Children's Home run by Keys Child Care Limited in Lancashire

Unique reference number SC064500 Inspector Mandy Williams Type of inspection Full Provision subtype Children's home

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Registered person Keys Childcare Ltd Registered person address Laganwood House 44 New Forge Lane Belfast BT9 5NW Responsible individual Heather Ann Laffin Registered manager Oliver Jon Birtwistle Date of last inspection 12/02/2014 2 of 11 Inspection date 29/07/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness adequate

Outcomes for children and young people good Quality of care adequate Keeping children and young people safe adequate Leadership and management adequate

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Overall effectiveness

Young people living in the home are making pleasing progress across all areas of their development. Some have made significant progress with their education and they appreciate the significance of this for their future. Young people benefit from good routines, clear expectations and the support of a committed group of staff members.

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Overall effectiveness

Young people largely demonstrate respectful relationships with staff who support them to respect the individuality of others. Young people routinely describe 'the staff' as the best thing about the home. Similarly one social work professional commented in feedback taken by the home, 'this has been a very supportive, committed placement. Thank you for all your hard work'.

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Overall effectiveness

Staff work well with other professionals, although there has been some breakdown in communication since the last inspection. The home has been through a difficult period; managing the challenging behaviours of some young people. This presented challenges for the staff team and tested their resilience. This has impacted on the Registered Manager's ability to fulfil some of his management functions to a high standard and on the judgements made at this inspection. However, the home is now settled. The Registered Manager and staff in the wider organisation have learnt from this experience. The Registered Manager demonstrates a commitment to address 3 of 11 the identified shortfalls. A settled staff team is now back in place and they are enthusiastic about their work with young people. 4 of 11

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Information about this children’s home

This home is owned and operated by a private organisation. It is registered to provide care and accommodation for up to three children and young people. The young people may have emotional and/or behavioural difficulties; including attachment disorder.

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Inspection date Inspection type Inspection judgement

12/02/2014 Interim good progress 17/09/2013 Full good 31/01/2013 Interim good progress 24/07/2012 Full good

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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

4 (2001) ensure that the children's home is at all times conducted in a manner which is consistent with its statement of purpose (Regulation 4(6)) 31/08/2014

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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 safeguarding and welfare of children accommodated there (Regulation 11(1)(a)) 31/08/2014

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Reg. Requirement Due date

(2001) ensure that the person carrying out the visit according to this regulation interviews, with their consent and in private, the children accommodated there, their parents and relatives in order to form 31/08/2014 5 of 11 an opinion of the standard of the care provided in the home. (Regulation 33(4)(a))

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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

 ensure that all staff are trained in the use of physical restraint techniques and only use the home's agreed techniques; this specifically relates to the use of agency staff (NMS 3.15)  ensure that the registered person and staff work effectively in partnership wit other agencies; specifically that feedback is provided to them when they have raised concerns with the home (NMS 4.7)  ensure that staff have access to appropriate support and advice; specifically regular consultancy with therapists who are working with young people (NMS 19.4)  ensure that the manager regularly monitors, in line with regulations, all record kept in the home to ensure compliance with the homes policies, to identify an concerns and to identify patterns and trends; and that immediate action is tak to address any issues raised as part of this monitoring. (NMS 21.2) 6 of 11

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Outcomes for children and young people good

Young people living in the home are make pleasing progress across all areas of their development while residing here. Young people resident in the home have frequently had poor early life experiences and many disrupted placements prior to their admission to the home. This has impacted on their ability to make attachments and often left them with poor self-esteem. The ethos of the home is to provide young people with a stability of placement, where they will receive a consistency of care. Staff make it clear to young people that they can safely manage their challenging behaviours and that they are committed to their care. Young people's anxieties reduce as a result and ultimately this enables them to invest emotionally in their placement.

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Outcomes for children and young people good

Young people are in good health and largely follow a healthy lifestyle. Young people are encouraged to eat a healthy and varied diet and take regular exercise. Young people are also encouraged to follow good personal hygiene routines. Young people receive incentives to encourage their participation if they are struggling to engage with this. Staff hope that if young people establish healthy routines while living at the home they will continue to follow these when they move on from here.

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Outcomes for children and young people good

Young people's emotional health needs are met as they have access to therapists within the organisation. This gives young people the opportunity to develop an understanding of their past and learn coping strategies for the future. Young people receive support to keep positive memories alive and young people maintain a 'memory box' with items of particular importance to them. The organisation employs a consistent approach and shared terminology, so that young people become familiar with this.

