Children's Home run by Keys Nhcc Ltd in Shropshire

Unique reference number SC020607 Inspection date 09/05/2013 Inspector Robin Whistlecraft Type of inspection Full Provision subtype Children's home

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Date of last inspection 15/10/2012 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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Brief description of the service

The home provides care for up to three children or young people. The service is for children and young people with emotional and/or behavioural difficulties aged between age 8 and 17 years; it is privately owned. There is also a satellite property that may provide care for an additional child or young person.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be inadequate .

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Overall effectiveness

The overall picture for this home is mixed. Some young people make good progress, personally, socially and academically, because they receive at least adequate and sometimes good quality care. However, because some aspects of the home are unsuitable for their needs and behaviour, some young people experience care that has to focus on their safety. As a result, they experience many physical restraints in order to protect them and lose privacy because staff have removed their bedroom curtains. They are also isolated from other young people.

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Overall effectiveness

The good experiences and outcomes for some young people cannot outweigh the poor experience of a minority. This situation is the result of a lapse in the mostly sound management of the home.

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Overall effectiveness

Young people say they feel safe. The home keeps them safe. Relationships between staff and young people are friendly and warm. On the whole, managers understand the strengths and weaknesses of the home and have development plans in place in order to continue to improve the quality of care provided.

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Overall effectiveness

This report contains seven requirements for areas for improvement. The requirements are in relation to ensuring that the home can meet young people’s needs and that it does so without adversely impacting on their other needs; ensuring that young people can have telephone calls in private; supporting young people to achieve in school; the appropriate use of physical restraint, ensuring that full recruitment checks are carried out on temporary workers from staffing agencies; and provision of staff training for workers from staffing agencies.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that the children’s home is conducted so as to promote and make proper provision for the welfare of children accommodated there. This is in relation to ensuring that the home is able to protect young people without seriously detracting from its ability to meet their other needs and rights (Regulation 11 (1)(a)) 28/06/2013

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Reg. Requirement Due date

(2001) ensure that children accommodated in the home are provided at all reasonable times with access to a telephone on which to make and receive telephone calls in private. This is in relation to where access is not subject to constraint because of a known and current risk (Regulation 15 (4)(a)) 28/06/2013

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Reg. Requirement Due date

17A (2001) ensure that a measure of restraint may only be used on a child accommodated in a children’s home for the purpose of preventing injury to any person (including the child being restrained) and preventing serious damage to the property of any person (Regulation 17A (9)(a)(b)) 28/06/2013

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Reg. Requirement Due date

(2001) promote the educational achievement of children accommodated in a children’s home, in particular by ensuring that the routine of the home is organised so as to further children’s participation in education, including regular attendance at school and participation in school activities (Regulation 18 (1)(b)) 28/06/2013

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Reg. Requirement Due date

(2001) ensure that no person starts work at a children’s home until such time as full and satisfactory information is available in relation to him in respect of each of the matters specified in Schedule 2 (Regulation 26 (5)(b)) 28/06/2013

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Reg. Requirement Due date

(2001) ensure that the premises are not used for the purpose of a children’s home unless they are in a location, and of a physical design and layout, which are suitable for the purpose of achieving the aims and objectives set out in the home’s statement of purpose (Regulation 31 (1)) 28/06/2013

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Reg. Requirement Due date

(2001) ensure that all the person's employed by him receive appropriate training, supervision and appraisal. This is relates to the training of agency workers in safeguarding procedures and the use of physical restraint which accord with those 28/06/2013 approved for use in the home. (Regulation 27 (4)(a))

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Outcomes for children and young people

Outcomes for young people are inadequate .

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Outcomes for children and young people

Although there are sometimes reversals, most young people make progress in the home. Progress has been in relation to reduced influence from peers at home, reduced incidence of going missing and developing self-confidence, emotional resilience and understanding their background.

