Children's Home run by Keys Direct Care Limited in Norfolk

Inspection report children’s home: SC450994 1 SC450994 Registered provider: Direct Care Ltd

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

The home, which is owned by an independent provider, is registered for up to four children who have emotional and/or behavioural difficulties.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

requires improvement to be good

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

p.1

requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

p.1

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.

p.1

requires improvement to be good

Date of last inspection: 28 September 2016

p.1

requires improvement to be good

Overall judgement at last inspection: requires improvement

p.1

requires improvement to be good

Enforcement action since last inspection: none

p.1

Key findings from this inspection

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

p.1

Key findings from this inspection

 Care plans contain gaps and inaccuracies.  The impact risk assessment completed since the last inspection contains Inspection report children’s home: SC450994 2 significant omissions.  The management team has not submitted the home’s statement of purpose to Ofsted, despite updates taking place.  There remain discrepancies between policies and practice in relation to medication.  Recruitment checks are not sufficiently thorough to support safe recruitment.  In one incident, a child went missing without anyone in the home being aware of this until the police returned the child.  Issues, including key information missing from individual missing from home protocols, and inaccurate contact numbers for support agencies being provided to children, were rectified by the manager during the inspection.  The home’s own review of the quality of care contains inaccuracies and lacks sufficient analysis.

p.1

Key findings from this inspection

 The staff and management team are very child focused.  There are good relationships between the children and the staff. This generally enables the staff to manage behaviour well.  The children make progress, and the risks to children have reduced.  There are good links with local specialist support services for children who are at risk of child sexual exploitation.  When children go missing, the staff are tenacious in attempts to contact and locate them.  The manager and staff challenge external professionals when they feel that the service is not good enough for the children.

p.2

Inspection date Inspection type Inspection judgement

28/09/2016 Full Requires improvement 28/04/2016 Interim Sustained effectiveness 17/11/2015 Full Good 23/07/2015 Interim Improved effectiveness Inspection report children’s home: SC450994 3

p.2

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.

p.3

Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) 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, and that 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. (Regulation 12(1)(2)(a)(i)(b) This is with particular regard to ensuring that impact risk assessments are thorough. 31/07/2017

p.3

Requirement Due date

The care planning standard is that children receive effectively planned care in or through the children’s home and have a positive experience of arriving at or moving on from the home. 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)(b)(2)(c)) This is with particular regard to ensuring that care plans are accurate and up to date. 31/07/2017

p.3

Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16(3)(a)(b)) 31/07/2017

p.3

Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (Regulation 23(1)) 31/07/2017

p.3

Requirement Due date

The registered person must ensure that full and satisfactory information is available in relation to staff recruited to work at the home in respect of each of the matters in Schedule 2. (Regulation 32(3)(d)) 31/07/2017 Inspection report children’s home: SC450994 4

p.3

Recommendations

 Ensure that all incidents of control, discipline and restraint are subject to systems of regular scrutiny to review their effectiveness. (‘Guide to the children’s homes regulations including the quality standards’, page 46, paragraph 9.36)  Ensure that the review of the quality of care review enables the registered person to identify areas of strength and possible weakness in the home’s care. (‘Guide to the children’s homes regulations including the quality standards’, page 65, paragraph 15.4)

p.4

improvement to be good

The quality of the service has improved since the last inspection. However, a number of areas need further improvement before the home can be judged to be consistently good. So far, these issues have had limited effect on the children, although unchecked they have the potential to do so in the future. There are clear strengths in some areas. The staff and the management team are very child focused. They see everything through a child-first, relationship-based lens. This approach results in strong relationships that enable children to make progress and reduce risk. The staff know the children well. Interactions are commonly warm and positive. When children become heightened, the staff remain calm, and their approach results in situations not spiralling out of control. A child said, ‘I have got really bad anger issues. I try to control it here. Being as good as I can will get me out of here. They help me calm

