Children's home run by Merryvale Children’s Home Limited in Merton

Inspection report for children's home - monitoring visit: SC476069 1 SC476069

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Information about this children's home

This home is privately owned and provides care for up to five young people who have emotional and/or behavioural difficulties.

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This monitoring visit

This home was judged inadequate at the previous full inspection undertaken on 17 May 2017. Eight requirements were made as a result of breaches of the Children’s Homes Regulations (2015). Three of the requirements were subject to formal compliance orders, issued by Ofsted on 6 June 2017. Three recommendations were also made in order to improve practice in line with the quality standards for children’s homes (2015). The purpose of this inspection was to monitor progress in relation to the requirements and compliance notices.

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This monitoring visit

This visit found that the home has not addressed the concerns that were subject to compliance notices so these remain unmet. In addition, all but one of the requirements remain unmet.

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This monitoring visit

In relation to care planning, the home has not improved practice. Leaders and managers do not demonstrate how they can safely meet the needs of young people admitted to the home. A young person was admitted to the home for a short period recently. Prior to admitting her, the home gathered sufficient information to be informed of the young person’s needs, vulnerabilities and presenting behaviour. However, the risk assessment and behaviour management plan put in place for this young person did not use the available information to identify how the staff should intervene to keep her safe. Furthermore, the provider did not address risks in relation to this young person, posed by the location of the home or risks in relation to self-harm.. The safety plan did not give clear instruction to staff as to when, or if, physical intervention may be used to protect the young person from harm. As a result of these shortfalls, the young person was involved in a high number of serious

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This monitoring visit

incidents that placed her at risk of harm. Her placement ended after four nights. Inspection report for children's home - monitoring visit: SC476069 2 Leaders and managers have failed to provide staff with updated training in relation to behaviour management and the use of physical restraint. As a result, staff are ill- equipped to manage the risks and behaviours of young people with complex needs. One young person was subject to physical intervention on six separate occasions. However, staff recorded only one of these events. The physical interventions, as described in the daily records, indicate that the methods of restraint used were unsafe. Staff do not understand their responsibilities in relation to the use of physical interventions. This places the young people at risk of harm.

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This monitoring visit

The absence of recording in relation to serious incidents and physical interventions means that staff do not demonstrate that they use physical interventions safely. There is no evidence that staff receive sufficient support and guidance to reflect on incidents so as to learn from them. Nor is there evidence that staff undertake any work to help or support the young person involved. Worryingly, it is not clear what methods of physical interventions are used, which staff members were involved or the duration of the intervention. It is also not clear what efforts staff take to de- escalate situations in order to try to avoid the need for physical intervention.

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This monitoring visit

The manager of the home was unaware that staff had used physical intervention. This demonstrates poor management oversight of safeguarding practice. Because of this, the manager was unable to review the incidents or be reassured that the young person was safe.

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This monitoring visit

The provider has obtained references to support the appointment of senior staff. However, these references have not been verified. This means that the provider cannot be sure that they are genuine. This runs the risk that staff who may be unsuitable to work with vulnerable young people are permitted to work in the home.

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This monitoring visit

The manager has partially addressed one shortfall from the previous inspection. This relates to the recording and administration of medications. Staff now record the reasons for administering medicines. However, the instructions for staff in relation to giving medications to young people are not always clear. For example, one young person was prescribed medication for hay fever but the manager was unclear whether he should be given this daily or only when symptoms were present. The records in relation to this were also unclear. Furthermore, staff do not record the times that doses of medication are administered or consistently sign to show that they have been given. This demonstrates poor practice in relation to promoting the health and well-being of young people.

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This monitoring visit

The manager has improved some recording systems in response to the shortfalls identified at the previous full inspection. The care plans, behaviour management plans and risk assessment for the young person currently living in the home are fit for purpose. There is a risk assessment in place to consider matching the needs of young people when admitting new residents to the home. Unfortunately, these documents are not making a positive difference to the quality of care provided to young people. The home continues to admit young people without being clear how they can keep them safe or support them to make progress. Inspection report for children's home - monitoring visit: SC476069 3 The manager has produced a comprehensive report on the quality of care provided to young people in the home. This is a positive step, but the impact of this is undermined by the lack of management oversight into the day-to-day care delivered

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This monitoring visit

to young people, particularly in relation to safeguarding practice.

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This monitoring visit

There is only one young person currently living in the home. He is very positive about his experience there. He reported that he feels safe and that he gets on well with staff. He feels that staff push him hard to engage in education and reports that this has helped him. He enjoys a range of constructive activities and he is looking forward to starting college in September. He said that he has fun in the home and that staff had arranged ‘an amazing birthday party’ for him at a ‘posh’ restaurant. He feels that staff listen to him and he is really looking forward to going on a holiday abroad with staff during the school holidays.

