Children's home run by Chartwell Care Services Ltd in Islington

Inspection report for children’s home – monitoring visit: SC468315 1 SC468315

p.1

Chartwell Care Services Ltd

Monitoring visit Inspected under the social care common inspection framework

p.1

Information about this children’s home

This privately owned home provides care for up to four children who have a learning disability. Children have varying needs, which may include an autistic spectrum disorder, attachment issues, communication difficulties, and all may present specific challenges in terms of difficult behaviours, whether diagnosis-related or learned.

p.1

Information about this children’s home

The registered manager was registered in March 2018.

p.1

This monitoring visit

The purpose of this monitoring visit was to examine the current safeguarding arrangements in the home. This is in light of an ongoing police investigation following an incident when staff restrained a child. In addition, the visit was to establish why the incident was not initially referred by management to the designated officer for the local authority.

p.1

This monitoring visit

The visit involved examining the restraint log, one risk management plan, records of staff training, and safeguarding and whistleblowing documentation. The visit explored whether there was a reduction strategy in place to address the challenging behaviour of children and analysis of restraints. In addition, the visit also explored whether staff received expert guidance regarding the management of behaviour.

p.1

This monitoring visit

The visit focused on the improvements in practice and learning from this incident. Individual discussions were held with the registered manager, the responsible individual and three staff members. The management of challenging behaviour was also observed by the inspector.

p.1

This monitoring visit

An incident occurred on 5 July 2018 where a child sustained injuries during a restraint. The designated officer for the local authority was made aware of this incident due to a staff member whistleblowing their concerns regarding the management of this incident. Inspection report for children’s home – monitoring visit: SC468315 2 Ofsted were notified of the incident on 9 July 2018. Ofsted were informed that the child sustained injuries during the restraint and that the child’s placing authority were reporting this incident to the police. The notification stated that an incident de- brief had been carried out with the staff involved, to reflect on whether things could have been handled differently.

p.1

This monitoring visit

On 10 July the responsible individual informed Ofsted that a staff member may have inappropriately held a child during the restraint on 5 July 2018.

p.2

This monitoring visit

A strategy meeting was held on 12 July with the designated officer for the local authority, the child’s placing authority, the home and the police. Ofsted was not invited to this meeting. It was reported that the child had stated his injuries were caused by two staff members while they were in his bedroom. The child has not raised any concerns regarding the incident. Both staff members were suspended pending the investigation.

p.2

This monitoring visit

On 13 July the designated officer for the local authority contacted the Ofsted inspector. The designated officer for the local authority confirmed that a police investigation is being undertaken due to the injuries. They confirmed that the incident occurred when the manager was not on duty.

p.2

This monitoring visit

At the last inspection from 15 to 16 May 2018, the home was judged to be requires improvement to be good in all areas. The report highlighted that although children were thriving and their parents and placing authorities expressed their satisfaction with the care being given, children did not benefit from consistently good practice regarding their safety. Although staff had regular training and discussions regarding safeguarding, there were shortfalls in their knowledge. For example, although staff knew how to report child protection concerns within the organisation, some were unaware of the external agencies they must report concerns to.

p.2

This monitoring visit

The last inspection found that restraint records were inconsistently maintained and occasionally illegible. Records did not always detail that discussions with children and debriefings with staff have been undertaken. There was insufficient analysis and learning from restraints. There was limited opportunity for amending practice to ensure that it meets the needs of each child. An example is exploring how injuries occur and considering whether there were trends or patterns.

p.2

This monitoring visit

Ofsted attended a strategy meeting on 7 August 2018. It was confirmed that the police investigation was ongoing and that there were concerns regarding safer recruitment. During the meeting, managers from the home confirmed that risk assessments had been undertaken for staff.

p.2

This monitoring visit

All local authorities who have children living at the home are satisfied with the care. Placing authorities highlight they would like their children to remain living at the home. Social workers have increased their visits to the home to monitor the safety and welfare of their children. Inspection report for children’s home – monitoring visit: SC468315 3 During the visit, children appeared comfortable in the home’s surroundings. The child who sustained an injury during the restraint in question had a temper outburst during the visit and hit a member of staff. The inspector observed that the incident was managed well with the registered manger’s intervention. The child was encouraged to take responsibility for his actions and apologised to the staff member.

p.2

This monitoring visit

The incident on 5 July occurred while the registered manager was on leave. The home was being managed by the shift leader with support from the responsible individual. The deputy manager post is currently vacant. The responsible individual explained that they did not refer this incident to the designated officer for the local authority as they were not fully aware of all the information. At the time, no concerns were highlighted regarding this restraint. Staff were unsure where the child’s injuries were from.

p.3

This monitoring visit

The responsible individual explained a week after the incident that all staff undertook recording and reporting training. Logs evidenced a need for more detailed record keeping.

p.3

This monitoring visit

The responsible individual confirmed that when the police investigation is completed, the organisation will undertake a critical review. This review will examine the safeguarding culture within the home, whistleblowing, reporting procedures and restraints. Team meetings will also include discussions regarding whistleblowing and safeguarding.

