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

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 Young people make progress in all areas of their development.  Staff give young people, including those with communication difficulties, regular opportunities to make decisions about their care, environment and activities.  Staff are kind, caring and very involved with the young people.  Staff work well with local schools and virtual schools, ensuring that young people make at least good progress in education.  Staff reinforce positive behaviours in young people, aiding them to gain an understanding of how to behave appropriately in social situations.  Staff give young people, who were previously socially isolated, opportunities to make and develop friendships.  The registered manager provides good guidance, support and structure to the staff and young people. This ensures that young people are well cared for in a safe environment by suitably qualified and experienced staff.  The registered provider supports the home by supplying sufficient finance

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The children's home provision is good because:

and resources to allow the registered manager to create a pleasant homely setting, providing healthy, culturally appropriate food.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Ensure that the workforce development plan records the ongoing training and continuing professional development needs of staff and, in particular, that it includes a training plan for the coming year and a monitor of staff supervision ('Guide to the children's homes regulations including the quality standards', page 53, paragraph 10.8).

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Recommendations

 Provide a homely domestic environment for young people and, in particular, ensure that repairs are conducted in a timely manner ('Guide to the children's homes regulations including the quality standards', page 15, paragraph 3.9).

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Recommendations

 Ensure that staff understanding of restraint includes physical restraint techniques that involve using force and includes restricting a child's liberty of movement. In addition, ensure that training in the use of restraint fits with the homes approach to restraint and is appropriate to the needs of the children ('Guide to the children's homes regulations including the quality standards', pages 47, 49, paragraphs 9.41, 9.42 and 9.58).

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Recommendations

 Ensure that records of restraint are accurate and sufficiently detailed to enable staff to review the use of control, discipline and restraint, to identify practice and to respond promptly when any issues or trends emerge ('Guide to the children's homes regulations including the quality standards', page 49, paragraph 9.59).

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Recommendations

 Ensure that the independent visitor makes a rigorous and impartial assessment of the home's arrangements for safeguarding and promoting the welfare of the children in the home's care. In particular, ensure that the report only contains relevant and current information and, when possible, interviews with young people, their parents and relatives ('Guide to the children's homes regulations including the quality standards', page 65, paragraph 15.5).

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Recommendations

 Ensure that at least one person on duty at any given time has a suitable first-aid certificate ('Guide to the children's homes regulations including the quality standards', page 35, paragraph 7.13).

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Recommendations

 Ensure that the processes put in place to review the quality of care provided by the home, the experiences of children living there and the impact that the care is having on outcomes and improvements for the children are underpinned by the quality standards. Also ensure that a report is generated at least once every six months and it is sent to Ofsted and the placing authority of all children who are children looked after ('Guide to the children's homes regulations including the quality standards', page 64, paragraphs 15.2, 15.3).

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Information about this children's home

This privately owned home provides care and accommodation for up to seven children with learning disabilities and or physical disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

17 February 2016 Interim Improved effectiveness

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Good

Young people make progress in a range of areas in the home. They have individual targets that show progress in self-care skills, independence skills, health, leisure activities, behaviour management and the development of self-esteem. Staff monitor targets monthly and adjust them when relevant to ensure that they remain suitably challenging and achievable for each young person. The manager ensures that records are current and cross-referenced with other recordings, such as health, care and behavioural plans. This provides clear evidence of tracked progress of young people in the home. Young people have good relationships with staff. One said, ‘I am friends with the staff. They are nice people,’ and another said, ‘The best thing about home is how friendly the staff are.’ Staff impose appropriate boundaries in the home, showing respect and sensitivity towards the young people. They take young people to

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Good

settings where they can make friends and develop relationships. In particular, young people enjoy the youth club. Young people are gaining confidence in social situations and developing friendships in safe environments, with staff support. Staff assist young people in meeting their religious and cultural needs. They have discussions with young people about religion and support them in following any aspect of their religion that they wish, such as attendance at a place of worship. Staff provide culturally appropriate meals and aid young people in personal care. One young person has significantly improved their skin and hair condition with staff assistance. The staff create an inclusive atmosphere in the home, where they encourage young people to celebrate their religious and cultural backgrounds and to learn about others. All young people are involved in some form of education, most attending school or

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Good

college. A representative from the virtual school praised the home’s engagement in the support of young people, including staff attendance at all meetings. One young person who had not attended school for five years is making good progress with staff support and a tutor, in preparation for college. One social worker said that the school has commented that the young person is always properly prepared, clean and well dressed. Staff attend parents’ evenings and education meetings in schools and support young people into new schools or colleges. One young person said, ‘I took part in the sports day at school because the staff here encouraged me to. They always support me with my school work and homework.’ Staff provide good support to young people regarding their education, aiding them to have regular attendance and to make good progress. All young people have healthcare plans in place. These identify targets, which staff

