Children's Home run by Keys Care Limited in Sandwell

Unique reference number SC374268 Inspection date 14/09/2010 Inspector Christy Wannop Type of inspection Key

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Date of last inspection 20/11/2009 Website: www.ofsted.gov.uk

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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 Crispins, 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.

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About this inspection

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 outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

This home offers medium to long term care for three children aged between 10 years and 17 years of age who have emotional and behavioural difficulties. It is operated by a large national provider of children's residential care.

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Brief description of the service

Children live in a detached house with a garden, on a main road, near local shopping and leisure facilities. There are three bedrooms for children, one staff sleeping room, bathrooms, a private room for small meetings and therapy on the first floor, and two separate living rooms on the ground floor. There is a kitchen dining room and ground floor toilet and utility room.

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Brief description of the service

Three young people currently live at the home and all contributed their views. The Registered Manager was also present.

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Summary

This is an overview of what the inspector found during the inspection.

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Summary

This was an unannounced full inspection and covered all the key national minimum standards in each of the Every Child Matters outcome groups, plus organisation. The Registered Manager has continued to improve the quality of the service provided to children at the home.

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Summary

Outcomes for children continue to be good, and there are some outstanding features in this service in how children enjoy and achieve and their positive contribution. The therapeutic support given to both children and staff is excellent. Good child centred care planning and focussed creative key working sessions link directly the needs of the child and ensure that care is delivered in a non-institutional way. Children at this home are well cared for by sensitive staff who have strong relationships with them. They are encouraged to lead healthy lifestyles, their individual needs are promoted and they have a high level of person centred care. They are listened to and respected by the manager, who has a strong child focus. Management is effective and there is strong support from the provider.

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Improvements since the last inspection

No improvements were identified at the last inspection.

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Helping children to be healthy

Children's good health is promoted. They lead healthy lifestyles, learn about making positive choices and live in a healthy environment. Staff encourage energetic and sporting activities and talk to children in one to one key working sessions; giving guidance, advice and support about health and social issues, including sexual health. The records of discussions with children show that good health is seen as an intrinsic part of the children's life experience. Staff learn about child health through an induction programme linked to nationally recognised standards.

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Helping children to be healthy

Children's health needs are identified and staff work with a range of external health professionals, including Child and Adolescent Mental Health services, to make sure services are provided to meet them. There is an excellent written health plan with good detail about children's medical histories and the current levels of support needed. Health professionals view the health care as good and find staff knowledgeable and very familiar with young people's needs. Staff ensure routine follow ups and keep to appointments.

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Helping children to be healthy

Children's welfare is safeguarded by the home's policies and procedures for administering medicine and treatment. The Registered Manager makes sure that only competent, trained staff take responsibility for giving medication or first aid, so that children get the medication and treatment they need. Staff have worked successfully with prescribing doctors to reduce dependency on medication as a means of controlling children's behaviour.

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Helping children to be healthy

Children enjoy good, healthy food, hygienically prepared by staff who are trained in food safety. Children are actively involved in trying a wide variety of foods and they learn about different cultures and countries during mealtimes. Children say that staff encourage them to eat and explain the benefits of healthy food. Mealtimes are social occasions and staff encourage conversations about cultural and religious aspects of diet, and vegetarianism is integrated into the weekly planning for menus. Children are encouraged to plan, shop and develop cooking skills and think about budgeting as part of independence plans. Menus show food to be wholesome and nutritious and children or staff who need different food, have this in a way that does not stigmatise them, but celebrates their difference.

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Protecting children from harm or neglect and helping them stay safe

Children are safe and sound at this home because there is well thought out policy, procedure and safe care practice that is reinforced by an effective management structure. The Registered Manager has established good working relationships with the Local Safeguarding Children Board and has negotiated protocols to improve referral action when there have been safeguarding allegations or concerns. Children have sometimes put themselves at risk through absconding and staff have increased the support and care they give to children when there is a likelihood of this happening. Local police confirm good use of police and safeguarding procedures to keep children safe when they run away. One social worker described the way that staff worked with one young person to safeguard them as,' brilliant, balancing age, emotions and independence.'

