Children's Home run by Keys Care Limited in Sandwell

Unique reference number SC374268 Inspection date 20/09/2011 Inspector Sharon Treadwell Type of inspection Full Provision subtype Children's home

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Date of last inspection 07/03/2011 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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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 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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The inspection judgements and what they mean

Outstanding : a service that significantly exceeds minimum requirements Good : a service that exceeds minimum requirements Satisfactory : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Brief description of the service

This home offers medium to long-term care for a maximum of three young people who have emotional and behavioural difficulties. The home is operated by a large national provider of children's residential care.

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Brief description of the service

Specific direct work and individual therapy programmes are provided, to young people, by a qualified and experienced psychotherapist, employed by the provider organisation, who makes weekly visits to the home. Staff employed at the home are trained in creating a therapeutic environment to support the work of the psychotherapist.

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Overall effectiveness

The overall effectiveness is judged to be outstanding .

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Overall effectiveness

Young people think that this home deserves to be rated as outstanding. Child- centred and comprehensively detailed care planning identifies a range of achievable placement objectives to promote very positive outcomes for young people. Therapeutic care packages are overseen by a qualified psychotherapist, who undertakes weekly sessions with the young people as well as guiding, advising and training staff, so that young people receive consistent care of a very high standard. A confident, dedicated and strongly motivated staff team help young people to feel safe and confident to explore some of their feelings of failure and rejection. Staff additionally support young people to develop a sense of self-worth and to refine some of their more challenging behaviours.

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Overall effectiveness

Young people are having positive life experiences. They are being strongly encouraged to value themselves and others. Young people are enjoying school and achieving well and feel happy and settled in a placement they strongly regard as their home.

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Overall effectiveness

There are excellent quality assurance systems in place to monitor practice and to identify areas for potential improvement. This ensures that the service consistently strives to fully meet the needs of the young people accommodated.

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Overall effectiveness

Young people's files do not always contain a copy of their personal education plan. Although staff are receiving good guidance and support in relation to supporting young people's contact arrangements, they have not undertaken specific training in relation to this role.

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 provide staff with training where they are involved in supervising and facilitating contact arrangements for young people (NMS 9.2)  retain a copy of each young person's personal education plan on their file (NMS 8.7)

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Outcomes for children and young people

Outcomes for children and young people are outstanding .

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Outcomes for children and young people

Young people feel happy and settled at this home and enjoy very positive relationships with the staff. Interaction between young people and staff is observed to be warm and affectionate, with young people openly asking for a hug when they come in from school and saying, 'I've missed you today' to staff on duty. Young people have clearly stated their wish to remain in this placement.

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Outcomes for children and young people

Young people are in good physical health and are not receiving any regular medication. The home has established sound relationships with the local doctor, dentist and optician to help in supporting young people to access these services quickly, confidently and appropriately. Young people are provided with good, home cooked meals and are very aware of the need to eat lots of fruit and vegetables.

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Outcomes for children and young people

Young people have weekly sessions with a qualified psychotherapist to address mental and emotional health and attachment issues. Staff are extremely well trained and supported to ensure that their daily interaction with the young people fully supports this therapeutic work. The very strong therapeutic focus of placement is evident in the language used by the staff and in the approach to managing presenting behaviours and in resolving any conflicts. For example the words sad, glad, mad and scared are common terms used for helping young people to understand how they are feeling and to learn to manage those feelings. This approach is helping young people to come to terms with difficult elements of their past, such as rejection, and to move towards a much more positive self view.

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Outcomes for children and young people

Staff are ambitious for young people and robustly encourage and support them to both enjoy school and to work hard. In some cases young people have been helped, through strong partnership working with the school, to return to full time schooling following lengthy periods out of education. School reports demonstrate that young people are achieving well. Where young people's presenting behaviours have the potential to impede their access to education the psychotherapist has worked with teaching staff to share strategies, which have been successful in challenging these behaviours, within the home. Young people are encouraged to get involved in extra curricular activities, for example being selected as a member of the school football team. Staff have negotiated funding for young people to sign up for educational trips abroad. This ensures that young people's experiences and achievements are comparable with

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Outcomes for children and young people

their peers and that their looked after status is not placing them at any disadvantage. Young people are supported to access a wide range of leisure activities, to pursue interests they already have and to experience new opportunities. Young people regularly attend football practice, local football matches, go swimming, visit local playgrounds, attend children's fitness classes and go horse riding.