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Outcomes for children and young people good

Young people's attendance and achievement at school or college is good. Young people are able to access the organisation's school but staff advocate for young people to attend mainstream establishments if they are able. Young people have been supported to transition into mainstream school successfully and are rightly proud of their achievements. Young people have also successfully completed college courses and are keen to continue their learning and further their education. This will improve young people's employment opportunities in the future.

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Outcomes for children and young people good

Young people receive encouragement and support to maintain contact with those important to them. Arrangements for contact are clear in young people's placement plans and staff demonstrate a commitment to facilitate this. Some young people also have friendships in the local community. Staff support these in the same manner as they would do for a child in their own family, ensuring that they know where the young person is and have appropriate contact details. Young people have access to the home telephone, as well as internet access. Young people also have their own 7 of 11 mobile telephones subject to a positive risk assessment. This allows staff to maintain contact with young people when they are outside of the home and also for young people to maintain contact with their family and friends.

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Outcomes for children and young people good

Young people are engaged in a range of activities of their choosing. Staff listen to young people's wishes and will try to access what they have requested. Some young people enjoy swimming or playing at the activity centre, while another receives support to follow their long term passion of horse riding. One young person said that 'lots of activities' was one of the best things about living in the home. Young people are also able to experience a special day out with staff or plan a holiday. Young people were looking forward to an imminent camping holiday during the inspection.

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Quality of care adequate

Staff are good at developing positive relationships with young people. Young people say that they like the staff who work in the home. They set clear and consistent boundaries about acceptable behaviour. Some staff have worked in the home for many years and know the home and young people very well. However, there has been some staff sickness since the last inspection resulting in an increased reliance on bank staff; shifts being covered by staff who work in other children's homes in the organisation; and the use of agency staff. There has been a period of instability but this has been resolved over recent weeks.

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Quality of care adequate

Staff are keen to involve young people in the running of the home. Weekly young people's meetings provide a forum for young people to raise ideas for the week ahead and plan their menu, as well as raise any issues that they have. Staff also utilise this forum to provide general information to young people. For example, to give them details and advanced preparation about a new young person being admitted to the home. The Registered Manager provides feedback to young people relating to any issues that have arisen. The Registered Manager also consults with young people in relation to the formulation of his development plan for the home, so that they able to identify their own targets as well as suggest other ways to develop the home. An effective keyworker system also allows young people the opportunity for personal discussion. Young people are involved in choosing the décor to the home and are able to personalise their own bedrooms. Consequently, young people feel

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Quality of care adequate

that their views are important and that they belong in the home.

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Quality of care adequate

Young people receive clear guidance on how to make a complaint. This is outlined in the young person's guide to the home, which they receive on admission. Young people have made a number of complaints since the last inspection. The Registered Manager has appropriately investigated all of these. Young people are informed about the outcome either formally in writing or via a keyworker session depending on the young person and the nature of their complaint. Young people also have access to an independent advocate who visits the home regularly. However, young people have not yet been able to develop a relationship with the independent individual 8 of 11 employed to complete the external monitoring of the home, as visits have been conducted when young people are not at the home.

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Quality of care adequate

Staff care for young people in line with their personalised placement plans. Young people are able to contribute to their care planning and they are clear about their targets. These are subject to review following a young person's statutory review meeting, ensuring that they continue to be targeted on improving outcomes for the young person. Social workers agree young people’s placement plans and a system is also in place to ensure that all staff working in the home are familiar with them. This helps ensure that all those working with young people are adopting an agreed approach.

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Quality of care adequate

Young people's health needs are clearly outlined in their placement plans. Arrangements for the administration of medication are safe. Staff are also able to access advice from therapists working with young people, as to the most appropriate way to respond to the young person's presenting behaviour at any point in time. However, the system established for staff to receive this advice routinely has not been effective over recent months.

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Quality of care adequate

Staff prepare regular comprehensive update reports for social workers and parents on the progress that young people are making. Staff have also established positive working relationships with other organisations that work with young people. However, feedback has not always been given to them when they have raised concerns about the home, despite action actually having being taken to address the issue.

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Keeping children and young people safe adequate

Young people confirm that they feel safe and settled living in the home. Staff complete safeguarding training as part of their induction to the home and a number of policies and procedures are in place that underpin this. Staff are familiar with the actions to take should they have any concerns and have indeed demonstrated that they are confident to do so. Safe staff recruitment processes support this prior to staff being employed to work in the home. Appropriate referrals are made to other agencies and disciplinary procedures are followed if safeguarding concerns arise following employment. However, other involved professionals do not always receive feedback in a timely fashion at the conclusion of the investigation and on one occasion a whistleblowing procedure had not been satisfactorily concluded.

