Children's home run by Keys Childcare Limited in Belfast

Good

The children’s home provides effective services that meet the requirements for good.

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The children’s home provision is good because:

 The registered manager and staff have a detailed understanding of each young person’s needs. They spend time with young people so that they understand what is important to them.  Staff develop positive relationships with young people. As a result, young people are able to talk about what is difficult with staff and therapists and to begin to understand their early life experiences.  Staff work effectively as a team. This ensures that young people benefit from high levels of consistency, which provides them with security.  Staff are highly skilled in working in partnership with professional stakeholders and families. Staff are particularly effective in working with the in-house therapist to provide research-based nurturing care.  Young people all make significant progress from their starting points, which leads to them becoming increasingly safe.  Staff de-escalation techniques are used to good effect. They understand the

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The children’s home provision is good because:

patterns and trends of young people’s behaviour and review their intervention and support to meet young people’s needs.  Staff support young people to attend education. Young people engage well and achieve public examinations.  The registered manager is robust in her challenge to placing authorities and specialist health providers when their response to meeting young people’s needs is inadequate. She is proactive in ensuring that young people’s needs are met.  There have been some shortfalls. The registered manager has not ensured that there is consistency in pathway plans and placement plans regarding missing-from-home protocols. She has not ensured that all visitors to the home are recorded in the visitor’s book or that Ofsted is informed in a timely manner of significant events. Staff do not always ensure that young people receive medication as it is prescribed for them, although this has not had an

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The children’s home provision is good because:

adverse impact on young people’s health. Leaders have not addressed shortfalls in staff practice in supervision to support staff development and improve their practice. Staff respond appropriately to young people’s increased risk-taking behaviours by increasing supervision in the short term. However, this cannot be maintained in this environment as it constitutes a deprivation of liberty.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meet(s) the Care Standards Act 2000, the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In order to meet the protection of children standard, the registered provider must ensure that:

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Requirement Due date

2(b) the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm. 09/02/2017

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Requirement Due date

The registered person must ensure that medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed. (Regulation 23(2)(b)) 09/02/2017

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Requirement Due date

The registered provider must notify HMCI without delay of any other incident relating to a child which the registered person considers to be serious. (Regulation 40(4)(e)) 09/02/2017

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendations:  Staff should be familiar with the home’s policies on record-keeping and understand the importance of careful, objective and clear recording. In particular, ensure that all handwritten records are clearly legible. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)  Staff should continually and actively assess the risks to young people and the arrangements in place to protect them. Where there are safeguarding concerns for a young person, their placement plan, agreed between the home and their placing authority, must include details of the steps the home will take to manage any assessed risks on a day-to-day basis. In particular, there must be consistency between young people’s pathway plans and placement plans and risk assessments regarding missing-from-home protocols. (‘Guide to the children’s

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Recommendations

homes regulations including the quality standards’, page 42, paragraph 9.5)  The registered manager must have a system in place so that all staff receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the young people assigned to their care. In particular, supervisors must address shortfalls in staff practice. (‘Guide to the children’s homes regulations including the quality standards’, page 60, paragraph 13.2)  Deprivation of liberty may occur when a young person is under continuous supervision and control and is not free to leave the home. In particular, the registered manager must ensure that any responses to increased risks are only short term while appropriate specialist care is sought. (‘Guide to the children’s homes regulations including the quality standards’, page 50, paragraph 9.63)

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Information about this children’s home

The home is registered to provide care for five young people who have emotional and/or behavioural difficulties. The home forms part of a large social care company.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

24/02/2016 Interim Improved effectiveness

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Recent inspection history

18/02/2015 Interim Improved effectiveness

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Good

Young people benefit from highly individualised research-based care. Staff understand the impact of abuse and neglect on young people. They develop plans with the in-house psychologist that are specific to young people’s needs and behaviours and that provide structure and goals for young people to progress. All young people progress from their starting points. Staff invest in young people. They develop strong and positive relationships with young people so that they feel able to talk about what is difficult. An independent reviewing officer recognises this: ‘My young person has progressively improved in placement, and staff have been able to develop positive relationships with her, which has helped in times of when she has been highly anxious or stressed.’ Staff’s individual skills and positive relationships with young people enabled staff to manage extremely challenging behaviour during the inspection. Staff investment in young people was evident as

