Any illnesses or hospital admissions since last review? If yes, details
Verona house have now managed to .establish links with the hospital *Redacted The Thing” and are progressing the appointment. This information will be passed to the 16 Plus team

Highlight any other outstanding health/developmental needs/issues not referred
to above and whether any changes are needed to the current health care
arrangements There are still concerns regard the permanent damage Li has caused himself from his previous self harm. “Redacted The Thing” It has taken Li many years to comply with health professionals regarding his self harm and it is an incredible thing that Li has engaged this year. It is hoped he will continue to do so and his body will heal.

Regarding Li previous issues regarding body odour, I feel this is down to self care skills and still is needing to be prompted by staff at Verona but had made progress considering how he was in his previous placement. Li did however regress and his self care behaviours were becoming a significant concern including refusing to change wet bedding, wash clothes or self and generally live in filthy conditions if allowed. This has again improved slightly with staff and Dr Nairac working together to move Li Harris forward Other then this, Li has a healthy appetite, is growing taller and taller! and is growing into a strapping young man. He is still wearing glasses. Li has previously taken medication for his ADHD, He requested that he come off his
meds as he felt that he was in a good place to see if he could cope. This was a brave move on Li’s part and he should be proud that he took the initiative to take risks to better himself. Li struggled with this and made the adult decision to come back on his meds

Have there been any changes in school/nursery since last review?
If yes, details including date of change
Li is currently being tutored through Verona House and Ellington and Hereson School are providing this tutor with work to catch up with. Li has refused to fully engage with this or attend the provision supplied by Verona.16 Plus team will take this forward in terms of potential attendance at college

Number of school days missed this academic year
Highlight child/young person’s achievements in school since last review (both
academic and non academic achievements)
Li left Ellington and Hereson, May 2012. Li still remains as a bright young man, with passions around computing and web design and also enjoys photography. Li has been accessing the library whilst at Verona to research subjects such as photography and I think this is great of Li, trying to stimulate himself rather then relying on others. However there is only so much he can do in the library and it is important that appropriate education is in place a.s.a.p. Especially it being his last year of school.
Li has not properly engaged with the tutor supplied

 

Is child/young person involved in any after school clubs or leisure I
activities?
If yes, details
Li since being at Verona House has been apart of many activities and this has kept Li stimulated. He especially enjoys outings to the unit’s own caravan and has taken this opportunity a few times since he came to Verona. There is no internet access in Verona House or mobile phones. Li had been managing this well but more recently there have been significant issues with Li refusing to comply with the house rules and this has also caused disruption for other children and young people in the unit

Highlight any concerns or outstanding issues regarding child/young person’s
education, learning, language and social development and whether there need
to be any changes to the current arrangements for child/young person .

The concerns for Li as he moves forward to the 16 plus team remain and there has been meetings with Verona Staff and the 16 Plus team to make sure there is a smooth
transition. Li’s emotional health remain fragile and his ability to cope with stress and change areof concern. The allocated social worker is working closely with the 16 Plus team to ensure that all risks are understod and all plans in place support Ii and his emotional health as much as possible

 

Where appropriate, has life story work been completed? No If no, when will this be done and by whom?
Li is starting to question his past and is aware that I would need to do this work with him. He is resistant to this as wants to complete on his own but is too vulnerable at this
time.

Comment on quality of the attachment between child/young person and carers
Li has recently started to detach from the staff at the care home and is making it clear that he no longer believes he should be there Staff at Verona continue to try and engage with him

Highlight any other changes/issues regarding emotional/behavioural development
Li has regressed recently and there has been signs of potential self harm

Highlight any issues/concerns regarding child/young person’s sense of identity,
social presentation, religion, language, culture, sexuality, disability, gender
Earlier this year, Li had a lot of unanswered questions regarding his life especially his earlier childhood, He feels like he needs to feel like life is not all bad and needs a light
at the end of the tunnel. He requested his files and I advised due to his vulnerability he would not be allowed them and we both could go through them together. He declined
this offer, which I respect, however this will keep being an issue for Li and he will need support with this.
Li continues to see his mother, which is good and continues to have a great relationship with her.

Are any changes required to ensure child/young person’s needs relating to identity are being met?
If yes, details
When Li is ready he will need to work alongside someone he trusts to unpick his history, helping Li to acknowledge he may not find the answers he wishes for,

Comment on stability of this placement and whether it is meeting the various needs of child/young person including any cultural, religious, linguistic, disability issues. Highlight strengths of placement as well as any areas of concern
I feel that Verona House are meeting Li’s needs and are keeping him safe. They have been in regular contact and have seeked advise from myself when decision making. Li has clearly come far since being at Verona House and this only evidences the positive impact that Verona House is having on Li and his development and management of his self harm and mental health needs. This placement will be changing as soon as appropriate alternative provision is identified

 

Comment on quality of the relationships/attachment between child/young person and members of birth family
Li states he has a lot of family and enjoys talking to me about them. He is very open about his thoughts regard his father and states that he still maintains and enjoys his
relationship with his mother, brother Michael and twin siblings. His relationship with his brother David is difficult however Li is looking to meet up with David in Herne Bay and this is to be supervised by a member of staff at Verona House, The difficulties with this relationship have escalated over the last few weeks and is of concern as the social worker believes that this increases Li’s vulnerabilities

Details of current contact arrangements, comment on how these are working and any changes needed. Include details of any 5.8 or 5.34 Orders
Li has unsupervised contact with his mother every Saturday. This continues to be going well and Li’s mother and Verona House are in good communication with
each other. Li has indirect contact with all his other family members.

