Children's home run by Keys Childcare Limited

Inspection report children‟s home: 1255796 1 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 provides care and accommodation for three young people who may have emotional and/or behavioural difficulties. The service is operated by a national provider in partnership with a local authority.

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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 requires improvement to be 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: This is the first inspection after re-registration.

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good

Overall judgement at last inspection: Not applicable

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Enforcement action since last inspection

None Inspection report children‟s home: 1255796 2

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Key findings from this inspection

 Living at the home is a positive experience for children. They make good all-round progress. Their health, education and social development are well supported. They enjoy new experiences and positive engagement with staff.  Staff consult with children about all aspects of their care so that children are fully involved in their own care planning and in the day-to-day running of the home.  Children feel cared for and have a sense of belonging. Good safety measures and effective partnership working help to protect them.  The home is well led by an experienced and capable registered manager. The staff are knowledgeable, competent and well trained. Their professional development is promoted so that they are up to date with current trends and developments in social care.  The transition of the home from the local authority to the new provider has been well managed.

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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

 There are shortfalls in leadership and management that have arisen as a result of the home‟s transfer to the new provider. These are mostly wider organisational issues that do have a detrimental effect on the home.  The use of agency staff is high. This is partly because permanent staff are being relocated to provide cover at a newly registered home. This measure is not well liked by children as it impacts on continuity and consistency of care.  Some of the documentation used for recording is duplicated and unwieldy. Staff need extra time to complete these documents, which impacts on the time they have available to care for children.  Children‟s individual risk assessments cover a wide range of risks. The documents are not tailored to the specific needs of the child.  Up-to-date, relevant information for agency staff is not succinctly presented so there is a risk that they may not have the information they need to care for

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Key findings from this inspection

children effectively. Some agency staff are not well trained in child protection procedures.  The independence programme, which is good in some areas, does not provide enough nurture and emotional support to children at this crucial time. Children express dissatisfaction with the programme. Inspection report children‟s home: 1255796 3

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Inspection date Inspection type Inspection judgement

This is the first inspection after re-registration. Inspection report children‟s home: 1255796 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

13(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children‟s home that— (a) helps children to aspire to fulfil their potential; and (b) promotes their welfare. (2) In particular, the standard in paragraph (1) requires the registered person to— (e) ensure that the home‟s workforce provides continuity of care to each child; (f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of care provided in the home. (Regulation 13 (1) (2)) 15/09/2017

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Recommendations

 Ensure that the home meets children‟s needs in the way that a good parent would, recognising that many children in residential care have experienced environments where these needs have not been consistently met. In particular, in consultation with children, review the independence programme. Ensure that the arrangements for promoting independence do not deter staff from providing a nurturing and supportive environment which demonstrates that staff care for the child and value them as an individual. („Guide to the children‟s homes regulations including the quality standards‟, page 15, paragraph 3.7)  Review relevant documents to ensure that they support the home to deliver the ethos and outcomes of the statement of purpose and thereby provide high quality care to children. In particular, ensure that recording is not overly onerous and does not negatively impact on the care of the children. („Guide to the children‟s

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Recommendations

homes regulations including the quality standards‟, page 52, paragraph 10.4)  Ensure that the registered person considers the skills, qualifications and any induction necessary before allowing external agency staff to commence work in the home. In particular, ensure that the induction for agency staff is carried out Inspection report children‟s home: 1255796 5 before they start working with children in the home and that it covers their role and responsibilities, the home‟s procedures and the arrangements for contacting senior managers. („Guide to the children‟s homes regulations including the quality standards‟, page 54, paragraph 10.16)  Ensure that agency staff are familiar with the home‟s procedures for reporting allegations or disclosures of abuse immediately to a senior manager. („Guide to the children‟s homes regulations including the quality standards‟, page 44, paragraph 9.17)  Ensure that risk assessments relating to children‟s individual behaviour and needs

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Recommendations

are individually tailored and demonstrate that the home continually and actively assesses the risks to each child and the arrangements in place to protect them. („Guide to the children‟s homes regulations including the quality standards‟, page 42, paragraph 9.5)

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Overall experiences and progress of children and young people: good

The home was previously run by the local authority. The transition of the home to the new provider was carried out smoothly, with no disruption to children‟s placements. Changes include a reduction in the number of children from four to three. This means that children now have more communal space and a dedicated visitor‟s room. Children are well cared for in a homely, well-kept environment.