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Good

they sensitively secured appropriate specialist support and treatment to meet young people’s needs. Young people value their relationships with staff. One young person said: ‘Staff here are amazing. They always do their job properly and are really supportive.’ Staff are proactive in ensuring that young people benefit from the services of an advocate so that young people’s wishes and feelings are at the centre of not just the home but also their care plans. Young people feel able to discuss their feelings about their identity with staff and to explore issues of sexuality in a safe way. Young people make good educational progress. Some young people achieved public examinations in the summer and others are working towards them. Staff work in partnership with schools and colleges to ensure that young people achieve their academic potential. Staff ensure that there is an open dialogue with teachers and attend regular meetings. One young person said: ‘I wasn’t enjoying school

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Good

until I came here. There is a great teacher and now I’m enjoying English, maths, art and science.’ When young people are not able to attend college, staff ensure that they benefit from educational experiences and are able to return to an appropriate course as soon as possible. Young people are well prepared for their transitions to adult life. One young person has moved on to live independently. She benefited from continued therapy to support this transition when particularly challenging events were going on in her life. Young people make excellent progress in learning important life skills, such as cooking, budgeting, using public transport and accessing services. Staff promote young people’s health. Young people make good progress in improving their emotional and physical health. This progress is exceptional for some young people. For other young people, this is not maintained over time as their previous life experiences impact on their emotional well-being and behaviour.

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Good

Staff and professional stakeholders recognise that progress may regress at times, particularly when young people are undertaking life-story work. An independent reviewing officer said: ‘My young person has made significant progress in respect of her safety since being at the home. In relation to her self-harming and being missing from home, I do note that she has recently regressed in her behaviour. However, I need to acknowledge that she is a young person who has significant complex emotional needs. Placement are insightful into her emotional needs.’ Staff are robust in their challenges to mental health providers to achieve the best outcomes for young people. Staff promote young people’s identities through carefully assessed contact with their families, including those whose families live a long way from the home. They promote contact which is positive and take action to protect young people when contact arrangements are not in their best interests.

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Requires improvement

Staff usually safeguard young people effectively. However, a member of staff recently made two errors in providing the correct dose of medication for young people. Staff sought appropriate medical attention, and the young people were not harmed. The registered manager did not ensure that these shortfalls in staff behaviour were addressed in supervision. As a result, the member of staff did not reflect on how to improve their practice. The registered manager acted quickly to remove the member of staff from the home while this was investigated and has identified areas for improvement in the administration of medication. Staff understand how to manage allegations and child protection concerns. They are robust in their responses, which safeguards both young people and staff. The registered manager has a positive relationship with the designated officer. Staff usually ensure that they check the identity of all visitors to the home.

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Requires improvement

However, there are incomplete entries in the visitors’ book, and people have visited the home without staff recording this. This does not safeguard young people. The registered manager does not notify Ofsted of all significant events in a timely manner. This does not enable the regulator to have oversight of events in the home as they occur. Staff have an excellent understanding of young people’s individual risks. They support all young people to address these behaviours and become increasingly safe. Some young people’s risks increase as they recover from abuse. However, staff recognise these patterns and take appropriate steps to keep them safe. The registered manager and staff provide clear boundaries and consistent care for young people. They challenge placing authorities when those authorities are not able to maintain the consistency that young people’s security demands. Staff are highly skilled in responding to young people who are at risk of sexual

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Requires improvement

exploitation or go missing. They developed an agreed protocol with local police to ensure that young people receive a coordinated response when they are missing. This means that young people are at risk for the minimum amount of time. Staff always follow young people and try to maintain contact with them when they are missing. They contact family and friends to try to locate them. They always ensure that an independent person interviews the young person when they return so that they improve their understanding of why they went missing. There are some shortfalls: the recording of who has undertaken independent return interviews is not clear, and there are inconsistencies between pathway plans and placement plans in terms of what some young people’s missing protocol is. Young people in the home are unlikely to be missing from the home, and staff have a clear understanding of why they are missing. Staff work effectively with the police to

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Requires improvement

keep these young people safe. Staff are trained and skilled in managing self-injurious behaviour. They are alert to young people’s behaviour and intervene using de-escalation techniques as far as possible. For some young people, there is a significant reduction in suicidal ideation and self-injurious behaviour. For others, this reduces and then increases as their patterns of behaviour change in response to a growing understanding of their early life experiences of abuse and trauma. A young person said: ‘The best thing is that staff are caring. They help me with my problems.’ Staff increase levels of supervision to meet young people’s increased needs in the short term, while they identify more appropriate specialist services. If continual supervision is required to safeguard young people, the registered manager must ensure that there is no deprivation of young people’s liberty without appropriate legal orders in place.