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This monitoring visit

Staff at the home work constructively to promote diversity and equality of opportunity. They undertake direct work with young people to help them understand and explore their identity. Staff provide opportunities for young people to develop skills for independence and encourage them to put these skills into practice.

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Recent inspection history

Inspection date Inspection type Inspection judgement 17/05/2017 Full Inadequate 01/09/2016 Full Requires improvement 17/05/2016 Full Inadequate 14/01/2016 Interim Declined in effectiveness Inspection report for children's home - monitoring visit: SC476069 4

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What does the children's home need to do to improve?

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 within the given timescales.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— – understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children; – de-escalate confrontations with or between children, or potentially violent behaviour by children

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Requirement Due date

This is with particular reference to ensuring that staff have a clear understanding of the needs of young people living in the home and implement safe strategies to prevent harm. 05/09/2017

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure that staff: – have the skills to identify and act on signs that a child is at risk of harm; – understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; – take effective action whenever there is a serious concern about a child’s welfare; and – are familiar with and act in accordance with, the home’s child protection policies. That the home’s day-to-day care is arranged and delivered 05/09/2017 Inspection report for children's home - monitoring visit: SC476069 5 so as to keep each child safe and to protect each child effectively from harm. (Regulation 12 (1) (2)(a)(iii)(v)(vi)(vii) (b))In particular, this is in relation to helping young people reduce the risk that

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Requirement Due date

they may be to themselves or others. The leadership and management standard The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that: – helps children to aspire to their full potential; – promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to: – ensure that staff have the experience, qualifications and skills to meet the needs of each child; – understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home; – use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1) (2)(c)(f)(h)) 05/09/2017

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Requirement Due date

The care planning standard The care planning standard is that children receive well- planned care from the home and have a positive experience of admission and transition processes. In particular, the standard in paragraph (1) requires the registered person to ensure: – that the child’s placing authority is contacted, and a review of that child’s relevant plans is requested, if— – the registered person considers that the child is at risk of harm or has concerns that the care provided for the child is inadequate to meet the child’s needs; – the child is or has been persistently absent from the home without permission. (Regulation 14 (1) (2)(e)(i)(ii)) In particular, this relates to the failure of managers to ensure that young people are only admitted to the home if staff can safely meet their needs and keep them safe. 05/09/2017

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Requirement Due date

Medicines The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the home. (Regulation 23 (1)) In particular, that staff follow the home’s own policies and 05/09/2017 Inspection report for children's home - monitoring visit: SC476069 6 procedures when giving young people medication. Fitness of manager A person may only manage a children’s home if: – full and satisfactory information is available in relation to the person in respect of each of the matters in Schedule 2. (Regulation 28 (1)(c )) This is in particular reference to ensuring that two written references, including a reference from the person’s most recent employer, are verified by the responsible individual. 05/09/2017

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Requirement Due date

Review of quality of care In order to complete a quality of care review, the registered person must establish and maintain a system for monitoring, reviewing and evaluating: – the quality of care provided for children; – the feedback and opinions of children about the children’s home, its facilities and the quality of care they receive in it; and – any actions that the registered person considers necessary in order to improve or maintain the quality of care provided for children. The system referred to in paragraph (2) must provide for ascertaining and considering the opinions of children, their parents, placing authorities and staff. (Regulation 45 (2)(a)(b)(c) (5)) 05/09/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  The behaviour management strategy should be understood and applied at all times by staff, and must be kept under review and revised where appropriate. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.34)  Ensure that placements are only accepted for children where they are satisfied that the home can respond effectively to the child’s assessed needs as recorded in the child’s relevant plan. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.4)  The registered person must challenge (under regulation 5(c ) any placing authority who asks them to accept a child in the absence of a complete and current relevant plan, as the expectation that a placement of a child without the necessary information would go ahead ( in circumstances other than an

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Recommendations

emergency) is inadequate in relation to their role. It is essential that homes understand what will be required of them before they accept responsibility for a child’s placement, to avoid disruption and instability for the child in future and for Inspection report for children's home - monitoring visit: SC476069 7 other children in the home. (‘Guide to the children’s homes regulations including the quality standards’, page 56, paragraph 11.5)

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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 children's home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children's home - monitoring visit: SC476069 8

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Children's home details

Registered provider: Merryvale Children's Home Limited

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Children's home details

Registered provider address: Beech Farm House, Beech Farm Road, Warlingham, Surrey, CR6 9QJ

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Inspector

Lee Kirwin, social care inspector Inspection report for children's home - monitoring visit: SC476069 9 to 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children's services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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