Children's Home run by Keys Care Limited in Leicestershire

SC063997 Unique reference number 1 June 2009 Inspection date Warren Clarke Inspector Key Type of Inspection

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26 January 2009 Date of last inspection .

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 10 Inspection Report: SC063997

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Brief description of the service

This children's home provides accommodation for three young people aged from 10 years to under 18. The home is located on the outskirts of two local towns. There is reasonable access to local services and bus routes into the main shopping areas. The home is a detached house offering individual bedrooms and a bathroom for young people on the first floor where the staff sleeping-in accommodation and the therapy room are also located. On the ground floor there is: a good-sized lounge and a well-equipped kitchen; laundry; a classroom, the general office. There is a large mature and well-maintained garden at the rear of the building.

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Brief description of the service

At the time of inspection there were two children, average age 14 years, accommodated. All of them were seen and both contributed to the inspection.

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Summary

This unannounced key inspection assessed the home's performance against all the key National Minimum Standards (NMS) as currently grouped under each of the Every Child Matters national outcome areas: Being Healthy, Staying Safe, Enjoying and Achieving, Positive Contribution, Economic Well-being and Organisation. The home retains its overall satisfactory quality rating, but with some good features. As reflected in the requirements and recommendations the focus of greatest weaknesses is in the Staying Safe outcome area. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

At the last inspection six recommendations were made to address deficits in the Being Healthy, Staying Safe and Organisation outcome areas. All except two have these have been addressed in full. For example, two related to the handling of medicines for which new guidance, procedure and training have been provided. Those which have not been met in full are about behaviour management and the ratio of staff with relevant qualifications.

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Helping children to be healthy

The provision is good. In keeping with its overall homely environment, the home's catering arrangements are of domestic scale and facilitate the children's and young people's involvement to a high degree. The kitchen is spacious and well equipped enabling the children and young people to use it to prepare drinks, snacks and, under staff supervision, prepare meals. The young people are fully involved in planning weekly menus and purchasing provisions thus incrementally acquiring some of the practical skills they will need in adult life. The menus are set out in sufficient detail demonstrating that the children and young people are provided with a reasonable choice of varied and wholesome food. The young people express satisfaction with this aspect of their care. They rate the quality and quantity of food as mostly good. Staff successfully promote healthy eating to the extent that the children and young people are themselves making healthy

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Helping children to be healthy

food choices and recognise the importance of fruit and vegetables in their diet.

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Helping children to be healthy

Arrangements for the children's and young people's health care are underpinned by a clear, coherent system for identifying and responding to young people's health needs. A health care 4 of 10 Inspection Report: SC063997 plan is established for each child setting out relevant details about their past and current health problems. Where such health problems are identified, the plans include a clear strategy to address them. This is, for example, reflected in ensuring access to primary health services such as local medical doctors, dentist and opticians. Medication is properly administered and health monitoring appointments are kept.

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Helping children to be healthy

Young people are satisfied that staff look after them properly when they are ill. They are able to talk to staff about health worries and to see the doctor when necessary. Importantly, staff look after them with competence and caring when they are unwell ensuring that they are comfortable and get the care and treatment they need. Clear strategies for promoting good health are evident and the children and young people recognise this. They cite as examples, the encouragement that staff give to stop smoking, eat healthily and to get enough exercise.

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Helping children to be healthy

The home ensures that it has the necessary consent to arrange any medical or first aid treatment that the children and young people might need. It also has in place clear procedures for handling medication. Where appropriate and, as part of the drive to encourage young people to take some responsibility for their own health they are permitted, subject to risk assessment, to manage their own medication.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. All young people accommodated in the home enjoy privacy relevant to their age and circumstances. They each have their own bedroom in which they are able to lock and keep their personal possessions private and safe. Bathroom and toilets, with clear separation of those for staff, are equipped and arranged so that they too may be used in private. Where young people's placement plans require that they are closely supervised, staff do this as discreetly as possible so that the privacy of those concerned is not unreasonably compromised. Staff work to a strict code to ensure that young people's personal details are kept confidential and accessible to only those who are authorised. Circumstances in which there is a risk that a young person's privacy might be infringed, such as search of the bedrooms for contraband, there are clear procedures and guidance for staff to follow. Young people are satisfied with this aspect of their

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Protecting children from harm or neglect and helping them stay safe

care except a small minority who would prefer to have less supervision than is in place to protect them.