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Protecting children from harm or neglect and helping them stay safe

Arrangements for protecting children's privacy and confidentiality are well understood and children have a house phone on which they can contact their family, friends and social workers or advocates. Children are keen to have mobile phones and the manager has organised this as part of helping them experience ordinary life, while also protecting their vulnerability. Children know how to make a complaint if they need to and are confident that issues are sorted out and their views respected. They say that complaints are sorted out through talking and having a meeting. Staff are alert to bullying and work to reduce opportunities and the impact of this on others. Children did report bullying but say that staff speak about it openly and address it through meetings, key working sessions, and by getting children involved in creating art work about unsafe behaviour and displaying these posters around the house. They wrote ' bullying is not Ok, we do not like it and there is no place for it at

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Protecting children from harm or neglect and helping them stay safe

There is a positive, considered approach to managing behaviour, promoted by a visiting therapeutic practitioner employed by the organisation. The Registered Manager is effective in monitoring how staff relate to children, including the imposition of consequences or sanctions when children behave angrily or in a way that harms themselves or others; and when they need to be restrained for safety. There has been a dramatic reduction in the number of times that staff have had to use physical intervention to keep children safe. Children say that sanctions are usually called 'consequences' and know that they will be given positive treats and rewards for their socially responsible or kind behaviour. Staff are able to apply the therapeutic theoretical perspective about attachment to the behaviour and experience of the children, and this results in insightful, planned interventions. Staff help children develop an emotional vocabulary to describe their difficult feelings and

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Protecting children from harm or neglect and helping them stay safe

this enabling approach is a strength of the service. Respect and affection are evident in the relationships between adults and children. Placing social workers described a prompt staff response to 'manage behaviour and crises effectively', while another professional said the service was, 'good at managing difficult behaviours as well as high risk sexualised behaviour'

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Protecting children from harm or neglect and helping them stay safe

The manager ensures that the building, the way staff work, children's activities and the risks from their behaviour are managed to make them as safe as possible. Staff balance children's need for independence and responsibility for their actions as they grow up, with the need to protect vulnerable children from specific risks in the community.

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Protecting children from harm or neglect and helping them stay safe

Children are also protected because all staff who work at the home, or adults who have contact with the children, have been judged safe through a careful recruitment procedure. However, reference requests do consistently ask whether the applicant is suitable to work with vulnerable children. This process is managed at the organisation's head office, but the final responsibility for deciding fitness to work with children lies with the Registered Manager and is supported by thorough records.

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Helping children achieve well and enjoy what they do

Children receive effective individual support. The service cares for a small number of children and staff ratios enable close care. Staff are sensitive and fully informed about young people's individual needs and wishes. Staff give help and guidance about personal, health, social and sex and relationship education in one-to-one key working sessions. Staff think about children in a holistic way, balancing their emotional and chronological maturity and this is evident form the key working reports. In addition children have weekly sessions with a qualified therapist employed by the organisation. The therapeutic approach views children's sense of self as rooted in their experience of attachment within their childhood. Young people value the time alone, talking about past and present worries. Young people know that their cultural, religious and racial identities are respected and that any additional support for mental or emotional or physical health needs will be organised. Police

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Helping children achieve well and enjoy what they do

report that staff are well matched to the young people and the service provides a supportive environment in which young people can grow and develop.

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Helping children achieve well and enjoy what they do

Staff value children's education and it is seen as part of their preparation for adulthood. They are aware of personal education plans, and the day to day detail of how staff implement this is clear in care plans. Staff give intensive support to young people at college, when making the transition from primary to secondary school, and in settling into the registered school operated locally by the organisation. Children have benefitted from this one to one help and have achieved well in academic terms. Social workers confirm that staff encourage children to complete school work and keep them informed about activities and education.

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Helping children achieve well and enjoy what they do

There is a good understanding of how children need to be occupied, challenged and excited by leisure time as well as the importance of lots of fresh air and running around. Local police say that staff keep young people active and occupied by good leisure support in the community. Children go horse riding, swimming, like walking with staff, go bowling, and play football as well as planning their holiday in the summer. Each child has at least one good individual holiday tailored to their interests, ages and needs. Social workers confirm that staff encourage children's individual hobbies and interests and this is clear from the toys, art and craft equipment and literature in the house.

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Helping children make a positive contribution

There are excellent systems in place for assessing, planning and reviewing children's care. Children have clear, up to date written placement plans that outline how their needs will be met. The manager ensures these are implemented in the day to day care and key worker support, so that care helps children develop. Plans are written in the child's voice and this helps to reduce institutional style records and make them easier for children to understand. Daily reports too are written as though the staff are talking to the child and this makes the day real. Social workers also report good feedback and say staff are good at keeping all other professionals 'in the loop as part of supporting individual needs.' Records show that excellent key working sessions cover feelings about family, racial and ethnic identity, different religions, insecurities and complaints. This is excellent focussed work by staff who clearly value the

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Helping children make a positive contribution

importance of communicating with children. The therapist guides and advises staff through a written communication book about each child. This helps everyone to keep the child's experience and development at the heart of all daily contact. Staff are learning skills in interpreting the meaning behind behaviour as children struggle with confusing, sad and angry feelings.

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Helping children make a positive contribution

Children know they are cared for and are making progress at the home because staff give this daily feedback. Staff have been successful in involving some children for the first time in their statutory review meetings, preparing and giving the support needed to participate and so have their own voice heard.

