Children's home run by Keys Group Progressive Care & Education Limited in Birmingham

Inspection report children’s home: 1249031 1 Registered provider: Keys Childcare Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The home is registered to provide care and accommodation for up to three children who may have learning disabilities. It is owned and managed by a private provider.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

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

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good

Date of last inspection: 23 February 2017

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good

Overall judgement at last inspection: Sustained effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: 1249031 2

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Key findings from this inspection

 Children make positive, sustainable progress as a result of the strong and nurturing relationships promoted by the staff.  Staff provide consistently warm, supportive and aspirational care which promotes children’s sense of dignity and well-being, and develops their confidence.  Staff have a good understanding of children’s individual needs. Their knowledge enables them to deliver high-quality care and support to keep children safe from harm.  Children who have previously not accessed education for considerable periods now achieve 100% attendance and are making progress.  The health needs of children are promoted well, and the home effectively seeks input from other health agencies to support children’s needs. This reduces the impact of health issues on children’s ability to engage in education and other activities.  Children are encouraged to try new activities to expand their life experiences and promote their integration within the local community.

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Key findings from this inspection

 The home tenaciously challenges placing authorities when children’s needs are not being met and proactively seeks updates regarding input from external agencies.  Staff seek alternative strategies creatively to minimise the occurrence of incidents, in the best interests of children.  A strong and knowledgeable registered manager has developed an evolving team, providing staff with the leadership and confidence to provide the consistent care to children that promotes good outcomes.  Team members support one another, and have high aspirations for children’s outcomes. They are keen to increase their skills and knowledge to improve their practice. Effective communication promotes shared understanding in meeting children’s needs.  The manager has good systems in place which give staff a clear understanding of how to develop and improve the service provided by the home.

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Key findings from this inspection

The children’s home’s areas for development

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Key findings from this inspection

 Risk assessments should be reviewed and updated to reflect any increase or change in children’s behaviour. Staff need to sign risk assessments to confirm that they understand and are able to respond effectively to any changes. Inspection report children’s home: 1249031 3  The independent visitor needs to consistently demonstrate their opinion on whether children’s well-being is promoted effectively and whether they are safeguarded, based on a thorough evaluation of records held by the home.  Minor amendments to records for administration of medication need to be clear, with the author of any changes noted.  Repairs within the home and to the decor need to be completed to maintain a homely environment for children to live in.  Senior managers should promptly provide managerial oversight of any incidents in which the registered manager is involved to ensure debriefing and analysis are provided.  The home needs to consider ways to demonstrate progress in a child’s health

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Key findings from this inspection

journey within their plans so that this is easily understood by the child and others.

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Inspection date Inspection type Inspection judgement

23/02/2017 Interim Sustained effectiveness Inspection report children’s home: 1249031 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, 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 requires the registered person to ensure that staff— assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child. (Regulation 12(2)(a))

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Requirement Due date

In particular, that the risk assessment for self-harming behaviour is reviewed and updated, and that all staff sign risk assessments to demonstrate their understanding. 05/06/2017

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Requirement Due date

44: Independent person: visits and reports

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Requirement Due date

The independent person must produce a report about a visit ("the independent person’s report") which sets out, in particular, the independent person’s opinion as to whether— children are effectively safeguarded; and the conduct of the home promotes children’s well-being. (Regulation 44(4)(a)(b)). 05/06/2017

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Recommendations

 Records must be kept of the administration of all medication. These records must be legible, and with any minor errors clearly initialled by the author. (‘Guide to the children’s homes regulations including the quality standards’, page 35, paragraph 7.15)  Staff should provide a nurturing environment that is welcoming. Any repairs, such as replacement of radiators or redecoration, should be completed in a timely manner. (‘Guide to the children’s homes regulations including the quality standards’, page 15, paragraph 3.7)  The registered person should ensure that all incidents of control, discipline and restraint are subject to systems of regular scrutiny to ensure that their use is fair and the principles for behaviour management are respected. Where the Inspection report children’s home: 1249031 5 registered manager is involved in any incidents or restraints, senior managers should review the records within a short period of time. (‘Guide to the children’s

