefited from receiving consistency of care from staff they can form strong relationships with.

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This monitoring visit

Since the interim inspection, one member of staff, out of six permanent staff, has received formal supervision. The home’s statement of purpose makes provision for staff to receive supervision once per month. This is not being achieved. The requirements set at the interim inspection, relating to staff supervision, have not been met.

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This monitoring visit

Sufficient progress, in relation to other requirements made at the interim inspection, has not been made. Staff have recently received training to enable them to administer emergency medication, if required, to a young person with a serious medical condition. However, the acting manager was unable to attend this training. Managers and staff have not consulted with the young person’s allocated health-care practitioners, in relation to the effects of the young person failing to follow medical advice and not taking medication in the way prescribed. Consequently, the potential negative impact on the young person’s health and well-being is not known to staff caring for him.

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This monitoring visit

Relationships between the young people remain complex and fragile. An external agency is undertaking work with two of the residents on managing personal relationships and recognising when these may be harmful. However, managers are not knowledgeable about the work being undertaken. No planning, regarding how staff can enhance and support the work being done by the external practitioners, has taken place. Since the interim inspection staff have not undertaken key-work sessions addressing personal relationships, with any of the young people.

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This monitoring visit

At the time of the monitoring visit, the third resident was receiving respite care, delivered by the organisation, in a rented holiday cottage. The purpose of this was described as providing a period for the young person to reflect on recent incidents at the home relating to peer relationships. However, no plan had been produced in respect of work to be undertaken with the young person during the respite period. The acting manager could not produce any reports or evaluation of how the young person was responding to the period of reflection.

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This monitoring visit

No evidence could be found that staff have taken effective action to de-escalate violent and confrontational behaviour between young people. Despite two of the young people becoming involved in a violent incident, resulting in police intervention, there are no records of any restorative work taking place. Furthermore, the acting manager confirmed that no discussion has taken place, within the staff team, on how to recognise and manage bullying.

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This monitoring visit

The response of managers and staff to child protection concerns has been poor. Adequate steps have not been taken to protect a young person known to be at risk of sexual exploitation, following inappropriate messages and images being received on a computer in the home’s school room. No internal investigation took place to establish how these messages were received. No action was taken to determine whether inappropriate images remain on the computer. Records do not indicate whether consideration was given to reporting this matter to the police.

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This monitoring visit

The risk assessments and associated guidance on managing this young person’s access to the internet have been ineffectual. These risk assessments have not been reviewed or updated since this incident. The general standard of risk management is poor. The risk assessment relating to a young person’s medical condition does not reflect that his use of prescribed medication is sporadic. Risk assessments were not updated as a result of young people purchasing alcohol while out on a shopping trip with staff.

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This monitoring visit

Poor communication between staff and management further impedes the effectiveness of safeguarding measures within the home. A senior manager was under the impression that a young person had not come to any harm while missing from the home, after receiving verbal feedback from a member of staff. The written report identified serious concerns for the young person’s mental health and emotional well-being. It became apparent during the monitoring visit that neither the senior manager, nor the home’s acting manager, were familiar with the content of the report relating to this incident. Poor communication meant this had not been recognised as a safeguarding matter.

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This monitoring visit

The standard of recording child protection concerns, and actions taken following a referral being made to a young person’s placing authority, has not improved since the interim inspection. It was noted that child protection documentation does not record decision-making processes, such as extending a young person’s time in respite care due to child protection issues. Documentation also fails to record consistently contacts made with relevant professionals.

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This monitoring visit

The standard of care planning is weak. It does not take into account the vulnerabilities of young people, and fails to take account of significant incidents. The acting manager could not evidence that consideration had been given to how young people would react to sensitive information being shared with one individual, and the impact this would have on the group. No consultation in relation to managing the situation had taken place with relevant professionals.

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This monitoring visit

Managers and staff do not reflect on or learn from incidents such as young people purchasing alcohol when out shopping with staff. No evidence could be found that this incident had led to a review of young people’s placement plans and behaviour management strategies.

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This monitoring visit

The requirement made at the interim inspection, relating to the independent person’s monitoring reports, was not examined at this monitoring visit. The organisation has not submitted an independent visitor’s report to the regulator, since the interim inspection was undertaken.

