Children's Home run by Keys Group Progressive Care & Education Limited in Southampton

Inspection report children’s home: SC389180 1 SC389180

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Registered provider: Keys Group Progressive Care & Education 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

This home is privately owned by a national organisation. It provides care and accommodation for up to six children and young people with complex health needs arising from learning disabilities and physical disabilities. On occasion, the home may accommodate one child or young person on a short break.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected outstanding

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outstanding

The effectiveness of leaders and managers good

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Date of last inspection: 21 February 2017

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outstanding

Overall judgement at last inspection: outstanding

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Enforcement action since last inspection

None. Inspection report children’s home: SC389180 2

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Key findings from this inspection

This children’s home is outstanding because:

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Key findings from this inspection

 Children and young people live in a happy, fun environment where they are confident that staff meet their needs.  Disability is no barrier. Children and young people live in an inclusive culture. They thrive through participation in activities in the home and the wider community.  Children and young people with severe communication difficulties have a clear, strong voice. Staff work with other professionals to move children and young people on from one-word answers to conversation.  Children and young people develop their identity, improve their self-esteem and believe in their ability. They engage with others, some from a starting point where such engagement caused severe anxiety.  Staff advocate for children and young people so that their complex physical health needs are met. Children and young people get the specialist support and equipment they need.  Staff are equally concerned about children and young people’s emotional well-

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Key findings from this inspection

being. They regularly check on how children and young people are feeling, especially after significant life changes, providing the necessary support.  Staff enjoy being with the children and young people. They have fun with them. They are attentive to their individual needs and ensuring their ongoing happiness.  Professionals and parents say that they have excellent relationships with the registered manager and staff. Communication between the managers and staff of home and others involved with young people’s care is excellent.  The registered manager has high expectations and there are clear lines of responsibility and accountability. All staff embrace a culture of providing children with the absolute best care.  The registered manager values all of her staff, including the agency staff who work regularly in the home. She praises staff for the commitment and enthusiasm they show the children and young people.

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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

 The registered manager is required to prepare quality of care statutory reports and submit them to Ofsted within the period in the regulations.  The registered manager is required to challenge health professionals to remain accountable for the appropriateness of the delegation of healthcare tasks.  The registered manager is required, in all cases, to obtain consents for strategies to safeguard children and young people, especially monitoring and Inspection report children’s home: SC389180 3 calming techniques.

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Inspection date Inspection type Inspection judgement

21/02/2017 Full Outstanding 29/09/2016 Interim Sustained effectiveness 22/03/2016 Full Good 14/09/2015 Interim Sustained effectiveness Inspection report children’s home: SC389180 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

In order to meet the engaging with the wider system to ensure children’s needs are met standard the registered person must:

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Requirement Due date

Challenge the relevant person to seek to ensure that each child’s needs are met in accordance with the child’s relevant plans. (Regulation 5 (c)) 28/02/2018

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Requirement Due date

Complete a review of the quality of care provided for children at least once every 6 months and supply to HMCI a copy of the quality of care review report within 28 days of the date on which the quality of care review is completed. (Regulation 45 (1) (4)(a)) 31/10/2017

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Recommendations

 Prepare and implement policies setting out arrangements for the safeguarding of children; especially consent for monitoring equipment and calming techniques involving touch. (‘Guide to the children’s homes regulations including the quality standards’, paragraph 9.19, page 44)

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Overall experiences and progress of children and young people: outstanding

Children placed in this home have enjoyed long and fruitful placements over a prolonged period. Staff, some with many years of service, provide outstanding care, always with children and young people at the forefront of all they do on a daily basis. Children and young people make exceptional progress in relation to their starting points. Examples are social engagement from a starting point of self-induced vomiting, developing skills to use an eye gaze communication system and allowing staff to assist with personal care, such as cleaning teeth. Staff do not see disability but ability. They work with other professionals to give children and young people the best possible support in all areas of their lives to enhance their life chances.