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Outcomes for children and young people

The young people, currently accommodated at the home are very young. They often help staff with household chores, and are encouraged to help with shopping for food and preparing meals. This equips them with some of the skills they will need as they move towards adulthood. Some young people travel independently, on public transport, to school each day and all are supported to develop good self care and personal hygiene practices. Young people are consistently helped to become more confident and capable in all areas. In the past many young people have moved on positively from the home into more independent situations.

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Quality of care

The quality of the care is outstanding .

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Quality of care

The home provides a warm, welcoming and homely environment where young people feel settled and happy. All young people have single bedrooms, which are clean, comfortable and personalised to their individual taste, whether they prefer cartoon characters or are keen supporters of the local football team. In the questionnaires completed prior to the inspection, young people stated: 'It's spacious and my room is really nice' and 'I really like my room.’ Young people's bedrooms are fitted with appropriate locking mechanisms, but neither currently has a key to their room. Young people say that they do not wish to keep their bedroom doors locked because this is their home. The staff respect young people's privacy by knocking on bedroom doors when they wish to enter.

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Quality of care

Young people have access to a telephone for private calls and there are contact details for a range of advocacy services. Staff have made application to young people's placing authorities for the appointment of independent visitors where they feel this would give young people valuable independent support and help them in making positive relationships with adults.

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Quality of care

The staff team comprises a good mix of male and female staff, of varying ages and from a range of cultural backgrounds, providing young people with appropriate role models. Staff encourage young people to be aware of and to value difference, and to be proud of their own achievements and of each others.

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Quality of care

For many young people family relationships are complex and are often the subject of sessions with the psychotherapist. Young people's contact arrangements are clearly detailed in their contact plan, so that all staff are fully aware of the support they need, and their continuing appropriateness is discussed at young people's reviews. All staff receive training in working with young people with attachment difficulties, child development and direct work with young people. This provides them with good theoretical knowledge to support their work with young people who have difficulties making positive attachments. Additionally staff have a monthly meeting with the psychotherapist, to guide their work in helping young people to come to terms with their family relationships. This provides staff with good systems of support where they are facilitating or supervising young people's contact arrangements; however,

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Quality of care

staff do not receive specific training for this role. Staff have been pro-active in supporting young people to voice their wishes around family contact to their placing authorities and to have those wishes granted.

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Quality of care

Young people's educational support needs are clearly identified within placement planning. Staff have established positive working relationships with young people's schools, to promote and recognise positive achievements. Personal education plans are regularly reviewed and updated and young people are supported to be part of this process. Where young people have statements of special educational needs these too are regularly reviewed. Although staff always attend such meetings and have very good awareness of young people's educational needs, young people's files do not all contain a copy of their current personal education plans.

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Quality of care

Placement planning is excellent. Individual placement planning incorporates a daily living plan, a health care plan, a contact plan and a positive handling plan. Placement objectives are very clearly stated and are achievable by young people. Plans are written in the first person to reflect young people's involvement in compiling them. There is really good identification of very specific individual needs in relation to culture and religious belief and clear identification of how staff will ensure that these needs are met. Where appropriate, young people are being supported to attend church services and to purchase culturally appropriate toiletries. Daily recording is to a very high standard with records written as if the staff member is writing to the child about their activities and behaviours that day. This makes these records very easy to share with young people. Key worker sessions have clear goals and are

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Quality of care

geared to addressing specific concerns or incidents or to the progressive achievement of stated placement objectives. The very solid nature of young people's relationships with the staff is demonstrated by young people's willingness to engage positively in these sessions.

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Quality of care

Young people consistently sign records at the home, to demonstrate their agreement with the content. Records of individual key work sessions and young people's house meetings show that the young people play a very active part in decision making at this home. Young people regularly attend their reviews and personal education plan meetings with their key workers. Some had never attended meetings prior to coming to live at this home. This is an excellent example of the young people's increasing confidence.

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Quality of care

Robust policies and procedures guide staff practice in ensuring that medication is appropriately stored and that receipt and administration is properly recorded. Medication is securely stored in a locked cabinet in the office. This ensures that young people do not have inappropriate access to medication and that the potential for error in administration is low.

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Safeguarding children and young people

The service is outstanding at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

The audit of the provider organisation in March 2011, conducted under Ofsted's National Provider Scheme, assessed the organisation's recruitment procedures and practices and stated, 'There are very good systems in place to make suitability decisions about staff and records are maintained to a high standard.’ Recruitment records examined confirm that great care is taken to prevent unsuitable people being employed to work with the young people.