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This monitoring visit

Currently, interior door alarms are constantly left switched on. Normal practice within the home is to use these devices only at night. A senior manager explained that this measure has been introduced to safeguard the young people, as some are known to be in harmful relationships with one another. The organisation’s policy on the use of door alarms states that alarms will not be activated during the day, unless it states otherwise in young people’s ‘placement plan, looked after children care plan, 24-hour management plan, or risk assessments’. None of these documents have been updated to reflect the current situation.

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This monitoring visit

The home is not currently providing young people with an environment where they can feel stable and secure, address their complex emotional and behavioural difficulties or make good progress. Inadequate leadership and management has resulted in the weaknesses identified at the interim inspection not being effectively addressed. The permanent staff are demoralised, and staffing shortages mean there are occasions when many of those on duty lack the skills to meet the needs of young people. Consequently, the quality of care being delivered is poor, and the safety and well-being of young people is not being protected.

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Information about this children's home

The service can accommodate three children, with emotional and/or behavioural difficulties, irrespective of gender. It is one of eight children's homes operated by a private company. Education can be provided on site.

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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 (England) Regulations 2015 and the ‘Guide to the children's homes regulations including the quality standards’. The registered person(s) must comply with the given timescales.

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Requirement Due date

In order to meet the health and well-being standard, specifically in relation to seeking medical advice when young people fail to take prescribed medication and working with health professionals to support young people, ensure:

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Requirement Due date

(1)(a) the health and well-being needs of children are met. In particular, ensure:- (i) consultation takes place with the young person's named diabetic nurse. A health care plan is produced which contains measures to address the young person's failure to accurately record blood sugar levels and take medication as prescribed. (ii) that, following consultation with the named diabetic nurse, managers and staff are familiar with the health implications for the young person if he fails to take prescribed medication, and that these are recorded in the health care plan (iii) that managers and staff have received the training required to ensure the health care plan is implemented in practice. 08/04/2016

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Requirement Due date

*11: The positive relationships standard

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Requirement Due date

In order to meet the positive relationships standard, with particular reference to managing harmful relationships and staff supervision, the registered person should ensure staff:

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Requirement Due date

(2)(a)(vi) help each child to understand, in a way that is appropriate according to the child's age and understanding, 08/04/2016 personal, sexual and social relationships, and how those relationships can be supportive or harmful; in particular, ensure:- (i) staff consult with relevant professionals and make a plan which focuses on how individual young people can be helped to recognise when a personal relationship is supportive or harmful (ii) young people have a consistent, named key-worker. The key worker engages the young person in weekly key-work sessions until the planned work around managing personal relationships has been completed.

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Requirement Due date

(2)(a)(vii) help each child to develop the understanding and skills to recognise or withdraw from a damaging, exploitative or harmful relationship; in particular, ensure:- (i) key-work sessions are used to provide young people with information so they can recognise the characteristics of a damaging, exploitative or harmful relationship. (ii) staff assess whether each young person has the skills to withdraw from a harmful relationship. Use placement plans to identify what work staff will do to enhance the young person's ability to keep themselves safe in personal relationships.

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Requirement Due date

(2)(a)(x) are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same; in particular, ensure:- (i) all staff receive practice based supervision within the time frame described in the home's statement of purpose and that notes are made of each supervision session. (ii) supervision provides staff with the opportunity to reflect on the emotional impact of working with vulnerable young people.

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Requirement Due date

In order to meet the positive relationships standard, with particular reference to de-escalating confrontational and violent behaviour and bullying, the registered person should ensure staff:

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Requirement Due date

(2)(a)(xi) de-escalate confrontations with or between children, or potentially violent behaviour by children (2)(a)(xiii) have the skills to recognise incidents or indications of bullying and how to deal with them. 08/04/2016

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Requirement Due date

*12: The protection of children standard

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Requirement Due date

In order to meet the protection of children standard, with particular reference to risk management, preventing children harming each other, supervision and keeping children safe, the 08/04/2016 registered person must ensure that staff:

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Requirement Due date

(2)(a)(i) assess whether each child is at risk of harm, taking into account information in the child's relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; in particular, ensure:- (i) risk assessments are evaluated for effectiveness following an incident where a young person has placed themselves at risk of harm. (ii) risk assessments are regularly reviewed and amended, and particularly after each incident where a young person has placed themselves at risk of harm.