Summary of review discussion
Jill Taylor attended today from the local office. Harry Deering and Martin Collins were present from Verona House but were not expecting this meeting to take place
Care Plan yes
Care Plan includes Permanency Plan (From second review meeting) no
COAS yes
ICS Review Report (part one) yes
Health Action Plan no
Personal Education Plan needs to be arranged
Placement Plan yes
Did everyone receive a copy of the last Looked After Children Review minutes? Yes

CHILD/YOUNG PERSON’S PARTICIPATION IN THE REVIEW PROCESS:
Has the IRO met with the child/young person prior to the review? Brief summary of issues discussed. Li met with the IRO before the meeting. He had not realizes that there was to be a meeting this morning but was happy to meet .

What is the child and young person’s understanding of their Care Plan?
Li understands that he is staying at Verona House until an alternative provision is found. He had met with Jo Jarvis Jones and Adrian Miles but was concerned that the resource would not be in Thanet.

If appropriate, have arrangements been made for an independent person to speak on
behalf of the child/young person?

He had seen a solicitor previously to appeal the decision about detention under the MHA. He had not wanted an advocate for today.

HAVE THE DECISIONS REACHED AT THE LAST REVIEW BEEN ACTED UPON?
Record which decisions have not been acted upon and why?
DECISIONS AND RECOMMENDATIONS:
1 Li to remain in present placement until coas and care plan are completed to clarify the issues. The need for ongoing psychological therapy needs to be addressed This needs to be done within 3 weeks as the IRO understands that funding has been agreed for this placement until the end of October 2012- this has been ongoing
2 Stacey to arrange a dental appointment as treatment is needed. Li has a dentist in Ramsgate- – achieved on 10/12/12
3 Professionals meeting to be held next week to clarify educational planning- achieved
4 IRO to write to Jacky Cador, achieved same day about low level of tuition and school work- achieved
5 Karly to check whether CRB check was completed on mother’s partner and speak to mother about arrangements for Saturday so a safe plan is made-apparently achieved as Li attended the wedding, that went well.
6 Li to continue at gym as he finds this helpful- ongoing
7 Li to attend health assessment and ultrasound scan appointment.- not achieved
8 IRO to be forwarded any health reports from Woodlands and CAMHS as she has not seen any assessments- today received minutes from Woodlands provided by Verona House

WHAT HAS BEEN THE EFFECT OF ANY CHANGE IN THE CHILD AND YOUNG PERSON’S CIRCUMSTANCE (SINCE THEY BECAME LOOKED AFTER) OR SINCE
THE LAST REVIEW? IF THE CHILD HAS HAD AN UNPLANNED PLACEMENT, HAS THEIR BEEN A DISRUPTION MEETING? BRIEFLY OUTLINE
no change

SOCIAL WORK INTERVENTIONS SINCE THE LAST REVIEW:
Are the frequency of visits meeting statutory requirements and the needs of the child/young person?

Yes although Karly was unable to attend today and Li said that she has been unwell at times
ASSESSMENT:

Is the care plan/pathway plan based on an up to date assessment which identifies the child’s needs and takes into consideration other assessments undertaken? The Woodland report will inform the LA assessment and be forwarded to Verona House. The IRO has seen this today. The COAS has been updated.

THE CARE PLAN
Does the care plan meet the needs of the child? Yes
Does the care plan meet the needs for permanency? no
Does the Placement Plan address all the child’s needs within the Placement yes
Does the Health Action Plan address all the child’s Health needs? The IRQ has not read the latest report and has not seen a report from the appointment.
Does the PEP address all the child’s educational needs? None current
Is there an agreed contact plan which meets the needs of the child? Contact with brother David has been problematic
Is there an appropriate contingency plan? There is not a clear care plan yet as a suitable therapeutic resource needs to be identified
Identify where the child’s needs are not being met and if there is any delay? Are all the Pledge commitments for the child being provided?

Yes and Li has been going to the gym as membership is funded on a monthly basis.