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Protecting children from harm or neglect and helping them stay safe

The home provides young people and others, access to a clear complaints procedure for any concerns about their individual care or how the home is run. The procedure, which complies to all the NMS requirements, is actively promoted to young people who use it to good effect. The home demonstrates successfully that where young people make complaints, these are taken seriously, are fairly considered and provide outcomes with which the complainants are satisfied. This is one of the aspects of the running of the home that is regularly monitored by those in charge of the home.

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Protecting children from harm or neglect and helping them stay safe

Staff operate with a comprehensive child protection policy in their safeguarding of children and young people from abuse. Clear procedures together with relevant training to identify abuse, equip staff to contribute to prevent it and to be able to respond appropriately to allegations. Staff have available to them the child protection procedures of the Local Safeguarding Children Board and the manager demonstrates that where child protection concerns emerge, they are referred to the appropriate authorities. There is clear demonstration 5 of 10 Inspection Report: SC063997 of effective working together between staff and the child protection authorities to safeguard and promote the welfare of the children and young people.

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Protecting children from harm or neglect and helping them stay safe

Bullying behaviour and the impact of this on children and young people are properly addressed. The home has an anti-bullying strategy which is set out in a comprehensive policy and staff guidance. There is a common understanding among staff and young people of the nature and impact of bullying and the response that victims and bullies may expect. Staff promote anti-bullying in one-to-one work with the children and young people complementing similar work done in school. The success of this is reflected in young people reporting no incidents of peer bullying for some considerable time. However, there continues to be a worrying number of incidents of young people assaulting staff. Left unaddressed someone is likely to be seriously hurt and the young people may come to regard this as tolerable behaviour.

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Protecting children from harm or neglect and helping them stay safe

A clear procedure is in place for staff to follow on occasions when a child or young person absconds or is absent from the home without permission. The procedure is in line with the local joint police and local authority missing from care protocol, which takes account of the child's or young person's vulnerability and the particular circumstances of their absence. Although there are a number of instances when the young people absent themselves from the home, their absences are usually for short periods and seem motivated by a quest to assume greater freedom rather than to escape from problems in the home.

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Protecting children from harm or neglect and helping them stay safe

Staff are provided clear guidance and a sound framework in which to operate in their control and disciplining of the children and young people. This is driven by the home's comprehensive behaviour management policy which provides safeguard of the children and young people from unfair treatment and unacceptable punishment. The emphasis is on encouragement of good behaviour and gives staff clear instructions on punishment or sanctions, which are not permissible. In essence, each child or young person has a behaviour management plan, which identifies their specific behavioural difficulties and the approach staff must take in dealing with them. This approach is successful most of the time and with most of the young people. There are, however, some events of serious unacceptable behaviour occasionally necessitating physical restraint and involvement of the police. A minority of young people observe that whilst

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Protecting children from harm or neglect and helping them stay safe

they sustain no injuries when physically restrained, they nevertheless experience pain and staff do not readily recognise this. This accords with one of the issues featured among the most recent complaints and is currently being investigated.

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Protecting children from harm or neglect and helping them stay safe

The safety and security of children and young people are given a high priority and they are safeguarded by a wide range of sound health and safety measures. There are effective precautions against intruders and they are well protected from potential dangers in the environment. All the necessary fire safety precautions such as drills and tests of the alarm system are regularly conducted. Where potential dangers are identified measures have been put in place to eliminate or reduce them.

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Protecting children from harm or neglect and helping them stay safe

The children and young people have the requisite level of protection from staff who may be unsuitable to look after them. Prospective staff members are subject to a thorough selection and vetting process and are only permitted to take up employment in the home once the outcome of the necessary checks is satisfactory. No-one has commenced work at the home without satisfactory reference and criminal records disclosure. Similar robust systems are in place to control visitor access to the home and to ensure that they are adequately supervised during any visit. 6 of 10 Inspection Report: SC063997

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Helping children achieve well and enjoy what they do

The provision is good. Children and young people are provided access to a wide range support in and out of the home to address their personal difficulties. Staff ensure necessary information is available to provide a clear understanding of each young person's needs and the personal support they require. Each young person has a placement plan that takes full account of needs arising from their sex, religion and culture. Joint work is done by care and teaching staff to raise the children's and young people's awareness of differences among people. Currently none of the children and young people practise their religion, but the home is organised to enable those who may wish to do so.