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Requirement Due date

(2)(a)(iv) manage relationships between children to prevent them from harming each other; in particular, ensure:- (i) the numbers of staff on duty allow for the young people to be supervised in accordance with their risk assessments and behaviour management plans. (ii) staff undertake planned key-work sessions with young people. These focus on developing young people's ability to recognise when a personal relationship is supportive or harmful, and provide young people with the skills to withdraw from harmful relationships. (iii) team meetings provide staff with the opportunity to discuss and analyse group dynamics between young people.

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Requirement Due date

(2)(a)(vi) take effective action whenever there is a serious concern about a child's welfare; in particular, ensure:- (i) an investigation is undertaken in respect of a young person receiving indecent images via the internet. This investigation to analyse the effectiveness of actions taken immediately after the incident and make recommendations for preventing a similar occurrence. (ii) the indecent images are no longer accessible. (iii) in partnership with other relevant agencies, assess whether the young person who received the indecent images is now at increased risk of child sexual exploitation. Identify actions to be taken to reduce the risk of the young person being sexually exploited.

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Requirement Due date

In order to meet the protection of children standard, with particular reference to the day-to-day care being delivered, the registered person must ensure: 08/04/2016 (2)(b) that the home's day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. Specifically, ensure staff inform managers when there are concerns for a young person's mental health and emotional well-being.

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Requirement Due date

13: The leadership and management standard

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Requirement Due date

In order to meet the leadership and management standard, with particular reference to children's welfare, leading and managing the home, staff practice, qualifications and skills, staffing levels and continuity of care, the registered person should ensure staff:

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Requirement Due date

(1)(b) promote children's welfare; (2)(a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home's statement of purpose; (2)(b) work as a team where appropriate; (2)(c) have the experience, qualifications and skills to meet the needs of each child; (2)(d) ensure that the home has sufficient staff to provide care for each child; (2)(e) provide continuity of care for each child 08/04/2016

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Requirement Due date

In order to meet the care planning standard, with particular reference to effectively planning how to share sensitive information and prevent young people purchasing alcohol, ensure children:

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Requirement Due date

(1)(a) receive effectively planned care in or through the children's home. Specifically, plan how sensitive information will be shared with young people, taking into account the likely impact on other young people in the home. Furthermore, ensure staff plan how they will deter young people from purchasing alcohol. 08/04/2016

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Requirement Due date

Ensure that all employees receive practice related supervision by a person with appropriate experience (Regulation 33(4)(b)). 08/04/2016

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Requirement Due date

*Provide for records to be kept of an allegation of abuse or neglect, and the action taken in response (Regulation 34(2)(d)). 08/04/2016

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Requirement Due date

Ensure the independent person produces a report which sets out, in particular, the independent person's opinion as to whether children are effectively safeguarded and the conduct of the home promotes children's well-being. Specifically, the report should 08/04/2016 evaluate whether children are being prevented from harming one another (Regulation 44(4)(a)(b)).

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Requirement Due date

* These requirements are subject to statutory compliance notice.

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendations:

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Recommendations

 Ensure children are consulted regularly on their views about the home's care, to inform and support continued improvement in the quality of care provided. Specifically, ensure young people's views are recorded and taken into account when appointing new staff to the home (‘Guide to the Quality Standards’, page 22, paragraph 4.11).  Ensure all children have access to appropriate advocacy support. Specifically, ensure young people are informed about the role of an advocate and how they can access an advocacy service (‘Guide to the Quality Standards’, page 23, paragraph 4.16).  Ensure children are supported to sustain or regain their confidence in education and be engaged in suitable structured activities (‘Guide to the Quality Standards’, page 28, paragraph 5.15).  Ensure the necessary support is given to children to enable them to access their education or training. Specifically, ensure that actions identified in personal

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Recommendations

education plan meetings are progressed, so young people can attend their education provision. (The Guide to the Quality Standards, page 28, paragraph 5.13).  Ensure that all staff consistently follow the home's policies and procedures for the benefit of the children in the home's care. Specifically, adhere to the home's policy in relation to door alarm sensors (‘Guide to the Quality Standards’, page 54, paragraph 10.20).

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the home since its last Ofsted inspection. This inspection was carried out under the Care Standards Act 2000. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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