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Outcomes for children and young people

The home has admitted some young people who present a high risk of self-harm. Some of the home’s accommodation contributes rather to, rather than reduces, that risk. As a result, staff supervise those young people very closely in order to protect them from themselves. This means their privacy is significantly constrained and they are socially isolated from other young people. They are also living in accommodation that is deteriorating because staff have to remove risks that are exposed by some young people’s attempts to self-harm. As a result, these young people are not in a position to develop well-being and, therefore, emotional health.

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Outcomes for children and young people

Young people generally enjoy good physical health. They are encouraged to eat a balanced and healthy diet. Young people receive support from specialist health services, such as child and adolescent mental health services, if they require it. Some young people smoke, but have reduced their use of tobacco. The home ensures that they receive advice and support to use various methods to give up smoking.

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Outcomes for children and young people

Young people experience mixed success in relation to their education. Some make significant achievements, especially given their starting points, despite being unable to attend school. Others attend school regularly but are often disruptive with peers, so reducing their opportunities to make progress. Other young people experience only limited home tuition and therefore, have limited opportunity to achieve. This means that while some are making progress, others are not achieving educationally.

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Outcomes for children and young people

The home does not currently operate a full independence preparation programme. However, young people learn to budget, cook and take care of their clothes as part of the general regime. They learn basic domestic skills through weekly chores in the home and responsibility for cleaning and tidying their own bedrooms. Young people also have the opportunity to make a positive contribution to the home. As well as influencing the choice of leisure activities and meals, they have significantly influenced the colour schemes used for the redecoration of the accommodation.

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Outcomes for children and young people

Most young people are able to make a positive contribution to the wider community. Some have developed the necessary self-confidence to seek out and obtain part-time work. Others have proved themselves so reliable that neighbours have entrusted them with the care of their animals while taking a significant holiday. Some young people have had some of their family contact inappropriately supervised by staff. Other young people have experienced significant improvements in their contact with their families. Some young people have developed the emotional resilience and self-confidence to challenge family members’ past behaviour. This means that they are developing the ability to withstand unfair pressure and to understand the context of their own experiences.

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Quality of care

Young people enjoy sound and friendly relationships with each other and with staff. Young people may not appreciate everything the home does, but they do consider that staff have their interests as the focus of their work. One said ‘you don’t have to try so hard with them, they just get it.’

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Quality of care

The home’s current redecoration programme demonstrates that the home listens to young people’s wishes and views, because the redecoration came about, in part, because of their comments about the previous décor. Young people know how to complain and do use the home’s complaints process. The home’s manager always responds to complaints and often follows them up again later, especially if the young person withdraws a complaint. This means that young people benefit from care that takes their complaints seriously.

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Quality of care

Staff encourage the young people’s education. Staff provide support for young people to go to education as well as supporting young people to do school work within the home, if they wish to engage with that support. The home also provides a range of purposeful activities, both inside and outside in the community.

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Quality of care

The home’s system for the giving out and recording the use of medication is effective and safe. Staff promote young people’s health. This ranges from encouragement about diet and support for dental health, to enabling them to receive advice and support regarding contraception. Staff routinely register young people with health support agencies in the community, such as general practitioners, dentists and opticians. Staff persistence supported one young person to begin going to the dentist. One young person wrote: ‘I love my new toothbrush. Thank you!’

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Quality of care

Staff have a basic understanding of equality and diversity and managers are encouraging further exploration of this with young people. For example, staff enabled one young person to cook a meal for the whole home in celebration of a cultural festival.

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Quality of care

Most young people are cared for in line with their care plan. However, some young people do not have an adequate plan apart from risk assessments and behaviour management plans. This is despite the home having prior knowledge and experience of those young people. This means that the care for those young people is reactive, addressing only safety, and lacks strategies to promote well-being in other areas. The main parts of the accommodation are homely, and the provider keeps them adequately maintained. Young people are able to personalise their bedrooms and most do. However, some parts of the accommodation are not adequate to meet some young people’s known needs and challenges. The shortfalls relate to both location, and the fabric of the building in relation to young people who self-harm. This means that staff spend additional time and effort reacting to, and being alert for, new risks rather than developing their care for those young people’s well-being.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people say they feel safe in the home whether from other young people, in the company of staff or in relation to the security of the accommodation. They are able to identify adults they could talk to if they felt unsafe or had a concern.

