Children's Home run by Choices Home for Children Limited in Stockport

Inspection report children‟s home: SC407169 1 SC407169 Registered provider: Choices Home For Children Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This privately owned home is registered to care for up to four children and young people who may have emotional and/or behavioural difficulties.

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Information about this children’s home

There has been no registered manager since 19 May 2018.

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Information about this children’s home

A new manager is in post but has not yet applied to Ofsted to be the registered manager.

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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

The children‟s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Date of last inspection: 6 December 2017

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report children‟s home: SC407169 2

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Inspection date Inspection type Inspection judgement

06/12/2017 Full Good 29/03/2017 Interim Sustained effectiveness 28/06/2016 Full Outstanding 28/01/2016 Interim Improved effectiveness Inspection report children‟s home: SC407169 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

The quality and purpose of care standard is that children receive care from staff who— understand the children‟s home‟s overall aims and the outcomes it seeks to achieve for children; use this understanding to deliver care that meets children‟s needs and supports them to fulfil their potential.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to— ensure that the premises used for the purposes of the home are designed and furnished so as to— meet the needs of each child; and enable each child to participate in the daily life of the home. (Regulation 6 (1)(a)(b) and (2)(c)(i)(ii))

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Requirement Due date

In particularly refers to the need to repair the damp patch on the lounge ceiling. 03/08/2018

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on— mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure— that staff— encourage each child to take responsibility for the child‟s behaviour, in accordance with the child‟s age and understanding; help each child to develop and practise skills to resolve conflicts positively and without harm to anyone. (Regulation 11 (1)(a)(b)(c)(2)(a)(ii)(iii)) 03/08/2018

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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 03/08/2018 Inspection report children‟s home: SC407169 4 registered person to 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; help each child to understand how to keep safe. (Regulation 12 (1)(2)(a)(i)(ii)) 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 aspire to fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to— ensure that the home‟s workforce provides continuity of care to each child; use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b)(2)(e)(h)) 03/08/2018

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Requirement Due date

The care planning standard is that children— receive effectively planned care in or through the children‟s home; and have a positive experience of arriving at or moving on from the home. (Regulation 14 (1)(a)(b)) 03/08/2018

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Requirement Due date

The registered person must— keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16 (3)(a)(b))

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Requirement Due date

In particular, this refers to ensuring that the statement of purpose clearly identifies which staff work in the home on a permanent basis. 03/08/2018

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children‟s home.

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Requirement Due date

In particular the registered person must ensure that— medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them; a record is kept of the administration of medicine to each child. (Regulation 23 (1)(2)(a)(c)) 03/08/2018

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Requirement Due date

The registered person may only use devices for the monitoring or surveillance of children if— the monitoring or surveillance is for the purpose of safeguarding 03/08/2018 Inspection report children‟s home: SC407169 5 and promoting the welfare of the child concerned, or other children; the monitoring or surveillance is no more intrusive than necessary, having regard to the child‟s need for privacy. (Regulation 24 (1)(a)(d))

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Requirement Due date

In particular, this refers to assessing the need for bedroom door alarms based upon the individual needs of young people. The registered person must ensure that all employees— have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4) (c)) 03/08/2018

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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— the name of the child; details of the child‟s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised

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Requirement Due date

person”)— has spoken to the user about the measure; and has signed the record to confirm it is accurate; and 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 (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii) and (c)(iv)) 03/08/2018

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Requirement Due date

The registered person must maintain records (“case records”) for each child which— include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 03/08/2018 Inspection report children‟s home: SC407169 6

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improvement to be good

Young people do not always receive individualised care and support from staff. Although this appears to be improving, key documents such as placement plans are not always sufficiently personalised and, as a result, do not provide staff with clear guidance on how to promote positive outcomes for young people.

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improvement to be good

The regular use of non-permanent staff means that there is not a stable staff team caring for young people. This reduces the opportunity for young people to experience consistent and reliable care. This contributes to some young people feeling anxious and unsettled at times.

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improvement to be good

Young people do not always receive the support they need to manage feelings of anxiety. In one instance, staff took limited action to respond to one young person‟s request for extra support, despite thoughts of self-harm being expressed. This placed the young person at potential risk of harm.

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improvement to be good

Positively, this is an improving picture, as staff are beginning to develop more effective links with the provider‟s clinical therapy team. Fortnightly consultations are helping staff to better understand how to meet the emotional health needs of young people.

