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

Inspection report children’s home: SC025657 1 SC025657 Registered provider: Creating Care Choices Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately owned home provides care and accommodation for up to 11 young people who have learning disabilities and/or physical disabilities.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

Overall judgement at last inspection: sustained effectiveness

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Key findings from this inspection

This children’s home requires improvement to be good because:

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Key findings from this inspection

 Young people with significant needs are admitted without proper assessment of their risks and impact. This reduces the home’s capacity to manage the needs of young people, resulting in poor placement outcomes.  Not all young people have updated care plans and risk assessments. Inspection report children’s home: SC025657 2  Some young people have made allegations against staff working in the home. While these have been investigated in line with the child protection procedures and found to be unsubstantiated, there are learning points for the home to implement.  Not all serious incidents have been reported to Ofsted.  Staff and managers failed to notify the placing authority of an allegation made against staff working in the home.  The systems in place for recording restraints and sanctions are weak. Staff are not recording the incidents accurately or not at all, and the management oversight of the recordings is not robust.

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Key findings from this inspection

 Young people’s health needs are well managed.  Most of the young people who are currently accommodated experience stability and positive relationships with the staff and managers.  Staff are attuned to the needs of the young people they are assigned to as key workers.  Young people have made good progress in their self-care skills.

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Inspection date Inspection type Inspection judgement

08/03/2017 Interim Sustained effectiveness 15/06/2016 Full Good 17/02/2016 Interim Improved effectiveness 10/06/2015 Full Good Inspection report children’s home: SC025657 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet 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

In order to meet the protection of children standard, the registered person must ensure – that staff: 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;

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Requirement Due date

help each child to understand how to keep safe;

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Requirement Due date

understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person;

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Requirement Due date

take effective action whenever there is a serious concern about a child’s welfare;

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Requirement Due date

are familiar with, and act in accordance with, the home’s child protection policies;

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Requirement Due date

that the effectiveness of the home’s child protection policies is monitored regularly. (Regulation 12 (2) (a) (i) (ii) (v) (vi) (vii) (e))

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Requirement Due date

In particular, ensure that risk assessments are updated and reviewed by managers; ensure that the young people are supported by staff to understand what abuse is, and that staff report any allegation of abuse immediately. 21/12/2017

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Requirement Due date

In order to meet the care planning standard, the registered person must ensure – that children receive effectively planned care in or through the children’s home;

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Requirement Due date

that children are admitted to the home only if their needs are 21/12/2017 Inspection report children’s home: SC025657 4 within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose. (Regulation 14 (1) (2) (a))

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Requirement Due date

In particular, ensure that robust impact assessments are completed on new referrals; only accept placements for children where the provider is satisfied that the home can respond effectively to the child’s assessed needs.

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Requirement Due date

In order to meet the positive relationship standard, the registered person must ensure – that staff: meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans;

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Requirement Due date

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;

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Requirement Due date

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;

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Requirement Due date

de-escalate confrontations with or between children, or potentially violent behaviour by children. (Regulation 11 (2) (i) (ix) (x) (xi))

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Requirement Due date

In particular, ensure that supervision and support provided to staff include practice observations and feedback to help enhance staff’s understanding of the young people’s needs and deliver effective service. 21/12/2017

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Requirement Due date

In order to meet the leadership and management standard, the registered person must:

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Requirement Due date

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;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child; 21/12/2017 Inspection report children’s home: SC025657 5 ensure that the home has sufficient staff to provide care for each child;

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Requirement Due date

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;

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (2) (c) (d) (f) (h))

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Requirement Due date

In order to meet the education standard, the registered person must ensure – that staff: maintain regular contact with each child’s education and training provider, including engaging with the provider and the placing authority to support the child’s education and training and to maximise the child’s achievement;

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Requirement Due date

help a child who is excluded from school, or who is of compulsory school age but not attending school, to access educational and training support through the period of exclusion or non-attendance and to return to school as soon as possible. (Regulation 8 (2) (a) (vi) (vii))

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Requirement Due date

In particular, ensure that staff act as effective advocates for or on behalf of a young person who may be experiencing difficulties with education, as a good parent would do. 21/12/2017

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Requirement Due date

Behaviour management policies and records

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Requirement Due date

The registered person must keep the behaviour management policy under review and, where appropriate, revise it.

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Requirement Due date

The registered person must ensure that – within 24 hours of the use of a measure of control, discipline, or restraint in relation to a child in the home, a record is made which includes –

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

details of any methods used or steps taken to avoid the need to use the measure;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; 21/12/2017 Inspection report children’s home: SC025657 6 within 48 hours, the registered person, or a person who is authorised by the registered person to do so –

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Requirement Due date

has spoken to the user about the measure;

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (2) (3) (a) (iv) (v) (vii) (b) (i) (ii) (c))

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Requirement Due date

In particular, ensure that staff are familiar with the home’s policies on record-keeping and understand the importance of careful, objective and clear recording; ensure that the behaviour management policy contains a list of actions that are prohibited.