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Good

cross-reference in the individual target plans for each young person. The good planning ensures that young people address all healthcare targets within defined timescales. Young people are knowledgeable about healthcare issues, in particular, healthy eating. One young person said, ‘Food? I love it here. I am always looking forward to dinner. We have a nutritionist here who talks to us about how many calories are in meals and how we can eat healthily. She is always telling us to eat vegetables and salad.’ Staff monitor young people’s appointments, medication and health factors, including their body mass indicators to track their progress with health targets. They work well with other agencies, such as child and adolescent mental health services, to ensure that young people receive appropriate healthcare. Young people make good progress in gaining an understanding about healthy lifestyles and benefit from healthy eating and exercise programmes in the

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Good

home. The home has good independence planning for young people. All are completing a comprehensive assessment of their current position, which is feeding into ongoing targets to address any areas for development. Young people’s targets are highly personal, as identified in the detailed assessment. Some are working on the use of money, others on independent use of public transport and those with high- dependency needs have basic care targets such as brushing their teeth. The young people are making good progress working through this highly structured programme moving on once they have achieved success in the targeted areas. One young person proudly showed how he keeps his room tidy and does all of his own laundry, including ironing. Young people are making good progress in developing independence skills in a highly structured and closely monitored way. Staff give young people multiple opportunities to make choices and to express

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Good

preferences in the home. They ensure that young people with limited communication skills can make their own choices and shape their experiences in the home. They do this through regular, recorded key-worker sessions and home meetings and through providing daily opportunities to make decisions. Young people are empowered by these opportunities and learn skills in decision making in a safe environment. They enjoy this experience and love being in the home. One young person said, ‘This is a good place to say I grew up in. I have a photograph album of what I am doing here, and in years to come I will look back on it and remember being happy and learning so much.’

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Good

All young people have risk assessments in place. Staff regularly review and adjust these when appropriate. Each young person has their own risk assessment for activities and a personal emergency evacuation plan. These risk assessments are easy to follow, regularly reviewed and are effective in keeping young people safe. The home has a safeguarding policy, which staff are familiar with and put into practice. The policy was adjusted during the inspection to include a detailed section on the Prevent agenda including helpful guidance to staff. The manager is working with a local school to improve staff training on keeping young people safe. Staff application of this training is designed to aid young people to stay safe in the community and the home. Staff understanding and application of training in safeguarding and child protection enhance young people’s safety. Staff application of risk assessments and good involvement with young people

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Good

ensure that they are safely cared for. No young people have gone missing from the home since the last full inspection. Some young people had previously gone missing from other settings, and placing social workers initially reported them to be at high risk of going missing from the home or on trips. Staff vigilance, effective risk assessments and good planning ensure that young people do not go missing. Staff maintain effective behaviour support programmes for each young person. They target improving social skills, developing independence, self-esteem and confidence, and supporting behaviour management. These are positive plans, which focus on young people developing new social and communication skills and provide guidance to staff on managing difficult behaviours. This is leading to improved behaviour in young people, through a positive framework for reinforcing desired behaviours rather than focussing on sanctioning negative behaviours.

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Good

There have been no sanctions since the last inspection. Staff have asked young people to leave situations to calm down and record this in the incident log as behaviour management rather than as a sanction. Staff recognise positive behaviours with instant small rewards that they know the young person will value, for example, a packet of crayons or a drawing book. Young people are reducing incidents and improving their behaviour with this support from staff. There has been only one recorded use of restraint since the last inspection. Staff were vague in discussion about what actions they should define as restraint. For example, they frequently lead young people away from others but without the use of actual holds, and were unsure whether this was a restraint or not. For the one incident that staff recognised as a restraint, the member of staff did not include all necessary detail in his recording of events leading to its use. This was due, in part,

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Good

to the limited space in the logbook. Young people say that when staff manage difficult behaviour they do it carefully and do not cause any hurt or injury. Staff generally manage behaviour in the home without the use of restraint. However, recording and staff understanding of what interventions constitute restraints require improvement to aid the manager’s monitoring of their appropriateness. Staff supervise the young people’s use of the computer. There are safeguards blocking inappropriate sites. The manager checks site usage to ensure that there is no inappropriate use. Young people enjoy supervised use of computers in the home, which maintains a safe environment for them. Staff safely record and store medication in the home. Controlled drugs are appropriately recorded in a separate logbook and their use is monitored by a qualified nurse. All staff have successfully completed training in the control of

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Good

medication and have a basic first-aid qualification. However, there are insufficient staff with appropriate first-aid qualifications to ensure that each shift has one on duty to provide safe care to the young people. The manager ensures that the home is a safe environment. All health and safety checks are in place and reviewed with appropriate regularity. This includes all fire safety checks and the maintenance of a fire risk assessment. To support this, staff conduct monthly fire evacuations because of the vulnerability of the young people. In addition, staff are working with young people to help them to gain an understanding of hazards in the home and of how to stay safe. Young people live in a safe environment and are learning how to use hazardous equipment such as irons and ovens safely.