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Safeguarding children and young people

Young people are protected because the home has a robust safeguarding policy and all staff have attended safeguarding training, provided by the Local Safeguarding Children Board. Staff know the procedures and are fully aware of their responsibilities in reporting and recording any concerns. Where young people have made disclosures relating to historical abuse, the staff have responded quickly and appropriately in notifying all relevant professionals and have ensured that good support has been provided to the young people concerned. This has included challenging other professionals where staff have felt that their responses have not been fully supportive or appropriate.

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Safeguarding children and young people

Young people's positive handling plans provide good information about the potential triggers for young people's adverse behaviours. The plans detail potential indicators for behaviour that is deteriorating and guide staff in the most effective techniques for addressing challenging and unsafe behaviours. Staff often use predictive strategies very successfully, to allay negative behaviours when they can see that young people's mood or behaviour is deteriorating.

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Safeguarding children and young people

Physical intervention is appropriately recorded and records demonstrate that, for many young people, levels of physical intervention have been high early in their placement but have reduced significantly as they have engaged with staff. The young people rarely leave the home without permission and clear individual protocols are in place to clarify who staff need to inform and what action they should take, should this happen.

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Safeguarding children and young people

Appropriate records are retained when young people are given sanctions and young people have themselves written the house rules and think that these are fairly applied by the staff. There is good information in the young people's guide about what constitutes bullying and detail that this is not acceptable in any form. Staff observe relationships between young people carefully for any indication of inequality. Recently the home held a bullying awareness day and young people designed some excellent anti-bullying posters.

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Safeguarding children and young people

Sound systems promote the safety of young people, staff and visitors within the home. There is appropriate servicing of electrical and fire safety equipment and young people are involved in regular fire drills and discussions about fire safety. This ensures that they understand the importance of evacuating the building quickly to be safe. Staff conduct appropriate checks on fridge and freezer temperatures and have good access to relevant training such as food hygiene, fire safety, health and safety and first aid. There is good promotion of appropriate risk assessment, both in relation to the home itself and to young people's presenting behaviours.

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Leadership and management

The leadership and management of the children's home are outstanding .

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Leadership and management

The provider organisation is a member of the Ofsted National Provider Scheme and an audit of the head office was carried out in March 2011. The organisation was judged to have sound policies and procedures in place to guide staff practice and to provide staff with appropriate training opportunities.

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Leadership and management

The home is effectively and very efficiently managed. The Registered Manager has a wealth of relevant experience. The home employs sufficient staff to ensure that the care and support needs of young people accommodated are fully met. Staff have good access to initial and refresher training covering key areas such as first aid, food hygiene, restraint, health and safety and child protection. Additionally staff receive training to specifically equip them in creating and maintaining a supportive environment, for the young people they care for, such as child development, attachment and loss, behaviour management and victims who victimise. The manager is pro-active in identifying staff training needs arising from young people's particular experiences. For example, staff recently undertook training on domestic violence in preparation for a potential admission even though the young person was ultimately not placed.

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Leadership and management

Staff feel that they are very well supported by management and by other members of the team. Records and discussions with staff relating to the handling of recent concerns that a member of the team was the target of young people's adverse comments and behaviours, demonstrate robust mutual support systems. Staff receive regular supervision and there are monthly team meetings and monthly staff meetings with the psychotherapist This promotes consistent management of young people's behaviour and effective promotion of positive placement outcomes.

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Leadership and management

Complaints are appropriately recorded and are managed in a timely way with good information provided to complainants regarding progress and outcomes. Guidance for staff about receiving and recording complaints, and about supporting young people to make complaints, is very thorough. This ensures that all relevant professionals receive timely and appropriate information and that young people get good support when they wish to make a complaint.

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Leadership and management

There are thorough and robust systems for monitoring the operation of the home and the quality of care. The manager completes monthly reports to evidence robust oversight of working practices and care provided. These reports incorporate good analysis of findings and the manager prepares graphs to support his findings and identify trends. For example, in relation to the occurrence of physical intervention, to guide practice development and improve services for young people. He has also reviewed the home's comprehensive development plan to reflect the changes in regulations and National Minimum Standards.

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Leadership and management

Monthly, unannounced visits to the home, on behalf of the provider organisation, provide an independent oversight of care practice, incorporate regular discussions with staff and young people and identify any issues of concern. The reports of these visits are comprehensive and thorough, and help to improve service deliver to young people.

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Leadership and management

Equality and diversity practice is outstanding .

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