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Requirement Due date

The registered person must notify HMCI and each other relevant person without delay if –

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Requirement Due date

an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious;

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Requirement Due date

there is an allegation of abuse against the home or a person working there;

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Requirement Due date

there is any other incident relating to a child which the registered person considers to be serious. (Regulation 40 (4) (b) (c) (e))

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Requirement Due date

In particular, ensure that there are effective arrangements in place for the provider to send notifications to Ofsted in the absence of the registered manager; ensure that the notifications contain any actions taken to prevent further occurrence; and ensure that there is clear recording in place that explains why the incident was not considered sufficiently serious for a notification to be sent. 21/12/2017

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Requirement Due date

The quality and purpose of care standard

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Requirement Due date

In order to meet the quality and purpose of care standard, the registered person must ensure that: the premises used for the purpose of the home are designed and furnished so as to – 21/12/2017 Inspection report children’s home: SC025657 7 meet the needs of each child; and

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Requirement Due date

enable each child to participate in the daily life of the home. (Regulation 6 (2) (b) (c) (i) (ii))

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Requirement Due date

In particular, ensure that the planned repairs are completed in a timely manner so that the premises look homely.

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Recommendations

 The registered person should ensure that the home’s safeguarding policy includes detailed information on the arrangements for the safeguarding of young people from radicalisation, e-safety, gangs and female genital mutilation. (‘Guide to the children’s homes regulations including the quality standards’, page 44, paragraph 9.19)

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Recommendations

 Ensure that the children’s guide includes information on how to contact the Office of the Children’s Commissioner. (‘Guide to the children’s homes regulations including the quality standards’, page 24, paragraph 4.22)

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Recommendations

 Ensure that the young people have access to independent advocacy support. (‘Guide to the children’s homes regulations including the quality standards’, page 23, paragraph 4.16)

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Recommendations

 The home should play a full part in promoting the best interests of the child, proactively advocating for the child to ensure that others play their role and deliver the high quality support that is needed. Such partnership should always take place. (‘Guide to the children’s homes regulations including the quality standards’, page 11, paragraph 2.4)

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improvement to be good

Young people do not receive good enough care. Most of the young people, who were admitted since the last inspection, experienced poor placement outcomes. They were placed without proper impact assessments, and as a result, they did not enjoy positive stays. For example, a young person, who was discharged within a month of his admission, was involved in numerous incidents that required police intervention. The young person went missing from the home, caused property damage, assaulted staff, and caused other disturbances to a point where the other residents became afraid of him. The young person’s impact assessment did not reflect the high level of risks that were identified in his placement referral. Consequently, this resulted in an ineffective plan to meet the young person’s needs. Inspection report children’s home: SC025657 8 Since the last inspection, four young people have made allegations of harm against staff

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improvement to be good

members in the home. Allegations were investigated in line with the child protection procedures and found to be unsubstantiated. All of the four young people have since moved to other placements. They were in the home for only a short duration. While nothing conclusive was found, several areas of learning were identified for the home. For example, staff need to better understand young people’s needs and ny behavioural intervention must be appropriate to the individual young person. Also, staff need to support young people to understand what abuse is. In addition, any allegation against staff working in the home must be reportedly immediately. Following the allegations, the registered manager has put a hold on new referrals until improvements are made in the home.

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improvement to be good

Most of the eight young people currently accommodated in the home are long-term residents and have experienced stability in the home. Two of the eight young people have turned 18 years old and are waiting for a placement in adult care homes. Both of the young people are in full-time education and have made good progress with their self-care skills. However, the young people do not have updated care plans with specific, timely targets and clear, desired outcomes. Consequently, it is not clear when and how the young people are being supported to transition to their new homes.

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improvement to be good

Young people’s progress in education is varied. Five of the eight young people are in full- time education. A school professional stated that his young person is improving in his communication skills and engages in activities most of the time. A social worker stated that the home promotes her young person’s education. Young people’s education, health and care plans (EHC plans) are on file. However, it is not clear how the targets are being achieved. One young person has not been in school since she was excluded in March for destructive behaviour. No tutors have been provided. Another young person has not received any educational provision since being placed in the home several months ago. A third young person, who is not in school, is waiting to move to a residential specialist provision that has been identified for him, according to the virtual school. Staff and managers have made some efforts to support the young people’s education, such as

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improvement to be good

speaking with the schools and providing a daily programme of learning activities. However, there is room for improvement in staff and managers acting as effective advocates for the young people as a good parent would do.