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improvement to be good

In the main, the house is a pleasant and welcoming environment for young people. However, the home is in need of some redecoration. For example, a large damp patch on the lounge ceiling is unsightly. In other areas of the home, carpets and paintwork are showing signs of wear and tear. Reassuringly, the manager has recently requested remedial action from the home‟s owner to address these issues.

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improvement to be good

Staff have a good understanding of young people‟s physical health needs. Staff use specialist resources to meet the identified needs of young people. For example, staff have utilised the expertise of a personal trainer to support one young person to achieve his weight loss targets.

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improvement to be good

Staff ensure that all young people attend school. Staff enthusiastically celebrate academic achievements. For example, staff have gone to great lengths to make one young person‟s prom night a memorable and exciting event.

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improvement to be good

Staff‟s assessment of young people‟s vulnerability to harm is, at times, weak. For example, risk assessments do not always accurately reflect known risks or provide clear strategies to manage these risks. This means that staff are not provided with clear guidance on how to keep young people safe. Inspection report children‟s home: SC407169 7 Although there have been few incidents of young people going missing from the home, when such incidents have occurred staff have not always responded in a robust manner. This is because staff do not know the missing protocols for each young person, which places young people at increased risk of harm.

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improvement to be good

Staff have mixed success in managing young people‟s behaviour. In some instances, young people make noticeable progress and show signs that they are better able to regulate their emotions. However, an inconsistent staff and management team over the last six months means that, until recently, young people have not received a consistent quality of care. This has contributed to three young people‟s placements ending in crisis, as staff were unable to manage their behaviours.

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improvement to be good

Staff use a range of strategies to promote positive behaviour. For example, staff use spontaneous rewards to good effect to celebrate young people‟s achievements. Less successful strategies include behaviour reward charts. These generic charts are not personalised to the individual needs of each young person. As such, they have limited success in incentivising young people to make positive choices.

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improvement to be good

There are early signs that the use of physical interventions is reducing. Staff‟s greater focus on preventative rather than reactionary strategies appears to be a contributing factor to this. Despite this, there are missed opportunities to learn from significant incidents. For example, there has been limited follow up to one young person‟s use of a knife during a recent incident.

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improvement to be good

The manager‟s oversight of physical interventions is not always good enough. In some instances, the manager has not reviewed staff‟s use of such measures of control in expected timescales. This has not had any identifiable impact on young people.

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improvement to be good

Staff use bedroom door alarms to monitor young people during the day and night. Staff do not meaningfully review the need for such devices. Staff‟s indiscriminate use of bedroom door alarms reduces young people‟s opportunity for privacy.

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improvement to be good

Staff do not ensure that they safely administer medication to young people. Specifically, staff do not always document medication given to young people. Internal audits are ineffective, because when staff identify errors in administration, no remedial action is taken. However, there is no evidence that this has resulted in any direct harm to young people.

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

The home has experienced three changes of manager over the last six months. Currently, there is no registered manager. The lack of stable leadership has had an effect on the quality of care young people have received.

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

Positively, a new manager is in post and is in the process of submitting an application to Ofsted to be the registered manager. The new manager is energetic, keen and motivated. It is evident that he has re-energised the staff and he is currently working Inspection report children‟s home: SC407169 8 hard at consolidating their practice.

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

The manager has a realistic understanding of the home‟s areas of strength and weaknesses. However, his internal monitoring systems are not yet fully established. As a result, he has not been able to identify and take action to address shortfalls in the quality of care provided to young people.

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

Young people have not experienced a stable staff team. This is because there is an over- reliance on the use of bank and agency staff. Although this is an improving picture, there are currently insufficient permanent members of staff and there are no plans for further recruitment. The inconsistent staff team has an effect on young people‟s ability to develop trusting relationships with staff.

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

The manager has not ensured that the statement of purpose accurately reflects the staffing structure of the home. As a result, the statement of purpose provides children, parents and local authority commissioners with a misleading picture of the size and stability of the staff team.

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

In most cases, staff receive regular supervision. However, no staff have had their performance appraised in the last 18 months. This is a missed opportunity to address the performance of the staff team and improve the quality of care provided to young people.

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

Staff have developed collaborative relationships with key stakeholders and, in particular, young people‟s social workers. The inspector heard from social workers that communication with staff is good and that social workers are kept up to date with young people‟s progress.

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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: SC407169 9

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Children’s home details

Registered provider: Choices Home For Children Limited

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Children’s home details

Registered provider address: 31 Wellington Road, Nantwich, Cheshire CW5 7ED

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Inspector

Paul Robinson, social care inspector Inspection report children‟s home: SC407169 10 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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