p.4

improvement to be good

down. They sit me down. Calm down. Everything is going to be alright.’ The children make progress. There has been a reduction in missing from home incidents. A social worker said, ‘There has been a massive reduction in missing. They [staff] have worked hard with her on self-esteem and confidence. She knows she does not have to do those things anymore.’ The children say that they are able to better manage their emotions. They grow in confidence and their ability to relate to and interact with professionals increases. Some of the children make progress with their education. The staff support them to take examinations and access college placements. However, one child (who is outside of statutory school age) has not been in formal education for several months. Professionals spoke positively about the efforts made by the home to address this. One professional said, ‘They have been very supportive. They have tried very hard to get something for

p.4

improvement to be good

her.’ Although the staff and management team support and advocate for the child, this has had limited effect. Children move into the home in a planned way. The manager completes an impact risk assessment to inform placement decisions. This process has improved. However, the most recent impact risk assessment contains a significant gap, omitting any detail or Inspection report children’s home: SC450994 5 analysis regarding a child’s history of going missing, despite there being space for this on the form. The form has been signed as read by the whole staff team, but no-one has drawn attention to the gap. There is a reliance on signing documents as read and understood. However, there is not yet embedded a culture of checking staff’s understanding. More recent supervisions suggest that this may be beginning to take place. The children have the opportunity to contribute to the planning of their care. The staff

p.4

improvement to be good

communicate with children and try to help them to understand when their wishes cannot be fulfilled. The staff are proactive at engaging the children with advocacy services and local specialist child sexual exploitation support services. A specialist worker said, ‘They [staff] tend to refer as soon as they [children] come to the home. No other care home does.’ The children know how to complain. They are clear that they can raise concerns with staff. The children demonstrate the ability to raise concerns via external routes as well. However, contact information for advice and advocacy lines in the home’s statement of purpose and the children’s guide was out of date. Lack of accurate information could mean that children who may wish to seek advice without the assistance of the staff would be unable to do so in a timely way. The children are all registered with local health providers. The home has established

p.5

improvement to be good

links with local mental health services, and the staff make referrals when needed. A psychologist who is linked to the home visits regularly. The children describe his involvement as positive. At the last inspection, a requirement was made as there was a lack of consistency between the medication policy and the practices in the home. The process for monitoring medication has improved. However, at this inspection, inconsistencies were again identified. Therefore, staff are not following policies designed to keep children safe. The children are making progress with their independence. The staff and managers are not risk averse, despite working with children for whom risks are high. For example, the staff engage with the children and professionals to explore how to support the children to safely develop and extend their free time and how to access technology. This helps the children to take appropriate steps towards independence.

p.5

improvement to be good

The home environment can be volatile at times. The children report that staff manage the situation well when group dynamics lead to situations becoming heightened. A child said, ‘They [staff] calm people. They are funny. I feel comfortable around them all.’ A professional commented, ‘The boundaries are very clear and the children feel safe and able to talk to key members of the staff.’ Consequently, despite the occasional volatility, the children report feeling safe at the home. The children say that they have good relationships with the staff. The staff manage behaviour through the strength of these relationships. Physical intervention is rarely used and, when it is, it is minimal and proportionate to the risk posed. The staff use Inspection report children’s home: SC450994 6 consequences to support children to adapt their behaviour. The staff continue to record the details of these occurrences and make a record of their effectiveness. However, the

p.5

improvement to be good

review of the effectiveness remains ineffective, tending towards either a statement of the intended effect or an overly optimistic assertion. This continues to limit the service’s understanding of the effect that the sanctions have on children’s behaviour. The home works with children who arrive at the home with a high risk of going missing. The work that the staff and the management team undertakes with the children sees this risk consistently reduce. There remain occasions when children do go missing. This is predominantly from home contact, when children refuse to return to the home. However, there have also been occasions when children have gone missing from the home without staff’s knowledge. On one occasion, this resulted in a child being returned by the police with the staff unaware that she had left the building. This was despite warning signs that she may be planning to go missing, and the child triggering internal

p.6

improvement to be good

alarms. The staff did not follow known and expected practices. This resulted in the child being at significant risk. When children are missing, the staff are tenacious in their attempts to contact them. The staff maintain links with families, the police and the child throughout. The staff have established good working relationships with the local child sexual exploitation service. Recruitment processes need to improve. At present, efforts to ascertain why applicants have left any previous role working with children or vulnerable adults are minimal. There is a lack of awareness as to whether agency staff have had background checks that consider this. In addition, recruitment records are not consistently clear regarding gaps in employment history. Combined, these issues mean that there is insufficient assurance that recruitment procedures safeguard children and minimise potential risks to them. Neither the home’s location risk assessment, nor children’s individual missing from home