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improvement to be good

Young people know how to complain. The children’s guide includes young people’s rights and the complaint procedure. However, the guide does not contain a reference to the Office of the Children’s Commissioner.

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improvement to be good

Since the last inspection, four complaints made by the young people have been recorded in the complaints log. These were handled adequately by staff with clear outcomes. However, there are no dates recorded to note when the complaints were resolved and no evidence of any meaningful review of the complaints to inform service delivery.

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improvement to be good

Young people who have limited verbal abilities are supported to communicate with the use of the picture exchange communication system and Makaton signing. Young people Inspection report children’s home: SC025657 9 are encouraged to express their views on the activities and meals they prefer. This helps young people feel heard and valued.

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improvement to be good

Young people’s health needs are well supported by staff, who also ensure that medications are administered to young people according to their plans. A social worker complimented the staff for how they helped her young person to gain a healthier weight. The young person was obese at the time he was admitted to the home. His weight is now appropriate to his age and development. The social worker stated that the young person’s behaviour is ‘better regulated due to consistent care and structure’.

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improvement to be good

Young people, who have been placed in the home for over a year, have made good progress in their self-care skills. For example, a young person is now able to wash himself, get dressed and cross the road, none of which he could do prior to his placement. In addition, he is now able prepare breakfast for himself, clean his room and adapt to social situations.

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improvement to be good

Staff and young people build positive relationships with each other. During the inspection young people were observed to interact with staff with ease and comfort. Young people appeared healthy and happy. One young person, who can be resistant to staff, was observed to be amenable to staff’s redirection.

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improvement to be good

A parent stated that her son has ‘made good progress’ since being placed in the home. The parent has frequent contact with her son and stated that the staff ‘are very good’ with him. Another parent stated that she ‘always visits the home’ and knows ‘everything that takes place’ in the home. She stated that she was ‘happy with the way staff are looking after’ her child.

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improvement to be good

The lack of robust impact assessments and proper planning has led to inappropriate placements. This means that young people’s significant needs are not well managed. Furthermore, risks are not clearly identified. Not all young people have robust risk assessments that reflect their vulnerabilities to child sexual exploitation, going missing, self-harm, substance misuse or offending.

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improvement to be good

The quality of the young people’s behaviour management plans varies. Some young people have comprehensive plans while others do not. Moreover, many of the assessments and plans are not signed or reviewed; hence, there is a lack of ownership and limited evidence of how staff are working to the plans.

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improvement to be good

The systems in place for recording restraints and sanctions are weak. Staff are not recording the incidents accurately or not at all. There is limited evidence of management oversight of the recordings. Descriptions of incidents, including restraints, are unclear and confusing. In addition, the views of the young people are not consistently recorded. Where the young people’s views are recorded, it is not clear how these were obtained when the young person has limited verbal abilities. It is also not clear whether the young Inspection report children’s home: SC025657 10 people have been supported to understand behavioural expectations and whether they have been offered access to advocacy support.

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improvement to be good

The home’s behavioural management policy is comprehensive. However, it does not list the behaviour management sanctions that are prohibited. This limits the young people’s and families’ understanding of the home’s approach to behaviour management.

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improvement to be good

Staff follow the home’s procedures when young people go missing. However, missing incidents are not always recorded, and it is unclear whether young people are offered independent return home interviews. While the young people who receive two-to-one support do not go missing, others who receive minimal support have been known to leave the home without the staff’s knowledge. It is unclear how the learning from the episodes of going missing is utilised effectively to better manage these incidents given the young people’s level of vulnerabilities, regardless of the infrequent rate of them going missing.

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improvement to be good

The registered provider notified Ofsted without delay of a serious incident that had taken place. However, other notifications, although submitted, were sent after a considerable time lapse. Also, where the provider has delayed in sending updated notifications, some of the notifications have gaps in the actions that the staff and managers have taken as a result of the matter. Consequently, it is unclear whether effective actions have been taken to prevent further incidents. Furthermore, there were some serious incidents that were not reported to Ofsted, and there is no recording justifying the reason why.

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improvement to be good

The home’s location risk assessment is comprehensive. The safeguarding policy is also comprehensive. However, it lacks information on the arrangements in place to protect young people from the risks of gangs, radicalisation, e-safety and female genital mutilation.

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improvement to be good

The physical environment of the home is safe but there are outstanding repairs, such as painting and decorating, which prevent the home from being homely and child-friendly.

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improvement to be good

A rewards system is in place to reinforce positive behaviour, which has had some impact on one young person’s behaviour.

