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

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

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Information about this children’s home

The manager has been registered since 2015.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and/or widespread failures that mean young people are not protected or their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: improved effectiveness

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inadequate

Enforcement action since last inspection: none Inspection report children‟s home: SC025657 2

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Inspection date Inspection type Inspection judgement

01/03/2018 Interim Improved effectiveness 24/10/2017 Full Requires improvement to be good 08/03/2017 Interim Sustained effectiveness 15/06/2016 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

The registered person must complete a review of the quality of care provided for children (“a quality of care review”) at least once every 6 months.

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Requirement Due date

In order to complete a quality of care review the registered person must establish and maintain a system for monitoring, reviewing and evaluating—

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Requirement Due date

the quality of care provided for children;

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Requirement Due date

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.

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Requirement Due date

After completing a quality of care review, the registered person must produce a written report about the quality of care review and the actions which the registered person intends to take as a result of the quality of care review (“the quality of care review report”).

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Requirement Due date

supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed; and

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Requirement Due date

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 (1)(2)(a)(b)(c)(3)(4)(a)(5)) 27/07/2018

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Requirement Due date

Statement of purpose 27/07/2018 Inspection report children‟s home: SC025657 4 The registered person must compile in relation to the children‟s home a statement (“the statement of purpose”) which covers the matters listed in Schedule 1.

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Requirement Due date

If a home has a website, the registered person must ensure that a copy of the statement of purpose is published on that website unless the registered person considers that such publication would prejudice the welfare of children in the home.

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Requirement Due date

Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (1)(4) (5))

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

receive practice-related supervision by a person with appropriate experience. (Regulation 33 (4)(b))

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Requirement Due date

This relates, in particular, to the registered manager receiving regular supervision. 27/07/2018

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

undertake appropriate continuing professional development.

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Requirement Due date

This relates, in particular, to maintaining complete and up to date staff training records. 27/07/2018

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Requirement Due date

The registered person must maintain records (“case records”) for each child which—

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Requirement Due date

include the information and documents listed in Schedule 3 in relation to each child;

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Requirement Due date

are signed and dated by the author of each entry. (Regulation 36 (1)(a)(b)(c)) 27/07/2018 * Inspection report children‟s home: SC025657 5 This relates in particular to all children‟s files which must contain, as a minimum, those documents listed in Schedule 3 and care plans, placement plans, risk assessments, behaviour management plans, health plans, and all other relevant documents.

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Requirement Due date

Schedule 4 sets out the other information that the registered person must keep in relation to a children‟s home.

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Requirement Due date

maintain in the home the records in Schedule 4;

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Requirement Due date

ensure that the records are kept up to date. (Regulation 37 (1)(2)(a)(b))

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Requirement Due date

This relates, in particular, to the register of children (Schedule 4 (1)) 27/07/2018 *

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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—

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and

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Requirement Due date

a record is kept of the administration of medicine to each child. (Regulation 23 (1)(2)(b)(c))

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Requirement Due date

In particular, the doctor prescribing medication must provide written confirmation whenever medicines are administered in a non-prescribed manner, while the administration of medicines must include systems for staff to conduct regular medicine stock checks. 27/07/2018

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Requirement Due date

The health and well-being standard is that— 27/07/2018 Inspection report children‟s home: SC025657 6 the health and well-being needs of children are met. (Regulation 10 (1)(a))

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Requirement Due date

This relates, in particular, to maintaining food hygiene standards in the home.

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Requirement Due date

Engaging with the wider system to ensure children‟s needs are met

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Requirement Due date

In meeting the quality standards, the registered person must, and must ensure that staff—

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Requirement Due date

seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children‟s home is to provide care and accommodation. (Regulation 5 (d)) 27/07/2018

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Requirement Due date

The quality and purpose of care standard

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

ensure that the premises used for the purposes of the home are designed and furnished so as to—

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Requirement Due date

meet the needs of each child. (Regulation (6)(2)(c)(i)) 27/07/2018

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Requirement Due date

* These requirements are subject to a compliance notice.