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Overall experiences and progress of children and young people: outstanding

Children and young people live in a happy and harmonious environment. They enjoy warm and positive relationships with staff, laughing and joking with them, confident that Inspection report children’s home: SC389180 5 staff fully understand their individual needs. Staff’s attention to detail is outstanding. A parent said, ‘It’s the little things, the suggestions like asking if she likes her nails painted. Her hair is always done and she is always dressed nice. She is their little princess.’ A professional said, ‘They found a specialist hairdresser for [name of child]. He always looks good.’

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Overall experiences and progress of children and young people: outstanding

Children and young people engage in activities they enjoy, such as boat trips and ice- skating. A child with an interest in animals was able to visit a local farm and have an owl sit on his arm. A parent said, ‘They always take [name of child] out. He is happy to be here.’ A professional said, ‘They take him to music festivals, which he loves.’

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Overall experiences and progress of children and young people: outstanding

Children and young people with severe communication difficulties make significant progress. Staff work closely with other professionals, such as speech and language therapists, to develop and use strategies to improve communication. Children and young people move from a response of ‘yes’ or ‘no’ to having a short conversation. They are able to communicate their true feelings when dealing with painful events, such as a bereavement. Children and young people are able choose what clothing is purchased for them. They express their identity further through the personalisation of their bedrooms. A parent said, ‘[name of child] is very happy and loves the personal touches in the room.’

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Overall experiences and progress of children and young people: outstanding

Staff have empathy for the children and young people in their care. They stay up to date with their emerging needs, such as specialist treatment following complications after an operation. They are attentive to minute changes in expression or behaviour, for example to indicate whether a child or young person is uncomfortable in their wheelchair, making adjustments with the consent of the child or young person. Staff advocate for new wheelchairs to meet the new needs of a child or young person. They are successful in obtaining the specialist equipment.

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Overall experiences and progress of children and young people: outstanding

Children and young people enjoy excellent contact with their parents and others who are important to them. Relatives and friends are able to visit the home. Staff support home visits. Parents are able to join community activities with their child and staff. All spoke most positively of their relationships and the inclusive environment. A parent said, ‘It is an excellent service. They meet his needs medically and emotionally. I can visit regularly or they drop off at home.’ Another parent said, ‘It is far, far better than any other home. They are fantastic.’

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Overall experiences and progress of children and young people: outstanding

Staff work with school staff to agree the best strategies to support children and young people’s education. They share practice and equipment to help children and young people make the best possible progress.

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Overall experiences and progress of children and young people: outstanding

Staff celebrate key events in each child or young person’s life, including their 18th birthday. Staff help write transition plans to prepare for young people to move into adult care. The registered manager works tirelessly to help assess a suitable placement. Inspection report children’s home: SC389180 6

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

The registered manager has established a strong safeguarding culture. Children and young people’s physical and emotional safety are paramount in this home. The registered manager and staff follow agreed procedures and in the event of any concern, consult other safeguarding professionals until matters are brought to conclusion.

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

Medicine management is an exemplar. The registered manager has an excellent medication room as well as systems and practice in place to administer a vast array of medicines. She learns from incidents, such as an apparent stock discrepancy, revising policies as appropriate. She listens to other professionals and changes practice if necessary. Staff readily accept any change.

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

Health professionals have diagnosed some children and young people with epilepsy. Staff follow the agreed protocols, including the administration of regular medication and emergency medication. In one case, although parents have no objection, the registered manager has not obtained formal consent for the use of a camera to monitor seizure activity at night. Some children and young people are distressed after a significant seizure and require comfort, such as a hug. Parents speak highly of the strategies that staff use to keep their child safe. They report significant improvement in epilepsy management, in one case a significant decrease from a starting point of multiple seizures daily.

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

Key workers keep risk assessments under constant review. Children and young people continue to enjoy the activities that are important to them without compromising their safeguarding, for example when there are complications after an operation.