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Recommendations

homes regulations including the quality standards’, page 46, paragraph 9.36)  The home’s records on each child represent a significant contribution to their life history. Children should be supported to understand the nature of records kept by the home and how to access them. Where children experience complex health needs, health plans should be set out so that they are readily accessible to understand the progress made. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.5)

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Overall experiences and progress of children and young people: good

The child currently living at the home is making significant progress across all aspects of his life. He is developing trusting relationships with staff who nurture him and understand his needs, despite limited current assessments being available from his placing authority. This is due to his relatively short period of being a child looked after and as a result of being placed in different authorities. The home is proactively seeking the initiation of an education, health and care plan to identify his holistic needs and appropriate support. The team continues to learn more about his needs as they emerge, and will soon benefit from the input of the provider’s clinical psychologist to support its practice in his care. Since moving to the home, professionals involved in his care, including his social worker and independent reviewing officer, identify the positive impact that the home has had on his progress. His social worker stated that the home had gone

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Overall experiences and progress of children and young people: good

‘above and beyond’ for him, and his reviewing officer is confident in the continued potential of the home to meet his complex needs.

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Overall experiences and progress of children and young people: good

School is a positive experience and the child now has 100% attendance, integrating into the school community and proudly participating in the school concert. He is achieving well, and above expectations, based on previous information on his abilities. He is now able to share a classroom with another child, whom he identifies as a friend, and demonstrates improved social interactions. He has shown interest in inviting school friends to his home for tea, which the staff are exploring. There is clear communication between the school and the home, and a commitment to close liaison to develop positive behaviour support strategies. The child joined a meeting at the school and managed being with a large group of professionals, smiling and indicating that he was happy.

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Overall experiences and progress of children and young people: good

The child has a number of complex health needs. The home ensures that he attends all his appointments and proactively seeks the support of local health professionals, such as the nurse allocated to children looked after and the dietician, to promote his health. Advice is sought regarding required medication and the child enjoys participation in auditing, counting to check that the stock balance is correct and signing his records. A small number of entries by staff are not clearly initialled by the author to show amendments, although this does not impact on the child’s welfare. The child now enjoys helping staff to cook nutritious meals and is increasing his repertoire of healthy foods. This not only helps to improve his diet, but is contributing to gradual and necessary Inspection report children’s home: 1249031 6 weight gain. Staff are pleased to report how he has grown and he is able to see this on

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Overall experiences and progress of children and young people: good

his measurement chart. He now looks healthier and brighter in his presentation, and enjoys the nightly routine of bathing before he goes to bed. Staff describe how he seeks to be more actively involved in his self-care and is beginning to demonstrate more pride in his appearance, as expected of a young teenager. Any personal care supported by staff is done with sensitive regard to his dignity and with appropriate safeguards in place. Through encouragement of physical activities such as football, swimming and basketball, the child’s stamina and coordination are improving. Staff support him to develop his confidence in social skills, and he regularly enjoys talking to the staff of a local shop when they go shopping. He has been taken to the local community centre that offers a range of activities and participated in a karate session, after previously going to observe and deciding that this was something that he wanted to try. He has

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Overall experiences and progress of children and young people: good

also enjoyed other activities, such as the circus, cinema trips, going to locals parks and beaches, and particularly enjoys being competitive with the staff at bowling. At the home, he likes arts and crafts, popcorn and DVD nights, gardening and baking. He continues to enjoy bedtime stories before he goes to sleep. This encourages a broad range of positive experiences, and promotes his inclusion within his local community and a sense of belonging within a nurturing environment.