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Safeguarding children and young people

Young people have reduced the frequency that they go missing, though some young people still do occasionally go missing. However, these incidents do not now involve being missing overnight. The home’s risk assessments identify possible triggers and include clear guidance about the steps that staff are to take if young people do go missing. The home has arrangements with the local police if young people go missing. These factors mean that the home protects young people as far as possible in relation to this behaviour.

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Safeguarding children and young people

Managers deal robustly with incidents or events that might be interpreted as possible abuse and refer them to the local authority designated officer. This approach protects everyone involved. However, some staff rely on managers to know safeguarding procedures and are not aware of the responsibilities of external agencies for carrying out investigations. It is clear that the home’s managers know and operate safeguarding procedures appropriately. Nevertheless, staff need to know the role of external safeguarding agencies in order to recognise if proper referrals have not been made.

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Safeguarding children and young people

The home promotes positive behaviour by operating a reward system that involves individual targets for each young person. Staff also use their relationships to encourage young people to be positive. However, there have been a small number of occasions when staff have used low-level restraint to prevent young people leaving the home without permission. On those occasions, the home’s records do not indicate that staff were preventing serious damage to property or injury to persons. This means that young people were subject to restraint, on those occasions, when they should not have been.

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Safeguarding children and young people

Some young people experience periods of a high frequency in the use of physical restraint, and sometimes for long periods; for or example, interventions of forty minutes, forty-five minutes and one hour and fifteen minutes have been recorded. The home’s records show that these episodes occurred because staff acted to prevent self-harm. However, they also demonstrate that some young people have experienced care in a setting that is unsuitable to address their known and specific needs and behaviours.

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Safeguarding children and young people

The home generally carries out sound recruitment checks on permanent staff. However, managers have not ensured that workers from staffing agencies have been subject to all of the required recruitment checks. This means that young people have received care that managers have not assured by safe staff recruitment practices.

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Leadership and management

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

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Leadership and management

The home has a Registered Manager. There are no outstanding requirements or recommendations from previous inspections. Managers deal with concerns and complaints as they arise.

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Leadership and management

The provider appropriately oversees the home’s conduct through regular external monitoring visits. The home’s managers take appropriate action in response to recommendations made as a result of the external monitoring visits.

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Leadership and management

The home’s manager periodically reviews the quality of care provided in the home, and produces reports for the provider as a result of these. Those reports identify appropriate actions to improve the quality of care provided in the home. The home’s managers have also compiled a development plan for the home that further identifies actions to continue to improve the quality of care. These factors mean that young people benefit from a care regime that is regularly scrutinised with a view to its continual improvement.

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Leadership and management

The numbers of staff reflect young people’s risk assessments and behaviour management plans. Permanent staff receive training in core areas and there is an effective system to ensure that they receive refresher training when that is due. However, managers have not ensured that temporary workers from staffing agencies have received training in safeguarding procedures. Nor have managers checked that the agency workers’ training in the use of physical restraint is compatible with the techniques used by trained permanent staff. This means that some young people have received care from some staff whose competence in significant areas is unknown.

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Leadership and management

Managers appropriately maintain the home’s physical environment. The home’s records are detailed and clear and support an understanding of young people’s lives in the home. The home appropriate notifies relevant authorities about significant events in the home.

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Leadership and management

The home’s Statement of Purpose is clear. Staff are fully aware about how the home works. However, managers have agreed to admit some young people for whom parts of the home are unsuitable to meet their needs. The information available to the home’s managers and line managers clearly indicated what staff would need to deal with. Therefore, the adverse impact was predictable. This means that some young people’s well-being has not been supported by effective management.

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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 and the evaluation schedule for the inspection of children's homes.

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