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Requires improvement

Staff promote positive behaviour. They use clearly identified goals to provide incentives for rewarding young people’s behaviour. They are highly skilled and work effectively as a team to manage young people’s complex and challenging behaviours. When incidents of restraint increase, staff have a good understanding of why, and work closely with therapists to review their responses to young people’s needs. Staff respond quickly to young people’s rapidly changing presentations. They intervene to protect young people from other young people’s behaviour, but this has not always prevented them from harming each other. The registered manager responds robustly to this behaviour and provides training in managing bullying for her staff and direct work sessions for young people, to help them to understand what constitutes bullying. As a result, further incidents of harm are prevented. Staff understand the dangers that use of the internet may pose to young people.

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Requires improvement

They are alert to how young people use social media and act quickly when they are concerned about unsafe behaviour. The registered manager appropriately vets staff before they work in the home, including agency staff who work on a temporary basis. This protects young people from unsuitable people being recruited and having the opportunity to harm them. Staff receive a suitable induction to the home so that they are well prepared to meet young people’s needs.

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Good

A suitably qualified and experienced registered manager, who has been in post for four years, manages the home. She has achieved the level 5 diploma in leadership and management in residential childcare. Young people make progress from their starting points. For some young people, this is significant and is maintained over time. For others, their progress is not linear as their childhood experiences impact on their behaviour. The registered manager has a clear understanding of how young people’s experiences impact on their behaviour and she takes robust action to challenge placing authorities and health services to ensure that young people receive the care that they need. When she is unable to safeguard young people effectively, she seeks support from specialist services and placing authorities to create a more appropriate team around the young person, which will safeguard them and meet their complex

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Good

needs. She continually acts as a concerned parent would, to protect young people and to promote their welfare. The registered manager prioritises the needs of each young person in her care. She understands the impact that young people’s behaviour has on others and puts safeguards in place so that each young person is protected. For example, she ensures that additional staffing is in place so that, when young people’s behaviour escalates, there are sufficient staff to meet each young person’s needs, and she seeks assurances from her operations manager that no further admissions will be accepted due to increases in young people’s needs. The registered manager promotes positive relationships with stakeholders. They speak highly of her commitment to young people and her excellent communication skills. The registered manager recognises the impact of effective relationships and, when she sees inadequacies in the responses of other services, she is proactive in

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Good

tackling them and seeking support from others involved in young people’s care to fight for the right support. The registered manager runs the home in accordance with the statement of purpose. Staff understand the theory and research which inform their practice. They use their psychologically informed plans to continually review young people’s needs and progress. Staff work in partnership with the home’s therapist, who sees young people weekly and attends team meetings. Staff work effectively as a team, and both staff and young people describe being part of a ‘family’. As a result, young people benefit from well-coordinated and consistent nurturing care. The registered manager understands the strengths and weaknesses of the home and takes effective action to respond to identified shortfalls. For example, she ensures that there is recruitment to staff vacancies and seeks assurance that there will be no further young people admitted to the home. The registered manager

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Good

ensures that staff receive appropriate training to ensure that they can confidently meet the needs of the complex young people living in the home. She recognises the emotional impact of the work, and staff receive regular formal and informal supervision to support them in their roles. The registered manager has not ensured that all handwritten records are legible. This does not enable young people or anyone else to understand the young people’s experiences and achievements, now or in the future.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against ‘Inspection of children’s homes: framework for inspection’.

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What the inspection judgements mean

An outstanding children’s home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help, protection and care. Their progress exceeds expectations and is sustained over time. A good children’s home provides effective services that help, protect and care for children and young people and ensure that their welfare is safeguarded and promoted. In a children’s home that requires improvement there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of children looked after is safeguarded and promoted. Minimum requirements are in place. However, the children’s home is not yet delivering good protection, help and care for children and young people. A children’s home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or that result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors looked closely at the experiences and progress of children and young people living in the children’s home. Inspectors considered the quality of work and the difference that adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other, and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition, the inspectors tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people whom it is trying to help, protect and look after. This 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 Children’s

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Information about this inspection

Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. the guidance ‘Raising concerns and making complaints about Ofsted’, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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