Children's Home run by Keys Care Limited in Buckinghamshire

Unique reference number SC421063 Inspector Louise Redfern Type of inspection Full Provision subtype Children's home

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Registered person BetterCare Keys Limited Registered person address Laganwood House 44 Newforge Lane Belfast BT9 5NW Responsible individual Heather Ann Laffin Registered manager Christopher Eric Davis Date of last inspection 03/03/2014 2 of 10 Inspection date 22/01/2015

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

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Overall effectiveness

Young people are settled in this home, because of the quality of care provided by the small and dedicated staff team. Young people report that they feel safe living at the home and that they feel listened to. Parents and professionals support young people’s view in the quality of care provided. One grandparent stated, ‘there’s no fault with the staff, they are lovely and upfront. They know X and understand him.’

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Overall effectiveness

Young people develop strong community links in the local area, while maintaining a clear attachment to their family and community. Young people receive well-planned care, taking into account their individual needs. The home promotes positive outcomes for all young people. Young people are encouraged and supported to understand the importance of maintaining good health. There are good links with other specialist agencies that provide useful advice and guidance to staff and young people about the dangers associated with some lifestyle choices.

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Overall effectiveness

Managers in the home have a development plan in place and have an understanding of the strengths and weaknesses in the home. There is clear evidence of action being taken to reduce the recent risk taking behaviour displayed by some of the young people in placement.

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Overall effectiveness

Areas identified for improvement at this inspection relate to administration of 3 of 10 prescribed medication, staff supervisions and appraisals, all staff being suitably qualified, ensuring records of investigations held on file and measures of control are analysed to review the effectiveness of practice. 4 of 10

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Information about this children’s home

This service is run by a private organisation. The home is registered to provide medium to long-term care for up to four young people with emotional and behavioural difficulties. Young people living in the home can attend a school also run by the provider and have access to in-house therapeutic support.

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Inspection date Inspection type Inspection judgement

03/03/2014 Interim good progress 23/10/2013 Full good 29/01/2013 Interim good progress 31/07/2012 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

17B (2001) ensure that within 24 hours of the use of any measure of control a written record is made which includes the effectiveness and any consequences of the use of the measure. (Regulation 17b (3)(f)) 27/02/2015

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s): 5 of 10  ensure that prescribed medication is given to the child in accordance with the prescription (NMS 6.14)  ensure all existing care staff have attained a minimum level 3 qualification and all new staff are working towards the diploma within six months of confirmation of employment (NMS 18.5)  ensure that all staff have access to regular supervision by appropriately qualified and experienced staff (NMS 19.4)  ensure that all staff appraisals take into account any views of children the service is providing for (NMS 19.6)  ensure that a clear and comprehensive summary is maintained of any allegations made against a particular member of staff, including details of how the allegation was followed up and resolved; record of any action taken and the decisions reached; and retain the record on the person’s

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Outcomes for children and young people adequate

Young people are making good progress to develop a positive understanding of their own identity and are engaged in regular individual activities in the community. These activities build self-esteem and broaden their horizons. Young people play for a local sports team and enjoy horse riding and spending time at a local stable yard.

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Outcomes for children and young people adequate

Young people are encouraged to enjoy healthy lifestyles by engaging in positive activities, such as horse riding and playing rugby and eating a balanced diet. Young people's health care needs are well met. They attend regular routine health care appointments. They have good information and access to external support agencies with regard to anti-smoking and drug and alcohol awareness. Despite this support some young people continue to smoke and use cannabis.

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Outcomes for children and young people adequate

Despite staff working with educational professionals to engage young people in education, they are not sustaining good levels of attendance or making good progress in core subjects. They are however, engaged in their vocational subjects and showing a commitment to these aspects of their education.

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Outcomes for children and young people adequate

Young people enjoy regular contact with their family and are encouraged to develop and sustain age-appropriate friendships. One professional stated, ‘contact is well supported. Staff make sure contact arrangements are followed.’

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Outcomes for children and young people adequate

Young people are developing their life skills through the internal independence package. They say, ‘the staff are helping me to try to get ready to move on from the home. I am on independence I do my own shopping and cooking.’ Young people acquire the skills to prepare them to move into independent living.

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Quality of care good

The quality of care provided has a positive impact on young people. The majority of the young people living at the home have been in placement for a significant amount of time. This means young people have remained in a stable placement and established good relationships with the staff team who have remained consistent in their lives. Young people report that they receive a good quality of care; family members and professionals confirm this too. One young person commented, ‘the staff are all brilliant, they really care about us.’

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Quality of care good

Young people are registered with a local doctor, dentist and optician and are well supported to attend routine appointments and check-ups. Arrangements for the administration of medication are generally well managed. However, a minor shortfall 7 of 10 was identified at the inspection regarding the recording of prescribed medication. There was no impact on the young person as a result of this shortfall.