p.6

improvement to be good

protocols, contained key information about additional actions to take if a child goes missing in the hours of darkness. There was no information in these records regarding the need to take a designated grab bag. This is significant, as the home is situated on an unlit, unpaved road and the bag contains torches and florescent jackets. This information was added to the relevant documents by the manager during the course of the inspection. The staff complete key-work sessions with the new residents regarding the risk from the road. Regular fire tests and drills take place. An up-to-date fire risk assessment is in place. When children do not participate fully in a drill, they have a key-work session to emphasise the importance of fire safety. The staff are aware of the procedures to follow to raise and report concerns about the safety of children. The staff are able to say what they would do if they were unhappy

p.6

improvement to be good

about the response from a manager to any concern that they raise. Senior managers have a visible presence in the home and are known to staff and children. The management team notifies Ofsted of serious incidents at the home as necessary. When managers identify concerns, they seek advice, undertake investigations and share the outcomes with appropriate agencies. The quality of the information the management team provides to safeguarding professionals has improved. Inspection report children’s home: SC450994 7

p.6

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

The manager has been in post for four and a half years. She has a level 5 diploma in residential childcare. A newly appointed deputy manager supports her. This support enables a greater focus on monitoring and driving improvement. The home is almost fully staffed. However, the staff team is in its infancy and all but two of the staff have worked at the home for less than a year. This vulnerability is being managed by ensuring that each shift includes at least one experienced care worker. The management team has not met all of the requirements made at the last inspection. The new impact risk assessment lacks analysis of key information. The medication policy remains inconsistent with practice at the home. Some of the shortfalls have been addressed. The requirement regarding the location risk assessment was been met following changes made during the course of this inspection. Monitoring arrangements have improved. The fire risk assessment has been updated. The staff in post have, or

p.7

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

are working towards, qualifications within regulatory timeframes. Supervisions are taking place. Notifications contain relevant information and are of a sufficient quality. The quality of case records, while variable, has also improved. The management team recently updated the statement of purpose. However, the provider has not submitted this, or previous updates, to Ofsted. This does not directly affect the children, but it does mean that Ofsted, as the regulator, does not have current information regarding the service. The manager has a clear understanding of the progress that children make. She is passionate about their development and has a thorough knowledge of their individual needs, experiences and plans. However, this understanding is not supported by clear and consistent written care plans. The plans sampled during the inspection contained inaccuracies and inconsistencies. This has the potential to affect the staff’s

p.7

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

understanding of, and response to, the needs and experiences of the children. The staff receive supervisions, which they say are supportive and frequent. Records show some variability in quality, but there is evidence of supervisors offering challenge to assist professional development. The staff have access to a range of training. All of the staff either have a relevant level 3 qualification or are working towards one. The manager and the staff challenge practice that they do not consider to be good enough for the children. This has resulted in changes to external professionals’ practice. The staff are good advocates for the children. The level and quality of monitoring that takes place has improved. This includes the introduction of weekly and daily checks. However, the internal review of the quality of care needs to improve. This contains inaccurate dates and confused data. For example, charts in the report note a significant increase in sanctions, but the accompanying text

p.7

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

refers to a decrease. There is also limited evaluation of the data. This limits the effectiveness of the review and lessens the likelihood that it will contribute to improvements in the overall quality of the service. Inspection report children’s home: SC450994 8

p.7

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 who it is trying to help, protect and look after.

p.8

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: SC450994 9

p.8

Children’s home details

Registered provider address: Goldwyns, Rutland House 90 92, Southend On Sea SS2 6HZ

p.9

Children’s home details

Responsible individual: Rebecca Ouellani

p.9

Inspector

Ashley Hinson, social care inspector Inspection report children’s home: SC450994 10 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 children looked after, safeguarding and child protection.

p.9

Inspector

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, 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 http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.10

Inspector

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

p.10

Inspector

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

p.10