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Recommendations

 At least one person on duty at any given time in the children‟s home must have a suitable first aid qualification. („Guide to the children‟s homes regulations including the quality standards‟, page 35, paragraph 7.13) In particular, every shift must have an identified and named lead first aider.

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Overall experiences and progress of children and young people: inadequate

This inspection identified significant shortfalls in how young people are helped and protected as well as shortfalls in the leadership and management of the home. These shortfalls have resulted in inadequate judgements in these two areas and so the overall judgement for the service is inadequate. Young people do not receive a service that Inspection report children‟s home: SC025657 7 meets regulatory requirements or the quality standards and the service does not follow good practice guidance.

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Overall experiences and progress of children and young people: inadequate

Admission procedures and care planning arrangements are poor. In some instances, there is no evidence that any consideration was given to how young people would have their needs met or their risks managed. This is a significant shortfall that places young people at risk of harm, particularly given the communication and comprehension difficulties experienced by many of the young people.

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Overall experiences and progress of children and young people: inadequate

The inadequate leadership and management of the home increase the risks to young people of not having their welfare safeguarded and promoted effectively. The registered manager and staff team fail to work consistently in effective partnership with professionals and parents. Feedback from professionals and carers is mixed. An independent reviewing officer praised the staff for their knowledge of a young person‟s needs, and a social worker said a young person had made progress. A parent described a young person as „really settled down, more confident and calm‟. However, another social worker expressed concern in relation to the staff‟s limited attendance at a young person‟s reviews and a failure of the home to provide regular welfare updates. In addition, a parent was concerned that staff provided very limited feedback regarding a young person‟s well-being, routines and activities. These shortfalls mean that young

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Overall experiences and progress of children and young people: inadequate

people do not benefit from a coordinated approach to meeting their needs, reviewing their development or ensuring that their welfare is robustly considered.

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Overall experiences and progress of children and young people: inadequate

Young people do not receive sufficient help to develop their independence. Staff support young people with their independent living plans, although these plans only outline basic chores such as washing up, making beds and supervised clothes ironing. There is no formal measurement of progress and there are no regular reviews. This limits the amount of progress that young people make.

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Overall experiences and progress of children and young people: inadequate

The approach to help young people to make progress is inconsistent. Some young people do make progress in the home. Examples include increased attendance at school and reductions in their challenging behaviour. However, an incentive scheme put in place for one young person was ineffective and not in keeping with their ability to understand what it was for.

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Overall experiences and progress of children and young people: inadequate

Young people live in an environment that lacks a homely feel and which is in need of repair and redecoration. While one part of the home appears suitably maintained, other areas look neglected. There are broken showers, missing window restrictors and damaged paintwork.

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Overall experiences and progress of children and young people: inadequate

Staff understand young people‟s communication styles. When necessary, staff use pictorial symbols that help young people to confirm their requests.

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Overall experiences and progress of children and young people: inadequate

Young people have opportunities to engage in various activities within the home and out in the community, including regular contact with their families. Inspection report children‟s home: SC025657 8

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How well children and young people are helped and protected: inadequate

Young people are not adequately protected from harm.

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How well children and young people are helped and protected: inadequate

Some young people are admitted without any written assessment or guidance on how staff will meet their complex needs. Two young people‟s files did not contain care plans, risk assessments, medication and health plans, behaviour management plans or parent/placing authority contact or consent details. One of these young people had been living at the home for 18 months.

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How well children and young people are helped and protected: inadequate

As a result of these failures, staff‟s knowledge of young people is limited to what they are told rather than any written guidance, professional assessment or expert advice. This means that young people are not sufficiently safeguarded.

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How well children and young people are helped and protected: inadequate

Young people live in a home that places their health at risk. One kitchen was found to be dirty and unhygienic, with a large number of cobwebs hanging directly above a food preparation area. In addition, a fridge in another kitchen contained out-of-date dairy products and unlabelled food items.