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Overall experiences and progress of children and young people: good

Children benefit from good transition planning. For example, of the three children who were living at the home when the new provider took over responsibility of the home, one has reached adulthood and has moved on to a supported-living placement. This was a well-planned transition and the young person visited her new placement in advance and was fully involved in discussions and decisions about the move.

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Overall experiences and progress of children and young people: good

One child has been admitted to the home and this was a positive experience for him. The transition was very well planned. The child received a copy of an age-appropriate children‟s guide before his admission. He had introductory visits, including an overnight stay. He reports he was made to feel very welcome. This helped to reduce his anxieties about the move and helped him to settle well into placement.

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Overall experiences and progress of children and young people: good

At the point of a child‟s admission, and as needed thereafter, the provider holds a clinically informed care planning and intervention meeting which draws together professionals who can offer additional support to meet a child‟s specific needs, including psychological support. This helps to ensure that each child receives the individual support they need. As yet, none of the children has required intervention from these professionals.

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Overall experiences and progress of children and young people: good

The home offers children many and varied opportunities to engage in positive experiences, so they are able to try new things and develop their interests, skills and confidence. They learn to bake, enjoy trips out with staff and some join local groups, Inspection report children‟s home: 1255796 6 including the Children in Care Council. Children benefit from making a positive contribution to society. For example, some engage in volunteering with local charities.

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Overall experiences and progress of children and young people: good

The quality of individualised care is good and children say this is a good home where they are well looked after. They are fully engaged in their individual placement planning and risk assessments. Their views are listened to, respected and taken into account. This helps to build their self-esteem. When decisions are made against their wishes, the home ensures that children understand the reasons for this. They have independent advocacy from a „Voice of the Children‟ advocate, whom they know well.

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Overall experiences and progress of children and young people: good

Staff consult with children about all aspects of their care and their day-to-day lives. They ensure that children have the same opportunities as their peers, as far as possible. For example, children have an annual holiday that meets their individual preferences. This year, this has meant three different holidays, to meet the needs and wishes of each child. The home supports children to apply for part-time work as they get older. This helps them to develop independence, a good work ethic and a sense of personal responsibility.

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Overall experiences and progress of children and young people: good

Staff actively promote tolerance and understanding of each other‟s needs but take account of how children might struggle to be patient with each other. They address this by making sure children have time apart, so that their levels of tolerance are not tested too far.

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Overall experiences and progress of children and young people: good

Children enjoy positive relationships with staff which develop through engagement in fun activities with them. A child who described the home as „a good place to live‟ said the best thing about the home is the activities. Children‟s achievements are valued and there are lots of photographs of them around the home, including one of a young person receiving an award from the Lord High Commissioner.

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Overall experiences and progress of children and young people: good

Although children report they have good relationships with staff, they do not always feel they are given the time and attention they would like to talk things through. For example, one child said: „Sometimes I feel they do not want to listen to what I want to say about how I feel about different aspects of life.‟

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Overall experiences and progress of children and young people: good

Engagement with education is extremely good. All children have full-time education placements at school or college and high levels of attendance. Two are currently awaiting public exam results and have high hopes of success and high aspirations for the future. Collaboration with education providers is good. The home addresses any concerns quickly and supports children to carry out set work. This helps to ensure that children do not fall behind and quickly catch up on any work they have missed. The manager ensures that children are not sent home from school inappropriately. She professionally challenges schools to manage children‟s behaviour effectively within school. This helps to ensure that children receive the education to which they are entitled.

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Overall experiences and progress of children and young people: good

The home promotes healthy eating and exercise. Children are encouraged to be active and some regularly engage in cycling and visit the gym. Although some children smoke Inspection report children‟s home: 1255796 7 cigarettes and cannabis, their use is low and is actively discouraged. Staff encourage and support children to attend health checks and appointments, and they actively support children to maintain good sexual health. The looked after children nurse visits the home and delivers health advice where appropriate. The home ensures that children receive the medicines and treatment they need. Consequently, children‟s health is well promoted.

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Overall experiences and progress of children and young people: good

Children who administer their own medicines are provided with a lockable safe in which to store their medicines, and the arrangements are subject to regular monitoring. This ensures that children are taking their medicines regularly and that the home can quickly intervene and alert health professionals should this not be the case. The arrangements protect other children from accessing medicines not meant for them.

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Overall experiences and progress of children and young people: good

Some children are currently receiving a service from the child and adolescent mental health service (CAMHS) and the home has good links with the local authority cared-for children support team as well as therapists within the organisation. Close working with partners ensures that children‟s needs are regularly assessed so that therapeutic support to address emotional and psychological needs can be sought and provided, where appropriate. Referrals have recently been made for two of the children to receive additional support.