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Helping children achieve well and enjoy what they do

Staff work effectively to accommodate the difference in age and interests among the children and young people. Group outings, communal meals and house meetings to consider issues about routine matters successfully create cohesion which was apparent at inspection.

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Helping children achieve well and enjoy what they do

All the children and young people currently resident at the home are educated in the registered school on the premises. The value of education remains enshrined in the home's care principles and practices. Clear written guidance of how the registered person expects staff to support the children's and young people's education is successfully put into practice. This is reflected in the children's regular school attendance and their access to leisure facilities such as books, games and a computer. Sufficient space and staff support is available to facilitate private study and any homework that is set. The children and young people engage positively with the individual attention this arrangement provides them and the good working partnership between the teacher and the care staff continues to be one of the positive features of the care arrangements.

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Helping children make a positive contribution

The provision is good. The care and education of the children and young people are underpinned by sound systems of assessment and care management which are well-established aspects of the running of the home. There are in these systems built-in processes for monitoring the care given day-to-day, the impact it has on each child and the progress they make. For example, progress is evident in areas such as health and education. Whilst progress in some aspects of the young people's specific behavioural difficulties is slower, the assessment and care management approach being used to address them is soundly based. Above all, the systems in place are effective in preventing young people drifting in the home. There is clarity about why they are placed there, what is to be achieved and the strategy to achieve it.

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Helping children make a positive contribution

Documentation kept of the input of care that the children and young people receive is used efficiently to inform regular formal review of their placement arrangements. Each child or young person, therefore benefits from a coherent monitoring and review system, which enables any lack of progress to be identified and addressed in a timely manner. Where, for example, particular vulnerable young people absent themselves from the home without permission or demonstrate that they are placing themselves at risk of harm or abuse, there is clear evidence of variation to their care arrangements to address this. The children and young people are aware of their particular circumstances and are supported to make active contributions to how they are looked after routinely and in the decision-making for their future. 7 of 10 Inspection Report: SC063997 The commitment that the home makes to enable children and young people to have contact

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Helping children make a positive contribution

with their families and others who are significant in their lives, is reflected in all those currently accommodated having such contact. Telephone facility is provided that enables contact by this means to be done in private and visiting arrangements at the home are reasonably flexible. This together with examples of staff providing transport and supervising contact where required serves the children and young people well.

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Helping children make a positive contribution

A sensitive and clear process is in place to facilitate children and young people joining and leaving the home without too much anxiety. All children and young people currently resident have joined the home on a planned basis, which permits time and space to consider properly whether it is an appropriate setting and for them to be become familiar with the home before moving in. When a young person leaves the home this is usually also handled on a planned and careful basis. Unless countered by the wishes of parents and the young person, time is allowed for severing of attachments and gradual introduction to wherever he or she is to be transferred. As a tradition and with the individual's agreement, there is usually some form of farewell event to mark a young person is leaving.

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Helping children make a positive contribution

Young people say that the home performs well in most of what it does to look after them; that they are settled and listened to even if staff do what they are told rather than what some young people believe is right. All the young people present a confident demeanour and in some instances are forthright yet balanced in their views about the home. This reflects positively the ethos of the home where staff provide opportunities such as weekly house meetings and other means of consultation for them to have a say in how they are looked after.

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Achieving economic wellbeing

The provision is good. The daily care regime for all the children and young people includes elements that inherently promote their independence and contribute to their preparation for adulthood. The regime allows the children and young people to manage their pocket money and other allowances and thereby they begin to learn about budgeting. They are guided into being wholly independent in self-care such as keeping themselves clean, taking care of their appearance and establishing their own style. They are taught how to launder clothes, plan menus, shop for provisions and prepare healthy meals. Importantly, they are learning, indirectly through house meetings and group living, something of the give and take of human relationships. Where the home is required to contribute to more focused preparation of those who will soon graduate to living either semi-independently or independently, there is a clearly considered programme for this. Among

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Achieving economic wellbeing

many other topics, the programme which is usually implemented in partnership with the school includes: keeping well, preparing meals, budgeting, looking after your home, being a good neighbour.

