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

Inspection report for children’s home - monitoring visit: SC025657 1 SC025657

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Creating Care Choices Limited

Monitoring visit 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 disabled children on a permanent basis or for short breaks. The provider states that the home is for children with special needs, such as learning difficulties, epilepsy, challenging behaviours, sensory impairment and communication difficulties.

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Information about this children’s home

The manager has been registered with Ofsted since 8 May 2019.

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Information about this children’s home

At the time of the visit, nine children lived at this home across three different houses. Three children were able to communicate verbally.

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This monitoring visit

This visit was conducted at a time of national lockdown due to the COVID-19 (coronavirus) pandemic. The visit included on-site and off-site activities. One inspector spent five and a half hours in the home. This inspector observed staff practice, sampled some records and talked with two children, three staff members and the manager. Another inspector had a telephone conversation with one child’s social worker.

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This monitoring visit

The visit focused on children’s safety and, in particular, on the use of physical interventions. The arrangements for children’s education were also reviewed.

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This monitoring visit

Both children spoken to said that they liked the home and liked the staff who worked there. Both children said that they felt safe. When asked what they would do if they had any concerns, both children said that they would speak to staff.

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This monitoring visit

Not all the staff members know how to deal with children’s concerns and allegations. One staff member did not give a satisfactory answer when they were asked what they would do if a child disclosed to them that another staff member had hit them. Inspection report for children’s home - monitoring visit: SC025657 2 The staff’s lack of knowledge on how to deal with allegations against staff members undermines children’s safety.

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This monitoring visit

The home’s management follows appropriate procedures for dealing with allegations against staff members. During this visit, a child made an allegation against a staff member and the manager made a child protection referral on the same day. Ofsted has not prejudged the outcome of the child protection investigation in any way during the visit and when making requirements.

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This monitoring visit

Staff are committed to creating a positive environment for children. Staff work in close partnership with social workers and other professionals to help children develop safer and more constructive behaviours. The home has a good record in helping children to improve their behaviours over time. One child’s social worker said that she was thrilled with a child’s progress.

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This monitoring visit

Staff use physical interventions as a last resort to protect children and adults from harm. However, a number of shortfalls in relation to the use of physical interventions were identified during the visit. These shortfalls undermine the safeguarding of children.

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This monitoring visit

The monitoring of physical interventions is weak. The manager’s report of the review of the quality of care for the period of July 2020 to December 2020 states that no physical interventions were used. However, the home’s log of physical interventions lists two physical interventions during that period. Not taking into account physical interventions when reviewing the quality of care means that the valuable opportunities for reflection and learning are lost. Not providing the correct information to Ofsted negatively affects its monitoring function.

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This monitoring visit

Staff are not trained appropriately for their roles and have a poor knowledge of physical interventions. The last time the home provided training to staff on physical interventions was in July 2018. The staff spoken to could not name, describe or show any of the permissible physical-intervention techniques.

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This monitoring visit

Children’s positive behaviour management plans are vague about the use of physical interventions. For example, one child’s plan states that in crises staff have to ‘remove’ the child from the environment. The manager explained that this meant calling the child by their name or gently leading them out of the room. There is no guidance for staff about how to do this and at which point removing the child from their environment becomes a physical intervention that must be logged.

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This monitoring visit

Neither the staff nor the manager are aware that using medication to control behaviour is a chemical restraint. There is no written guidance to staff on when they need to administer an antipsychotic drug to a child other than ‘when required’.

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This monitoring visit

The home’s log of physical interventions is not completed in the required detail. Only the first names of staff members who were involved in the physical interventions are Inspection report for children’s home - monitoring visit: SC025657 3 recorded. The names of the staff who witnessed the physical interventions are not recorded at all.

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This monitoring visit

None of the staff have had training on deprivation of liberty. One staff member said that they have not heard of it and did not know what it meant. This is despite the home’s statement of purpose making it clear that the entrance doors to the properties are kept locked due to children’s vulnerabilities and risks. In addition, children’s individual risk assessments explain situations that may lead to some doors inside the houses being locked on occasions, such as the kitchen door or the connecting door between the properties.

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This monitoring visit

Children receive good support from staff to engage in their education. Both children said that they ‘loved’ learning.

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Recent inspection history

Inspection date Inspection type Inspection judgement 10/02/2020 Full Good 13/09/2018 Full Requires improvement to be good 06/06/2018 Full Inadequate 01/03/2018 Interim Improved effectiveness Inspection report for children’s home - monitoring visit: SC025657 4

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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 prepare and implement a policy which—

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Requirement Due date

is intended to safeguard children accommodated in the children’s home from abuse or neglect; and

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Requirement Due date

sets out the procedure to be followed in the event of an allegation of abuse or neglect.

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Requirement Due date

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

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Requirement Due date

provide for liaison and co-operation with any local authority which are, or may be, making a child protection enquiry in relation to a child accommodated in the home;

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Requirement Due date

provide for the prompt referral of an allegation about current or ongoing abuse or neglect in relation to a child to the placing authority and, if different, the local authority in whose area the home is located;

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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;

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Requirement Due date

provide for records to be kept of an allegation of abuse or neglect, and the action taken in response;

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Requirement Due date

describe the measures which may be necessary to protect children following an allegation of abuse or neglect; and

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Requirement Due date

describe how and to whom staff are to report, without delay, any concern about abuse or neglect of a child. (Regulation 34 (1)(a)(b)(c)(d)(e)) 1 June 2021 Inspection report for children’s home - monitoring visit: SC025657 5 Specifically, the registered person must ensure that all staff have a good understanding of the child protection policy and implement it in practice.

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Requirement Due date

The registered person must prepare and implement a policy (“the behaviour management policy”) which sets out—

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Requirement Due date

how appropriate behaviour is to be promoted in the children’s home; and

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Requirement Due date

the measures of control, discipline and restraint which may be used in relation to children in the home.

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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

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

details of the child’s behaviour leading to the use of the measure;

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Requirement Due date

the date, time and location of the use of the measure;

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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 name of the person who used the measure (“the user”), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; 1 June 2021 Inspection report for children’s home - monitoring visit: SC025657 6 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 person”)—

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Requirement Due date

has spoken to the user about the measure; and

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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 five 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 (1)(a)(b) (2) (3)(a)(i)(ii)(iii)(iv)(v)(vi)(vii)(viii)(b)(i)(ii)(c)(iv))

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Requirement Due date

Specifically, the registered person must ensure that all staff receive training in the use of physical interventions and restriction of liberty. The appropriate records must be kept of physical interventions, including the use of chemical restraint. In particular, the full names of staff who used the physical intervention and those who were present at the time of the intervention being used must be recorded.

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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 six 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

The registered person must— 1 June 2021 Inspection report for children’s home - monitoring visit: SC025657 7 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

make a copy of the quality of care review report available on request to a placing authority, if the placing authority is not the parent of a child accommodated in the home.

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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)(b) (5))

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Requirement Due date

Specifically, the registered person must ensure that this review and the report include the correct information and an analysis of the physical interventions used by the home’s staff during the review period.

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Information about this inspection

The purpose of the monitoring visit was to investigate information received that suggests there may be a breach of regulations. The recommendations given at the last full inspection will be considered at the next full inspection.

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Information about this inspection

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

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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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Children’s home details

Registered manager: Parmeswar Gopee Singh

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Inspectors

Seka Graovac, Social Care Inspector Victoria Jones, Social Care Inspector Inspection report for children’s home - monitoring visit: SC025657 8 Inspection report for children’s home - monitoring visit: SC025657 9 to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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