Children's Home run by Keys Care Limited in Leicestershire

Inspection report children's home: SC063997 1 SC063997 Registered provider: Bettercare Keys Ltd

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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 or young people who have emotional and/or behavioural difficulties. It is one of a number of registered children’s homes operated by a large private provider.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children’s home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: Declined in effectiveness

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Key findings from this inspection

This children’s home requires improvement to be good because:

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Key findings from this inspection

 The home is going through a period of change. The registered manager has Inspection report children's home: SC063997 2 left. Although an acting manager has been seconded to the home, she will be leaving soon. A new deputy manager is also acting in a temporary role. This has contributed to low morale among the staff team and a lack of continuity of care for young people.  Young people struggle to form strong and trusting relationships with some staff. Staff do not know some young people well, which means that they do not always de-escalate challenging behaviours effectively.  Medication errors continue to occur.  Young people eat unhealthy meals regularly. This could impact negatively on their health.  Young people who do not have a school placement often have poorly structured and poorly planned days. This will not help them to settle back into school when a school placement is found.  Young people’s concerns and views are not fully valued because staff do not tell

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Key findings from this inspection

them what the manager has recorded on the minutes of house meetings.

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Key findings from this inspection

 The operations manager and support manager visit regularly and provide good support, guidance and training.  The company therapist visits the home regularly to provide support to the staff team.  The acting manager and, more recently, the deputy manager have worked hard to try to inspire and motivate the staff team. They have formed warm and nurturing relationships with young people.

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Inspection date Inspection type Inspection judgement

23/03/2017 Interim Declined in effectiveness 29/06/2016 Full Good 18/02/2016 Interim Improved effectiveness 15/06/2015 Full Requires improvement Inspection report children's home: SC063997 3

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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

Ensure that there are effective arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23(1)) 30/06/2017

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Requirement Due date

The care planning standard is that children—

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Requirement Due date

receive effectively planned care in or through the children’s home.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that each child’s relevant plans are followed. (Regulation 14(1)(a) and (2)(c)) 30/06/2017

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

children are helped to lead healthy lifestyles. (Regulation 10(1)(c)) 30/06/2017

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

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Requirement Due date

mutual respect and trust; an understanding about acceptable behaviour; and positive responses to other children and adults.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure that staff— meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans; help each child to develop socially aware behaviour; communicate to each child expectations about the child’s behaviour and ensure that the child understands those expectations in accordance with the child’s age and understanding; strive to gain each child’s respect and trust; understand how children’s previous experiences and present emotions can be communicated through behaviour and have the competence and skills to interpret these and develop positive relationships with children; 30/06/2017 Inspection report children's home: SC063997 4 de-escalate confrontations with or between children, or potentially violent behaviour by children. (Regulation 11(1)(a)(b)(c) and (2)(a)(i)(ii)(v)(viii)(ix)(xi)) The leadership and management standard is that the registered

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Requirement Due date

person enables, inspires and leads a culture in relation to the children’s home that— helps children aspire to fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to— ensure that staff work as a team where appropriate; ensure that the home’s workforce provides continuity of care to each child. (Regulation 13(1)(a)(b) and (2)(b)(e)) 30/06/2017

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Recommendations

 Children should be able to see the results of their views being listened to and acted upon. This specifically refers to children being given the manager's feedback about issues they raise at their meetings. (’Guide to the children's homes regulations including the quality standards’, page 22, paragraph 4.11)  Where children placed in a home are not participating in education because they have been excluded or are not on a school roll for some other reason, the registered person and staff should support the child to sustain or regain their confidence in education and engage them in suitable structured activities. (’Guide to the children’s homes regulations including the quality standards’, page 28, paragraph 5.15)

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improvement to be good

Staff do not know all the young people well. Some do not prioritise them over the work they have to do in the office. They do not consistently challenge young people who use offensive language. They do not manage difficult situations well, relying on managers to take the lead. This means that young people go into crisis when staff could have prevented escalation with clear and decisive action, or by actively demonstrating to the young person that they are being listened to and are cared about.

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improvement to be good

A young person who is waiting for a school placement does not have a planned or structured day during school time. This means she regularly gets up late in the morning and refuses to complete work set for her. The work set for this young person lacks imagination and creativity. It often does not include material that interests her. This Inspection report children's home: SC063997 5 means the young person spends her day in bed, chatting to people on her phone, shopping and watching television. This will not help her settle back into school when a school placement is found.

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improvement to be good

Young people are not challenged about the choices they make about unhealthy food. They have regular takeaway meals, ‘fry-ups’ and processed foods. One young person ate a packet of baked corn snacks for her breakfast. Staff do talk to young people about healthy options but then allow them to continue to choose unhealthy meals when out shopping with them. This does not promote good health.