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improvement to be good

A social worker stated that she considers the home’s safeguarding practice as ‘good’. Another social worker stated that she has ‘no concerns’ about the home’s safeguarding practice. A social worker of one of the young people, who made an allegation against staff, stated that the home ‘managed and supported’ her young person ‘very well’, and that the allegation was ‘investigated fully’.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager has substantial experience of working with vulnerable young people in residential care and is suitably qualified. The registered manager is supported by a deputy manager. However, the characteristics of good leadership and management have slipped since the last inspection. For example, most of the admissions to the home Inspection report children’s home: SC025657 11 during this period lacked robust impact assessments. There is a lack of effective assessment of the appropriateness of referrals and the potential impact of the young people on the existing young people and staff.

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The effectiveness of leaders and managers: requires improvement to be good

Safe recruitment is in place. Staff’s identity, qualifications and background checks are completed. However, the manager’s verifications of references are not recorded.

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The effectiveness of leaders and managers: requires improvement to be good

The home is not adequately staffed. There are 19 staff members who work various shifts. All of the staff are permanently employed. Of the eight young people who are currently accommodated, four receive two-to-one support. Staff and managers stated that the four young people consistently receive two-to-one support because staff work long shifts. There is some evidence of young people receiving two-to-one support. However, this is not always the case and the registered manager accepts that the home needs additional staff and is in the process of recruiting through an agency.

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The effectiveness of leaders and managers: requires improvement to be good

Seven members of the staff team have their level 3 qualifications. The rest of the staff are either currently enrolled on a level 3 course or will start this in January 2018. One member of staff, who began working in the home in 2015, neither has his qualifications nor is he due to start the course in the foreseeable future. There is no planning in place to ensure that the staff member gains this qualification.

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The effectiveness of leaders and managers: requires improvement to be good

Monitoring of the quality of care is weak. There is limited evidence of the managers and leaders overseeing staff’s direct practice and record-keeping and taking effective action where necessary to ensure that good care is delivered. Furthermore, there is limited evidence of the managers ensuring that young people’s assessments and plans are updated and that the staff are working to those plans.

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The effectiveness of leaders and managers: requires improvement to be good

Supervision and appraisals take place regularly for most of the staff but the recordings are poor. There is no meaningful evaluation of the work undertaken by the staff and how they are impacting the lives of the young people. This results in lost opportunities to review staff performance and provide useful feedback to help improve practice.

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The effectiveness of leaders and managers: requires improvement to be good

Arrangements for cover when the registered manager is away from the home are ineffective. For example, there are delays in sending notifications to Ofsted when the registered manager is off-site. Also, the home did not notify the placing authority of an allegation made against staff working in the home.

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The effectiveness of leaders and managers: requires improvement to be good

Feedback from professionals is mixed and includes both positive and less positive comments. For example, one social worker had no concerns about how her young person’s care was being managed. However, another social worker stated that partnership working can be improved. For instance, the progress reports on the young person could be sent without prompts by the placing authority. Also, the reports can include detailed information on the activities organised for the young person and the purpose behind these activities. A school professional stated that he has not received regular correspondence from the home as agreed. This means that an opportunity to provide weekly communication about the young person’s challenging behaviour and mood that would be helpful in managing their difficulties is lost. Inspection report children’s home: SC025657 12 The registered manager has accepted the learning points for the home from the

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The effectiveness of leaders and managers: requires improvement to be good

allegations made against staff working in the home. There are knowledge and skills gaps for staff which impact the care of the young people. Not all staff have completed the home’s mandatory training on restraint and on safeguarding; in particular, working with young people with learning disabilities, which the registered manager has arranged.

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The effectiveness of leaders and managers: requires improvement to be good

The registered manager’s assessment of the home’s strengths and areas of improvement is thoughtful and considered. He has a good understanding of what needs to change and how he will undertake the improvement work. The registered manager has carried out some practice observations and has knowledge of the issues. However, there is room for improvement in the written report under regulation 45. The report does not reflect the serious issues that the registered manager has identified, nor does it capture the plan of action he is putting together to tackle both the short-term and long-term issues. Also, the workforce development plan is comprehensive but there is limited evidence of the plan being followed. Despite this, the registered manager stated that he is committed to ensuring that the staff and managers are working in line with the ethos of the home’s statement of purpose.

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The effectiveness of leaders and managers: requires improvement to be good

A staff member, who has worked in the home for several years, stated that she feels supported by her colleagues and her managers. Another staff member also stated that he feels supported by the team and finds the training offered helpful. Staff have good knowledge of the needs of the young people for whom they are key workers. They understand the young people’s strengths as well as their vulnerabilities. Staff have stated that they enjoy working with the young people and want to help them make progress in their lives.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC025657 13

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Children’s home details

Registered provider: Creating Care Choices Limited

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Children’s home details

Registered provider address: 38 Castle Drive, Ilford, Essex IG4 5AE

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Inspector

Linda Kim-Newby, social care inspector Inspection report children’s home: SC025657 14 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 children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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