p.3

This monitoring visit

The registered manager was on leave when the incident on 5 July occurred. She explained on her return that there appeared to be conflicting information. The body maps did not indicate any injuries. However, details given to the organisation’s on- call person mentioned marks and bruising. The registered manager confirmed a lessons-learned exercise will be completed after the police investigation.

p.3

This monitoring visit

Discussions were held with three staff members. They unanimously confirmed that restraints are used as a last resort in the home. Staff use a range of distraction techniques to de-escalate situations. Techniques include planned ignoring, withdrawing from the situation, using humour, alternative activities and incentives. Staff stressed the importance of having a good relationship with children and understanding their individual needs.

p.3

This monitoring visit

Since the incident, staff confirmed that the registered manager had provided a wide range of information regarding reporting procedures. This was confirmed by the observation of visual aids in the staff office. Flowcharts detailed the procedures for managing safeguarding concerns, complaints and physical intervention.

p.3

This monitoring visit

The organisation has updated their safer recruitment procedure. The organisation is currently recruiting two residential support workers and one team leader. A deputy manager will be recruited at a later date. Inspection report for children’s home – monitoring visit: SC468315 4 The home does not have access to expert behavioural management guidance from within the organisation. The child involved in the incident is receiving support from the child and adolescent mental health service (CAMHS). The registered manager explained CAMHS will be providing training for staff to help with understanding this child’s behaviour.

p.3

This monitoring visit

Following the incident, a range of documents have been updated or implemented. The staff supervision record has been updated to include debriefings, safeguarding and incidents. A management tool also provides oversight of the number of physical interventions involving specific children and the times that they occur, to see if patterns or trends exist.

p.4

This monitoring visit

Individual restraint logs are now kept for each child. Tracking sheets detail each child’s physical interventions, measures of control, accidents and injuries. The updated form details briefings for children and staff. The child involved in the incident helped to select the emojis used to help express feelings.

p.4

This monitoring visit

Staff are all appropriately trained to undertake restraints. In May 2018, staff benefited from advanced ethical care, control and restraint training. All staff have received relevant safeguarding training.

p.4

This monitoring visit

There are shortfalls in four documents. The whistleblowing procedure at the time of the inspection seemed more suited to adults and referred to the Care Quality Commission and not Ofsted. A further policy was emailed to Ofsted on 14 August. The policy, although it included Ofsted’s details, still referred to the Social Care Association, which was closed in 2012. The whistleblowing policy therefore requires updating, as it is not a clear working document that guides members of staff effectively.

p.4

This monitoring visit

The child protection procedure does not make reference to promptly referring allegations about past abuse or neglect. The safer recruitment policy does not refer to current guidance and does not explain the decision making and safeguarding measures if employing persons with convictions. The risk analysis and behaviour plan for the child involved in the incident did not contain this child’s risk of injury during physical interventions.

p.4

This monitoring visit

This visit concluded that there are no immediate safeguarding concerns. The members of staff involved in the restraint have been suspended. The police investigation is ongoing. Placing authorities are satisfied with the care provided by the home and would like their children to remain living at the home. Social workers are visiting children on a regular basis. Inspection report for children’s home – monitoring visit: SC468315 5

p.4

Inspection date Inspection type Inspection judgement

15/05/2018 Full Requires improvement to be good 17/07/2017 Full Good 07/03/2017 Interim Improved effectiveness 20/10/2016 Full Good Inspection report for children’s home – monitoring visit: SC468315 6

p.5

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.

p.6

Requirement Due date

The procedure to be followed in the event of an allegation of abuse or neglect must, in particular—

p.6

Requirement Due date

provide for the prompt referral of an allegation about past abuse or neglect in relation to a child to the placing authority and, if different the local authority in whose area the alleged abuse or neglect occurred. (Regulation 34 (2)(c)) 1/9/2018

p.6

Recommendations

 As part of the policies for the protection of children, the registered person should include information about whistle blowing with clear procedures for how a staff member should report to an appropriate authority any concern they have about a child. The policy should reflect the principles set out in the Francis review ‘Freedom to speak up’. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.15)

p.6

Recommendations

 Staff should continually and actively assess the risks to each child. (‘Guide to the children’s homes regulations including the quality standards’, page 42, paragraph 9.5)

p.6

Recommendations

In particular, risk assessments must include all identified risks.

p.6

Recommendations

 The registered person is responsible for maintaining good employment practice. They must ensure that recruitment safeguards children and minimises potential risks. (‘Guide to the children’s homes regulations including the quality standards’, page 61, paragraph 13.1)

p.6

Recommendations

In particular, the safer recruitment policy must include up-to-date guidance and the decision making regarding employment. Inspection report for children’s home – monitoring visit: SC468315 7

p.6

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.

p.7

Information about this inspection

This inspection was carried out under the Care Standards Act 2000.

p.7

Children’s home details

Registered provider: Chartwell Care Services Ltd

p.7

Children’s home details

Registered provider address: 12 Helmet Row, London EC1V 3QJ

p.7

Children’s home details

Responsible individual: Olubunmi Fabusuyi

p.7

Inspector

Sharon Payne, social care inspector Inspection report for children’s home – monitoring visit: SC468315 8 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 children looked after, safeguarding and child protection.

p.7

Inspector

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.8

Inspector

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.8

Inspector

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

p.8