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Achieving economic wellbeing

Most areas of the home have been redecorated giving a fresh, clean and homely appearance. The occupied bedrooms are decorated and furnished to a good standard and, where the occupants so choose, the rooms are personalised. There is ample communal space, for example, large sitting room with sufficient comfortable seating and a pleasing outlook to the large rear garden, which is maintained in satisfactory condition. The kitchen and dining areas which are combined are of good size and well equipped to cater for the number of children and staff. These too are domestic in scale and of homely appearance. Combined, all these facilities create the kind of 'sticky domesticity' that the Dartington Research Team once commented that looked 8 of 10 Inspection Report: SC063997 after children are often denied. There is satisfactory heating, floor and window coverings and light both artificial and natural. All the essential facilities such as water supply, shower, washing

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Achieving economic wellbeing

machine are in good working order. Above all, the children and young people are satisfied with the standard of equipment and comfort of the home.

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Organisation

The organisation is satisfactory. The home is being operated in accordance with its accurate and compliant written Statement of Purpose (SOP). This document is also summarised in a clear, helpful and thoughtfully prepared children's guide. Both documents provide those who require the information, a realistic guide of the principles and methods by which the home is run and the experience of care that a child or young person might reasonably expect.

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Organisation

Staff are employed in sufficient number to respond comfortably to the children's and young people's needs and complete the administrative and other tasks involved in doing so competently. For instance some children and young people require a greater level of supervision than others and current staff ratios accommodate this. During the last 12 months successful staff recruitment has created a more stable situation in the home. Although some staff are still relatively new in post, the children are benefiting from more continuity and consistency of approach from those who look after them.

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Organisation

The ratio of staff holding a relevant qualification for their posts falls significantly below that which is required. This is likely to remain the case unless those who acquire the qualifications while in service are retained and there is greater success in recruiting those already in possession of them. The assumption in the home that staff without the necessary experience are employed on the grounds that they will acquire this during their employment, is of concern. This is at odds with the purpose of the home to care for children and young people with significant emotional and behavioural difficulties. The registered person demonstrates, however, that there are arrangements in place to protect children with swift and decisive staff action, where their welfare and safety are believed to be compromised.

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Organisation

Staff receive the necessary support to look after the children and young people. Those joining the home benefit from a well-established and comprehensive induction programme. The ongoing in-service staff training and development programme provided, complies with what is needed to ensure that staff are equipped to look after the children and young people safely and competently. Moreover, they are provided regular one-to-one supervision. Periodic performance appraisal ensures that they are competent to respond effectively to the children's and young people's needs and contribute to meeting the home's objectives.

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Organisation

The registered provider acts diligently to ensure that the care of the children and young people is continuously monitored. A system is in place whereby the home is visited monthly by the provider's representative who having consulted children and staff reports on the how effectively it is being run. The children and young people benefit from this and from similar audits conducted by the manager in that weaknesses or problem are identified at an early stage and dealt with in timely fashion. Staffing levels and maintenance of the required standard of the children's and young people's accommodation are some areas in which this system is most effective. This aspect of quality assurance and monitoring is complemented by the home's 9 of 10 Inspection Report: SC063997 development plan within which there are objectives for ongoing improvement of the quality of care.

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Organisation

Children's records are well organised in files that provide information about their individual circumstances, needs and progress. The records kept conform to that required by the relevant regulations. There is an access to records policy and should the children opt to access their individual records, the way they are structured should enable this to happen with ease.

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Organisation

The promotion of equality and diversity is good. This is, amongst others, reflected in the diverse range of staff in terms of the sex and racial origin and the richness of experience they bring to the children and young people's lives. The young people are actively being made aware of their own and other people's differences particularly in relation to race, religion and culture. This is used to introduce concepts such as discrimination and its effects.

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Statutory requirements

This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Due date Action Standard

31 July 2009 ensure that the behaviour management policy is kept under review and address any issues of concern such as observations by young people that they experience pain during events of physical restraint (Regulation 17 (3) (a) ) 28 August 2009 ensure that those employed to look after the children and young people have the qualifications, skills and experience necessary for the work they are to perform (Regulation 26 (3) (b)).

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure that where there has been physical intervention, the child or young person is advised of his or her right to be examined by a registered nurse or a medical practitioner within 24 hours (NMS 22.13) • ensure that the children and young people are given the opportunity, when disciplinary measures or restraint is used, to write or have their views recorded and sign their names against the records kept by the home (NMS 22.14) • ensure that at least 80 per cent of the care staff team holds the NVQ Level 3 in Caring for Children and Young People or its equivalent (NMS 29.5). 10 of 10 Inspection Report: SC063997

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