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Overall experiences and progress of children and young people: good

Staff are acutely sensitive to the trauma that he has previously experienced, and show empathy and concern for his distress. They speak of him with warm affection, highlighting his achievements. He now seeks out different members of staff to meet his emotional needs, and is beginning to appropriately seek hugs and reassurance. At his pace, staff are endeavouring to reintroduce more items to his bedroom. He can now tolerate having his clothes being left in his room in preparation for the following day. He will now tell staff if too much is introduced, rather than throwing items out of his bedroom if he becomes anxious at their presence. His social worker stated that she is able to see how he is forming close relationships with staff, getting on and joking with them during her visits. She is aware that he is testing them, but that staff work well together to maintain boundaries and routines, understanding him well and listening to

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Overall experiences and progress of children and young people: good

him. His views are regularly sought through direct work and, recently, more formal children’s meetings. Professionals have acknowledged the distress caused by discussing contact with family members and work together to minimise the impact. He is reassured that contact will only take place in line with his wishes and feelings. His well-being is central to the home’s practice, and staff are clearly committed to providing him with high-quality care.

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How well children and young people are helped and protected: good

The child lives at a home where he is happy and safe, because staff understand the risks to his well-being and respond effectively. There are clear risk assessments in place which, in general, are reviewed and updated in response to newly emerging behaviours which may be harmful. However, the assessment of the child’s self-injurious behaviour requires an update to reflect recent incidents, so that staff are fully aware of the actions required to mitigate and reduce the risk of serious harm. Not all staff have signed updated risk assessments to demonstrate that they have read and understood them to support practice in the home, although all the staff who spoke with the inspector were Inspection report children’s home: 1249031 7 clearly able to identify the risks and how they respond to keep the child safe. The gaps in recording have therefore had limited impact on the staff’s working knowledge of and

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How well children and young people are helped and protected: good

ability to manage risk, reflecting effective handovers, leadership direction and communication across the team.

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How well children and young people are helped and protected: good

Behaviour support plans, which reflect risk assessments, allow staff to understand the child’s behaviours and any incidents. These include the use of positive praise at the base level, on which the child in placement thrives, which helps him to develop confidence and skills. Consistent and structured boundaries are proving effective in supporting his sense of stability and routines, and incidents are reducing in both frequency and duration. Staff use strategies such as social stories and ‘now and next’ concepts to reduce the child’s anxieties in new situations. This has enabled him to try novel experiences, such as using public transport, and engage with the driver to purchase tickets. Progress is being made in redirecting some unwanted behaviours, and the child will often help staff to tidy up following a crisis. He is also beginning to remove himself to a quiet space to help him to calm and to try to regulate his own emotions. This shows

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How well children and young people are helped and protected: good

that the consistency in practice of the staff team is positively impacting on the child’s sense of his place in his world. He is also beginning to spend time alone playing, reflecting his sense of security and an emerging ability to express himself imaginatively.

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How well children and young people are helped and protected: good

Appropriately high levels of supervision ensure that the child is safeguarded from risks such as going missing from the home. The home environment is responsibly secure, yet provides the child living there with free access to safe outdoor areas without relying on staff. Assessments are completed to minimise risks while travelling and for activities, so that the child can safely access and participate in his local community. Currently, the child has no access to the internet, but has recently expressed a renewed interest in having a computer. Staff have access to training to ensure that they are fully equipped to manage any internet use by children safely. Bullying does not occur at the home, but the child speaks about the work that he has done in school about the issue. Staff are clearly aware of the impact that visitors to the home can have on his emotional state, and provided the inspector with appropriate advice. While he was aware that she would

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How well children and young people are helped and protected: good

be present on his arrival home from school, the staff supported him calmly when he became distressed and used creative techniques to distract him.

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How well children and young people are helped and protected: good

At times of crisis, physical intervention has been used to ensure the safety of the child and others. Following any such event, the child has always been given the opportunity to understand why the measures have been necessary, and it is clearly recorded if he does not wish to discuss it. The manager provides effective oversight of incident and restraint records to ensure that any action taken is appropriate and necessary. However, on some occasions when the manager has been involved in such circumstances, there has been delay in the review of records by senior managers. The social worker is always informed of any incidents that occur.