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How well children and young people are helped and protected: inadequate

Young people do not always have plans in place that help staff to know how to meet their challenging behaviours. Two young people did not have any behaviour management plans whatsoever. The generic behaviour management plans that are in place fail to consistently identify each young person‟s unique needs or how staff should respond to them. This places young people, their peers and staff at risk of harm.

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How well children and young people are helped and protected: inadequate

Medication storage and administration procedures fail to robustly protect young people. Staff do not carry out routine medicine stock checks, while a limited administration audit trail leaves the process open to error or misuse. On occasion, staff administer young people‟s medicines in a covert manner. Although there is some information that makes reference to this approach, including review notes from a prescribing medical practitioner, there is no written consent to confirm that these arrangements are safe or appropriate.

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How well children and young people are helped and protected: inadequate

Not all staff are recorded on the home‟s training timetable. As a result, the inspectors were unable to confirm that all staff receive training in child protection and safeguarding vulnerable young people. This raises the risk that not all staff are competent in child protection and safeguarding procedures and compromises the safety of the young people who live in the home. Training records are completed using a number of different formats. Training refresher dates are not recorded. This increases the risk that not all staff receive training and updates in line with guidance.

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The effectiveness of leaders and managers: inadequate

The home is not effectively managed and monitoring systems are inadequate.

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The effectiveness of leaders and managers: inadequate

Leaders and managers admit young people to the home without any assessment of how staff will meet their needs. For one young person, this has meant living in the home for Inspection report children‟s home: SC025657 9 18 months without any written evaluation of their needs being completed and scant information kept regarding their life in the home.

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The effectiveness of leaders and managers: inadequate

During the inspection, inspectors found that the registered manager had provided inconsistent information regarding a young person‟s care and accommodation arrangements. The registered manager subsequently confirmed that his initial explanation of the young person‟s care arrangements was inaccurate.

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The effectiveness of leaders and managers: inadequate

The home‟s website provides information that is incorrect and misleading. In particular, the website currently refers to an inspection judgement of „good‟. However, this was the home‟s inspection judgement in June 2016 and is out of date.

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The effectiveness of leaders and managers: inadequate

The home‟s published statement of purpose is three years out of date and is not an accurate reflection of the service. An updated statement of purpose provided to inspectors during the inspection is inaccurate in parts and does not provide all of the information required by regulation.

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The effectiveness of leaders and managers: inadequate

Internal monitoring processes fail to capture the views and opinions of young people, professionals, parents or staff. The registered manager‟s quality of care review is limited, with few action points or development plans identified. This limits any effective evaluation in relation to the quality of care that the home provides.

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The effectiveness of leaders and managers: inadequate

The home does not receive robust external scrutiny. An independent visitor conducts monthly visits to the home. Although the subsequent reports consider relevant aspects of care, they fail to identify areas for improvement in the home or highlight shortfalls.

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The effectiveness of leaders and managers: inadequate

Leaders and managers fail to maintain the home‟s admission and discharge book as required. Two young people admitted to the home have not been included in the book, despite living at the home for a considerable period of time. In addition, there is missing information concerning where young people previously lived or where they may have moved on to.

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The effectiveness of leaders and managers: inadequate

The registered manager has not received formal supervision this year. This has limited the level of professional support that he has received and fails to assist him to reflect on his own practice and the wider issues of running a children‟s home.

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The effectiveness of leaders and managers: inadequate

The home is fully staffed. Around 40% of the staff team members have obtained the required level 3 qualification, while all others are enrolled to undertake it. Staff spoken with said that they felt supported and that they liked working in the home.

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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 Inspection report children‟s home: SC025657 10 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 11

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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(s)

Victoria Jones, social care inspector Kevin Whatley, regulatory inspection manager Inspection report children‟s home: SC025657 12 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(s)

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Inspector(s)

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Inspector(s)

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