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Good

The manager completed his registration with Ofsted for this setting on 20 April 2015. He has previous experience of managing children’s homes as a registered manager and has a generally good inspection history. He has suitable care and management qualifications and maintains his learning through reading, supervision and engagement in professional forums. The manager has made significant positive changes to the home since his appointment, in particular improving: staff support and training; effective target setting and monitoring of young people’s progress; maintenance of young people’s files, risk assessments, behavioural and care plans; and communication with the young people including improving their involvement in decision making. One young person said of him, ‘The manager is very friendly. He always works things out when there are problems. He likes talking to the young people. He is very involved.’

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Good

As previously mentioned, the manager has significantly improved the quality and effectiveness of care plans, risk assessments and behaviour modification plans. Staff recording in them is good, and they are carefully cross-referenced records of young people’s progress. The manager rigorously monitors records, ensuring that they are current and show progress of young people. All documents show evidence of successful staff engagement with young people, producing good outcomes in behaviour control, education, health, self-esteem and self-help skills. The manager plans admissions carefully, seeking detailed risk assessments on all young people before considering them for acceptance. His communications with social workers and placement teams shows evidence of his consideration of the balance of young people in the home. All young people have detailed risk assessments and well-planned introductions in place before admission, aiding in

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Good

their successful admission to the home without a negative impact on the other young people. The registered manager has developed a strong team ethos in the home. Staff work to the aims and objectives described in the statement of purpose, and are clear about their roles and responsibilities. They present as confident and relaxed with the young people. All talk about the strength of the team, the good support from the registered manager and their mutual support. One member of staff said, ‘Our manager is a gentleman. He makes sure everything works with the first priority being the young people. We are happy to work here. We work well together as a team, eat together and enjoy ourselves together.’ All staff say that they have monthly supervision, which they find helpful and which aids them in addressing any personal difficulties that they experience in work. However, the supervision records are individual and there is no overview, making it

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Good

difficult to track the frequency of sessions for each member of staff. Records show that supervision is reflective in nature and provides appropriate support to staff. The home has a workforce development plan that clearly details the induction process for staff. All staff receive regular training and updates on key areas such as behaviour management, basic first aid and safeguarding. The manager has ensured that all staff either have an appropriate qualification or are studying for one. However, there is no training matrix or training plan for the coming year. The effectiveness and efficiency of the training plan relies on the manager’s personal recall and monitoring of individual staff files. As the staff team has increased in size, this is no longer an effective way of organising training. During the inspection, the manager created a training plan for the coming year from records held on individual files.

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Good

The independent visitor reports up until May 2016 were checklists of activity in the home and rarely included dialogue with young people, parents or relatives, or comments on how well the home safeguarded the young people. The reports were a detailed audit of the files, health and safety and policies, but did not comment on the relationship between staff and young people. The manager and visitor have agreed a new format for reporting. The most recent report included comments from one young person and reports that young people are safe in the home and that staff interactions are appropriate and caring. However, the report included an out-of-date comment from earlier reports, which was no longer relevant and detracted from the integrity of the report. The manager makes good use of the detailed review of records included in the independent person’s reports to aid in his continuous improvement of the home. The changes to the reporting format and

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Good

the conduct of the inspections is generally improving the quality of the reports and the safeguarding of young people in the home. The manager completed a monitoring report in October 2015. This covered the period from April to September 2015. The report provided a good overview of the service and functioned as an audit of practice during the manager’s initial period in the home. However, he had not underpinned the report by the quality standards and did not set a clear action plan for the following six months. The manager monitors practice in the home and is completing a report on the quality of care in the home to a revised format. However, he was due to complete the report and submit this to relevant parties in April. The manager maintains good monitoring of the home. However, his failure to complete the monitoring report weakens the planning for the next six months. The manager has written the statement of purpose in easy-to-understand

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Good

language, and has ensured that all staff are aware of the content and apply it in their practice. It contains a helpful guide to how the home provides care and accommodation to young people, structuring the work of the staff team. The manager corrected some minor errors and omissions during the inspection, ensuring that it provides complete guidance on how to access policies and procedures. He also corrected an omission in the young people’s brochure, ensuring that it now contains contact details for the children’s commissioner. These documents are good practical guides to the positive ethos and practice in the home. The registered manager ensures that he has the home generally pleasantly decorated and well resourced. Young people say that they love the bright colours on the walls. Young people’s bedrooms have modern furniture and include a study area and suitable storage space. One young person said, ‘I love my room.’ A social

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Good

worker described one young person’s bedroom as a little princess’s room and praised the brightness of the rest of the setting. However, the manager had not organised the repair of a large hole in the wall, caused by one young person, detracting from the homely environment created by staff.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against ‘Inspection of children's homes: framework for inspection’.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or that result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference that adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition, the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people whom it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the ‘Guide to the children's homes regulations including the quality standards’. 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

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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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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