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How well children and young people are helped and protected: good

Effective liaison with other safeguarding agencies ensures that the manager has a clear understanding of any safety concerns in the local area. Staff are able to describe clearly the procedures to follow to ensure that children are safeguarded. At the home, there is good understanding of how to escalate concerns to statutory agencies, where necessary. Inspection report children’s home: 1249031 8

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The effectiveness of leaders and managers: good

The suitably qualified and very experienced registered manager has been in post since October 2016. He has brought consistency in leadership to a team which has been evolving and is now gelling well. Longer-serving staff report the positive benefits that he has brought to the home and the team’s practice, after a period of instability. The manager has high expectations of himself and the team, and aspires to deliver the best outcomes for children. He ensures that there is sufficient opportunity to discuss any emerging needs or significant events during handovers between shifts, and continues to emphasise the need for qualitative recording to reflect the child’s daily experiences and progress. Staff report that they feel well supported through day-to-day contact and informal discussion, as well as through regular formal supervision and team meetings, which offer challenge and support to develop their practice. They recognise the

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The effectiveness of leaders and managers: good

importance of reflective practice and how this promotes teamwork to provide consistent care and stability for the child. Staff are enthusiastic about forthcoming training in attachment and trauma, which will deepen their understanding and supplement their skills in supporting his individual needs. Further training designed specifically around particular behaviours is also scheduled to promote confidence in their practice.

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The effectiveness of leaders and managers: good

Thorough monitoring and review of children’s plans enables the manager to analyse and identify areas of success, as well as specific areas to focus on for improvement. For example, an analysis of restraints identified that the majority were occurring when staff were taking the child to school. Alternative transport arrangements were commissioned by the home to provide a distinct demarcation between home and school life, which has resulted in a significant reduction in the use of physical intervention. The young person is happier, as a result, and enjoys being waved goodbye in the mornings and being greeted by staff on his return. The staff share pride in the child’s achievements, have aspirations for him and share creative ideas on how to help him to make further progress. They have learned collectively that negative consequences have little impact on the child’s behaviour, due to his level of functioning, and are exploring alternative

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The effectiveness of leaders and managers: good

approaches and incentives to promote positive behaviours.

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The effectiveness of leaders and managers: good

The manager has effective systems in place and a clear plan to develop and drive improvements at the home. The child is involved in planning improvements to the home’s physical environment, although he has not yet settled on a definite colour scheme for his bedroom. Most of the communal areas of the home have been redecorated recently, with further changes planned for the kitchen decor. However, repairs to a radiator and minor decorative improvements remain outstanding.

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The effectiveness of leaders and managers: good

The manager is receptive to suggestions about how to improve documents, such as health plans, so that they more clearly document the progressive journey of the child’s complex needs. This will enhance the child’s understanding of records. Further changes to documents and systems are anticipated as a result of the home recently becoming part of a large provider’s portfolio. External scrutiny by an independent visitor provides additional monitoring to support these systems. However, the reports require more Inspection report children’s home: 1249031 9 detailed analysis to consistently support evidence that children are effectively safeguarded and their well-being promoted. This will assist the home to deliver care which is continually improving.

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The effectiveness of leaders and managers: good

Focused participation in multi-agency meetings enables the manager and his team gain important information so that they can develop strategies to help overcome barriers to success. The home works effectively with other professionals to support improvements in the child’s well-being and achievements. When necessary, the manager challenges other professionals where there are shortfalls, such as obtaining essential medical consents for procedures to be undertaken. He proactively pursues updates regarding the allocation of a case worker from the child and adolescent mental health team, so that vital support for the child’s emotional well-being is secured. There is recognition that a holistic approach is required to meet all of the child’s needs to underpin the care and support that the home delivers, and to enhance his life chances.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: 1249031 10

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Children’s home details

Registered provider: Keys Childcare Limited

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Children’s home details

Registered provider address: Laganwood House, 44 Newforge Lane, Belfast BT9 5NW

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Inspector(s)

Karen Willson, social care regulatory inspector Inspection report children’s home: 1249031 11 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector(s)

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Inspector(s)

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Inspector(s)

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

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