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Keeping children and young people safe adequate

Young people benefit from individualised behaviour management plans. These outline the most effective way for staff to manage their behaviours. All permanent members of staff are trained in the safe implementation of restraint. There have been a large number of incidents for some young people since the last inspection who have presented some very challenging behaviour. Staff have been required to 9 of 11 engage in a restraint in order to safeguard the young person themselves; other young people; or staff. Detailed records are maintained following a restraint and support provided to the young person and staff involved. However, agreements have been made with some agency staff for them to become involved in a restraint if required, when they have not received the appropriate training. Although, this eventuality did not occur when they were on duty in the home this process does not ensure the safe management of young people's behaviour.

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Keeping children and young people safe adequate

Young people confirm that bullying is not an issue in the home. They receive a young people's guide on bullying outlining what action they should take if it were to be an issue in the home. Young people express confidence in approaching an adult if they have any concerns. Staff are proactive with young people about how to keep themselves safe. Topics such as drugs, alcohol, smoking and sexual exploitation are discussed openly with young people. Staff hope this will help equip young people with the skills to keep themselves safe. Information leaflets for young people are also freely available in the home.

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Keeping children and young people safe adequate

The home complies with locally agreed protocols for young people that go missing from home. The number of incidents is low and there has been a significant reduction for some young people since they moved into the home. Staff have worked with young people to help them appreciate the implications of this risk taking behaviour. Some young people have struggled with this initially but have learnt to accept the rules of the home and that staff need to ensure their safety. Young people do spend time in the community with their friends and delegated authority allows staff to risk assess a young person's request to stay overnight with a friend. This ensures that young people feel listened too; that they are enabled to take age appropriate risks; but also that staff know where young people are and that appropriate checks have taken place.

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Keeping children and young people safe adequate

The home is physically safe and appropriately secure. Regular environmental safety checks are routinely completed. Fire drills take place regularly in day-time and night- time conditions; and soon after the admission of a new young person to the home. Visitors to the home are also informed about emergency evacuation procedures. This ensures that everyone in the home is aware of the actions to take in the event of an emergency.

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Leadership and management adequate

There is a suitably qualified and experienced manager in charge of the home. He has been managing this home for the last two years. He is well respected by staff, young people and professionals involved with the home. The majority of staff employed in the home have a level three qualification in caring for children and young people and the remainder are working towards this qualification. A range of other training opportunities are available to staff in order for them to meet the particular needs of 10 of 11 the young people that they are caring for, for example, specialised attachment training. The Registered Manager uses a training matrix to assist him in the monitoring of this. This ensures that staff are provided with the skills they require to effectively meet the needs of the young people that they are caring for.

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Leadership and management adequate

The home's Statement of Purpose has been recently revised and a copy forwarded to Ofsted as required. However, the home is not consistently operating in accordance with this. Monthly therapeutic consultancy for staff has not been taking place and not all staff on duty in the home have been trained in restraint, as outlined above.

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Leadership and management adequate

The one requirement and one recommendation made at the last interim inspection have both been satisfactorily addressed. Duty rosters clearly indicate who is in charge of each shift and these reflect other records maintained in the home. Additionally, the procedure that is in place to ensure that all staff are aware of any changes to young people's placement plans or other actions planned in the home has been effective since the last inspection. The Registered Manager has introduced a new system to alert staff to any changes and this is working well, ensuring that everyone is up-to- date and aware of the current position.

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Leadership and management adequate

The Registered Manager is aware of the strengths and weaknesses of the home and is in the process of reviewing the home's development plan. He has consulted with staff and young people and is keen to ensure that their views are central to this. He is also in the process of completing a 'safe area risk assessment' for the home and has consulted with local partners. He demonstrates a commitment to develop the home.

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Leadership and management adequate

Records indicate, and staff confirm, that they receive supervision and appraisal to support them in their role of caring for young people. However, the matrix used by the Registered Manager to monitor this contained incorrect details. This had not been identified through the managers internal monitoring of the home. Additionally, a minor error in the medication record book and an incomplete visitors book had not been identified and addressed prior to this inspection. Hence the internal monitoring of the home has not been robust. Similarly, although the organisation has now appointed an independent individual to complete the external monitoring of the home, these visits have not included consultation with the all the individuals required. Some shortfalls in communication between managers in the wider organisation were also evident during this inspection. For example, the Registered Manager had addressed a concern raised with him but was not aware of the source of this

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Leadership and management adequate

concern. Consequently, he had not been able to respond directly to the instigator.

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Leadership and management adequate

Appropriate systems are established to inform Ofsted of the occurrence of any notifiable incidents. The Registered Manager is also good at providing regular updates as to the progress and outcomes of any investigations completed. Website: www.ofsted.gov.uk

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Leadership and management adequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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