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Overall experiences and progress of children and young people: good

Children learn and practise the practical skills required for future independent living. For example, those who have finished Year 11 at school quickly learn to take responsibility for all their own budgeting, shopping, cooking and laundry. They develop the skills to live independently on a low budget.

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Overall experiences and progress of children and young people: good

Those engaged in the independence programme are required to make a significant financial contribution towards any activities they wish to engage in. This is strictly applied and some children interpret it as a lack of care. A member of staff explained: „If they came out with us to the park or seaside and we bought an ice cream for the younger child, we would not buy one for those on the independence programme. They would have to buy their own‟. Consequently, those on the independence programme usually opt out of outings and spend increasing amounts of time in the community, with friends. Staff do not always know where or with whom they are spending their time. This makes them more vulnerable to negative influences. The arrangement undermines children‟s ability to maintain and build on their relationships with staff. At a time when they need strong guidance and support to make the right choices in life, children begin

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Overall experiences and progress of children and young people: good

to withdraw emotionally. Staff acknowledge that the older children do not always receive the level of attention they need.

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Overall experiences and progress of children and young people: good

One young person explained: „I don‟t do stuff with staff because I‟d have to pay for myself. I have to get used to being on my own. N (a younger child) goes out on activities every day. They offer for me to go; but I can‟t afford it. Sometimes I‟d love to go, like when they were going to Alton Towers. It‟s the same for the other young person. You get completely excluded and forgotten about. The programme gets you ready for independence but socially isolates you. It‟s upsetting when you come in and you‟re hungry and they‟ve got a load of food left over from tea, but they don‟t even let Inspection report children‟s home: 1255796 8 you try it because it belongs to the house and you‟ve got to make your own. They throw it in the bin. It feels so rude.‟

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Overall experiences and progress of children and young people: good

While there is good evidence to show that the reality is not as bleak as suggested by this child, and indeed, for the most part, interactions with staff are positive, the home needs to reflect on the child‟s comments. The manager and staff should consider how they can improve the independence programme so that children see it as a positive step and do not feel pushed out and undervalued.

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

The manager carries out effective impact and compatibility risk assessments at the point of a child‟s referral. Her views are taken into full account in decisions about which children to admit to the home. This reduces the likelihood of children having a negative impact on each other.

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

Individualised risk assessments and behaviour management plans guide staff in how to care for children and promote their safety and well-being. There are numerous risk assessments relating to each child but they are not always tailored to children‟s individual needs. This means it is difficult for staff to quickly focus on those risks that are pertinent to a particular child.

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

Consistent behaviour management is a strength of this home. A partner professional explained: „The staff are considered in their approaches to their children. They have positive relationships with them and tailor all interventions based on the direct needs of the child.‟

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

There have been no restraints since the last full inspection. Positive behaviour management strategies are effective. They include planned incentives and open discussion with children. Sanctions are infrequent and appropriately used. Children report they feel safe living in this home.

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

Each child has an agreed missing from home protocol, based on their assessed safety needs. Staff search for missing children and wherever possible, maintain contact with them, their friends and families. Those who went missing frequently prior to admission have significantly reduced this behaviour, which means they are safer living in this home. A partner professional said: „In my very honest opinion, the home is a strong example of best practice around missing and CSE [child sexual exploitation]. They raise concerns without prompting, share intelligence when it is available, endeavour to find out as much detail as they possibly can (including taking down licence plate numbers, descriptions, etc.).‟ The home regularly updates police and other relevant agencies of changes to risk.

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

Children are made welcome on their return from being missing. The police conduct safe and well checks and an independent agency conducts return interviews on behalf of the local authority. This promotes children‟s safety and welfare. It ensures that children have the opportunity to report any concerns about the home or any dangers to them while Inspection report children‟s home: 1255796 9 missing.

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

Strong partnerships with other agencies help to protect children. A partner professional explained: „The home are heavily linked with the missing from home team, child sexual exploitation team and the integrated team, and provide regular updates on concerns, identified behaviours, and other key factors. They are committed to ensuring they prevent episodes of missing and have robust procedures in place.‟

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

Staff have a good understanding of caring for children at risk of self-harm, grooming and exploitation. They support children to develop self-esteem and help them to understand about risks to their safety. They promote safe, social and sexual relationships. This is a work in progress. While children know how to stay safe, some engage in behaviour and relationships that are harmful, both in the community and via social media.