CARE PLANNING:

Identify any changes, services or actions needed to meet the child’s needs:

Placement- Harry , manager described the recent chain of events that have led to Verona House stating that they are unable to meet Li’s needs. At first Li was using the placement well but more recently meeting with his brother, David at the library. David seemed influential and together they were talking of joint ventures, designing websites and continually on the phone.
It is a rule at Verona House for all residents that phones are not allowed but even though Li has been told that he could have one when off the premises, ie that they
would make an exception, Li has been unable to compromise. He retains a phone and it his inability to work with the unit that has led to the request that he leave. One particular weekend the police were called as David was threatening on the phone and Li pushed a member of staff and locked himself in his room. When he left to use the toilet, staff used this opportunity to empty his room of all his belongings except his bed. His self care and hygiene at this time had really deteriorated. Dr Nairac was contacted and he made suggestions to Li about washing and brushing his teeth. Li responded to this advice and the situation was partially resolved. Since then Jo Jarvis Jones and Adrian Miles have visited together to discuss future plans but these were not really clear to anyone present today other than it was not a return to foster care. Li has engaged more again with staff in the unit and things seem to have settled down again. At the moment there is no contact between David and Li. He is allowed to go out un supervised and he has been going to the library and gym. Verona have supplied monthly gym membership that will be repeated as he is making good use of the money.
Health– Li has been a psychiatric inpatient and his needs have been assessed. He still bed wets sporadically. He attended his  appointment with Dr  but did
not go for the follow up ultra sound appointment. The reason given was that it was too early and another appointment was made for October but Li did not go. As Li had failed two appointments he was taken off the list and the GP will need to refer again. This is now in hand as Stacey has liased with Dr at Maidstone hospital. Li said that Dr Nairac had been in touch with a London hospital but could not be more specific. The health assessment took place but the report was not available today. The findings
from the appointment was significant *redacted the thing* , the registrar will be writing to Li’s GP with a recommendation for referral to a paediatric in London. Last dentist appointment was December 12 at Kelvin House, Whitstable and he attended an optician in January 2013. He was given a new prescription and needs to organise new glasses/frames.
Li has seen Dr Nairac on 27 /11, 10, 12 and 14/01. He is waiting for a further appointment. Previously he requested a trial without medication. He subsequently
decided that he wanted to remain taking it . Dr Nairac has decided to keep him as a patient rather than transfer him to Canterbury. Li reported that occasionally he suffers
with insomnia and described “A messed up sleeping Pattern”. It has not disturbed night staff

Emotional and Behavioural.

Li had seen Oliver, the psychologist on 10 occasions when in hospital . Oliver recommended continuing psychological intervention but this was not discussed in detail today. The view of the IRO is that as this is a temporary placement these supports need to be built into the next stage of the planning. He has enjoyed going to the caravan in Hastings where he has been in the club house. This has stopped over winter but will resume in February half term. Li seemed keen to go.
Education– Li is in year 11 in September 2012. A PEP and AER was undertaken on 13th July. The view at the last review was that a return to main steam school would
not be appropriate and Verona house has its own small unit.. Li has not wanted to attend as it does not offer a GCSE curriculum. Li has been seeing a tutor for some time but could not remember her name, this is probably indicative of the level of engagement. The IRO asked to see some examples of work but seemingly this is” bagged up “in the shed .. This is not a satisfactory plan and there does not seem to have been any planning for next year. This is more difficult as residence is not clear.
Li said he would like to study business and media.

 

Contact Li has been seeing his mother, sisters and older brother Michael on Saturday, spending time at the family home. It came to light last time that mother was getting
married , this information is not in the COAS, Li explained that the wedding went well. He returned sober and said that he and David had been very clear that they would not argue and spoil the day. At present he is not in contact with David.

Have the views of the Child/young person, parents, other significant adults, carers,
and other professionals been taken into consideration?

No. It would have been helpful for mother to come today as she has been indicating to Li that of all the children he is the one who could go home. Although she knows that Li was in hospital
last year, Li has not wanted her to know of the self harming issues and his views will be respected.

Legal
Li remains subject of a care order Other issues Li was 16 in November so transfer to sixteen plus has started. Adrian Miles was not present today and he has been working closely with children and families. The general view last time was that Li had benefitted from his time in hospital and the emphasis now was on sustaining the changes that have been made Karly has updated her coas and care plan with the health information in order to clarify future planning but will need further updates as the situation changes. Li today said that he had been in touch with his previous foster carers and was agreeable to seeing them if this could be facilitated by the social worker. The IRO stressed that this was a positive development. Although Li has seen Dr Nairac there is no psychological therapy currently and this needs to be considered in the care planning. The IRO did not have all the information today but it was apparent that Li will need to move on. Li was very resistant to thinking about a move outside Thanet. He mentioned that Rochester had been suggested and was not keen. The IRO reminded
him that his older sister had lived in Seal for a couple of years at Li’s age and has now returned to Thanet but he did not want to consider this.

DECISIONS AND RECOMMENDATIONS:
1 Li to remain in present placement where 28 days notice has been given until an
appropriate plan is agreed. Harry stressed today that it is Li’s inability to compromise
that has forced the issue. He will need to confiscate Li’s phone if he sees it.
2 Staff to help Li get a new prescription/glasses as Li said that he needs stronger
prescription- within a week
3 IRQ to write to Jacky Cador, VSK about low level of tuition and educational planning
in general within a week
4 Li to continue at gym as he finds this helpful
5 Li to attend ultrasound scan appointment. Sw will need to write to GP so that a re
referral is made. Within 2 weeks
6 Sw to clarify care planning and inform IRQ of developments- ongoing
7 SW to facilitate some direct contact with previous foster carers- within a month
8 Mother to be involved in the planning
9 staff at Verona House to contact Dr Nairac about appointment
10 Transfer to sixteen plus at appropriate time