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Helping children make a positive contribution

Staff help children to maintain constructive contact with families, and other people who play a significant role in their lives. Children have the contact they want and need according to the placing authority plan. Some children have independent visitors because they have little contact with families. Social workers say staff are good at recognising the distress felt about family contact and put supportive strategies in place. Staff encourage local friends and community contacts to extend opportunities for meeting and mixing; in this way children build friendships and get opportunities to lead as ordinary a childhood as possible.

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Helping children make a positive contribution

The Registered Manager has developed systems so that children move into and leave the home in a planned and sensitive manner. The home accepts only planned admissions to ensure that all needs can be met. The manager has a highly effective documented system for assessing the needs of the new residents alongside those of the existing children. Children talk about new admissions so that any anxieties are understood.

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Helping children make a positive contribution

Children can make their views known and have a say in what happens in this home. This is clear from the way the staff build their day around the children, and in the records of meetings with them. There are regular group meetings chaired by children so they get plenty of opportunities for mature conversation. Children had some suggestions about improving the information they get about allowances and some do not like the shift changes and being looked after by a staff team rather than just a few people. The manager is aware of these issues. Professionals say the service is 'professional, friendly and young person focussed.'

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Achieving economic wellbeing

Children receive care and active support that helps them to prepare for adulthood. They are helped to save money in their own accounts. Staff adapt independent living programmes to take account of emotional needs and worries. Self-esteem and personal life skills are promoted through involvement with household chores, independence training, key working sessions and therapy. Professionals have said that the service is particularly good in promoting 'small steps towards independence' for children with self esteem and dependency issues.

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Achieving economic wellbeing

This is a large, modern, family sized home providing sufficient space and facilities to meet the needs of children with emotional and behavioural difficulties. There has been a focus on improving the décor and furnishings throughout and maintenance in the building is now promptly carried out. The bathroom is still showing signs of damp but the manager has organised remedial work to put this right. The garden is better equipped with garden furniture and play equipment. There is also a good range of large private and communal spaces so that children can be sociable or alone when they want to. Children like their bedrooms and have decorated them personally.

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Organisation

Children live in a home that is organised around their needs, and prioritises and seeks to improve their life experiences. Leadership and management of the service is effective. A placing social worker says, (name of home) provides an excellent, nurturing therapeutic environment.' Children have the information they need about life in the home so they know what to expect, how they will be cared for and who they are likely to share with. The children's guide is an enabling and interesting leaflet with the aim of empowering, not patronising the child. Parents and placing authorities also have a clear, revised statement about the operation of the home.

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Organisation

The promotion of equality and diversity is good. Policy, procedure and good practice helps children to know that their individual needs on the basis of race, ethnicity, disability, sexuality, gender, age and religion are valued. The service is able to meet their diverse needs in everyday life in the home. Staff are drawn from a range of ethnic and cultural backgrounds, both male and female. The Registered Manager trains staff in equality issues for the organisation.

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Organisation

Children are cared for by an increasingly confident staff team. Children do have challenging needs and the staff team have built on skills and experience through continuous professional development, so children benefit from a consistent and qualified adult approach. Qualifications such as the National Vocational Qualification (NVQ) at level 3 working with children and young people are well established at the organisation's registered NVQ centre. The Registered Manager takes staff development seriously and promotes training linked to the needs of the children living at the home and the home's purpose and function. A visiting professional said, ' The manager provides a good solid base from which the team can learn, experience and grow.'

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Organisation

There are sufficient staff on duty to give children plenty of one-to-one time. The management of the home has been strengthened by the creation of a deputy post and a senior usually leads each shift. Staff are well supported through systematic induction and probation periods, professional supervision, appraisal and regular staff meetings. Systems for staff discipline and performance monitoring are in place and effective, with the aim of improving practice, and this is an active and enabling process. Social workers value the staff's prompt communication with them about any incidents and say that there is good joint working with other agencies.

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Organisation

The welfare of the children in the home is promoted by regular monitoring by the Registered Manager. He carries out a considered and comprehensive review of operations and gives a picture of the children's lives behind the records. A social worker describes communication with the manager as ' effective, and very consistent and regular.' There is good support from peer and senior managers through highly effective monitoring visits. This strengthens the day-to-day operation to build a service that meets children's needs beyond day-to-day care. Records about children reflect their individuality. They are securely stored and children can access and add personal statements. The records contribute to the child's progress and development and the service takes their experience of life in the home seriously.

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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):

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Recommendations

 ensure employment references clearly state whether there any concerns about suitability to work with children (NMS 27.8)  maintain the interior of the home in a good state of structural and decorative repair. For example repair and keep clean the children's bathroom. (NMS 24.3)

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