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Quality of care good

Young people benefit from the internal clinical service, which provides support to them individually and to the staff team. This level of support enables young people to receive prompt support and not rely on a referral to community health services.

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Quality of care good

Staff provide good support to young people, enabling them to contribute to meetings and formal reviews. This ensures young people are actively involved in making decisions about their lives and are aware of their individual care plans. Young people have a clear voice and influence in the home through daily discussions, individual discussions and young people’s meetings. They discuss menu and activity choices for the week ahead, as well as issues impacting on the home at the time, this has included incidents of bullying.

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Quality of care good

Young people benefit from living in a spacious home. The house blends into the community and has transport links to local towns. This means young people are able to maintain links with family and friends in the local community. Young people say they have an input into decisions about décor and furnishings within the home and plans for holidays and celebrations. As a result young people are confident in sharing their views and feel listened to by the staff team.

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Keeping children and young people safe adequate

Young people say that they generally feel safe in the home. There have been recorded incidents of bullying. While young people acknowledge this has occurred, they do confirm that the staff ‘sort it'. Young people's meetings are used to discuss any issues around bullying; this ensures that there are discussions about the impact of bullying on group living. Staff are supported to manage behaviour through comprehensive risk management plans.

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Keeping children and young people safe adequate

Group risk assessments are used to consider the impact of new admissions and identify risk reducing strategies. The majority of young people have been settled in placement for some time. However, following a recent admission to the home incidents of risk taking behaviour have increased. This has meant an increase in episodes of missing from home. The manager and staff team have taken steps to address this through strategy meetings, increased staffing and a review of the placement plans for each young person. This demonstrates the provider’s commitment to providing stable and appropriate placements for young people. One placing social worker commented, ‘X’s negative behaviour is a blip and with staff support I am confident X’s behaviour will settle.’

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Keeping children and young people safe adequate

Young people are encouraged to behave positively in the home; there are few incidents of physical restraint. Clear and consistent boundaries are in place across the home, this provides for consistent care. On the occasions young people engage in 8 of 10 negative behaviour, measures of control are imposed and young people are encouraged to reflect on their behaviour. However, the manager does not review the effectiveness of the imposed measures of control, which is a missed opportunity to offer guidance to staff and reflect on use of consequence.

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Keeping children and young people safe adequate

Staff are selected and checked through the organisation's recruitment procedure. Ensuring the safe recruitment of staff, who are able to meet the young people’s needs. Staff have a strong understanding of safeguarding procedures and policies in place. Investigations into allegations are handled appropriately and in line with the LSCB policies. However, records of the investigation are not held against the individual staff member’s confidential file. The operations manager took action to address this during the inspection. This had no impact of the safety of young people, given the allegation had been investigated.

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Keeping children and young people safe adequate

Young people live in a physically safe environment. They are well protected by a range of detailed health and safety procedures, risk assessments and routine maintenance and fire checks. Fire drills are regularly undertaken and recorded.

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Leadership and management adequate

At the time of the inspection the Registered Manager was in post, he is suitably qualified and experienced. However, he has resigned from his post. The provider has recruited a new manager who is due to start in March 2015. The previous recommendation has been addressed.

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Leadership and management adequate

Monitoring of the service is regular and effective for identifying improvement. There is a development plan in place for the home. The manager and staff have good working relationships with key professionals in other agencies. Social work professionals comment positively on the frequent and good quality exchange and update of information.

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Leadership and management adequate

Young people are looked after by an adequate number of competent staff. Staff report that they enjoy their work and have shown commitment to their roles. Most staff are suitably qualified, however, there has been a delay in new staff gaining their formal qualification.

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Leadership and management adequate

Staff members confirm they are provided with a good training programme, regular team meetings and appraisals. However, young people do not have the opportunity to contribute to the appraisal process. This is a missed opportunity to gather young people’s views on the quality of care they feel they receive. The majority of staff receive regular supervision from the management team. However, senior staff have not had regular supervision. As a result, they have not had the opportunity to gain feedback and support as individuals from the Registered Manager.

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Leadership and management adequate

Ofsted receive notification of any significant incidents. These have increased since 9 of 10 December 2014, reflecting the recent unsettled period of increased incidents of disruptive behaviour.

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Leadership and management adequate

The home meets the aims and objectives of its Statement of Purpose. Child-friendly information is available in the children's guide. These documents ensure young people and stakeholders are clear about the purpose of the home and the services and support it provides.

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Leadership and management adequate

Young people's records and case files are clear and appropriately stored. They are reviewed and updated to ensure they provide a comprehensive picture of young people's needs, development and progress. 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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