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

Staff understand the whistle-blowing procedures and know how to respond to an allegation or disclosure of abuse. However, not all agency staff know how to respond appropriately in the event of a child protection incident. This is a potential risk to children‟s safety.

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

Leaders and managers have high aspirations for children. The manager is suitably experienced and qualified. She has a history of providing high standards of care that help children to make good progress.

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

The home has been well supported during the transition to the new provider. This has helped to ensure that any issues or concerns are quickly addressed. The manager benefits from good management consultation, including regular one-to-one meetings with her line manager and group meetings with other registered managers in the locality. The management team has a good understanding of the strengths and weaknesses of the home.

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

Staff are well supervised and supported through monthly team meetings and one-to-one supervision. This ensures regular scrutiny of their continuing professional development, their day-to-day practice and their well-being. Staff are working through an induction programme which is helping them to become familiar with the new provider‟s policies and procedures. Their progress is monitored through regular supervision. This is helping to ensure that they acquire a sense of understanding and belonging as they adjust to working for a new organisation and to understand the ethos and aims of the provider.

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

The new service benefits from the previous provider‟s long-established and effective working relationships with partner agencies. Professionals comment positively on the current service which supports children‟s all-round development and safety. Communication with other agencies is good. The manager and staff advocate well for children, actively challenging other professionals who fall short of providing a good level of service to children. Inspection report children‟s home: 1255796 10 The home meets children‟s diverse and complex needs well. Social workers and parents recognise this. For example, one said: „My young person has unique preferences in music, films, fashion. Staff promote my young person‟s identity and each child in the home is treated as an individual to ensure their needs are met.‟

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

Permanent staff know the children well. They know each other‟s strengths and weaknesses and provide consistent care. Regular case work discussions about each child take place at team meetings and inform care practice very well. The manager and staff have found it difficult to adjust to the recording systems introduced by the new provider. They find the paperwork repetitive and cumbersome. For example, when a child goes missing, this needs to be recorded in 13 different places. Staff report that this takes them away from spending time with the group and this is having a negative impact on children. For example, a child said: „Staff are always “too busy” to spend any time with me, especially in the evenings.‟ The manager has raised the matter with the provider and a review of paperwork has begun.

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

The number of staff assigned to the home was reduced when the new provider took over the home. This meant a reduction from three care staff at each shift to two. While the staffing numbers and ratio are mostly sufficient, the home has struggled to meet gaps in the rota resulting from long-term sickness and holidays. The home has employed various agency workers to cover the gaps in the rota; however, this does not provide continuity and consistency for children. In addition, the home is supporting a newly registered home run by the same provider. This involves staff from this home covering shifts at the other home, often at short notice. They are replaced by agency workers. This is not acceptable practice as it means moving staff with whom children have good relationships to another home because of shortfalls in the provider‟s arrangements and care planning at that home. It creates instability for children and places unnecessary

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

Since the start of July 2017, agency staff have been used frequently. The manager is very aware that this arrangement has had a huge impact on children. Although there is always one permanent member of staff on shift, the second staff member is often one of many agency workers whom children do not know well. One child explained how this is affecting them: „They use agency staff every day. I don‟t like it. It makes me feel uncomfortable. Sometimes they don‟t even introduce themselves. I feel awkward with strangers in my home. I don‟t know who‟s going to be here when I come downstairs. I see so many, I don‟t speak to them now. I don‟t even know their names. I stay in my room.‟ While the manager has begun to take action to reduce the use of so many different agency workers, the impact of this action is not yet evident.

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

Agency staff are not well inducted to the home. For example, they are expected to read children‟s files when they arrive on duty, even though time to do so is very limited. This means they are not well informed about children‟s needs before starting to look after them. The shift leader usually shares pertinent information with them but this is not always possible. For example, during the inspection the shift leader was busy dealing with and reporting a missing from home incident and so had little time to supervise and Inspection report children‟s home: 1255796 11 direct an agency member of staff. Agency staff do not always know how to contact the duty manager, should the need arise.

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

Staff morale is beginning to dip. One described the impact of working continually with different agency workers: „Having two staff on with three children is fine, but with agency staff it‟s hard, because I can‟t leave the agency worker alone with the children because of the altercations between the children. They don‟t know them. It‟s hard in the evenings when we want to spend time with the children, but we are busy with paperwork because we have to get things written down.‟

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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: 1255796 12

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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

Sharon Lloyd, social care regulatory inspector Inspection report children‟s home: 1255796 13 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

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Inspector

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Inspector

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