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improvement to be good

Medication is not always safely managed. Young people are given their medication at varying times which has meant, on occasion, that a young person has had too much of their prescribed medication within a 24 hour period. The contra-indications have not been checked when young people regularly smoke cannabis while taking prescribed medication. The doctor has not been informed that the young person smokes cannabis. This could mean that the prescribed medication will not work properly or may cause complications. Furthermore, on one occasion the medication administration record had not been completed.

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improvement to be good

Young people are generally in good health. They are encouraged to attend health appointments and generally do attend. They receive good emotional support from the company therapist who visits the home regularly. Young people also have good access to mental health services.

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improvement to be good

Young people are consulted about their care. Key-work sessions help young people to understand more about the way they are being cared for, help them to progress through their life, and help them to develop a better understanding of the risky situations they put themselves in. However, a young person said that some staff listen to them and some staff don’t. Staff not listening to a young person was evident throughout an incident during the inspection. Young people have regular house meetings where they can express any concerns or issues they have. The manager records her response on the minutes, but this is not fed back to the young people. This does not demonstrate staff valuing the young people’s views.

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improvement to be good

Staff understand the importance of young people maintaining and building on family relationships and friendships. This can be difficult when family and friends live far away. One young person says the distance from her family makes her feel unhappy. However, staff facilitate contact with family and friends. Family and friends visit the home and are made to feel welcome.

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improvement to be good

Young people are prepared well for independent living. They learn to shop, cook, perform household tasks, budget and use public transport. They are encouraged to join and attend college courses.

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improvement to be good

The home is well maintained and clean. It is a homely environment where young people can relax. Single bedrooms provide young people with privacy away from others. Inspection report children's home: SC063997 6

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improvement to be good

The behaviour of young people is generally good. However, staff are not always competent in managing difficult situations with young people when they do arise. Angry and agitated behaviour is allowed to escalate because staff do not know what to do or say to support the young person who is in crisis. They do not demonstrate good parenting skills. Furthermore, they are not following clear and informative behaviour management plans.

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improvement to be good

Staff are trained in restraint techniques but rarely use these. They understand that they only use restraint as a very last resort. Similarly, sanctions are not often used in response to challenging behaviour. However, when sanctions are used, staff are not noting the response of young people. It is therefore difficult to ascertain what the young person’s view of the consequence was.

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improvement to be good

Staff have acted quickly and appropriately when young people have been at risk of sexual exploitation. They have worked well with external agencies to ensure the safety and well-being of young people. Young people rarely go missing from the home. If they do go missing, it tends to be for a very short period of time.

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improvement to be good

Following an incident at the home, staff have tried to educate young people about the dangers of setting fires. Staff have worked closely with the police and fire service. No repeat incidents have occurred.

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improvement to be good

Staff have a satisfactory understanding of the home’s child protection procedures, including whistle-blowing procedures, and receive regular training to reinforce the guidance. Young people say they feel safe.

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The effectiveness of leaders and managers: requires improvement to be good

The home is going through a period of change. The registered manager and a senior member of staff have left, and a new manager has not yet been appointed. A temporary manager has been seconded to the home but is due to leave shortly. The new deputy manager is also only temporary. The acting manager has demonstrated enthusiasm and provided a good role model for staff. However, she is struggling to motivate and enthuse them. This does not provide a stable environment for young people or staff. Staff morale is low and sickness absence is an issue. This means there is a regular use of agency staff. Although staff try to book agency workers whom young people have met before, this is not always possible. This means that young people struggle to form meaningful relationships with some staff.

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The effectiveness of leaders and managers: requires improvement to be good

External agencies have mixed views about the home. One social worker was very complimentary about the therapeutic approach taken by staff and the communication staff have with her. She felt the home should be rated as ‘outstanding’ and said: ‘They’re amazing.’ Another raised a number of concerns including: the behaviour of young people Inspection report children's home: SC063997 7 not being appropriately managed, a lack of communication with the social worker, not complying with agreed actions at statutory reviews, concerns about weight gain in young people, and a lack of structure within the home. The complaints of this social worker meant that the young person was removed from the home.

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The effectiveness of leaders and managers: requires improvement to be good

The acting manager, staff and young people are supported by the very experienced operations manager and support manager who regularly visit the home. The operations manager is clear about how she wants the home to develop. Both the acting manager and operations manager have a good understanding of the strengths and weaknesses of the service.

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The effectiveness of leaders and managers: requires improvement to be good

Staff feel supported by the new management team. They say training and support have improved under the new management. They feel morale will improve when they know what the management arrangements will be after the acting manager and deputy manager leave.

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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 differences 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: SC063997 8

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Children’s home details

Registered provider: Bettercare Keys Ltd

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Children’s home details

Registered provider address: The Keys Group, Laganwood House, Newforge Lane, Belfast BT9 5NW

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Inspector(s)

Joanne Vyas, social care inspector Inspection report children's home: SC063997 9 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)

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