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

The registered manager prioritises a safe and healthy environment, for example ensuring that hoists are currently certified as to their safety. She has recently arranged for an independent review of the fire risk assessment. This confirms that the stay-put policy at night is the best strategy. Personal emergency evacuation plans inform staff of the action to take for each individual. The registered manager organises for contractors to certify the sprinkler system.

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

The registered manager adopts safer recruitment practice. She only employs adults deemed to be suitable to work with children and young people.

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

Given the level of support that children and young people need, there are no issues around missing from care or challenging behaviour.

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The effectiveness of leaders and managers: good

A strong management team supports the competent staff team. Morale is high. Staff focus on delivering high-quality care. New staff speak positively of their induction, established staff of their development plans, and agency staff say that they feel valued. All staff have high regard for the registered manager. They say that she supports them and values their work on a daily basis as well as through formal supervision and Inspection report children’s home: SC389180 7 appraisal.

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The effectiveness of leaders and managers: good

The registered manager is a registered nurse and also well qualified in leadership and management. She maintains an active and visible presence in the home. She stays abreast of the children and young people’s needs. She has high expectations of staff, ensuring that they deliver exceptional care. Staff show a thorough knowledge of the specialist needs of the children and young people. They work well as a team, sharing ownership of their responsibilities to deliver high-quality, consistent care.

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The effectiveness of leaders and managers: good

The registered manager has developed an effective system of care planning. Key workers keep the plans up to date and pass on essential information.

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The effectiveness of leaders and managers: good

The registered manager has a comprehensive training programme in place. She monitors this well so that staff are up to date with their specialist training. Health professionals train senior staff to undertake delegated health tasks, such as gastrostomy and suctioning. Senior staff cascade that training to the staff team. Staff speak highly of their training. A member of staff said, ‘I am under no pressure to do this clinical task until I feel totally confident.’ Staff state that they have a great relationship with the community nurse and can raise any queries. Each member of staff is very clear on what delegated healthcare tasks they can do. However, the registered nurse delegating the care is not assessing the competence of each staff member for each clinical skill for each named child. This is not in strict accordance with published guidance issued by the Care Quality Commission and Ofsted. The registered manager considers no child or young person to

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The effectiveness of leaders and managers: good

be at risk. She has made strenuous efforts to obtain the endorsement but has not formally challenged this shortfall.

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The effectiveness of leaders and managers: good

The registered manager and staff form good relationships with parents and professionals. Parents say that staff keep them informed, that nothing is too much trouble and staff make them welcome in the home. Professionals speak of the high quality of the information flow. They say that they are impressed with the diligence and commitment of the staff.

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The effectiveness of leaders and managers: good

The registered manager’s use of external agency staff has been a positive choice to complement the skills and experience of other staff. She utilises a core agency team. They are clear on their delegated duties. They say that the registered manager is excellent and supportive. One agency staff member said, ‘We are not the poor cousins; we are part of the team, one team.’ Agency staff were observed to be fully engaged in the life of the home, with some wonderful interactions with the children and young people.

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The effectiveness of leaders and managers: good

The registered manager monitors the quality of care through daily contact with staff, children and young people as well as producing the statutory reports. However, she is not producing and submitting such reports within the time frame set out in the regulations. She notifies relevant agencies of any significant events. She has a comprehensive action plan for the upcoming period.

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The effectiveness of leaders and managers: good

Key staff and contractors maintain the home to a good standard. They respond to Inspection report children’s home: SC389180 8 maintenance requests efficiently with minimum disruption to children and young people. They consider the children and young people’s needs when, for example, fitting a medication cabinet in a bedroom. They select items that fit well with the decor and do not give an institutional feel.

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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, 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: SC389180 9

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Children’s home details

Registered provider: Keys Group Progressive Care & Education Limited

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Children’s home details

Registered provider address: Keys Attachment Centre, New Hall Hey Road, Rossendale BB4 6HR

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Inspector

Keith Riley, social care inspector Inspection report children’s home: SC389180 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.

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Inspector

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